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ERRATUM01-15-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views3In the article “The ethics of nursing care for transgender people”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 3):e20220797, in authorship: Where it read: […]See more -
01-15-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATA
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views1En el artículo “La ética del cuidado de enfermería para personas transgénero”, con número DOI: , publicado en la Revista Brasileira de Enfermagem, 2023;76( Suppl 3):e20220797, en autoría:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views2See moreABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views2In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
Views2See moreABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
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ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views2No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Social representations of oncologic surgery for patients with cancer
Revista Brasileira de Enfermagem. 2024;77(6):e20230273
Abstract
ORIGINAL ARTICLESocial representations of oncologic surgery for patients with cancer
Revista Brasileira de Enfermagem. 2024;77(6):e20230273
DOI 10.1590/0034-7167-2023-0273
Views2See moreABSTRACT
Objectives:
to analyze the social representations of patients with cancer regarding oncologic surgery.
Methods:
a qualitative study based on Social Representation Theory was conducted with 126 participants between October 2021 and May 2022 in a public hospital in Rio de Janeiro. A characterization questionnaire, free evocations of the inducing term “surgery”, and semi-structured interviews with 60 participants were applied. Data were analyzed using Microsoft Excel® and IRaMuTeQ.
Results:
the central core of the representation is composed of fear, cure, hope, and removing the disease. The analysis of interviews resulted in six classes that highlight the social changes caused by treatment as well as the need for a support network to cope with the surgical process.
Final Considerations:
the representations reflect fear and hope towards the procedure and the desire to remove the disease, thus translating the cure through surgery.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views3See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ORIGINAL ARTICLE05-18-2020
Militancy of nurses in the institutionality field: printed media versions
Revista Brasileira de Enfermagem. 2020;73(4):e20180835
Abstract
ORIGINAL ARTICLEMilitancy of nurses in the institutionality field: printed media versions
Revista Brasileira de Enfermagem. 2020;73(4):e20180835
DOI 10.1590/0034-7167-2018-0835
Views0See moreABSTRACT
Objectives:
to analyze nurses’ professional militancy in the institutionality field, presented by the printed media from Bahia State in the 1970s and 1980s.
Methods:
a historical and qualitative research under Social History’s perspective, whose data source was the newspaper A Tarde. The temporal cut-off encompasses milestones such as professional body restructuring and creation.
Results:
the Associação Brasileira de Enfermagem democratization movement was reported in a superficial way, highlighting the struggle for power spaces. With respect to Conselhos Federal e Regional de Enfermagem daBahia, the newspaper notified creation and function of bodies, however, there was no visibility to the newspaper’s performance. Concerning the union, there was political fragility of nurses against the creation and union participation in the fight for labor rights.
Final Considerations:
organization of political action occurred from isolated groups mobilization of professionals who were already traveling in political spaces, not the large mass of professionals.
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ORIGINAL ARTICLE06-08-2020
Family experience living with advanced neoplasm: a glance at the rural population
Revista Brasileira de Enfermagem. 2020;73(4):e20180895
Abstract
ORIGINAL ARTICLEFamily experience living with advanced neoplasm: a glance at the rural population
Revista Brasileira de Enfermagem. 2020;73(4):e20180895
DOI 10.1590/0034-7167-2018-0895
Views1See moreABSTRACT
Objectives:
to understand the experience of rural families living with advanced cancer, from Family Management Style Framework’s perspective.
Methods:
a qualitative research conducted in seven cities of the northern of state of Rio Grande do Sul in homes of 11 families (27 people). Data collection took place in 2014, using the genogram and narrative interview. Analysis followed Family Management Style Framework’s theoretical model.
Results:
the results were organized into three categories based on conceptual components of the referred model: no more normal life: situation definition; attempt to reconcile care and work: management behavior; imminence of the finitude of life: perception of consequences.
Final Considerations:
living in rural context gives families specific ways of dealing with advanced cancer. Understanding the movements undertaken by rural families throughout the experience can guide nursing professionals in planning interventions collaborating with this population’s health.
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ORIGINAL ARTICLE06-01-2020
Construction and validation of an educational technology for mother-child bond in the neonatal intensive care unit
Revista Brasileira de Enfermagem. 2020;73(4):e20190083
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational technology for mother-child bond in the neonatal intensive care unit
Revista Brasileira de Enfermagem. 2020;73(4):e20190083
DOI 10.1590/0034-7167-2019-0083
Views0See moreABSTRACT
Objectives:
to describe the process of construction and validation of an educational booklet to promote bonding between mothers and newborns in a Neonatal Intensive Care Unit.
Methods:
methodological study developed through data collection in the literature and with the target audience; construction of the booklet; qualification of the material through validation by judges (health and communication experts/designer) and assessment by the target audience (mothers of at-risk newborns). Data were analyzed descriptively.
