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01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
DOI 10.1590/0034-7167.20166905e01
Views0Article “Alcohol and alcoholism: attitudes of nursing students”, with number of DOI: http://dx.doi.org/10.1590/S0034-71672013000100013, published in the journal Revista Brasileira de Enfermagem, v66(1):84-9, page 89 that read: “18. Miranda SP, Vargas D. Satisfação de pacientes de um centro de atenção Psicossocial álcool e drogas com o atendimento do enfermeiro. SMAD, Rev Eletrônica Saúde Mental Alcool Drog […]See more -
01-01-2016
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
Abstract
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
DOI 10.1590/0034-7167-2015-0135
Views1For those interested in nursing and health, the book entitled “Research methodology for nursing and health: from theory to practice”() was released in October 2015, at the 67th Brazilian Congress of Nursing, sponsored by National ABEn. The interest emerged from two organizers: Dr. Maria Ribeiro Lacerda (UFPR) and Dr. Regina Gema Santini Costerano (UNIFRA). Forty-seven […]See more -
01-01-2016
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
Abstract
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
DOI 10.1590/0034-7167-2015-0133
Views0See moreABSTRACT
Objective:
to reflect on the consequences of workplace violence experienced by nursing professionals.
Methods:
this is a reflection paper based on recent publications related to the subject, particularly researches carried out in Brazil and in other countries.
Results:
exposure to workplace violence has been associated with health problems in nursing professionals, which may be physical damage, emotional manifestations, and psychic disorders. It also affects the employee performance, his or her family and social interactions.
Conclusion:
this phenomenon is potentially noxious and costly, for it leads to suffering, illness, absence from work, and even death. This reflection calls attention moreover to the importance of a safe and adequate health care work environment.
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REFLECTION01-01-2016
Construcción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
REFLECTIONConstrucción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0RESUMEN
El desarrollo de la enfermera de práctica avanzada (EPA) ha supuesto un reto para las enfermeras en países como EE.UU., Canadá, Gran Bretaña y Australia, entre otros, y desde hace escasos años está siendo considerada en Catalunya y España como un sistema para desarrollar nuevos roles que aporten eficacia y eficiencia al sistema sanitario. El presente artículo pretende conceptualizar la EPA y los modelos de referencia así como contextualizar y reflexionar sobre la EPA en Catalunya, desde el punto de vista de formación y de la implantación de los denominados nuevos roles de enfermería, asimilándolos a la práctica avanzada.
Keywords:Competencia ClínicaEnfermeríaEnfermería de Práctica AvanzadaPráctica ProfesionalRol de la EnfermeraSee more -
01-01-2016
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0See moreABSTRACT
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.
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01-01-2016
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
Abstract
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
DOI 10.1590/0034-7167-2015-0128
Views0See moreABSTRACT
Objective:
report the experience of international academic mobility in Ireland through the program Science Without Borders during undergraduate education in nursing.
Method:
a report of experience presented in chronological order, with a descriptive nature.
Results:
the opportunity to know and be able to discuss questions regarding health and nursing in Ireland allowed the review of concepts and a more reflective perspective regarding nursing practices. Additionally, the exchange promoted personal strengthening regarding the confrontation and solution of problems, development of technical and scientific abilities, improvement of linguistic competences and construction of personality, independence and maturity.
Conclusion:
regarding such constructive and enriching experience that this mobility provides to students, to the governing authorities, to the population and to Brazilian nursing, sharing this experience is expected to serve as encouragement for those who search for new horizons, with the objective of adding knowledge for their personal and professional life.
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01-01-2016
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
Abstract
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
DOI 10.1590/0034-7167.2016690506
Views0See moreABSTRACT
Objective:
to describe online training experience aimed at professionals working in the public health service in 27 Neonatal and Pediatric Intensive Care Units, and to reflect concerning the training process and possible improvements in this process.
Method:
this is an experience report study about the online training with multidisciplinary content, planned from the situational diagnosis of 27 institutions. The training target set was 10 participants per institution and per module, including the following topics: Indicators of Quality as a Management Tool, Hand Hygiene, Patient Safety, Intravenous Therapy and Patients’ Chart Record.
