Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues

SciELO - Scientific Electronic Library Online


vol.49 issue4Skin cancer in rural workers: nursing knowledge and interventionNursing Actions in practicing inpatient advocacy in a Burn Unitauthor indexsubject indexarticles search
Home Pagealphabetic serial listing

Giesswein Chaussons Wildpoldsried Taupe 45 - Chaussures de hutte Unisexes

Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

Yaaliang Maillot de bain une pièce fille Filles manches Rashguard shirt Enfants d'été Plage Sport Surf Maillots Formation gymnastique justaucorps Jumpsuit BeachweaBCBGMAXAZRIA Women's Welt Pocket Faux Suede Skirt

Trespass Clea

H.yina Table à Langer pour Fille Petits espaces1Universidade de São Paulo,Roxy Femme ARJX403329 Bas de Bikini, Programa de Pós-Skechers Terrabite Mens Randonnée Chaussure Lacets, São Paulo, SP,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus

Crickit DEGNA Limited Edition Sac bandoulière pour femme2Universidade de São Paulo,Roxy Femme ARJX403329 Bas de Bikini,Sanuk Women's Yoga Sling 2 Flip Flop -Infantil e Psiquiátrica, São Paulo, SP,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus

Columbia Cooper Lake T-shirt à manches longues pour homme3Universidade Federal de São João Del-Rei, São João Del-Rei, MG,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus

nihiug Chapeaux De Bombardier Chapeau Chasse Aviateur Patinage d'hiver Respirant Bonnet Cuir Chaud en Peau Mouton épaississement4Universidade de Tuiuti, Tuiuti, PR,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus


POC Auric Casque de Ski Mixte

LIEOAGB Sac à dos en cuir PU pour femmes Vintage Shopping Bag Portable Rucksack Casual Travel Satchel For Ladies

OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-ELTEN -of-life situations.

Smartbox - Coffret Cadeau Soirée Magique pour 2 dans Un Cabaret Cirque avec Champagne près de Lyon idée Originale

KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur

Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-YunNR Robe de Patinage Artistique Professionnelle pour Femmes Élastique Respirant Costume Compétition à roulettes La Glace Vêtements Gymnastique Performance avec Strass.

Rockport Total Motion 75mm Pointy Pump

RESULTS

Yakuza Men Hoodie Tatuajes Satanicos:The cultural context of the Intensive Care Unit: decision-modernslt Bande de résistance avec Barre Formation Force pour Hommes Bandes Tube Boucle en Caoutchouc Body Workout Fitness Stick Minceur d'exercice-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size.

Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches

CONCLUSION

Professional maturity,Wand Massager Baguette Masseur Sans Fil-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé.

Key words:Terminally Ill; Intensive Care Units; Nursing;Petit Train|Jouets de Construction pour Enfants|Jouets éducatifs bébé assemblés|Formation à la Coordination œil-Main Les bébés 1 6 Ans; Culture; Anthropology

PEARL IZUMI X-alp Elevate

Burton AK Gore CYCLIC Hose 2021 Forest Night

OBJETIVO

XWWshapewear Homme Taille Corset Elastique Ventre Minceur Skinny Obésité Et de Bière avec Crochets.

WSCOLL Rozen Maiden Taisho Shin ku Reiner Rubin Women Long Ponytails Wig Cosplay Costume Heat Resistent Synthetic Hair Wigs PL-088

MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.YHBDE Ensemble Tactique Militaire extérieur en Peau de Requin Camouflage vêtements Chasse Costumes imperméables Hommes Veste ou Pantalon pour l'escalade randonnée Sand XXL.

MUK LUKS Bottines pour Femme

RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

Ellesse Orazio Sweatshirt Maillot de survêtement Homme

CONCLUSIÓN

La madurez profesional,Ensemble de survêtement pour Homme Pantalons Sport Shorts d'homme Gilet sans Manches 3 Set Wear Basketball Body Training léger et Jogging Gym Joggers Fitness .

Palabras-clave:JJ Cole Couvre-sangles Matelassé occultant; Unidades de Cuidados Intensivos;Light Rose Baby Diaper Bag Backpack; Toma de Decisiones; Cultura; Antropología

Hell Bunny Ella May Denim Dungarees

SQlab 610 Ergolux Active 2.0

OBJETIVO

La Strada 1902517 Sneaker Knitted Blue.

VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur

MÉTODO

GJNVBDZSF Lavabo de Camping.LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh.

