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ORIGINAL ARTICLE12-04-2023
30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study
Revista Brasileira de Enfermagem. 2023;76(6):e20220544
Abstract
ORIGINAL ARTICLE30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study
Revista Brasileira de Enfermagem. 2023;76(6):e20220544
DOI 10.1590/0034-7167-2022-0544
Views0See moreABSTRACT
Objective:
Estimate the incidence of the 30-year high cardiovascular risk and its determinants among graduates of federal universities in Minas Gerais.
Methods:
This is a prospective cohort of 2,854 adults aged 20 to 59. The incidence of the outcome was calculated using the Framingham equation and its determinants were determined through multivariate Cox regression.
Results:
After an average of 2.62 years, the incidence of high cardiovascular risk was 8.09 and 20.1 cases per 1,000 person-years, for females and males respectively. Being male (HR: 2.34; 95% CI: 1.58 – 3.46), employment (HR: 2.13; 95% CI: 1.13 – 3.99), high consumption of processed foods (HR: 2.44; 95% CI: 1.21 – 4.90), and being physically active (HR: 0.63; 95% CI: 0.41 – 0.98) were associated with high cardiovascular risk.
Conclusions:
Among highly educated adults, being male, employment, and high consumption of processed foods are predictors of high cardiovascular risk, while being physically active acts as a protective factor.
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ORIGINAL ARTICLE12-04-2023
“Fala-M@no-COVID-19”: technological development of a health navigation program for men during the pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220534
Abstract
ORIGINAL ARTICLE“Fala-M@no-COVID-19”: technological development of a health navigation program for men during the pandemic
Revista Brasileira de Enfermagem. 2023;76(6):e20220534
DOI 10.1590/0034-7167-2022-0534
Views0See moreABSTRACT
Objective:
to develop a care-educational technology similar to a health navigation program for men during the COVID-19 pandemic.
Methods:
a methodological and qualitative study of a care-educational technology of health navigation program, structured by Program Development Cycle, with 16 patient navigators and 10 professional navigators. It used reflective thematic content analysis and an adaptation model for data processing.
Results:
the ; navigation program was developed by: I) Observation of reality, problem mapping, needs assessment: content selection, creation of domains and questions; II) Theoretical-conceptual and methodological definition, creation of product under the elaboration of care plans, based on theory, process and taxonomies by a flowchart of operationalization of actions; and III) Self-assessment: qualitative research with professional navigators.
Final considerations:
the technology developed, with theoretical and methodological support, allowed to derive a viable navigation program compatible with reality based on the audience’s needs.
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The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health
Revista Brasileira de Enfermagem. 2023;76(6):e20220331
Abstract
The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health
Revista Brasileira de Enfermagem. 2023;76(6):e20220331
DOI 10.1590/0034-7167-2022-0331
Views0See moreABSTRACT
Objective:
to reflect on the applicability of the Medical Healing of Souls (MHS) by health professionals as a welcoming strategy in post-pandemic mental health.
Methods:
a theoretical and reflective study, based on Viktor Frankl’s philosophy, based on the book “The Doctor and the Soul, From Psychotherapy to Logotherapy” and scientific literature.
Results:
the study was structured in two discursive approaches: MHS in the field of health; The applicability of MHS in post-pandemic mental health care.
Final considerations:
MHS can be used in mental health care, in health emergencies, promoting a more humane performance of health professionals, facilitating the integration of inevitable suffering into a meaningful life.
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ORIGINAL ARTICLE12-04-2023
Translation, cross-cultural adaptation and validity study of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil
Revista Brasileira de Enfermagem. 2023;76(6):e20220281
Abstract
ORIGINAL ARTICLETranslation, cross-cultural adaptation and validity study of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil
Revista Brasileira de Enfermagem. 2023;76(6):e20220281
DOI 10.1590/0034-7167-2022-0281
Views0See moreABSTRACT
Objective:
to describe the translation, cross-cultural adaptation and validity process of the “Play Nicely Program: The Healthy Discipline Handbook” for use in Brazil.