Results:
a total of 2,071 active students in the modules, with 1,046 approved. The mean of 76 students per module exceeded the target set.
Conclusion:
experience has shown that online training is comprehensive as a potential tool for the professional technical development and digital inclusion. The online learning system becomes weakened if participants are unaware of the technological resources.
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01-01-2016
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
Abstract
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
DOI 10.1590/0034-7167.2016690505
Views0See moreABSTRACT
Objective:
to identify the causes of adverse events affecting clients resulting from the use of equipment in intensive care services; to point out the main recommendations for clinical practice to minimize these events and, then, discuss the implications to nursing care.
Method:
integrative and descriptive review on the SciELO, Medline, LILACS, and PubMed databases. Articles were selected based on the inclusion criteria and the structured instrument was applied.
Results:
altogether, 11 articles were selected where three evidence units were outstanding: Equipment failure; inadequate use of equipment; and team failure. Permanent education of professionals; evaluation of production and availability of equipment; and use of checklists are recommended.
Conclusion:
preventing adverse events related to equipment is one of the nursing responsibilities and requires the establishment of defensive barriers to prevent these.
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ORIGINAL ARTICLE12-04-2023
Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
Abstract
ORIGINAL ARTICLEBurnout, ethical climate and work organization in covid-19 intensive care units: mixed method study
Revista Brasileira de Enfermagem. 2023;76:e20220684
DOI 10.1590/0034-7167-2022-0684
Views0See moreABSTRACT
Objectives:
to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units.
Methods:
mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used.
Results:
the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit.
Conclusions:
there was an association between burnout and ethical climate and elements of the work organization.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views2In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views2In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more -
ORIGINAL ARTICLE07-29-2024
Educational technology for multidisciplinary training for managing waiting lists for elective patients
Revista Brasileira de Enfermagem. 2024;77(3):e20230299
Abstract
ORIGINAL ARTICLEEducational technology for multidisciplinary training for managing waiting lists for elective patients
Revista Brasileira de Enfermagem. 2024;77(3):e20230299
DOI 10.1590/0034-7167-2023-0299
Views1See moreABSTRACT
Objectives:
to construct and assess an educational technology for managing patient waiting lists for multidisciplinary training.
Methods:
study supported by Instructional Design – ADDIE model, whose stages of construction of educational technology were developed in the form of a multi-professional training course. Its respective content assessment was carried out by a committee of experts from 2021 to 2022. The analysis occurred based on the proportion of content adequacy with 95% Confidence Interval.
Results:
seventeen products were created as educational technology learning objects: five storyboards; four videos; three comic books; two pedagogical action plans; a mind map; and a YouTube® playlist. Nine experts assessed content adequacy, which reached 0.89.
Conclusions:
this educational technology contributes to the performance of professionals who manage waiting lists by reducing inequalities, alleviating differences, in addition to promoting equity in care and good health for patients in the Brazilian Health System.
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REVIEW11-22-2024
Spirituality and religiosity in children, adolescents and their families in a vulnerable context: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230425
Abstract
REVIEWSpirituality and religiosity in children, adolescents and their families in a vulnerable context: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230425
DOI 10.1590/0034-7167-2023-0425
Views1See moreABSTRACT
Objective:
to map evidence in the literature on the spirituality and religiosity of children, adolescents and their families in social vulnerability.
Methods:
this is a scoping review based on the JBI methodology, with the search without delimiting the time period, in English, Portuguese and Spanish, in the Virtual Health Library, PubMed, Embase, Cochrane Library, Scopus and Web of Science databases.
Results:
twenty-two studies were identified. The most studied population were adolescents, followed by children and their families. Regarding the setting, the context of vulnerability related to the low socioeconomic level experienced by these populations was highlighted. Furthermore, spirituality and religiosity were considered important for coping, social support, purpose and strength.
Conclusion:
there is an influence of spirituality and religiosity in the lives of children, adolescents and families, being a protective factor and a source of comfort, playing essential tools for living in context.
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ORIGINAL ARTICLE12-13-2024
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
Abstract
ORIGINAL ARTICLEStress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Views1See moreABSTRACT
Objectives:
to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.
Methods:
this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.
Results:
nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.
