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01-01-2015
Social representations about religion and spirituality
Revista Brasileira de Enfermagem. 2015;68(4):609-616
Abstract
Social representations about religion and spirituality
Revista Brasileira de Enfermagem. 2015;68(4):609-616
DOI 10.1590/0034-7167.2015680406i
Views0See moreABSTRACT
Objective:
to identify the social representations about the concepts of spirituality and religion of of health teachers.
Method:
exploratory and descriptive study, based on a qualitative approach. 25 subjects participated in it. The following instruments were used to collect data: questionnaire to identify the profile; questionnaire of free association, whose inducing words were religion and spirituality, and an interview based on the scale FICA (Puchalski, 2006).
Results:
the representations about religion and spirituality, for professors, are forged around the faith in God and it gives them meaning and purpose to deal with the challenges of personal and professional living.
Conclusion:
there are still barriers that need to be overcome with a view to a comprehensive care. For this, it is essential to incorporate spirituality in the process in the curricula of health courses.
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01-01-2015
Prevalence and factors associated with smoking among tobacco growers in southern Brazil
Revista Brasileira de Enfermagem. 2015;68(4):603-608
Abstract
Prevalence and factors associated with smoking among tobacco growers in southern Brazil
Revista Brasileira de Enfermagem. 2015;68(4):603-608
DOI 10.1590/0034-7167.2015680405i
Views0See moreABSTRACT
Objective:
identify the prevalence and factors associated with smoking in tobacco growers.
Method:
descriptive, cross-sectional research. Data collection occurred in 2012 through household survey and interviews, including application of a structured instrument and scale Fargeström.
Results:
there were 100 growers included, average age of 46,9 ± 10,8 years; 90(90%) married; 72(72%) white, average family composition 3,7±1,1 people; median number of children 3(1-3), and the average study time 6±2,5. The prevalence of smoking among tobacco growers was 17%, which had less education (p=0.010) and fewer people in the household (p=0.049).
Conclusion:
the prevalence of smoking among tobacco growers was higher than the national average, but the nicotine dependence was low, which can facilitate the smoking cessation process. Highlights the need to implement a program to control smoking among tobacco growers.
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01-01-2015
The family living the child recovery process after hospital discharge
Revista Brasileira de Enfermagem. 2015;68(4):594-602
Abstract
The family living the child recovery process after hospital discharge
Revista Brasileira de Enfermagem. 2015;68(4):594-602
DOI 10.1590/0034-7167.2015680404i
Views1See moreABSTRACT
Objective:
to understand the meaning attributed by the family to its experience in the recovery process of a child affected by an acute disease after discharge, and to develop a theoretical model of this experience. Symbolic interactionism was adopted as a theoretical reference, and grounded theory was adopted as a methodological reference.
Method:
data were collected through interviews and participant observation with 11 families, totaling 15 interviews. A theoretical model consisting of two interactive phenomena was formulated from the analysis: Mobilizing to restore functional balance and Suffering from the possibility of a child’s readmission.
Results:
the family remains alert to identify early changes in the child’s health, in an attempt to avoid rehospitalization.
Conclusion:
the effects of the disease and hospitalization continue to manifest in family functioning, causing suffering even after the child’s discharge and recovery.
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01-01-2015
Multiprofessional residency in health: a document analysis of political pedagogical projects
Revista Brasileira de Enfermagem. 2015;68(4):586-593
Abstract
Multiprofessional residency in health: a document analysis of political pedagogical projects
Revista Brasileira de Enfermagem. 2015;68(4):586-593
DOI 10.1590/0034-7167.2015680403i
Views0See moreABSTRACT
Objective:
To analyze MPRH political pedagogical projects (PPP) developed in the state of São Paulo and identify scenarios that are highly favorable to IPE.
Method:
This was a descriptive exploratory study conducted through document analysis.
Results:
The analysis revealed a heterogeneous scenario regarding the curricula, didactic and pedagogical organization, educational objectives, pedagogical matrices and evaluation systems employed. One of the programs was identified as providing a highly favorable setting for IPE.
Conclusion:
The analysis adequately evaluated IPE in educational settings and found a highly favorable scenario for it, identifying didactic, pedagogical, political and organizational MPRH elements.
