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01-01-2016
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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01-01-2016
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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01-01-2016
Social network of adolescents under probation from the perspective of public health
Revista Brasileira de Enfermagem. 2016;69(2):298-306
Abstract
Social network of adolescents under probation from the perspective of public health
Revista Brasileira de Enfermagem. 2016;69(2):298-306
DOI 10.1590/0034-7167.2016690213i
Views0See moreABSTRACT
Objective:
to analyze the meaning of the social networks of adolescents who are under probation and to identify the essential components of these networks.
Method:
an exploratory study with a qualitative approach. Twenty-six teenagers, aged 13 to 18, participated in the study. For data gathering, the authors chose semi-structured interviews and network maps. Results: it became evident that social networks are essential for adolescents, with the family in a central position – especially the mothers – as well as the Centro de Referência Especializadode Assistência Social (Center for Specialized Reference of Social Assistance – CREAS) for social promotion and construction of new life projects, away from juvenile offending. However, adolescents reported no ties to health workers.
Conclusion:
the authors observed the need for nurses, as workers in primary health care, to practice in a way that is intersectoral and interdisciplinary, with the aim of strengthening the social networks of adolescents at conflict with the law.
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01-01-2016
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
Views0See moreABSTRACT
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.
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01-01-2016
Humanization knowledge of undergraduate nursing students
Revista Brasileira de Enfermagem. 2016;69(2):282-289
Abstract
Humanization knowledge of undergraduate nursing students
Revista Brasileira de Enfermagem. 2016;69(2):282-289
DOI 10.1590/0034-7167.2016690211i
Views0See moreABSTRACT
Objective:
identify the senses and practices representative of humanization in the training of undergraduate nursing students.
Method:
a qualitative study, supported on the national policy of humanization and the concept of social representation. An interview was conducted with 40 undergraduate nursing students from a public institution. ALCESTE software was used for lexical content analysis.
Results:
the sense of humanization is built on the practice and disciplines of social and human sciences. The coordination between theory and practice is representative of humanization, but does not take place in learning experiences. The professor’s participation and teamwork are elements that influence humanization.
Conclusion:
humanization should be reinforced in the training of undergraduate nursing students, using learning-teaching strategies and experiences that make sense to students, including alliances between theory and practice, learning and service, research and care.
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01-01-2016
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
Views0See moreABSTRACT
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.
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01-01-2016
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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01-01-2016
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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01-01-2015
Analysis of the decision-making process of nurse managers: a collective refl ection
Revista Brasileira de Enfermagem. 2015;68(4):668-675
Abstract
Analysis of the decision-making process of nurse managers: a collective refl ection
Revista Brasileira de Enfermagem. 2015;68(4):668-675
DOI 10.1590/0034-7167.2015680414i
Views0See moreABSTRACT
Objective:
to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories.
Method:
qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis.
Results:
data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model.
Conclusion:
the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that infl uence and determine right decisions.
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01-01-2015
Social representations of sexuality for the elderly
Revista Brasileira de Enfermagem. 2015;68(4):662-667
Abstract
Social representations of sexuality for the elderly
Revista Brasileira de Enfermagem. 2015;68(4):662-667
DOI 10.1590/0034-7167.2015680413i
Views0See moreABSTRACT
Objective:
to know the social representations of sexuality for the elderly, based on the Social Representation Theory.
Method:
study performed in a Basic Family Health Unit in Maracanau-CE, Brazil, with 30 elderly adults. Data were collected from March through April of 2013, using the free word evocation technique. Data were organized and processed using the EVOC 2000.software
Results:
the subjects evoked 150 words associated with the evocator word “sexuality”. Out of these, 43 were different. At the possible core of the representation of sexuality for the elderly, the following words were found: love, affection and respect. Sex, companionship, understanding and coexistence composed the intermediate elements of representation.
Conclusion:
the performed analyses pointed to love, respect and affection as central elements that structured and organized the social representation of sexuality in the elder years for the group studied.
