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ORIGINAL ARTICLE12-16-2024
Construction and validation of an educational game on biosafety in the central sterile supply department
- Tatiana Nemoto Piccoli Moraes
, - Fernanda Moura D’Almeida Miranda ,
- Rafaela Danta de Sousa ,
- Luciana Schleder Gonçalves ,
- Maria de Fatima Mantovani , [ … ],
- Jenira Priscila dos Anjos
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational game on biosafety in the central sterile supply department
Revista Brasileira de Enfermagem. 2024;77(6):e20230478
DOI 10.1590/0034-7167-2023-0478
- Tatiana Nemoto Piccoli Moraes ,
- Fernanda Moura D’Almeida Miranda ,
- Rafaela Danta de Sousa ,
- Luciana Schleder Gonçalves ,
- Maria de Fatima Mantovani ,
- Jenira Priscila dos Anjos
Views0See moreABSTRACT
Objectives:
to construct and validate an educational game on biosafety in the Central Sterile Supply Department of a hospital in Curitiba, PR.
Methods:
the study was conducted using a quantitative approach, employing applied and technological research with an exploratory design. The process was divided into six stages, from the definition of the theme to the validation and application of the game. The study was carried out from May to August 2022, involving 17 nursing professionals from a Central Sterile Supply Department during day and night shifts, as well as 9 judges.
Results:
the study resulted in the construction of a board game named by the authors as “My Health First.”
Conclusions:
the research achieved its objective of constructing and validating an educational game. By reflecting on professional practice and correlating the occupational risks present, the professionals were able to list safe actions, identify problems, and seek solutions.
- Tatiana Nemoto Piccoli Moraes
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ORIGINAL ARTICLE12-16-2024
Health literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
Abstract
ORIGINAL ARTICLEHealth literacy development of Primary Health Care patients: qualitative research
Revista Brasileira de Enfermagem. 2024;77(6):e20240154
DOI 10.1590/0034-7167-2024-0154
Views0See moreABSTRACT
Objectives:
to identify the process of health literacy development among primary care patients, relating it to their self-care practices.
Methods:
qualitative, prospective research with 22 patients from two Family Health Strategy units. Data were obtained through individual semi-structured interviews, examined through descriptive statistics and thematic content analysis.
Results:
the results discuss how participants learn about health and how this resonates in their behaviors, culminating in two thematic categories: “Health knowledge construction”; and “Dialogue between health knowledge construction and patient care actions”.
Final Considerations:
health knowledge is developed mainly through interpersonal relationships, mediated by health professionals through bonding and communication. Community educational actions and training of health professionals in communication can promote health literacy and self-care among patients.
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ORIGINAL ARTICLE12-16-2024
Analysis of omission of antimicrobial doses in Intensive Care Units
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella , [ … ],
- Lucas Rodrigo Garcia de Mello
Abstract
ORIGINAL ARTICLEAnalysis of omission of antimicrobial doses in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(6):e20240102
DOI 10.1590/0034-7167-2024-0102
- Isabelle Ribeiro Machado ,
- Danielle de Mendonça Henrique ,
- Flávia Giron Camerini ,
- Vanessa Galdino de Paula ,
- Cintia Silva Fassarella ,
- Lucas Rodrigo Garcia de Mello
Views0See moreABSTRACT
Objectives:
to analyze the rate of antimicrobial dose omission in intensive care units.
Methods:
cross-sectional study carried out between March 1 and September 30, 2023, in intensive care units of a University Hospital in Rio de Janeiro.
Results:
the sample consisted of 452 prescriptions and 1467 antimicrobial doses. The dose omission rate was 4.29%. Each antimicrobial prescribed increased the chance of omission by 51%. The strategy of double-checking prescriptions helped prevent 30% of antimicrobial dose omissions (p=0.0001).
Conclusions:
monitoring the omission of antimicrobial doses can guide nursing actions to improve quality and patient safety, contributing to the prevention of medication errors, antimicrobial stewardship and the fight against antimicrobial resistance.
- Isabelle Ribeiro Machado
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REVIEW12-16-2024
Recommendations for guidelines for promoting mental health in the workplace: an umbrella review
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
REVIEWRecommendations for guidelines for promoting mental health in the workplace: an umbrella review
Revista Brasileira de Enfermagem. 2024;77(6):e20240086
DOI 10.1590/0034-7167-2024-0086
- Evelin Daiane Gabriel Pinhatti ,
- Amanda Salles Margatho do Nascimento ,
- Regina Celia Bueno Rezende Machado ,
- Rosangela Aparecida Pimenta ,
- André Estevam Jaques ,
- Maria do Carmo Fernandez Lourenço Haddad
Views1See moreABSTRACT
Objectives:
to summarize the recommendations of guidelines for promoting mental health in the workplace.
