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06-01-2015
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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06-01-2015
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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06-01-2015
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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06-01-2015
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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06-01-2015
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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06-01-2015
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views0See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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06-01-2015
Drug addicts treatment motivations: perception of family members
Revista Brasileira de Enfermagem. 2015;68(3):474-481
Abstract
Drug addicts treatment motivations: perception of family members
Revista Brasileira de Enfermagem. 2015;68(3):474-481
DOI 10.1590/0034-7167.2015680314i
Views1See moreABSTRACT
Objective:
to identify the reasons and motivations why family members search treatment for the drug addicted.
Method:
descriptive qualitative research, developed in 2012 and 2013, in a Drug Addicts Rehabilitation Unit of Parana State, Brazil. A total of 19 semi-structured interviews were conducted with the drug addicts’ family members in treatment. The results were analyzed based on the Transtheoretical Model of Behavior Change and organized in thematic categories according with qualitative data analysis.
Results:
the search for treatment for drug addicts occurred: in the pre-contemplation stage infl uenced by external factors; in the contemplation stage both for ambivalence and behavioral changes needs; in the action stage by awareness of drug addiction and also professional help needs; and in the maintenance stage because of the non-conservation of behavioral changes.
Conclusion:
an evaluation of motivational stages in the beginning of treatment is required for expansion of success possibilities in the rehabilitation process.
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06-01-2015
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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ORIGINAL ARTICLE10-09-2023
Construction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
Abstract
ORIGINAL ARTICLEConstruction and validation of a scenario for recognizing sepsis by nursing students: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220537
DOI 10.1590/0034-7167-2022-0537
Views0See moreABSTRACT
Objective:
To build and validate a clinical simulation scenario for teaching Nursing students about early recognition of signs and symptoms of sepsis in the context of the emergency unit.
Methods:
Methodological study developed in two phases: construction of a simulated scenario and content validation by expert judges. For data analysis, the Content Validity Index (CVI) was calculated considering agreement equal to or greater than 80%. The minimum acceptable CVI value for scenario validation was 1.0.
Results:
The simulation scenario proved to be appropriate, with a global Content Validity Index equal to 1. Some adjustments related to the clarity of the wording were necessary, as suggested by the judges. Conclusions: A medium-complexity, high-fidelity scenario was successfully constructed and validated for teaching early recognition of sepsis signs and symptoms.
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EXPERIENCE REPORT10-09-2023
Service organization protocol for coping with undergraduate students’ psychological distress: a collective construction
Revista Brasileira de Enfermagem. 2023;76(4):e20220535
Abstract
EXPERIENCE REPORTService organization protocol for coping with undergraduate students’ psychological distress: a collective construction
Revista Brasileira de Enfermagem. 2023;76(4):e20220535
DOI 10.1590/0034-7167-2022-0535
Views0See moreABSTRACT
Objective:
to report on the experience of the elaboration process of a service organization protocol for coping with public undergraduate students’ psychological distress in the countryside of São Paulo.
Method:
experience report on protocol production, an action research product, carried out according to the health care and service organization protocol model, made possible by remote meetings with 33 professionals linked to the management and services of the university’s health and social assistance departments.
Results:
collective protocol production provided an opportunity for an institutional agreement on educational, therapeutic and support actions, to be developed in groups or individually with students, with provision for permanent education with civil servants.
Final considerations:
this experience made it possible to list specific actions to face undergraduate students’ psychological distress, bringing health professionals closer to those in management, promoting the exchange of concepts and practices to re-signify and transform the work developed.
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ORIGINAL ARTICLE10-09-2023
Performance of Family Health Strategy Nurses in LGBT+ Healthcare
- Ariane Tufaile Paiva
, - Flávio Adriano Borges ,
- Pablo Ramon Carloni ,
- Walkiria Jéssica Araújo Silveira ,
- Márcia Niituma Ogata , [ … ],
- Guadalupe Calvo García
Abstract
ORIGINAL ARTICLEPerformance of Family Health Strategy Nurses in LGBT+ Healthcare
Revista Brasileira de Enfermagem. 2023;76(4):e20220514
DOI 10.1590/0034-7167-2022-0514
- Ariane Tufaile Paiva ,
- Flávio Adriano Borges ,
- Pablo Ramon Carloni ,
- Walkiria Jéssica Araújo Silveira ,
- Márcia Niituma Ogata ,
- Maria do Perpétuo Socorro de Sousa Nóbrega ,
- Luciano Garcia Lourenção ,
- Guadalupe Calvo García
Views0See moreABSTRACT
Objective:
To analyze the role of Family Health Strategy (FHS) nurses in the health care of LGBT+ individuals.
