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ORIGINAL ARTICLE11-28-2023
Nursing protocol in chronic kidney disease prevention in older adults in primary care
- Fernanda Ferreira Krepker
, - Cristina Arreguy-Sena ,
- Luciene Muniz Braga ,
- Paula Krempser ,
- Jéssica de Castro Santos , [ … ],
- Herica Silva Dutra
Abstract
ORIGINAL ARTICLENursing protocol in chronic kidney disease prevention in older adults in primary care
Revista Brasileira de Enfermagem. 2023;76(1):e20220052
DOI 10.1590/0034-7167-2022-0052
- Fernanda Ferreira Krepker ,
- Cristina Arreguy-Sena ,
- Luciene Muniz Braga ,
- Paula Krempser ,
- Jéssica de Castro Santos ,
- Herica Silva Dutra
Views0See moreASBTRACT
Objectives:
to develop a protocol for Nursing Process operationalization in approaching older adults with vulnerability to chronic kidney disease in Primary Health Care, based on Neuman’s stressors.
Methods:
a methodological study, carried out in two stages: 1) synthesis of evidence using an inductive strategy (mixed method study) and 2) protocol development to support the nursing process operationalization with older adults enrolled in a Basic Health Unit, using a deductive strategy (Neuman’s stressor concepts, NANDA, NIC, and NOC taxonomies, Risner’s line of reasoning, and cross-mapping), described according to A Step-by-Step Guide to Developing Protocols.
Results:
102 older adults participated, and 17 diagnoses, 34 interventions and 26 nursing outcomes were identified.
Conclusions:
the protocol developed is a technology that makes it possible to operationalize the Nursing Process, based on Neuman’s stressors and on taxonomy, conceptual and care frameworks, guiding care and nursing records.
- Fernanda Ferreira Krepker
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ORIGINAL ARTICLE11-28-2023
The Chronic Care Model and its implications for Specialized Outpatient Care
- Francielle Renata Danielli Martins Marques ,
- Grazieli Adrieli Rodrigues Pires ,
- José Luís Guedes Dos Santos ,
- Vanessa Denardi Antoniassi Baldissera ,
- Maria Aparecida Salci
Abstract
ORIGINAL ARTICLEThe Chronic Care Model and its implications for Specialized Outpatient Care
Revista Brasileira de Enfermagem. 2023;76(1):e20210315
DOI 10.1590/0034-7167-2021-0315
- Francielle Renata Danielli Martins Marques ,
- Grazieli Adrieli Rodrigues Pires ,
- José Luís Guedes Dos Santos ,
- Vanessa Denardi Antoniassi Baldissera ,
- Maria Aparecida Salci
Views0See moreABSTRACT
Objective:
to assess the Chronic Care Model implementation in Specialized Outpatient Care and its repercussions for health care.
Methods:
qualitative evaluative research, conducted by the Chronic Care Model. We used observation techniques, document analysis and interviews with 21 health professionals from specialized care. Analysis was conducted by triangulation, with the aid of MAXQDA software for initial and focused coding. All ethical aspects were respected.
Results:
professionals recognized that the model reorganized service care and administrative practices, presenting positive repercussions for the health of people assisted. The absence of continuing education for service professionals compromised the complete model implementation.
Final considerations:
the implementation, even if partial, of the model brings contributions to service improvement. The weaknesses that are still present are compatible with professionals’ difficulty in distancing themselves from the biomedical model.
- Francielle Renata Danielli Martins Marques
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ORIGINAL ARTICLE11-28-2023
Effects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room
Revista Brasileira de Enfermagem. 2023;76:e20220171
Abstract
ORIGINAL ARTICLEEffects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room
Revista Brasileira de Enfermagem. 2023;76:e20220171
DOI 10.1590/0034-7167-2022-0171
Views0See moreABSTRACT
Objectives:
to assess the level of anxiety of nurses in an emergency room in view of the new Coronavirus and describe the relationship between the degrees of anxiety and their sociodemographic variables.
Methods:
quantitative descriptive-correlational study with a sample of 60 nurses. A questionnaire was used as a data collection instrument based on the Hamilton Anxiety Assessment Scale.
Results:
the nurses’ average anxiety is mild. A statistically significant relationship was found between anxiety and the variables “sex” and “children”, with women having higher levels of anxiety than men, and nurses who do not have children showing mild, moderate, or severe anxiety.