Methods:
a methodological study that followed the translation, back-translation, expert committee assessment, and pre-test steps. The Content Validity Index (CVI) was calculated for both the judge population and the pre-test population. Four translators, seven expert judges in the field of child health and thirty participants in the pre-test, including parents, teachers and healthcare professionals, participated in the study.
Results:
in experts’ analysis (98.4%), a value of 100% of adequate assessments was obtained, and in the target population’s analysis (89.5%), there were 100% of adequate assessments. In both analyses, suggested adaptations were made.
Conclusios:
cross-cultural adaptation and content validity into Brazilian Portuguese of the “Play Nicely Program: The Healthy Discipline Handbook” were considered adequate for application in the target population.
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ORIGINAL ARTICLE12-04-2023
Emergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients
Revista Brasileira de Enfermagem. 2023;76(6):e20210869
Abstract
ORIGINAL ARTICLEEmergency units and COVID-19: Burnout, and empathy reported by nursing professionals and perceived by patients
Revista Brasileira de Enfermagem. 2023;76(6):e20210869
DOI 10.1590/0034-7167-2021-0869
Views0See moreABSTRACT
Objective:
To investigate Burnout Syndrome and empathy self-reported by the nursing staff and empathy perceived by the patient.
Method:
Cross-sectional study in a public emergency unit in São Paulo (from October/2020 to March/2021). The nursing staff answered the Maslach Burnout Inventory and the Consultation and Relational Empathy Measure-Nurses (Brazilian version), whereas adult patients answered the Consultation and Relational Empathy Measure (Brazilian version). Descriptive and inferential analysis, with a 5% significance level.
Results:
A total of 92 professionals and 271 patients participated. Most professionals reported impact of COVID-19 (80; 86.96%) and, among them, increased Burnout Syndrome (93; 75%), but with low emotional exhaustion (71; 74%), low depersonalization (59; 78%) and high level of professional accomplishment (72; 83%). Most reported impact and increased empathy, and the results reported by professionals and patients (mean and standard deviation) were: 39.89 (6.44) and 38.25 (9.45), respectively.
Conclusion:
The professionals reported a low level of Burnout Syndrome and a high level of empathy in pandemic.
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ERRATUM11-27-2023
ERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2023;76(5):e2023n5e05
DOI 10.1590/0034-7167.20237605e05
Views0In the article “Performance of Family Health Strategy Nurses in LGBT+ Healthcare”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(4): e20220514, authored:Where it read:[…]See more -
ORIGINAL ARTICLE11-27-2023
Mental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
Abstract
ORIGINAL ARTICLEMental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
DOI 10.1590/0034-7167-2023-0258
Views0See moreABSTRACT
Objectives:
to describe the family’s experience in relation to daily life with a family member experiencing mental suffering.
Methods:
a qualitative, descriptive, phenomenological study grounded in Merleau-Ponty’s ontology of experience was conducted in ten households in a city in the state of Bahia, Brazil, where 24 participants of the Intersubjectivity Wheels reside. The descriptions produced were subjected to the Ambiguity Analytics technique.
Results:
the descriptions were categorized into: absence as a creative power of the sense of “being” and “not being a family”; and exclusion and acceptance as expressions of mental suffering in the family context.
Final Considerations:
the experience of mental suffering in the family’s daily life is marked by ambiguous feelings, such as joy and sadness, disappointment and satisfaction, lack of love and love. However, experiencing these feelings can mobilize the desire to “become” a family, increase the sense of autonomy and independence, and drive the formation of new family configurations.
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Nursing instrument to attend mothers who recently gave birth in primary health care
Revista Brasileira de Enfermagem. 2016;69(2):316-325
Abstract
Nursing instrument to attend mothers who recently gave birth in primary health care
Revista Brasileira de Enfermagem. 2016;69(2):316-325
DOI 10.1590/0034-7167.2016690215I
Views0See moreABSTRACT
Objective:
To build a nursing instrument to attend mothers who have recently given birth in primary health care.
