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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
- Paula dos Santos Brito
, - Lívia Maia Pascoal ,
- Mário Vinicius Teles Costa ,
- Lorrany Fontenele Moraes da Silva ,
- Liana Priscilla Lima de Melo , [ … ],
- Floriacy Stabnow Santos
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
- Paula dos Santos Brito ,
- Lívia Maia Pascoal ,
- Mário Vinicius Teles Costa ,
- Lorrany Fontenele Moraes da Silva ,
- Liana Priscilla Lima de Melo ,
- Marcelino Santos Neto ,
- Francisca Elisângela Teixeira Lima ,
- Floriacy Stabnow Santos
Views0See moreABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
- Paula dos Santos Brito
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07-31-2023
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
- Mariana Torreglosa Ruiz ,
- Karoline Faria de Oliveira ,
- Nayara Freitas Azevedo ,
- Marina Carvalho Paschoini ,
- Wellington Francisco Rodrigues , [ … ],
- Monika Wernet
Abstract
Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review
Revista Brasileira de Enfermagem. 2023;76:e20220173
DOI 10.1590/0034-7167-2022-0173
- Mariana Torreglosa Ruiz ,
- Karoline Faria de Oliveira ,
- Nayara Freitas Azevedo ,
- Marina Carvalho Paschoini ,
- Wellington Francisco Rodrigues ,
- Carlo José Freire de Oliveira ,
- Jacqueline Faria de Oliveira ,
- Luciana Mara Monti Fonseca ,
- Monika Wernet
Views0See moreABSTRACT
Objectives:
to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19.
Methods:
a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation.
Results:
fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90–72.88), and artificial breastfeeding, 43.23% (CI = 30.99 – 55.88), without statistically significant differences.
Conclusions:
despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
- Mariana Torreglosa Ruiz
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ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
- Maria Cristina Lins Oliveira Frazão ,
- Lia Raquel de Carvalho Viana ,
- Gerlania Rodrigues Salviano Ferreira ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva , [ … ],
- Kátia Neyla de Freitas Macedo Costa
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
- Maria Cristina Lins Oliveira Frazão ,
- Lia Raquel de Carvalho Viana ,
- Gerlania Rodrigues Salviano Ferreira ,
- Cláudia Jeane Lopes Pimenta ,
- Cleane Rosa Ribeiro da Silva ,
- Kaisy Martins de Albuquerque Madruga ,
- Patrícia Serpa de Souza Batista ,
- Kátia Neyla de Freitas Macedo Costa
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
- Maria Cristina Lins Oliveira Frazão
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07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0See moreRESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
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REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more
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ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
- Geórgia Silva Marques ,
- Alessandra Maciel Almeida ,
- Isabel Cristina Gomes ,
- Michele Renata Barbosa da Silva ,
- Bruno Almeida Rezende
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
- Geórgia Silva Marques ,
- Alessandra Maciel Almeida ,
- Isabel Cristina Gomes ,
- Michele Renata Barbosa da Silva ,
- Bruno Almeida Rezende
Views0See moreABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
- Geórgia Silva Marques
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ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
- Antônio José de Lima Júnior ,
- Ariane Cristina Barboza Zanetti ,
- Bruna Moreno Dias ,
- Andrea Bernardes ,
- Francielly Marques Gastaldi , [ … ],
- Carmen Silvia Gabriel
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
- Antônio José de Lima Júnior ,
- Ariane Cristina Barboza Zanetti ,
- Bruna Moreno Dias ,
- Andrea Bernardes ,
- Francielly Marques Gastaldi ,
- Carmen Silvia Gabriel
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
- Antônio José de Lima Júnior
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06-26-2023
- Paulo Jorge dos Santos-Costa ,
- Margarida Maria da Silva Vieira ,
- João Manuel Garcia Nascimento Graveto
- Paulo Jorge dos Santos-Costa
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01-01-2016
Perfil dos pacientes com tumores cerebrais e o papel do enfermeiro
Revista Brasileira de Enfermagem. 2016;69(1):150-155
Abstract
Perfil dos pacientes com tumores cerebrais e o papel do enfermeiro
Revista Brasileira de Enfermagem. 2016;69(1):150-155
DOI 10.1590/0034-7167.2016690120i
Views0See moreRESUMEN
Objetivo:
describir el perfil de los 200 pacientes con tumores del sistema nervioso central (TSNC) y el papel de la enfermería.