Conclusions:
COVID-19 triggers anxiety in nurses, sometimes at pathological levels. Being female and not having children increase the anxiety experienced. Sex can be considered the determining factor for the level of anxiety experienced.
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ORIGINAL ARTICLE11-28-2023
Construction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases
Revista Brasileira de Enfermagem. 2023;76:e20220081
Abstract
ORIGINAL ARTICLEConstruction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases
Revista Brasileira de Enfermagem. 2023;76:e20220081
DOI 10.1590/0034-7167-2022-0081
Views0See moreABSTRACT
Objectives:
to develop and validate an algorithm to guide professionals in cleaning and disinfecting ambulances after transferring patients with contagious infectious diseases.
Methods:
the study was conducted between September and November 2021. The developed algorithm was validated by 104 judges, including nurses, physical therapists, and physicians who care for patients with contagious infectious diseases. It used the Delphi technique and content validity index.
Results:
in the first evaluation, the judges considered the algorithm “unsuitable” and “fully suitable”. The algorithm reviewed according to the judges’ suggestions was rated between “suitable” and “fully suitable” in the second evaluation. The overall content validity index was 0.960 and 0.998 in the first and second evaluations.
Conclusions:
the algorithm to guide the cleaning and disinfection of ambulances after transferring patients with contagious infectious diseases was developed and validated by specialists in the field, with consensus among the judges in the second evaluation.
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ORIGINAL ARTICLE11-28-2023
Geospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory
- Ingrid Bentes Lima ,
- Laura Maria Vidal Nogueira ,
- Lidiane de Nazaré Mota Trindade ,
- Ivaneide Leal Ataide Rodrigues ,
- Suzana Rosa André , [ … ],
- Ana Inês Sousa
Abstract
ORIGINAL ARTICLEGeospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory
Revista Brasileira de Enfermagem. 2023;76:e20220216
DOI 10.1590/0034-7167-2022-0216
- Ingrid Bentes Lima ,
- Laura Maria Vidal Nogueira ,
- Lidiane de Nazaré Mota Trindade ,
- Ivaneide Leal Ataide Rodrigues ,
- Suzana Rosa André ,
- Ana Inês Sousa
Views1See moreABSTRACT
Objective:
To analyze the spatial pattern of tuberculosis in Indigenous peoples from the State of Pará and its correlation with income transfer.
Methods:
Ecological study, with 340 cases reported in Indigenous peoples in the State of Pará, Brazil, in the period 2016-2020. The study performed a descriptive analysis and calculation of incidence rates with smoothing by the local empirical Bayesian method. The Global Moran index assessed the autocorrelation of the rates with income transfer data, p<0,05.
Results:
The Marajó and metropolitan mesoregions of Belém had the highest tuberculosis rates, and a reduced number of people benefited from income transfer (high-low correlation). The study identified high rates, and a significant number of people benefited from financial aid (high correlation high), I=0.399, p=0.027 in the Southwest.
Conclusions:
The spatial autocorrelation between tuberculosis and access to income transfer programs constitutes a relevant subsidy for the formulation of social protection policies and may impact the disease control actions in Indigenous territories, valuing the epidemiological heterogeneity identified in the mesoregions.
- Ingrid Bentes Lima
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ORIGINAL ARTICLE11-28-2023
Remote consultation with people with eating disorders during the COVID-19 pandemic
- Camila Biscacio Falco ,
- Maria Angélica de Almeida Peres ,
- Jose Carlos Appolinario ,
- Livia Lopes Menescal ,
- Izabella de Góes Anderson Maciel Tavares
Abstract
ORIGINAL ARTICLERemote consultation with people with eating disorders during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220197
DOI 10.1590/0034-7167-2022-0197
- Camila Biscacio Falco ,
- Maria Angélica de Almeida Peres ,
- Jose Carlos Appolinario ,
- Livia Lopes Menescal ,
- Izabella de Góes Anderson Maciel Tavares
Views0See moreABSTRACT
Objectives:
to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic.
Methods:
a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence.
Results:
the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations.
Final Considerations:
the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.
- Camila Biscacio Falco
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11-28-2023
Efeitos da pandemia de COVID-19 no bem-estar psicológico dos enfermeiros de um serviço de urgência
Revista Brasileira de Enfermagem. 2023;76:e20220171
Abstract
Efeitos da pandemia de COVID-19 no bem-estar psicológico dos enfermeiros de um serviço de urgência
Revista Brasileira de Enfermagem. 2023;76:e20220171
DOI 10.1590/0034-7167-2022-0171
Views0See moreRESUMEN
Objetivos:
evaluar nivel de ansiedad de enfermeros de un servicio de urgencia frente al nuevo coronavirus y describir la relación entre niveles de ansiedad y variables sociodemográficas.
