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ORIGINAL ARTICLE10-09-2023
Construction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
Abstract
ORIGINAL ARTICLEConstruction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
DOI 10.1590/0034-7167-2022-0537
Views0See moreABSTRACT
Objective:
To build and validate a clinical simulation scenario for teaching Nursing students about early recognition of signs and symptoms of sepsis in the context of the emergency unit.
Methods:
Methodological study developed in two phases: construction of a simulated scenario and content validation by expert judges. For data analysis, the Content Validity Index (CVI) was calculated considering agreement equal to or greater than 80%. The minimum acceptable CVI value for scenario validation was 1.0.
Results:
The simulation scenario proved to be appropriate, with a global Content Validity Index equal to 1. Some adjustments related to the clarity of the wording were necessary, as suggested by the judges. Conclusions: A medium-complexity, high-fidelity scenario was successfully constructed and validated for teaching early recognition of sepsis signs and symptoms.
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EXPERIENCE REPORT10-09-2023
Service organization protocol for coping with undergraduate students’ psychological distress: a collective construction
Revista Brasileira de Enfermagem. 2023;76(4):e20220535
Abstract
EXPERIENCE REPORTService organization protocol for coping with undergraduate students’ psychological distress: a collective construction
Revista Brasileira de Enfermagem. 2023;76(4):e20220535
DOI 10.1590/0034-7167-2022-0535
Views0See moreABSTRACT
Objective:
to report on the experience of the elaboration process of a service organization protocol for coping with public undergraduate students’ psychological distress in the countryside of São Paulo.
Method:
experience report on protocol production, an action research product, carried out according to the health care and service organization protocol model, made possible by remote meetings with 33 professionals linked to the management and services of the university’s health and social assistance departments.
Results:
collective protocol production provided an opportunity for an institutional agreement on educational, therapeutic and support actions, to be developed in groups or individually with students, with provision for permanent education with civil servants.
Final considerations:
this experience made it possible to list specific actions to face undergraduate students’ psychological distress, bringing health professionals closer to those in management, promoting the exchange of concepts and practices to re-signify and transform the work developed.
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ORIGINAL ARTICLE10-09-2023
Performance of Family Health Strategy Nurses in LGBT+ Healthcare
- Ariane Tufaile Paiva
, - Flávio Adriano Borges ,
- Pablo Ramon Carloni ,
- Walkiria Jéssica Araújo Silveira ,
- Márcia Niituma Ogata , [ … ],
- Guadalupe Calvo García
Abstract
ORIGINAL ARTICLEPerformance of Family Health Strategy Nurses in LGBT+ Healthcare
Revista Brasileira de Enfermagem. 2023;76(4):e20220514
DOI 10.1590/0034-7167-2022-0514
- Ariane Tufaile Paiva ,
- Flávio Adriano Borges ,
- Pablo Ramon Carloni ,
- Walkiria Jéssica Araújo Silveira ,
- Márcia Niituma Ogata ,
- Maria do Perpétuo Socorro de Sousa Nóbrega ,
- Luciano Garcia Lourenção ,
- Guadalupe Calvo García
Views0See moreABSTRACT
Objective:
To analyze the role of Family Health Strategy (FHS) nurses in the health care of LGBT+ individuals.
Methods:
This qualitative study is based on Institutional Analysis. Data was collected in August 2021 through semi-structured interviews with 14 Family Health Strategy nurses from municipalities in the state of São Paulo. The data was processed using the IRaMuTeQ® software and analyzed lexically.
Results:
The textual corpus gave rise to three themes, which addressed the nurses’ practice, the difficulties and challenges they face in providing care to LGBT+ individuals, and the direct association of LGBT+ individuals with sexually transmitted infections.
Conclusion:
Lack of preparedness, access to information, and the need for expanded listening skills are still gaps in the performance of FHS nurses in caring for LGBT+ individuals. However, fostering acceptance and building strong relationships have been effective strategies in bridging the gap in nursing care for the LGBT+ community.
- Ariane Tufaile Paiva
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ORIGINAL ARTICLE10-09-2023
Perceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics
Revista Brasileira de Enfermagem. 2023;76(4):e20220505
Abstract
ORIGINAL ARTICLEPerceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics
Revista Brasileira de Enfermagem. 2023;76(4):e20220505
DOI 10.1590/0034-7167-2022-0505
Views0See moreABSTRACT
Objective:
To investigate the association of sociodemographic and occupational characteristics with a high level of perceived stress in motorcycle taxi drivers.
