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02-26-2024
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201
Views0The professional practice of patient navigation is incipient in Brazil and, therefore, a broad discussion with various sectors of society is essential, which is the main purpose of this editorial. Shall we start with the story. Patient navigation was defined in 1989 as a community-based service delivery intervention aimed at appropriately promoting access to diagnosis […]See more -
REVIEW02-26-2024
Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
Abstract
REVIEWEvidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
DOI 10.1590/0034-7167-2023-0134
Views0See moreABSTRACT
Objectives:
to synthesize and analyze evidence on intrauterine device insertion by nurses in Primary Health Care.
Methods:
an integrative review, carried out in the BDENF, CINAHL, LILACS, SciELO, Scopus, PubMed and Web of Science databases in June 2022, delimiting the period from 1960 to 2022.
Results:
141 articles were identified in the initial search, and 10 studies made up the final sample. Four (40%) were developed in the United States and one (10%) in Brazil, with publications from 1979 to 2021. The findings were grouped into three categories: Nurse training to insert an intrauterine device; Nurses’ competency to insert an intrauterine device; and Women’s access to intrauterine devices.
Conclusions:
nurse theoretical and practical training is a prominent element, consolidated in the favorable outcomes of insertions performed by nurses and satisfaction among women, a practice that has expanded access to the contraceptive method in Primary Health Care.
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ORIGINAL ARTICLE02-26-2024
Artificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
Abstract
ORIGINAL ARTICLEArtificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
DOI 10.1590/0034-7167-2023-0201
Views0See moreABSTRACT
Objectives:
to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients.
Methods:
a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed.
Results:
among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%.
Conclusions:
the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.
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ORIGINAL ARTICLE02-26-2024
Technological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
Abstract
ORIGINAL ARTICLETechnological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
DOI 10.1590/0034-7167-2023-0084
Views0See moreABSTRACT
Objectives:
to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents.
Methods:
a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring.
Results:
212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology.
Conclusions:
the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
DOI 10.1590/0034-7167.20247701e04
Views2In the article “Coping strategies for chronically ill children and adolescents facing the COVID-19 pandemic”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 2):e20230045, in the author:Where it read:[…]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
DOI 10.1590/0034-7167.20247701e02
Views2In the article “Active teaching model to promote critical thinking”, with DOI number: , published in Revista Brasileira de Enfermagem, 2019;72(1):293-8, on page 297:Include before REFERENCES:[…]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views2In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
REVIEW02-26-2024
Practice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
Abstract
REVIEWPractice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
DOI 10.1590/0034-7167-2023-0260
Views1See moreABSTRACT
Objectives:
to identify immersion use in hot water to relieve pain in newborns.
Methods:
an integrative literature review, carried out in the PubMed, VHL, EMBASE, Scopus, CINAHL, Cochrane and SciELO databases, with investigations in English, Spanish, French or Portuguese, published between 2002 and 2022. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used to answer the following question: what are the uses of hot water immersion in relieving pain in newborns?
Results:
nine studies were included, mainly Brazilian, experimental, with a predominance of strong and moderate levels of evidence. Hydrotherapy and bath use (immersion and bandaging) was observed, promising interventions in reducing pain scores, assessed using scales, physiological and endocrine parameters.
Conclusions:
hot water proved to be a promising non-pharmacological intervention in relieving pain in infants in different contexts.
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REVIEW01-01-2018
Coping strategies for domestic violence against pregnant female adolescents: integrative review
Revista Brasileira de Enfermagem. 2018;71:693-699
Abstract
REVIEWCoping strategies for domestic violence against pregnant female adolescents: integrative review
Revista Brasileira de Enfermagem. 2018;71:693-699
DOI 10.1590/0034-7167-2017-0682
Views0See moreABSTRACT
Objective:
To investigate and analyze in the scientific literature coping strategies for domestic violence against pregnant female adolescents.
Method:
This is an integrative literature review, conducted from July to August 2017 on LILACS, SciELO and PubMed, using the descriptors and the MeSH terms: confrontation, violence, adolescent, pregnant women, prenatal care.
Result:
The sample comprised 9 articles that were organized and characterized according to year, country of study and coping strategy used. The main forms of coping involved the active search for cases and the primary care approach with all family members.
Conclusion:
Individualized prenatal care, the change in professional training and networking activities were pointed out as important components of the strategies for coping with violence against pregnant adolescents.