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01-01-2015
Post-accident work behavior in caring for people with HIV/Aids
Revista Brasileira de Enfermagem. 2015;68(4):656-661
Abstract
Post-accident work behavior in caring for people with HIV/Aids
Revista Brasileira de Enfermagem. 2015;68(4):656-661
DOI 10.1590/0034-7167.2015680412i
Views0See moreABSTRACT
Objective:
To identify post-accident conduct in the workplace by health professionals in caring for people with HIV/Aids.
Method:
A qualitative and descriptive research study with a socio-historical perspective (1986-2006), performed in a reference hospital for infectious diseases in the State of Santa Catarina. To collect data, interviews were conducted with oral history among 23 health workers and, for the treatment of data, Bardin’s content analysis was used.
Results:
Post-accident behaviors emerged that included assessment, accident records, chemoprophylaxis when necessary, support, monitoring of the injured worker, and mainly psychological support.
Conclusion:
In situations in which the accident could not be avoided, post-exposure behaviors were important biosecurity strategies mentioned by health workers caring for patients with HIV/Aids, in the sense of minimizing the possible transmission of the HIV virus.
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01-01-2015
Social support towards the necessity of caring after myocardial infarction
Revista Brasileira de Enfermagem. 2015;68(4):649-655
Abstract
Social support towards the necessity of caring after myocardial infarction
Revista Brasileira de Enfermagem. 2015;68(4):649-655
DOI 10.1590/0034-7167.2015680411i
Views0See moreABSTRACT
Objective:
to know the received or assisted social support by the family towards the necessity of care after acute myocardial infarction.
Method:
qualitative and exploratory research. Data collection was carried out through observation and interviews with six families, from February to May, 2012. Data were also analyzed based on the thematic analysis.
Results:
three categories emerged: Immediate social support; Mediate social support; Late social support.
Conclusion:
social support follows the infarction trajectory, which attains the family members and favors the support according to the needs of care in each lived moments by the patient.
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01-01-2015
Nursing care management for children hospitalized with chronic conditions
Revista Brasileira de Enfermagem. 2015;68(4):641-648
Abstract
Nursing care management for children hospitalized with chronic conditions
Revista Brasileira de Enfermagem. 2015;68(4):641-648
DOI 10.1590/0034-7167.2015680410i
Views0See moreABSTRACT
Objective:
to understand the interactions of nurses managing nursing care for the hospitalized child with a chronic condition.
Method:
Theoretical and methodological references were used, Complex Thought and grounded theory, respectively. In the study 18 subjects have participated arranged in three groups: nurses, nursing technicians and family members. A semi-structured interview was used as technique for data collection. The data analysis followed three stages of coding: open, axial and selective.
Results:
the category “Needing to manage nursing care to the hospitalized child with chronic condition in Pediatric Inpatient Unit” and their subcategories show the complex inter subjective bindings established by nurses that support the practice of nursing care management.
Conclusion:
There are difficulties for nursing professionals to interact with the child’s family and the dialogical order/disorder/interaction/organization in the implementation of the management process of care is.
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01-01-2015
Functional disability and socioeconomic and demographic factors in elderly
Revista Brasileira de Enfermagem. 2015;68(4):633-640
Abstract
Functional disability and socioeconomic and demographic factors in elderly
Revista Brasileira de Enfermagem. 2015;68(4):633-640
DOI 10.1590/0034-7167.2015680409i
Views0See moreABSTRACT
Objective:
to verify the prevalence of functional disability and associated socioeconomic and demographic factors in elderly patients of Campina Grande/PB.
Method:
cross-sectional study with elderly patients of both genders. The variables associated with functional disability were assessed using Poisson regression.
Results:
A total of 420 elderly patients were included (68.1% women). The highest prevalence of functional disability were found among females aged 80 or older, white, widowed, of economic classes D/E , who lived alone, with frequency of contacts of up to 224 people and diversity of contacts of up to 14 people. After multivariate analysis, statistically significant association was observed between functional disability, gender and age group.
Conclusion:
the association between functional disability gender and age group is shown to be an important guidance for health interventions since it will allow health services to plan actions aiming to improve, maintain or restore the functional capacity of the elderly population.