Methods:
This qualitative study is based on Institutional Analysis. Data was collected in August 2021 through semi-structured interviews with 14 Family Health Strategy nurses from municipalities in the state of São Paulo. The data was processed using the IRaMuTeQ® software and analyzed lexically.
Results:
The textual corpus gave rise to three themes, which addressed the nurses’ practice, the difficulties and challenges they face in providing care to LGBT+ individuals, and the direct association of LGBT+ individuals with sexually transmitted infections.
Conclusion:
Lack of preparedness, access to information, and the need for expanded listening skills are still gaps in the performance of FHS nurses in caring for LGBT+ individuals. However, fostering acceptance and building strong relationships have been effective strategies in bridging the gap in nursing care for the LGBT+ community.
- Ariane Tufaile Paiva
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ORIGINAL ARTICLE10-09-2023
Perceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics
Revista Brasileira de Enfermagem. 2023;76(4):e20220505
Abstract
ORIGINAL ARTICLEPerceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics
Revista Brasileira de Enfermagem. 2023;76(4):e20220505
DOI 10.1590/0034-7167-2022-0505
Views0See moreABSTRACT
Objective:
To investigate the association of sociodemographic and occupational characteristics with a high level of perceived stress in motorcycle taxi drivers.
Method:
Cross-sectional study carried out with motorcycle taxi drivers who answered instruments on sociodemographic and occupational variables – Perceived Stress Scale, Job Content Questionnaire and Effort-Reward Imbalance. Descriptive statistics, Pearson’s chi-square test and Poisson regression with robust variance were used. Statistical significance was 5%.
Results:
Of the 800 motorcycle taxi drivers, 46.8% had a high level of perceived stress. In the multivariate analysis, a high level of stress was associated with low control over work (PR=7.76; 95%CI=5.19-11.61), low social support at work (PR=3.87; 95%CI =2.95 5.08), working hours longer than eight hours a day (RP=1.47; 95%CI=1.21-1.78) and monthly income less than or equal to two minimum wages (PR=1.34;95%CI=1.13-2.58).
Conclusion:
Long working hours, occupational stressors and low income were associated with a high level of perceived stress. Public policies and interventions to minimize occupational stressors are essential.
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ORIGINAL ARTICLE10-09-2023
Educational intervention in social skills for Primary Care nurses
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
ORIGINAL ARTICLEEducational intervention in social skills for Primary Care nurses
Revista Brasileira de Enfermagem. 2023;76(4):e20220503
DOI 10.1590/0034-7167-2022-0503
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto ,
- Maria do Carmo Fernandez Lourenço Haddad
Views0See moreABSTRACT
Objective:
to assess an educational intervention on social skills for nurses who work in Primary Health Care.
Method:
a qualitative research-intervention study, carried out in the municipalities covered by the 17th Health Regional of Paraná. It was developed in three interrelated stages: exploratory, where meetings were held with the managers to define the groups and logistics for running the course; intermediate, developed in meetings with different groups of nurses, addressing selected topics; assessment, in which the nurses developed a personal plan to improve their social skills.
Results:
participants were 57 nurses who acted as coordinators of Primary Care. They considered the educational intervention in social skills fundamental for positive changes in their professional performance.
Final considerations:
the educational intervention in social skills was assessed as an important strategy to strengthen the development of nurses’ managerial and care skills.
