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EDITORIAL05-13-2024
Qualitative methodology: considerations and singularities regarding the implementation of person-centered interventions
Revista Brasileira de Enfermagem. 2024;77(3):e770301
Abstract
EDITORIALQualitative methodology: considerations and singularities regarding the implementation of person-centered interventions
Revista Brasileira de Enfermagem. 2024;77(3):e770301
DOI 10.1590/0034-7167.2024770301
Views0Qualitative health research allows for an in-depth understanding of how a person experiences different health transitions, their relationship with healthcare professionals and their passage through different clinical practice environments. At the same time, it has the potential to support professionals’ clinical decision-making and to empower citizens in their autonomy and responsibility for the health-disease process, […]See more -
REVIEW05-13-2024
Lean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
Abstract
REVIEWLean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
DOI 10.1590/0034-7167-2023-0322
Views0ABSTRACT
Objective:
to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects.
Method:
an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively.
Results:
the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod.
Conclusion:
three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.
Keywords:Cost Efficiency AnalysisCost SavingsEfficiencyOrganizationalProcess OptimizationTotal Quality ManagementSee more -
ORIGINAL ARTICLE05-13-2024
Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
Abstract
ORIGINAL ARTICLEGeneralized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
DOI 10.1590/0034-7167-2023-0246
Views0See moreABSTRACT
Objective:
to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit.
Method:
qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison.
Results:
13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole.
Final considerations:
knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.
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REVIEW05-13-2024
Preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
REVIEWPreditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático: Uma revisão do escopo
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreRESUMEN
Objetivo:
Identificar indicadores de desnutrición crónica entre niños de 0 a 24 meses en el Sudeste Asiático.
Métodos:
Esta revisión de alcance se centró en artículos con diseño de estudio observacional publicados en inglés, entre los años 2012 y 2023 de cinco bases de datos internacionales. Las principales palabras clave utilizadas fueron: “stunting (Desnutrición crónica)” o “growth disorder (Desorden del crecimiento)”, y “newborn (Recién nacido)”, y “predict (Predecir)”, y “Southeast Asia (Sudeste Asiático)”.
Resultados:
De los 27 artículos seleccionados para el análisis final, se encontraron trece indicadores que influyen en la desnutrición crónica en siete países del Sudeste Asiático. Los trece indicadores incluyen el niño, la madre, el hogar, la alimentación inadequada complementaria, la lactancia materna inadecuada, la atención inadecuada, los alimentos de mala calidad, la seguridad de los alimentos y el agua, la infección, la economía política, la salud y la asistencia sanitaria, el agua, el saneamiento y el medio ambiente, y por último el factor sociocultural.
Conclusión:
Todos estos indicadores pueden provocar desnutrición crónica en niños del Sudeste Asiático. Para poder prevenirlo los prestadores de servicios de salud y otros sectores relacionados, necesitan realizar actividades de promoción y prevención de la salud de acuerdo con los indicadores encontrados en este artículo.
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REVIEW05-13-2024
Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
REVIEWStunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreABSTRACT
Objective:
To identify predictors of stunting among children 0-24 months in Southeast Asia.
Methods:
This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: “stunting” OR “growth disorder” AND “newborn” AND “predict” AND “Southeast Asia”.
Results:
Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor.
Conclusion:
All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.
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ORIGINAL ARTICLE05-13-2024
Factors associated with Community Health Agents’ knowledge about tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20220520
Abstract
ORIGINAL ARTICLEFactors associated with Community Health Agents’ knowledge about tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20220520
DOI 10.1590/0034-7167-2022-0520
Views0See moreABSTRACT
Objective:
To analyze the factors associated with the knowledge of Community Health Agents (ACS) about tuberculosis.
Methods:
A cross-sectional study was conducted with 110 ACS. A questionnaire was used to assess knowledge about pulmonary tuberculosis (component 1) and the work functions of ACS in the National Tuberculosis Control Program (component 2). The level of knowledge, according to the scores converted into a scale of 0 to 100, was classified as: 0-50% (low), 51-75% (medium), and over 75% (high). Multiple regression was used in the analysis of associated factors.
Results:
The global score (average of the scores of components 1 and 2) median knowledge was 68.6%. Overall knowledge about tuberculosis was positively associated with the length of professional experience, having received training on tuberculosis, and access to the tuberculosis guide/handbook.
Conclusions:
Investments in training and capacity-building strategies for ACS will contribute to increasing these professionals’ knowledge, resulting in greater success in tuberculosis control.
