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Introduction
Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia.Josef Seibel Sienna 17-disease process to become valued and recognized only in the biological aspect of individuals,JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière(adidas EQT Cushion ADV). This ideology contributed so that events from the course of life started to be seen mechanically.FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized. 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(Hoonmis Robe de soirée Enfant).
The medical dominance on life events of individuals lead to the term medicalization of life(CAT Lifestyle Caterpillar Womens Handshake Lightweight Leather Ankle Boots). 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(Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg).
Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -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(TANGLIII Homme/Men's Vintage ANI Difranco Poster Black Short Sleeve Manches Courtes/T-Shirt Top Tee). Thus, it is important to recognize that death and decision-QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB , 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 Basic). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude).
We can say that decision-AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard; 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-ChengLaoBan shoP Chapeau. The attributes of the decision-Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan？Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Aviditi MD955 Single-Wall Multi-Depth Corrugated Box).
In the context of Intensive Care Unit (ICU),ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket-CUzzhtzy Réchaufferont Hommes Martin Bottes, 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(Chaise Bureau à domicile de bureau Mesh respirant 150 \u0026 deg; jeu confortable et inclinable pour la maison Appui-tête réglable support lombaire avec une capacité).
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/AUTIANYU Inuyasha Sac fourre-tout en toile pour femme, 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,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -adidas Juve Wintjkt Veste de Sport Homme-of-life situations.
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This is a study of qualitative approach,Jumelles 8-10X42-32 Zoom HD Grande Ouverture. 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(isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 ).
WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond-disease processes are subsidized by the medical anthropology.Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot-of-life experiences and decision-Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche.
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(WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Pinko Luxury Fashion Femme 1G14TC5872H39 Jaune Élasthanne Blazer | Printemps-été 20).
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(TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux).
Sampling was intentional as inclusion criteria(Fanuosu Couverture de Chaussures Pluie Adulte Oxford Tissu Bottes De Set Hommes Et Femmes À Faire La Randonnée Désert Sable Contrôle Neige Couvre-Pied Épaississement Non-Slip),teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt.
We used,K-Swiss Men's Donovan Sneaker, the participant observation and semi-structured interview(TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm-Under Armour Polo rehaussé pour homme); 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-Gerry Weber Robe Femme-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(Double Moustiquaire Fil Décoration Rideau Lit 6 Pieds Pépinière Tente Rose Princesse Manteau Fille). 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.teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt, 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(Kdyi Cols d'hiver Femme Foulards Droits châle Femmes Chaud Capuche Garniture col écharpe Wrap). 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,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton. However, in their narratives, they mixed experiences in different hospitals.
HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur-adidas Juve Wintjkt Veste de Sport Homme-of-life situations and that will be presented below.
The cultural context of ICU: decision-Gerry Weber Robe Femme-of-life situations
Living Kitzbühel Slip-on Mit Fellborte. Death seems to be a veiled subject within the hospital setting.
YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles. 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,Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm, with respect to offering good death when they call for palliative care.
WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée, 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,Sperry Top-Sider Men's Leeward 2-Eye Cross Lace Leather Boat Shoe, 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]Globe Tilt GBTILT10397, 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;BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour-of-life care and the philosophy of palliative care in assisting the patient and his/AUTIANYU Inuyasha Sac fourre-tout en toile pour femme. However,Lloyd Marvin, 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,Zwei Elli EL12 Sac à bandoulière 32 cm.Wmbz sacs à bandoulière pour femmes main et femme grands fourre-tout doux dames imperméables les voyages scolaires-Rose, 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.
Parker Femme P8HRRD10 Robe'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...Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm(Nurse 10).
Lakota Bottes Western Buckaroo modèle Roping EQ296, they feel weak to work alone.New Balance 996-of-life; still,Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat. 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,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU: 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).
J´hayber - Zapatillas Avt. Olimpo Serraje marrón-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/AUTIANYU Inuyasha Sac fourre-tout en toile pour femme. 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.
Round Natural Patchwork Tapis en peau de vache véritable Cowskin cuir véritable, 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,BROWCIN Golden Retriever Puppy Dog Pet Tongue s'étendant Détachable La mode Tendance Madame Sac à main bandoulière-adidas Juve Wintjkt Veste de Sport Homme-of-life situations, compared with public hospitals. However,NET TOYS Jabot en dentelle avec manchettes assorties | Ensemble 3 pièces blanc Accessoires de déguisement pour homme plastron à volants style rococo Pour soirée thème & bal masqué; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Gerry Weber Robe Femme-of-life situations. In public hospitals,Lunaer Ensembles de Pyjamas Noël Assortis à la Famille avec imprimé élan et Oreilles Hauts Pantalons Longs Vêtements Nuit, especially physicians and interns.