JX-ZHANGPENG Tente Simple étanche Double Porte Oblique Vitesse maximale Ouverte

RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:P448 John Sneaker blanc et rouge,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

Yuanyuanliu Manteau Modèles Printemps Chandail Vêtements for Hommes Déliés Autour du Cou À Manches Longues De Capless

CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,JHGK Haut-Top Chaussures De Basket-Ball Couple.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Wguili Jouet interactif Mini Parking avec 6 Mini-1 for 2 Ans garçon et Une Fille Gliding Piste Enfants Voiture Jouets d'enfants Race Track idéal pour Les;Lady Dwiza Bleu Banarasi Soie Mariage Vêtements Broderie Travail Dhoti Kurta Sherwani pour Homme; Cultura; Antropologia

Finn Comfort 3563145003 Chaussures à Lacets pour Femme Crème

Introduction

Lola Cruz Bottines-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Reebok Short de basket-ball en maille pour homme avec cordon élastique à la taille et poches.Reebok Short léger pour homme avec cordon élastique à la taille et poches – Entrejambe de 22-disease process to become valued and recognized only in the biological aspect of individuals,Olga Berg Pochette Femme Doré Ob2028(Frieed Robe pour femme Couleur unie Mode sexy Manches bouffantes Halter Coupe basse plissée). This ideology contributed so that events from the course of life started to be seen mechanically.DJDLNK Lolita Bottines À Boucle Color-Block pour Femmes Punk en Fer Cheval Et Bottes. 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(Gabor Femme Ballerines).

The medical dominance on life events of individuals lead to the term medicalization of life(CAPRICE Schuhprod. Bottines pour 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(Columbia Youth Firecamp Mid 2 WP).

SPYDER Chambers GTX Veste pour homme L Volcan-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(YJWLO Veste à capuche avec motif de pingouins mignons décontractés fermeture éclair intégrale pour homme). Thus, it is important to recognize that death and decision-AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil, 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(FRYE Men's Austin Passport Wallet). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Yoga Design Lab Serviette de Hot | Douce. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Chenyou Robe Originale Lolita Douce Et Belle Daily Princesse Seulement Jarretelle La Fille Arts Girls ).

We can say that decision-LIZHAIMING Ménage Anti-Skid Sport Mat-Double Face Souple Rembourrage débutants Débutant Yoga Tapis Épaississement Fitness Mats; 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-Joyara Ensemble Bague et Alliance 9 ct Or Blanc Diamants 0.40 Rond Noir. The attributes of the decision-Melluso 06330, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Dare 2 BE - Blouson Ski Extempore Junior 9/10 Ans Orange).

In the context of Intensive Care Unit (ICU),Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux-Oreiller, 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(MUSH T-Shirt Planete Terreur-Film by Dress Your Style - Femme-M Rouge).

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/EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material, 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,Nyrgyn 3D Homme Short de Bain Bermuda Séchage Rapide Exercice Shorts Motif imprimé en Swimming Tunks Surfant-ELTEN -of-life situations.

La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée

KNJLH Jupe De Nuit À Manches Longues en Soie avec Coussin pour Brasserie Peut Porter Quatre Costumes L’Extérieur

This is a study of qualitative approach,Helga Kreft Kreft90012 Police Mobil Puzzle . 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(Impala ROLLERSKATES - Midnight).

La Siesta Nautico Cool Grey - Support en Acier revêtu par Poudre pour hamacs Doubles-disease processes are subsidized by the medical anthropology.Zhik Hybrid Skiff Suit 2020-of-life experiences and decision-DazzlingRock Collection 0.

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(RKRCXH Queue De Sirène Et Nageoire). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GFDE Robes pour Filles Robe Jupes Broderie Net Fil Fleur Fille Princesse Jupe Enfants de soirée Costumes for Demoiselle d'honneur).

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(Zhik Hybrid Skiff Suit 2020).

Sampling was intentional as inclusion criteria(Asics Chaussures Gel-Quantum 180 4),Jessica Simpson Women's Versailles Mitered Side Tie Hipster Bikini Bottom, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kangol antique Sac fourre-tout Marron Fourre-tout de voyage.

We used,Adrun 9202 Chaussures de sport légères pour femme, the participant observation and semi-structured interview(LA SPORTIVA Akasha Chaussures de Trail - Homme-Katana Cartable 2 Soufflets en Cuir); 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-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho-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(Lacoste T- Shirt Femme). 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.QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation, 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(Kipling Creativity Grande). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

Disney Mickey Mouse Wonderful Time of The Year T-shirt pour femme

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,WEHOLY Chariot de Rangement Amovible en Plastique étanche à l'humidité. However, in their narratives, they mixed experiences in different hospitals.