Método:
análisis prospectivo, cuantitativo y descriptivo de los registros médicos de 200 pacientes con TSNC.
Resultados:
61% de los pacientes tenían TSNC benignos y 39% tumores malignos. El grado de la dependencia de los pacientes según la Escala de Karnofsky fue significativamente mayor en los pacientes con tumores malignos (P <0,05), lo que indica que estos pacientes necesitan más apoyo en las actividades diarias.
Conclusión:
los pacientes con tumores cerebrales requieren atención especializada, con directrices específicas sobre su enfermedad y aspectos de la vida diaria después del tratamiento. Por lo tanto, los enfermeros pueden ser un elemento clave para la eficacia de la atención prestada a los pacientes y sus familias con el objetivo de mejorar la calidad de vida de las personas afectadas por la enfermedad.
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01-01-2016
Profile of patients with brain tumors and the role of nursing care
Revista Brasileira de Enfermagem. 2016;69(1):150-155
Abstract
Profile of patients with brain tumors and the role of nursing care
Revista Brasileira de Enfermagem. 2016;69(1):150-155
DOI 10.1590/0034-7167.2016690120i
Views0See moreABSTRACT
Objective:
to describe the profile of 200 patients with central nervous system tumors (CNST), and the role of the nursing care.
Method:
prospective, quantitative and descriptive analysis of medical records of 200 patients with TSNC.
Results:
a total of 61% of our patients had benign CNST and 39% had malignant tumors. The extent of patient dependence, according to the Karnofsky Performance Status scale, was significantly greater for patients with malignant CNST (p < .05), indicating that these patients needed more support with their activities of daily living.
Conclusion:
patients with CNST need specialized care, with specific guidance regarding their disease and aspects of daily living after treatment. Thus, the nurse can function as a key element for the effectiveness of care provided to patients and family members with the aim of enhancing the quality of life of all those affected, directly or indirectly, by the disease.
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01-01-2016
Clinical competences of nursing assistants: a strategy for people management
Revista Brasileira de Enfermagem. 2016;69(1):142-149
Abstract
Clinical competences of nursing assistants: a strategy for people management
Revista Brasileira de Enfermagem. 2016;69(1):142-149
DOI 10.1590/0034-7167.2016690119i
Views0See moreABSTRACT
Objective:
to identify the clinical competences of nursing assistants in a hospital organization and to understand how professional acquired these competences.
Method:
an exploratory study of a qualitative approach, performed at a private hospital in southern Brazil, through a semi-structured interview, in May and June 2013 with 20 nursing assistants.
Results:
the nursing assistantswho worked longer in the same work unit had a higher list of clinical competences. The acquisition of clinical competences occurred through interaction with other professionals; in daily nursing practice; in previous experiences and in formal learning.
Final considerations:
the identification of clinical competences and the way nursing assistants acquire these competences can be important resources for managing people, which can be used by nurse managers to better allocate these professionals and provide th e opportunity for their professional development.
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01-01-2016
Quality of life and accession to the pharmacological treatment among elderly hypertensive
Revista Brasileira de Enfermagem. 2016;69(1):134-141
Abstract
Quality of life and accession to the pharmacological treatment among elderly hypertensive
Revista Brasileira de Enfermagem. 2016;69(1):134-141
DOI 10.1590/0034-7167.2016690118i
Views0See moreABSTRACT
Objective:
to compare variables obtained in adherence and non-adherence to drug treatment for hypertension, according to socioeconomic situation, time of diagnosis, self-reported morbidities, indicative of depression and quality of life.
Method:
cross-sectional analytical study of 524 elderly with adherence and 505 non-adherence to the treatment. A descriptive analysis, Chi-square test and Student t test (p < 0.05) were held.
Results:
there was higher proportion of older subjects, indicative of morbidity and depression among those with adherence. Non-adherence subjects had lower scores in all domains and quality of life facets.
Conclusion:
actions favoring the adherence to pharmacological treatment should be recommended, to minimize the impact of comorbidities and improve quality of life.
