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ORIGINAL ARTICLE11-22-2024
Safe practices for prevention and management of antineoplastic agent extravasation: development of an educational video
Revista Brasileira de Enfermagem. 2024;77(5):e20240172
Abstract
ORIGINAL ARTICLESafe practices for prevention and management of antineoplastic agent extravasation: development of an educational video
Revista Brasileira de Enfermagem. 2024;77(5):e20240172
DOI 10.1590/0034-7167-2024-0172
Views0ABSTRACT
Objectives:
to develop, validate, and evaluate an educational video on the prevention and management of antineoplastic agent extravasation, aimed at nursing professionals.
Methods:
this methodological study was developed according to Falkembach’s theoretical framework, which outlines five phases in the production of educational video materials: analysis and planning, modeling, implementation, evaluation, and distribution.
Results:
content validation demonstrated agreement above the minimum threshold stipulated. The overall Content Validity Index was 90.8%, and it was 94.2% among the content and technical evaluation judges, respectively. The target audience evaluated the video positively, highlighting the importance of the content, the clarity of the language used, and the understanding of the information pertinent to the topic.
Conclusions:
the video proved to be an appropriate strategy for instructing interventions on the prevention and management of extravasation, with the potential to improve educational practices among nursing professionals.
Keywords:Antineoplastic AgentsEducational TechnologyExtravasation of Diagnostic and Therapeutic MaterialsInstructional Film and VideoNursingSee more -
REVIEW11-22-2024
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
Abstract
REVIEWTelenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
DOI 10.1590/0034-7167-2024-0093
Views1See moreABSTRACT
Objective:
to identify telenursing contributions in Primary Health Care during the COVID-19 pandemic.
Methods:
an integrative literature review, conducted between January and August 2022 in the PubMed, CINAHL, LILACS, BDENF, Scopus, WoS, EMBASE and SciELO databases. A total of 493 studies was found, 62 were read in full, and of these, 16 were selected. For analysis, a dynamic reading of the studies and synthesis of the main results were carried out.
Results:
the main results highlighted telenursing practice as a challenge for professionals and the population. Among the contributions and positive points and aspects that require improvement, practice showed promise when considered in a post-pandemic scenario.
Final considerations:
through telenursing, the population’s access to Primary Health Care was guaranteed in the face of the COVID-19 pandemic. However, a critical look at current technological advances in healthcare is necessary.
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ORIGINAL ARTICLE11-22-2024
Percepções de pessoas com deficiência física sobre acessibilidade e condições sociais: intervenções para enfermagem de reabilitação
Revista Brasileira de Enfermagem. 2024;77(5):e20240005
Abstract
ORIGINAL ARTICLEPercepções de pessoas com deficiência física sobre acessibilidade e condições sociais: intervenções para enfermagem de reabilitação
Revista Brasileira de Enfermagem. 2024;77(5):e20240005
DOI 10.1590/0034-7167-2024-0005
Views0RESUMEN
Objetivos:
analizar las experiencias de personas con discapacidad física adquirida en cuanto a accesibilidad y condiciones sociales; identificar intervenciones de rehabilitación dirigidas por enfermeras para la accesibilidad y condiciones sociales; determinar indicadores sensibles a la enfermería para mejorar la accesibilidad y condiciones sociales.
Métodos:
estudio cualitativo descriptivo-exploratorio utilizó entrevistas semiestructuradas con personas con discapacidad física adquirida mediante muestreo intencionado en bola de nieve para cumplir con todos los objetivos. El análisis de datos siguió los principios del análisis de contenido de Bardin. Los objetivos 2 y 3 se lograron mediante un enfoque teórico reflexivo.
Resultados:
los 27 participantes informaron desafíos de accesibilidad, que impactan las actividades de la vida diaria y las condiciones sociales. Esto influye en la enfermería de rehabilitación, dando lugar a tres campos de intervención: Evaluar la capacidad para realizar actividades diarias y los factores que influyen; Desarrollar e implementar capacitación para la realización de actividades diarias; Promover la movilidad, la accesibilidad y la participación social.
Consideraciones Finales:
a partir de las experiencias de los participantes, identificamos intervenciones de rehabilitación dirigidas por enfermeras para promover la accesibilidad y condiciones sociales.