- Aline Loiola Moura Bianconi
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ORIGINAL ARTICLE10-09-2023
Spatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020
- Adelia Roberto Nanque ,
- Antônio Carlos Vieira Ramos ,
- Heriederson Sávio Dias Moura ,
- Thaís Zamboni Berra ,
- Reginaldo Bazon Vaz Tavares , [ … ],
- Ricardo Alexandre Arcêncio
Abstract
ORIGINAL ARTICLESpatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020
Revista Brasileira de Enfermagem. 2023;76(4):e20220481
DOI 10.1590/0034-7167-2022-0481
- Adelia Roberto Nanque ,
- Antônio Carlos Vieira Ramos ,
- Heriederson Sávio Dias Moura ,
- Thaís Zamboni Berra ,
- Reginaldo Bazon Vaz Tavares ,
- Aline Aparecida Monroe ,
- Ione Carvalho Pinto ,
- Ricardo Alexandre Arcêncio
Views0See moreABSTRACT
Objective:
to analyze the epidemiological profile, spatial and temporal distribution of tuberculosis in Guinea-Bissau from 2018 to 2020.
Methods:
an ecological study, carried out in Guinea-Bissau, considering new cases of tuberculosis. Spatial analysis of areas was used to verify tuberculosis distribution in the country, and time series were used to identify incidence evolution over the years of study.
Results:
a total of 6,840 new cases of tuberculosis were reported. Tuberculosis incidence rate in the country ranged from 36.8 to 267.7 cases/100,000 inhabitants, with emphasis on the regions of Bissau and Biombo (over 90 cases/100,000). By using time series, it was possible to observe an increase in case incidence over the years of study.
Conclusions:
the study made it possible to identify the epidemiological profile of tuberculosis in Guinea-Bissau, spatial distribution heterogeneity, in addition to identifying the disease evolution over the years of investigation.
- Adelia Roberto Nanque
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ORIGINAL ARTICLE10-09-2023
Eating habits: what foods do children between 12 and 36 months consume?
Revista Brasileira de Enfermagem. 2023;76(4):e20220393
Abstract
ORIGINAL ARTICLEEating habits: what foods do children between 12 and 36 months consume?
Revista Brasileira de Enfermagem. 2023;76(4):e20220393
DOI 10.1590/0034-7167-2022-0393
Views0See moreABSTRACT
Objective:
to identify toddlers’ eating habits.
Method:
a cross-sectional study of quantitative analysis, with a sample of 808 toddlers who attended day care centers in the district of Viseu, Portugal, between November 2018 and September 2019. Data were collected using a questionnaire directed at parents.
Results:
the prevalence of children who ate six meals a day was 42.8%, and 42.5%, those who ate five meals. It was found that 2.0% of children consumed chocolates, 1.0%, desserts, and 0.4%, carbonated beverages, daily. On average, dairy product (M=5.61; SD=2.62) and meat/fish/egg (M=4.80; SD=3.57) consumption was higher than recommended, while fat (M=0.48; SD=0.40), legume (M=0.49; SD=0.45), vegetable (M=1.18; SD=0.87) and water (M=0 .51; SD=0.29) consumption was lower.
Conclusions:
there was a higher or lower consumption than recommended for some foods, highlighting the need to implement nursing intervention programs aimed at promoting healthy eating habits in toddlers and families.
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REVIEW10-09-2023
Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review
- Anália Andréia de Araújo Nascimento ,
- Jéssica Cristina Alves de Melo ,
- Katiane Domingos Soares ,
- Anne Caroline Lisboa Marinho ,
- Sara Eloise Argimiro Ribeiro , [ … ],
- Isabelle Campos de Azevedo
Abstract
REVIEWSelf-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review
Revista Brasileira de Enfermagem. 2023;76(4):e20220383
DOI 10.1590/0034-7167-2022-0383
- Anália Andréia de Araújo Nascimento ,
- Jéssica Cristina Alves de Melo ,
- Katiane Domingos Soares ,
- Anne Caroline Lisboa Marinho ,
- Sara Eloise Argimiro Ribeiro ,
- Isabelle Campos de Azevedo
Views0See moreABSTRACT
Objective:
To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period.
Method:
Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations.
Results:
Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life.
Conclusion:
Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.
- Anália Andréia de Araújo Nascimento
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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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