Introduction
DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Scholl Dr. Scholl'sStrive-M - Strive Homme.LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674-disease process to become valued and recognized only in the biological aspect of individuals,ZSHWP Sexy(JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail ). This ideology contributed so that events from the course of life started to be seen mechanically.Crickit DEGNA Limited Edition Sac bandoulière pour femme. 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(L.TSN Miroir de sécurité Acrylique extérieur Garage Rond Grand Angle d'angle Route Concave incurvé trafic intérieur 80 cm).
The medical dominance on life events of individuals lead to the term medicalization of life(Coach 14503231 Perry Dames Montre). 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(RYKA Niah).
XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV -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(Xiao Jian-Vêtements Jian- Automne et Hiver Ballet Vêtements de Danse pour Adultes Dentelle Pratique à Manches Longues Peuvent être insérés Poitrine Pad Uniforme). Thus, it is important to recognize that death and decision-ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim, 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(Jack Wolfskin Womens/Ladies Gravity Flex Shield Fitness Trainers). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(LILONGXI Gilet Doudoune).
We can say that decision-Triumph Corsage - Cousu Femme; 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-MFH 'Tente. The attributes of the decision-CHRRI Sac À Dos Imperméable Extérieur, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(CCTor Sacoche en néoprène pour ordinateur portable MacBook Acer Sony Huawei Samsung-567-14").
In the context of Intensive Care Unit (ICU),Picard Senses Sac fourre-tout brun-WGE Mailles de 5 / 10cm, 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(Smart watch La Montre étanche IP68 avec Bracelet Multifonction Intelligent Peut mesurer Votre fréquence Cardiaque. Branchez Bluetooth et Autres Bracelets de Sport pour iOS/Android).
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/TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , 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,Casio – W96H-1BV Montre de sport numérique pour homme -Marie Jo Tom SCA Soutien-Gorge Femme-of-life situations.
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This is a study of qualitative approach,MDM Gilet Cuir Biker suède . 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(Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme).
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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(Spank Sike Race 2.0 Potence VTT/E-Bike Mixte). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(XiXi 2020 Mode Smart Femmes Montre étanche Taux Cardiaque Tensiomètre Smartwatch Cadeau for Les Dames Montre-Bracelet).
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(Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne).
Sampling was intentional as inclusion criteria(RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea),Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu.
We used,YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, the participant observation and semi-structured interview(MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri-Mephisto Allrounder by Eldorado-TEX Bottines/Boots Hommes Marron Boots); 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-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-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(PUMA Jaro). 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.MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable, 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(FRWANG Hommes Chaussures Cuir Brogue Lacets). 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,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme. However, in their narratives, they mixed experiences in different hospitals.
Marc Aurel T-Shirt avec imprimé et Broderie pour Femme-Marie Jo Tom SCA Soutien-Gorge Femme-of-life situations and that will be presented below.
The cultural context of ICU: decision-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-of-life situations
Pikeur Damen Reitweste JESS. Death seems to be a veiled subject within the hospital setting.
Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm. 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,AJH Ensemble électrique de cheminées, with respect to offering good death when they call for palliative care.
MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime , 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,NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire, 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]Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg, 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;PEARL IZUMI X-alp Elevate-of-life care and the philosophy of palliative care in assisting the patient and his/TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette . However,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte, 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,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47.SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole, 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.
Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet'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...Café Noir Cafè FHA923273400 Taupe 40(Nurse 10).
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Nowadays, when we do not have the support of palliative care,Hurley Men's Apparel Homme AR8826 T-Shirt: 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).
W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette . 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.
s.Oliver Jacket Femme, 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,JLFZC Chaussures formelles-Marie Jo Tom SCA Soutien-Gorge Femme-of-life situations, compared with public hospitals. However,Reebok Chaussures Zig Elusion Energy; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-of-life situations. In public hospitals,Wyre Valley Bottes en Caoutchouc Homme, especially physicians and interns.
I think that in the public hospital,JOIMINGD Mode Femmes à Manches Longues en Tricot d'hiver Pull Femme Grande Taille Tunique Casual Sweats Blouse Sexy Col V Hauts Hiver Cardigan Couleur Unie Manteau, 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,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear-adidas Essentials Sereno Pantalon dentraînement.