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01-01-2015
Hypertension and Diabetes Mellitus Program evaluation on user’s view
Revista Brasileira de Enfermagem. 2015;68(4):626-632
Abstract
Hypertension and Diabetes Mellitus Program evaluation on user’s view
Revista Brasileira de Enfermagem. 2015;68(4):626-632
DOI 10.1590/0034-7167.2015680408i
Views0See moreABSTRACT
Objectives:
to evaluate the program proposed by the Reorganization Care Plan for Hypertension and Diabetes Mellitus on user’s view, and describe aspects of the trajectory of the participants correlating with the program’s evaluation.
Method:
evaluative study with a qualitative approach conducted in health units with the Family Health Strategy, in a city of the metropolitan region of Curitiba, in the period from September to March, 2012. A total of 30 adults with hypertension and/or Diabetes mellitus were interviewed. Data were analyzed through content analysis.
Results:
Four categories were identified: Disease diagnosis; Reasons for the program need; Knowledge of the program, and program evaluation.
Conclusion:
there was the recognition of the orientations, and the monitoring of activities developed, with emphasis in cost reduction for users.
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01-01-2015
Violence in the eye of adolescents: education intervention with Culture Circles
Revista Brasileira de Enfermagem. 2015;68(4):617-625
Abstract
Violence in the eye of adolescents: education intervention with Culture Circles
Revista Brasileira de Enfermagem. 2015;68(4):617-625
DOI 10.1590/0034-7167.2015680407i
Views0See moreABSTRACT
Objective:
to apply the methodology of Culture Circles on adolescents as a strategy for health education of nurses in the construction of the collective knowledge of the thematic violence.
Method:
action research type and qualitative study. Participants were 11 adolescents from a public school in Recife, PE, Brazil. Data production in Culture Circles included the participant observation with field diary, photographic recording and filming, as well as the photovoice technique. The analysis was performed by triangulating data in dialogue with the literature.
Results:
it was shown that the problematizing action provided by the Culture Circle made possible to create situations in which adolescents felt invited to critically refl ect on the phenomenon of violence in all its complexity.
Conclusion:
the health education intervention, performed by Culture Circles, added learning and mutual growth subsidizing nursing care actions that excel at leadership and autonomy of adolescents.
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01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(5):1002-1002
DOI 10.1590/0034-7167.20166905e01
Views0Article “Alcohol and alcoholism: attitudes of nursing students”, with number of DOI: http://dx.doi.org/10.1590/S0034-71672013000100013, published in the journal Revista Brasileira de Enfermagem, v66(1):84-9, page 89 that read:“18. Miranda SP, Vargas D. Satisfação de pacientes de um centro de atenção Psicossocial álcool e drogas com o atendimento do enfermeiro. SMAD, Rev Eletrônica Saúde Mental Alcool Drog 2019;5(2):1-15”.[…]See more -
01-01-2016
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
Abstract
Research methodology for nursing and health: a book review
Revista Brasileira de Enfermagem. 2016;69(5):1000-1001
DOI 10.1590/0034-7167-2015-0135
Views1For those interested in nursing and health, the book entitled “Research methodology for nursing and health: from theory to practice”() was released in October 2015, at the 67th Brazilian Congress of Nursing, sponsored by National ABEn. The interest emerged from two organizers: Dr. Maria Ribeiro Lacerda (UFPR) and Dr. Regina Gema Santini Costerano (UNIFRA). Forty-seven […]See more -
01-01-2016
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
Abstract
Violence in the workplace in Nursing: consequences overview
Revista Brasileira de Enfermagem. 2016;69(5):996-999
DOI 10.1590/0034-7167-2015-0133
Views0See moreABSTRACT
Objective:
to reflect on the consequences of workplace violence experienced by nursing professionals.
Methods:
this is a reflection paper based on recent publications related to the subject, particularly researches carried out in Brazil and in other countries.
Results:
exposure to workplace violence has been associated with health problems in nursing professionals, which may be physical damage, emotional manifestations, and psychic disorders. It also affects the employee performance, his or her family and social interactions.
Conclusion:
this phenomenon is potentially noxious and costly, for it leads to suffering, illness, absence from work, and even death. This reflection calls attention moreover to the importance of a safe and adequate health care work environment.