Method:
Cross-sectional study carried out with motorcycle taxi drivers who answered instruments on sociodemographic and occupational variables – Perceived Stress Scale, Job Content Questionnaire and Effort-Reward Imbalance. Descriptive statistics, Pearson’s chi-square test and Poisson regression with robust variance were used. Statistical significance was 5%.
Results:
Of the 800 motorcycle taxi drivers, 46.8% had a high level of perceived stress. In the multivariate analysis, a high level of stress was associated with low control over work (PR=7.76; 95%CI=5.19-11.61), low social support at work (PR=3.87; 95%CI =2.95 5.08), working hours longer than eight hours a day (RP=1.47; 95%CI=1.21-1.78) and monthly income less than or equal to two minimum wages (PR=1.34;95%CI=1.13-2.58).
Conclusion:
Long working hours, occupational stressors and low income were associated with a high level of perceived stress. Public policies and interventions to minimize occupational stressors are essential.
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ORIGINAL ARTICLE10-09-2023
Educational intervention in social skills for Primary Care nurses
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
ORIGINAL ARTICLEEducational intervention in social skills for Primary Care nurses
Revista Brasileira de Enfermagem. 2023;76(4):e20220503
DOI 10.1590/0034-7167-2022-0503
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto ,
- Maria do Carmo Fernandez Lourenço Haddad
Views0See moreABSTRACT
Objective:
to assess an educational intervention on social skills for nurses who work in Primary Health Care.
Method:
a qualitative research-intervention study, carried out in the municipalities covered by the 17th Health Regional of Paraná. It was developed in three interrelated stages: exploratory, where meetings were held with the managers to define the groups and logistics for running the course; intermediate, developed in meetings with different groups of nurses, addressing selected topics; assessment, in which the nurses developed a personal plan to improve their social skills.
Results:
participants were 57 nurses who acted as coordinators of Primary Care. They considered the educational intervention in social skills fundamental for positive changes in their professional performance.
Final considerations:
the educational intervention in social skills was assessed as an important strategy to strengthen the development of nurses’ managerial and care skills.
- Aline Loiola Moura Bianconi
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ORIGINAL ARTICLE10-09-2023
Spatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020
- Adelia Roberto Nanque ,
- Antônio Carlos Vieira Ramos ,
- Heriederson Sávio Dias Moura ,
- Thaís Zamboni Berra ,
- Reginaldo Bazon Vaz Tavares , [ … ],
- Ricardo Alexandre Arcêncio
Abstract
ORIGINAL ARTICLESpatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020
Revista Brasileira de Enfermagem. 2023;76(4):e20220481
DOI 10.1590/0034-7167-2022-0481
- Adelia Roberto Nanque ,
- Antônio Carlos Vieira Ramos ,
- Heriederson Sávio Dias Moura ,
- Thaís Zamboni Berra ,
- Reginaldo Bazon Vaz Tavares ,
- Aline Aparecida Monroe ,
- Ione Carvalho Pinto ,
- Ricardo Alexandre Arcêncio
Views0See moreABSTRACT
Objective:
to analyze the epidemiological profile, spatial and temporal distribution of tuberculosis in Guinea-Bissau from 2018 to 2020.
Methods:
an ecological study, carried out in Guinea-Bissau, considering new cases of tuberculosis. Spatial analysis of areas was used to verify tuberculosis distribution in the country, and time series were used to identify incidence evolution over the years of study.
Results:
a total of 6,840 new cases of tuberculosis were reported. Tuberculosis incidence rate in the country ranged from 36.8 to 267.7 cases/100,000 inhabitants, with emphasis on the regions of Bissau and Biombo (over 90 cases/100,000). By using time series, it was possible to observe an increase in case incidence over the years of study.
Conclusions:
the study made it possible to identify the epidemiological profile of tuberculosis in Guinea-Bissau, spatial distribution heterogeneity, in addition to identifying the disease evolution over the years of investigation.
- Adelia Roberto Nanque
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ORIGINAL ARTICLE10-09-2023
Eating habits: what foods do children between 12 and 36 months consume?
Revista Brasileira de Enfermagem. 2023;76(4):e20220393
Abstract
ORIGINAL ARTICLEEating habits: what foods do children between 12 and 36 months consume?
Revista Brasileira de Enfermagem. 2023;76(4):e20220393
DOI 10.1590/0034-7167-2022-0393
Views0See moreABSTRACT
Objective:
to identify toddlers’ eating habits.