Method:
This is a methodological research developed in five stages: identification of empirical indicators associated with mothers who have recently given birth by reviewing integrative literature; evaluation of empirical indicators by focal group; instrument structuring by categorizing indicators; instrument validation using the Delphi technique; and application and development of diagnostic statements and nursing interventions.
Results:
The instrument comprises identification data on mothers who have given birth recently, on the assessment of their human needs, and on nursing Care items. In the final version, we selected 73 diagnoses and 155 nursing interventions.
Conclusion:
With the completion of this study, nurses will have an instrument for Nursing Care Systematization to attend mothers who have given birth recently in primary health care. Besides, this study will also work as a tool in research and teaching of Obstetric Nursing.
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Nursing diagnoses in intensive care: cross-mapping and NANDA-I taxonomy
Revista Brasileira de Enfermagem. 2016;69(2):307-315
Abstract
Nursing diagnoses in intensive care: cross-mapping and NANDA-I taxonomy
Revista Brasileira de Enfermagem. 2016;69(2):307-315
DOI 10.1590/0034-7167.2016690214i
Views0See moreABSTRACT
Objective:
to identify nursing diagnoses in intensive care unit (ICU) patients by means of a cross-mapping of terms contained in nursing records with the NANDA-I taxonomy.
Method:
an exploratory, descriptive study with a retrospective analysis of nursing records in 256 medical records of patients that were hospitalized in the general ICU of a hospital in the western border of the state of Rio Grande do Sul. Terms indicating conditions demanding nursing interventions were collected from the records; cross-mapping of these terms with the NANDA-I taxonomy diagnoses was performed and confirmed in a nursing focus group. Data were analyzed through descriptive statistics.
Results:
a total of 832 terms and expressions referring to 52 different diagnoses in 9 of the 13 domains of the NANDA-I taxonomy were identified.
Conclusion:
the present study enabled the identification of nursing diagnoses in patients hospitalized in ICUs, affecting care management, the training process of experts in the area, and information systems.
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Direct cost of dressings for pressure ulcers in hospitalized patients
Revista Brasileira de Enfermagem. 2016;69(2):290-297
Abstract
Direct cost of dressings for pressure ulcers in hospitalized patients
Revista Brasileira de Enfermagem. 2016;69(2):290-297
DOI 10.1590/0034-7167.2016690212i
Views0ABSTRACT
Objective:
to identify the average direct cost (ADC) on the direct labor (DL) for nurses and the consumption of materials and solutions used in performing dressings for pressure ulcers (PU) in hospitalized patients.
Methods:
case study, exploratory and descriptive case conducted in a teaching hospital. For six months, 228 dressings were performed for the treatment of PU patients. We calculated the cost by multiplying the time spent by nurses by the DL unit cost, adding to the cost of materials and solutions consumed.
Results:
the dressings ADC of PU corresponds to US$ 19.18 (PUs-category I); US$ 6.50 (PUs-category II); US$ 12.34 (PUs-category III); US$ 5.84 (PUs-category IV); US$ 9.52 (PUs-unclassifiable) and US$ 3.76 (PU suspected deep tissue injury).
Conclusion:
the methodology used can be reproduced in different hospital settings for the development of other studies to expand and complement the knowledge gained.
Keywords:Costs and Cost AnalysisNursing Administration ResearchNursing CareNursing Service, HospitalPressure UlcerSee more -
Prevention of vertical mother-to-child transmission of HIV: care and adhesion provided by couples
Revista Brasileira de Enfermagem. 2016;69(2):275-281
Abstract
Prevention of vertical mother-to-child transmission of HIV: care and adhesion provided by couples
Revista Brasileira de Enfermagem. 2016;69(2):275-281
DOI 10.1590/0034-7167.2016690210i
Views0ABSTRACT
Objective:
to unveil the existential movement of a couple when performing vertical HIV transmission prophylaxis.
