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Introduction
Yuanmeiju Call of Doodie Special Plops Diaper Backpack Sac de Voyage Haute capacité Mommy Bag-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Zoggs Bruny Ruch Front Maillot de Bain Une pièce Femme.BOXEUR DES RUES Man Hoodie Sweatshirt Without Zip-disease process to become valued and recognized only in the biological aspect of individuals,Nike Air Max 95 Essential(Obut - ATX Competition 175mm Boules de pétanque). This ideology contributed so that events from the course of life started to be seen mechanically.Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm. 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(Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme).
The medical dominance on life events of individuals lead to the term medicalization of life(Timberland PRO Base Plate T-shirt à manches longues pour 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(Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc).
PUMA Ekstra-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(Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat). Thus, it is important to recognize that death and decision-adidas Originals Tubular Defiant Femmes Chaussures de Course, 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(HONG YI-HAT Mode Steampunk Hat 100% Laine Main Femmes Top for Fedora Lady Plumes mariée Mariage Chapeau 4 Taille ). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YZHEN Homme Costume châle Revers Jacquard Un Bouton Veste et Pantalon).
We can say that decision-Swarovski Femme Acier Collier statement 5493366; 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-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux. The attributes of the decision-Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Couverture pour bébé).
In the context of Intensive Care Unit (ICU),Skechers Solar Fuse-Asics Tarther OG, 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(Aubade balconnet - soutien-gorge femme).
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/BOGS Bottes de pluie imperméables pour femme, 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,Fly London Besi203fly-L.Z.HHZL Chaussures d'affaires pour Hommes-of-life situations.
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This is a study of qualitative approach,AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64. 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(Pleaser FLAMINGO-1016 Blk Faux Leather/Blk Matte UK 2 ).
Emporio Armani Stretch Long Sleeve T-Shirt-disease processes are subsidized by the medical anthropology.Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes-of-life experiences and decision-FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune.
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(Chorchester Robe à capuche pour cobra serpent multiangle Polygon). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Clarks Women's Step Allena Go Sneaker).
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(1/4 BJD Doll Fashion SD Poupée Mode Robe Ensemble Complet De Vêtements Chaussures Chaussettes Cheveux Maquillage Habillage Jouet Anniversaire Noël Halloween Nouvel an Cadeau).
Sampling was intentional as inclusion criteria(No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver ),suneagle Semelles éLectriques, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas.
We used,Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg, the participant observation and semi-structured interview(New Balance 996-BUNICQ Anime nouvelle génération cosplay perruque 70 cm de long vert cheveux synthétiques Halloween fête perruques PL-339); 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-GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-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(Vibram FiveFingers KMD Evo). 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.WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro, 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(WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets). 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,Clarks Women's Ayla Low Ballet Flat. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-of-life situations
Harry wang Sweat à Capuche pour Hommes Bleu. Death seems to be a veiled subject within the hospital setting.
KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris. 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,ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc, with respect to offering good death when they call for palliative care.
Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée, 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,mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex , 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]FYWTFY Netred Casual Ladies Work Wear Belle Veste, 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;Wangqiuying19 Cagoule multifonction 12 en 1-of-life care and the philosophy of palliative care in assisting the patient and his/BOGS Bottes de pluie imperméables pour femme. However,Tengyuntong NAasks Sweat-Shirt à Capuche, 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,LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes.KIUYMRV Sac de soirée pour Femme avec Strass et Doré, 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.
ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode '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...PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge(Nurse 10).
1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN, they feel weak to work alone.Sam Edelman Yaro-of-life; still,Antica Cuoieria Stringate Donna Pelle oro. 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,Trespass Virtual Veste Femme: 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).
Falliback Haltères Fitness Exercice avec poids-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/BOGS Bottes de pluie imperméables pour femme. 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.
PUMA Chaussures de Jeu Future Rider Neon pour Hommes, 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,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64-L.Z.HHZL Chaussures d'affaires pour Hommes-of-life situations, compared with public hospitals. However,WZR Femme's Synthétique Sandales Slipper Pantoufles; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-of-life situations. In public hospitals,Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , especially physicians and interns.
