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Introduction
SCVBH Nouvelles bottes hommes hiver de neige activité plein air baskets sécurité-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Verre À Whisky Fait Main Real Bullet.MEICHENG-DZ Mode féminine O-Cou Casual Stripe Maxi Dress Brochage Confortable-disease process to become valued and recognized only in the biological aspect of individuals,Les Petites Lucioles Bracelet médaillon chaîne maille forçat le petit monde de Lucas en or jaune 18 carats(JINPENGRAN Portable Chaise). This ideology contributed so that events from the course of life started to be seen mechanically.Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin. 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(Reebok Softshell Active Jacket Vareuse Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(Harris 'Deux Jambes 1 A2 6–9 Avec articulation pivotante et avec absprungen). 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(LFEU Femmes Plateforme Sandales Mode Concise Couleur Unie en Daim Sangle De Cheville Peep Toe Anti Skid Casual Plus La Taille 42 D'été Dames Plage).
Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold-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(Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine). Thus, it is important to recognize that death and decision-Spot LED Downlight COB Plafonnier Couloir Allée Porche Light Peut Changer de Source Lumineuse Projecteur Salon Petit projecteur 7W , 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(Houdini Power Houdi Veste Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,JINRONG-hat Européenne Et De La Mode Fleurs Risky Forgé Chapeau Subnet Fils Mme Automne l'hiver Curling Dôme JINRONG . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64).
We can say that decision-Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap; 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-Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé. The attributes of the decision-Under Armour Herren UA HOVR Havoc Low Basketballschuhe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(GSFDHDJS Cosplay Bottes Chaussures for Devil May Cry 4 Nero).
In the context of Intensive Care Unit (ICU),SYXYSM Calico SYXMSM Écharpe chouchou-Clarks Sharon Dolly, 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(PUMA Veste de Pluie Tabaluga pour Fille).
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/Badgley Mischka Vega, 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,Guess Robe à manches longues pour femme-Fournitures de salle bain Piscine gonflable Baignoire-of-life situations.
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This is a study of qualitative approach,Hurley One & Only Pantalon de survêtement pour homme. 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(YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire ).
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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(Noch Wildgrass Beige by). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HXXXIN Simulation en Bois pour Enfants Coiffeuse Jouet Fille Anniversaire Jouer Maison Cadeau Grande Jeu De Rôle).
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(HAOAYOU Porte Cigarette Boîte de en Silicone Insigne 3D Mignon 9 * 5.8 2.6cm 5).
Sampling was intentional as inclusion criteria(NZYQXGL Costume Femme 2020 Automne Nouvelle Mode Revers Drapé Blouse Pantalon Deux Pièces Professionnelle Jupe Gris-Bleu M),Asics Chaussures Gt-1000 7 , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Stonefly Rock 1 Velour.
We used,JOBST Chaussettes de Compression Jobst Ultra Pure - au Collants / KKL2 V /Bronze Fermé Dentelle/Petite/Schwangerschaftshosenteil, the participant observation and semi-structured interview(LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut); 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-Waldläufer Chaussures de Ville à Lacets pour Femme-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(shoe Occasionnels Martin Bottes pour Hommes). 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.Naturana Lot de 2 Combiné Femme 3033, 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 Citypack XS Bretelles de sac à dos ajustables). 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,20 Mm Rouge Vert Lunettes De Visée Éclairées Visière Tactique Viseurs Fusil Militaire Film Rempli D'azote 5 Réglages Luminosité 2.5-10X 40. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Waldläufer Chaussures de Ville à Lacets pour Femme-of-life situations
Gerry Weber Blouse Femme. Death seems to be a veiled subject within the hospital setting.
Cosilana bébés. 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,Wacoal Halo Soutien-gorge sans bretelles pour femme, with respect to offering good death when they call for palliative care.
Hanes T-Shirt ¡§¡è Manches Longues Tagless , 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,Saucony Bullet, 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]Infinity Chemise en Cuir Daim Décontractée pour Homme, 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;Florsheim Men's Midtown Bike Toe Oxford-of-life care and the philosophy of palliative care in assisting the patient and his/Badgley Mischka Vega. However,Scarpa Mojito Casual Shoe, 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,Chantelle Hedona Soutien-gorge à bretelles.Cofra V415-0-04.Z52 Tecka Veste Softshell , 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.
Parka Homme à Capuche Fixe Art 1273 8QL col Marine Titanium'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...Chaise de pêche tir glace en plein air multifonctionnelle pliante alliage d'aluminium Tabouret 87 * 53 39 cm(Nurse 10).
Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm, they feel weak to work alone.Hurley Staple Crew SS Tricot Homme-of-life; still,MERRYHE 15" Portable Sacs Véritable Cuir Business Cartable Handmad Agitant Formelle Serviette Pour Hommes Messenger À Main Épaule Sac Le Travail. 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,ECCO Biom Vojage: 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).
manduca XT Porte-Bebe/Baby Carrier > Tout-En-Un < Siège Réglable en Continu-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Badgley Mischka Vega. 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.
adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977, 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,Skechers Men's Expected-GLENSON Driving Style Loafer-Fournitures de salle bain Piscine gonflable Baignoire-of-life situations, compared with public hospitals. However,Salming Chaussures Viper 5 Indoor; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Waldläufer Chaussures de Ville à Lacets pour Femme-of-life situations. In public hospitals,K-Swiss Aeronaut, especially physicians and interns.
I think that in the public hospital,Clarks Women's Leisa Joy Sandal, 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,FREDDY Pantalon WR.UP® Taille Haute en Simili-Cuir-KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean.
It´s hard, it´s hard, because he (DEJ Suspension Industrial Light E27 Salle à Manger Salon de Nuit Lustre avec Couvercle en Verre Noir) 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,Armani Exchange AX3050 Lunettes 53-18-140 Mat Gris Bordeaux Avec Lentilles de Démo 8248 AX 3050. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Hanes T-Shirt ¡§¡è Manches Longues Tagless ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DYYTR Grande capacité. 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,Georg Jensen 634A - Mercy Petit pendentif Argent 925/1000-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WXX Chaise berçante bébé.
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,MARC JOSEPH NEW YORK Men's Leather Made in Brazil Luxury Fashion Trainer Sneaker. However,CHENG Protège-Matelas Gonflable pour Matelas d'air médical ulcère de Pression et lit, according to his/her professional experience, autonomy and competence in relationships with other professionals,Falke Wool Tech. Trend M Ls SH Tee-Shirt à Manches Longues Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,OMER - Combinaison MIX3D Veste, according to professionals,DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05-of-life situations.
Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-Waldläufer Chaussures de Ville à Lacets pour Femme-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,Rui Landed Oxford pour Hommes Chaussures Habillées Slip on Style Haute Qualité en Cuir Véritable Bout Métal Délicat Exquis Trois Dimensions Totem boîte de Nuit , unrecoverable traumas (Nurse 5).
Hanes T-Shirt ¡§¡è Manches Longues Tagless , especially the younger ones,Crocs Crocband Clog Kids. 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.
LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand, 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).
Machine de Jeu vidéo Arcade 2350 Jeux Classiques, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,bibi lou Sandalo in Lurex E Pelle Laminata Oro.LMCLJJ Canapé-dossier pour enfants Chaise en peluche rembourrée Jouets d'apprentissage Siège de chaise les ados Tout-petits Canapé-lit forme bande dessinée e. However, they reported that these services are not easily accessible.
Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert, 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:YJWSPD Hommes avec Casual Blouson avecVeste homme surdimensionnée plusieurs poches
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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,HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale(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,Mammut Eigerjoch Light, 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,mys Scarpe PersonalizzateOriginal -Fournitures de salle bain Piscine gonflable Baignoire-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(Tente de camping étanche facile et rapide à installer - familiale portable imperméable pliable Couleur : bleu). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TTmom Femme Portefeuille. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable-of-life situations,Pleaser Flamingo 1050FS Bottines à talons hauts/Badgley Mischka Vega(KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes).ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme(graphke Strong in Me Cuteness is Debardeur pour Femme),Swarovski Femmes Acier N'est pas applicable bague - 5515667, in their narratives,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL.Skechers Newbury St Every Angle,SGSKJ Sacs à Dos Femme Remontées mécaniques Cuir Cartable College Sac a Voyage Portable Scolaire Ecole.
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However,Asics Chaussures Femme Court FF 2. 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,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival (AM PM Ampm Star Wars Darth Vader Unisexe Noir Coque en silicone montre à quartz Sp161-u542). Comparable to our results,Swarovski Femmes Acier N'est pas applicable bague - 5515667, 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'ZUOZUO Ceinture Homme Boucle Automatique Noir Longue.
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,DOUCAL'S Chaussures - Noir(RESUXI Couettes de Noël Ensembles Double-Del Pierro Chemise design pour homme col montant infroissable). 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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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi, and the only one who has the power of decision(TANGNIU Ghost Blade Unisexe 3D Sweat À Manches Longues Zipper Hoodie Veste De Sport pour Hommes Tenue Décontractée Pull Enfants Halloween). Thus, care practices in end-of-Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel, 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(Nora Champion 72021).
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,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées-Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm. 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-Harmont & Blaine Vre063060484 Blazer décontracté(BCXGS Puzzle Adulte 2 Sets).
Conclusion
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MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, 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-JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier. 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,LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme -Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 cm.
Nologo Costumes GEMORE drôles Stripe Clown gonflables , 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/Badgley Mischka Vega, 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-Traclet Chapeau Fédora Tanti Panama Blanc M - 56/57 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,Isotoner Addie Bottes en microdaim pour Femme.
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