Results:
booklet content was validated, obtaining an overall Content Validity Index of 0.92. Appearance was rated “Superior” with 80% percentage. Mothers performed an assessment with 100% agreement between the items.
Conclusions:
the booklet was validated in all domains assessed and can be used by mothers with children hospitalized in the Neonatal Unit.
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ORIGINAL ARTICLE06-08-2020
Risk factors for site complications of intravenous therapy in children and adolescents with cancer
Revista Brasileira de Enfermagem. 2020;73(4):e20190471
Abstract
ORIGINAL ARTICLERisk factors for site complications of intravenous therapy in children and adolescents with cancer
Revista Brasileira de Enfermagem. 2020;73(4):e20190471
DOI 10.1590/0034-7167-2019-0471
Views0See moreABSTRACT
Objectives:
to analyze predictive factors for the incidence of complications related to peripheral venous catheters in children and adolescents with cancer.
Methods:
a longitudinal follow-up study, conducted at a pediatric oncology clinic unit of a hospital in Bahia, with 333 peripheral venous catheters inserted in 77 children and 26 adolescents. Data collection took place between April 2015 and December 2016 through direct observation of peripheral intravenous catheter insertion, medical record data collection and daily observation of the puncture site.
Results:
the incidence of complications was 18.6%. The modeling of the variables confirmed that the risk factors for complications in children/adolescents with cancer were: prolonged peripheral intravenous therapy (p=0.002), history of complications (p=0.000), non-irritating/vesicant medications (p=0.003) and vesicant solutions (p=0.000).
Conclusions:
the goal has been achieved. Results can contribute to the theoretical, practical and social context.
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ORIGINAL ARTICLE07-06-2020
Nurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
Abstract
ORIGINAL ARTICLENurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
DOI 10.1590/0034-7167-2018-0923
Views1See moreABSTRACT
Objectives:
to analyze the nurses’ work process in an Emergency Hospital Service.
Methods:
a qualitative, exploratory and descriptive research conducted with 17 nurses from the emergency service of a high complexity hospital in southern Brazil. Data were collected through interviews, focus group and document analysis. Data analysis followed the thematic content analysis framework.
Results:
four categories emerged: Work environment characteristics; Assistance dimension; Management dimension; Care management.
Final Considerations:
the nurses’ work process in Emergency Hospital Service is characterized by the peculiarities of the setting, with centrality in care and care management aiming at quality care and safety to patients.
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REVIEW07-06-2020
Effectiveness of the automated drug dispensing system: systematic review and meta-analysis
Revista Brasileira de Enfermagem. 2020;73(5):e20180942
Abstract
REVIEWEffectiveness of the automated drug dispensing system: systematic review and meta-analysis
Revista Brasileira de Enfermagem. 2020;73(5):e20180942
DOI 10.1590/0034-7167-2018-0942
Views0See moreABSTRACT
Objectives:
to compare the effectiveness of the decentralized automated drug dispensing system with pockets.
Methods:
an effectiveness study based on a systematic review guided by the question: for patients admitted to hospital units, is the use of automated drug dispensing effective for reducing medication errors when compared to manual unit dose dispensing? The evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses instrument, used in the report.
Results:
the sample was composed of 15 studies and none of them directly compared both technologies; however, the meta-analysis showed that there is no difference in effectiveness between them [OR 1.03 95%CI (0,12 – 8,99)].
Conclusions:
the conclusion is that the recommendation in favor of the automated dispensing system is weak.
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ORIGINAL ARTICLE07-06-2020
Educational actions: an action research with Family Health Strategy professionals and users
Revista Brasileira de Enfermagem. 2020;73(5):e20180969
Abstract
ORIGINAL ARTICLEEducational actions: an action research with Family Health Strategy professionals and users
Revista Brasileira de Enfermagem. 2020;73(5):e20180969
DOI 10.1590/0034-7167-2018-0969
Views0See moreABSTRACT
Objectives:
to identify the factors that influence educational actions, and building with professionals and users proposed educational strategies that encourage popular participation.
Methods:
an action research, in which individual interviews, participant observation and Focus Group were conducted. Sixteen professionals and ten users from 2 Family Health Strategy from Rio Branco, Acre, Brazil participated. The results were organized by using the Thematic Analysis technique.
Results:
the thematic units emerged: Health education as a strategy that encourages changes in the lives of Family Health Strategyusers; Critical reflection on diagnosis of the causes that interfere in educational actions in the Family Health Strategy and proposition of new strategies; Potentialities that encourage the development of educational practices at Family Heath Units; Proposals for improving educational practices focused on soft health education technology in the dialogue dimension.
