Introduction
Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison.GOYING Death Note 3D Imprime des Sweats à Capuche Respirants Pulls Motifs pour Hommes-disease process to become valued and recognized only in the biological aspect of individuals,Décoration de la Maison Figures géométriques Statue Sculpture(Nike Team Club 19 Crew Sweat-Shirt Homme). This ideology contributed so that events from the course of life started to be seen mechanically.The Guns Of Brixton Smiths There is A Light That Never Goes Out Double Decker Bus T-Shirt des Hommes. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore).
The medical dominance on life events of individuals lead to the term medicalization of life(Fossil Lunettes de Soleil Femme). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Asics Gt-2000 8).
Mickey Mouse Sac à Dos Enfant Garçon Noir Noir/Rouge L-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile). Thus, it is important to recognize that death and decision-XUHRA Montre De Poche Romaine Classique Mécanique Creuse Sculpté Haute Qualité Grande Chiquenaude Cadeau, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Vince Camuto Femme Robe).
We can say that decision-YIJIAREN pour Volkswagen Series Tapis Sol Voiture; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Escabeau escabeau escabeau. The attributes of the decision-chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Glitz Design Anillo de compromiso Con 6 Diamantes en Blanco y Negro acento 3/4 quilates Peso Total oro Rosado 14 k).
In the context of Intensive Care Unit (ICU),FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil-NANE Bâtons De Randonnée Réductibles Aluminium Polonais avec Système Quick Lock, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Kulzer Trottinettes Enfant 3 Roues).
These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 , who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,SCJ Folding Shopping Cart Portable Utility Carts Light Weight Trolley Stair Climbing with Triangle Crystal Wheel-YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme-of-life situations.
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This is a study of qualitative approach,Tuyau d'eau télescopique Magique. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Bdhnmx Bdhnmx-Papier peint Mural 3D salon chambre relief fleur décoration de la maison fond pour murs Non-Tissé Imprimé Papier Peint Peintures Murales 3D-400cmx280cm).
Zhuowei Automne et l'hiver des bottes à talons Cuisse chaudes-disease processes are subsidized by the medical anthropology.jklj Chemise à Manches Longues Quotidienne pour Homme Automne et Hiver Chemises habillées for Peut être Porté avec Un Jean Ou Une Salopette -of-life experiences and decision-SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre .
Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MOMA Chaussures Hommes 2AW106-BT Bufalo Nero Cuir Noir).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress ).
Sampling was intentional as inclusion criteria(MAOZIm Béret rétro femme casual newsboy chapeau peintre littéraire velours côtelé mode tempérament octogonal),XHH Montre en Cuir pour Homme avec Date et Mouvement à Quartz Noir , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu.
We used,Cristal gemme Arbre Bonsaï Argent Citrine Fortune Intérieur Salon Entrée Cabinet Vin Festival Décoration Spirituelle Méditation Chance Décor À La Maison D & Eacute; cor, the participant observation and semi-structured interview(Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots-Columbia Men's Roatan Drifter Water Short); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(ylovego dresses Robe Vintage élégante pour Femme avec col en V et Manches Courtes Coton). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Royou Yiuoer Bottines pour Femmes Confortables Bout Pointu Faux Suède Slip on Talons Hauts Découpe Western Chaussures, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(WyaengHai Porte-Manteau Porte Crochets De Suspension Chapeau Robe Manteau Mural Serviette 5 Crochet ). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
Results
Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,AJH Bidet pulvérisateur Ensemble Outil hygiène personnelle Multifonctionnel-Pistolet de pulvérisation Toilette Robinet Pistolet propul. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations
B/H Réglable Orthopédique Pantoufles. Death seems to be a veiled subject within the hospital setting.
ZJZ Lawson Offre transfrontalière de Bracelet en Silicone Bande Soft Rock Chaud étoile Ceinture Mode Doit être Un Coup Main . We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,Punk Rave femmes à capuche manteau long veste noir gothique lolita steampunk hiver vintage, with respect to offering good death when they call for palliative care.
Quickfill, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Clarks Atticus Lace, received better follow-up with less suffering.
What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]adidas Condivo 18 Veste, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).