Methods:
an umbrella review, according to Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses methodological assumptions. Data collection was carried out in January 2021 and updated in July 2023 in the American Psychological Association, Cochrane Library, EMBASE, National Library of Medicine, and Scopus databases. Systematic reviews that assessed guidelines with recommendations for mental health care for workers were included. PROSPERO registration CRD42023461845.
Results:
four systematic reviews published between 2015 and 2018 were identified. The abstracts highlighted actions that facilitate and inhibit the recommendations as well as three categories of intervention: primary prevention – worker protection; secondary prevention – promoting workers’ mental health; and tertiary prevention – supporting, monitoring and rehabilitating workers upon returning to work.
Conclusions:
the interventions are based on prevention, promotion and early recognition, support and rehabilitation of mental health problems.
- Evelin Daiane Gabriel Pinhatti
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ORIGINAL ARTICLE12-16-2024
Psychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Abstract
ORIGINAL ARTICLEPsychometric analysis of ProQOL-BR in nursing: building hospital safety and protection
Revista Brasileira de Enfermagem. 2024;77(6):e20240085
DOI 10.1590/0034-7167-2024-0085
- Frederico Marques Andrade ,
- Lanuza Borges Oliveira ,
- Igor Monteiro Lima Martins ,
- Maria Eduarda Borges Rodrigues ,
- Carla Silvana de Oliveira e Silva
Views0See moreABSTRACT
Objectives:
to analyze the psychometric properties of the ProQOL-BR instrument in hospital nursing professionals.
Methods:
a methodological study to validate the ProQOL-BR. Confirmatory factor analysis, assessment of local and global adjustment quality, Pearson hypothesis testing and Cronbach’s alpha internal consistency analysis were used.
Results:
a total of 490 professionals participated. The model presents adequate quality due to factor weights (λ≥ 0.40), acceptable overall fit quality and adequate chi-square ratio and degrees of freedom (χ2/g.1=2.51) for the parameters of CFI (0.923), GFI (0.902), TLI (0.914) and RMSEA (0.042). In terms of validity, it was shown to be adequate with CC=0.89. The internal consistency obtained by standardized Cronbach’s alpha was 0.761. Criterion validity was shown to be favorable with significant correlations (0.001).
Conclusions:
the instrument was validated regarding content, criteria and reliability. Three questions were removed from the original instrument, ProQOL-BR, leaving the final instrument with 25 questions.
- Frederico Marques Andrade
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12-16-2024
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
Abstract
GerenciaDOR™: development of digital technology by nurses for the assessment of patients with chronic pain
Revista Brasileira de Enfermagem. 2024;77(6):e20240050
DOI 10.1590/0034-7167-2024-0050
Views0See moreABSTRACT
Objectives:
to develop a digital technological solution (prototype) for assessing patients with chronic pain.
Methods:
this is a methodological and technological development study based on the Human-Centered Design framework and the principles of Patient-Centered Care. The prototype guides patients through a body diagram and directs them to an evaluation using specific instruments that address the multidimensional aspects of chronic pain.
Results:
the GerenciaDOR* project enables navigation through the Web App screens, providing access to pain assessment features up to the presentation of results.
Final Considerations:
the study describes a systematic approach to pain assessment and expands nurses’ knowledge in pain management. Additionally, it can promote the development of other digital technologies for chronic pain assessment and contribute to a multidisciplinary, patient centered treatment.
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ORIGINAL ARTICLE12-16-2024
Respectful care for postpartum women with sickle cell disease: a netnographic study
- Zannety Conceição Silva do Nascimento Souza ,
- Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva , [ … ],
- Evanilda Souza de Santana Carvalho
Abstract
ORIGINAL ARTICLERespectful care for postpartum women with sickle cell disease: a netnographic study
Revista Brasileira de Enfermagem. 2024;77(6):e20230545
DOI 10.1590/0034-7167-2023-0545
- Zannety Conceição Silva do Nascimento Souza ,
- Luana Gabriella Pinheiro Barrêto ,
- Paulo Roberto Lima Falcão do Vale ,
- Elysangela Dittz Duarte ,
- Cristiane dos Santos Silva ,
- Evanilda Souza de Santana Carvalho
Views1See moreABSTRACT
Objectives:
to analyze principles of respectful maternity care in narratives of postpartum women with sickle cell disease, relating them to Sustainable Development Goals.