Métodos:
estudio cuantitativo descriptivo-correlacional con una muestra de 60 enfermeros. Recorrido a la aplicación de una encuesta como instrumento de recolecta de datos basándose en la Escala de Evaluación de Ansiedad de Hamilton.
Resultados:
el escore mediano de ansiedad de los enfermeros es leve. Verificado que hay una relación estadísticamente significante entre la ansiedad y la variable “sexo” e “hijos”, con mujeres presentando niveles de ansiedad superiores a los hombres y los enfermeros sin hijos presentando niveles de ansiedad leve, moderada o severa.
Conclusiones:
la COVID-19 desencadena ansiedad en los enfermeros, por veces a niveles patológicos; y ser del sexo femenino y no tener hijos la aumenta. Es posible afirmar que el sexo fue el factor determinante para el nivel de ansiedad experimentado.
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ORIGINAL ARTICLE11-27-2023
Mental suffering in family daily life: a temporal journey according to Merleau-Ponty
- Patricia Anjos Lima de Carvalho ,
- Vanessa Thamyris Carvalho dos Santos ,
- Marlene Gomes Terra ,
- Márcia Aparecida Ferreira de Oliveira ,
- Ricardo Henrique Soares , [ … ],
- Edite Lago da Silva Sena
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
- Patricia Anjos Lima de Carvalho ,
- Vanessa Thamyris Carvalho dos Santos ,
- Marlene Gomes Terra ,
- Márcia Aparecida Ferreira de Oliveira ,
- Ricardo Henrique Soares ,
- Edite Lago da Silva Sena
Views1See 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.
- Patricia Anjos Lima de Carvalho
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07-05-2021
Educational technology for bathing/hygiene of elders at home: contributions to career knowledge
- Vitória Lídia Pereira Sousa ,
- Andréa Carvalho Araújo Moreira ,
- Marília Campos Fernandes ,
- Maria Adelane Monteiro da Silva ,
- Iane Ximenes Teixeira , [ … ],
- Francisco Wellington Dourado Júnior
Abstract
Educational technology for bathing/hygiene of elders at home: contributions to career knowledge
Revista Brasileira de Enfermagem. 2021;74:e20200890
DOI 10.1590/0034-7167-2020-0890
- Vitória Lídia Pereira Sousa ,
- Andréa Carvalho Araújo Moreira ,
- Marília Campos Fernandes ,
- Maria Adelane Monteiro da Silva ,
- Iane Ximenes Teixeira ,
- Francisco Wellington Dourado Júnior
Views0See moreABSTRACT
Objective:
to build and validate an educational booklet for bathing and hygiene of elders at home.
Methods:
a methodological study, developed through data collection in literature and situational diagnosis, booklet construction, material qualification through validation by expert judges (11 nurses) and target audience (30 caregivers). Data were analyzed descriptively. The minimum content validity index of 0.80 was considered.
Results:
in content and appearance validation, experts assigned Content Validity Index global of 0.92, while for assessment of the material’s suitability, the booklet was classified as “superior”, with an average of 90%. In the validation of caregivers, the overall Content Validity Index was 1.0.
Conclusion:
the booklet was successfully validated and can be considered in the context of health education and collaborate with an adequate and safe practice of bathing and hygiene of elders at home.
- Vitória Lídia Pereira Sousa
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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 ARTICLE12-05-2019
Quality of life, burden, family emotional support: a model for older adults who are caregivers
Revista Brasileira de Enfermagem. 2019;72:169-176
Abstract
ORIGINAL ARTICLEQuality of life, burden, family emotional support: a model for older adults who are caregivers
Revista Brasileira de Enfermagem. 2019;72:169-176
DOI 10.1590/0034-7167-2018-0439
Views0See moreABSTRACT
Objective:
To investigate associations between quality of life, sex, age, burden, and nature of emotional support available in the family in older adults who are caregivers of older relatives.
Method:
Cross-sectional and correlational study on 148 caregivers gathered in public and private healthcare services, who were subjected to psychological measures of quality of life, burden, exchange of emotional support, sex, and age. Data were analyzed using Chi-square, Fisher’s exact test and path analyses (p < 0.05).
