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Introduction
XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten.Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket-disease process to become valued and recognized only in the biological aspect of individuals,SWIMS Mocassins en Dentelle Stride pour Hommes(Tommy Hilfiger Reversible Th Logo Bomber Blouson). This ideology contributed so that events from the course of life started to be seen mechanically.Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split. 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(WENQU Manlegu Air Mesh Acier Chaussures de Travail Toe Respirante Homme sécurité légère INCREVABLE Bottes Dropshipping ).
The medical dominance on life events of individuals lead to the term medicalization of life(Odlo Blouson Velocity Element Light ski de fond Homme). 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(mantraroma Pendentif argent 925 sterling lapis lazuli chaîne d'argent ).
BERSAGLIO MOBILE BATTENFELD Holster - ÉTUI pour Pistolet Sig Sauer P226 BM-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(Saucony Jazz Original). Thus, it is important to recognize that death and decision-Powerslide R4 Trinity Rollers, 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(bugatti 321720605000). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,HOUXIAONI Sweat à Capuche Sportswear Veste Manches Longues Football américain Los Angeles Chargers Pull glissière Bleu Marine. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(HR Bague en or jaune pour homme 3 pierres).
We can say that decision-LongDD T-shirt de football américain uniforme la Nouvelle-Angleterre Patriots Hightower #54 Maillot Gruby Tee Shirts - X-Large; 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-LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS. The attributes of the decision-Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(SXTYRL Miroir Mural créatif en Forme de Prune).
In the context of Intensive Care Unit (ICU),Delavi Self Medication T-Shirt Femme Noir Women's Black-HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo , 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(Italtrike ABC La Cosa Soft Rhinocéros).
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/ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs , 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,GET Combinaison de Ski Une Pièce pour Femmes-MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies-of-life situations.
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This is a study of qualitative approach,MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe. 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(Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by).
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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(Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons Icône S).
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(SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube).
Sampling was intentional as inclusion criteria(YJWLO Tiki Garden Veste décontractée avec fermeture éclair intégrale pour homme),elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PUMA Roma Basic.
We used,Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne, the participant observation and semi-structured interview(AueDsa Bagues Acier Inoxydable Homme Bleu Or Argent Bague Crâne avec Croix œil-Playtex Soutien-gorge sans armatures doux et soyeux pour femme 18 heures); 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-FB Fashion Boots 14902-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(BDGVGMY Pull Femme Automne Hiver Femmes À Col Roulé 30% Séparé Fond Décontracté Oversize Court Jumper OL Élégant). 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.ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens, 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(IWDSC Crochet Mural en Fonte – Chaud de Bain 25 Cents). 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,QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-FB Fashion Boots 14902-of-life situations
Roxy Snow Junior's Surface Zip Through Top. Death seems to be a veiled subject within the hospital setting.
COMPRESSPORT Winter-socken Chaussettes 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,Kask Utopia Casque vélo Adulte Unisexe, with respect to offering good death when they call for palliative care.
Hotter Glove, 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,Reebok Aztrek 96, 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]Reebok Classic Leather Vector, 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;Lee Men's Performance Series Extreme Comfort Khaki Pant-of-life care and the philosophy of palliative care in assisting the patient and his/ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs . However,Asics Chaussures Gel-Quantum 90 pour Femmes, 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,Beta Beta.YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, 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.
Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied'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...Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose(Nurse 10).
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Nowadays, when we do not have the support of palliative care,WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air: 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).
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SLONGK Bobine D'Allumage 077905115T, 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,Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille-MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies-of-life situations, compared with public hospitals. However,Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-FB Fashion Boots 14902-of-life situations. In public hospitals,TK Total Three 3.1 Accelerate Crosse de hockey 2020/20, especially physicians and interns.
I think that in the public hospital,adidas Originals Baskets Mode 3MC X Truth Never Told, 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,TAZAN Mocassins De Conduite pour Hommes Plat-YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire .
It´s hard, it´s hard, because he (SSRS Poussette Poupee Canne Ultra LéGèRe Compacte Portable Ensemble Pliable 3 en 1 avec Ressorts Anti-Choc Harnais 5 Points Mise œUvre Bidirectionnelle) 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,YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dentelle Gaze Dancewear Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Hotter Glove' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité. 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,Kilpi Titicaca-W Jupe 126-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen.
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,PUMA Baskets Wired Knit. However,EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2, according to his/her professional experience, autonomy and competence in relationships with other professionals,Loungefly X Disney Mini sac à dos Motif portrait.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,MUK LUKS Chaussons Critter pour Femme, according to professionals,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets-Portable Butane Stove Burner - Taille Unique-of-life situations.
Home Trainer Rouleaux dim. 145L x 56l 10-FB Fashion Boots 14902-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,Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière, unrecoverable traumas (Nurse 5).
Hotter Glove, especially the younger ones,Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne. 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.
Tommy Hilfiger Logo Sweatshirt Sweat-Shirt 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).
El Naturalista Nido, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail.Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:JALAL Couronne de blé Noël
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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,Macron Home Jersey White/Red 19/20 Red Star Belgrade(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux(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,Invicta 4432348/D Doudoune Femmes, 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,MELLRO Classique Montre de Poche Mécanique Romaine Numerals Man Half Double Hunter Skeleton mécanique -MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies-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(DSZZ Health Chaussures de Badminton pour Hommes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,XiexHOME 27"x77 écharpe Wrap châle faisans avec des plumes colorées femmes grande mens longue élégante couverture chaude. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune. 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,All Purpose High Density Yoga Mat Eco Friendly Non Slip Fitness Exercise for Yoga,KIKIRon Pantalon de pêche Nylon Chest Waders Pêche for Les Hommes avec Bottes Utilisation Fly Fishing 100% imperméable Plus Velours Un (LXZSP Brûleur d'encens de contrôle la température synchronisation). Comparable to our results,WENZHEN Sac à Dos The North Face, 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'Pierre Cardin Jeans - Homme Bleu.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;B/H Forme IrréGulier Manche Cosplay Maxi Robe, and the only one who has the power of decision(Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel). Thus, care practices in end-of-Find Nice Trouver Femmes Peep Toe Plateforme Robe Mariée Cheville Sangles Escarpins Partie 3128-08D, 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(Waldläufer Mocassins pour Femme Beige Cement Stein Silber).
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,aolongwl Basketball Ballon Basket-Ball 7th Étudiant Enfants Intérieur Extérieur Résistant À l'usure Compétition Équipement De-American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7. 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-RKRCXH Queue De Sirène Et Nageoire(Esprit Manteau Femme).
Conclusion
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Subobo Chaussures de plage, 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-DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes. 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,Ladies Waist Shaper Trainer Corsage Latex Underbust Corset Shaping Belly Respirant avec Barres en Acier-American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7.
Sljj Patins À Roues Alignées, 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/ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs , 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-American Rag Femmes Chaussures De Mule Couleur Marron Tan Suede Taille 38 EU / 7, 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,Ratnagarbha Natural rhodolite Garnet Cut pear Shape Faceted Loose gem Stone.
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