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ORIGINAL ARTICLE05-13-2024
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
ORIGINAL ARTICLEA influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreRESUMEN
Objetivos:
describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea.
Métodos:
391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística.
Resultados:
la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo.
Consideraciones Finales:
conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.
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ORIGINAL ARTICLE05-13-2024
The influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
ORIGINAL ARTICLEThe influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreABSTRACT
Objectives:
to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults’ decisions about their health based on information collected online.
Methods:
391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression.
Results:
higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice.
Final Considerations:
knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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RESEARCH01-01-2016
Prevalence and factors associated with frailty in non-institutionalized older adults
Revista Brasileira de Enfermagem. 2016;69(3):435-442
Abstract
RESEARCHPrevalence and factors associated with frailty in non-institutionalized older adults
Revista Brasileira de Enfermagem. 2016;69(3):435-442
DOI 10.1590/0034-7167.2016690304i
Views0See moreABSTRACT
Objective:
to investigate the prevalence and factors associated with frailty in non-institutionalized older adults living in northern Minas Gerais, Brazil.
Method:
data were collected in their homes, in 2013, based on a census cluster sampling. Demographic and socioeconomic variables, morbidities, utilization of health care services, and scores on the Edmonton Fragility Scale were analyzed. The adjusted prevalence ratios were obtained using the Poisson regression multiple analysis with robust variance.
Results:
the prevalence of frailty was 41.3%. The variables associated with frailty were: female gender, very old age, education of less than four years, not having been hospitalized in the last 12 months, having a caregiver, falling in the prior year, diabetes mellitus, cardiac disease, and osteoarticular disease.
Conclusion:
the prevalence of frailty was high. Some factors consist of modifiable conditions, which should encourage health actions aimed at this group.
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RESEARCH01-01-2016
“To be a nurse”: a professional choice and the construction of identity processes in the 1970s
Revista Brasileira de Enfermagem. 2016;69(3):428-434
Abstract
RESEARCH“To be a nurse”: a professional choice and the construction of identity processes in the 1970s
Revista Brasileira de Enfermagem. 2016;69(3):428-434
DOI 10.1590/0034-7167.2016690303i
Views0See moreABSTRACT
Objective:
to analyze the factors that influenced the choice for nursing made by graduates from the first class of the Undergraduate Nursing and Obstetrics Course of the Federal University of Rio Grande do Norte in the 1970s and to understand the senses and meanings of being a nurse when choosing this profession.
Method:
a qualitative socio-historical study was performed, using oral history to collect data.
Results:
the analysis generated the following categories: “To be a nurse: a professional choice” and “The ideal of being a nurse: senses and meanings”. The senses of “being a nurse” are associated with graduates’ perspective of this profession and the meanings included the traditional conceptions that have historically affected it.
Conclusion:
professional choice was influenced by family and work expectations and the nursing course had an effect on the construction of nurses’ professional identity.
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EDITORIAL01-01-2016
The challenges of USA nursing education to meet local, regional and global need
Revista Brasileira de Enfermagem. 2016;69(3):417-418
Abstract
EDITORIALThe challenges of USA nursing education to meet local, regional and global need
Revista Brasileira de Enfermagem. 2016;69(3):417-418
DOI 10.1590/0034-7167.2016690301i
Views1The National League for Nursing (NLN), the voice for nursing education, is committed to the education of an exemplary nursing workforce that values and incorporates the richness of difference and inclusion to advance the health of the nation and the global community. With its population of over 320 million people, the United States of America […]See more -
EDITORIAL01-01-2016
As dificuldades do ensino de enfermagem dos Estados Unidos para atender necessidades locais, regionais e globais
Revista Brasileira de Enfermagem. 2016;69(3):417-418
Abstract
EDITORIALAs dificuldades do ensino de enfermagem dos Estados Unidos para atender necessidades locais, regionais e globais
Revista Brasileira de Enfermagem. 2016;69(3):417-418
DOI 10.1590/0034-7167.2016690301i
Views0A Liga Nacional de Enfermagem (NLN, National League for Nursing), a voz do ensino de enfermagem, está comprometida com o preparo de profissionais de enfermagem exemplares que valorizam e incorporam a riqueza das diferenças e a inclusão com vistas à evolução da saúde da nação e da comunidade global. Com sua população acima de 320 […]See more -
REVIEW01-01-2016
Interventions that facilitate adherence to Pap smear exam: integrative review
Revista Brasileira de Enfermagem. 2016;69(2):404-414
Abstract
REVIEWInterventions that facilitate adherence to Pap smear exam: integrative review
Revista Brasileira de Enfermagem. 2016;69(2):404-414
DOI 10.1590/0034-7167.2016690226i
Views0See moreABSTRACT
Objective:
to identify scientific productions showing relevant interventions to implement the Cervical Uterine Cancer Prevention Program increasing adherence to exams.