Methods:
netnographic study, with two videos published in 2020. Deductive iconographic and thematic analysis by Respectful Maternity Care Charter, organized in MAXQDA.
Results:
principles identified were the right to: freedom from harm and ill-treatment; information, informed consent, refusal of medical procedures, and respect for their choices and preferences including companion; be considered a person from birth, with dignified and respectful treatment; health at the highest possible level; newborns being with their parents or guardians. The Sustainable Development Goals for women by 2030 were not positively contemplated in postpartum women’s experience.
Final Considerations:
it is appropriate that health workers qualify themselves to provide respectful maternity care, with qualified listening, understanding, and resolution of unique demands of postpartum women with sickle cell disease, seeking equality in care for women.
- Zannety Conceição Silva do Nascimento Souza
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REVIEW12-16-2024
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
- Janaina Fonseca Almeida Souza ,
- Thales Philipe Rodrigues da Silva ,
- Camila Kümmel Duarte ,
- Anna Luiza de Fatima Pinho Lins Gryschek ,
- Elysângela Dittz Duarte , [ … ],
- Fernanda Penido Matozinhos
Abstract
REVIEWStrategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
DOI 10.1590/0034-7167-2023-0343
- Janaina Fonseca Almeida Souza ,
- Thales Philipe Rodrigues da Silva ,
- Camila Kümmel Duarte ,
- Anna Luiza de Fatima Pinho Lins Gryschek ,
- Elysângela Dittz Duarte ,
- Fernanda Penido Matozinhos
Views1See moreABSTRACT
Objectives:
to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage.
Methods:
systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines.
Results:
initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees.
Conclusions:
we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.
- Janaina Fonseca Almeida Souza
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04-16-2021
Questionnaire for assessing patient safety culture in emergency services: an integrative review
Revista Brasileira de Enfermagem. 2021;74(2):e20190693
Abstract
Questionnaire for assessing patient safety culture in emergency services: an integrative review
Revista Brasileira de Enfermagem. 2021;74(2):e20190693
DOI 10.1590/0034-7167-2019-0693
Views0See moreABSTRACT
Objective:
to identify the instruments used to assess patient safety culture in emergency settings.
Method:
an integrative literature review conducted from 2000 to 2018.
Results:
13 instruments were identified to assess patient safety culture in hospital and pre-hospital emergencies, comprising 12 to 50 questions, grouped from three to 12 dimensions, with dimensions related to teamwork, support, and management actions for patient safety and for continuous process improvement and continuing education. The Emergency Medical Service Safety Attitude Questionnaire, which is exclusive for pre-hospital care, stands out.
Conclusions:
the choice and the best decision regarding the instrument are linked to the objectives, the environment and the population to be investigated, as well as the instrument’s reliability.
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ORIGINAL ARTICLE09-16-2019
Spatial analysis on tuberculosis and the network of primary health care
- Beatriz do Nascimento Leal ,
- Cristal Ribeiro Mesquita ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Lívia Félix de Oliveira , [ … ],
- Rosinelle Janayna Coelho Caldas
Abstract
ORIGINAL ARTICLESpatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
DOI 10.1590/0034-7167-2017-0897
- Beatriz do Nascimento Leal ,
- Cristal Ribeiro Mesquita ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Lívia Félix de Oliveira ,
- Rosinelle Janayna Coelho Caldas
Views1See moreABSTRACT
Objective:
to analyze the spatial distribution of new cases of tuberculosis compared to the location of the Primary Healthcare Units that performed the compulsory notification.
Method:
ecological study conducted in Belém, Pará, with 5,294 new cases of tuberculosis notified to Sistema de Informação de Agravos de Notificação for the period from 2010 to 2014. The cases were georeferenced using the software applications ArcGis 10.2 and TerraView 4.2.2. The techniques of Kernel density and global Moran geostatistics were used.
Results:
the incidence of tuberculosis cases did not vary significantly between the years studied, however there was a variation in incidence between neighborhoods. Health units that exhibited higher number of notifications can suffer great influence of migration from nearby neighborhoods.
Conclusion:
the spatial dynamics of tuberculosis associated with health services allows to know the areas with increased risk of tuberculosis and the density of notifications of health units.
