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ORIGINAL ARTICLE05-08-2023
Validity of a booklet to promote the health of people with diabetes in the face of COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220472
Abstract
ORIGINAL ARTICLEValidity of a booklet to promote the health of people with diabetes in the face of COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220472
DOI 10.1590/0034-7167-2022-0472
Views0ABSTRACT
Objectives:
to validate the content and appearance of a booklet to promote the health of people with diabetes mellitus in the face of COVID-19.
Methods:
a methodological study, carried out in a virtual environment with experts who had practical and scientific experience in diabetes mellitus, from November 2021 to February 2022. Data were analyzed using the Content Validity Ratio.
Results:
twenty-seven experts from different states of Brazil and with different academic backgrounds participated in the study. In content validity, reviews were suggested in items in relation to objectives and structure, in appearance validity, adjustments in layout were suggested.
Conclusions:
the results showed that the booklet achieved adequate content and appearance validity rates. Therefore, when adapting to experts’ suggestions, it becomes an accurate tool.
Keywords:Coronavirus InfectionsDiabetes MellitusEducational TechnologyHealth PromotionValidation StudySee more -
ORIGINAL ARTICLE05-08-2023
Pleasure and suffering of nursing in COVID-19 hospital units: between disenchantment and formation of meanings
Revista Brasileira de Enfermagem. 2023;76:e20220356
Abstract
ORIGINAL ARTICLEPleasure and suffering of nursing in COVID-19 hospital units: between disenchantment and formation of meanings
Revista Brasileira de Enfermagem. 2023;76:e20220356
DOI 10.1590/0034-7167-2022-0356
Views0See moreABSTRACT
Objective:
to analyze the experiences of pleasure and suffering of nursing workers in COVID-19 hospital units.
Methods:
a multicenter, qualitative study, developed with 35 nursing workers from COVID-19 units in seven hospitals in southern Brazil. Data were produced through semi-structured interviews, submitted to thematic content analysis with the help of NVivo.
Results:
experiences of pleasure were linked to gratification, identification with work content, positive results in care, recognition, integration with the team and personal overcoming. Suffering was revealed in daily life of deaths and losses, feelings of helplessness, team conflicts, institutional demands, professional devaluation. Workers reported disenchantment, but also strengthening the meaning of their work, highlighting frontline impacts on their mental health.
Final considerations:
in the dynamics between pleasure and suffering in nursing work in COVID-19 hospital units, elements point to the risk of psychological illness.
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ORIGINAL ARTICLE05-08-2023
Interactive gerontechnology for fall prevention in the elderly: a descriptive study
Revista Brasileira de Enfermagem. 2023;76(2):e20220739
Abstract
ORIGINAL ARTICLEInteractive gerontechnology for fall prevention in the elderly: a descriptive study
Revista Brasileira de Enfermagem. 2023;76(2):e20220739
DOI 10.1590/0034-7167-2022-0739
Views0See moreABSTRACT
Objectives:
to develop interactive gerontechnology for the prevention of falls in the elderly at home.
Methods:
an exploratory and descriptive study that consisted of gerontechnology development and evaluation by experts and the target audience. For evaluation, researchers used the Agreement Index (AI), considering values greater than 80%.
Results:
the three-dimensional virtual scale model was elaborated through the SketchUp program, with the distribution of rooms and floors, constituting Prototype 1 (P1). Fifty-four judges evaluated the P1, and all presented agreement above the established, with a minimum AI of 88% and a maximum of 100%, producing Prototype 2 (P2). Thirty elderly participants from a philanthropic institution evaluated Prototype 2. On all items, AI ranged from 83% a 100%, resulting in the final version.
Conclusions:
the product of this research reveals itself as an innovative and scientifically based tool aimed at preventing falls in the elderly.
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ORIGINAL ARTICLE05-08-2023
Trend in hospitalizations due to ambulatory care-sensitive conditions in the Federal District
Revista Brasileira de Enfermagem. 2023;76(2):e20220351
Abstract
ORIGINAL ARTICLETrend in hospitalizations due to ambulatory care-sensitive conditions in the Federal District
Revista Brasileira de Enfermagem. 2023;76(2):e20220351
DOI 10.1590/0034-7167-2022-0351
Views0ABSTRACT
Objectives:
to analyze the trend, according to sex, of Ambulatory Care-Sensitive Conditions in the Primary Health Care of the Federal District, from 2009 to 2019.
Methods:
ecological trend study using ACSC hospitalization data available in the Hospitalization System of the Single Health System. The Prais-Winsten method was used to calculate the annual rate variation, expressed in percentages. The dependent variable was the logarithm of the rates, and the independent one, the years in the time series.
