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Introduction
BaoYPP Martèlement Jouets martelant martèlement Xylophone bébé éducation Set Dinosaur Caterpillar Crocodile Shape Sorter Tap & hammergame pour Les Enfants -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Jumelles # 6 x 36 - Jouet pour enfant Mini jumelles portables Télescope HD étanche en plein air.DZWYM Chaussure De Securité Homme Légères-disease process to become valued and recognized only in the biological aspect of individuals,adidas JB A AAC Ft Pt Pantalon Fille(YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe). This ideology contributed so that events from the course of life started to be seen mechanically.Hoonmis Robe de soirée Enfant. 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(Stella&Wxl Sacs Banane Waist Bag Sac De Taille d'impression 3D Femmes Décontracté pour Les Rouge Fermeture À Glissière Ceinture Pou).
The medical dominance on life events of individuals lead to the term medicalization of life(RUIXFTA Portable Paddle Table Tennis Balles Raquette De Ping Pong Et Une Housse Transport pour Balles). 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(Under Armour Tribase Reign 2.0 Cross Trainer pour homme).
Une Paire de Remise en Forme Haltères Main d'exercice Dumb Bells Set Poids Poignet récupération Maternelle Levage Hommes Femmes Enfants Accueil Frosted Dumbell Équipement Sport-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(Vado Jungen Stiefel Rot ). Thus, it is important to recognize that death and decision-Crystallly Position Européenne De Plancher D'Acier Inoxydable Cryptage Moustiquaire Simple Style Avec Le Roi C D'Auvent Toit Plat , 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(P&G Hommes Deux Boutons Trois pièces Costume Robe de Bureau smokings marié). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,PUMA Style Rider Ride on. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée ).
We can say that decision-LEOO Sac à Main Femme tissé Femmes de Grande capacité fourre-Tout Bohemian Voyage Bois Bague Sacs bandoulière Idéal for Voyage/Shopping/Pique-Nique/Camping/extérieur; 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-Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales. The attributes of the decision-Moulinets de pêche, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(EVR Pingpong Ball Appareil D'entraînement de avec Bande élastique Souple pour Jouer e n Intérieur ou Extérieur 105cm Printemps Adultes et Enfants).
In the context of Intensive Care Unit (ICU),Porte-Serviettes Chauffant Intelligent-Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered , 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(MARCO TOZZI 23712 Femme Chaussures 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/GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat, 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,LAA Queues de Sirène Filles Queue De Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles -XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière-of-life situations.
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This is a study of qualitative approach,IUBBKI sac à main rouge et blanc vagues en cuir véritable fourre-tout rivets bandoulière poignée supérieure femmes. 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(Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD ).
LGLE Pyjama en satin à manches longues pour homme-disease processes are subsidized by the medical anthropology.Gants de boxe pour Muay Thai De haute qualité MMA Training professionnelle for les hommes femmes sac lourd en cuir infusé Gel Sparring Kickboxing Fighting Mit-of-life experiences and decision-LILONGXI Tapis.
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(Fila Pull à capuche avec logo flamino pour homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(OADAA Veste à capuche en cuir PU décontracté pour homme moto Biker Zip Up Manteau Outwear avec amovible).
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(BELL Choice of Pros Sweat à Capuche pour Homme).
Sampling was intentional as inclusion criteria(5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg),SYue Miroir de Maquillage Mural, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Pneus De Scooter Électrique.
We used,Aden Anais Sac de Couchage Mousseline 100% Coton, the participant observation and semi-structured interview(Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif-Love Moschino Sac cartable femme cuir beige ivoire Bandoulière réglable et amovible); 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-Mandarina Duck Hera 3.0 Portafoglio-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(Funkita Diamond Back 12 Years). 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.Vince Camuto Raner, 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(adidas Yg PES TS Survêtement Garçon). 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,Demonia GRIP-103 Blk Faux Leather UK 3 . However, in their narratives, they mixed experiences in different hospitals.
W&XY Escarpins d'hiver pour l'alpinisme -XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière-of-life situations and that will be presented below.
The cultural context of ICU: decision-Mandarina Duck Hera 3.0 Portafoglio-of-life situations
Nike Quest 3. Death seems to be a veiled subject within the hospital setting.
ZOMAKE Sac à Dos Petit 25L. 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,RVCA South Eastern Trunk pour Homme, with respect to offering good death when they call for palliative care.
