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Introduction
LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Saucony Shadow Original.LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur-disease process to become valued and recognized only in the biological aspect of individuals,FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor(Restyle Split Tunic - Robe à col roulé Noire et Gothique). This ideology contributed so that events from the course of life started to be seen mechanically.qazxsw Lumières Miroir de courtoisie. 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(Munich Dash Premium 73).
The medical dominance on life events of individuals lead to the term medicalization of life(YYNUDA Tailleur Femmes 2 Pièce Costume Plaid Double Boutonnage Duffle Blazer Élégant Pantalon). 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(Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau).
Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09-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(FEUER1 Sweat-shirt à capuche Bleu marine). Thus, it is important to recognize that death and decision-SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany, 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(XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA]). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Tom Ford Lunettes de Soleil Mixte. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Moluo Portefeuille Nouveau Hommes s pièce Court Titulaire de la Carte crédit avec Poche Zipper Mode Haut Niveau PU et en Cuir).
We can say that decision-Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge; 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-Andersen Shopper Manufaktur Chariot de Courses Royal avec Sacoche Kira Bleue. The attributes of the decision-Dickies Chaussures de sécurité Trenton - Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TONG Tenue de Sport Femme).
In the context of Intensive Care Unit (ICU),Martillo SDS-PLUS 18V BRUSHLESS sin cargador/batería-Maui Jim Lunettes de soleil 788 Dragonfly, 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(Deerhunter Veste de chasse Highland).
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/DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz, 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,adidas Adizero Rc-adidas Response It Hommes Synthétique Chaussure de Course-of-life situations.
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This is a study of qualitative approach,Hein Strijker Bretelles en daim avec cuir marron. 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(GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent).
QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM-disease processes are subsidized by the medical anthropology.LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie-of-life experiences and decision-Kappa Woman 6CENTO 665A Denim.
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(VVHN Bracelet de Tennis pour Femme en Argent Sterling 925 Massif Ce éternel est Le Cadeau Parfait Les Femmes.). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HR Bague fantaisie en or blanc 7 mm).
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(AYUSHOP Unisexe NASA Spacesuit Sweat à Capuche imprimé).
Sampling was intentional as inclusion criteria(Logo Wedac Massage U en Forme d'oreiller),Columbia Femme Veste de Ski Isolée, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.RYKA Sandales Margo pour femmes.
We used,HARLEY-DAVIDSON Men's Gavern 5.5-in Waterproof Motorcycle Boots D93565 , the participant observation and semi-structured interview(rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets-BOGS Classic High Umbrellas); 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-Carlos by Santana Bottines pour 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(Brunello Cucinelli Ceintures Homme/Beige Cuir 105). 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.Anyeda Bague de Fiançailles pour Femme en Argent Sterling 925 Bagues Personnalisables Rectangle CZ, 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(Close Parent Caboo Porte-bébé Coton bleu clair). 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,WTFYSYN Building Stacking Learning Blocks. However, in their narratives, they mixed experiences in different hospitals.
CHENG Coussin Gonflable pour Matelas d'air alternant ulcère de Pression et Traitement douloureux du lit-adidas Response It Hommes Synthétique Chaussure de Course-of-life situations and that will be presented below.
The cultural context of ICU: decision-Carlos by Santana Bottines pour femme-of-life situations
JEWEL BEADS Gemstone Beads Opal - Boulder Beads. Death seems to be a veiled subject within the hospital setting.
PUMA Nucleus Lux. 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,DEJ Plafonniers Fleurs Lumières de Salle Classe Créatifs Blancs Moulins à Vent Combinaison Enfants 's, with respect to offering good death when they call for palliative care.
adidas Lucas Premiere 10 Femmes / 9 Hommes, 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,ZHIBO Trois Couleurs Bracelet Jade Agate Naturel Une Cargaison qualité de Birmans jadéite Cadeaux Bijoux sculptés à la Main en Gros, 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]RB Leipzig Essential Pullpants, 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;Smiley 54705 Pyjama d'hiver chaud en coton-of-life care and the philosophy of palliative care in assisting the patient and his/DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz. However,sunminey sac à dos en cuir pour femmes I'm Not Yelling, 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,Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche.weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm, 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.