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01-01-2015
Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses
Revista Brasileira de Enfermagem. 2015;68(4):579-585
Abstract
Beliefs of older adults about their vulnerability to HIV/Aids, for the construction of nursing diagnoses
Revista Brasileira de Enfermagem. 2015;68(4):579-585
DOI 10.1590/0034-7167.2015680402i
Views0See moreABSTRACT
Objective:
to know the beliefs of older adults about their vulnerability to HIV/Aids, and to identify nursing diagnoses.
Method:
a field research implemented in Family Health Units, in João Pessoa, Brazil. The sample included 250 older adults of both genders with data collected from April to July of 2011. A Test of Free Word Association was applied using the term HIV/Aids. A content analysis and cross-mapping of the most frequent terms with the International Classification for Nursing Practice, 2011 were performed.
Results:
202 terms were identified in terms, with an overall frequency of 1156. Of the 202 terms, 16 were more frequent and were used to construct the nursing diagnoses. The diagnoses identified were knowledge about appropriate sexual behavior, ability for partial protection, fear of death and hopelessness.
Conclusion:
understanding these beliefs drew from knowledge about factors related to, vulnerability to HIV/Aids aimed at planning health care actions for this population segment.
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LETTER TO THE EDITOR01-01-2015
Considerations about the manuscript published
Revista Brasileira de Enfermagem. 2015;68(4):577-577
Abstract
LETTER TO THE EDITORConsiderations about the manuscript published
Revista Brasileira de Enfermagem. 2015;68(4):577-577
DOI 10.1590/0034-7167.20156804c
Views0Re: Chinese auriculotherapy to improve quality of life of nursing team To the Editor,[…]See more -
01-01-2015
Research in nursing and new pathways based on SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
Abstract
Research in nursing and new pathways based on SENPE
Revista Brasileira de Enfermagem. 2015;68(4):571-572
DOI 10.1590/0034-7167.2015680401i
Views1Almost half a century after the beginning of nursing research in Brazil, there is still a need for investment before it can be considered consolidated. The truth of this statement can be seen in the national seminars that discuss research in the field through 17 events that present results and participation of nursing researchers and […]See more
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01-01-2015
Factors associated with immunization against Hepatitis B among workers of the Family Health Strategy Program
Revista Brasileira de Enfermagem. 2015;68(1):84-92
Abstract
Factors associated with immunization against Hepatitis B among workers of the Family Health Strategy Program
Revista Brasileira de Enfermagem. 2015;68(1):84-92
DOI 10.1590/0034-7167.2015680112p
Views0See moreObjective:
to investigate the report of vaccination against Hepatitis B, verification of immunization and the factors associated with dosages of anti-HBs.
Method:
we collected blood samples from those reported that they had one or more doses of the vaccine. We evaluated the association of the dosage of anti- HBs with sociodemographic conditions, occupational and behavioral. The associations were verified by Mann Whitney and Kruskal Wallis and correlation Spermann by linear regression using SPSS® 17.0.
Results:
among the 761 respondents, 504 (66.1%) were vaccinated, 52.5 % received three doses, 30.4 % verified immunization. Of the 397 evaluated for the determination of anti-Hbs, 16.4% were immune.
Conclusion:
it was found that longer duration of work was associated with higher levels of anti-HBs, while levels of smoking were inversely associated with anti-HBs. These workers need for vaccination campaigns.
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01-01-2015
The decreasing number of cigarettes during psychiatric hospitalization: intervention or punishment?
Revista Brasileira de Enfermagem. 2015;68(1):76-83
Abstract
The decreasing number of cigarettes during psychiatric hospitalization: intervention or punishment?
Revista Brasileira de Enfermagem. 2015;68(1):76-83
DOI 10.1590/0034-7167.2015680111p
Views0See moreObjective:
To identify the mental disorders carriers’ perception, the smokers ones, about the decreasing number of cigarettes during psychiatric hospitalization.
Method:
Exploratory study with 96 hospitalized carriers of mental disorders who are smokers: G1 (34 subjects hospitalized when was allowed one cigarette by hour) and G2 (62 subjects hospitalized when it was reduced to eight cigarette by day). Semi-structured questionnaire. Thematic content analysis.
