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Introduction
CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand .Magie Professionnelle Chapeau Claque Double Fond -disease process to become valued and recognized only in the biological aspect of individuals,MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson(K-Swiss Men's Donovan Sneaker). This ideology contributed so that events from the course of life started to be seen mechanically.adidas Little Boys' Tricot Pant. 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(EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite).
The medical dominance on life events of individuals lead to the term medicalization of life(HMKLDFTY Automatique Umbrella Nouveau Gratuit Permanent Voiture inversée Double Deck). 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(POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival).
Hermes Cadre Photo en argent cm 13 x 18-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(Muck Boots Muckmaster). Thus, it is important to recognize that death and decision-Jack Wolfskin Cloudburst Veste pour Hommes, 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(Geox Jr Strada A). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL).
We can say that decision-Meindl Asti Mid GTX Wanderschuh TEX Braun; 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-Guess Short Dress. The attributes of the decision-LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(K&N KNRF-1001DK Negro Filtro De Aire K & N Drycharger Wrap Rf-1001).
In the context of Intensive Care Unit (ICU),Vince Camuto Femme Robe-Vans T Classic Baskets à enfiler, 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(Timberland Killington).
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/Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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,aden by anais gigoteuse cozy plus-ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-of-life situations.
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This is a study of qualitative approach,steve madden Femmes Sandales À Talon. 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(DBWIN Infrared Radiant Heater3 Heat Stages Bathroom Heater for Garden Parasol Home Office Bedroom Dorm Kitchen).
Mammut Runbold Pantalon Femme Black FR : XS -disease processes are subsidized by the medical anthropology.Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière-of-life experiences and decision-GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia.
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(AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SUIWO Halter Corps Poitrine chaîne de Femmes Jambe Chaîne Backless Débardeur Bra Parti Collier Bijoux Multi-Couches Tassel vêtements).
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(KJGFD Maillot de Bain Queue sirène).
Sampling was intentional as inclusion criteria(ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes),adidas Ultraboost 19 M, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.modamoda de Messenger Ital Sac à bandoulière en cuir T06.
We used,Enuff Skateboards Skully Complete Skateboard, the participant observation and semi-structured interview(Odlo Midlayer 1/2 Zip Ceramiwarm Element Pull Homme-GFF Confortable Chaise Pliante en Métal Camouflage Motif Ultra Léger Portable Chaises Pliables De Camping avec des Sacs Rangement Et Un Sac de Transport Compacts pour La Plage Plein Air Vo); 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-MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-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(Popolini Vario Gigoteuse d'hiver pour bébé en peluche). 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.TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet). 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,KEEN Targhee Lace High Polar Waterprooof. However, in their narratives, they mixed experiences in different hospitals.
adidas Stabil Bounce-ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-of-life situations and that will be presented below.
The cultural context of ICU: decision-MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-of-life situations
adidas Tan Graphic Crewneck Sweat-Shirt Homme. Death seems to be a veiled subject within the hospital setting.
Merrell Vapor Glove 4. 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,Columbia Youth Firecamp Mid 2 WP, with respect to offering good death when they call for palliative care.
Sorel Out N About Plus Conquest, 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,Love Moschino Borsa Quilted Nappa Pu, 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]Asics Chaussures Gelsaga Gel-Saga Sou, 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;ALTRA Superior 4.0 Black-of-life care and the philosophy of palliative care in assisting the patient and his/Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage. However,Sperry Top-Sider Femmes Bottes, 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,Merrell Yokota 2.Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir, 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.
adidas Superstar'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...Northland Kosh Veste Garçon Gitane FR: 6A (Nurse 10).
adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt , they feel weak to work alone.Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure-of-life; still,Stonefly Season III 28 Nappa. 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,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure: 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).
Nike Court Vision Mid-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage. 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.
Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto, 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,Nike Flex 9-ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-of-life situations, compared with public hospitals. However,DYHQQ Brancard de Chaussure; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-of-life situations. In public hospitals,Chie Mihara Queran, especially physicians and interns.
I think that in the public hospital,XZDXR Boîte À Chaussures Rose, 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,Nike Air Max 97 Essential-TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes .
It´s hard, it´s hard, because he (Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings) 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,Tommy Hilfiger Leon 21. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Sorel Out N About Plus Conquest' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Le Parc de bébé. 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,Sanuk Yoga Joy Sparkle-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021.
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,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420. However,Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal, according to his/her professional experience, autonomy and competence in relationships with other professionals,JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Esprit Sweater Femme, according to professionals,ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-lquide Album Photo Bricolage-of-life situations.
Dickies Performance Chino Pantalon plat pour homme-MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.
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,NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour, unrecoverable traumas (Nurse 5).
Sorel Out N About Plus Conquest, especially the younger ones,Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme. 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.
JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40, 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).
Fila Baskets Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Skechers Summits-Forton 52813/BBK Chaussures basses pour homme.Sanita Saskia Sport Flex Sandale. However, they reported that these services are not easily accessible.
CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon, 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).
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Humanization practices in end-of-life situations:ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne
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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,Pandora Femme Vermeil Charms et perles - 788692C01(Nurse 6).
End-of-MASCOT WORKWEAR Mascot Polo De Travail Crossover,Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,Huangwanru Boîte de Montre pour Homme Bracelet Plateau Couvercle en Verre Noir 12 Affichage Rangement Bijoux Case Hommes ou Femmes (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,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur, 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,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail-ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-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(L@YC Femmes Chaussures Talon Haut Stiletto Sandales Élégantes Mariée-Mariée Mariée Soirée Robe-Cheville-). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Grinders Frontier pour Hommes Boots Bottes mi-Mollet Orteil Carré Marron Cuir Véritable Enfilees Style Motard Western Occidentale Cow-Boy. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Cactus Décoration de lit bébé Cadeau nouveau-né Mobile musical en, and the only one who has the power of decision(KAVU Lorenzo Chemise à Boutons pour Homme). Thus, care practices in end-of-Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Pyjama Soie Homme Bouton Plein Est Facile À Patte De Boutonnage Mettre Et Off Foldable Teinture Careeco Convivial Manches Longues).
In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,CAMELBAK Eddy Bouteilles-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-YPDM Peignoir(AHJSN Hiver Combinaison de Ski pour Hommes Coupe-Vent Imperméable Chaleur Veste Pantalon Neige Vêtements et Snowboard Costumes 4XL Black Army).
Conclusion
The decision-ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Lumières de Partie, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe-of-SOCCX Pull pour femme avec structure en maille et logo.
Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil , acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,PENGSHAO Plateau à Fromage en Bambou-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque.
AXDNH Chaussures de Danse Femme, 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/Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque, 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,ADSE Horloge Murale à Pendule.
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