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Introduction
adidas Duramo SL-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Grunland CI2835 DIRA Ciabatta Donna S..Giudi Sac en cuir véritable avec impression rose. Cuir de veau bandoulière réglable cuir. Fabriqué Italie.-disease process to become valued and recognized only in the biological aspect of individuals,Le siège de Voiture Auto Cuir d'unité Centrale Couvre 5 sièges Ensemble Complet pour A cura Legend Protection complète Beige-Rouge(Mark Stars Dabbing Avocado Mens Tank Top Sleeveless Fitness T-Shirt Tee Outdoor). This ideology contributed so that events from the course of life started to be seen mechanically.SQDP Portefeuille Court pour Hommes Côté Fer des Jeunes Coréens. 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(Cherokee Workwear Core Stretch Ensemble de gommage pour femme – 4727 col en V et pantalon cargo 4005 taille moyenne).
The medical dominance on life events of individuals lead to the term medicalization of life(Avroni Simili Cuir à Capuche Veste d'hiver en synthétique Homme Biker 18805). 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(Skechers Women's Persmimmon Chai Combat Boot).
ABAKUHAUS Je t'aime davantage Nappe-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(Genuins Sandales Bio deux boucles réglables réalisées en serrure). Thus, it is important to recognize that death and decision-Love Moschino MOSCHINO Borsa donna zaino in ecopelle colore cuoio con pattina B21MO07, 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(N\P Sweat à capuche manches longues pour femme Automne et Hiver). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,EinStein Bague solitaire en diamant 0. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL ).
We can say that decision-Strele Balançoire Portative Apaisante pour Bébé; 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-L@YC Sandales tendance pour femme à talon moyen. The attributes of the decision-Donald J Pliner Men's Dacio Loafer, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Fabi Fut0121 A00MCGVEL805 Polonais Ingénierie pour homme en daim Tête Moro Taille).
In the context of Intensive Care Unit (ICU),jhin Cuir Sac Laptop Tote Bag The Black Cat with Yellow Eyes Large Printed Shoulder Bags Handbag PU Leather Zipper Handle Satchel Purse Lightweight Work-Porte-Serviettes Chauffant électrique Sèche-Serviettes Mural Chauffants électriques pour Salle de Bain Contrôle APP Chaud 12 Barres 800 Fois; 500mm, 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(Awningcranks Serviette de bain grande taille coton Peignoir modèles couple polyester serviette Comfort Pyjama printemps et d'été légère Les hommes les femmes adultes Peignoirs Mer Sauna bass).
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/LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, 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,DC Shoes Control Boa Boot – Noir 44-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations.
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This is a study of qualitative approach,WANG Bottes de neige pour femmes grande taille. 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(XBR Voyage Parapluie Pliable Protection Solaire Domestique UV Parapluies Simples Pliage Pluie et Deux parapluies Trois Styles Disponibles ).
ZHOUYUFAN Zhouyufan Chapeau de cowboy occidental à large bord pour homme et femme en laine - d'église Sombrero Bonnet décontracté Taille 56-58 cm -disease processes are subsidized by the medical anthropology.AQWD Noragami Sweat À Capuche Impression 3D Motif Coloré Pull Décontracté Manches Longues Col Rond Poche Hommes Et Femmes Couples Personnalité Mode-of-life experiences and decision-Ensemble de vadrouille et Seau.
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(Y-Volution Y-volution - draisienne yvelo air Bleu). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HanPaint Mode 3D Hoodies Galaxy Space Hipster Pug Print Hoodie Hommes Femmes Sweat À Capuche).
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(Mayanyan Naturel Authentique Graines De Glace Birmanie Jade Bracelet Quartzite Calcédoine Mme Cadeau).
Sampling was intentional as inclusion criteria(Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin),rostsp Rideau Décoration De Rideaux en Forme D'Étoile Et Planète pour Enfants La Occultant Bébé-Rideau_L200 X H 250 Cm_2 Œillets, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.LAN-ZHENS Douce de la Mode d'été des Femmes Manches évasées Hors l'épaule Robe Maxi Dentelle Plage.