Conclusions:
exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views2See moreABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
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ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views1See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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ORIGINAL ARTICLE05-15-2020
Stress and quality of sleep in undergraduate nursing students
Revista Brasileira de Enfermagem. 2020;73:e20180227
Abstract
ORIGINAL ARTICLEStress and quality of sleep in undergraduate nursing students
Revista Brasileira de Enfermagem. 2020;73:e20180227
DOI 10.1590/0034-7167-2018-0227
Views0See moreABSTRACT
Objective:
to analyze the level of stress and sleep quality in nursing students according to terms of the nursing program.
Method:
descriptive and cross-sectional research developed in a higher education institution in Northeastern Brazil on 167 students. We used data collection, sociodemographic information, and a scale for assessing stress and sleep quality in nursing students.
Results:
we identified a statistically significant difference between domains of the stress scale and the terms of the undergraduate program, and between the quality of sleep and such terms such as as in the fourth and sixth semesters.
Conclusion:
different stress scores show that the semester which concerns students the most is the fifth. Quality of sleep was deemed good for the first, third, fifth, seventh, and eighth semesters; and poor for the fourth and sixth terms.
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ORIGINAL ARTICLE09-21-2020
Clinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
Abstract
ORIGINAL ARTICLEClinical judgment and diagnostic reasoning of nursing students in clinical simulation
Revista Brasileira de Enfermagem. 2020;73(6):e20180878
DOI 10.1590/0034-7167-2018-0878
Views0See moreABSTRACT
Objectives:
to determine the degree of association between clinical judgment and diagnostic reasoning of nursing students in clinical simulation.
Methods:
this is a correlational research design using a quantitative approach. The sample consisted of 41 nursing students who assisted a patient with vaso-occlusive crisis in a high-fidelity clinical simulation setting. The instruments used included the Lasater Clinical Judgment Rubric – Brazilian Version and the Diagnostic Thinking Inventory.
Results:
clinical judgment was associated with diagnostic reasoning (r=0.313; p=0.046), as well as the “noticing” aspect of clinical judgment with diagnostic reasoning (r=0.312; p=0.047).
Conclusions:
the results show that skills to interpret patient data are associated with diagnostic reasoning skills. Teaching clinical judgment skills is necessary to develop the diagnostic reasoning of nursing students.
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ORIGINAL ARTICLE12-05-2019
Quality of life of institutionalized aged with and without symptoms of depression
Revista Brasileira de Enfermagem. 2019;72:127-133
Abstract
ORIGINAL ARTICLEQuality of life of institutionalized aged with and without symptoms of depression
Revista Brasileira de Enfermagem. 2019;72:127-133
DOI 10.1590/0034-7167-2018-0316
Views0See moreABSTRACT
Objective:
compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores.
Method:
cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis.
Results:
symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged.
Conclusion:
social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.
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ORIGINAL ARTICLE07-08-2020
Spirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
Revista Brasileira de Enfermagem. 2020;73:e20190034
Abstract
ORIGINAL ARTICLESpirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer
Revista Brasileira de Enfermagem. 2020;73:e20190034
DOI 10.1590/0034-7167-2019-0034
Views0See moreABSTRACT
Objective:
to understand spirituality and religiosity in the experience of suffering, guilt, and death of the elderly with cancer.
Method:
qualitative research based on Viktor Frankl’s Existential Analysis. Twenty phenomenological interviews were conducted with people over 60 years old undergoing chemotherapy treatment at an oncology unit of a hospital in the city of Salvador, Bahia State, Brazil, between August and October 2018.
Results:
the following categories emerged: Experiences spirituality and religiosity in the face of the tragic triad and existential emptiness; Uses spirituality/religiosity as resilience strategies. After apprehension of ontic aspects, it was possible the ontological understanding of spirituality and religiosity in the face of suffering, guilt, and death experienced in the elderly with cancer’s daily life.
Final considerations:
spirituality and religiosity were understood as coping strategies used in the unstable experience of the elderly with cancer, providing comfort and resilience.