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REFLECTION01-01-2016
Construcción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
REFLECTIONConstrucción de la enfermera de práctica avanzada en Catalunya (España)
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0RESUMEN
El desarrollo de la enfermera de práctica avanzada (EPA) ha supuesto un reto para las enfermeras en países como EE.UU., Canadá, Gran Bretaña y Australia, entre otros, y desde hace escasos años está siendo considerada en Catalunya y España como un sistema para desarrollar nuevos roles que aporten eficacia y eficiencia al sistema sanitario. El presente artículo pretende conceptualizar la EPA y los modelos de referencia así como contextualizar y reflexionar sobre la EPA en Catalunya, desde el punto de vista de formación y de la implantación de los denominados nuevos roles de enfermería, asimilándolos a la práctica avanzada.
Keywords:Competencia ClínicaEnfermeríaEnfermería de Práctica AvanzadaPráctica ProfesionalRol de la EnfermeraSee more -
01-01-2016
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
Abstract
Developing the Advanced Practice Nurse in Catalonia
Revista Brasileira de Enfermagem. 2016;69(5):991-995
DOI 10.1590/0034-7167.2016690507
Views0See moreABSTRACT
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.
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01-01-2016
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
Abstract
International academic mobility in nursing education: an experience report
Revista Brasileira de Enfermagem. 2016;69(5):986-990
DOI 10.1590/0034-7167-2015-0128
Views0See moreABSTRACT
Objective:
report the experience of international academic mobility in Ireland through the program Science Without Borders during undergraduate education in nursing.
Method:
a report of experience presented in chronological order, with a descriptive nature.
Results:
the opportunity to know and be able to discuss questions regarding health and nursing in Ireland allowed the review of concepts and a more reflective perspective regarding nursing practices. Additionally, the exchange promoted personal strengthening regarding the confrontation and solution of problems, development of technical and scientific abilities, improvement of linguistic competences and construction of personality, independence and maturity.
Conclusion:
regarding such constructive and enriching experience that this mobility provides to students, to the governing authorities, to the population and to Brazilian nursing, sharing this experience is expected to serve as encouragement for those who search for new horizons, with the objective of adding knowledge for their personal and professional life.
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01-01-2016
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
Abstract
Online training for health professionals in three regions of Brazil
Revista Brasileira de Enfermagem. 2016;69(5):981-985
DOI 10.1590/0034-7167.2016690506
Views0See moreABSTRACT
Objective:
to describe online training experience aimed at professionals working in the public health service in 27 Neonatal and Pediatric Intensive Care Units, and to reflect concerning the training process and possible improvements in this process.
Method:
this is an experience report study about the online training with multidisciplinary content, planned from the situational diagnosis of 27 institutions. The training target set was 10 participants per institution and per module, including the following topics: Indicators of Quality as a Management Tool, Hand Hygiene, Patient Safety, Intravenous Therapy and Patients’ Chart Record.
Results:
a total of 2,071 active students in the modules, with 1,046 approved. The mean of 76 students per module exceeded the target set.
Conclusion:
experience has shown that online training is comprehensive as a potential tool for the professional technical development and digital inclusion. The online learning system becomes weakened if participants are unaware of the technological resources.
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01-01-2016
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
Abstract
Technologies in intensive care: causes of adverse events and implications to nursing
Revista Brasileira de Enfermagem. 2016;69(5):972-980
DOI 10.1590/0034-7167.2016690505
Views0See moreABSTRACT
Objective:
to identify the causes of adverse events affecting clients resulting from the use of equipment in intensive care services; to point out the main recommendations for clinical practice to minimize these events and, then, discuss the implications to nursing care.
Method:
integrative and descriptive review on the SciELO, Medline, LILACS, and PubMed databases. Articles were selected based on the inclusion criteria and the structured instrument was applied.
Results:
altogether, 11 articles were selected where three evidence units were outstanding: Equipment failure; inadequate use of equipment; and team failure. Permanent education of professionals; evaluation of production and availability of equipment; and use of checklists are recommended.
Conclusion:
preventing adverse events related to equipment is one of the nursing responsibilities and requires the establishment of defensive barriers to prevent these.
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