Results:
The G1 admitted satisfaction with the restriction – smoking during hospitalization as entitlement. The G2 resists the restriction change occurred without dialogue or support. In spite of the difficulties, some attitude changes about the cigarette were noticed such as increase of the responsibility, discovery of the ability to reduce smoking and the meaning of its role.
Conclusion:
Some subjects understand the smoking health policy change as punishment, while others as opportunity to think about the role of cigarette in their life.
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01-01-2015
Family functionality in oldest old household residents
Revista Brasileira de Enfermagem. 2015;68(1):68-75
Abstract
Family functionality in oldest old household residents
Revista Brasileira de Enfermagem. 2015;68(1):68-75
DOI 10.1590/0034-7167.2015680110p
Views0See moreObjective:
the aim of this study was to identify factors associated with family functionality of non-institutionalized long-lived subjects, who were residents in Goiânia (GO), Brazil.
Method:
this was a population-based epidemiological study with cross-sectional outline. Evaluation scales of the functional and cognitive capacities were used. Family dynamics was measured using the Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) instrument by making home interviews with 131 long-lived individuals.
Results:
there was prevalence of the female gender, average of age of 83.87 years old, widowhood condition, and residence in a big family, primary schooling, and self-perception of regular health. A great amount showed independence for self-care and partial dependence for daily life instrumental activities. Family functionality prevailed with score average of 9.06 points.
Conclusion:
in conclusion, family functionality in long-lived subjects is associated with self-perception of poor/bad health, osteoporosis, and fall. Results allowed characterizing long-lived subjects’ family functionality with the aim of valuing and prioritizing family as a caregiver.
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01-01-2015
Prevalence of non-adherence to antihypertensive pharmacotherapy and associated factors
Revista Brasileira de Enfermagem. 2015;68(1):60-67
Abstract
Prevalence of non-adherence to antihypertensive pharmacotherapy and associated factors
Revista Brasileira de Enfermagem. 2015;68(1):60-67
DOI 10.1590/0034-7167.2015680109i
Views0See moreObjective:
the aim of the study was to determine the prevalence of non-adherence to antihypertensive drug treatment and its association with factors bio-socio-economic and welfare.
Method:
it was a descriptive, cross-sectional study, performed with 422 hypertensive individuals. Data were collected through home interviews, conducted between December 2011 and March 2012.
Results:
the results showed that the respondents were mostly female, married, elderly, low income and little time of diagnosis. Were considered non adherent to medication 42.65% of participants. Non-Caucasian hypertensive patients, with fewer than eight years of schooling, who did not regularly attend doctor’s appointments, took more than two anti-hypertensive medications and did not have private health insurance, showed higher likelihood of not complying with the drug treatment.
Conclusion:
these findings suggest that hypertensive patients with unfavorable socioeconomic characteristics and difficulty of access to the service require different interventions in order to encourage them to adhere to medication treatment.
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01-01-2015
Adherence and knowledge about the use of personal protective equipment among manicurists
Revista Brasileira de Enfermagem. 2015;68(1):52-59
Abstract
Adherence and knowledge about the use of personal protective equipment among manicurists
Revista Brasileira de Enfermagem. 2015;68(1):52-59
DOI 10.1590/0034-7167.2015680108i
Views0See moreObjective:
this study aimed to assess adherence and knowledge of manicures/pedicures on the use of Personal Protective Equipment (PPE).
Methods:
it was a survey with 235 manicures/pedicures in salons, Belo Horizonte/Brazil. Data were analyzed with the software Statistical package for the social sciences (17.0), using descriptive statistics, chi-square and logistic regression.
Results:
the adherence and the knowledge of the professional were evaluated using the median of the results, obtaining 52% and 63% respectively. The professionals younger than 31 were more likely (2.54 times) to adhere to PPE and those who claimed to have done biosafety course and to use uniform during work, had better chance of understanding (2.86 and 3.12 times, respectively). The majority (83.4 %) stated that the use of PPE should occur for all procedures, meanwhile 71.5 % cited not use them.
Conclusions:
the results indicate the poor adherence to PPE, strengthen occupational biological risk and need for training of these professionals.