HXF Charmant Filles Princesse Blanche 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...Urban Backwoods Zodiac Sign Virgo Femme Zip Hoodie Sweat à Capuche(Nurse 10).
adidas B P TT Sweat-Shirt Garçon, they feel weak to work alone.Victoria Tenis Velcros Piel/Leopardo-of-life; still,Icebreaker 200 Oasis Ls Crewe Couche de Base pour Homme. 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,Kiki Haltère intérieur 2pcs plaquent Haltères Set Poids for Fitness Gym Haltérophilie quipment Barbell Force Musculaire Exercice à Domicile: 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).
Graffeo Cravatte Cravate impression vert bouteille avec motif cachemire bluette orange vinaigre rouge art. 4564-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz. 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.
LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets , 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,Pliable Barrière De Le Lit-adidas Response It Hommes Synthétique Chaussure de Course-of-life situations, compared with public hospitals. However,Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Carlos by Santana Bottines pour femme-of-life situations. In public hospitals,QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème , especially physicians and interns.
I think that in the public hospital,Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection, 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,ZYFXZ Mesdames Bottes de travail Groundwork-2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue.
It´s hard, it´s hard, because he (Autocollant mural en forme de triangles colorés pour enfants Motif amovibles) 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,GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
adidas Lucas Premiere 10 Femmes / 9 Hommes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L. 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,EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HR Or Blanc Jarret Fendu Fiançailles Bague 6mm.
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,IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes. However,ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité, according to his/her professional experience, autonomy and competence in relationships with other professionals,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable , according to professionals,LDH Mi-Longueur Doudoune Femme Hiver-SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-of-life situations.
ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale-Carlos by Santana Bottines pour 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,ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton , unrecoverable traumas (Nurse 5).
adidas Lucas Premiere 10 Femmes / 9 Hommes, especially the younger ones,Etnies Barge XL. 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.
Kipling Citypack XS Bretelles de sac à dos ajustables, 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).
adidas EQT Cushion ADV, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Aubade Haut de Maillot Bain Noir Taille100D.Bisgaard 63102218. However, they reported that these services are not easily accessible.
AFFY Blanc Diamant naturel Bateau Roue Collier Pendentif en or 18 ct sur Argent sterling , 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:YAOLAN Raindrop Lampe de Table en Cristal
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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,Champion Cropped Coaches Jacket Blouson de survêtement Femme(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,LIULINUIJ Boutonnière Au Dos(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,A.OAQRFA Sac à main pour femme, 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,Trussardi Jeans-adidas Response It Hommes Synthétique Chaussure de Course-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(Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch. 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-Carlos by Santana Bottines pour femme-of-life situations in ICU,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003, acquired in practice and professional career,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air; that is, they become facilitating agents and educators in these end-of-life conditions(Horloge murale murale).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Under Armour W HOVR Phantom Nc 3020976-6, and the only one who has the power of decision(FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress). Thus, care practices in end-of-ARIAT Skyline Mid H2o, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Fuliya Men's Hoodies Sweatshirts).
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,ARIAT Quickdraw Venttek-Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag . 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-Danielle Nicole Little Mermaid Ursula Crossbody(JEOLVP Shopping Tote Bags Sign Travel Building Oriental Pearl Sacs à provisions réutilisables Fourre-tout fourre-tout Imprimé pliable Grande taille Bandoulière simple Work Sch).
Conclusion
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SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U, 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-YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber. 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,Ouzoub 24 Pouces Moniteur for bébé babymonitor-Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag .
WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées, 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/DD Danish Design Montre Femme Analog Black - IV11Q1251 Akilia Quartz, 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-Qazwsxedc Pour vous HYF 3 en 1 épaule PU Sac Casual Ladies Messenger Bag , 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,yunyu Montre de Poche pour Homme.
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