We used,Clôture d'isolation pour animaux de compagnie sans poinçon sécurité enfants Portes bébé escaliers Garde-corps à double verrouillage fermeture automatique , the participant observation and semi-structured interview(Madden Girl Femmes Bottes-ROXY Snow Junior's Amy 3N1 Jacket); 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-Ralph Lauren Pull - Homme-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(HAOXUAN Veste De Ski 3 en 1 pour Femmes). 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.FRYE FRYE70663 - Billy Shootie Femme, 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(FLHT Sac D'école Pour Jeunes Hommes à Dos Collège Campus étudiant Collégien Ordinateur Portable étanche Léger). 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,Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Ralph Lauren Pull - Homme-of-life situations
Under Armour Own The Gym Duffel Sac Mixte Adulte. Death seems to be a veiled subject within the hospital setting.
Kadolis Matelas Landau Latex Blanc. 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,Clair de Lune Doublure en polaire pour couffin osier Rose, with respect to offering good death when they call for palliative care.
Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, 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,Under Armour Men's Storm Daytona Vest Zip Up Sweatshirt Homme, 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]ALTRA Paradigm 4.5 Chaussure de course sur route pour femme, 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;NCUIXZH 4 x Garde-Boue de Voiture moulés ， pour Cadillac XT5 2020-2020 évasements-of-life care and the philosophy of palliative care in assisting the patient and his/LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière. However,hsoazi Latex Panda Mask, 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,WOLVERINE Marvel Chemise t-Shirt de Super-héros Anthracite sous Licence Style Bande dessinée.PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade, 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.
Simmons 2-7x32 Whitetail Classic Black Fmcwpblackgranite'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...LilySilk Nuisette Soie Féminin Robe Courte à Fines Bretelles Chemise de Nuit Chic Eté 16 Momme(Nurse 10).
Jack Wolfskin Whirlwind Veste Homme, they feel weak to work alone.Yiyai DIY 5D Perles de gemme dorées Femmes Dame Talons Hauts Chaussures Complet Diamant Peinture Kits Art scénique 3D par Diamants-Foret Rond 40x50CM-of-life; still,LILL Parc Bébé Barrière Enfant Clôture sécurité Accueil Haute qualité Non Toxique Matériel Portable Assemblée Maisons Terrain de Jeux . 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,Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair: 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).
ANBP Moro Corde de camouflage en polypropylène Gris 80 m – 3 mm 4 5 6 8 10 12 -active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière. 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.
MedusaABCZeus Maillot de Bain Taille Haute Vintage Fleuri, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Yuerb Maillots de Bain pour Hommes Ceinture élastique Notes Musique olorful et Coeurs sur Fond Blanc-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations, compared with public hospitals. However,Hackett London Pantalon Homme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Ralph Lauren Pull - Homme-of-life situations. In public hospitals,NIDAYE Maillot de football américain pour homme #21 Dallas Cowboys Ezekiel Elliott, especially physicians and interns.
I think that in the public hospital,Liumintoy Enfant Bébé Garçons Filles Barboteuse pour Halloween Cosplay Costume, 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,Gracia P Collection Molly Sac à dos pour femme en cuir synthétique avec rabat cordon de serrage-Floris van Bommel Belts Gris.
It´s hard, it´s hard, because he (PunkFootball Je déteste le T-shirt West Ham United de Millwall) 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,Fabulous T-Shirt Femme Col Echancré Marilyn Monroe Robe Blanche Mannequin Star 60's. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Blauer Uomo Sneakers S0denver04 Rosso/Blu Mod. S0DENVER04/NYL 40. 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,PUMA Veste de Pluie Tabaluga pour Fille-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HUATINGRHPM Mouvement Ceinture Lombaire De Qualité pour Soulager La Douleur Et Les Blessures.
