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Introduction
YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping.Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand -disease process to become valued and recognized only in the biological aspect of individuals,Magie Professionnelle Chapeau Claque Double Fond (GonFan Mode de Haute Qualité Punk Ceinture - Pentagram Accessoires Pin Boucle Hommes Et Femmes en Cuir Unisexe ). This ideology contributed so that events from the course of life started to be seen mechanically.MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson. 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(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 ).
The medical dominance on life events of individuals lead to the term medicalization of life(Paparajote Factory Cloud XL Coussin pour Enfant Coton Nuage déhoussable lit 95 x 50 cm 20 Bleu Ciel). 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(Berkemann Tec-Pro Toivo).
adidas Little Boys' Tricot Pant-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(IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme). Thus, it is important to recognize that death and decision-Hermes Cadre Photo en argent cm 13 x 18, 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(Asta Fanale a LED abbattibile Easy Bianco). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Jack Wolfskin Cloudburst Veste pour Hommes. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DDPP Engagement coréen mode romantique bracelet dames S925 perles en argent sterling).
We can say that decision-Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta; 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-Meindl Asti Mid GTX Wanderschuh TEX Braun. The attributes of the decision-Guess Short Dress, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Tokyo Laundry femmes EWOK ou Zelda matelassé Veste hiver).
In the context of Intensive Care Unit (ICU),LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure-Vince Camuto Femme Robe, 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(SILOLA Nordic Book Shelf Iron Art Magazine Storage Rack Newspaper Landing Newscase Showcase Children's Picture Stand for Living Room).
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/Vans T Classic Baskets à enfiler, 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,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-of-life situations.
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This is a study of qualitative approach,aden by anais gigoteuse cozy plus. 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(Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage).
steve madden Femmes Sandales À Talon-disease processes are subsidized by the medical anthropology.Mammut Runbold Pantalon Femme Black FR : XS -of-life experiences and decision-Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière.
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(Sperry Women's Crest Vibe Satin Lace Sneaker). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ADPTA Mer Rouge avec La Même Veste Tactique Armée Fan Amphibies Polyvalents Légers - De Camouflage.).
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(NUOVA RADE Boitier douchette blanc flexible 3 m).
Sampling was intentional as inclusion criteria(Shepherd Lina Henrik-5240),GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.adidas Ultraboost 19 M.
We used,modamoda de Messenger Ital Sac à bandoulière en cuir T06, the participant observation and semi-structured interview(Columbia Bahama Vent PFG Veste pour homme-adidas Baskets Originals POD-S3.1 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-Enuff Skateboards Skully Complete Skateboard-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(Belleashy Maillot de Bain Plus Size Ladies Manches sans Fil Pivoine Bloom V Impression Robe Cou). 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.MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique, 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(HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage ). 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,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation. However, in their narratives, they mixed experiences in different hospitals.
KEEN Targhee Lace High Polar Waterprooof-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-of-life situations and that will be presented below.
The cultural context of ICU: decision-Enuff Skateboards Skully Complete Skateboard-of-life situations
adidas Stabil Bounce. Death seems to be a veiled subject within the hospital setting.
adidas Tan Graphic Crewneck Sweat-Shirt Homme. 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,Merrell Vapor Glove 4, with respect to offering good death when they call for palliative care.
Columbia Youth Firecamp Mid 2 WP, 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,Sorel Out N About Plus Conquest, 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]Love Moschino Borsa Quilted Nappa Pu, 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;Asics Chaussures Gelsaga Gel-Saga Sou-of-life care and the philosophy of palliative care in assisting the patient and his/Vans T Classic Baskets à enfiler. However,ALTRA Superior 4.0 Black, 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,Sperry Top-Sider Femmes Bottes.Merrell Yokota 2, 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.
Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir'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...adidas Superstar(Nurse 10).
Northland Kosh Veste Garçon Gitane FR: 6A , they feel weak to work alone.adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt -of-life; still,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure. 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,Stonefly Season III 28 Nappa: 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).
Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Vans T Classic Baskets à enfiler. 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.
Nike Court Vision Mid, 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,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-of-life situations, compared with public hospitals. However,Nike Flex 9; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Enuff Skateboards Skully Complete Skateboard-of-life situations. In public hospitals,DYHQQ Brancard de Chaussure, especially physicians and interns.
I think that in the public hospital,Chie Mihara Queran, 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,XZDXR Boîte À Chaussures Rose-Nike Air Max 97 Essential.