Method:
qualitative research, using Martin Heidegger’s phenomenological approach. A phenomenological interview was conducted with 14 participants between December/2011 and February/2012 in the outpatient facilities of an university hospital, Brazil. A comprehensive and interpretative heideggerian analysis was developed.
Results:
the couple understands that they have followed the guidance of the health professionals as indicated. By not being able to breastfeed, the woman did not fail to be a mother, but it was also not a complete experience. The senses of the occupation of the couple-being unfolded to the prophylactic treatment and facticity due to the fact of not breastfeeding.
Conclusion:
we indicate the need to rethink care, proposing a working relationship that transcends the impersonal that dictates about what the couple must deal with, enabling their active participation in care decisions and actions.
Keywords:Child HealthNursingPrenatal CareQualitative ResearchVertical Transmission of Infectious DiseaseSee more -
Attitudes and pleasure/suffering in mental health work
Revista Brasileira de Enfermagem. 2016;69(2):266-274
Abstract
Attitudes and pleasure/suffering in mental health work
Revista Brasileira de Enfermagem. 2016;69(2):266-274
DOI 10.1590/0034-7167.2016690209i
Views0See moreABSTRACT
Objective:
to investigate the existence of a relationship between attitudinal profiles and the pleasure/suffering dynamic in workers of Mental Health Services.
Method:
a quantitative, descriptive-analytical, correlational and cross-sectional study conducted in 2014. We used three instruments: characterization questionnaire, Opinions on Mental Illness Scale and Pleasure and Suffering Indicators at Work Scale, answered by 80 workers of the Network for Psychosocial Care of Alfenas, state of Minas Gerais, Brazil.
Results:
Authoritarianism proved to be the predominant profile. As for the pleasure/suffering at work, Gratification was considered adequate, and indicators such as Freedom, Wear and Insecurity were considered moderate critical. There were positive correlations between the most favorable attitudes and pleasure indicators at work. The values of both scales showed a relationship with socio-demographic and professional variables.
Conclusion:
the less favorable attitudes are prevalent and, in spite of suffering being present, these professionals feel gratified about their work.
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Overweight in young adult students: the vulnerability of a distorted self-perception of body image
Revista Brasileira de Enfermagem. 2016;69(2):258-265
Abstract
Overweight in young adult students: the vulnerability of a distorted self-perception of body image
Revista Brasileira de Enfermagem. 2016;69(2):258-265
DOI 10.1590/0034-7167.2016690208i
Views0See moreABSTRACT
Objective:
To analyze overweight in young adult students from the individual dimension of vulnerability, especially its interpersonal and subjective markers.
Method:
An analytical quantitative study was performed with 560 young adults from 26 schools in a capital city in Northeastern Brazil. After obtaining data to administer specific questionnaires, logistic regression was used to identify markers of individual vulnerability.
Results:
In the bivariate analysis, overweight showed a statistically significant association with self-perception of health, satisfaction with body image and self-perception of overweight, the latter remaining in the final regression model.
Conclusion:
It can be mainly concluded that self-perception of overweight is distorted when compared to one’s actual body weight and, for this reason, young adults are vulnerable to dysfunctional health states. However, it was confirmed that this health condition must be understood in an individual and contextual perspective.
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ORIGINAL ARTICLE11-22-2024
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
Abstract
ORIGINAL ARTICLEPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
DOI 10.1590/0034-7167-2023-0327
Views0See moreABSTRACT
Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
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ORIGINAL ARTICLE11-22-2024
Knowledge sharing: nurse managers’ practices
Revista Brasileira de Enfermagem. 2024;77(5):e20230287
Abstract
ORIGINAL ARTICLEKnowledge sharing: nurse managers’ practices
Revista Brasileira de Enfermagem. 2024;77(5):e20230287
DOI 10.1590/0034-7167-2023-0287
Views0ABSTRACT
Objective:
To analyze how management practices for sharing knowledge are developed in public hospitals in the context of nursing.
