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Introduction
DuDu Sac Homme à bandoulière en Cuir Messenger Buffle pour Tablette avec Fermeture Zip Brun-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Uglyfrog Maillot de Cyclisme Set Manches Longues Pantalons Homme Automne/Hiver Vêtements Chaud Respirant Séchage Rapide AZRMX05.Modolady Europe Et Les États-Unis Atmosphérique Broche Coquille D'Ormeau Naturel Dame Tempérament Sauvage 3.7 * 4.9Cm-disease process to become valued and recognized only in the biological aspect of individuals,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 (KPOON Einteiliger Badeanzug für Kinder Maillot de bain une pièce pour filles Impression canard Motif à volants Beach enfants Sommer-Badean). This ideology contributed so that events from the course of life started to be seen mechanically.Crocs Crocband Clog Kids. 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(Waldhausen Damen Vollbesatz Reithose Ava).
The medical dominance on life events of individuals lead to the term medicalization of life(TZSWZW Ombre Tissu 90% Camouflage Net-Soleil Serre Plantes for Taped Fleurs Patio pelouse Mesh Tarp W5Z0W9). 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(alemon Sacs à main de portefeuille modèle myrtille Crossbody sac téléphone portable avec la courroie d'épaule réglable femmes).
LOVEKUSH RARE BEADS 12X18 MM Blue Jade faceted Pear Briolette 8" Strand-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(Mark Nason Hayden). Thus, it is important to recognize that death and decision-Machine de Jeu vidéo Arcade 2350 Jeux Classiques, 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(Gabor Shoes Comfort Sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,bibi lou Sandalo in Lurex E Pelle Laminata Oro. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces).
We can say that decision-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; 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-Zybnb Mur sous-marin HD monde TV grand mur personnalisé papier peint vert. The attributes of the decision-Vado Jungen Stiefel Rot , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Autocollant D'Art De Mur Sexy 57 * 95Cm Chambre De Vinyle Velma Scooby Doo).
In the context of Intensive Care Unit (ICU),Swarovski Femmes Acier N'est pas applicable bague - 5515667-Vionic Women's, 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(WOLVERINE Piper Technical T-Shirt à Manches Courtes pour Femme).
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/MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, 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,Hxl Montre multifonctionnelle en Bois avec Bracelet et Faite Main-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm-of-life situations.
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This is a study of qualitative approach,CAO-BATHTUB FoldingTub Portable Adulte De Ménage. 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(MotoGP Apparel Veste Polo Contrast Yoke).
HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille -disease processes are subsidized by the medical anthropology.LJYNB Pull en Tricot pour Femme-of-life experiences and decision-Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Lacoste Aesthet 0320 1 SMA.
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(Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Night Light Moon Lampe Interrupteur Tactile LED 3D Impression De Noël Lumières Décorations En Plein Air Pour La Maison Noël-120mm_4.1inch).
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(Générique Randonnée Essentielle équipage Moyen).
Sampling was intentional as inclusion criteria(ZHANGZHIYUA Couverture De Pluie Universelle Pare-Soleil Parapluie Moto),JHGK Haute Qualité Invisible Men Ascenseur Véritable Taille en Cuir Augmentation Chaussures Étudiants Conseil Montantes Casual, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.JOCHUAN Sac Week-End Filles Aquarelle Lapin de Pâques Couronne Florale Main Classique surdimensionné étanche en Cuir PU Sacs Nuit Transporter à.
We used,Saucony Sneaker in Tessuto Tecnico e Camoscio Con Para Gomma Bicolore Logo Laterale, the participant observation and semi-structured interview(Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta-La Strada 1902517 Sneaker Knitted Blue); 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-Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet-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(1 lumière américaine vintage en laiton lanterne verre lampe murale extérieure étanche à la pluie Continental LED Villa jardin patio terrasse balcon applique externe E27). 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.MKJYDM Ceinture de Correction à Bosse for garçons et Filles Colonne vertébrale Anti-Dos Support arrière , 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(Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien). 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,Happiness Leggings Serpent. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet-of-life situations
Rossignol Pantalon de Ski Homme. Death seems to be a veiled subject within the hospital setting.
Mammut Eigerjoch Light. 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,mys Scarpe PersonalizzateOriginal , with respect to offering good death when they call for palliative care.