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RESEARCH01-01-2018
Repercussions of hospitalization due to fall of the elderly: health care and prevention
Revista Brasileira de Enfermagem. 2018;71:763-769
Abstract
RESEARCHRepercussions of hospitalization due to fall of the elderly: health care and prevention
Revista Brasileira de Enfermagem. 2018;71:763-769
DOI 10.1590/0034-7167-2017-0069
Views0See moreABSTRACT
Objective:
To know the repercussions of the fall reported by the elderly and their caregiver during hospitalization in a public hospital in Florianópolis city from October to December 2014.
Method:
Exploratory research with a qualitative approach, conducted by depth interviews with 16 participants, the eight elderly were hospitalized for falls and eight elderly caregivers. Data analysis were performed through the Thematic Content Analysis.
Results:
It was evidenced the thematic axis: Faller Elderly supported by four thematic categories: Changes caused by Falls, I am a faller, I take care of me and Prevention of the Fall. The repercussions of the fall were evidenced in the impairment of the health condition, self-care and functional capacity. We observed the naturalization of the phenomenon and the passivity with the harmful consequences of the event.
Final Considerations:
The fall is valued the more negative its repercussion, such as the need for hospitalization and surgery. Managing the vulnerability of the elderly, especially in primary care, evaluating their comorbidities and their internal and external environment, will minimize unfavorable consequences and the social and financial cost of hospitalizations.
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RESEARCH01-01-2018
The adolescent and the institutionalization: understanding the phenomenon and meanings attributed to it
Revista Brasileira de Enfermagem. 2018;71:1373-1380
Abstract
RESEARCHThe adolescent and the institutionalization: understanding the phenomenon and meanings attributed to it
Revista Brasileira de Enfermagem. 2018;71:1373-1380
DOI 10.1590/0034-7167-2017-0242
Views1See moreABSTRACT
Objective:
To understand the meaning of being institutionalized and in conflict with the law for the institutionalized adolescent.
Method:
A qualitative, phenomenological-comprehensive study carried out in a Socio-educational Service Foundation in the northern region of Brazil, with 05 institutionalized adolescents. The analysis was carried out under the understanding of the content suggested by Heidgger, thus allowing the construction of analytical categories for a hermeneutical interpretation.
Results:
Conflicting with the law means something negative and bad for the institutionalized adolescents, in which they understand that although there is deprivation of liberty, the period of hospitalization is an important moment for the reflection on the need to start over.
Conclusion:
The meaning of conflicting with the law goes far beyond a simple word, act or behaviour, it is something that only those who experience the phenomenon are able to unveil, arouse deep feelings and provide reflection to the adolescent about the damages caused by the infraction.
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RESEARCH01-01-2018
Identification of post-cesarean surgical site infection: nursing consultation
Revista Brasileira de Enfermagem. 2018;71:1395-1403
Abstract
RESEARCHIdentification of post-cesarean surgical site infection: nursing consultation
Revista Brasileira de Enfermagem. 2018;71:1395-1403
DOI 10.1590/0034-7167-2017-0325
Views0See moreABSTRACT
Objective:
To describe the profile of women in relation to their living conditions, health status and socio-demographic profile, correlating it with the presence of signs and symptoms suggestive of post-cesarean surgical site infection, identifying information to be considered in the puerperium consultation performed by nurses and proposing a roadmap for the systematization of care.
Method:
Quantitative, exploratory, descriptive, cross-sectional and retrospective review of medical records of women who had cesarean deliveries in 2014, in the city of São Paulo.
Results:
89 medical records were analyzed, 62 of them with incomplete information. In 11, there was at least one of the signs and symptoms suggestive of infection.
Conclusion:
Given the results of the study, the systematization of puerperal consultation is essential. The roadmap is an instrument that can potentially improve the quality of service and the recording of information.
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RESEARCH01-01-2018
Nursing laboratory and critical education of nurses: approaches and distances
Revista Brasileira de Enfermagem. 2018;71:1500-1506
Abstract
RESEARCHNursing laboratory and critical education of nurses: approaches and distances
Revista Brasileira de Enfermagem. 2018;71:1500-1506
DOI 10.1590/0034-7167-2017-0339
Views1See moreABSTRACT
Objective:
to analyze the contribution of the laboratory of nursing to the critical education of nurses.
Method:
qualitative study, conducted among 18 professors of higher education institutions, being one public and the other private. Data were collected between February and November of 2016 by means of semi-structured interview. To analyze data, it was used a content analysis in the thematic modality.