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01-01-2015
Predictive value of the Manchester Triage System: evaluation of patients’ clinical outcomes
Revista Brasileira de Enfermagem. 2015;68(1):45-51
Abstract
Predictive value of the Manchester Triage System: evaluation of patients’ clinical outcomes
Revista Brasileira de Enfermagem. 2015;68(1):45-51
DOI 10.1590/0034-7167.2015680107i
Views0See moreObjective:
to analyze the predictive value of the Manchester Triage System in relation to clinical outcome of patients.
Methods:
prospective observational study of 577 patients admitted to the ER and subjected to risk classification. The Therapeutic Intervention Scoring System-28 (TISS-28) was used to measure the severity of patients (primary outcome) and secondary outcomes: high / transfer, death, and length of hospital stay. Descriptive and univariate analyzes were conducted.
Results:
patients classified as red are 10.7 times more likely to have scores above 14 in TISS-28 in relation to others. Patients classified as red have 5.9 times more chance of progression to death compared to others. Patients of high priority service are 1.5 times more likely to be hospitalized over five days than low priority.
Conclusions:
STM proved a good predictor of clinical outcomes.
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01-01-2015
Entrepreneurship in Nursing: overview of companies in the State of São Paulo
Revista Brasileira de Enfermagem. 2015;68(1):40-44
Abstract
Entrepreneurship in Nursing: overview of companies in the State of São Paulo
Revista Brasileira de Enfermagem. 2015;68(1):40-44
DOI 10.1590/0034-7167.2015680106i
Views0See moreObjective:
the present study aimed to identify and characterize nursing companies managed by entrepreneur nurses registered at the Commercial Registry of São Paulo by 2011.
Method:
it’s a descriptive, exploratory study, whose data collection, made throughout January 2012, was carried out on the Commercial Registry of Sao Paulo website. This non-governmental body has the function of registering the opening of companies and supervising their trade situation.
Results and conclusion:
this study allowed us to identify that the entrepreneur nurse is a growing reality through the identification of 196 companies opened by these professionals. Afterwards, it was analyzed their time of functioning, the main economic activity of the company, capital value, percentage of nurse partners and the distribution of companies by region of Sao Paulo State.
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01-01-2015
Knowing blood donation surroundings: Implications for nurse service in hemotherapy
Revista Brasileira de Enfermagem. 2015;68(1):32-39
Abstract
Knowing blood donation surroundings: Implications for nurse service in hemotherapy
Revista Brasileira de Enfermagem. 2015;68(1):32-39
DOI 10.1590/0034-7167.2015680105i
Views0See moreObjective:
the study aims at discussing the significations apprehended by the non-blood donators, considering the context and the consequences of the acting of the nurse in hemotherapy.
Method:
it is a qualitative approach, with theoretical frame of Symbolic Interactionism and Grounded Theory method. The data production was carried out by intensive interview with subjects of three sample groups of a University Hospital of Rio de Janeiro City.
Results:
the phenomenon originated two analysis categories: “Perceiving the blood matter” and “Reflecting about the blood donation campaigns”. It was observed that the environment of the donor is not composed by contact with the other and the information that it can achieve, including the media.
Conclusion:
these were the main basis for the knowledge of blood donation according to their beliefs, culture and values. Therefore, all these aspects must be considered by the nurse acting on donors capture.
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RESEARCH01-01-2018
Validation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
Abstract
RESEARCHValidation of nursing diagnoses, interventions and outcomes in a pediatric clinic
Revista Brasileira de Enfermagem. 2018;71(1):80-88
DOI 10.1590/0034-7167-2016-0647
Views0See moreABSTRACT
Objectives:
To elaborate operational definitions for the Nomenclature nursing diagnoses, interventionsand outcomes of the Pediatric Clinic at a University Hospital and carry out a validation of the content and clinical aspects of this Nomenclature.
Method:
Methodological research, developed in two stages: documentary study, for the validation of content of the operational definitions of nursing diagnoses; and secondly applied research, via clinical cases, performed with children from 0 to 5 years.
Results:
The 126 diagnoses were submitted to consensus validation and 55.6% were validated. Six clinical case studies were carried out, using the phases of the nursing process, based on the theory of Basic Human Needs, identifying 24.3% of the validated diagnoses and 54.5% of the nursing interventions listed in the Nomenclature.