Methods:
Qualitative research, carried out with 15 nurse managers from six public hospitals, from July to September 2022. Data were collected through semi-structured interviews and analyzed according to content analysis and in a model for sharing knowledge at work.
Results:
Knowledge sharing in nursing occurs through intraand extra-organizational training (training, courses and events), use of digital communication tools (media and social networks) and individual and collective contact between professionals during the service (experiences, exchange of experiences and assessment feedback).
Final considerations:
Sharing knowledge is relevant to nursing work. To improve it, it must be understood that effective sharing occurs from person to person, in their daily practices, and must be conducted as a strategically planned process by nurse managers.
Keywords:Health Information ManagementHealth Services AdministrationKnowledge ManagementNursing Service, HospitalNursing Staff, HospitalSee more -
ORIGINAL ARTICLE11-22-2024
Transitions experienced by people living with limitations resulting from leprosy: a research-care study
Revista Brasileira de Enfermagem. 2024;77(5):e20230229
Abstract
ORIGINAL ARTICLETransitions experienced by people living with limitations resulting from leprosy: a research-care study
Revista Brasileira de Enfermagem. 2024;77(5):e20230229
DOI 10.1590/0034-7167-2023-0229
Views0See moreABSTRACT
Objective:
to understand the transitional processes that affect the adaptation of people who live with limitations resulting from leprosy.
Methods:
This is a qualitative study based on the precepts of Transition Theory, mediated by care-research, with 24 people with limitations resulting from leprosy in an ex-hospital colony in Piauí. Semi-structured interviews were carried out. The interviews were analyzed using Iramuteq software.
Results:
the researched-caregivers experienced the four types of transitions, including feelings of fear, worry, loneliness, hopelessness, guilt and a tendency to hide the diagnosis. Breakdowns and resignation were revealed, with spirituality, adaptation to the new life situation and acceptance as facilitating conditions for coping with the transitional process, with a consequent improvement in quality of life.
Final considerations:
the transitional processes had a positive significance, since they contributed to adaptation and the achievement of quality of life.
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ORIGINAL ARTICLE11-22-2024
Study for the validation of evaluation indicators of electronic health records in immunization: Delphi technique
Revista Brasileira de Enfermagem. 2024;77(5):e20230112
Abstract
ORIGINAL ARTICLEStudy for the validation of evaluation indicators of electronic health records in immunization: Delphi technique
Revista Brasileira de Enfermagem. 2024;77(5):e20230112
DOI 10.1590/0034-7167-2023-0112
Views0ABSTRACT
Objective:
To develop and validate indicators for the evaluation of computerized systems in vaccination rooms.
Methods:
Methodological study. From the construction of a logical model for managing information produced in computerized systems in vaccination rooms, an evaluation indicator matrix was developed, and its contents were validated by specialists using the Delphi method. The degree of relevance and clarity were judged, using the following parameters: agreement percentage ≥ 90%; content validity index > 0.78. Internal consistency was tested using Cronbach’s alpha coefficient of 0.93.
Results:
Of the 55 proposed indicators, 48 were validated and composed the final matrix, with 13 in the structure dimension, 29 in the process dimension, and six in the outcome dimension.
Conclusion:
The set of indicators shows validity and high reliability, and can be used to evaluate computerized systems in vaccination rooms throughout the country, as it adhered to the recommendations of the National Immunization Program.