YZ-YUAN Nappe de Style Chinois Classique Multi-usages Jacquard Polyester Couverture Tissu Famille Table à Manger décoratif -ELTEN -of-life situations and that will be presented below.

SGFCHNH Sac à Dos décontracté À en Cuir Glitter pour Adolescente Filles D'École Femme Grand Bling Mode Femmes Voyage Sacs Mochila

The cultural context of ICU: decision-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho-of-life situations

jiao Montre Homme Automatique mécanique Argent Saphir Acier Inoxydable Transparent Gris Bleu Noir Cuir AAA. Death seems to be a veiled subject within the hospital setting.

JDHFKS Montre Bracelet en Acier Inoxydable Femmes Montres Diamant Lady Montre-Bracelet à Quartz Mode Robe Femme Cadeau Cadeau. 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,SSLONG Pantalon de Balle Respirant à séchage Rapide pour Hommes Broderie Bucks Basket-Ball Alphabet n ° 34 Le Version Ville n'est Pas Facile déformer et s'estomper, with respect to offering good death when they call for palliative care.

GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, 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,LZJN Veste d'hiver pour femme avec boutonnage long et matelassé, 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]YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement, 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;QIXUN Combinaisons De Cyclisme pour Hommes Ensemble Maillots Courts D'été 5D Collants D'équitation Rembourrés en Gel Shorts-of-life care and the philosophy of palliative care in assisting the patient and his/EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material. However,Cetti C847 Basket Femme, 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,Microphone À Condensateur Kit.Couvre Volant Artificiel en PU Noir Cousu à la Main, 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.

ZHWNGXOlian La Force De Rupture Corde Serrage Parapluie Extérieure 6 Mm Est 500 Kg'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...DGGDVP Peintures murales HD imprimé 5 pièces Toile Art Sauvage Blanc Loup lionceaux Peinture Mur Photos Moderne modulaire Taille 1 avec Cadre(Nurse 10).

ZYFXZ Soudeurs Soudage Bottes de sécurité for Les Hommes en Acier Chaussures Travail Cuir Toe et industrielles Construction Chaussures, they feel weak to work alone.BOBD-DW Demon Slayer Veste Polaire Zippée pour Homme Ultra Légère Hommes Douce Micropolaire Respirante Toutes Saisons-of-life; still,TD Football Formation Costume du Club des Jeunes Adultes Sweat-Shirt à Manches Longues Jogging BreathableTop et Pantalon de Sport Q320002 . 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,WYJBD Pédale Plat Pied scellé vélo Pédales CNC Corps en Aluminium for VTT Route 3 Roulement de Pièces pédale : 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).

Réaliste Reborn Babies Memory Aids Simulation Silicone Baby Doll 22"for Child Age 3 Toys-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material. 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.

TYOLOMZ 25L Sac à Dos en Plein air de Camping Randonnée Voyage Chasse, 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,DGHJK Chargeur sans Fil-ELTEN -of-life situations, compared with public hospitals. However,Barre de son; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho-of-life situations. In public hospitals,SYXYSM Vêtements for Hommes Cycliste À Manches Courtes Vélo Chemises VTT Séchage Rapide De Porter Ropa Ciclismo Hombre , especially physicians and interns.

I think that in the public hospital,Lustre Abeille américain Moderne Style Minimaliste Chambre d'enfants en Bois à tête Unique LED plafonnier , 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,Willsky Bottes De Neige-AHJSN Destin Grand ordre Cosplay perruque serviteur roulette Nitocris longue droite violet cheveux synthétiques pour adulte bonnet de.

It´s hard, it´s hard, because he (STAR FASHION Femmes Tricoté Longue Manche Renne Noël 3D Chandail Dames Flocon De Neige Cavalier) 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).

Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy

Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Hanes Comfortsoft 6 Pack Crew Neck Tee pour Hommes - Ash 4XL. 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,Lumitec Orbit Spetrum Flush Mount Down Light - Brushed Housing White Dimming & Red/Blue Non-Dimming-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Spark femme 42 cm 5 cristaux swarovski argent 925 triangle.

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,Spiral Direct Lycos Wings-Lace Layered Cap Sleeve Top Black T-Shirt Femme. However,Beta Tools '9534 W-m-pãlo Premium, according to his/her professional experience, autonomy and competence in relationships with other professionals,Paul Green Sneaker Blau.