Results:
it was observed the emphasis in the technical skills development by propagation of behavior and practices; the creation of bonds between professors and students happens on the limit of good interpersonal relationship; the laboratory of nursing may help the critical reflection about the practice, being a place that allows the learning of ethics.
Final considerations:
the nurse education, carried out by the laboratory of nursing, have to overcome the emphasis in the uncritical reproduction of practices and to observe the nurse’s power to think about the reality in the meaning of its modification.
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RESEARCH01-01-2018
Introduction of the School Health Program in the city of Cascavel, Paraná State: report of nurses
Revista Brasileira de Enfermagem. 2018;71:1540-1547
Abstract
RESEARCHIntroduction of the School Health Program in the city of Cascavel, Paraná State: report of nurses
Revista Brasileira de Enfermagem. 2018;71:1540-1547
DOI 10.1590/0034-7167-2017-0188
Views1See moreABSTRACT
Objective:
to understand the introduction of the School Health Program in the city of Cascavel, Paraná State, as opposed to the report of nurses.
Method:
a qualitative study with fifteen participants. The data were collected from April to August 2015, through semi-structured interviews, analyzed by content analysis and thematic modality.
Results:
the category “Introduction process” of the School Health Program integrates the subcategories “Identified health problems” and the “Challenges of intersectoriality”. The program was implemented quickly, with a fragile training of professionals to perform in the phases that compose it. Structural conditions of schools, human and material resources, and emerging intersectoral interaction were identified obstacles. The integration of the health, school, and family constitutes the program’s potentiality.
Final considerations:
it is understood that the actions of the program were based on health assessments of students, and it is necessary for professionals and managers to discuss and analyze the obstacles identified to achieve all the proposed objectives.
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RESEARCH01-01-2018
Knowledge about precautions in Primary Health Care: tool validation
Revista Brasileira de Enfermagem. 2018;71:1589-1595
Abstract
RESEARCHKnowledge about precautions in Primary Health Care: tool validation
Revista Brasileira de Enfermagem. 2018;71:1589-1595
DOI 10.1590/0034-7167-2017-0886
Views0See moreABSTRACT
Objective:
To elaborate and validate a tool to assess knowledge and behavior of nursing professionals about standards and specific precautions in the Primary Health Care.
Method:
Methodological study of the elaboration and validation of the tool by thirteen experts judges, using a Likert scale of 4 points, with Content Validity Index ≥ 0.80, on clarity, relevance and pertinence.
Results:
A tool composed of 47 dichotomous questions to assess knowledge and 12 questions, with five options of answers, for the referred behavior. In the validation, only one item was deleted, related to the “Hands Hygiene” axis and one item was reformulated, regarding “Use of Common Gloves” and another 11 changed writing. The tool as a whole was assessed for relevance, comprehensiveness and representativeness within the scope of the topic investigated.
Conclusion:
The developed tool has been validated and is now available for use in Primary Health Care.
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RESEARCH01-01-2018
Training in diabetes education: meanings attributed by primary care nurses
Revista Brasileira de Enfermagem. 2018;71:1611-1618
Abstract
RESEARCHTraining in diabetes education: meanings attributed by primary care nurses
Revista Brasileira de Enfermagem. 2018;71:1611-1618
DOI 10.1590/0034-7167-2017-0792
Views1See moreABSTRACT
Objective:
seize meanings attributed by primary care nurses to training in diabetes education.
Method:
exploratory and descriptive study, with a qualitative approach, with twenty primary care nurses; semistructured interview script, with interviews processed in the IRaMuTeQ software and analyzed through the Descending Hierarchical Classification. The results were subsidized in the Representational Theory of Meaning.
Results:
nurse training in diabetes education is insufficient for holistic action, although it allows the community to be instrumentalized in specific issues about the disease, using the limited tools available, especially lectures. Nurses find themselves in a context of challenges, improvisations, weaknesses, and limitations that determine the meaning attributed to diabetes education and subsequent actions.
Conclusion:
the meanings attributed by the nurses revealed an incipient training, which limits the quality of care provided and instigates the search for qualification.