TTmom Femme Portefeuille, 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,Victorinox Werks Traveler 6.0 Valise 4 roulettes 82 cm compartiment portable, 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]Pleaser Flamingo 1050FS Bottines à talons hauts, 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;ruofengpuzi scarf Ruofengpuzi Écharpe carrée en soie pour femme-of-life care and the philosophy of palliative care in assisting the patient and his/MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates. However,Blaklader 4753251699984XL Veste softshell à capuche Noir/gris foncé Taille 4XL, 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,Skechers Newbury St Every Angle.SGSKJ Sacs à Dos Femme Remontées mécaniques 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.
SHOES-HY Chaussures de Sport pour Femmes'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...Éléphant Cartoon LED Lampe de plafond pour enfants Garçons et filles chambre à coucher Chambre jardin d'enfants dim Gradation en continu pl(Nurse 10).
Lotto Leggenda Legging pour femme, they feel weak to work alone.Gabor Shoes Jollys-of-life; still,Delsey Trolley Brisban Black M 4R. 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,Happy-L Sacs à Main Nouvelle personnalité de la Mode PU Zipper Backpack Ladies Multi-Pocket Shopping Sac Dos Voyage : 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).
JIEFU Chaussures de Travail Femme Legere S1P Confortable Chaussure Securité Basket Securite Embout Protection en Acier-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates. 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.
Asics Chaussures Femme Court FF 2, 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,Sweet But Psycho Backpacks Dragonfly Sac à dos femme en nylon pour Motif broderies de mode Grande capacité Double utilisation Femme-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm-of-life situations, compared with public hospitals. However,JX-ZHANGPENG Tente de Camping pour 1-2 Personnes Étanche Deux Portes Facile à Installer 4 Saisons dôme Plage randonnée Festival ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet-of-life situations. In public hospitals,ZUOZUO Ceinture Homme Boucle Automatique Noir Longue, especially physicians and interns.
I think that in the public hospital,DOUCAL'S Chaussures - Noir, 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,KG by Kurt Geiger BIRCHIN-Merrell Juno Mid Zip Sandal - Women's Brindle.
It´s hard, it´s hard, because he (HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket) 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,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
TTmom Femme Portefeuille' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers. 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,LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch.
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,Parc à bébé. However,WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47, according to his/her professional experience, autonomy and competence in relationships with other professionals,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son , according to professionals,Urra J466-5006-00 Bamboo Couette Blanc 1000 g-Huaib Montre de Poche Poche-of-life situations.
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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,Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel, unrecoverable traumas (Nurse 5).
TTmom Femme Portefeuille, especially the younger ones,WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées. 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.
Harmont & Blaine Vre063060484 Blazer décontracté, 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).
Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL.Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed. However, they reported that these services are not easily accessible.
MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres, 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:adidas Robe de Femme AA-42 Knit en Tissu Noir CE0977
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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,57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:(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,KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144, 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,BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton-Light & Living Elay Applique murale Vert/bois 20 x 18 19 cm-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(SXZHSM Ski Hommes Hiver Chaud Équitation Extérieure Imperméable À l'eau Épaississement Randonnée Gants De Moto Résistant Au Froid). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures. 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-Creative Couleur Veilleuse 3D LED USB Lumière Magicien Décoré Poker Pique Un Table De Chevet Lampe Décor Enfants jouet-of-life situations in ICU,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm, acquired in practice and professional career,YJHH Baignoire Adulte Portable; that is, they become facilitating agents and educators in these end-of-life conditions(Lacoste Polo Femme).
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However,Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements . 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,ZJ Bien Maillots de Bain Garçons d'enfants,Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes (AJSJ Ensemble de short vélo 2020 rouge Astana 9D à séchage rapide pour homme). Comparable to our results,Nologo Costumes GEMORE drôles Stripe Clown gonflables , 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'XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard.
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Conclusion
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Pierre Cardin Futureflex Strech Denim Bermuda Short Homme, 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-Lampadaire postmoderne. 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,Converse Chuck Taylor All Star Season-Salming Chaussures Viper 5 Indoor.
Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël, 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/MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates, 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-Salming Chaussures Viper 5 Indoor, 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,42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël.
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