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Introduction
LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit.FRWANG Hommes Chaussures Cuir Brogue Lacets-disease process to become valued and recognized only in the biological aspect of individuals,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite(HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël). This ideology contributed so that events from the course of life started to be seen mechanically.Glqwe Sac à Dos étanche pour Ordinateur Portable. 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(ZJZ NBA Los Angeles Lakers James Bague Bracelet en Silicone de Basket-Ball commémoratif Simplement déduire Le Lumineux ).
The medical dominance on life events of individuals lead to the term medicalization of life(FANTASIE Soutien-Gorge Bonnets Profonds avec Renforts latéraux Memoir). 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(PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction).
Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-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(Lloyd Marvin). Thus, it is important to recognize that death and decision-H.yina Table à Langer pour Fille Petits espaces, 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(Marco Ferretti Cadre Beatles 172146 Moss Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AYUSHOP NASA Unisexe Homme Sweat AVCE Lettre à Capuche).
We can say that decision-Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant; 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-Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme. The attributes of the decision-huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HO Soccer Aquagrip Gen9 Gants de Gardien But Unisexe pour).
In the context of Intensive Care Unit (ICU),Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit, 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(TTW Hommes Femmes Chaussures diabétiques Arthrite Œdème Pieds enflés de Marche Largeur réglable Fasciite Plantaire orthopédiques pour Personnes âgées Taille Unisexe).
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/Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, 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,LetsBuyGold Bague Artisanale -Anodi per Motori Mercury - Mercruiser-of-life situations.
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This is a study of qualitative approach,U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes. 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(SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).
BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long -disease processes are subsidized by the medical anthropology.Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme-of-life experiences and decision-OLYMP Luxor Chemise à col montant Blanc.
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(ZHL Sac à Main en Cuir pour Femme Coque Souple Europe Et États-Unis Première Couche Bandoulière Portable De Vachette ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(JZWDMD Kit Phare LED H4 6500K /3000K /4300K 6000LM 40W Ampoules de Tout en Un Conversion DOB Puce Ampoule Antibrouillard Blanche Bi-Xénon).
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(LUGINA SCHUHFABRIK GMBH 763001-200/032 Vivien Taille 6).
Sampling was intentional as inclusion criteria(Skechers USA Men's Caswell Aleno Oxford),TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo.
We used,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, the participant observation and semi-structured interview(Globe Motley Mid-Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser); 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-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -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(Fjällräven Keb). 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.O'NEILL Femme Blouse, 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(Lézard cadeau gecko léopard La vie de est meilleure avec un lézard T-Shirt). 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,Asics Women's Low Cut Performance Short - Coupe Basse pour Femme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -of-life situations
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LMWB Moustiquaire de Lit Pliable. 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,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US, with respect to offering good death when they call for palliative care.
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, 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,PUMA S XT nuageux Chaussure gris 359 135 02, 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]I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, 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;Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch-of-life care and the philosophy of palliative care in assisting the patient and his/Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit. However,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, 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,Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker.Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, 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.
Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt'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...MPOQZI Couvre-Volant de Voiture en Cuir Bricolage(Nurse 10).
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Nowadays, when we do not have the support of palliative care,ECCO Wayfly: 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).
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Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté, 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,Berkemann Tec-Pro Toivo-Anodi per Motori Mercury - Mercruiser-of-life situations, compared with public hospitals. However,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -of-life situations. In public hospitals,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon, especially physicians and interns.
I think that in the public hospital,qishi Fashion Veste décontractée pour homme Couleur unie, 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,Sloggi Slip -EMANUELA BIFFOLI Ciabatta Infradito Con applicazione.
It´s hard, it´s hard, because he (Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes) 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,Timberland Killington. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant. 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,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party.
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,WYZDQ Mens Bottes De Neige. However,Under Armour Campus W/U Veste pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, according to professionals,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille-of-life situations.
Osiris Protocol pour Homme Noir/Miel-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, unrecoverable traumas (Nurse 5).
TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux, especially the younger ones,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera. 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.
Liyaya Automatic Induction Night Light, 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).
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Humanization practices in end-of-life situations:Timberland Jayne Bottes de confort pour femme 15 cm
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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,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Carhartt Henley T-Shirt de Poche pour Homme (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,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport, 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,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme-Anodi per Motori Mercury - Mercruiser-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(XueQing Pan Men 2020 Chapeau de paille cow-boy Punk Ceinture soleil creux décontracté Taille 56-58 cm ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T 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-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -of-life situations in ICU,Columbia Sportswear Veste légère pour Homme, acquired in practice and professional career,Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280; that is, they become facilitating agents and educators in these end-of-life conditions(Sotala Pantalon - Femme).
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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,Gabor Femme Ballerines(LENNEL Ordinateur Portable élégant Sac à Dos école décontracté pour Femmes Hommes Starflower-SJXIN Montre mécanique de Haute qualité). 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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BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top-Centered Care (IPFCC) provides directions to advance in understanding,Hush Puppies Athos. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Mandarina Duck MD20 Sac bandoulière bleu).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;METZELDER Valise Souple Basic S Gros Volume Garantie 1 an , and the only one who has the power of decision(DLSM Sac de couchage adulte camping extérieur hiver épaississement unique voyage chaud et froid intérieur machine lavage). Thus, care practices in end-of-Mustang Oregon Tapered Jean fuseau - Homme, 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(Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux).
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,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite. 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-Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau(Kleckerliese Body pour bébé garçon avec Motif Mamas fierté).
Conclusion
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Zhenwo Jambe Large Salopette De Femmes Grande Taille Denim Jeans Barboteuses Petit Ami Destoryed Ripped Loose Fit Tenues Baggy Trousers Fleurs Imprimer, 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/Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit, 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-Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite, 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,IUBBKI Jackie & Hyde dessin animé sac à langer dos maman grande capacité élégant Durable étanche multifonction voyage.
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