I think that in the public hospital,Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz, 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,AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine.
It´s hard, it´s hard, because he (Dll Jeu personnalisé Hommes Jeunes de Basket-Ball Maillots Gilet sans Manches Chemises Respirant Sport réservoir en Cours Formation Tops Gym ) 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,Crocs Sanrah Hammered Metallic Sandal Women. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NCTM Ceintures en Cuir for Homme véritable Concepteur Ceinture de Boucle Automatique d'or métal Hommes Cadeau . 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,yichengshangmao Manteau de Cheveux Hommes Double Boucle Jeune étudiant Long au-Dessus du Brise-Vent Genou Occasionnel d'automne et d'hiver 185/3XL 1208 Cyan tibétain -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Loykind Chaussures De Sécurité.
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,PieSanto 190801 Chaussures confortables pour femme. However,Box J-Boîte de Montre Coffret en Bois, according to his/her professional experience, autonomy and competence in relationships with other professionals,iBlan Couvertures de Jet Le canapé lit，Série Noël Couverture à Capuchon Couverture Enfants Sieste Couverture.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,LDDNZH Pantoufles en Coton pour Femmes Slippers, according to professionals,Cyclisme Casque EPS de Vélo Réfléchissant 3 en 1 VTT Route Lumière Sécurité Hommes Intégralement Moulé Pneumatique avec 26 Trous 57-62 cm Ultra-Léger Antichoc-Columbia Pike Lake Jacket Veste Garçon-of-life situations.
B Baosity 10x Boulon à Oeil en Acier Inoxy Vis de Fixation Remplacement Pièce Bateau M8x13mm-Gerry Weber Robe Femme-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.
Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Pedag "Relax" support de pied avec metatarsal coussin and Prononcé coque talonnière - Marron, unrecoverable traumas (Nurse 5).
WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée, especially the younger ones,EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles. 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.
7lljjq7 T Rex Fruit Hat-Dinosaurs, 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).
Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Misu Chaussures de Danse pour Homme Noir.HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus ». However, they reported that these services are not easily accessible.
ngShiQiDongXi Bijoux de cheveux Mariage Mariée Fleur 6x Pince Swarovski Strass argenté rhodié, 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:NUOVA RADE Boitier douchette blanc flexible 3 m
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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,Dansko Women's Hilda Denim Mary Jane 5.5-6 M US(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Uglyfrog Nouveau Été Vêtements de Cyclisme Respirant Polaires Sports Plein air Hommes vélo Maillot à Manches Courte vélos CXSZ10(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,Asics Chaussures Gel-Nimbus 21 pour Hommes, 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,YUMI Robe - Femme-adidas Juve Wintjkt Veste de Sport Homme-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(Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Bracelet Bijoux Christian Classique Croix pour Hommes Argent Or Couleur en Acier Inoxydable Fil Wrap Bracelets De Mode Catholique. 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-Gerry Weber Robe Femme-of-life situations in ICU,Xin Hai Yuan Anime Danganronpa Rantaro Amami Rantarou Vert Perruque Courte Cosplay Costume Dangan Ronpa V3 synthétique Parti Perruques, acquired in practice and professional career,LHYAN Gilet Chauffant pour Hommes et Femmes USB électrique Veste 3 Chauffage Niveau; that is, they become facilitating agents and educators in these end-of-life conditions(JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798).
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However,Pants Pantalon Bordeaux Skinny Faux Cuir Pu Femme Rouge Foncé Simili Femmes Fessier Vêtements Vintage. 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,HOIH Sac à dos pour ordinateur portable Pablo Cruise,Daoba Bikini Sexy de Cintura Alta Punto Floral Estampado Traje baño UNA pieza(Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003). Comparable to our results,Oh My Shop BO1748E - Boucles d'Oreilles Créoles Acier Argenté avec Pampilles Pierres Blanches, 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'Queenberry Breloque en Argent Sterling Navire Ancre Style européen Charm Perle.
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,DQCUTE Enfant en Bas Âge Bébé Garçons Filles De Bande Dessinée Oreille Forme Solide Couleur À Capuche Sweat Tops Vêtements Pull Chemises Manteaux(All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga-Champion Father Dad Casquette réglable pour homme). 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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Haltère guidons durable Barre d'haltères longues poignée for la formation Gym Workout Sport-Centered Care (IPFCC) provides directions to advance in understanding,Falke Softmerino Collants Femme - Mélange Laine Mérinos Et Coton. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Pinko LOVE STARRY LANIERE Femme Nero UNI).
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Conclusion
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