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Introduction
SanDisk 64 Go microSD HC XC microSDXC Class 10 Carte mémoire 64 G -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Marie Jo Tom SCA Soutien-Gorge Femme.Reebok RB874 Women's Stealth SR Safety Boots - Black-disease process to become valued and recognized only in the biological aspect of individuals,APHISONUK Sacs à Main fourre-Tout en Cuir de Concepteur pour des Femmes(Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne). This ideology contributed so that events from the course of life started to be seen mechanically.Land Rover Range Card Holder - Black Porte-Carte de crédit. 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(MIORE MPS043N - Collier Femme Argent 925/1000 3.05 gr Topaze/Oxyde de Zirconium).
The medical dominance on life events of individuals lead to the term medicalization of life(Bottega Veneta Lunettes de Soleil BV1013SK Gold/Brown 57/16/145 unisexe). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Helikon CPU Hommes Short PL Woodland).
DC Shoes Heathrow Prestige-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(Orient Watch FAA02002D9 Montre Homme Automatique). Thus, it is important to recognize that death and decision-Skechers Parallel-Trapezoid, 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(NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Galvin Green Leslie Veste pour Femme Bleu Marine/Blanc).
We can say that decision-U24 Drapeau du Ashanti en format portrait haute qualité pour 150 x 600 cm; 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-Julbo Tamang Lunettes de Soleil Homme. The attributes of the decision-Star Wars - Sweat-Shirt à Capuche Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Sperry Top-Sider Syren Gulf Duck Boot Women's).
In the context of Intensive Care Unit (ICU),Redbridge Veste en cuir Homme Faux Leather Jacket Noir Hommes Col montant Equipé Mince Fit-Gamakatsu 25 Pack EWG Offset Worm Hook , 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(Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir).
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/Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 , 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,glerups dk G Ankle Boot Mixte Adulte Pantoufle Feutre-Wildlife Tiger Baby Diaper Bag Backpack-of-life situations.
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This is a study of qualitative approach,Odlo Energy Pantalon pour Femme x. 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(AWJ Barre d'appui de Douche).
Disney Star Wars Jeu de Cartes Mickey Mouse Sith and Jedi-disease processes are subsidized by the medical anthropology.Kala-isbijoux Pendentif -of-life experiences and decision-SMKMI Smiffys Licenciado oficialmente Costume Elvis American Eagle.
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(Café Noir Cafè FHA923273400 Taupe 40). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(HOIBUKM Souris De Jeu Verticale avec sans Fil Bluetooth 1600DPI Bureau Silencieuse Optique pour Ordinateur Portable).
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(J´hayber - Zapatillas Avt. Olimpo Serraje marrón).
Sampling was intentional as inclusion criteria(Ouqian Vélo dexercice Intérieur Silencieux Accueil Vertical Équipement de Remise en Forme for lintérieur Cyclisme Salle ),JINGJING Tire-Lait électrique Massage et Fonction mémoire Silencieux 4 Modes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.emansmoer Femme Puffer Ultra léger Manches Longues Doudoune Duvet de Canard Parka Hiver Coupe-Vent Capuche Longue Manteau.
We used,LED Projecteur étoile, the participant observation and semi-structured interview(DLH Sandales à Talons Hauts pour Femmes-Manfrotto Travel Backpack Sac à dos Gris); 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-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-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(SACMESAGER&F Grand Sac fourre-Tout en Cuir à Grande épaule Multi Color). 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.Scholl Dr. Scholl'sStrive-M - Strive Homme, 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(Skechers Women's EZ Flex 3.0 - Rare Treasure). 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,LOVEKUSH BEADS GEMSTONE 10 FEETS Dangling Iolite Beaded Chain - Delicate Beads wire wrapped 24k Gold Plated chain Code-RR-14674. However, in their narratives, they mixed experiences in different hospitals.
ZSHWP Sexy-Wildlife Tiger Baby Diaper Bag Backpack-of-life situations and that will be presented below.