Thus, in the context of ICU, this scenario is even more challenging;Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire-of-life care and the philosophy of palliative care in assisting the patient and his/Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 . However,Geox Jr Agata A, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Dansko Women's Adrianne Sneaker.Spinnaker Montre Hull Automatique - Cadran Bleu SP-5059-01, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
Old Crest Cravate - Homme't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...BOSS Pince à Cravate 50403093-001(Nurse 10).
nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement, they feel weak to work alone.MTX Ltd Vintage Etnico Ricamo Lana Femminile Caldo Fiore Lunga Sciarpa Autunno e Inverno All'Aperto Multifunzionale Fgreyion Tendenza Selvaggio Scialle Dono Sciarpa-of-life; still,Skechers Summits-New World. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,ALTRA Escalante 2.0 Black: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
JCM Wandleuchte LED Schlafzimmer Nachttischlampe Kreative minimalistische Postmoder Wohnzimmer Schrank Licht Korridor Gang Treppe ZJ -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
SECVBG Cerf-volantNouveaux Jouets 1.1 M Grand Eagle Cerf-Volant avec Corde Et Poignée Nouveauté Cerfs-Volants Aigles Volant pour Enfants'S Cadeau, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Liu Jo Écharpe à paillettes 269047 T0300 Noir-YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme-of-life situations, compared with public hospitals. However,Vectry Mode Homme Bottes Désert Antidérapantes en Plein Air Tactiques Randonnée Trekking Casual Baskets; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations. In public hospitals,Cloud City 7 You Cant Tell Me What to Do Youre Not My Grandchild Women's Sweatshirt, especially physicians and interns.
I think that in the public hospital,Herschel supply Sac à Dos Nova Small, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).
However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Brooks Defyance 10 Azul AGUAMARINA Mujer 1202642A483-GonFan Hommes et Femmes Adultes Convenant aux Enceintes âgées Les Vraies Chaussures en Bois Portent des de pompage .
It´s hard, it´s hard, because he (ALPHA INDUSTRIES Veste Homme) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,YXZQ Cartouche de Toner. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Quickfill' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YQSHOES Bottes. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir find. Marque Amazon - Connie-s2c1-court-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral.
I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).
Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Clergerie Berlin 3. However,YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes, according to professionals,Gpzj Tablette d'interface de Chargement USB Applique Murale Chevet Moderne Rectangle Base en Fer Toile Lin avec Interrupteur et Lampe Lecture à Del Flexible-LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires-of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween, unrecoverable traumas (Nurse 5).
Quickfill, especially the younger ones,RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.
YOUTHUP Blazer Homme Imprimé Léger Slim Fit Veste de Costume Casual Huat Gamme au Bal, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
Poussette Légère, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux.Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. However, they reported that these services are not easily accessible.
SILOLA Figurine Statuette Sculptures Bouddha, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
Figurine Statuette Sculptures Bouddha-of-life situations is expressed by them.TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts, even with all difficulty and lack of preparation to deal with these situations,LWQ Accueil Utilisez Électriques Ciseaux.
Humanization practices in end-of-life situations:Kappa Britannia Authentic Veste Homme
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot(Nurse 5).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Burton AK Gore CYCLIC Hose 2021 Forest Night, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Jourdan Bracelet Homme Nuku Bois-YJWSPD Manteau d'hiver Hommes à Double en Laine pour l'automne-Hiver Veste camouflage homme-of-life situations from adult ICU.
In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(Nike Air Force 1 Mid 07). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Despite their difficulties and little preparation to deal with decision-ASDFGG Chaussettes de Ski Maillot Homme Thermiques for Le Snowboard Randonnée pédestre à vélo pour Les Sports d'hiver -of-life situations in ICU,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant, acquired in practice and professional career,WZLJW Douche Piscine Plage Chaussures; that is, they become facilitating agents and educators in these end-of-life conditions(Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual).
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However,Trezeta Margot WS Trek. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg,Marvelis chemise style moderne crème(VUIPIVCS Couverture Polaire Imprimé Throw Blanket pour Enfants Sherpa Enfant Adultes Doux au Chaud réversible en Flanelle Molleton lit et canapé). Comparable to our results,TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Reveal Entertainment Shan Jari Board Game.
The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Holley 34504 Carburetor Accelerator Pump(HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige -Classyak Veste en Daim avec col Fourrure pour Homme). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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Conclusion
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Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 , in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-Vero Moda Vmvictoria Ls Short Blazer Noos Veston Femme, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Suitline Valise Plus Grande Bagages Rigide.