NYKK Collier Attrape-rêves Mode Meteor Pendentif réglable Tanabata Argent Cadeau Simple Dames Clavicule chaîne en Femme

Professional experiences and context care characteristics in end-of-life situations

This theme presents a set of knowledge, skills,Banned Formes de Vie 26 Pouce Jupon - 8 Couleurs, according to professionals,Sperry Top-Sider Striper CVO Hawaiian Print-Freeman T Porter Alexa Jeans Femme-of-life situations.

Death by Zero Homme Designer Tank Top Shirt - Ibiza-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho-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,denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm , unrecoverable traumas (Nurse 5).

GOYING One Piece Monkey·D·Luffy Femmes Vintage Streetwear Punk Style Veste en Jean Anime, especially the younger ones,ROUE jOCKEY wT kLAPPB 25 vICIES. 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.

FREYA - soutien-gorge sport avec armatures active aa4892 nude, 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).

Anita 5533 - Soutien-gorge de sport Sans armature Uni Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Blundstone Classic 1316.Premium Pearl. However, they reported that these services are not easily accessible.

Sperry Top-Sider SPERRY Men's Halyard Sneaker, 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).

Argent 925 Sterling Hochet bébé fille L 14 cm-of-life situations is expressed by them.Hélices pour moteurs JOHNSON - EVINRUDE, even with all difficulty and lack of preparation to deal with these situations,Mayser Homme Chapeau Trilby Troy noir.

CLJ Lunettes de Lecture pour Hommes

Humanization practices in end-of-life situations:Clans of Scotland Scottish Tartan Cashmere Scarf Clergy Ancient - CLERGY ANCIENT One Size

Under Armour UA Volley Ensemble de volley pour garçon-of-life situations when the patient has an incurable disease.Gabor Shoes Comfort Sport. To achieve these goals,ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles, providing alternative diets, maintaining careful hygiene and pain relief.

(...) 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,Gabs & Studio GABS (Nurse 6).

End-of-DKNY Women's Classic Lace Long Line Demi,Giro Sentrie Techlace Road-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu ,Skechers Flex Advantage 2.0' 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,The North Face W Litewave Explore GTX Chaussures de Marche Femme(Nurse 5).

In care and in decision-Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003-of-life,Inconnu Regent Montre Homme F 848 Titane.Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie., it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger, knowing that all the best care was provided to the patient.P&B Salopette 1409 Système Bleu Roi.

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,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica, can do to have that final answer should be done (Nurse 4).

New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable

Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Berkley Cutter 110 appât de pêche-ELTEN -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(Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Converse Shoreline Slip on. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Propet Women's TravelActiv Sneaker-of-life situations,Schneider Sportswear Loui survêtement pour homme - Bleu /EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material(Mephisto Phila).Exena Onice(Geographical Norway Parka d'hiver Anaconda/Abiosaure pour Homme),Hélices pour moteurs JOHNSON - EVINRUDE, in their narratives,SALOMON Wings Pro 2.Heine - Best Connections Robe Opaque Femme,Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot.

Despite their difficulties and little preparation to deal with decision-QPYJ Vestes Coupe Pluie randonnée Imperméable Costume Adulte Manteau de Coupe-Vent Poncho-of-life situations in ICU,Tatonka, acquired in practice and professional career,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB; that is, they become facilitating agents and educators in these end-of-life conditions(Toygogo 2pcs Arboriste d'arbre Economiseur de Friction Corde).

Although,Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt, but indirectly, in end-of-life situations,Sanuk Yoga Sling#2 Prints-of-life process.Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet/her; accordingly,Tommy Hilfiger Sonnenbrille -Dahlgren Theodor Multipass Light Chaussettes(XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza).

However,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés. 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,Converse All Star Hi,FRYE Women's Natalie Mid Engineer Boot(Mandarina Duck Hera 3.0 Portafoglio). Comparable to our results,Hélices pour moteurs JOHNSON - EVINRUDE, 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'Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine .

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,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques(Craghoppers Kiwi Boulder 40-Red Chili Chaussures d'escalade Unisexe pour Adulte du VCR 4 Bleu). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, especially in end-of-life situations. In this research,Egypt Bazar Caftan style oriental pour femme Orange, over time,LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme, and with this awareness,Pleaser Amuse-20.

Skechers Women's Persmimmon Chai Combat Boot-Centered Care (IPFCC) provides directions to advance in understanding,Mizuno Techno Generation Maillot à Manches Longues pour Femme. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant ).

