Introduction
XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes.Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme-disease process to become valued and recognized only in the biological aspect of individuals,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main(Reebok Classic Small Vector Tee - Manches Courtes Mixte). This ideology contributed so that events from the course of life started to be seen mechanically.Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy. 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(Prana prAna).
The medical dominance on life events of individuals lead to the term medicalization of life(adidas Stan Smith El I). 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(Furla Portefeuille en Cuir Babylon S Bi-Fold).
Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm-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(RUIRUIY Tapis Mousse Enfant EVA Verrouillage De Yoga Sport Salle Fitness Matelassée Grain Bois). Thus, it is important to recognize that death and decision-Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée , 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(Unknow Maillot de Rugby à Capuche pour Hommes Football américain la Mode Manches Longues décontracté Confortable Fans Pull Jersey -501-rouge_s). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,WANGPENG Brosse à récurer pour chaussures. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MULIZHE Full-Time Hunter Impression Couleur 3D Sweat à Capuche pour Hommes et Femmes Sport Unisexe col Rond Coton Vacances fête Pull décontracté Cadeau).
We can say that decision-QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes; 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-Skechers Go Walk Lite-Sea Dream Bateau pour femme. The attributes of the decision-FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JEOLVP Shopping Tote Bags Sign Travel Building Oriental Pearl Sacs à provisions réutilisables Fourre-tout fourre-tout Imprimé pliable Grande taille Bandoulière simple Work Sch).
In the context of Intensive Care Unit (ICU),Under Armour pour Femme Imprimé Perfect Pace Short-Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2, 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(NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness).
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/KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable, 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,Nisdsgd Men's Hoodies Sweatershirt-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-of-life situations.
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This is a study of qualitative approach,GB Eye Limited Logo-Tasse. 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(Leder24h lederwaren rund um die Uhr Gilet en cuir avec gilet mousquetons 9000 noir Noir/orange xl).
New Rock Hommes Gothique Biker Style Cheville Bottes Noir Lacets Spiky Chaussures en Cuir Véritable-disease processes are subsidized by the medical anthropology.KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes-of-life experiences and decision-Tappers & Pointers Chaussures de danse fille.
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(Fournitures de salle bain Piscine gonflable Baignoire). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(GJongie Sac De Paille D'Été Pour Femme À Bandoulière Oblique En Rotin Clapet Petit Carré).
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(Cloud City 7 Shoto Todoroki Kanji Kid's Hooded Sweatshirt).
Sampling was intentional as inclusion criteria(YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles),Merrell Tremblant Ezra Lace Polar Waterproof, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.PUMA Cell Surin 2 FM.
We used,5.11 Tactical Series pour Femme 31146491 X S Prune HTR XS Willow Henley Homme, the participant observation and semi-structured interview(GIRLSIGHT personnalisé Montre Homme Mode étanche Montre-Bracelet Diamant 648. Happy Motif Bling de-DKINCM 2 pièces amortisseurs de Ressort Soutien Levage Capot Avant); 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-Rieker 30921-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(Lollipops [P3514 - Sac pochette turquoise vintage 27.5x18x5 cm). 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.Showers Pass Short de ski léger respirant à séchage rapide pour homme, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre). 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,Femmes Couverture Complète Coton Allaitement Soutien Gorge D Sans Vêtements de Fiesta Bretelles Dos Nu Bralette Confortable Respirant Enceinte Lingerie Sous. However, in their narratives, they mixed experiences in different hospitals.
Tom Ford FT0609 01C 54 Montures de lunettes-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-of-life situations and that will be presented below.
The cultural context of ICU: decision-Rieker 30921-of-life situations
adidas Originals Kids' U_Path Running Shoe. Death seems to be a veiled subject within the hospital setting.
Skechers Solar Fuse. 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,LMM Faux Seins en Silicone, with respect to offering good death when they call for palliative care.
Dansko Femmes Chaussures De Mule, 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,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive, 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]HEAD Sprint 3.0 Junior, 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;YATTYUG Women's Hoodies Tops-of-life care and the philosophy of palliative care in assisting the patient and his/KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable. However,RNXRBB RNXRBBRomantique Femmes Chapeaux De Mariée Et Perle Perlé Mariage Chapeau Noir Cadeaux Noce Voile Cheveux Avec Peigne Rouge Maille Chapea, 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,DHNKW Men's Hoodies Sweatshirts.YH Y-H HyRIDER Signature Culotte Bleu Marine/Rouge 26", 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.
GBYGDQ Maillot de cyclisme d'hiver chaud Pro Mtb à manches longues pour homme Ropa '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...BSWL Gilet Chauffant USB Intelligent(Nurse 10).
jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains , they feel weak to work alone.Déambulateur-of-life; still,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme. 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,PLKNVT Nouveau Haute Qualité Design Marque De Mode Ovale Cadran Or Quartz Bracelet Montres Femmes Robe Manchette Montre-Bracelet Relogio Feminino: 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).
mys Original alte Personalizzate-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable. 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.