Method:
a cross-sectional study of quantitative analysis, with a sample of 808 toddlers who attended day care centers in the district of Viseu, Portugal, between November 2018 and September 2019. Data were collected using a questionnaire directed at parents.
Results:
the prevalence of children who ate six meals a day was 42.8%, and 42.5%, those who ate five meals. It was found that 2.0% of children consumed chocolates, 1.0%, desserts, and 0.4%, carbonated beverages, daily. On average, dairy product (M=5.61; SD=2.62) and meat/fish/egg (M=4.80; SD=3.57) consumption was higher than recommended, while fat (M=0.48; SD=0.40), legume (M=0.49; SD=0.45), vegetable (M=1.18; SD=0.87) and water (M=0 .51; SD=0.29) consumption was lower.
Conclusions:
there was a higher or lower consumption than recommended for some foods, highlighting the need to implement nursing intervention programs aimed at promoting healthy eating habits in toddlers and families.
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REVIEW10-09-2023
Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review
- Anália Andréia de Araújo Nascimento ,
- Jéssica Cristina Alves de Melo ,
- Katiane Domingos Soares ,
- Anne Caroline Lisboa Marinho ,
- Sara Eloise Argimiro Ribeiro , [ … ],
- Isabelle Campos de Azevedo
Abstract
REVIEWSelf-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review
Revista Brasileira de Enfermagem. 2023;76(4):e20220383
DOI 10.1590/0034-7167-2022-0383
- Anália Andréia de Araújo Nascimento ,
- Jéssica Cristina Alves de Melo ,
- Katiane Domingos Soares ,
- Anne Caroline Lisboa Marinho ,
- Sara Eloise Argimiro Ribeiro ,
- Isabelle Campos de Azevedo
Views0See moreABSTRACT
Objective:
To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period.
Method:
Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations.
Results:
Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life.
Conclusion:
Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.
- Anália Andréia de Araújo Nascimento
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01-01-2016
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
Abstract
Determining impacts and factors in ventilator-associated pneumonia bundle
Revista Brasileira de Enfermagem. 2016;69(6):1108-1114
DOI 10.1590/0034-7167-2016-0253
Views0See moreABSTRACT
Objective:
Assessing the determining impacts and factors in ventilator-associated pneumonia (VAP) bundle.
Method:
descriptive retrospective longitudinal study, with quantitative approach, held at a public teaching hospital. Collection held between May 2014 and April 2015. Patients of the ICU with VAP participated in the research. For organizing data, the Microsoft Excel 2010 program was used. A critical analysis between the data collected and infection rates was performed. The survey was approved under no. 566,136.
Results:
an increase in the incidence of VAP after implementing the bundle was observed; the prevalent pathogens were gram-negative bacteria. Deaths were equal to or greater than 50%. Changes of professionals and lack of supplies were determining factors.
Conclusion:
in this context, the need for permanent qualification of the team is emphasized, with the purpose of promoting the adherence to the protocol and preventing VAP.
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01-01-2016
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
Abstract
Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process
Revista Brasileira de Enfermagem. 2016;69(6):1099-1107
DOI 10.1590/0034-7167-2016-0221
Views0See moreABSTRACT
Objective:
to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team.
Method:
descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis.
Results:
from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization.
Conclusion:
care activities in intensive therapy are guided by the humanization of care and corroborate the hospital management as a challenge to be overcome to boost advances in the operationalization of this Brazilian policy.
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01-01-2016
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
Abstract
Humanized Care: insertion of obstetric nurses in a teaching hospital
Revista Brasileira de Enfermagem. 2016;69(6):1091-1098
DOI 10.1590/0034-7167-2016-0295
Views0See moreABSTRACT
Objective:
to evaluate the care provided at an Antepartum, Intrapartum, Postpartum (AIP) unit at a teaching hospital following the inclusion of obstetric nurses.
Method:
transversal study, performed at a AIP unit at a teaching hospital in the capital of the Brazilian state of Mato Grosso. The sample comprised data regarding the 701 childbirths that took place between 2014 and 2016. The data were organized using Excel and analyzed using version 7 of Epi Info software.
Results:
the results suggest that including obstetric nurses contributed towards qualifying the care provided during labor and childbirth, followed by a reduction in the number of interventions, such as episiotomy caesareans sections, and resulting in encouragement to employ practices that do not interfere in the physiology of the parturition process, which in turn generate good perinatal results.