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01-01-2016
Exposure and sun protection practices of university students
Revista Brasileira de Enfermagem. 2016;69(1):126-133
Abstract
Exposure and sun protection practices of university students
Revista Brasileira de Enfermagem. 2016;69(1):126-133
DOI 10.1590/0034-7167.2016690117i
Views0See moreABSTRACT
Objective:
to learn exposure and sun protection practices for university students.
Method:
a descriptive, cross-sectional study performed at a university in São Paulo.
Results:
the sample consisted of 385 young and data collection conducted through a form. Of the total, 239 (62%) young people were classified as skin type III and IV and 69 (17.9%) affirmed to have a history of skin cancer in the family. Most affirmed exposure to the sun between 10 a.m and 04 p.m and for more than one hour; 112 (29.1%) informed not employ safeguards. Among those who use sunscreen, the minority does so regularly.
Conclusion:
although the sample was made up of people with greater access to information, it was found exposure and sunscreen improperly. Education, individual and collective actions should be strengthened and prioritized given the incidence of skin cancer in the country.
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01-01-2016
Hospitalizations sensitive to primary health care at a regional hospital in the Federal District
Revista Brasileira de Enfermagem. 2016;69(1):118-125
Abstract
Hospitalizations sensitive to primary health care at a regional hospital in the Federal District
Revista Brasileira de Enfermagem. 2016;69(1):118-125
DOI 10.1590/0034-7167.2016690116i
Views0See moreABSTRACT
Objective:
to characterize hospitalizations for sensitive conditions to primary care of a regional hospital in the Federal District.
Method:
this is a descriptive study, such as case series that considered users admitted between 2008 and 2012 in the Regional Hospital of Ceilândia. The selection of hospitalizations was based on the Brazilian List, and the data were obtained from the Hospital information System. The descriptive statistics was used in the data processing and analysis.
Results:
ACSC (Ambulatory Care Sensitive Conditions) showed a growth tendency, mainly due to cerebrovascular diseases, lung diseases and infections in the kidney and urinary tract. Female and elderly patients showed a higher frequency of hospitalizations.
Conclusion:
the results may help managers and health professionals to implement actions that aim higher solvability of primary care, and contribute to the systematization of nursing care and improved health care.
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01-01-2016
Significations of being the caregiver of the companion with cancer: an existential look
Revista Brasileira de Enfermagem. 2016;69(1):110-117
Abstract
Significations of being the caregiver of the companion with cancer: an existential look
Revista Brasileira de Enfermagem. 2016;69(1):110-117
DOI 10.1590/0034-7167.2016690115i
Views0See moreABSTRACT
Objective:
to unveil the significances of women who experience being the caregiver of their companion with cancer.
Method:
a Heidegger’s phenomenological research, performed with ten women who are caregivers of their companions with cancer in a town in the northwest of the state of Paraná, Brazil, from December 2013 to February 2014. The following guiding question was used: “How has it been for you to care for your companion with cancer?”.
Results:
from the analysis of the speeches the following ontological themes emerged: “Taking responsibility of caring for the companion with cancer”, “Learning to live with the intimacy changes” and “Learning to live with the feelings related to care”. The data revealed the wives’ sense of responsibilities for caring and the influence of feelings in the act of caring, including the impact on the couple’s intimacy.
Conclusion:
in the midst of difficulties, the feelings of affection are the driving force behind these women to continue their actions as wife-caregivers.
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01-01-2016
Defining characteristics of the nursing diagnosis “ineffective airway clearance”
Revista Brasileira de Enfermagem. 2016;69(1):102-109
Abstract
Defining characteristics of the nursing diagnosis “ineffective airway clearance”
Revista Brasileira de Enfermagem. 2016;69(1):102-109
DOI 10.1590/0034-7167.2016690114i
Views1See moreABSTRACT
Objective:
to analyze the defining characteristics of the nursing diagnosis “ineffective airway clearance” in children with acute respiratory infection.
Method:
cross-sectional descriptive study, developed in two hospitals specialized in care for children. It was held a detailed respiratory evaluation of the child to identify the defining characteristics of the diagnosis under study.
Results:
a total of 249 children were evaluated, 55.8% were male and the median age was 13.76 months. Ineffective airway clearance was identified in 222 children (89.2%). The following defining characteristics presented statistically significant associations: dyspnea, expectoration, orthopnea, respiratory adventitious sounds, decreased breath sounds and ineffective cough. Decreased breath sounds, ineffective cough and respiratory adventitious sounds composed the logistic regression model.