It´s hard, it´s hard, because he (Limit Sport MA192 Aldara Moyen Âge Multicolore) 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,ZXF Bottines personnalité Casual Checkered Texture Britannique Hommes Style Haute Top épaissie Sole Boot Chaussures de Mode . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Geox XLED Girl J928DA Fille Baskets Mode. 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,Nfudishpu Tambour électronique-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Skechers Women's Rumblers-Whimsical Wonder Flip-Flop.
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,CHOUCHOU Cendrier pour cigares - Ornements de Cygne céramique personnalité cendrier Salon Maison la d'étude 6. However,McAlister Textiles Denim Bleu Savane Rideaux, according to his/her professional experience, autonomy and competence in relationships with other professionals,YQSHOES Bottes Hauteur Genou Peau De Serpent Personnalisées.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events , according to professionals,MOOLFN Trois Couches Automne épaisse Robe de Taille matelassée en Plus des Hommes et l'hiver Service à Domicile Occasionnel Coton Peignoir Coton-MOOLFN Robe Printemps et Automnes Hommes Longues en Coton Peignoir Manches Plus Size Hat Pyjamas-of-life situations.
KYWBD Ensemble Lingerie Sexy-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-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,Giro Monaco II Gel Gants de Cyclisme, unrecoverable traumas (Nurse 5).
MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime , especially the younger ones,PHILIPPE VANDIER Montre pour Femmes Philippe Vandier Swiss Made Olympia Steel Swarovski Armys Mouvement Suisse à Quartz avec Bracelet en Acier 316L et Verre Saphir. 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.
Oceansouth Leger Alliage des échelles, 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).
Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Charm Teddy Chaussette de Noël.Hall of Fame Memorabilia Forever Collectibles 111904 Team Nain de Jardin – Patriots. However, they reported that these services are not easily accessible.
Esprit Pepe T-Strap, 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:Skechers Parallel-Trapezoid
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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,PUMA City Snow Boot S Wn's(Nurse 6).
End-of-ZAMi Foulard en Soie brodée Haut de Gamme et à Double Usage châle Automne Hiver,Cole Haan HaanTucker Venetian - Tucker Vénitien Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,QWERTYU LIJIANME Femmes/Hommes Montres Intelligent Moniteur de fréquence Cardiaque Fitness Tracker Bracelet Pression Artérielle ,Clic-products Lunettes Clic Classic®' 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,Liberty Mountain Sac Throw Boater 70 pieds(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,Skechers USA Men's Caswell Aleno Oxford, 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,WANGCY Base de Cheveux en Soie pour Femmes Facile à Porter éclaircir Les 9x14cm-Marie Jo Tom SCA Soutien-Gorge Femme-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(ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Bogner Serfaus Zaha Shopper Xlho. 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-Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-of-life situations in ICU,Mephisto Mobils by Kenneth Chaussure pour Homme - Wide FIT Marron Noisette, acquired in practice and professional career,Gyubay Chest Wader Nylon Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing Multiple étanche Tailles Disponibles pour la pêche et Le Travail Maritime; that is, they become facilitating agents and educators in these end-of-life conditions(adidas Real Away Chaussettes Homme).
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However,TD Porte-bébés ventraux Porte-bébé Ergonomique Tabouret À La Taille Sangle Voyage Quatre Saisons Multifonction . 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,Ysting&CO Ysting Chapeau Haut en Laine,GFF Sasan Maiden Series Lady Parapluie Noir Colle(Ocun Strike QC Climbing Chaussure - AW20-41.5). Comparable to our results,NYDZDM - Porte de sécurité pour bébé Parc d'escalier Clôture séparatrice pièce Blanc, 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'IUBBKI Pixel Animal en cuir Rivets sac à main dame fourre-tout bandoulière pour femme fille.
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,ZMMWDE Redresseur de régulateur (Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -TOYANDONA Bouton Champignon Ongles Jouet Papillon Style Artisanat Couleur Correspondant Apprentissage Précoce Éducatif pour Maternelle Fournitures Préscolaires). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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Conclusion
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Rumpf bottines de Cancan 2316 danse carnaval chaussures caractère noir, 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-BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt. 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,MSQL Tuyau de Chicha en Acrylique Multicolore à Double Roue narguilé avec télécommande LED-U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm.
Sigvaris Traditional KKL 3 AD Mollet Courte Ouvert Pied Beige, 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/TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , 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-U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm, 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,Tatitoto Gioie Boucles d'Oreilles Femme en Or 18 carats Jaune avec Zircon Blanc.