Conclusion:
inserting these nurses collaborated towards humanizing obstetric and neonatal care.
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01-01-2016
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
Abstract
Normative grounds of health care practice in Brazilian nursing
Revista Brasileira de Enfermagem. 2016;69(6):1082-1090
DOI 10.1590/0034-7167-2016-0228
Views0See moreABSTRACT
Objective:
to understand the normative grounds of health care practice in Brazilian nursing.
Method:
qualitative study with the use of document research, carried out based on resolutions of the Federal Nursing Council. From a total of 263 resolutions, in the period from 1975 to 2015, 38 which were in accordance with the objective of the study were selected.
Results:
three analytical categories were systematized: Normative grounds of health care practice by the nursing team, under coordination/supervision of the nurse; Normative grounds of the care performed privately by the nurse; and Management and administrative aspects which affect and permeate the practice of health care in nursing.
Conclusion:
the set of normative grounds of health care practice by the nursing team leads to the reflection on the possible overlapping of attributions between professional levels and requires expansion to the other fields of nursing which are coherent with the health care network model.
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01-01-2016
Palliative care and the intensive care nurses: feelings that endure
Revista Brasileira de Enfermagem. 2016;69(6):1074-1081
Abstract
Palliative care and the intensive care nurses: feelings that endure
Revista Brasileira de Enfermagem. 2016;69(6):1074-1081
DOI 10.1590/0034-7167-2016-0267
Views0See moreABSTRACT
Objective:
to know the feelings of nurses regarding palliative care in adult intensive care units.
Method:
qualitative study, which adopted the theoretical framework of Social Representations, carried out with 30 nurses of the state of Santa Catarina included by Snowball sampling. Data were collected through semi-structured interviews conducted from April to August 2015, organized and analyzed through the Collective Subject Discourse.
Results:
the results showed how central ideas are related to feelings of comfort, frustration, insecurity and anguish, in addition to the feeling that the professional training and performance are focused on the cure.
Conclusion:
the social representations of nurses regarding the feelings related to palliative care are represented mainly by negative feelings, probably as consequence of the context in which care is provided.
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01-01-2016
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
Abstract
Multi-professional intervention in adults with arterial hypertension: a randomized clinical trial
Revista Brasileira de Enfermagem. 2016;69(6):1067-1073
DOI 10.1590/0034-7167-2016-0320
Views0See moreABSTRACT
Objective:
assess the influence of an intervention, comprised of counseling related to health and aerobic physical training for lowering pressure values, in anthropometric indicators and in the adjustment of biochemical parameters in individuals with hypertension.
Method:
intervention study of the randomized clinical trial variety, with 42 individuals. The intervention-group followed the protocol of health counseling, nutrition and physical activity.
Results:
two intervention groups were considered: intervention-group (a) and intervention-group (b). Intervention-group (a) showed significant decrease in measurements of systolic and diastolic arterial pressure, of high-density lipoprotein parameters, hip circumference values and waist-hip ratio. Intervention-group (b) presented significant decrease in systolic arterial pressure values.
Conclusion:
it was found that the health intervention in conjunction with physical activities were effective in decreasing and/or controlling values for pressure, biochemical and anthropometric indicators.
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01-01-2016
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
Abstract
Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people
Revista Brasileira de Enfermagem. 2016;69(6):1059-1066
DOI 10.1590/0034-7167-2016-0359
Views0See moreABSTRACT
Objective:
to describe the use of the Clinical Caritas Processes in workshops for caregivers of institutionalized elderly people, aimed at analyzing these professionals’ perception on humane care towards the institutionalized elderly.
Method:
a convergent care research was conducted with 18 caregivers of a long-term care institution for elderly people in the state of Paraíba, Brazil. Data were collected from June to November 2013, consisting of two months of interaction with the care service and ten meetings conducted in workshops for caregivers. Data were based on the theoretical framework of the Clinical Caritas Processes. Data analysis was based on content analysis and produced ten thematic categories based on the Caritas factors of caring.
Conclusion:
it was found that the use of the ten Caritas factors of caring were useful for humanistic formations when introducing the group to the conceptions of caring that value the self of the people providing the care and of the ones-being cared for.
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01-01-2016
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
Abstract
Technological innovation for peripheral venipuncture: ultrasound training
Revista Brasileira de Enfermagem. 2016;69(6):1052-1058
DOI 10.1590/0034-7167-2016-0125
Views0See moreABSTRACT
Objective:
to evaluate the training of nurses in the use of ultrasound in peripheral venipuncture.