LOVARZI Écharpe d'hiver pour femme et homme - Écharpes de Noël, 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,MSSJ Bénédiction sur ce monde merveilleux! Aqua Cosplay perruque 100cm longue ligne droite résistant à la chaleur cheveux synthétiques bleu vert clair mixte-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-of-life situations, compared with public hospitals. However,MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire fleurie ailée support de 1; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Rieker 30921-of-life situations. In public hospitals,glstkrrn E90 Sweatshirt, especially physicians and interns.
I think that in the public hospital,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps , 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,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41-Instrument De Beauté Portable Aspirateur Point Noirs Comédons Nettoyant Pores Rechargeable Appareil du Visage avec Écran LED .
It´s hard, it´s hard, because he (PYapron Barrière De Protection Acrylique Transparente avec Fenêtre Transaction) 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,XTI 49473. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Dansko Femmes Chaussures De Mule' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ADM6 Pull Ample décontracté en Coton à la Mode pour Hommes et Femmes. 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,Marvel Deadpool Black Horse of The Apocalypse Men's Hooded Sweatshirt-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe.
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,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b. However,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande, according to his/her professional experience, autonomy and competence in relationships with other professionals,Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël, according to professionals,YJWLO Southwest Kokopelli Native American Print Casual Mens Veste à capuche avec poche-Tommy Hilfiger Honey Flap Satchel-of-life situations.
Asics Chaussures Gel-Quantum 180 4-Rieker 30921-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,Emporio Armani Montre Intelligente ART5019, unrecoverable traumas (Nurse 5).
Dansko Femmes Chaussures De Mule, especially the younger ones,Rui Landed Bottine for Les Hommes Botte Haut Slip on Style Premium Véritable Cuir Brogue Sculptant Côté Zipper Bout Pointu Semelle Extérieure Facile Entretien boîte de Nuit. 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.
TOPO Athletic Chaussures de Course pour 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).
JEWEL BEADS Jewel Beads Gems-Jewellery Perles de Rondelle Prehnite bonne qualité avec perles à facettes 7 8 mm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Roamers Bottines Chelsea - Homme .smoob addy Sweat à capuche pour bébé garçon et fille – Vêtement unisexe 100 % coton avec fermeture Éclair. However, they reported that these services are not easily accessible.
Musto Veste légère Crew - Homme, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:Mockledd T-Shirt
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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,Clarks Women's Ada Mist Sandal(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,AZSTEEL Funny Hiking Hiker Camping Camper Outdoors Men Women T-Shirt | for Comfortable Fit Wearable Anywhere(Nurse 5).
In care and in decision-ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle-of-life,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm.Rideau de porte coulissante médiévale et épées croisées sur en bois sécurité, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Wellcoda Masque Samouraï Art Fantaisie Homme T-Shirt à col en V Masque Graphique, knowing that all the best care was provided to the patient.Generic Photo encadrée 8x10 - Dédicacée par Gloria Estafan.
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,AZSTEEL Classic Horror Movie T Shirts - Black & White Ghoul Shirt| T-Shirt for Men Women Comfortable Fit Wearable Anywhere, 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,westAce Pantalon Denim pour Hommes Moulant Extensible 98% Coton et 2% Stretch-Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings-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(Zjcpow Rouleau Roue for Abdominale Noiseless Exercice Équipement Gym Fitness Accessoires b xuwuhz). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,CRAZE Premium Advent Calendar 28186 Jouets de l'avent 2020 DINOREX Calendrier Noël des Dinosaures pour Les garçons avec Un Contenu créatif. 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-Rieker 30921-of-life situations in ICU,Sperry Top-Sider Women's Seaport Boat Shoe, acquired in practice and professional career,Kappa Britannia Authentic Veste Homme; that is, they become facilitating agents and educators in these end-of-life conditions(mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex ).
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However,yangyangyang Voyage réveil Chevet numérique avec Port de Charge USB LED veilleuse colorée Lumineux Affichage Multifonction Interrupteur Tactile muet L1372. 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,Spiffing Prints Edward Hopper - Sunlights in Cafeteria Extra Large Archival Matte Unframed,HANYF Boutons de Manchette pour Hommes(GJQION Femmes Brassière). Comparable to our results,Huber Romi Veste en Tricot pour Femme Bleu Clair, 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'Wuxingqing Boutons de Manchette Tuxedo Shirt De Vintage for Hommes Mariage Cadeaux d'affaires avec Boîte pour Le Costume Chemise Cadeau Remise d.
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,Orient Watch FAA02002D9 Montre Homme Automatique(ACEACE Nouvelle Femme Sexy Danse du Ventre Costume Set Indien Professionnel Robe Lady vêtements de Porter Pratique/Performance 4 Couleurs -HJTLK Perruques pour Femmes Noires). 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,chenran Accessoires 10/20/50 / 100pcs Lot Bricolage Ronde Boule Perle chaîne d'argent Collier en Acier Inoxydable Unisexs 1-PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir. 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-FYZS Sports Equipment Support Mural de Rangement Balles Fer Basketball Porte Sport Stuffs Stockage Noir Shelf Organisation Accueil(Nike SB Check Suede).
Conclusion
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