Method:
integrative literature review through an online search in the following databases: LILACS, SciELO, and PubMed® comprising articles published from 2009 to 2014.
Results:
thirty-eight articles made up the study’s final sample. Results showed the following interventions: use of case manager; telephone call; invitation letter; educational activities; media outreach work; community health agents; partnerships; population database screening; and multiple interventions.
Conclusion:
studies are mainly focused on women from developing countries and interventions are efficacious to increase women’s knowledge about and adherence to prevention of cervical uterine cancer.
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RESEARCH01-01-2016
Anxiety in the preoperative period of heart surgery
Revista Brasileira de Enfermagem. 2016;69(2):397-403
Abstract
RESEARCHAnxiety in the preoperative period of heart surgery
Revista Brasileira de Enfermagem. 2016;69(2):397-403
DOI 10.1590/0034-7167.2016690225i
Views0See moreABSTRACT
Objective:
to characterize the patients’ anxiety in the preoperative period of heart surgery.
Method:
We conducted a cross-sectional study in which 106 patients, between one and five days from the date of surgery, were interviewed using a socio-demographic questionnaire and the Beck Anxiety Inventory.
Results:
The evaluated patients accounted for 59.4% (63) in minimal anxiety and 19.8% (21) in the range considered severe, and the sample had a mean in the mild anxiety level (15.8±19.79). The women had scores (22.13±23.41) significantly (p=0.003) higher than men (10.76±14.71); as well as patients who had undergone previous heart surgery (24.4±28.05 X 13.14±15.74). There was no significant difference between older adults and younger patients, nor in terms of weight variations, presence of diabetes, or alcoholism.
Conclusion:
We reinforces the importance of nurses in recognizing the preoperative anxiety and intervene through strategies of health education and nursing visits.
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ORIGINAL ARTICLE06-14-2024
Mid-range theory of the nursing diagnosis Overweight
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
Abstract
ORIGINAL ARTICLEMid-range theory of the nursing diagnosis Overweight
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
DOI 10.1590/0034-7167-2023-0372
Views0See moreABSTRACT
Objective:
To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults.
Methods:
A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles.
Results:
The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships.
Final considerations:
From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science’s advancement and strengthening.
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ORIGINAL ARTICLE06-14-2024
Cardiovascular Risk and Lifestyle: comparison between teaching workers in Portugal and Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230354
Abstract
ORIGINAL ARTICLECardiovascular Risk and Lifestyle: comparison between teaching workers in Portugal and Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230354
DOI 10.1590/0034-7167-2023-0354
Views0ABSTRACT
Objective:
Compare Cardiovascular Risk between workers in Brazil and Portugal who work in the teaching context and its relationship with Lifestyle and Common Mental Disorder.
Methods:
Cross-sectional study that compared the cardiovascular health conditions of teaching workers in Manaus (Brazil) and Coimbra (Portugal). The odds ratio between groups was estimated.
Results:
The differences were: Smoking and hypercholesterolemia in participants from Portugal. Hypertension, chronic disease, increased abdominal perimeter, common mental disorder, and absence from work in Brazil. The variables with the greatest effect for high cardiovascular risk were: Country-Portugal [17.273 (95%CI1.538-193.951)], sex-male [61.577 (95%CI5.398-702.469)] and smoking [593.398 (95%CI57.330-6.142.020)].
Conclusion:
The differences in risk between groups showed that participants from Portugal, men, with high blood pressure and/or smokers are the most vulnerable to having a cardiovascular event. There is a need for interventions to promote cardiovascular health in the workplace in both countries.
Keywords:Community-Based Participatory ResearchHeart Disease Risk FactorsLife StyleOccupational HealthUniversitiesSee more -
ORIGINAL ARTICLE06-14-2024
Functional performance assessment scale for children and adolescents with cancer: cross-cultural study
Revista Brasileira de Enfermagem. 2024;77(2):e20230331
Abstract
ORIGINAL ARTICLEFunctional performance assessment scale for children and adolescents with cancer: cross-cultural study
Revista Brasileira de Enfermagem. 2024;77(2):e20230331
DOI 10.1590/0034-7167-2023-0331
Views0ABSTRACT
Objectives:
to describe the methodological process of cross-cultural adaptation of the PlayPerformance Scale for Children to Brazilian Portuguese.