Keywords:Acessibilidade ArquitetónicaCondições SociaisEnfermagem em ReabilitaçãoObjetivos de Desenvolvimento SustentávelPessoas com DeficiênciaSee more -
ORIGINAL ARTICLE11-22-2024
Rondas a beira leito no ambiente hospitalar na perspectiva de equipes multiprofissionais de saúde
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
Abstract
ORIGINAL ARTICLERondas a beira leito no ambiente hospitalar na perspectiva de equipes multiprofissionais de saúde
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
DOI 10.1590/0034-7167-2023-0493
Views0RESUMEN
Objetivo:
Analizar la configuración de las relaciones de poder entre el equipo multiprofesional en el proceso de rondas de cabecera en el hospital.
Método:
Investigación cualitativa con datos analizados a través del análisis del discurso, basado en el marco teórico de Michel Foucault. De septiembre a diciembre de 2022, realizamos entrevistas y observaciones de campo con el equipo multiprofesional de un hospital de Belo Horizonte, Minas Gerais, Brasil, así como entrevistas cualitativas semiestructuradas con 37 profesionales.
Resultados:
Los participantes señalaron que las experiencias de los profesionales involucrados en las rondas de cabecera dependen de cómo el médico conduce el proceso, y el proceso centrado en el médico dificulta la participación de otros profesionales del equipo.
Consideraciones finales:
La forma en que los hospitales organizan las rondas de cabecera no promueve la articulación del conocimiento de sus profesionales. Además, dificulta la circulación del poder y perjudica el trabajo interdisciplinario en un proceso que mantiene al médico como actor principal de las decisiones clínicas.
Keywords:Conhecimentos, Atitudes e Prática em SaúdeEquipe de Assistência MultidisciplinarHospitaisPrática ProfissionalRelações InterprofissionaisSee more -
ORIGINAL ARTICLE11-22-2024
Bedside rounds in the hospital environment from the perspective of multiprofessional health teams
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
Abstract
ORIGINAL ARTICLEBedside rounds in the hospital environment from the perspective of multiprofessional health teams
Revista Brasileira de Enfermagem. 2024;77(5):e20230493
DOI 10.1590/0034-7167-2023-0493
Views0ABSTRACT
Objective:
To analyze the configuration of power relations among the multiprofessional team in the bedside round process in the hospital.
Methods:
Qualitative research with data analyzed through discourse analysis, based on Michel Foucault’s theoretical framework. From September to December 2022, we conducted interviews and field observations with the multiprofessional team at a hospital in Belo Horizonte, Minas Gerais, Brazil, as well as qualitative, semi-structured interviews with 37 professionals.
Results:
The participants pointed out that the experiences of the professionals involved in bedside rounds depend on how the physician conducts the process, and the physician-centered process makes it difficult for other professionals in the team to participate.
Final considerations:
The way hospitals organize bedside rounds does not promote knowledge articulation for their professionals. It hinders the circulation of power and harms interdisciplinary work in a process that maintains the physician as the main actor in clinical decisions.
Keywords:Health Knowledge, Attitudes, PracticeHospitalsInterprofessional RelationsPatient Care TeamProfessional PracticeSee more -
REVIEW11-22-2024
Transition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
Abstract
REVIEWTransition to family parenting in the face of the first child: a scoping review
Revista Brasileira de Enfermagem. 2024;77(5):e20230487
DOI 10.1590/0034-7167-2023-0487
Views1See moreABSTRACT
Objectives:
to identify and summarize the elements that characterize the family transition process in relation to the first child.
Methods:
a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results:
ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process.
Final Considerations:
elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.
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RESEARCH01-01-2016
Nurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
Abstract
RESEARCHNurses’ managerial knowledge in the hospital setting
Revista Brasileira de Enfermagem. 2016;69(4):676-683
DOI 10.1590/0034-7167.2016690409i
Views0See moreABSTRACT
Objective:
to analyze nurses’ managerial skills in the hospital setting, their perception of their own education and the relevance of training for their professional practice.
Method:
qualitative study based on the dialectical hermeneutics framework. Thirty-two nurses from three hospitals in the Brazilian state of Minas Gerais contributed to the study by taking part in six focus groups. Records were transcribed and three categories emerged from content analysis.
Results:
results evidenced the following managerial skills: supervision, leadership, decision making, planning and organization, as well as the relevance of education centers for their improvement and the continuing development of the nurses’ managerial skills.
Conclusion:
the authors believe this investigation will contribute for the improvement of nurses’ necessary managerial skills and also to identify gaps in this area of their education.