Results:
A total of 77% women, average age of 69.7 years. There were significant associations between exchange of support and burden due to the provided assistance, being a woman and satisfaction with the received support, satisfaction with the received support and burden, burden and quality of life, and satisfaction with the received support and feeling of burden due to the provided support.
Conclusion:
Satisfaction with the received emotional support moderate the association between sex and burden, and such moderate the association between satisfaction with emotional support and perceived quality of life.
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ORIGINAL ARTICLE12-05-2019
Functional capacity assessment of long-lived older adults from Amazonas
- Daiane de Souza Fernandes ,
- Lucia Hisako Takase Gonçalves ,
- Angela Maria Rodrigues Ferreira ,
- Maria Izabel Penha de Oliveira Santos
Abstract
ORIGINAL ARTICLEFunctional capacity assessment of long-lived older adults from Amazonas
Revista Brasileira de Enfermagem. 2019;72:49-55
DOI 10.1590/0034-7167-2017-0798
- Daiane de Souza Fernandes ,
- Lucia Hisako Takase Gonçalves ,
- Angela Maria Rodrigues Ferreira ,
- Maria Izabel Penha de Oliveira Santos
Views0See moreABSTRACT
Objective:
To evaluate the functional capacity of long-lived older adults from Amazonas.
Method:
A cross-sectional epidemiological study was carried out with 116 older adults aged 80 years or older, registered in a primary health care unit in Belém, in the state of Pará, Brazil. The Functional Independence Measure (FIM) was used for functional capacity assessment and the Mini-Mental State Examination (MMSE) for cognitive screening. Univariate and bivariate analyses were carried out, in addition to the Pearson’s chi-square test.
Results:
The older adults presented modified independence in the self-care, sphincter control and locomotion dimensions, and needed supervision for mobility/transfers. In mobility, men presented complete independence. Modified independence was found in the 80-89 age group. It was observed that, the lower the education level, the worse the cognitive performance.
Conclusion:
In spite of their advanced age, long-lived older adults still present functional capacity for activities of daily living, even though they required supervision for high energy expenditure tasks, such as mobility and transfers.
- Daiane de Souza Fernandes
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06-11-2021
Educational technology on COVID-19 for families of children and adolescents with sickle cell disease
- Patrícia Peres de Oliveira ,
- Elaine Cristina Rodrigues Gesteira ,
- Rhillary Lorraine de Souza ,
- Nayara Cristine Protte de Paula ,
- Letícia Camilo Santos , [ … ],
- Edilene Aparecida Araújo da Silveira
Abstract
Educational technology on COVID-19 for families of children and adolescents with sickle cell disease
Revista Brasileira de Enfermagem. 2021;74:e20201045
DOI 10.1590/0034-7167-2020-1045
- Patrícia Peres de Oliveira ,
- Elaine Cristina Rodrigues Gesteira ,
- Rhillary Lorraine de Souza ,
- Nayara Cristine Protte de Paula ,
- Letícia Camilo Santos ,
- Walquíria Jesusmara dos Santos ,
- Edilene Aparecida Araújo da Silveira
Views1See moreABSTRACT
Objective:
to construct and validate educational technology on COVID-19 and essential care for families of children/adolescents with sickle cell disease.
Methods:
this is a methodological study, in three stages: 1) elaborated educational technology, using the Doak, Doak and Root theoretical-methodological model; 2) content and appearance validation by the content validity coefficient. Delphi technique was applied in two rounds (Delphi I [12 judges]/Delphi II [11 judges]); 3) conducting a pilot test with six families.
Results:
“Sickle cell disease and COVID-19: essential care” included: consequences of COVID-19 in sickle cell disease, guidelines for reducing the risks of contracting the virus and having complications, signs and symptoms of COVID-19, guidelines in case of child/adolescent with suspicion or symptoms of COVID-19. Global content validity coefficient (Delphi II): 0.98.
Conclusion:
educational technology presented content and appearance validity for families of children/adolescents with sickle cell disease, related to COVID-19.
- Patrícia Peres de Oliveira
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ORIGINAL ARTICLE12-05-2019
Self-care activities, sociodemographic variables, treatment and depressive symptoms among older adults with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2019;72:22-29
Abstract
ORIGINAL ARTICLESelf-care activities, sociodemographic variables, treatment and depressive symptoms among older adults with Diabetes Mellitus
Revista Brasileira de Enfermagem. 2019;72:22-29
DOI 10.1590/0034-7167-2017-0579
Views0See moreABSTRACT
Objective:
to analyze the association between self-care activities of older adults with Type 2 Diabetes Mellitus (DM) and sociodemographic variables, type of treatment and depressive symptoms.