Methods:
methodological study of translation and cross-cultural adaptation in six stages: translation, synthesis of translations, back-translation, evaluation by a committee of judges, evaluation by expert nurses, and pretest. The agreement and representativeness of the items were assessed using the content validity index. A minimum value of 80% agreement was considered.
Results:
all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation performed by the committee of judges, all items obtained agreement above 80%. Fifteen pediatric nurses conducted the content validation, suggesting necessary modifications for understanding and application. Thirty children and adolescents with cancer were assessed with the scale for the pre-test.
Conclusions:
the scale was cross-culturally adapted to Brazilian Portuguese. The need for psychometric testing in a consistent sample is emphasized.
Keywords:Cross-Cultural ComparisonNursing Methodology ResearchOncologyPediatric NursingPhysical Functional PerformanceSee more -
ORIGINAL ARTICLE06-14-2024
Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes
Revista Brasileira de Enfermagem. 2024;77(2):e20230314
Abstract
ORIGINAL ARTICLEMeanings attributed to health-related quality of life by caregivers of adolescents with diabetes
Revista Brasileira de Enfermagem. 2024;77(2):e20230314
DOI 10.1590/0034-7167-2023-0314
Views0See moreABSTRACT
Objective:
to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus.
Methods:
qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed.
Results:
the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network.
Final Considerations:
knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.
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REVIEW06-14-2024
Critical analysis of the scientific production on Jean Watson’s Theory of Human Care
Revista Brasileira de Enfermagem. 2024;77(2):e20230231
Abstract
REVIEWCritical analysis of the scientific production on Jean Watson’s Theory of Human Care
Revista Brasileira de Enfermagem. 2024;77(2):e20230231
DOI 10.1590/0034-7167-2023-0231
Views0See moreABSTRACT
Objectives:
to analyze current scientific production on the use of the theoretical-methodological precepts of Jean Watson’s Theory of Human Care/Clinical Caritas Process.
Methods:
quantitative, exploratory, descriptive study using data from 1979 to 2023 in the Scopus database. Analysis was carried out using VOSviewer software.
Results:
the 73 studies included establish a network of collaboration among 221 authors from 155 institutions in 18 countries, who discuss the development of ethical behavior in nursing staff, through technical improvement, implementation, and validation of instrumental strategies capable of measuring and evaluating the quality of holistic and empathetic care. The Theory of Human Caring contributes to nursing training and care, and Process Clinical Caritas-Veritas is useful for the different possibilities of practice and education.
Conclusions:
it is important to strengthen with more empirical data a nursing work model centered on individual human care, supporting the evolution of scientific nursing knowledge.
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REVIEW06-14-2024
Primary health care professionals’ practice in the face of leprosy: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230207
Abstract
REVIEWPrimary health care professionals’ practice in the face of leprosy: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230207
DOI 10.1590/0034-7167-2023-0207
Views0See moreABSTRACT
Objectives:
to identify Primary Health Care professionals’ practice in the face of leprosy.
Methods:
a scoping review, carried out between November 2022 and January 2023, conducted according to the methodological structure proposed by JBI and checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in six databases and additional literature.
Results:
the sample consisted of 11 articles, published between 2008 and 2022. The findings were synthesized into three categories: Early diagnosis and timely treatment; Physical disability prevention; and Household and social contact surveillance.
Final Considerations:
there is a need to align the practices carried out with those recommended by the Brazilian National Program for Leprosy Control and Elimination, as some were not identified in studies, which implies losses to qualified assistance directed to patient demands, with a view to control and elimination of leprosy.
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ORIGINAL ARTICLE06-14-2024
Validity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
Abstract
ORIGINAL ARTICLEValidity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
DOI 10.1590/0034-7167-2023-0195
Views1See moreABSTRACT
Objectives:
to describe the validity process of the TBApp mobile application for self-care management for people with tuberculosis linked to Primary Health Care.
Methods:
methodological research developed with ten expert judges, carried out virtually. The application was assessed in relation to content and technology quality in seven domains (objectivity; structure and appearance; relevance; functionality; reliability; usability; and efficiency), using an instrument with a Likert scale.
Results:
TBApp was considered valid, relevant, functional, reliable and effective by expert judges. The objectives, structure and presentation and relevance domains presented an overall Content Validity Index of 0.93, and the functionality, reliability, usability and efficiency domains presented characteristics and sub-characteristics values greater than 0.80.
Conclusions:
TBApp is a creative and innovative tool that can be used by people with TB and disseminated in the scientific community.
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