Conclusion:
The study showed the effectiveness of using the Nomenclature in the Pediatric Clinic, in order to optimize the care andquality of health services.
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RESEARCH01-01-2018
Cognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
Abstract
RESEARCHCognitive changes in nurses working in intensive care units
Revista Brasileira de Enfermagem. 2018;71(1):73-79
DOI 10.1590/0034-7167-2016-0513
Views0See moreABSTRACT
Objective:
To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours.
Method:
An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning.
Results:
Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99.9%. A strong correlation between stress and depression (ρ = 0.564 with p <0.05) and anxiety (ρ = 1 with p <0.05) was observed. There was a weak correlation between stress and task execution time in M2 (ρ = 0.055) for TMT A, a fact that did not occur in M0 (ρ = -0.249).
Conclusion:
The study shows that the workload of the nurses working in 24-hour shifts in the ICU is correlated with high levels of stress, decreases in the attention process, and psychomotor decline.
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RESEARCH01-01-2018
Realities and perspectives of adolescent mothers in their first pregnancy
Revista Brasileira de Enfermagem. 2018;71(1):65-72
Abstract
RESEARCHRealities and perspectives of adolescent mothers in their first pregnancy
Revista Brasileira de Enfermagem. 2018;71(1):65-72
DOI 10.1590/0034-7167-2016-0444
Views0See moreABSTRACT
Objective:
to understand the trajectory of adolescents regarding the first pregnancy, contemplating realities and perspectives.
Method:
qualitative study, based on the Schütz theoretical framework, with 30 adolescents assisted in an outpatient clinic for adolescents in Fortaleza, Ceará, Brazil. From the narrative interviews carried out in the first semester of 2013, in the return for the first consultation of the puerperium, the communicative processes were identified, the central ideas and units of meanings expressed in the themes were abstracted: I was dating and became pregnant; realities and perspectives.
Results:
adolescents justified pregnancy through sexual drive and insufficient prevention; they narrated the fear faced, difficulties in motherhood and continuity of studies. The realities coexisted with the prospects of family members and partners helping to educate the child to achieve a different future from what they themselves experienced.
Final considerations:
adolescents experienced motherhood with ambivalent conflicts because they were young mothers, but they wanted to raise and educate their children, even those with minimal living conditions.
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RESEARCH01-01-2018
Health advocacy by nurses in the Family Health Strategy: barriers and facilitators
Revista Brasileira de Enfermagem. 2018;71(1):57-64
Abstract
RESEARCHHealth advocacy by nurses in the Family Health Strategy: barriers and facilitators
Revista Brasileira de Enfermagem. 2018;71(1):57-64
DOI 10.1590/0034-7167-2016-0119
Views0See moreABSTRACT
Objective:
Identify the barriers and facilitators of health advocacy to users delivered by nurses from the Family Health Strategy.
Method:
Qualitative study carried out with nurses from the Family Health Strategy of a city in the south of Brazil. Study participants were 15 nurses, who were interviewed. The content of the interviews was recorded, transcribed and analyzed in the light of the discursive text analysis.
Results:
Two categories emerged, one about the lack of organization at the workplace, bureaucracy and limitations to professional work in health environments, and another about the facilitating aspects to exercise advocacy both individually and collectively.
Conclusion:
When nurses, provided with technical, scientific and relational knowledge, are empowered to make decisions, they are not only supported by other professionals at work but also develop actions of health advocacy to users, thus qualifying the care delivered.
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RESEARCH01-01-2018
Cultural adaptation of Quality Of Care Through The Patient’s Eyes -QUOTE-HIV
Revista Brasileira de Enfermagem. 2018;71(1):47-56
Abstract
RESEARCHCultural adaptation of Quality Of Care Through The Patient’s Eyes -QUOTE-HIV
Revista Brasileira de Enfermagem. 2018;71(1):47-56
DOI 10.1590/0034-7167-2016-0113
Views0See moreABSTRACT
Objective:
to translate and adapt Quality of Care Through the Patient’s Eyes – HIV (QUOTE-HIV) for the Brazilian population living with HIV/AIDS.