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RESEARCH01-01-2016
Analysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
Abstract
RESEARCHAnalysis of obstetric care provided by the Mobile Emergency Care Service
Revista Brasileira de Enfermagem. 2016;69(4):669-675
DOI 10.1590/0034-7167.2016690408i
Views1ABSTRACT
Objective:
analyze the pertinence of calls made by obstetric users of the Mobile Emergency Care Service (SAMU 192) of Botucatu-SP.
Method:
retrospective and analytical research. All records of prehospital obstetric care delivered by the SAMU 192 in 2012 were analyzed. To be considered responsive, calls should lead to referral to a reference obstetric hospital or be classified with the colors red, orange and yellow, according to risk criteria defined by the Ministry of Health.
Results:
considering the two outcomes evaluated: referral to a reference hospital and risk criteria defined by the Ministry of Health, 6.7% and 75.6% of the calls were not pertinent, respectively. There was no matching between outcomes, neither variation between primiparas and multiparas as regards the call pertinence.
Conclusion:
this study ratifies the need for implementing a risk classification protocol in obstetrics, and support managers in the organization, qualification and effective implementation of the Rede Cegonha.
Keywords:Emergence Medical ServicesEmergency NursingObstetric NursingPregnant WomenPrehospital ServicesSee more -
RESEARCH01-01-2016
Experiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
Abstract
RESEARCHExperiences with severe maternal morbidity: a qualitative study on the perception of women
Revista Brasileira de Enfermagem. 2016;69(4):662-668
DOI 10.1590/0034-7167.2016690407i
Views0See moreABSTRACT
Objective:
to know and analyze the experiences of women who developed an episode of Severe Maternal Morbidity.
Method:
this is a qualitative study, in which we interviewed 16 women admitted to a tertiary level hospital, as a result of this morbid state. We used content analysis in data processing.
Results:
two categories were identified: “Understanding maternal morbidity as a negative presence” and “Moving ahead: on constant alert”. The interviewees mentioned negative aspects, such as treatment difficulties and hospitalization, feelings of fear, concern for the fetus, frustration with the idealized pregnancy, trauma; and positive aspects, such as learning and the expression of the divine will in the experience of illness.
Conclusion:
effective care during the prenatal period, delivery and postpartum period should provide adequate support for the prevention and assistance in Severe Maternal Morbidity.
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RESEARCH01-01-2016
Dialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
Abstract
RESEARCHDialogue: network that intertwines the pedagogical relationship into the practical-reflective teaching
Revista Brasileira de Enfermagem. 2016;69(4):654-661
DOI 10.1590/0034-7167.2016690406i
Views0See moreABSTRACT
Objective:
to understand how dialogue occurs in the pedagogical relation in the practical reflective teaching in an undergraduate program in nursing.
Method:
qualitative research, case study. Data collection was conducted from May 2013 to September 2014 with eight professors of Nursing, by means of observation and interviews. Data analysis followed the operational proposal constituted by the exploratory stage and the interpretive stage.
Results:
point the dialogue established within the pedagogical relation as a challenge to be faced in practical-reflective teaching, so professor and student build a relationship that foster thought and action in the theoretical context and in the field of practice.
Conclusion:
in establishing a dialogic-reflective tone in the pedagogical relationship, the professor opens paths to new discoveries, enabling the creation of teaching-learning spaces that stimulate autonomy, abilities, and critical and reflective attitudes of students along their education.
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RESEARCH01-01-2016
Nursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
Abstract
RESEARCHNursing care through the perception of hospitalized children
Revista Brasileira de Enfermagem. 2016;69(4):646-653
DOI 10.1590/0034-7167.2016690405i
Views0See moreABSTRACT
Objective:
to describe the perception of hospitalized children of school age, on nursing care and understand what are, from their perspective, the best ways to address it to when performing such care.
Method:
qualitative, descriptive, exploratory research, with concepts of Vygotsky used as theoretical framework. The data collection occurred through interviews mediated by drawings and was performed with ten school children, with the interview later transcribed and submitted to a thematic analysis.
Results:
showed the importance of playing during hospitalization, of a friendly and caring approach and providing explanations regarding the performed procedures.
Conclusion:
nursing professionals need to consider how the children would like to receive the care being provided, so that their singularities are respected, characterizing nursing actions according to a perspective of the whole human being.