Results:
the Federal District registered 2,103,951 general hospitalizations, 16.4% of which were due to Ambulatory Care-Sensitive Conditions. Males had a higher rate of hospitalization in the period, and both sexes showed a stationary trend.
Conclusions:
the time trend of Ambulatory Care- Sensitive Conditions was stationary, but further studies are necessary regarding primary health care coverage.
Keywords:Ambulatory Care Sensitive ConditionsHealth Care Quality, Access, and EvaluationHealth Status IndicatorsHospitalizationPrimary Health CareSee more -
ORIGINAL ARTICLE05-08-2023
Factors associated with demand for emergency medical services by people with hypertension and diabetes
Revista Brasileira de Enfermagem. 2023;76(2):e20220147
Abstract
ORIGINAL ARTICLEFactors associated with demand for emergency medical services by people with hypertension and diabetes
Revista Brasileira de Enfermagem. 2023;76(2):e20220147
DOI 10.1590/0034-7167-2022-0147
Views0ABSTRACT
Objectives:
to analyze the association between recurrence of emergency service visits due to lack of blood pressure and/or glycemic control with sociodemographic variables and disease registration in Primary Care.
Methods:
quantitative study, which consulted medical records of people who attended these services two or more times for 26 months. Descriptive statistics and multiple logistic regression models were used in analysis.
Results:
most people did not have hypertension and/or diabetes record in their Primary Care records. The absence of this record was more frequent in males, aged between 18 and 59 years, with low education and lack of blood pressure. There was association between greater number of people seeking these services in the same year and not monitoring the chronic condition in specialized care.
Conclusions:
people who do not follow up hypertension and/or diabetes in Primary Care are more likely to need assistance due to blood pressure and/or glycemic management.
Keywords:Diabetes MellitusElectronic Health RecordsEmergency Medical ServicesHypertensionPrimary Health CareSee more -
ORIGINAL ARTICLE05-08-2023
Precarious work at a surgical center: implications for the organization and for the health of nursing workers
Revista Brasileira de Enfermagem. 2023;76(2):e20220120
Abstract
ORIGINAL ARTICLEPrecarious work at a surgical center: implications for the organization and for the health of nursing workers
Revista Brasileira de Enfermagem. 2023;76(2):e20220120
DOI 10.1590/0034-7167-2022-0120
Views0ABSTRACT
Objectives:
to analyze the implications of precarious work for the organization of work and for the health of nursing professionals in a surgical center.
Methods:
qualitative, descriptive study in which the interview technique was applied on 30 nursing professionals from a surgical center in a university hospital located in the Southeast region of Brazil. The project was approved by the research ethics committee. Thematic content analysis was applied in the categorization of speeches.
Results:
precarious work in the surgical center negatively affects the organization of work due to staff turnover, loss of skilled talent, and the need for continuous training of temporary workers. It also affects the quality of care, leading to risks to patient safety and workers’ health.Final Considerations: it is important to make work conditions less precarious in order to minimize staff turnover and promote the quality of the service offered and the health of the worker.
Keywords:HospitalHuman Resources ManagementNursingOccupational RiskSurgery DepartmentWorkers' HealthSee more -
EXPERIENCE REPORT04-14-2023
Construction of educational technology on non-violent communication between health professionals: an experience report
Revista Brasileira de Enfermagem. 2023;76:e20220414
Abstract
EXPERIENCE REPORTConstruction of educational technology on non-violent communication between health professionals: an experience report
Revista Brasileira de Enfermagem. 2023;76:e20220414
DOI 10.1590/0034-7167-2022-0414
Views0ABSTRACT
Objective:
to report the construction of an educational technology to promote non-violent communication for health professionals.
Methods:
an experience report on the development of an educational technology on non-violent communication for health professionals, prepared by members of a social university extension project. The Plan-Do-Study-Act cycle was used as a process or product management procedure.
Results:
two complete management method cycles were performed. A mini almanac was generated as a final product, which addressed the main elements of non-violent communication, an example of its use in everyday life, hobbies and interspersed activities.
Conclusion:
educational technology construction (mini almanac) by members of a university extension project was facilitated using the Plan-Do-Study-Act cycle, proving to be a resource for disseminating non-violent communication in health work and promoting a culture of peace.