Conclusion:
the characteristics decreased breath sounds, ineffective cough and respiratory adventitious sounds have better predictive capacity for the diagnosis “ineffective airway clearance” in children with acute respiratory infection.
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01-01-2015
Quality of life and physical activity in intensive care professionals from middle São Francisco
Revista Brasileira de Enfermagem. 2015;68(1):26-31
Abstract
Quality of life and physical activity in intensive care professionals from middle São Francisco
Revista Brasileira de Enfermagem. 2015;68(1):26-31
DOI 10.1590/0034-7167.2015680104i
Views0See moreObjective:
the objective was to assess the level of physical activity (LPA) and the quality of life QL of the professionals who work in ICU.
Method:
this was a cross-sectional study carried out in Adult ICUs. LPA was assessed by the International Questionnarie of Physical Activity – short form (IQPA-SF) and the QL by the Medical Outcomes Study 36 (SF-36) questionnaire.
Results:
it was classified active 50.89% out of a total of 59 professionals. Nursing technicians were considered the most active with 60.6%. The QL of the professionals who were considered active were better when compared to inactives, with statistical differences to the category of physical aspects limitation, social aspects and mental health. The working hours were higher than recommend, the physicians were higher than the physical therapist, nurses and technicians nurses (p = 0.046).
Conclusion:
physically active professionals who work in ICU had higher quality of life probably why have lower hours of work and consequently more free time to engage in physical activity.
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01-01-2015
Learning needs of Nursing students in technical vocational education
Revista Brasileira de Enfermagem. 2015;68(1):20-25
Abstract
Learning needs of Nursing students in technical vocational education
Revista Brasileira de Enfermagem. 2015;68(1):20-25
DOI 10.1590/0034-7167.2015680103i
Views0See moreObjective:
identify learning needs of students of Technical Vocational Education (TVE) in Nursing. Qualitative study conducted in a city of São Paulo state.
Method:
the subjects were students, teachers and coordinators of TVE and students of the bachelor degree who have had contact with TVE. Data collection was performed by questionnaire socioeconomic and cultural circles about the learning needs. For data analysis we used the content analysis.
Results:
it was found that students have difficulties contents not related to nursing as portuguese and mathematics, as well as introductory courses in the course of TVE which possibly may interfere negatively in learning specific content of nursing and the quality of health care.
Conclusion:
it is necessary to rethink the content taught and ways to teach from basic education, as well as the training of teachers who now works in the TVE.
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01-01-2015
Serious game e-Baby: nursing students’ perception on learning about preterm newborn clinical assessment
Revista Brasileira de Enfermagem. 2015;68(1):13-19
Abstract
Serious game e-Baby: nursing students’ perception on learning about preterm newborn clinical assessment
Revista Brasileira de Enfermagem. 2015;68(1):13-19
DOI 10.1590/0034-7167.2015680102i
Views0See moreObjective:
to evaluate students opinion regarding e-Baby educational technology.
Methodology:
exploratory descriptive study in which participated a sample composed of 14 nursing Portuguese students that used e-Baby digital educational technology in an extracurricular course. To achieve the aim of the study, the data collection was realized through an opinion instrument in Likert scale including the possibility of commentaries by students. Is was also collected data of participants’ characterization.
Results:
students made very satisfactory evaluations regarding the game e-Baby, varying since usability acceptation through suggestions of expansion of the game to other nursing themes.
Conclusion:
serious game e-Baby can be considered a didactic innovation and motivator tool of learning. Besides, it demonstrates have adequate interface in design and educative function aspects, evocating intense interaction between user and computational tool.
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01-01-2015
Challenges beyond the scientific knowledge production
Revista Brasileira de Enfermagem. 2015;68(1):7-8
Abstract
Challenges beyond the scientific knowledge production
Revista Brasileira de Enfermagem. 2015;68(1):7-8
DOI 10.1590/0034-7167.2015680101p
Views0For several decades, innumerous appeals and reflections on how to build the nursing science and achieve visibility in the scientific world led researchers to make efforts to produce knowledge that contributed to the well-being of people, improving their quality of life, relieving their suffering and transforming the reality in which we live. In addition to […]See more
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