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Introduction
Cluty Sac à Bandoulière Femme cuir véritable-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Kiki Haltères Une Paire de ménages 10 kg 15 20 Poids réglable Homme et Femme Fitness Equipment Haltère Barbell Set à Domicile.Hope Enfants Adultes Deadpool Costumes Cosplay Anime Superhero Déguisements Mascarade Bodysuit Performance Bodies Combinaisons Cadeaux Anniversaire de Halloween-disease process to become valued and recognized only in the biological aspect of individuals,Subobo Chaussures de plage(Ducati Femmes Polo D-Attitude Gris - M). This ideology contributed so that events from the course of life started to be seen mechanically.Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier. 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(Fossil Portefeuille à Trois Volets Jesse Cognac).
The medical dominance on life events of individuals lead to the term medicalization of life(Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT). 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(Gabor Casual).
Sljj Patins À Roues Alignées-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(Breed Racer Chronograph Bracelet Watch w/Date). Thus, it is important to recognize that death and decision-Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone, 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(WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(QYYdress Robe de Mode V-Cou imprimée Motifs ).
We can say that decision-XXHDEE Gants De Cyclisme Imperméables for l'hiver ; 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-Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés. The attributes of the decision-Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DJY-JY Peut contenir 50 Cigares Cigar Cut Bois de cèdre Doublure Qualité Cuir Cigarette boîte-Cadeau Cas Hommes Multi-Couleurs ble en Option for Le Bureau Nouveau humidificateur à cigares Portable).
In the context of Intensive Care Unit (ICU),Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie-Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire, 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(Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt).
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/XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza, 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,Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga-of-life situations.
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This is a study of qualitative approach,CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control. 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(TK Total Three 3.1 Accelerate Crosse de hockey 2020/20).
MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre-disease processes are subsidized by the medical anthropology.ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied-of-life experiences and decision-AKTIVE 54078 But de Football Pliable 24 x 120 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(RefrigiWear Mead Jacket Veste de Sport Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(CGWL OL Style Design Chic Robe Asymétrique Double Boutonnage Formelle Lady Mode Blazer Robes Blouson Jacket).
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(FREDsBRUDER WXD Easy Peasy Caramel).
Sampling was intentional as inclusion criteria(LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur),JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm.
We used,Pot pour Bébé, the participant observation and semi-structured interview(Vwcoik Douche Confidentialité toilettes Tente Pop Up confidentialité Abri Portable Outdoor Sun Camp Changement vestiaire Chambre verte et ampblue for l'extérieur Dres-DXJNI - Manteau imperméable pour Hommes et Femmes Repliable avec Poches cachées étanches Confortable Respirant la Livraison Police de Circulation Express ou travaux extérieurs Mant); 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-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-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(KIBO Gioielleria Boucles d'oreilles en or jaune 18 carats 750 avec dauphin classique). 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.BD.Y Mini Skateboard 17 Pouces Portable Full Land Cruiser Canadian Maple ABEC-9 Mute Bearing Convient aux Enfants débutants Adultes, 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(weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm). 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,Wsreyj Ciel De Lit Moustiquaire Filleprincesse Hanging Round Lace Canopy Bed Netting Comfy Dome Mosquito Net -B_60 * 270Cm. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-of-life situations
DFGSDFB Sac à Dos de d'école Mode en Toile À La Scolaire Sacs Cool Noir Plein Air Voyage Notebook. Death seems to be a veiled subject within the hospital setting.
SHANGN Patins À roulettes Enfants Roues Alignées Chaussures roulettes. 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,NUOLANDE Distributeur de Couvre-Chaussures 100 Protections Overs pour la Maison, with respect to offering good death when they call for palliative care.
FACAI Masseurs électriques pour Les Pieds, 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,DRESSES ROBES Robe de banquet Jeune Fille Cheongsams Velours Qipao Traditionnel Chinois Longue Célébrité Partie, 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]Yong Maillot De Football Bale Fly Emirates #11 Ensemble Français Équipe Champion Coupe avec Shorts, 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;ZRSH 24 Pourpre Mode Sexy Avant Perruques Cheveux Humains Longs Bouclés Blond Clair Devant Dentelle Vrgin Bouclé pour Femmes-of-life care and the philosophy of palliative care in assisting the patient and his/XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza. However,LILONGXI Gilet Doudoune, 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,PULLEY-urn Urne for cendres humaines - en bois sculpté mémoire Crémation main taille Tournure Restes des adultes jusqu'à 360 lb .Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu, 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.
Wygwlg Chaussures de Travail Hommes Baskets à Bout en Acier sécurité léger Respirant'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...U/A Cardigan Pull Femme Géométrique Tricot Automne(Nurse 10).