Conclusions:
the analysis showed a lack of community ties and traditional educational strategies. In the action phase, the actors agreed to participatory changes.
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ORIGINAL ARTICLE07-01-2020
The systems and signs of political militants in/of Brazilian nursing
Revista Brasileira de Enfermagem. 2020;73(5):e20180971
Abstract
ORIGINAL ARTICLEThe systems and signs of political militants in/of Brazilian nursing
Revista Brasileira de Enfermagem. 2020;73(5):e20180971
DOI 10.1590/0034-7167-2018-0971
Views0See moreABSTRACT
Objectives:
to analyze the systems and signs in the constitution of militant nurses.
Methods:
a historical and qualitative research based on oral history carried out with 11 nurses who had been working in the professional field since 1980. Data collected from semi-structured interviews were organized into NVivo software 10, being analyzed through dialectical hermeneutics.
Results:
systems and signs are systems that allow us to use senses, symbols or meaning to objectify and subjectivate the subject. The revealed senses were categorized and divided into improper, religious, heroic, communist, and socially involved.
Conclusions:
militancy signs are convergent with what is put in national and international literature. The difference found was in the heroic sense and implicated with the social. Militant is almost never associated with positive aspects. An individual who builds himself as a political being empowers himself as a social being, making knowledge of power, generating a break in traditional models.
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ORIGINAL ARTICLE11-10-2022
Effect of educational video on newborn care for the knowledge of pregnant and postpartum women and their families
Revista Brasileira de Enfermagem. 2022;75:e20201371
Abstract
ORIGINAL ARTICLEEffect of educational video on newborn care for the knowledge of pregnant and postpartum women and their families
Revista Brasileira de Enfermagem. 2022;75:e20201371
DOI 10.1590/0034-7167-2020-1371
Views0See moreABSTRACT
Objectives:
to evaluate the effect of educational video on newborn care to increase the knowledge of pregnant, postpartum, and family members.
Methods:
a quasi-experimental study, with pre-intervention and post-intervention evaluation with a single group. Fifty-eight pregnant, postpartum, and family members treated in basic health units and a hospital in Ceará, Brazil, participated. The study used the McNemar and binomial tests for the analysis.
Results:
after the intervention, there was an increase in the frequency of hits, from 70.82% to 92.97%. Most of the questions presented a significant increase of hits (p < 0.05) with an emphasis on sleeping position, drying of clothes, free demand for breastfeeding, and things to avoid (such as accessories in the sleeping place and talc in diaper change).
Conclusions:
the educational video was effective to participants in acquiring knowledge on the care of newborns and can assist in health education activities carried out by nurses.
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ORIGINAL ARTICLE06-27-2019
Health literacy of adults with and without arterial hypertension
Revista Brasileira de Enfermagem. 2019;72(3):646-653
Abstract
ORIGINAL ARTICLEHealth literacy of adults with and without arterial hypertension
Revista Brasileira de Enfermagem. 2019;72(3):646-653
DOI 10.1590/0034-7167-2018-0366
Views1See moreABSTRACT
Objective:
Assess the level of health literacy of adults, with and without hypertension, treated in three basic health units (UBS) in Picos, Piauí.
Methods:
Cross-sectional study conducted with 357 adults. Data were collected using a questionnaire with sociodemographic variables, and literacy was assessed by the Test of Functional Literacy in Adults. Descriptive analysis was performed followed by the association between literacy and exposure variables with Pearson’s chi-squared (X2) test and Mann-Whitney U test.
Results:
Inadequate or marginal health literacy was found in three units investigated (71.5%; 77.8% and 85.2%);. Age and the years of schooling were factors associated with inadequate literacy in adults with hypertension (p<0.0001).
Conclusion:
Inadequate literacy was found in more than 70% of the hypertensive patients investigated. This finding reinforces the need to improve the self-care skills of hypertensive patients, especially the older ones and those with few years of schooling.
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ORIGINAL ARTICLE03-30-2020
Clinical simulation in teaching Pediatric Nursing: students’ perception
Revista Brasileira de Enfermagem. 2020;73(2):e20180720
Abstract
ORIGINAL ARTICLEClinical simulation in teaching Pediatric Nursing: students’ perception
Revista Brasileira de Enfermagem. 2020;73(2):e20180720
DOI 10.1590/0034-7167-2018-0720
Views0See moreABSTRACT
Objectives:
to comprehend the perception of undergraduate nursing students about learning to care for the child and family through clinical simulation.
Methods:
this is a qualitative research conducted with ten nursing students through semi-structured interviews. Data were analyzed through content analysis.
Results:
data were organized into two categories: “learning a new way to learn,” in which students describe their experiences during the simulation, and “learning a new way to care,” in which they reflect on learning through simulation.