Keywords:Delphi TechniquesElectronic Health RecordsImmunization ProgramsInformation TechnologyValidation StudySee more -
ORIGINAL ARTICLE11-22-2024
Interpersonal violence in the state of Espírito Santo: analysis of mandatory notifications between 2011 and 2018
Revista Brasileira de Enfermagem. 2024;77(5):e20230081
Abstract
ORIGINAL ARTICLEInterpersonal violence in the state of Espírito Santo: analysis of mandatory notifications between 2011 and 2018
Revista Brasileira de Enfermagem. 2024;77(5):e20230081
DOI 10.1590/0034-7167-2023-0081
Views0See moreABSTRACT
Objective:
To identify the frequency of notifications of interpersonal violence in Espírito Santo from 2011 to 2018, and the factors associated with this issue.
Methods:
This is a cross-sectional study in which all cases of interpersonal violence from the Information System for Notifiable Diseases in the state of Espírito Santo during the period from 2011 to 2018 were analyzed. Absolute and relative frequencies and 95% confidence intervals were calculated, as well as Poisson regression.
Results:
During the analyzed period, 27,277 cases were reported in Espírito Santo (P: 75%; 95% CI: 74.5-75.4), being more prevalent among females, children, and the elderly, individuals of black/mixed race, people without disabilities, and residents of urban areas. Regarding the perpetrator, there was a higher prevalence of individuals aged 25 years and older, males, with a current or former intimate partner relationship with the victim, and suspected alcohol use at the time of the aggression. In terms of the characteristics of the aggression, there was a higher prevalence of repeat violence, involving a single aggressor, and occurring in the residence.
Conclusions:
The notification of interpersonal violence in Espírito Santo showed a high prevalence and was associated with characteristics of the victim, aggressor, and event. This scenario reinforces the need for interventions such as professional qualification, expansion of intersectoral actions, and reformulation of public policies.
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ORIGINAL ARTICLE11-22-2024
Sociodemographic and occupational influences on health professionals’ quality of life
Revista Brasileira de Enfermagem. 2024;77(4):e20240010
Abstract
ORIGINAL ARTICLESociodemographic and occupational influences on health professionals’ quality of life
Revista Brasileira de Enfermagem. 2024;77(4):e20240010
DOI 10.1590/0034-7167-2024-0010
Views0See moreABSTRACT
Objective:
To analyze the sociodemographic and occupational influences on health professionals’ quality of life.
Method:
This descriptive-exploratory, cross-sectional, analytical, and quantitative study addressed 94 health workers, including nursing technicians, nurses, and physical therapists working in Intensive Care Units in a town in the extreme south of Brazil in 2023. The student’s t-test and Spearman correlation were used.
Results:
A significant positive correlation was found between being a woman and the psychological domain and between income and the social and environmental domain while working hours were inversely related to general QoL. Additionally, workload negatively impacted the physical, psychological, and general QOL, furniture negatively influenced the psychological domain, and equipment was negatively associated with the physical and psychological domain.
Conclusion:
The characteristics of the work environment interfere with several areas of quality of life.
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REVIEW11-22-2024
Concept analysis of youth: understanding the plurality of subjects
Revista Brasileira de Enfermagem. 2024;77(4):e20240002
Abstract
REVIEWConcept analysis of youth: understanding the plurality of subjects
Revista Brasileira de Enfermagem. 2024;77(4):e20240002
DOI 10.1590/0034-7167-2024-0002
Views0See moreABSTRACT
Objective:
To analyze the concept of “youth.”
Methods:
This is a concept analysis guided by the method proposed by Walker and Avant, operationalized through an integrative literature review. The search in scientific databases was carried out using the descriptors: youth; young; adolescence. To compose the literary corpus, 22 studies were selected.
Results:
Various factors were found in the antecedents that influence the separation of youth groups, contributing to the heterogenization of this population. The attributes include characteristics that comprise the formation of youth groups, especially the idea of shared experiences and social construction, as well as the consequences of the mentioned concept. After systematizing the variables, the analysis was conducted, highlighting the conceptions that influence youth.
Conclusion:
The study demonstrated the multifactorial complexity of the formulation of the concept of youth, highlighting various factors that contribute to this construction. For nursing, this conceptual field allows for an understanding of the population and effective engagement with this group.
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