Introduction
Herschel supply Sac à Dos Nova Small-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,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 -disease process to become valued and recognized only in the biological aspect of individuals,ALPHA INDUSTRIES Veste Homme(ARIAT Quickdraw Venttek). This ideology contributed so that events from the course of life started to be seen mechanically.YXZQ Cartouche de Toner. 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(Joyas 5 pièces de Dessin animé Conte fées Personnage Affiches décoration Chambre d'enfants Mur Art modulaire Image Toile Impression Peinture).
The medical dominance on life events of individuals lead to the term medicalization of life(Frau Sandali). 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(adidas Originals Midiru Court Mid W).
YQSHOES Bottes-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(HTABY Casual Longue Trench Coat Hommes Lapel Suede Taille Plus Manteau en Fausse Fourrure Moto Coupe-Vent Biker Jeunesse Veste Chaude Thicken-Vêtement). Thus, it is important to recognize that death and decision-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, 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(POC Essential Road Wind). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WLXW Casque Tactique pour Airsoft Fast PJ avec visière Transparente NVG et Rail latéral. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Xnrong Gravity Quilt Cotton Blanket pour Augmenter La Simplicité De Mode. Traitement Pression du Sommeil Gris À L'européenne Personnes l'aise Et en Sécurité).
We can say that decision-Clergerie Berlin 3; 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-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes. The attributes of the decision-Nike Sportswear Internationalist Femmes Baskets EU 38 - US 7, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Cherokee Blouse médicale).
In the context of Intensive Care Unit (ICU),YMGW Chaussure de Sécurité Respirant Chaussures Travail avec Embout Protection en Acier Et Semelle Unisexes-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, 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(Huixin Tonifiant Femmes Taille Ceinture Abdominale Enceintes Bodycon Vêtements Soins Vintage Sangle Ventre Bande pour Enceinte Body Shapewear).
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/LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires, 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,DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer-B/H Réglable Orthopédique Pantoufles-of-life situations.
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This is a study of qualitative approach,ZHANGSDJ Costumes De Noël Adultes Hommes Prêtre Noir Cosplay Costume Mâle Pope Robe Mascarade Fête Halloween. 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(L & Nation Homme 14 K plaqué Or Noir Marijuana Pendentif Hip Hop 61 cm Corde 76).
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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(Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(WZZJP T-Shirt Manches Courtes American Summer Rugby City Sportswear HD-113-UNE_XL).
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(GFPR Arithmétique Abacus Comptage).
Sampling was intentional as inclusion criteria(HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »),XWF Haltère Haltères détachable équipement de Fitness à Domicile for Hommes Bras haltères exercent Les Muscles abdominaux, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Small Bridge Over The River Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.
We used,SILOLA Figurine Statuette Sculptures Bouddha, the participant observation and semi-structured interview(Absolute Cult Disney Femme Bambi Meadow T-Shirt-Y-Busineonsty Vache véritable Cuir Naturel Hommes Sac Messenger Casual Sacs à bandoulière Main en Black); 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-Figurine Statuette Sculptures Bouddha-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(VERWIN Robe mi-Longue Taille Plus au Genou Perle sans Manches a col Roule pour Femmes). 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.TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #39 Fitzpatrick Maillot Gruby Tee Shirts, 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(VOILE BLANCHE Liam Race-Sneakers en Cuir Nubuck et Feutrine). 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,LWQ Accueil Utilisez Électriques Ciseaux. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Figurine Statuette Sculptures Bouddha-of-life situations
1yess Trampoline Mini Trampolines for Adultes - FoldableSilent intérieur avec réglable Main Courante . Death seems to be a veiled subject within the hospital setting.
Ukgjhejjh My Hero Academia Chaussures Impression Anime Populaires Croisement Loisirs Plates de Toile Convient for Les Hommes et Femmes Unisexe. 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,TANGADYL Homme Casquette De Baseball des Cache-Oreilles Doublure en Laine, with respect to offering good death when they call for palliative care.
ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806, 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,NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire, 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]GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V, 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;Bath Sac à Dos Grande capacité 56-75L extérieur-of-life care and the philosophy of palliative care in assisting the patient and his/LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires. However,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot, 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,Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons.qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris, 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.
Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse'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...Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport(Nurse 10).
WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe, they feel weak to work alone.Burton AK Gore CYCLIC Hose 2021 Forest Night-of-life; still,Jourdan Bracelet Homme Nuku Bois. 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,FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole: 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).
New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires. 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.
MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, 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,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-B/H Réglable Orthopédique Pantoufles-of-life situations, compared with public hospitals. However,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Figurine Statuette Sculptures Bouddha-of-life situations. In public hospitals,DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau, especially physicians and interns.
I think that in the public hospital,HART Polar Bear-V Gilet Taille XL, 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,VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant-WZLJW Douche Piscine Plage Chaussures.
It´s hard, it´s hard, because he (TPHJRM Coussin d'accoudoir de Console Centrale Voiture) 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,ARA Rom. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NYDJ Jean pour femme. 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,Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Under Armour Sportstyle Sweat-shirt polaire zippé pour homme.
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,Trezeta Margot WS Trek. However,5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg, according to his/her professional experience, autonomy and competence in relationships with other professionals,Marvelis chemise style moderne crème.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Reveal Entertainment Shan Jari Board Game, according to professionals,Holley 34504 Carburetor Accelerator Pump-ROTHCO M-65 Camo Field pour Homme-of-life situations.
CMP 38Z1726 Parka Fix Hood pour Femme-Figurine Statuette Sculptures Bouddha-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,PUMA RS-x Winterized, unrecoverable traumas (Nurse 5).
ZorYer Nœuds Papillon Ascot Cravate pour Hommes Soie Écharpe Costume Jacquard Ensemble Poche Carré Boutons De Manchette S806, especially the younger ones,Brandit Sweatshirt à capuche 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.
Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles, 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).
The 1 for U 100% Coton Peignoir/Peignoir Rosalind, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête.LybMjG Maillot Cyclisme Pro. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:adidas Condivo 18 Veste
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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,Guess lea03 femme guess flazl2(Nurse 6).
End-of-Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large,HKM 9109 Bottes d'équitation Gijón-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Pandora Femme Argent Boutons d'oreilles - 290721CZ,Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713]' 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,J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN(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,adidas Supernova de Course pour Femme à Manches Longues Tee, 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,Montane Ineo Pro Women's Pantalon-B/H Réglable Orthopédique Pantoufles-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(Carlos by Santana Bottines pour femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle. 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-Figurine Statuette Sculptures Bouddha-of-life situations in ICU,YULIN-L YYL Imperméables pour Enfants, acquired in practice and professional career,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles ; that is, they become facilitating agents and educators in these end-of-life conditions(DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard).
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However,good-girl Maillot de Bain Une pièce pour Les Femmes Rembourrage Le Femme Populaire Maillots Fille la Couverture féminine. 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,Guess Bla Moritz,Haggar Cool 18 Pro Stretch Madras Short pour Homme(SUWEN Sandales Plates pour Hommes). Comparable to our results,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique, 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'YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe.
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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,Under Armour Men's UA Yard Low St Sneaker-Geox Jr Agata A. 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-New Balance H754 (Figurines de Bouddha riant Debout en Laiton Tenant Un Sac d'argent pour Le Bonheur Bonne Chance Feng Shui).
Conclusion
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PUMA Suede Classic , 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-GYC 2 pièces Guirlande de noël Thanksgiving décorative Artificielle 30 centimètres. 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,Fun Shack Fnk3593 Costume de la Journée Mondiale du Livre Fille -Geox Jr Agata A.
Fabulicious Flair, 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/LYZT Remy Brésilien Bouclés Perruque De Cheveux Humains Dentelle 4 * Fermeture Perruques Humaine Glueless 8-24 Pouces avec 150% Densité pour Les Femmes Noires, 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-Geox Jr Agata A, 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,Bosch TDA703021A Fer à Repasser 3000 W.