Method:
descriptive research of quantitative approach performed with nurses as part of an analytical cross-sectional study in two patient care centers: an intensive care unit and an adult emergency center.
Results:
the results showed contributions of training for professional skill and visibility of nurses, requiring, however, more time for complete assimilation of this technological innovation as a safer clinical practice.
Conclusion:
as the use of this technology represents an innovation aimed to facilitate difficult venipuncture and to provide subsidies to the most appropriate clinical decision-making, it is urgent to qualify nurses for its use.
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01-01-2015
Quality of life and physical activity in intensive care professionals from middle São Francisco
Revista Brasileira de Enfermagem. 2015;68(1):26-31
Abstract
Quality of life and physical activity in intensive care professionals from middle São Francisco
Revista Brasileira de Enfermagem. 2015;68(1):26-31
DOI 10.1590/0034-7167.2015680104i
Views0See moreObjective:
the objective was to assess the level of physical activity (LPA) and the quality of life QL of the professionals who work in ICU.
Method:
this was a cross-sectional study carried out in Adult ICUs. LPA was assessed by the International Questionnarie of Physical Activity – short form (IQPA-SF) and the QL by the Medical Outcomes Study 36 (SF-36) questionnaire.
Results:
it was classified active 50.89% out of a total of 59 professionals. Nursing technicians were considered the most active with 60.6%. The QL of the professionals who were considered active were better when compared to inactives, with statistical differences to the category of physical aspects limitation, social aspects and mental health. The working hours were higher than recommend, the physicians were higher than the physical therapist, nurses and technicians nurses (p = 0.046).
Conclusion:
physically active professionals who work in ICU had higher quality of life probably why have lower hours of work and consequently more free time to engage in physical activity.
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01-01-2015
Learning needs of Nursing students in technical vocational education
Revista Brasileira de Enfermagem. 2015;68(1):20-25
Abstract
Learning needs of Nursing students in technical vocational education
Revista Brasileira de Enfermagem. 2015;68(1):20-25
DOI 10.1590/0034-7167.2015680103i
Views0See moreObjective:
identify learning needs of students of Technical Vocational Education (TVE) in Nursing. Qualitative study conducted in a city of São Paulo state.
Method:
the subjects were students, teachers and coordinators of TVE and students of the bachelor degree who have had contact with TVE. Data collection was performed by questionnaire socioeconomic and cultural circles about the learning needs. For data analysis we used the content analysis.
Results:
it was found that students have difficulties contents not related to nursing as portuguese and mathematics, as well as introductory courses in the course of TVE which possibly may interfere negatively in learning specific content of nursing and the quality of health care.
Conclusion:
it is necessary to rethink the content taught and ways to teach from basic education, as well as the training of teachers who now works in the TVE.
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01-01-2015
Serious game e-Baby: nursing students’ perception on learning about preterm newborn clinical assessment
Revista Brasileira de Enfermagem. 2015;68(1):13-19
Abstract
Serious game e-Baby: nursing students’ perception on learning about preterm newborn clinical assessment
Revista Brasileira de Enfermagem. 2015;68(1):13-19
DOI 10.1590/0034-7167.2015680102i
Views0See moreObjective:
to evaluate students opinion regarding e-Baby educational technology.
Methodology:
exploratory descriptive study in which participated a sample composed of 14 nursing Portuguese students that used e-Baby digital educational technology in an extracurricular course. To achieve the aim of the study, the data collection was realized through an opinion instrument in Likert scale including the possibility of commentaries by students. Is was also collected data of participants’ characterization.
Results:
students made very satisfactory evaluations regarding the game e-Baby, varying since usability acceptation through suggestions of expansion of the game to other nursing themes.
Conclusion:
serious game e-Baby can be considered a didactic innovation and motivator tool of learning. Besides, it demonstrates have adequate interface in design and educative function aspects, evocating intense interaction between user and computational tool.
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01-01-2015
Challenges beyond the scientific knowledge production
Revista Brasileira de Enfermagem. 2015;68(1):7-8
Abstract
Challenges beyond the scientific knowledge production
Revista Brasileira de Enfermagem. 2015;68(1):7-8
DOI 10.1590/0034-7167.2015680101p
Views0For several decades, innumerous appeals and reflections on how to build the nursing science and achieve visibility in the scientific world led researchers to make efforts to produce knowledge that contributed to the well-being of people, improving their quality of life, relieving their suffering and transforming the reality in which we live. In addition to […]See more
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