Keywords:Educational TechnologyHealth CommunicationHealth PersonnelInterpersonal RelationsWorkplace violenceSee more -
ORIGINAL ARTICLE04-14-2023
Validity study of educational technology on gynecological high dose rate (HDR) brachytherapy
Revista Brasileira de Enfermagem. 2023;76:e20220232
Abstract
ORIGINAL ARTICLEValidity study of educational technology on gynecological high dose rate (HDR) brachytherapy
Revista Brasileira de Enfermagem. 2023;76:e20220232
DOI 10.1590/0034-7167-2022-0232
Views0See moreABSTRACT
Objective:
to construct and validate an educational booklet on high dose rate gynecological brachytherapy (HDR) for women with gynecologic cancer.
Methods:
a methodological study, with the construction and validity of a booklet based on the Doak, Doak and Root theoretical-methodological framework. Content and appearance validity was guided by the Delphi technique, by 11 judges, selected using Jasper’s criteria. Afterwards, clinical validity was carried out with the target population.
Results:
the booklet, built from evidence from an integrative review, validated with judges, obtained an overall CVI of 0.98. After clinical validity with 27 women, it presents 24 sheets with illustrations produced by a graphic designer, subdivided into topics: gynecological system anatomy and gynecological cancer epidemiology, gynecological brachytherapy definition, therapeutic steps, approach to side effects and management, and two pages for notes.
Conclusions:
the booklet has validity for use in HDR gynecological brachytherapy treatment.
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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 ARTICLE01-10-2024
Childbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization
Revista Brasileira de Enfermagem. 2024;77:e20240038
Abstract
ORIGINAL ARTICLEChildbirth dynamics in the riverside region of the Brazilian Amazon from the perspective of geospatialization
Revista Brasileira de Enfermagem. 2024;77:e20240038
DOI 10.1590/0034-7167-2024-0038
Views0See moreABSTRACT
Objective:
to analyze the spatial-temporal pattern of childbirths and flow of postpartum women assisted at a regional reference maternity hospital.
Methods:
ecological study of 4,081 childbirths, between September 2018 and December 2021, at a public maternity hospital in the Baixo Tocantins region, Pará, Brazil. With data collected from five sources, a geographic database was constructed, and spatial analysis was used with Kernel density interpolator. Maps were generated using QGis/3.5 and TerraView/4.3, calculating chi-square (p<0.05).
Results:
the highest concentrations of normal and cesarean childbirths were observed in Barcarena (n=2,558/62.68%), Abaetetuba (n=750/18.38%), Moju (n=363/8.89%) and Igarapé-Miri (n=219/5.37%). Among the municipalities in the region, ten had obstetric beds, totaling 210 beds. In this scenario, postpartum women traveled up to 288 km to reach the maternity hospital.
Conclusions:
long distances between certain municipalities of residence and maternity hospital, and low supply of obstetric beds, were identified as risk factors for unfavorable obstetric outcomes.
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REVIEW01-10-2024
Nurses’ practical contributions to improving healthy and sustainable public spaces: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240023
Abstract
REVIEWNurses’ practical contributions to improving healthy and sustainable public spaces: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240023
DOI 10.1590/0034-7167-2024-0023
Views0ABSTRACT
Objective:
to identify knowledge production about nurses’ contributions to improving healthy and sustainable public spaces.
Methods:
an integrative review carried out in February 2023 in electronic databases. Studies that answered the research question and that were available in full, in Portuguese, English and Spanish, were included.
Results:
a total of five articles were selected. The findings highlighted the importance of educational projects in the training of local managers and community autonomy; citizen participation and health promotion as ways to implement Sustainable Development Goal 11; nurses as facilitators of collective care; new health practices and modes of producing subjectivity; and use of public transportation, bicycles and/or walking in these spaces.
Final considerations:
there is a clear need for greater incentives from local governments to develop effective sustainability strategies that are led by nurses and the community.
Keywords:AttitudesCommunity HealthHealth KnowledgeHealthy Lifestyle, NursesNursesPracticeSustainable DevelopmentSee more -
ORIGINAL ARTICLE01-10-2024
Pain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20230421
Abstract
ORIGINAL ARTICLEPain management in hospitalized infants: recommendations for achieving the Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20230421
DOI 10.1590/0034-7167-2023-0421
Views0See moreABSTRACT
Objective:
to assess pain management in infants in a Neonatal Intensive Care Unit (NICU) and discuss its articulation with the Sustainable Development Goals, with a focus on promoting neonatal well-being.
Method:
a documentary study, retrospective in nature and quantitative approach, conducted in a NICU of a public hospital in Paraná, Brazil, between January and July 2022, with 386 medical records of infants, hospitalized for more than 24 hours, between 2019 and 2021. Data were subjected to descriptive and inferential analysis, considering p-value<0.05 as a statistical difference. National ethical guidelines were respected.