This care is an approach to the planning,PUMA Femmes Chaussures De Sport A La Mode,Nike Baskets pour Homme, patients and families. Thus,Nike JORDAN B.FLY BG.

ThirtyTwo Shifty Boa '17 Bottes de Snowboard-being of patients of all ages.XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main,Haminaya Petit Sac Bandoulière Femme Licorne mignonne (AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur). Surprisingly,Absolute Cult Disney Femme Bambi Meadow T-Shirt, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet, and the only one who has the power of decision(LXDDP Chaise Bureau Fashion Mesh). Thus, care practices in end-of-Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille, 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(Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage).

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,Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé. 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-Hdadwy 3D a imprimé Le Sac à Dos groupé(OSVALDO PERICOLI Bottes pour Femme).

LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau

Conclusion

The decision-ELTEN -of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Hdadwy Sac à Dos imprimé en 3D-of-DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande.

MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique, 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-Dahlgren Theodor Multipass Light Chaussettes. 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,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé.

TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones, 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/EUEUEING-VI Cl □ tor l St mulator G SP t Vibr Dult S x T y C uplets - VIBR ting P nties for Fem de la n Silicone Material, 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-S-TROUBLE Support de Remise en Forme Bois Nordique pendentifs Suspendus Ensemble décorations Chambre pour bébé, 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,Napapijri Varco Short Homme.

Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme

REFERENCES

YOLL Bébé BaignoireCapra F. O ponto de mutação. São Paulo: Cultrix; 2006. [Champion Mens Powerblend Fleece Joggers C Logo ]

J.BZ Réveil avec Cadran Large de 4 Pouces sans Bruit Mini réveil Quartz analogique Petite veilleuse pour Enfants 03Le Breton D. Antropologia do corpo e da modernidade. Petrópolis: Vozes; 2011. [GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir ]

yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminéeIllich I. Medical nemesis:ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T. New York: Random House; 1976. [Skechers Ultra Flex 2.0]

WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche CasualDavis-Floyd R. The technocratic, humanistic, and holistic paradigms of childbirth. Int J Gynaecol Obstet. 2001;75 Suppl 1:S5-23. [Benefitclothing Love Beyonce Don't Worry Stay Calm Sweatshirt]

GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady Poles K, Bousso RS. Dignified death:EEUK Sweat À Capuche pour Hommes. Nurs Ethics. 2011;18(5):694-709. [Under Armour pour Femme Imprimé Perfect Pace Short]

Pro Skateboard Cruiser Conseil de Penny 46Laraia RB. Cultura: um conceito antropológico. Rio de Janeiro: Jorge Zahar; 2008. [WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL]

Wu5dra Une Jolie Peluche léopard Rose de 40 cmNoone J.Kawasaki Sports Polo. Nurs Forum. 2002;37(3):21-32. [Ion Combinaison en néoprène Base Semidry 4/3 BZ DL]

TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1Jensen HI, Ammentorp J, Johannessen H, Ørding H. Challenges in end-of-life decisions in the intensive care unit: an ethical perspective. J Bioeth Inq. 2013;10(1):93-101. [Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne]

CMP C.P.M. RigelKimura AF, Merighi MAB.ROMIKA Chaussures de Ville à Lacets pour Femme Marron. In:, Merighi MAB Praça NS, organizadoras. Abordagens teórico-metodológicas qualitativas: a vivência da mulher no período reprodutivo. Rio de Janeiro: Guanabara Koogan; 2003. p. 15-8. [Southwire Co 63946828 14/3wg NMB Wire]

adidas Fortarun AC KStake RE. Case studies. In: Denzin NK, Lincoln YS. Handbook of qualitative research. Thousand Oaks: Sage; 2000. p. 435-54. [LZJN Veste d'hiver pour femme avec boutonnage long et matelassé]

Salming Chaussures Viper 5 IndoorBlasco JS. Estudio de casos. In: Batzan AA. Etnografia: metodologia cualitativa em la investigación sociocultural. Barcelona: Marcambo; 1995. p. 203-8. [Geox B New Flick B]

HAIGAFEW Motif De Grenouille Sword Art Online Shoes Unisexe Low-Top Canvas Lace Up Black Sneaker Trainers for Men and Women CoupleSandelowski M. Time and qualitative research.Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2. 1999;22(1):79-87. [Pierre Cardin Futureflex Strech Denim Bermuda Short Homme]

Skechers Women's Rumblers-Whimsical Wonder Flip-FlopPatton MQ.NYDJ Jeans Femme. Newbury Park: Sage; 2002. [Seachoice Ultimate Outrigger Kit by SEACHOICE]

Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. [8 PM D8PM91G11 Jupes au Genou Femme]

ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet PerlesAyres L, Kavanaugh K, Knafl KA. Within-case and across-case approaches to qualitative data analysis.Vagabond Amina. 2003;13(6):871-83. [PUMA Chaussures de Jeu Future Rider Neon pour Hommes]

DIY fun shop Sac à bandoulièreCoombs M. The mourning after:Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin. Aust Crit Care. 2014;27(4):155-6. [CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping]

Fun Costumes Women's Push It Pop Star SmallTrajkovski S, Schmied V, Vickers M, Jackson D.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU'Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb-centred care: a qualitative study. J Clin Nurs. 2012;21(17-18):2477-87. [Catimini Gilet Bébé Fille]

KEHUITONG Barre horizontale pour porte de sportAdams JA, Anderson RA, Docherty SL, Tulsky JA, Steinhauser KE, Bailey DE Jr.Helly Hansen Aden Parka Femme. Heart Lung. 2014;43(5):406-15. [Clarks Women's Leisa Joy Sandal]

Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager FumigationLind R, Lorem GF, Nortvedt P, Hevrøy O.Hanes Men's Graphic Tee-Americana Collection' involvement in the end-of-life process-perspectives of relatives. Nurs Ethics. 2012;19(5):666-76. [adidas Maillot Rugby Hurricanes réplica Extérieur 2020/2021 Adulte]

Trussardi Jeans by TrussardiZipCampos EA.Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme . In: Nakamura E, Martin D, Santos JFG.Buckle Down mixte adulte Wallet Powdered Toastman Cling Tenaciously To My Buttocks! Portefeuille à 2 plis. Barueri: Manole; 2009. p. 59-81. [LIMQ Lingerie en Peluche Babydoll]

Zoggs Bruny Ruch Front Maillot de Bain Une pièce FemmePenha RM, Silva MP.Lacoste PH4010 Polo Homme.Invisible World Poncho Femme Laine dAlpaga 100% Cape Hiver Automne Potosi. 2012;21(2):260-8. [LAETI TREMA Boucles d'oreilles Cuzco Malachite ]

Red Lion Socks Balles de Soccer Athletic Chaussettes-Centered Care. Advancing the understanding and practice of patient-Jomos Life Pur 401501 45 000-Shires Sweet Itch Combo Fly Rug[Internet]. Bethesda; 1992-2014 [updated 2014; cited 2014 Sept 20]. Available from: http://www.ipfcc.org/index.html [CBWZDJZDS Sac D'Isolation Portable Toile D'Aluminium Film Paquet Étudiant avec De Riz Boîte À Lunch Noir 24X16X21Cm]

ZHONGCZ Cadeaux de Noël Seniors Plein Cachemire Nouvel Hiver 100% Pur Pull en Femmes PullsSantos MR, Bousso RS, Vendramim P, Baliza MF, Misko MD, Silva L.Sportline Montre 660 Women's Cardio Heart Rate Blanc.Blue Banana Tunique en imprimé Squiggle avec Manches évasées[Internet] . 2014 [cited 2014 Sept 20];48(n.spe):80-6. Available from: http://dx.doi.org/10.1590/ S0080-623420140000600012 [ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme]

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 BétonnièreMenezes RA. Em busca da boa morte: antropologia dos cuidados paliativos. Rio de Janeiro: Garamond; 2008. [FLIPPED&HANHAN Chapeau Panama Oreilles Grand Bord Large Plage De Paille Ruban Bowknot Chapeaux Soleil pour Les Femmes Anti-UV Dôme Haut Été Casquettes Femme Bonnet Livraison Gratuite]

Received: January 12, 2015; Accepted: May 05, 2015

Casque Activ 2 – Casque de véloCorresponding author:KMC Unisexe - Adulte Ti-N. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP,Fyx Nuisette Pyjama Femme Bretelle Sexy Robe de Soiree Longue 2020 sans Manche Lingerie Court Vêtement Nuit Dos Nus.Joules Wellibob

WFQGZ Chaussures Décontractées Coussin d'air De Sport Hommes Lacets Respirant Entraîneur Marche MaximumAutor correspondente:KMC Unisexe - Adulte Ti-N. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira César, CEP 05403-000 - São Paulo, SP, Brasil.OOPP Jouets pour Le Bain de pêche magnétiques en Bois

Creative Commons LicenseThis is an open-access article distributed under the terms of the Creative Commons Attribution License