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ORIGINAL ARTICLE02-10-2020
Mental health profile of the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73(1):e20180191
Abstract
ORIGINAL ARTICLEMental health profile of the elderly community: a cross-sectional study
Revista Brasileira de Enfermagem. 2020;73(1):e20180191
DOI 10.1590/0034-7167-2018-0191
Views0See moreABSTRACT
Objective:
to describe the mental health profile of the elderly registered in a Family Health Unit in the city of Recife, Pernambuco State.
Method:
it was a descriptive quantitative study, conducted with 159 elderly through the scales Geriatric Depression, Resilience, Social Support, Life Satisfaction, and Positive and Negative Affects, Mini-Mental State Examination, Stressful Events Inventory and Brazil Old Age Shedule.
Results:
females, young and literate elderly predominated. Most were satisfied with life, 52.2% without depressive symptoms, 68.6% without cognitive impairment, 67.9% high resilience and 95.8% high social support, but 62% of elderly with depressive symptoms showed cognitive deficit. Negative correlation was identified between depression and cognitive impairment, resilience, social support and life satisfaction.
Conclusion:
assessment of these indicators identifies triggers of psychological distress, assisting the nursing staff in the development of preventive and care actions.
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EXPERIENCE REPORT10-26-2020
Collaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200470
Abstract
EXPERIENCE REPORTCollaborative practices from health care teams to face the covid-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200470
DOI 10.1590/0034-7167-2020-0470
Views0See moreABSTRACT
Objective:
To report the experience of collaborative practices facing the COVID-19 pandemic.
Methods:
This is a report about the experience of collaborative practices conducted by health care teams in emergency service in the Emergency Care Units facing of COVID-19 pandemic in the city of Fortaleza, State of Ceará, in the first semester of 2020.
Results:
Collaborative actions, cooperation and effective communication among nursing and medical team contribute to the management of mild and complex cases of COVID-19, as well as qualify them in suitable and necessary care and confrontation measures.
Final considerations:
The report shows the need for collaborative practices to minimize negative effects on the population in the face of the new coronavirus pandemic.
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ORIGINAL ARTICLE11-25-2020
Family experiences in discovering Autism Spectrum Disorder: implications for family nursing
Revista Brasileira de Enfermagem. 2020;73:e20190489
Abstract
ORIGINAL ARTICLEFamily experiences in discovering Autism Spectrum Disorder: implications for family nursing
Revista Brasileira de Enfermagem. 2020;73:e20190489
DOI 10.1590/0034-7167-2019-0489
Views0See moreabstract
Objectives:
to describe the family’s experience in the process of discovering the diagnosis and initiation of treatment of children with Autism Spectrum Disorder.
Methods:
this qualitative and descriptive study interviewed nine relatives of eight children on autism spectrum. They were inserted in health services, public education, and Association of Parents and Friends of The Exceptional of cities in the countryside of the Center-West. Data were collected through open interviews from July to September 2017. Data was submitted to thematic analysis.
Results:
at the beginning, the family was difficult to perceive the first atypical signs presented by the children. Families experience situations of vulnerability, since support networks are insufficient. The school played a significant role in recognizing unexpected behaviors.
Final Considerations:
support, offered by nurses, health professionals, school and social support devices, is important to family and children in this trajectory.
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ORIGINAL ARTICLE10-21-2019
Nurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
Abstract
ORIGINAL ARTICLENurses defending the autonomy of the elderly at the end of life
Revista Brasileira de Enfermagem. 2019;72(6):1639-1645
DOI 10.1590/0034-7167-2018-0768
Views1See moreABSTRACT
Objective:
to understand how nurses deal with the elderly’s autonomy at the end of life.
Method:
qualitative, exploratory study, guided by the Grounded Theory. Ten nurses, eight doctors and 15 nursing technicians were interviewed between November 2016 and May 2017 at a university hospital in Rio de Janeiro/Brazil.
Results:
nurses deal with the elderly’s autonomy in compliance with the code of ethics and exercise leadership in actions and interactions to defend this right, evaluating, guiding and listening to the preferences of the elderly; interacting with the family; and sharing information with the health team.
Final considerations:
the elderly’s autonomy must be ensured in care planning, based on patient-centered communication and developed in the interaction among agents involved in care. The discussion on “Living Wills” Health Care Directives and principles of palliative care must be encouraged.
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