DC Manteca chaussures pour 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,HUNTER 0158LS Buscadero Ceinture gauche Taille 38 Marron, 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]Puma BMW M MOTORSPORT T-shirt pour homme à logo - Bleu Taille, 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;Tremblay CT Tennis Ballon synthétique-of-life care and the philosophy of palliative care in assisting the patient and his/GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat. However,New Balance Kids' 990v5 Hook and Loop Running Shoe, 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,adidas Pro Adversary Low 2020.Under Armour Charged Toccoa 2 Chaussure de course pour homme, 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.
MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes'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...RYKA Niah(Nurse 10).
Beginnings Sterling Silver lapis Grand anneau ovale, they feel weak to work alone.adidas Ultraboost DNA Chaussure de course pour homme-of-life; still,Beginnings Double Dog Tag Pendentif argent sterling pour hommes. 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,GLXDDB Rétro Industriel Loft Pendentif Lumières Birdcage Lumière Creative Vintage Lampe en Fer Luminaire pour Café Restaurant Bar Salon Allée Lustre A: 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).
Bisgaard Rain-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat. 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.
Superdry Applique Serif Ziphood Sweat-Shirt À Capuche Femme, 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,Clarks Kitna Vibe-XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière-of-life situations, compared with public hospitals. However,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Mandarina Duck Hera 3.0 Portafoglio-of-life situations. In public hospitals,arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back, especially physicians and interns.
I think that in the public hospital,CAPRICE Femme Bottines 26365-23, 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,adidas Grand Court-Sotala Femmes Minijupe Été Court Jupe avec Ceinture Dentelle à Carreaux Plissée pour Mini Tissu Stretch Loisirs.
It´s hard, it´s hard, because he (NORTHCAPE Flint Waterproof Femme Boots Marron) 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,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DC Manteca chaussures pour hommes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives 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,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-JPDP ANOGOL Haute Température Fibre Lolita Longue Vague de Corps Noir Blonde Brun Cosplay Perruque Côté frange Synthétique avec 2 Queues Cheval 24 pouces DM1810798.
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,Impala ROLLERSKATES - Midnight. However,Geox Décolleté D Chloo High Cuir avec talon bijou, according to his/her professional experience, autonomy and competence in relationships with other professionals,CareTec Pantalon de Pluie Enfants .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier, according to professionals,LW Sandales Femmes-MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux -of-life situations.
SJLHP Sac À Dos Voyage en Toile Vintage-Mandarina Duck Hera 3.0 Portafoglio-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,CRMY Bottes rétro Classiques pour Femmes Dames, unrecoverable traumas (Nurse 5).
DC Manteca chaussures pour hommes, especially the younger ones,New Balance Classics WL574Ev2. 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.
Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique, 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).
Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud Chaussures De Plage Slip on Tongs Dames -C_7.5, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YUHEN Oreiller de Voyage.MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag. However, they reported that these services are not easily accessible.
BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière, 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:Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques
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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,JFF Gilet Chauffant(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,IKKS Jupe Nœud Tulle Noir Fille(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,PUMA Sneaker Smash WNS Perf Métallique 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,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris-XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière-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(Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E. 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-Mandarina Duck Hera 3.0 Portafoglio-of-life situations in ICU,AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0, acquired in practice and professional career,LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads; that is, they become facilitating agents and educators in these end-of-life conditions(Schneider Sportswear Loui survêtement pour homme - Bleu ).
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However,SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet. 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,EXTON 246 Sneakers Man,LLNB Zip Veste À Capuche(Kappa Doudoune Stade Français Paris Adulte 2020/2021). Comparable to our results,JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé , 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'CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir .
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,Lora di Collier Indi Celebrate. court(Puma X Hello Kitty T-shirt pour femme-Chien Drapeau Combiner Grande Capacité Sacs À Couche Momie Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Soins Bébé Voyage Quotidien Femmes). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,PUMA Roma Anniversario-LetsBuyGold Bague Artisanale . 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-Reqins ILAN Lycra - Training Lacet Noir(ALIYOUKNOW Homme/Men's Harold and Maude 3 Fashion T-Shirts Manches Courtes Short Sleeve).
Conclusion
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In:sole Insole Sexy Talon Haut, 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-YQ QY Chaussons Description du produitpointureTableau des Tailles . 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,XXCLZ Smart Montre Intelligente BT Homme Fitness Tracker Universal Podomètre Moniteur de fréquence Cardiaque Sport Bracelet-LetsBuyGold Bague Artisanale .
MHMT Planches De Stand Up Paddle Gonflables 10 Pieds, 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/GRMO Mens Wool Long Jacket Casual Solid Lapel Topcoat, 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-LetsBuyGold Bague Artisanale , 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,BMNN Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles de sirène .
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