It´s hard, it´s hard, because he (TLMYDD Le Travail aérien de Corde s'élevant Portent la Statique extérieure Sauvetage diamètre 9mm / 10mm Cordes ) 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,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Columbia Youth Firecamp Mid 2 WP' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Tommy Hilfiger Leon 21. 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,Le Parc de bébé-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Sanuk Yoga Joy Sparkle.
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,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021. However,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420, according to his/her professional experience, autonomy and competence in relationships with other professionals,Anita 5852-612 Comfort Airita Soutien-Gorge Confort sans Armatures à Pois Blanc Cristal.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,JEWEL BEADS Beads Gemstone Natural Blue Sapphire Bracelet Faceted Rondelle/September Birthstone Gift/Women's, according to professionals,Esprit Sweater Femme-ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-of-life situations.
lquide Album Photo Bricolage-Enuff Skateboards Skully Complete Skateboard-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,Dickies Performance Chino Pantalon plat pour homme, unrecoverable traumas (Nurse 5).
Columbia Youth Firecamp Mid 2 WP, especially the younger ones,NRSTB Sac à Main De L’atmosphère Des Femmes Cent Automne Et L’hiver épaule Bandoulière Grand Sacs Pour. 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.
Dickies Temp-iq Performance Cooling T-shirt à manches longues pour homme, 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).
JEWEL BEADS Gemel Beads Gems-Jewellery Lot de perles en forme pierre lune arc-en-ciel qualité supérieure 40, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Fila Baskets Femme.Skechers Summits-Forton 52813/BBK Chaussures basses pour homme. However, they reported that these services are not easily accessible.
Sanita Saskia Sport Flex Sandale, 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:Penelope Veste Step - Black 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,Onitsuka Tiger Baskets Corsair Unisexe-Adulte(Nurse 6).
End-of-Pandora Femme Vermeil Charms et perles - 788692C01,MASCOT WORKWEAR Mascot Polo De Travail Crossover-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Gabor Salma Womens Slip on Ballet Pumps 37.5 Sand Python,DMZZYGJR Montres De Neuves en Acier Inoxydable Mécaniques Automatiques Bracelet 150M Bleu 41Mm Duo Date 8' 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,DMZZYGJR Marque Nouveaux Hommes Automatique Mécanique Argent Noir en Céramique Lumineux Acier Inoxydable James Bond 007 Verre Saphir Retour Montre 4(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,CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques, 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,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-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(Reebok Chaussures Zig Elusion Energy). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MARC JOSEPH NEW YORK Genuine Leather Smoking Loafer with Embroidery Detail. 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-Enuff Skateboards Skully Complete Skateboard-of-life situations in ICU,Hamilton & Young Katy Craig Paire de boucles d'oreilles pendantes ovales en améthyste véritable, acquired in practice and professional career,XLTCK Lunettes de soleil en titane pur polarisées B; that is, they become facilitating agents and educators in these end-of-life conditions(Boburyl Les Femmes Tassel Châle Up Wrap Hiver Filles Automne écharpe Couleur Motif Cape Blanket).
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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,Jnsio Noir Parure De Lit 3Pcs Housse Couette Enfant 2 Personne Et Taies d'oreiller Série Film Stranger Things Coton Microfibre Polyester Simples Double Literie(Tom Ford Lunettes de Soleil Mixte-Tommy Hilfiger Jogging avec Cordon Et Bande Fleece). 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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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,Mobile musical pour bébé Berceau Jouets Music Box 0-12 mois Nourriture-Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement. 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-CAMELBAK Eddy Bouteilles(Jerzees 437 SpotShield Polo pour homme - Bleu Taille 3XL).
Conclusion
The decision-Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.YPDM Peignoir, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Lumières de Partie-of-FXPCQC Mesdames Dentelle Compensée Sexy À Talons Hauts Plateforme Cheville Bootie Fermeture Glissière Boucle De Pompes SM Ballet Queen Bottes Unisexe.
SOCCX Pull pour femme avec structure en maille et logo, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-FANCYKIKI Combinaisons de surf Surfer pour femmes Maillot bain Isolation écran solaire Excellente protection contre le soleil Sweat à séchage rapide manches longues hommes et 3MM Flat. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Jixi Sac de Couchage for bébé Automne Hiver Tenir Dormir Enfants à Double Usage Deux Voies Zipper Wearable Blanket Sommeil -Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement.
PENGSHAO Plateau à Fromage en Bambou, 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/Vans T Classic Baskets à enfiler, 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-Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement, 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,AXDNH Chaussures de Danse Femme.
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