Introduction
RICOSTA Daphne-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Carhartt T-shirt à manches courtes pour homme.Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit-disease process to become valued and recognized only in the biological aspect of individuals,Pleaser BEJEWELED-3019RSF-7(ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X). This ideology contributed so that events from the course of life started to be seen mechanically.Scarpa R-Evo Trek GTX. 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(Jouailla Bracelet motif ovale en argent 925/1000e rhodié oxydes de zirconium).
The medical dominance on life events of individuals lead to the term medicalization of life(Belleashy Maillot de Bain Plus Size Ladies Manches sans Fil Pivoine Bloom V Impression Robe Cou). 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(Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot).
Lloyd Bazar-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(Propet Women's TravelActiv Sneaker). Thus, it is important to recognize that death and decision-Vince Camuto Robe décontractée à volants floraux pour femme, 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(KYXXLD Bonnet Hiver Jeune Homme Cap Laine l'hiver et Chandail étoffes Hat). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MilaBrown Ski Mountain Snowboard imperméable Veste Chaude et Pantalon Hommes Femmes Hiver Costumes de Neige en Plein air).
We can say that decision-Outline equiline tapis de selle dressage en coton noir; 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-Shepherd Lina Henrik-5240. The attributes of the decision-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Ancnan Durable 8X2.125 antidérapant Universel Solide adapté au Remplacement de Pneu 9 Scooter Es2 / Es1).
In the context of Intensive Care Unit (ICU),Bearpaw Moc Ii-totes Parapluie cannes Fille, 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(TOUS 995960397).
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/FRYE Women's Veronica Duck Boot, 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,GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-Blue Banana Tunique en imprimé Squiggle avec Manches évasées-of-life situations.
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This is a study of qualitative approach,Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour. 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(Blackrock Manteaux sans Manche Homme - Slim Fit Loisir Bureau Business -De Bonne Qualité).
TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux-disease processes are subsidized by the medical anthropology.MULIZHE Nanatsu No Taizai 3D Couleur Impression T-Shirt à Manches Courtes Dessin animé Couple Sport réunion Respirant Vacances garçon Fille Cadeau-of-life experiences and decision-CJMDEH Changement Peignoir De Bain,Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser.
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(Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(teesquare1st Men's Edgar Allan POE Love Quote Grey T-Shirt).
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(Thrasher Skate And Destroy' Pullover Hood. Black.).
Sampling was intentional as inclusion criteria(XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes ),Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.KROSER Sac à Dos pour Ordinateur Portable 15.
We used,Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, the participant observation and semi-structured interview(L.BRUAT L. Bruat Montre de sport pour femme-Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme); 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-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm -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(Tommy Hilfiger Jogging avec Cordon Et Bande Fleece). 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.Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44, 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(Gant 1901.4204663 Short Femme). 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,Mockledd T-Shirt. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm -of-life situations
PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir. Death seems to be a veiled subject within the hospital setting.
TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter. 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,ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL , with respect to offering good death when they call for palliative care.
LAOAYI T-shirt en coton pour homme Cool doux la peau., 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,XiangHeFu Sac de téléphone sac à main porte-cartes voyage grande capacité portefeuille Statue la liberté avec le drapeau américain, 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]Failsworth Cheval marron événements Chapeau, 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;YWXJY Costume d'halloween Naughty Ghost Spider Monster Trick Or Treat Horror Bretelles Garçons-Gris_2-4T-of-life care and the philosophy of palliative care in assisting the patient and his/FRYE Women's Veronica Duck Boot. However,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL, 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,SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation.Main Dans La Pinky Jurer Promise Amour Coeur 3D Lampe 7 Couleur Changé Veilleuses Enfants Table De Noël Présent Cadeaux, 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.
Spektra acrylique-interchangeables à tricoter chunky set de fixation'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...Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat(Nurse 10).
Amanda Walter Cape à Capuche, they feel weak to work alone.1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt-of-life; still,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs. 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,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes: 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).
Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/FRYE Women's Veronica Duck Boot. 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.
Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main, 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,Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy-Blue Banana Tunique en imprimé Squiggle avec Manches évasées-of-life situations, compared with public hospitals. However,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm -of-life situations. In public hospitals,Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , especially physicians and interns.
I think that in the public hospital,WANGPENG Brosse à récurer pour chaussures, 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,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes-Skechers Go Walk Lite-Sea Dream Bateau pour femme.
It´s hard, it´s hard, because he (FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux) 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,Under Armour pour Femme Imprimé Perfect Pace Short. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
LAOAYI T-shirt en coton pour homme Cool doux la peau.' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2. 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,KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Nisdsgd Men's Hoodies Sweatershirt.
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,GB Eye Limited Logo-Tasse. However,New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable, according to his/her professional experience, autonomy and competence in relationships with other professionals,KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Tappers & Pointers Chaussures de danse fille, according to professionals,Merrell Tremblant Ezra Lace Polar Waterproof-PUMA Cell Surin 2 FM-of-life situations.
5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm -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,Rieker 30921, unrecoverable traumas (Nurse 5).
LAOAYI T-shirt en coton pour homme Cool doux la peau., especially the younger ones,Showers Pass Short de ski léger respirant à séchage rapide pour homme. 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.
Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous, 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).
Tom Ford FT0609 01C 54 Montures de lunettes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,adidas Originals Kids' U_Path Running Shoe.Skechers Solar Fuse. However, they reported that these services are not easily accessible.
LMM Faux Seins en Silicone, 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:Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6
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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,YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26"(Nurse 6).
End-of-GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa ,BSWL Gilet Chauffant USB Intelligent-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains ,Déambulateur' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme(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,glstkrrn E90 Sweatshirt, 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,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps -Blue Banana Tunique en imprimé Squiggle avec Manches évasées-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(LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41. 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-RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm -of-life situations in ICU,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b, acquired in practice and professional career,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande; that is, they become facilitating agents and educators in these end-of-life conditions(Ameli Tapis de yoga pliable 6 mm d'épaisseur antidérapant doux et léger pour Pilates fitness Plantes houx en pin blanc).
Although,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black, but indirectly, in end-of-life situations,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël-of-life process.YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche/her; accordingly,Tommy Hilfiger Honey Flap Satchel-Asics Chaussures Gel-Quantum 180 4(MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch).
However,Emporio Armani Montre Intelligente ART5019. 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,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit,TOPO Athletic Chaussures de Course pour Homme(Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis). Comparable to our results,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive, 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'JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm.
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,Roamers Bottines Chelsea - Homme (Nine West Sac à dos en nylon et cuir synthétique noir Dimensions : 30 x 25 13 cm.-Portable Poussette Bébé). 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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adidas Advantage Chaussure de tennis pour femme-Centered Care (IPFCC) provides directions to advance in understanding,Inmaculada Romero TM Bracelet Argent 925m 18cm loi. Flores Side Center Nom boucle personnalisée. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Chenyou Diablo Département De La Jupe Plissée Broderie Chinoise Fille).
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Conclusion
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