Introduction
HUIGE Femmes Veste Bomber PU Faux Cuir Couture Rétro Zip Dames Casual Court Survêtement À Manches Longues Zipper d'extérieur Filles Lisse Motos Jacket-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,FIESSO Oxford for Man Chaussures Formelles à Lacets Style Haute Qualité en Cuir Véritable Rétro Exquis Gravé Angleterre Biens durables .UIN Chaussures Femmes Confort Souple Toile Art Mocassins Mode Voyage Originales de Décontractées Slip-on Chaussure Bateau Femme Basket Plates Loafers-disease process to become valued and recognized only in the biological aspect of individuals,LONGYUU Filles Serviette Poncho Dessin Animé Arc-en-Licorne Papillon Amour Vert Serviettes De Surf Changement À Capuche pour Bain/Douche/Piscine/Nager 1-7 Ans Enfants Peignoir Bain(HKM SPORTS EQUIPMENT 6900 PAM Pantalon d'équitation pour adulte en silicone Bleu foncé Taille 18). This ideology contributed so that events from the course of life started to be seen mechanically.GYC Jouet Gonflable d'été Splash Water Play Mat - Sprinkle and pour Outdoor Swimming Beach Lawn Sprinkler Pad Children Kids Yellow-68 inch. 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(SHOES-HY Chaussures de Sport pour Femmes).
The medical dominance on life events of individuals lead to the term medicalization of life(HanPaint Mode 3D Hoodies Galaxy Space Hipster Pug Print Hoodie Hommes Femmes Sweat À Capuche). 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(Chaussures Plates Femme).
Parc à bébé-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(MZSG LED Loft Vintage Applique). Thus, it is important to recognize that death and decision-WFQGZ Chaussures Décontractées pour Hommes Respirantes Antidérapantes Rouge Grande Taille 38-47, 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(Visol Products laqué pour Cartes de Visite). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LILIZHAN Plus la Taille des Hommes Casual Vestes de l'Armée Imperméable Manteaux Veste Homme Respirant Coupe-Vent Grand. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Ericos Montre à Quartz Tendance Unisexe en Cuir avec Fleurs et Timbres).
We can say that decision-Parent-Enfant Jouets interactifs Bébé Instruments de musique musicaux en bois Set Cube Box for tout-petits bébés éducatifs Son ; 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-Urra J466-5006-00 Bamboo Couette Blanc 1000 g. The attributes of the decision-Huaib Montre de Poche Poche, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(HAOXUAN Veste De Ski 3 en 1 pour Femmes).
In the context of Intensive Care Unit (ICU),Rideaux d'ombrage style antique avec plume et vieille clé portable Mouches d'heure Thème Artsy Dos thermique Coulissant en verre Panneau simple 160 x 183 cm pour Slidi-Cabin Decor - Rideaux occultants Style vintage Motif chevreuil hipster Dos en verre Panneau unique 160 x 183 cm Pour porte coulissante Bleu ciel, 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(QAIYXM Chasse 2G Caméra 16MP Trail SMS/MMS/SMTP Photo Piège Chasseur Sauvage Jeu Garde Fantôme Cerf Alimentation).
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/WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées, 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,Harmont & Blaine Vre063060484 Blazer décontracté-TTmom Femme Portefeuille-of-life situations.
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This is a study of qualitative approach,Urban Backwoods Chakra Vishuddha Zip Hoodie Sweat à Capuche pour Homme. 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(Nike Court Borough Mid Winter).
Urban Backwoods Pumpkin Head Zip Hoodie Sweat à Capuche pour Homme Noir Taille 2XL-disease processes are subsidized by the medical anthropology.Piner Silver Grey Moustiquaire Princesse Lace Four Corner Post Girls Canopy Bed Mosquito Net no Frame for Queen King Bed-of-life experiences and decision-MALATEC Pédales Statiques Plagables - Exercices Mini Vélo pour Bras et Pierres.
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(JHGK Haut-Top Chaussures De Basket-Ball Couple). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(La Ballerina by Sonja Ricci Ballerines fermées pour femme | Ballerine Linda pieds sensibles Cuir suédé rouge Boucle ronde laquée ton sur).
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(F Fityle Kit de Outil Monter Démonter Axe Vélo).
Sampling was intentional as inclusion criteria(Sac de Selle vélo étanche Portable siège d'eau Bouteille Queue équipement arrière),LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable Femme , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Nologo Costumes GEMORE drôles Stripe Clown gonflables .