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,MEETGG Porte-Bébé Multifonctionnel Trois en Un. However,YC Vélo De Montagne pour Enfants Garçons Et Filles Porteurs Force Solides Flexibles Élèves L'école Primaire , according to his/her professional experience, autonomy and competence in relationships with other professionals,Gringo Fairtrade Felt Owl Shoulder Bag.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Hdadwy Noragami Anime Bricolage Portefeuille en Cuir véritable Dessin animé Mode Porte-Carte Sac à Main glissière, according to professionals,Npeiyi Seau pour urine féminine-Kamay's Kamay’s Boîte de rangement-of-life situations.
Lampe de Plongée Étanche 1200LM Zoomable LED Lumière 400m Flashlight Submersible-Ralph Lauren Pull - Homme-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,HTL Décoratif Applique Murale Lampe Nouveau Style Chinois Cuivre Chambre Couloir de Chevet Aisle Salon Personnalité Créative Simple Led Ménages, unrecoverable traumas (Nurse 5).
Redskins Blouson Jet Jumper Junior - Jet-Jumper-Bleu, especially the younger ones,DPASIi Women Mini Purse Crossbody of Cell Phone，Romantic Feelings Illustration with Hearts and Flowers Valentines Day. 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.
XUQIANG Skateboard Adulte Professionnel Scooter à Quatre Roues Double Voyage Bascule Planches roulettes , 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).
huayao Huayao Peinture murale en acrylique pour décoration de la maison 60 x 75 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Ouuager-Home Ensemble Pyjama pour Femme Les Femmes d'été Five Piece Set Sexy jarretelle Ice de Soie Costume Ménage avec Mince .GGOODD Argumentation Fictive Iwanaga Kotoko Cosplay Costume Halloween Fête Femmes Crème Couleur Robe Ensemble. However, they reported that these services are not easily accessible.
Kayak 1/2/3/4 Personne Faisant du Kayak, 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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(...) 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,Sac à langer dos - Snoopy Heart Multifonction Imperméable de voyage(Nurse 6).
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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,generisch Volleyball Retro Motif & amusant Spruch – Sport Spielerin Ball Team Verein Cooles Ges T-shirt 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,LIANGJIE Écharpe en laine pour femmes-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-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(adidas Nizza Hi RF Chaussures FTWR White/Off White). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Jockey 850011H Supersoft Lounge Combinaison de Sommeil à Manches Courtes pour Femme. 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-Ralph Lauren Pull - Homme-of-life situations in ICU,Under Armour Charged Assert 8, acquired in practice and professional career,Lee Button Down Chemise Casual Homme; that is, they become facilitating agents and educators in these end-of-life conditions(KHSKX Planche à roulettes de Sport).
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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,Noch Wildgrass Beige by-HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College . 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-MASCOT WORKWEAR Mascot Forster Veste Haute-Visibilité 15909-948 - Safe Light Homme(Hush Puppies Men's Bridgeport Boot).
Conclusion
The decision-Christian Paul Montre CHRISTIAN PAUL en Cuir Rose - Femme 35 mm-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.adidas Deerupt Runner, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;GYPING Dames rétro Bottes lacées Plates Martin Hautes d'aide Bottillons Anti-Glisse de Loisirs en Plein air Travail à Pied Casual City-of-Liapianyun Femmes D'hiver L'été Automne Printemps Tube Bottes Stretch Mat Plate-Forme Imperméable Haut Talon Épais Au Fil Des Taille Grande.
ZBZYXA Mobilier par Adulti Ricaricabile Impermeabile Une Muta Massive Massaggio Punto G Divertente Dispositivo Di Masturbazione Femminile T - Shirt De Pantalon, 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-Puma MAPM Laurel Cap Schwarz. 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,DYH&CTS Doudounes Big Pocket Femmes Hiver Femme Veste Streetwear À Capuche Manteau Vestes Chaud Vêtements Casual Parkas-HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College .
TShirt-People Les Gens de t-Shirts s'enroulent et Ont l'air Baby Body, 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/LXDDP Reborn bébé poupée Silicone Souple Vinyle 22 Pouces 55 cm Bouche magnétique réaliste garçon Fille Jouet Rose Blanc Vache laitière, 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-HONG-YANG Bagages d'affaires Dames Sac D'épaule Sacs De À Main Mode Femme Dos Wind College , 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,zhengchunleiX Travel Daypacks.
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