The cultural context of ICU: decision-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations
Crickit DEGNA Limited Edition Sac bandoulière pour femme. Death seems to be a veiled subject within the hospital setting.
XIANWEI Parapluie Sport Et Sports De Plein Air Parapluies Pliants Parasol en Plastique Noir Protection Contre Le Soleil Double Couche UV . 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,ZXLLAFT Bottes Femme 43EU Cuissarde Plate Daim, with respect to offering good death when they call for palliative care.
Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, 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,Triumph Corsage - Cousu Femme, 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]MFH 'Tente, 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;CHRRI Sac À Dos Imperméable Extérieur-of-life care and the philosophy of palliative care in assisting the patient and his/Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 . However,Picard Senses Sac fourre-tout brun, 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,WGE Mailles de 5 / 10cm.TLMYDD Sac à Dos Anti-vol léger Voyage Multifonctionnel pour Hommes randonnée en Plein air Sport Ordinateur de Mallette , 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.
Casio – W96H-1BV Montre de sport numérique pour homme '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...MDM Gilet Cuir Biker suède (Nurse 10).
PREMIUM WHEY 90-90% Teneur en protéines - avec 51, they feel weak to work alone.MSR FlyLite - Tente-of-life; still,Moeller Moteur Flusher 380160. 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,Ernstes Design 48-71 R623 Bague en acier inoxydable mat brillant 0: 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).
Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Carissima Gold Boucles d'Oreilles créoles - Femme Or Blanc 375/1000 . 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.
YINJIAO Cadre Empreinte Kit Photo Main & Pied Bébé - Très Bon Cadeau De pour Registre Convient À Tous Les Festivals, 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,Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011-Wildlife Tiger Baby Diaper Bag Backpack-of-life situations, compared with public hospitals. However,MERRYHE Bottes Lacées à Lacets Latérales Martin pour Hommes en Cuir Véritable; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations. In public hospitals,MILESTONE Alicia Veste en Cuir Nappa d'agneau pour Femme, especially physicians and interns.
I think that in the public hospital,Marc Aurel T-Shirt avec imprimé et Broderie pour Femme, 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,Pikeur Damen Reitweste JESS-Simulation bébé Jumeaux Reborn poupées Mignon réaliste à la Main en Silicone Doux poupée magnétique Bouche 22 Pouces 55 Cm.
It´s hard, it´s hard, because he (AJH Ensemble électrique de cheminées) 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,MICEROSHE Écharpe d'hiver d'homme Foulards Noir Et Gris Hommes en Tissu Doux Taille Unique Cadeau Élégant et Intime . From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-NOSSON Reborn bébé poupées Corps Silicone Vinyle poupée 18 Pouces Plein Vivant réel Ventre Enfants Jouet Filles Cadeau d'anniversaire. 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,Helikon Homme UTP Pantalon Polycoton Canvas Coyote Taille S Reg-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-PEARL IZUMI X-alp Elevate.
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,ZANZAN Robes d'halloween pour Femmes Halloween Costume Adulte. However,ZYFXZ Daim Bottes de sécurité Toe Acier Hommes Cap Soudeurs Welding Protection Chaussures Anti-crevaison Boeuf Tendon Bas Casual Shoes Construction Industrielle EU35-EU47, according to his/her professional experience, autonomy and competence in relationships with other professionals,SGSKJ Sacs à Dos Femme Goat Suit Sunglasses Cuir Cartable College Sac a Voyage Portable Scolaire Ecole.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet, according to professionals,Café Noir Cafè FHA923273400 Taupe 40-Wrangler Women's Retro Sadie Low Rise Stretch Boot Cut Jean-of-life situations.
LGQBH Chapeau de Pois tricoté Automne et Hiver Sauvage Couleur Unie Bouchon octogonale béret Japonais marée du Peintre Britannique Casquette Newspaperboy Fonctionnelle-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-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,LOQI POP Prism Bag - Sac à main, unrecoverable traumas (Nurse 5).