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08-20-2021
Validation of an educational game about first aid for schoolchildren
Revista Brasileira de Enfermagem. 2021;74(6):e20201107
Abstract
Validation of an educational game about first aid for schoolchildren
Revista Brasileira de Enfermagem. 2021;74(6):e20201107
DOI 10.1590/0034-7167-2020-1107
Views0See moreABSTRACT
Objectives: to validate the content and appearance of an educational game about first aid for schoolchildren with experts in education and health.
Methods: this is a methodological, quantitative and descriptive research, carried out using the Delphi technique, using an online collection instrument, covering 55 items of the game. Content and appearance assessment was performed by 26 judges. The data were analyzed using Content Validity index.
Results: the final prototype is presented in a board format, composed of four buildable pawns and 117 cards between questions, alerts and challenges. Overall Content Validity index of 0.95 and greater than 0.8 was obtained for all items in two Delphi rounds.
Conclusions: the educational game validated by experts is a pedagogical tool for teaching first aid to schoolchildren as an option to traditional educational practices.
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REFLECTION12-21-2020
War against the COVID-19 pandemic: reflection in light of Florence Nightingale’s nursing theory
Revista Brasileira de Enfermagem. 2020;73:e20200371
Abstract
REFLECTIONWar against the COVID-19 pandemic: reflection in light of Florence Nightingale’s nursing theory
Revista Brasileira de Enfermagem. 2020;73:e20200371
DOI 10.1590/0034-7167-2020-0371
Views0See moreABSTRACT
Objective:
To reflect on the relationship and importance of the environmental theory regarding practices for promotion, prevention, and treatment of COVID-19.
Methods:
A theoretical-reflexive study about the COVID-19 pandemic in light of the environmental theory proposed by Florence Nightingale.
Results:
It is observed that the application of the theoretical foundations proposed by the environmental theory is related to the current practices used in the fight against the COVID-19 pandemic.
Final Considerations:
It is believed that the theoretical basis is fundamental for the critical-reflexive training of the nursing professional, for the consolidation of Nursing as a science; therefore, it could provide a foundation in nowadays battle against the pandemic.
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ORIGINAL ARTICLE06-04-2021
Information demands from families of children with Autism Spectrum Disorder
Revista Brasileira de Enfermagem. 2021;74(5):e20200642
Abstract
ORIGINAL ARTICLEInformation demands from families of children with Autism Spectrum Disorder
Revista Brasileira de Enfermagem. 2021;74(5):e20200642
DOI 10.1590/0034-7167-2020-0642
Views0See moreABSTRACT
Objective:
to identify the information demands of families of children with Autism Spectrum Disorder.
Method:
this is a qualitative study conducted through semi-structured and audio-recorded interviews with 55 family members, in the states of Paraná, Ceará, and Macapá, between September 2018 and September 2019. Thematic category analysis and Qualitative Data Analysis Software resources were used for data organization.
Results:
it was identified that families need information regarding the characteristics of Autism Spectrum Disorder (definition, cause, possibility of cure, prognosis and the probability of having another child with Autism Spectrum Disorder); child’s routine and behavior; future rights and expectations.
Final considerations:
information demands are relevant to support professionals, health managers and other services in health care organization to support families of children with autism.
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12-04-2023
Nursing and the Sustainable Development Goals (SDGs): An Essential Commitment
Revista Brasileira de Enfermagem. 2023;76(6):e760601
Abstract
Nursing and the Sustainable Development Goals (SDGs): An Essential Commitment
Revista Brasileira de Enfermagem. 2023;76(6):e760601
DOI 10.1590/0034-7167.2023760601
Views0The Sustainable Development Goals (SDGs) are a global initiative launched by the United Nations (UN) in September 2015 as part of the 2030 Agenda for Sustainable Development, whose objectives summarize a universal call to action to end poverty, protect the environment and ensure that all people have access to opportunities and well-being, all in an […]See more -
ORIGINAL ARTICLE11-16-2020
From despair to hope: copying of relatives of hospitalized children before bad news report
Revista Brasileira de Enfermagem. 2020;73:e20200340
Abstract
ORIGINAL ARTICLEFrom despair to hope: copying of relatives of hospitalized children before bad news report
Revista Brasileira de Enfermagem. 2020;73:e20200340
DOI 10.1590/0034-7167-2020-0340
Views0See moreABSTRACT
Objective:
to understand the experiences of relatives of critically ill children before bad news report.
Method:
a phenomenological study based on Heidegger’s philosophical framework. Data collection was carried out from October 2018 to March 2019, through phenomenological interviews with 15 relatives of children hospitalized in a Pediatric Intensive Care Unit.