Final considerations:
we believe that clinical simulation practice in teaching should be encouraged because of the benefits it can offer to the students, faculty, patients and their families. However, we recommend further studies to validate scenarios of child and family healthcare.
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ORIGINAL ARTICLE10-18-2022
Methodological path to reach the degree of saturation in qualitative research: grounded theory
Revista Brasileira de Enfermagem. 2022;75(2):e20201379
Abstract
ORIGINAL ARTICLEMethodological path to reach the degree of saturation in qualitative research: grounded theory
Revista Brasileira de Enfermagem. 2022;75(2):e20201379
DOI 10.1590/0034-7167-2020-1379
Views0See moreABSTRACT
Objectives:
to achieve the degree of saturation in study that applied the grounded theory.
Methods:
qualitative research, carried out in four Family Health Units, between June 2018 and May 2019. The data from the interviews with 30 health professionals and non-participant observation were coded in the stages: open, axial and integration.
Results:
the degree of saturation was achieved by two conceptual models – theoretical saturation and inductive thematic. Theoretical saturation was considered: the development of conceptual codes and observation, in the collection and analysis of data, when they generated new categories/subcategories or only indicated increasing instances. For thematic inductive saturation, the use of new codes based on each interview stood out.
Final Considerations:
the visual layout for the number of codes, the theoretical scope of the concepts and the delimitation of the sample groups guided the identification of the degree of saturation for the development of the conceptual body that supported the substantive theory.
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08-01-2022
Monkeypox: between precision public health and stigma risk
Revista Brasileira de Enfermagem. 2022;75(5):e750501
Abstract
Monkeypox: between precision public health and stigma risk
Revista Brasileira de Enfermagem. 2022;75(5):e750501
DOI 10.1590/0034-7167.2022750501
Views0The World Health Organization (WHO) is on alert due to an unprecedented Monkeypox outbreak in non-endemic countries, such as Europe, which have been affected recently. Despite the low pandemic potential, the recent SARS-CoV-2 pandemic has contributed to heightened levels of public concern in the face of the threat of new global health emergencies().As of May […]See more -
ORIGINAL ARTICLE11-02-2020
Transitional care from hospital to home for older people: implementation of best practices
Revista Brasileira de Enfermagem. 2020;73:e20200187
Abstract
ORIGINAL ARTICLETransitional care from hospital to home for older people: implementation of best practices
Revista Brasileira de Enfermagem. 2020;73:e20200187
DOI 10.1590/0034-7167-2020-0187
Views0See moreABSTRACT
Objective:
to assess the conformity of nursing care concerning best evidence in transitional care from hospital to home for older people.
Methods:
a project to implement best evidence based on the model proposed by the Joanna Briggs Institute in surgical clinic of a university hospital with older people, caregivers or family members, and nurses, between July and August 2019. Eight evidence-based criteria have been audited through interviews, medical records and computerized system, presented in percentages.
Results:
the highest non-compliance rate found in a baseline audit was absence of continued training on transitional care and hospital discharge plan. Identifying barriers to best practices included educational programs; afterwards, there was an improvement in compliance rates in all the criteria assessed.
Final considerations:
the criteria based on audited evidence showed an increase in compliance rates with the strategies implemented, contributing to improving transitional care for older people.
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ORIGINAL ARTICLE10-21-2019
Practice challenges in patient safety
Revista Brasileira de Enfermagem. 2019;72(6):1504-1511
Abstract
ORIGINAL ARTICLEPractice challenges in patient safety
Revista Brasileira de Enfermagem. 2019;72(6):1504-1511
DOI 10.1590/0034-7167-2018-0441
Views0See moreABSTRACT
Objective:
to understand the professional practice challenges in reaching the goals and objectives of the National Patient Safety Program (Programa Nacional de Segurança do Paciente).
Method:
qualitative case study, based on the Comprehensive Sociology, carried out with 31 professionals from the Patient Safety Center (Núcleo de Segurança do Paciente) and the nursing team, working in a teaching hospital. Data collection took place between May and December 2015 through interviews, observation and documentary analysis. The analysis proceeded according to the prerogatives of the Content Analysis.
Results:
three categories emerged: the prescribed reality; material resources and their impact on care; and human resources related to the reality.
Final considerations:
challenges to safe professional practice are caused by inadequate physical structure, insufficient physical and human resources, but mainly invade the transition from the prescriptive reality scope.
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RESEARCH01-24-2017
Nurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
Abstract
RESEARCHNurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
DOI 10.1590/0034-7167-2016-0061
Views0See moreABSTRACT
Objective:
to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work.
Method:
an exploratory, descriptive study with a qualitative approach.
Results:
out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population. Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills.
Conclusion:
the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.
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