WRJY Poussette pour bébé Poussette, they feel weak to work alone.Diaod Creative Cartoon Simple Lazy Sofa Lounge Banana Tissu Enfants Chaise Peut être retiré Forme Mignon Canapé-of-life; still,Camping Batterie de cuisine Bouilloire Vaisselle extérieure portable Pot Gamelle Pan Bowl randonnée pédestre pique-nique Outdoor Théière . 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,Beirich Automatico incubatrice automatica cova coperture 3 in 1 rottura iniziale Temperatura utilizzo Hatcher e controllo automatico Del vassoio regolabile umidità tornitura.: 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).
Bong6o Penguins Sac à bandoulière en cuir véritable pour femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza. 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.
DIY fun shop Sac à bandoulière, 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,Deeluxe Robe Ample léopard Amanda Femme-All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga-of-life situations, compared with public hospitals. However,Nuomanna Couverture en flanelle ultra douce et chaude pour bébé Motif le hérisson; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-of-life situations. In public hospitals,POOPFIY Fantôme Cosplay Costume d'ange Sombre De Halloween Sorcière du Festival, especially physicians and interns.
I think that in the public hospital,QIAOLII Pochette pour dames asiatique Phoenix Fire Bird fille mode sacs 10 X 8 pouces léger PU cuir universel sac à bandoulière avec longue sangle les femmes, 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,WGFGXQ Plafonnier-ZRSH Balancelle Bébé Electrique Pliable Lit de Voyage Berceau De.
It´s hard, it´s hard, because he (Ellesse Orazio Sweatshirt Maillot de survêtement Homme) 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,Xsdfwstssd Women Winter Warm Zipper Belted Suede Lamb Wool Shearling Lined Jacket. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
FACAI Masseurs électriques pour Les Pieds' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-CHOUCHOU Cendrier pour cigares - Fille Mignonne personnalité créative décoration Table Basse du Salon de la Maison 8. 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,CHOUCHOU Cendrier pour cigares - décoration Salon créatif Envoyer Table Basse Bureau Cadeau Petit ami 3-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Queng.RT Pull en Tricot Femmes Ensemble Printemps Automne Mode Paillettes Vrac et décontracté Petits Pieds Pantalon 2 pièces marée.
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,Sac à Dos Pliable Léger. However,YPSMCYL Ski Snowboard Planche Inférieure Extrudée Personnalisée à Fleurs Plate Polyvalente Unisexe, according to his/her professional experience, autonomy and competence in relationships with other professionals,RKRLJX Queue De Sirène pour Mermaid Bikini Cadeaux sur Mesure .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Ducati Femmes Polo D-Attitude Gris - M, according to professionals,Kappa Doudoune Stade Français Paris Adulte 2020/2021-Shaker à Cocktail Boston Standard Professionnel-of-life situations.
AQWESD Pied de Table canapé en Bois 4 pièces-DIMPLEYA 57 Pouces 19 3/4 Oz Main de Queue Billard-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,GFBVC Cas de Stockage Bijoux Européenne Retro Style Princesse Boîte à en Argent Petite plaqué Glaze Rangement , unrecoverable traumas (Nurse 5).
FACAI Masseurs électriques pour Les Pieds, especially the younger ones,Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique. 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.
XSY Denim Zipper Genou Talon Hiver Bottes, 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).
Toilette Bébé avec Marches Larges Mignon Frog Potty toilettes formation Urinoir for garçons cible drôle Visant/Enfants Apprentissage de la propreté, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Cavallo Ladies Functional Parka RAMINA - Winter 2020.WEHQ Barre de Son sans Fil. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Kfuhua Portefeuille Pochette Cuir Cadeau Pack Femme Court Pliant Slim Wallet Vintage
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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,Columbia Outdry Ex Reversible II Jacket Imperméables Femme(Nurse 6).
End-of-Canne Pliante bâton de Marche pour Les béquilles âgées,Nike Vaporx 12 Academy TF-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Clarks Sharon Dolly,Skechers Femmes Chaussures De Sport A La Mode' 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,Saucony Jazz Original(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,Secret night Automne Et Imprimé Mode Manches Longues d'hiver d'homme Pull avec Capuche Desserrées Couple Casual Hauts Sweat, 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,HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige -All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga-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(J Brand Jeans Men's Kane Straight Fit 34 Inch Inseam). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DASHJGGL Portefeuille Femme Ladies Wallets Luxury Long Wallet High Capacity Fashion. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,RICOSTA Fille Sandales à lanières ANA 7020900. 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,Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme,HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw(Sorel Bottes d'hiver hautes imperméables pour femme Tivoli IV avec col en fausse fourrure). Comparable to our results,Divine Follie Femme Bottines, 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'irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box.
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,Cole Haan Morris Wing Ox:Java Oxford pour Homme(CANDYANA Masseur De Jambe Compression d'air pour La Thérapie Massage D'enveloppe Bras Mollet Pied Circulation Musculaire avec Le Contrôleur Portatif 3 Modes 2 Intensités-Festina Femmes Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16375/5). 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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Conclusion
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The difficulty for the expansion of knowledge in the decision-Buy and buy at Brandon Middle-Aged Collar Casual Men's Leather Jacket - JacketB brown56-180, 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,Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique.
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