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RESEARCH01-01-2016
Cost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
Abstract
RESEARCHCost of dressings for prevention of sacral pressure ulcers
Revista Brasileira de Enfermagem. 2016;69(4):641-645
DOI 10.1590/0034-7167.2016690404i
Views0See moreABSTRACT
Objective:
to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil.
Methods:
secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00).
Results:
the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment.
Conclusion:
the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.
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RESEARCH01-01-2016
Health practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
Abstract
RESEARCHHealth practices: the view of the black elderly population in a terreiro community
Revista Brasileira de Enfermagem. 2016;69(4):633-640
DOI 10.1590/0034-7167.2016690403i
Views1See moreABSTRACT
Objective:
to understand health practices of black, elderly people in a terreiro community (community of followers of traditional African-Brazilian religions).
Method:
qualitative descriptive study under the Black-African paradigm of civilization constituted by the Black-African cultural complex and the structuring elements of the African cosmovision. Semi-structured interviews were carried out from July to September 2013, with six black older people from a terreiro community in Porto Alegre, RS.
Results:
thematic content analysis resulted in the following categories: Ancestry; Belonging: the way to know and practice health; Health knowledge and practices in terreiro communities; and Complementarity: promoting health in the terreiro and traditional medicine and its respective subcategories.
Conclusion:
the study understood the importance of having a knowledge of the practices of African traditions in both the lifestyle and health of the older black population to help with nursing planning and interventions in response to their needs.
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ORIGINAL ARTICLE10-06-2023
Nursing students’ professional values for reinforcing the professional identity
Revista Brasileira de Enfermagem. 2023;76:e20220338
Abstract
ORIGINAL ARTICLENursing students’ professional values for reinforcing the professional identity
Revista Brasileira de Enfermagem. 2023;76:e20220338
DOI 10.1590/0034-7167-2022-0338
Views0ABSTRACT
Objectives:
to understand the nursing students’ professional values in different Brazilian universities and verify a correlation between the “Professional Value” and the sociodemographic variables.
Methods:
quantitative, cross-sectional, and descriptive study conducted through an electronic questionnaire with a Professional Values Scale (NPVS-3). Participants were Nursing students of all semesters from three universities – two in the Southeast region and one in the North region.
Results:
of the 337 participating Nursing students, 282 were female. The Caring dimension presented the highest score (mean=46.61), and Professionalism, the lowest score (mean=34.65). A statistically significant association was detected between the Caring dimension, “university where is attending,” and “gender.”
Conclusions:
the results indicate the Caring dimension as the one containing the most scored professional values since the nurses’ training, and the relation of those values in such dimension is more significant in the female sample.
Keywords:Code of EthicsKnowledge ManagementNursing EthicsNursing StudentsRole of the Nursing ProfessionalSee more -
EDITORIAL10-06-2023
Pesquisa Translacional em Saúde: para onde vamos?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
Abstract
EDITORIALPesquisa Translacional em Saúde: para onde vamos?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
DOI 10.1590/0034-7167.2023760501pt
Views0Os contributos das pesquisas científicas são incontestáveis para o avanço da ciência e para a sociedade. Por isso, cada vez mais reflexões acerca dos impactos e da aplicabilidade dos estudos têm permeado o centro das discussões em nível global, sobretudo diante do aumento crescente da produção de conhecimentos. Nesse cenário, a translação da pesquisa (TP) […]See more -
EDITORIAL10-06-2023
Translational Health Research: where are we going?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
Abstract
EDITORIALTranslational Health Research: where are we going?
Revista Brasileira de Enfermagem. 2023;76(5):e760501
DOI 10.1590/0034-7167.2023760501
Views0The contributions of scientific research are undeniable for the advancement of science and for society. Therefore, more and more reflections on the impacts and applicability of studies have permeated the center of discussions at a global level, especially considering the growing increase in knowledge production. In this scenario, research translation (RT) has a notable importance […]See more -
Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil
Revista Brasileira de Enfermagem. 2023;76(5):e20230118
Abstract
Advanced Practice Nursing: “Training” Pillar in Supporting the Proposal in Brazil
Revista Brasileira de Enfermagem. 2023;76(5):e20230118
DOI 10.1590/0034-7167-2023-0118
Views0ABSTRACT
Objectives:
to present the pillars that support what has been called Advanced Practice Nursing and discuss the necessary training for its implementation.
Methods:
elements contained in assessment documents for graduate programs proposals, reports of presentations by international professors in countries and selected scientific publications were gathered to compose the argument.