Results:
all infants underwent at least one painful procedure, but only 13.7% had documented pain. Pharmacological interventions, such as fentanyl (25.9%), and non-pharmacological interventions, such as breastfeeding encouragement (86%) were used. Only 2.8% were reassessed.
Conclusion:
there was a devaluation of neonatal pain management that may perpetuate neonatal well-being and sustainable development.
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LETTER TO THE EDITOR01-10-2024
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
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LETTER TO THE EDITOR01-10-2024
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
DOI 10.1590/0034-7167.202477Suppl101c
Views0Dear Dr Dulce Aparecida BarbosaEditor in Chief of the Revista Brasileira de Enfermagem[…]See more -
ORIGINAL ARTICLE01-10-2024
Clinical and epidemiological characteristics and outcomes of patients affected by COVID-19 in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2024;77:e20230527
Abstract
ORIGINAL ARTICLEClinical and epidemiological characteristics and outcomes of patients affected by COVID-19 in the Intensive Care Unit
Revista Brasileira de Enfermagem. 2024;77:e20230527
DOI 10.1590/0034-7167-2023-0527
Views0See moreABSTRACT
Objective:
To understand the clinical and epidemiological characteristics, outcomes, and nursing care of adult patients affected by COVID-19 in the Intensive Care Unit.
Methods:
This is a quantitative, retrospective, and descriptive study. The study participants were clinical and epidemiological statistical reports. Variables analyzed included age, gender, race, comorbidities, signs and symptoms, length of hospital stay, use of mechanical ventilation, medications, infections, monitoring, invasive devices, positioning, diet, comfort, and clinical outcomes.
Results:
The majority of individuals were men, of white race, with a mean age of 63 years, hypertensive, diabetic, and obese. The average length of hospital stay was 16 days. Most required invasive mechanical ventilation, vasopressor drugs, sedoanalgesia, and neuromuscular blockers.
Conclusion:
Nursing care is related to monitoring, ventilation, medication administration, installation of devices, prone positioning, diet administration, and providing comfort.
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ORIGINAL ARTICLE01-10-2024
Morbidity and factors associated with frailty in post-COVID-19 elderly patients attended at a reference center
Revista Brasileira de Enfermagem. 2024;77:e20230454
Abstract
ORIGINAL ARTICLEMorbidity and factors associated with frailty in post-COVID-19 elderly patients attended at a reference center
Revista Brasileira de Enfermagem. 2024;77:e20230454
DOI 10.1590/0034-7167-2023-0454
Views0See moreABSTRACT
Objective:
To assess the morbidity profile and identify factors associated with frailty syndrome in post-COVID-19 elderly patients treated at the only Reference Center for Elderly Health Care in northern Minas Gerais.
Methods:
This is a case series study, utilizing the Clinical-Functional Vulnerability Index-20 (CFVI-20) and Comprehensive Geriatric Assessment (CGA) to characterize and evaluate the health condition of the group. To define the variables associated with frailty, a multivariate analysis was conducted.
Results:
The study included 204 elderly individuals, with a predominance of females (63.7%). The variables associated with frailty were cognitive impairment (OR: 2.95; 95% CI: 1.12-7.80; p=0.029), the presence of five or more comorbidities (OR: 11.55; 95% CI: 2.22-60.01; p=0.004), and impairment in instrumental activities of daily living (OR: 41.97; 95% CI: 5.47-321.93; p<0.001).
Conclusions:
The results of this study highlight the need for a well-established and prepared coordination of integrated care to meet the demands of the post-COVID-19 elderly population.
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ORIGINAL ARTICLE01-10-2024
Nursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
Abstract
ORIGINAL ARTICLENursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
DOI 10.1590/0034-7167-20230254
Views0See moreABSTRACT
Objective:
To characterize nursing care management strategies for addressing the COVID-19 pandemic.
Method:
A descriptive, qualitative study conducted with 22 nurse professionals at a University Hospital in Southern Brazil. Data collection through interviews in June and August 2021, analyzed according to Bardin’s Content Analysis and the theoretical framework of complex thinking.
Results:
The identified strategies were organized into four categories: Reorganization of health services; People management and emergency admission; Multiprofessional articulation; and Bedside nursing care.
Final Considerations:
Professional performance revealed a complex interplay between leadership and care management practices, even in the face of working condition restrictions, and were understood as crucial in the pandemic scenario.
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