- Beatriz do Nascimento Leal
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ORIGINAL ARTICLE10-21-2019
Education in Diabetes Mellitus for blood glucose self-monitoring: a quasi-experimental study
- Marcelo Henrique Barbosa Baptista ,
- Fernanda Cristina Dourado ,
- Danielle dos Santos Gomides ,
- Carla Regina de Souza Teixeira ,
- Maria Cristina Foss de Freitas , [ … ],
- Ana Emilia Pace
Abstract
ORIGINAL ARTICLEEducation in Diabetes Mellitus for blood glucose self-monitoring: a quasi-experimental study
Revista Brasileira de Enfermagem. 2019;72(6):1601-1608
DOI 10.1590/0034-7167-2018-0731
- Marcelo Henrique Barbosa Baptista ,
- Fernanda Cristina Dourado ,
- Danielle dos Santos Gomides ,
- Carla Regina de Souza Teixeira ,
- Maria Cristina Foss de Freitas ,
- Ana Emilia Pace
Views0See moreABSTRACT
Objective:
to evaluate the contributions of an educational program for capillary blood glucose self-monitoring.
Method:
a quasi-experimental study performed in an outpatient unit of a tertiary health care service in a sample of 25 people with Type 2 Diabetes Mellitus, from July 2016 to December 2017, developed through interactive tools for care with capillary blood glucose self-monitoring.
Results:
among the items of capillary blood glucose self-monitoring that showed improvement after participation in the educational program, the most noteworthy are the “postprandial blood glucose values” (p=0.0039), “Interpretation of capillary blood glucose results with meals and medications” (p=0.0156), “recognition of the ‘weakness’ symptom for hyperglycemia” (p=0.0386) and “administration of medications correctly” for hyperglycemia prevention (p=0.0063).
Conclusion:
the study made it possible to recognize the main characteristics of blood glucose self-monitoring that may contribute to the care for the person with diabetes.
- Marcelo Henrique Barbosa Baptista
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ORIGINAL ARTICLE09-29-2022
Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
- Mariana Mendes ,
- Juliana Silveira Bordignon ,
- Robriane Prosdocimi Menegat ,
- Dulcinéia Ghizoni Schneider ,
- Mara Ambrosina de Oliveira Vargas , [ … ],
- Priscila Rodrigues da Cunha
Abstract
ORIGINAL ARTICLENeither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
Revista Brasileira de Enfermagem. 2022;75:e20201329
DOI 10.1590/0034-7167-2020-1329
- Mariana Mendes ,
- Juliana Silveira Bordignon ,
- Robriane Prosdocimi Menegat ,
- Dulcinéia Ghizoni Schneider ,
- Mara Ambrosina de Oliveira Vargas ,
- Evangelia Kotzias Atherino dos Santos ,
- Priscila Rodrigues da Cunha
Views1See moreABSTRACT
Objective:
to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of “angels and heroes” given by society during the pandemic of COVID-19.
Methods:
a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault.
Results:
they were organized into two thematic categories: “Angels and heroes? The (not) heroic reality of nursing during the pandemic” and “The search for recognition of the professional work of nursing: between what is said and what is not said”.
Final considerations:
the nurses’ speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.
- Mariana Mendes
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ORIGINAL ARTICLE08-19-2019
Guidebook for renal dialysis patients: care of central venous catheters and arteriovenous fistula
- Larissa Rodrigues de Freitas ,
- Viviane Peixoto dos Santos Pennafort ,
- Ana Elza Oliveira de Mendonça ,
- Francisco José Maia Pinto ,
- Letícia Lima Aguiar , [ … ],
- Rita Mônica Borges Studart
Abstract
ORIGINAL ARTICLEGuidebook for renal dialysis patients: care of central venous catheters and arteriovenous fistula
Revista Brasileira de Enfermagem. 2019;72(4):896-902
DOI 10.1590/0034-7167-2018-0131
- Larissa Rodrigues de Freitas ,
- Viviane Peixoto dos Santos Pennafort ,
- Ana Elza Oliveira de Mendonça ,
- Francisco José Maia Pinto ,
- Letícia Lima Aguiar ,
- Rita Mônica Borges Studart
Views0See moreABSTRACT
Objective:
To design and validate the content and format of a guidebook for chronic renal failure patients about the care with venous access for hemodialysis at home.
Method:
Methodological study, in which the steps for the guidebook design were: project planning, literature search, material content, and qualification selection.
Results:
After analysis of the articles, the content to be included in the guidebook was selected. The first draft of the guidebook was submitted for content and format validation, with the participation of 12 specialists. The necessary adjustments for the design of the final version were made with the help of an illustrator.
