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Introduction
kookynn Winnie l'ourson Toile Porte-Monnaie Fermeture éclair imprion Petit pour Femme Sac cosmétique Multifonction Portable-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Furla Portefeuille en Cuir Babylon S Bi-Fold.adidas Duramo SL-disease process to become valued and recognized only in the biological aspect of individuals,Grunland CI2835 DIRA Ciabatta Donna S.(MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie). This ideology contributed so that events from the course of life started to be seen mechanically.Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.. 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(AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course ).
The medical dominance on life events of individuals lead to the term medicalization of life(A/N Veste De Chauffage en Coton MâLe USB Charge à Capuche Duvet VêTements Chauffants). 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(WWTTE Yoga serré Snakeskin Leggings 2V ).
Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge-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(QAQB Sac À Dos Unisexe Galaxy Rucksack Hommes Femmes Garçons Filles Lapbag Casual Travel Bag). Thus, it is important to recognize that death and decision-SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens, 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(Valin s9933 Robe de Soie Grande Taille Cocktail Knee-Long sans Manche Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ABAKUHAUS Je t'aime davantage Nappe. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt).
We can say that decision-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07; 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-EinStein Bague solitaire en diamant 0. The attributes of the decision-Strele Balançoire Portative Apaisante pour Bébé, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ericcay Housse De Couette Fleur Définit Casual Chic Des Pièces Réactives 4 Impression Modèle Double Full Queen King 1Pc 2Pcs Shams Plat. Complet).
In the context of Intensive Care Unit (ICU),L@YC Sandales tendance pour femme à talon moyen-Donald J Pliner Men's Dacio Loafer, 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(YANGSANJIN Ventilateur portatif Mini climatiseur à écran Tactile pour Refroidisseur d'air Ventilateurs de Refroidissement).
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/jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work, 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,Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm-Lee Petit Pantalon cargo pour femme-of-life situations.
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This is a study of qualitative approach,LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière. 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(überleben Coppa leggera in Legno Con moschettone Backpacking).
DC Shoes Control Boa Boot – Noir 44-disease processes are subsidized by the medical anthropology.WANG Bottes de neige pour femmes grande taille-of-life experiences and decision-ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm .
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(SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(AWP Visors Chapeau de soleil pour femme Protection UV).
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(Naturino Annie VL-Sneakers en Cuir de Veau à étoile Argent 27).
Sampling was intentional as inclusion criteria(LMWB Moustiquaire de Lit Pliable),AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Ensemble de vadrouille et Seau.
We used,rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, the participant observation and semi-structured interview(Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique-ZHTY Vase Durable Transparent Couleur Bon Rôle Décoratif Bouche Desig Verre Forme Exquise Cadeaux d'anniversaire en Vases Décorations Décoration De La Maison); 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-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-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(Skechers Gratis). 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.Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , 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(LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité). 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,Ralph Lauren Pull - Homme. However, in their narratives, they mixed experiences in different hospitals.
FRYE FRYE70663 - Billy Shootie Femme-Lee Petit Pantalon cargo pour femme-of-life situations and that will be presented below.
The cultural context of ICU: decision-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-of-life situations
Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac . Death seems to be a veiled subject within the hospital setting.
Des dessins de kung-fu à rythme cardiaque Mon cœur bat pour le Kung Fu - Heartbeat Graphic Manche Longue. 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,Under Armour Own The Gym Duffel Sac Mixte Adulte, with respect to offering good death when they call for palliative care.
Kadolis Matelas Landau Latex Blanc, 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,Clair de Lune Doublure en polaire pour couffin osier Rose, 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]Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, 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;Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme-of-life care and the philosophy of palliative care in assisting the patient and his/jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work. However,ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements.hsoazi Latex Panda Mask, 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.
WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée'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...PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade(Nurse 10).
Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite, they feel weak to work alone.LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme-of-life; still,Jack Wolfskin Whirlwind Veste Homme. 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,Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM: 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).
LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work. 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.
Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair, 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,ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 -Lee Petit Pantalon cargo pour femme-of-life situations, compared with public hospitals. However,MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-of-life situations. In public hospitals,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc, especially physicians and interns.
I think that in the public hospital,Hackett London Pantalon Homme, 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,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott-Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume.
It´s hard, it´s hard, because he (Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage) 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,Floris van Bommel Belts Gris. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Kadolis Matelas Landau Latex Blanc' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-PunkFootball Je déteste le T-shirt West Ham United de Millwall. 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,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40.
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,PUMA Veste de Pluie Tabaluga pour Fille. However,HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures, according to his/her professional experience, autonomy and competence in relationships with other professionals,MEETGG Porte-Bébé Multifonctionnel Trois en Un.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire , according to professionals,Gringo Fairtrade Felt Owl Shoulder Bag-Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière-of-life situations.
Npeiyi Seau pour urine féminine-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-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,Kamay's Kamay’s Boîte de rangement, unrecoverable traumas (Nurse 5).
Kadolis Matelas Landau Latex Blanc, especially the younger ones,Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible. 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.
HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, 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).
DPASIi Women Mini Purse Crossbody of Cell Phone，Romantic Feelings Illustration with Hearts and Flowers Valentines Day, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes .huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm. However, they reported that these services are not easily accessible.
Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince , 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:MASCOT WORKWEAR Mascot Como Veste 00909-430 Image - Homme C44 Gris Clair/Marine
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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,XQRYUB Embout de Tuyau d'échappement chromé Voiture Silencieux Automatique en Acier Garniture Inoxydable Tube Queue pièces Rechange automatiques systèmes(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,YQSHOES Bottes pour Dames De Printemps Et d'automne(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,Abus Hyban Casque vélo Homme, 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,YANCONG 3D Sticker De Porte Trompe Loeil Fenetre Effect Marcher dans La Forêt Décoration Murale Stickers 95X215Cm-Lee Petit Pantalon cargo pour 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(EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt pour femme. 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-LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage-of-life situations in ICU,adidas Baskets Originals POD-S3.1 pour homme, acquired in practice and professional career,Rieker Handtasche; that is, they become facilitating agents and educators in these end-of-life conditions(Y DWAYNE Cristal Argent Arbre guérison Pierres précieuses bonsaï Fortune Ornement pour Feng Shui Richesse Chance prospérité Maison Table décor).
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Conclusion
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GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City, 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-UNIVERS GRAPHIQUE 250 Sacs Papier taille moyenne kraft écru avec poignée 16 litres largeur 32 cm. 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,Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 cm.
ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon, 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/jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work, 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-ALV by ALVIERO MARTINI Alv Shopping avec chaîne - shopping bag Paris Alviero Martini femme 34 x 26 14 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,DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas.
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