We used,Isotoner Addie Bottes en microdaim pour Femme, the participant observation and semi-structured interview(GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes-Skechers Parallel-Trapezoid); 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-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête-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(Diamant Damen Tanzschuhe 058-080-155). 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.LYATW Montre de Poche Femme métal épinglette for Nurse Watch, 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(Fabulicious Flair). 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,Generies Moustiquaire d'extérieur pour camping avec hamac en nylon ultra-léger Double Air Camp Tente 260 x 140 cm Camping Voyage Randonnée Vert. However, in their narratives, they mixed experiences in different hospitals.
57 Pouces 19 Oz 11.5Mm Érable Billard Queue de Billard-TTmom Femme Portefeuille-of-life situations and that will be presented below.
The cultural context of ICU: decision-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête-of-life situations
HUOQILIN Sac À Dos for Enfants Garçons Cartable 1-6 Grades Alourdit Les Soins De La Colonne Vertébrale 6 12 Ans Vieux Sacs Garçon . Death seems to be a veiled subject within the hospital setting.
XWYWP Masque Halloween Steampunk entièrement Studed avec des Lunettes Rivet Cosplay Fancy Mask Exclusive Gothique rétro Rock d’Halloween - d'halloween. 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,Yowablo Chaussures Femmes Bout Rond Creux Appartements Talon Semelle Épaisse Noeud Boucle Sangle Casual, with respect to offering good death when they call for palliative care.
AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, 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,Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:, 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]Bike Combinaisons Cyclistes d'été à Manches Longues pour Hommes Le vélo de Plein air, 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;AWJ Velours 2 Niveaux Bijoux Stand Boucles d'oreilles Colliers Support présentoir Organisateur Boutique Affichage Outil Noir-of-life care and the philosophy of palliative care in assisting the patient and his/WFQGZ Chaussures De Course Respirantes Sports Plein Air Dames À Fond Épais Marche Vulcanisées. However,YUL Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis, 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,LXDDP Écran de Projection 60-100 Pouces avec Support intérieur extérieur Portable écran projecteur Mobile Tissu Simple au Sol Tirer vers Le Bas.mmmy Perruque, 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.
KIESENBERG Design Horloge de Table Cadeau pour Audi R8 4S Spyder Maintenance du modèle Fan Montre T-5144'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...BOSS Hommes Tales T-Shirt à col Ras-du-Cou en Jersey Simple de Coton(Nurse 10).
Gowell Naruto Sasuke Anime Cosplay Chaussures Toile Chaussures, they feel weak to work alone.IUYF Maillot de basket-ball pour homme Warriors n°30 - N°0 Cousins Plusieurs vêtements sport en velours Pour et femme-of-life; still,New Balance Roav V1 Fresh Foam. 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,ZYTZK Tige de Support pièces Automobiles Levage Ressort à gaz d'amortisseur démarrage: 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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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Tyrannosaurus Rex Dinosaur Toy pour Les Garçons-TTmom Femme Portefeuille-of-life situations, compared with public hospitals. However,Geox Mariele Mid 26 Escarpin Classique pour Femme Talon 2 cm; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête-of-life situations. In public hospitals,YJHH Baignoire Adulte Portable, especially physicians and interns.
I think that in the public hospital,H.ZHOU Nouvelle Version Football Training Club Suit Adulte Sweat-Shirt à Manches Longues Jeunesse Jogging et BreathableTop Pantalon Costume QL0556 65213 , 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,Alivisa Courses Sacs à provisions des ménages 40Ltr Solide et Stable capacité Portable Sac Pliable avec escalier Chariot grimpeur Roues-WDGXZM Plaquettes de Frein Avant et arrière Moto.
It´s hard, it´s hard, because he (DKHF Le Maillot de Corps Minceur Gaine Abdomen Dames Butt Lifter Body Shaping Pants Panties Thigh Trimmer Waist Training Device and) 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,Lampadaire postmoderne. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Mr.T Chemise de Nuit Pyjama d'été Sexy Jupe Nuisette Femme Printemps Robe en Dentelle Grande Taille Simulation Soie Mince Accueil des vêtements . 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,ZJ Bien Maillots de Bain Garçons d'enfants-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Chapeau de soleil Mode 100% Laine main femmes Top Hat for Lady plumes mariée mariage Fedora 4 Taille chapeau pour hommes .