Method:
a methodological study, which followed the stages of translation, synthesis, back-translation, evaluation by the committee of experts and pre-test for cultural adaptation of the instrument.
Results:
the process of translation and cultural adaptation was considered adequate. Evaluation by the expert committee resulted in semantic, structural and grammatical adequacy of the evaluated items. 30 subjects considered the instrument to be easy to understand and suggested minor adjustments in some items.
Conclusion:
the Brazilian version of QUOTE-HIV has been adapted and validated in relation to its content. However, this is a study that precedes the process of evaluating the psychometric properties of the instrument, the results of which will be presented in a later publication.
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RESEARCH01-01-2018
Knowledge, beliefs, and attitudes of older women in HIV/AIDS prevention
Revista Brasileira de Enfermagem. 2018;71(1):40-46
Abstract
RESEARCHKnowledge, beliefs, and attitudes of older women in HIV/AIDS prevention
Revista Brasileira de Enfermagem. 2018;71(1):40-46
DOI 10.1590/0034-7167-2016-0521
Views0See moreABSTRACT
Objective:
To analyze the knowledge, religious beliefs and the adoption of preventive measures against HIV/AIDS of non-Catholic elderly women.
Method:
A qualitative study, carried out in religious institutions of a municipality in the state of Ceará, Northeast Brazil, with 78 elderly women. Of these, 64 were evangelicals, seven spiritualists and seven Jehovah’s Witnesses. A semi-structured interview script was used followed by thematic content analysis of participants’ responses.
Results:
After analyzing the empirical data, three categories were elaborated: the first presented the knowledge they had about AIDS; the second, highlighted the beliefs attributed to people with HIV/AIDS; and the third, presented the preventive measures to HIV/AIDS adopted by them.
Final considerations:
There were participants with knowledge gaps and failure to use preventive measures against HIV/AIDS. They suggested that religious institutions can be venues for lectures on HIV/AIDS prevention.
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RESEARCH01-01-2018
Mothers’ perspective on violence against children: constructing meanings
Revista Brasileira de Enfermagem. 2018;71(1):34-39
Abstract
RESEARCHMothers’ perspective on violence against children: constructing meanings
Revista Brasileira de Enfermagem. 2018;71(1):34-39
DOI 10.1590/0034-7167-2016-0568
Views0See moreABSTRACT
Objective:
To explore the construct elaborated by the mother on the meaning of violence against the child and to identify, according to the mother’s perspective, which measures are most used for the prevention of this phenomenon.
Method:
This is a qualitative research, with the participation of thirty mothers, in a health service in the city of Ananindeua, in the state of Pará, Brazil. The methodology consisted of the categorical content analysis, which identified three categories: Violence, Threats of violence and Protective measures.
Results:
The research showed that mothers attribute different meanings to violence, but the physical and sexual violence were markedly the most highlighted, and the dialogue was the most used protective measure.
Conclusion:
It is essential to strengthen public policies through effective interventions, seeking solutions to address this phenomenon in all segments of society.
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RESEARCH01-01-2018
Adolescent health promotion based on community-centered arts education
Revista Brasileira de Enfermagem. 2018;71(1):26-33
Abstract
RESEARCHAdolescent health promotion based on community-centered arts education
Revista Brasileira de Enfermagem. 2018;71(1):26-33
DOI 10.1590/0034-7167-2016-0078
Views0See moreABSTRACT
Objective:
To evaluate the contribution of arts education to health promotion of adolescents in situations of urban social vulnerability.
Method:
Participatory evaluative research, with a qualitative approach, using as a reference the theoretical constructs of Paulo Freire’s Conscientization and the Empowerment Evaluation as a method of collecting with adolescents and teachers of an arts education program in the field of the Family Health Strategy.
Results:
Participants constructed a collective mission that represented the concept of adolescent health promotion. Arts education activities were prioritized and ranked with a mission focus, and over a three-month period, the program implemented health goals through art. In the reevaluation, the group presented a broad look at the implementation of activities and self-determination for change.
Final considerations:
Arts education is a potential space for nurses to act in the conscientization and empowerment of adolescent health in Primary Health Care.
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