Results:
practice/competency (adds broad and in-depth knowledge about health processes and scientific evidence, clinical reasoning and clinical skills for therapeutic indications); 3) professional regulation (corresponding legislation and monitoring); and 4) funding (broad training and professional practice policy).
Final Considerations:
the agenda for implementing Advanced Practice Nursing in Brazil involves joining efforts to identify stakeholders for a work to legitimize their importance in the country’s health and education overview.
Keywords:Advanced Practice NursingEducationGraduateHealth Postgraduate ProgramsNursingNursing EducationPublic PolicySee more -
ORIGINAL ARTICLE10-06-2023
Quality of health care in Primary Care: perspective of people with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2023;76(5):e20230008
Abstract
ORIGINAL ARTICLEQuality of health care in Primary Care: perspective of people with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2023;76(5):e20230008
DOI 10.1590/0034-7167-2023-0008
Views0See moreABSTRACT
Objectives:
to identify how people with diabetes assess the care offered by Primary Care teams.
Methods:
a cross-sectional study based on structured interviews with the application of the Patient Assessment of Chronic Illness instrument to people with Type 2 Diabetes Mellitus. Data were submitted to statistical analysis.
Results:
451 individuals participated in the study, more than half aged 60 years or older (64.0%); 63.9% had been diagnosed for more than five years; and 23.9% used insulin. The average score obtained was 2.5, which indicated little involvement in self-care and low support for the care of the chronic condition by the Family Health Strategy team, and was higher among women and people with a partner.
Conclusions:
people with diabetes consider that they do not receive individualized treatment, with dialogue and discussion for setting goals, and that they are not prepared for self-managing their health condition.
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REVIEW10-06-2023
Nursing theories in the care of stroke patients: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220791
Abstract
REVIEWNursing theories in the care of stroke patients: a scoping review
Revista Brasileira de Enfermagem. 2023;76(5):e20220791
DOI 10.1590/0034-7167-2022-0791
Views0See moreABSTRACT
Objectives:
to map and synthesize nursing theories and conceptual frameworks that have been applied in the practice of nursing care for stroke patients in hospital settings.
Methods:
a scoping review was conducted in October 2022 using the MEDLINE (accessed via PubMed), CINAHL, Scielo, and Web of Science databases, following The Joanna Briggs Institute guidelines.
Results:
nine studies incorporated six nursing theories and three conceptual frameworks, which were employed to enhance stroke patient care. The objective of these theories and conceptual frameworks was to facilitate the identification of the patient’s psychobiological, psychosocial, and psychospiritual needs, elucidate the nurse’s role and expand their perspective on rehabilitation, and acknowledge the survivor’s process of transition.
Final Considerations:
this mapping exercise identified major nursing theories, middle-range theories, and conceptual frameworks applied to the care of stroke patients.
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ORIGINAL ARTICLE10-06-2023
Learning strategies of undergraduate nursing students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(5):e20220764
Abstract
ORIGINAL ARTICLELearning strategies of undergraduate nursing students during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76(5):e20220764
DOI 10.1590/0034-7167-2022-0764
Views0See moreABSTRACT
Objectives:
to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic.
Methods:
a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis.
Results:
the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently.
Conclusions:
self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.
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ORIGINAL ARTICLE10-06-2023
Nursing, history, and orthopedics in manuals (1875-1928)
Revista Brasileira de Enfermagem. 2023;76(5):e20220567
Abstract
ORIGINAL ARTICLENursing, history, and orthopedics in manuals (1875-1928)
Revista Brasileira de Enfermagem. 2023;76(5):e20220567
DOI 10.1590/0034-7167-2022-0567
Views0See moreABSTRACT
Objectives:
to discuss the content of manuals, with emphasis on orthopedics, in support of the development of nursing care culture.
Methods:
cultural-historical method articulated with document analysis technique. The sources were nursing manuals – Portuguese, French, English, and Spanish – from 1875 to 1928.
Results:
this study pointed to 12 works – 6 authored by physicians, 2 by nurses, 3 institutional, and 1 by a Sister of Charity – that presented, in a transversal way, the professionalization process initiated in Europe. The manuals addressed first aid care and immobilization methods, from the simplest, such as improvised splints, to the application of plaster casts.
Conclusions:
the nurses’ work, even in a limited capacity, showed that they were able to observe warning signs so that doctors could act, with some exceptions.
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