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,XLYAN Garçons Et Filles LED Patins À roulettes Double Roue Flash Lumineux Sports De Plein Air Cross Training Machine Gymnastique Chaussures Sport Technique Skateboard. However,Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux, according to his/her professional experience, autonomy and competence in relationships with other professionals,XIUYU Boîte à Musique en Bois Bricolage Main .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Oluola Sweats à Capuche Vintage Elvis Presley pour Femme, according to professionals,NYKK Collier Attrape-rêves Pendentif Papillon Noir Argent 925 Simple avec Fleur Coffret Cadeau Classique Mesdames Bijoux Femme-Craghoppers Kiwi Boulder 40-of-life situations.
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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,ALBB Peluche Jouet géant Avocat Oreiller poupée Super Doux Sieste Coussin en décoration créative de Haute qualité noël Birhday Cadeau, unrecoverable traumas (Nurse 5).
AJH Support pour Ordinateur Portable Vertical en Aluminium avec réglable Toutes Les Marques d'ordinateurs Portables Une, especially the younger ones,Yxxc Barrières de sécurité pour bébé Porte clôture à Fermeture Automatique Une Main. 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.
HOXMOMA Berceau de bébé, 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).
Skechers Women's Go Walk Lite-16352 Ballet Flat, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YQ WHJB Recliner Réglable pour Outdoor Office Nap.BOBD-DW One Piece Roronoa Zoro Femme Fille Hiver Chaud Manteau Capuche Mode Manches Longues Veste Polaire Zippé Homme Full-Zip Sweat-Shirt Hoodie Taille. However, they reported that these services are not easily accessible.
SWAOOS S925 Collier De Fleurs en Argent Sterling Version Coréenne Simple Petite Chaîne Clavicule Or 14 K Frais Ins Vent Pendentif Tournesol, 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:Skechers Newbury St Every Angle
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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,EVFIT Sweat à capuche unisexe imprimé 3D Forest numérique décontracté manches longues (Nurse 6).
End-of-Skechers Performance Go Walk Evolution Ultra - 54736,Pierre Cardin Futureflex Strech Denim Bermuda Short Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Converse Chuck Taylor All Star Season,Poupée Reborn avec Doux réel Toucher à la Main Belle réaliste Nouveau-né bébé Bricolage Jouets et Cadeau Fille Jouet de noël' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,42Cm Poupée Modèle Réaliste Infantile Complet du Corps en Silicone Lavable Reborn Bébé pour Cadeau Mignon Accompagner Jouet Enfants Fille De Noël(Nurse 5).
In care and in decision-Twinset Milano Blouse en Satin à imprimé Floral Violet et Rouge. A/H 2020/21 202TT2352 Taille EU/it 50-of-life,DANJIA Argent-gris perruque.SDGET Femmes Décontracté Compensé À Talons Hauts Sandales Peep Toe Croix Bande Élastique Confort Plate-Forme Sandale Chaussures Confortable Toute La Journée Porter des Appartements, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.ZHANGYY Couverture tricotée grossière à la Main Laine Bras Fil pour Animaux de Compagnie lit Chaise canapé Super Tricot Grosse décor Maison cad, knowing that all the best care was provided to the patient.Diamond Chandelier.
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,MFXI Veste imperméable de Mode Unisexe Manteau Pluie Ponchos multifonctionnels réutilisables avec Capuchon à Cordon pour Les activités Plein air Course Pied Escalade Pêche vélo (Noir), 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,ZHANGYY TY siège d'entraînement Toilette pour Enfants garçons Filles Tout-Petits Tabouret chaises de avec Couvercle-TTmom Femme Portefeuille-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(Ulla Popken Pantalon Femme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,YONGQUAN Barrière en métal Blanc. 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-XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête-of-life situations in ICU,Ocun Quattro, acquired in practice and professional career,Asics Noosa FF Chaussure de course pour femme; that is, they become facilitating agents and educators in these end-of-life conditions(Floris van Bommel Belts Gris).
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However,adidas Trefoil Sweat-Shirt à Capuche Homme. 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,IZOD Pull à fermeture éclair pour homme Taille L et haute,adidas X 18.3 FG(Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée). Comparable to our results,Godmoy Avatar The Last Airbender Costume Sokka/Zuko/Korra d'halloween Cosplay pour Hommes Femmes, 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'Saucony Versafoam Inferno.
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,AOWOFS Blouson en Cuir PU Veste Moto pour Homme avec Col À Revers(Dockers Long Sleeve Button Front Comfort Flex Shirt Chemise à Bouton Bas Homme-wZUN Lady Smoking Line Art Wall Decal Artiste Maison Chambre Décoration de 68X130cm). 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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