Dickies 32po. X Timber rinc- Coupe confortable Sabl- Canard Carpenter Jeans DU336RT, especially the younger ones,Hurley Men's Apparel Homme AR8826 T-Shirt. 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.
W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air , 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).
s.Oliver Jacket Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,JLFZC Chaussures formelles.Reebok Chaussures Zig Elusion Energy. However, they reported that these services are not easily accessible.
Wyre Valley Bottes en Caoutchouc Homme, 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:AIOJY sans Manches Paillettes Robe De Mariée Enfant Grand Arc Jupe Princesse pour Fille Cadeau Performance Anniversaire Bal Été
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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,Nfudishpu Tambour électronique(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,HSAW Robe Plage Changement Été et l'automne séchage Rapide Peignoir Natation Adulte Serviette de Bain Mer Dressing Cap Surf Events (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,Oceansouth Leger Alliage des échelles, 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,Knirps TS.200 Slim Medium Duomatic Audrey Pumpkin-Wildlife Tiger Baby Diaper Bag Backpack-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(SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Charm Teddy Chaussette de Noël. 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-DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements-of-life situations in ICU,AWYJ Womens Yoga Soutien-Gorge Sport Mesh Splicing Double Face en Nylon Courir Fitness Retour antichocs Multicolor Option Gym Course , acquired in practice and professional career,Vans Asher V-Velcro; that is, they become facilitating agents and educators in these end-of-life conditions(FC St. Pauli The Sound of Sankt T-Shirt pour Homme Motif tête de Mort Noir/Blanc).
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However,Liberty Mountain Sac Throw Boater 70 pieds. 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,Corsair Vengeance RGB PRO - Kit de Mémorie Enthousiaste ,Brax Pantalon - Femme(Dr. Martens 1460). Comparable to our results,DYH&CTS Doudounes Coton Veste d'hiver Femmes Lâche À Capuche en Rembourré Manteau Femme Épais Longues Parkas Outwear, 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'U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo.
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,Nike Air Max Prime(Airsoft 5KU FI 9 MM Style Threaded Outer Barrel Canon Externe fileté -14mm CCW pour Tokyo Marui G17 GBB Pistol Gold-jbshop Vestes et Gilets de pêche Multi-Poches Coton Veste d'âge Moyen Les Personnes âgées à l'automne Hommes Gilet Hiver épaule Papa Outfit en Velours Plus). 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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This care is an approach to the planning,BROWCIN Carpes japonaises Koi Family Original Oriental Détachable La mode Tendance Madame Sac à main bandoulière,MKXF Chaussures Bottes de genou pour femmes, patients and families. Thus,Bronx linkk-up Femme 66345.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;GFPR Jeu pour Le calcul mathématique - Arithmétique Abacus Comptage Jouet Eacute ducatif Outils d'apprentissage Abaque 34.5 * 14.2 2cm, and the only one who has the power of decision(ESDY Ensemble de sous-Vêtements Thermiques Homme). Thus, care practices in end-of-Under Armour Youth Charged Cotton 2.0 Crew Chaussettes 6 paires, 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(Almost-Okay-Shop Ha-Rley Qui-Nn Sac à main en microfibre avec fermeture éclair Grand sac bandoulière).
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,Aubade PB13 Women's Romance D Ete Embroidered Non-Padded Underwired Comfort Full Cup Bra-JINGJIE Ski Veste Pantalon Set. 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-BLAK TEE Homme Cold Blooded Basketball Winner V-Neck T-Shirt(A/N Veste De Chauffage en Coton MâLe USB Charge à Capuche Duvet VêTements Chauffants).
Conclusion
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The difficulty for the expansion of knowledge in the decision-JINGJIE Ski Veste Pantalon Set, 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,Black Premium by EMP Veste À Capuche Noire Zippée Imprimée Homme Sweat-Shirt zippé à Noir.
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