Conclusion:
The designed guidebook, “Hemodialysis: Care of Venous Accesses and Intercurrences at Home,” consists of educational material to help hemodialysis patients with daily care with central venous catheter and arteriovenous fistula practices in case of intercurrences.
- Larissa Rodrigues de Freitas
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REVIEW11-11-2020
Self-reported experience of hospitalized children: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20180740
Abstract
REVIEWSelf-reported experience of hospitalized children: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20180740
DOI 10.1590/0034-7167-2018-0740
Views0See moreABSTRACT
Objective:
To identify available evidence about the self-reported experience of hospitalized children.
Methods:
An integrative review was carried out, and the survey occurred between September and November 2017, in the electronic sources DLTD-USP, CAPES, IBICT, MEDLINE, LILACS and BDENF.
Results:
Ten studies were found, prevailing samples with descriptive design and approach in qualitative and mixed methods research. The literature evidenced the experience of hospitalized children through the report of parents and health professionals; few were self-reported by the child itself. Five themes were identified: Understanding the time of hospital admission, relevance of care received, feeling of pain, importance of the patient companion, information received about hospitalization.
Conclusion:
It was found that experiences in childhood are able to have repercussions throughout life, and it is relevant that nursing is attentive to their clients’ perception in order to have more satisfaction and the negative impact is diminished.
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REVIEW05-28-2021
Biological activities: anti-infectious, antioxidant and healing of the vegetable species Jatropha multifida
- Daniglayse Santos Vieira ,
- Fabianny Torres de Oliveira ,
- Jorge Andrés Garcia Suarez ,
- Davi Porfírio da Silva ,
- Thais Honório Lins Bernardo , [ … ],
- Maria Lysete de Assis Bastos
Abstract
REVIEWBiological activities: anti-infectious, antioxidant and healing of the vegetable species Jatropha multifida
Revista Brasileira de Enfermagem. 2021;74(2):e20200451
DOI 10.1590/0034-7167-2020-0451
- Daniglayse Santos Vieira ,
- Fabianny Torres de Oliveira ,
- Jorge Andrés Garcia Suarez ,
- Davi Porfírio da Silva ,
- Thais Honório Lins Bernardo ,
- Maria Lysete de Assis Bastos
Views0See moreABSTRACT
Objective:
to investigate the biological activities of interest to the health of Jatropha multifida plant species in published scientific literature.
Methods:
this is an integrative review, with searches between May and June 2019, using the descriptors, combined through the Boolean operator AND, Jatropha multifida, anti-infective agents, wound healing, cytotoxicity and antioxidants, in LILACS, BDENF, MEDLINE, SciFinder, Web of Science and Scopus databases and in the virtual libraries SciELO and ScienceDirect.
Results:
twelve publications were retrieved that showed nine biological activities. The antioxidant activity was reported in 04 (33.33%) studies; antimicrobial and anticancer, addressed by 03 (25%) and 02 (16.66%); anti-inflammatory, anti-melanin deposition, healing, antiophidic, purgative and anti-influenza, seen in 01 (8.33%) each.
Final considerations:
although scarce, the published scientific production highlights the biological potential of J. multifida and supports the need for further studies.
- Daniglayse Santos Vieira
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ORIGINAL ARTICLE09-21-2020
Transition of blind women to motherhood from the perspective of Transitions Theory
Revista Brasileira de Enfermagem. 2020;73:e20190234
Abstract
ORIGINAL ARTICLETransition of blind women to motherhood from the perspective of Transitions Theory
Revista Brasileira de Enfermagem. 2020;73:e20190234
DOI 10.1590/0034-7167-2019-0234
Views0See moreABSTRACT
Objective:
to analyze the transition of blind women to motherhood from the perspective of Transitions Theory.
Method:
a qualitative, descriptive study, which had as participants 11 blind women. An open interview was conducted using the narrative method. Analysis occurred in the light of Transitions Theory, with approval from the Research Ethics Committee with Human Beings.
Results:
the age group was 32 to 63 years, mostly Catholic, with social security benefits. Transition to motherhood mainly evidenced the experience when becoming a mother and feelings related to this new phase of life.
Final considerations:
the women in the study adapted themselves to the maternal role, even with difficulties, developed healthy relationships with their children, overcame their disability and nurtured dreams and desires. They were aware of their role, achieving with mastery a healthy transition. It was evidenced scarcity of nursing therapies.
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