Results:
relatives, in their existentiality, experience the facticity thrown into unpredictable situations, regardless of their choices and are faced with feelings of shock, despair and fear before bad news. After emotional impact, especially regarding the possibility of death, relatives reveal hope as a mechanism for coping with the situation.
Final considerations:
solidarity and sensitivity by health professionals, especially nurses, are essential in understanding the existential dimension of relatives who experience such an experience, understanding the several facets of their existence and offering them opportunities to project themselves.
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ORIGINAL ARTICLE12-21-2020
Social identity of transgender persons: concept analysis and proposition of nursing diagnoses
Revista Brasileira de Enfermagem. 2020;73:e20200070
Abstract
ORIGINAL ARTICLESocial identity of transgender persons: concept analysis and proposition of nursing diagnoses
Revista Brasileira de Enfermagem. 2020;73:e20200070
DOI 10.1590/0034-7167-2020-0070
Views0See moreABSTRACT
Objective:
To analyze the concept of social identity of transgender persons and develop nursing diagnoses related to it.
Methods:
A concept analysis according to the Walker and Avant model. A scope review was carried out with a search of eight databases, a portal and two information systems, during June and July 2019. Articles, theses, and dissertations were analyzed in Portuguese, English, and Spanish, with no time frame definition.
Results:
Of the 6.847 productions, 10 were included, and the concept of social identity was described in 4 of them. Critical, prior, and consequential attributes for the social identity of transgender persons were identified, and the analysis of the concept substantiated the proposal of the diagnosis: Willingness to improve the social identity of the transgender person.
Conclusion:
Social identity establishes a relationship with health, and the proposed nursing diagnosis strengthens the sense of belonging of transgender people, enhancing their rights as citizens.
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ORIGINAL ARTICLE06-27-2019
Nursing diagnoses in a home-based program: cross-mapping and NANDA-I Taxonomy
Revista Brasileira de Enfermagem. 2019;72(3):584-591
Abstract
ORIGINAL ARTICLENursing diagnoses in a home-based program: cross-mapping and NANDA-I Taxonomy
Revista Brasileira de Enfermagem. 2019;72(3):584-591
DOI 10.1590/0034-7167-2018-0323
Views0See moreABSTRACT
Objective:
to identify Nursing diagnoses in patients in home care by cross-mapping terms obtained in the anamnesis and clinical examination, with NANDA-I Taxonomy.
Method:
descriptive exploratory study, transversal type, performed with 131 patients from a home health care program in northern Minas Gerais State. With the aid of an instrument based on the theoretical model of Basic Human Needs, the terms indicators of conditions that required nursing interventions were extracted. The cross-mapping of these terms was also performed with NANDA-I Taxonomy diagnoses.
Results:
378 terms and expressions referring to 49 different diagnoses were identified in 11 of the 13 domains of NANDA-I Taxonomy.
Conclusion:
the profile of identified nursing diagnoses can contribute to care management and organizational processes of nurses who provide care to patients in home care.
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ORIGINAL ARTICLE08-20-2021
Resilience of family caregivers of children and adolescents in treatment of neoplasms and associated factors
Revista Brasileira de Enfermagem. 2021;74(6):e20190388
Abstract
ORIGINAL ARTICLEResilience of family caregivers of children and adolescents in treatment of neoplasms and associated factors
Revista Brasileira de Enfermagem. 2021;74(6):e20190388
DOI 10.1590/0034-7167-2019-0388
Views0See moreABSTRACT
Objectives:
analyze the level of resilience of family caregivers of children and adolescents hospitalized for cancer treatment and associated factors.
Methods:
cross-sectional study, carried out in 2018, with 62 family caregivers in a university hospital in the state of Rio Grande do Sul, Brazil. The instruments CDRisc-10-Br, SRQ20, PSS-14 and WHOQOL-Bref were used to measure resilience, minor psychological disorders, stress, and quality of life, respectively. Inferential statistics were used.
Results:
female caregivers, married, with one child and who practice some predominated religion. They were classified as having a moderate level of resilience (48.4%); with suspicion for minor psychological disorders (45%) and high level of stress (41%). In terms of quality of life, they were satisfied in the Physical, Psychological and Social Relations domains; and dissatisfied in the Environment domain.
Conclusions:
there were direct weak to moderate correlations between the level of resilience and quality of life and inversely with stress and minor psychological disorders.
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