Method:
inferential and cross-sectional study, with 121 older adults with Type 2 DM in ambulatory care. We used a questionnaire for characterization of sociodemographic and health, questionnaire self-care activities with DM, Mini Mental State Examination and Geriatric Depression Scale. The association of variables was used (Fisher’s exact test) and for comparing the means (Student’s t-test and analysis of variance).
Results:
The mean age was 68.1 years, the majority were women (57.2%), retired (71.9%) and married (65.3%). The highest averages were for the activities: “to dry the spaces between the toes, after washing them” and smaller averages for “exercise”.
Conclusion:
In spite of high average for self-care activities, there is a need for enhanced performance and compliance to them.
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ORIGINAL ARTICLE09-16-2019
Social representations of the elderly about HIV/AIDS
- Brígida Maria Gonçalves de Melo Brandão ,
- Rebeca Coelho de Moura Angelim ,
- Sergio Corrêa Marques ,
- Denize Cristina de Oliveira ,
- Regina Célia de Oliveira , [ … ],
- Fátima Maria da Silva Abrão
Abstract
ORIGINAL ARTICLESocial representations of the elderly about HIV/AIDS
Revista Brasileira de Enfermagem. 2019;72(5):1349-1355
DOI 10.1590/0034-7167-2018-0296
- Brígida Maria Gonçalves de Melo Brandão ,
- Rebeca Coelho de Moura Angelim ,
- Sergio Corrêa Marques ,
- Denize Cristina de Oliveira ,
- Regina Célia de Oliveira ,
- Fátima Maria da Silva Abrão
Views0See moreABSTRACT
Objective:
to understand the representational content about HIV/AIDS among seropositive elderly people.
Method:
a qualitative study carried out from April to May 2017, in the city of Recife/PE, with 48 seropositive elderly people, through a semi-structured interview. The Social Representations Theory was used as theoretical framework and the method of lexical analysis through IRAMUTEQ software.
Results:
it was observed that the social representation of HIV is structured around the proximity of death and that it is a disease of restricted groups, leading to feelings of sadness. On the other hand, it is evident a transformation of the representation linked to the reified knowledge, leading to the process of naturalization of the disease.
Final considerations:
it is concluded that the elderly living with HIV, when they undergo a process of reframing about the disease, become more flexible to deal with their condition of seropositivity.
- Brígida Maria Gonçalves de Melo Brandão
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ORIGINAL ARTICLE08-26-2022
Sickness absenteeism of Primary Health Care professionals before and during the COVID-19 pandemic
- Artênio José Ísper Garbin ,
- Carolina Carvalho Menez Pinto Nascimento ,
- Fabiana Costa Machado Zacharias ,
- Cléa Adas Saliba Garbin ,
- Suzely Adas Saliba Moimaz , [ … ],
- Nemre Adas Saliba
Abstract
ORIGINAL ARTICLESickness absenteeism of Primary Health Care professionals before and during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20220028
DOI 10.1590/0034-7167-2022-0028
- Artênio José Ísper Garbin ,
- Carolina Carvalho Menez Pinto Nascimento ,
- Fabiana Costa Machado Zacharias ,
- Cléa Adas Saliba Garbin ,
- Suzely Adas Saliba Moimaz ,
- Nemre Adas Saliba
Views0See moreABSTRACT
Objective:
to identify the frequency of occurrence of sickness absenteeism, according to the profile of Primary Health Care (PHC) professionals, and verify if there was an impact of the pandemic on absence duration and reason.
Methods:
a cross-sectional study, from January/2019 to December/2020, with PHC professionals from a municipality in northeastern São Paulo. Descriptive statistics were performed, with frequency calculation.
Results:
of the 977 PHC professionals, 633 (64.79%) used a medical certificate to justify their absence from work in 2019, and 837 (85.67%) in 2020. The main reason for leave was diseases of the musculoskeletal system and connective tissue in the two years. The mean duration of leave was 7.33 days (SD=17.33) in 2019 and 9.88 days (SD=16.05) in 2020. Nursing assistants were the ones who took the most leave in both years.
Conclusions:
there was an impact of the pandemic on absence duration and reason.
- Artênio José Ísper Garbin
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