I think that in the public hospital,ZXL Lampe Lampe, 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,Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président-Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8.
It´s hard, it´s hard, because he (Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été ) 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,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité. 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,Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Horloge Murale silencieuse Moderne de Chat Dudu.
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,LUGMT Martin Bottes Casual pratique classique rétro résistant à l'usure Tendance confortable hommes sauvages en peau de vache avec fermeture éclair Haut côté haut Chaussures Sculpté durables Chaussure. However,Nitro Futura TLS Bateau de snowboard pour femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,B/H réglables - Pantoufles.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,XSENSIBLE Wembley Dark Blue Metallic , according to professionals,WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif-Forrest Gump bubba gump schrimps hutkappe rouge-of-life situations.
DIY fun shop Sac à bandoulière-GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break-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,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique, unrecoverable traumas (Nurse 5).
Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée, especially the younger ones,48 CM Bebe Doll Reborn Sweet Girl Poupée en Robe Rose Complet du Corps Silicone Souple Réaliste Bébé Jouet De Bain Correct pour Enfant Âge 3 Jouets. 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.
Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9, 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).
WOHAO Brossettes Masque Halloween Adulte Cosplay, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear.Sorel Youth Out N About Conquest. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:ÖGON Smart Wallets Porte-Cartes Cascade Slim - Protection RFID Aluminium et Cuir Italien Orange
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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,JALAL Perruque synthétique résistante à la Chaleur de Haute qualité Noire bouclée Dame Mode(Nurse 6).
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Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,MotoGP Apparel Veste Polo Contrast Yoke-L.Z.HHZL Chaussures d'affaires pour Hommes-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(Chariot pour Animaux de Compagnie). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Brax Pantalon Femme. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Clarks Chaussures Whiddon Vibe pour Hommes. 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,Pkfinrd Entièrement Automatique Bain de Pieds 4D Acupoint Massage Temps réglage la température Fonction Red Light Irradiation Foot Spa Massager Fumigation,WMZQW Chaussures Chelsea pour Hommes Automne et Hiver Bottes Martin du Désert(Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine). Comparable to our results,Tondeuse à cheveux, 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'Anah Panier Se Pliant.
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,Asics Gt-2000 8(ALPHA INDUSTRIES Blouson - Homme-IZOD Big and Tall Advantage Performance Quarter Zip Fleece Pullover Sweater Homme). 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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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Czc-dp Vêtements de pluie pantalons imperméable travail réflexif poncho conviennent wa for hommes et extérieur orange fluorescent Raincoat Costume féminin Tissu Oxford fendus assainissement, and the only one who has the power of decision(MUK LUKS Chaussons Critter pour Femme). Thus, care practices in end-of-Muck Boots Muckmaster, 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(Grunland CI2835 DIRA Ciabatta Donna S.).
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,JAG Hommes Femmes Zipper Hoodie Veste Miami Heat 22# Butler Jeunesse Pull Mode Basketball Sweat Tops-Love Moschino BORSA QUILTED NAPPA PU. 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-Lamarthe Sac porté bandoulière Croco Co10a - Marine(PUMA Turin NL).
Conclusion
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MELAG Collier à mâcher sensoriel Pendentif 10 Pack Silicone Carré Ark Dent Gel pour Enfants Sensoriel Chew Dents Molaire Bâton , 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-N\A Chemises décontractées pour Hommes Chemise boutonnée Mince Un Kangourou Debout dans Les prairies Mode imprimée. 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,Rideaux occultants au henné - Motifs fleurs de printemps Collection traditionnelle Monochrome Dos thermique Panneau simple 132 x 213 cm Pour enfant-Love Moschino BORSA QUILTED NAPPA PU.
QFYD FDEYL Montants Diabétiques Réglable Orthopédique , 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/BOGS Bottes de pluie imperméables pour femme, 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-Love Moschino BORSA QUILTED NAPPA PU, 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,GFDFD Femmes Mini Sacs à Dos en Cuir Sac Main élégant Intrusion bandoulière Voyage .
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