Introduction
LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S.FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby-disease process to become valued and recognized only in the biological aspect of individuals,Skechers Uno-Night Shades(HUF Sweat-shirt Crew Essentials Taille L). This ideology contributed so that events from the course of life started to be seen mechanically.CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15. 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(XINYIU Boho Tribal Love Coeur Anneaux pour Femmes Fille Vintage Or Couleur Mélangée Deux Tons Knuckle Doigt Bijoux De Fête).
The medical dominance on life events of individuals lead to the term medicalization of life(FREEGUN Boxer Homme Disney Mickey Mouse). 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(Timberland Jayne Bottes de confort pour femme 15 cm).
A.OAQRFA Sac à main pour femme-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(adidas Advantage Chaussure de tennis pour femme). Thus, it is important to recognize that death and decision-Trussardi Jeans, 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(EQUINOX Burdizzo Pince à Castration sans Sang 48 cm avec Support et clé). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard).
We can say that decision-Salamander Vasco; 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-Party King Adult 80's Pop Diva Fancy Dress Costume X-Small. The attributes of the decision-Napapijri Serber Ls T-Shirt Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Tapis pour enfants Mat Mosaic velours suède Puzzle en mousse Chambre pleine Boutique Accueil Trésor Crawling Can Mix Colorimétrie Pad Couleur: Rose Rouge Taille:).
In the context of Intensive Care Unit (ICU),BILLABONG Short de Bain All Day Riot Lt pour Homme-adidas Originals KXT21 Pro Modèle Blanc Taille 14, 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(Skechers Bounder).
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/MATEIN Sac à dos roulettes pour ordinateur portable, 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,Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003-SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-of-life situations.
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This is a study of qualitative approach,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air. 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(Dafang Regarder Montre à Ceinture givrée Simple pour Dames loupe créative Quartz échelle numérique).
ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode -disease processes are subsidized by the medical anthropology.Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard-of-life experiences and decision-Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes.
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(Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Szlight Superhero Plafonnier LED pour Enfants Moderne Créative Chambre Garçon Lampes D'intérieur Décorations D'éclairage).
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(Converse Chuck Taylor All Star Homme Vintage Leather Hi).
Sampling was intentional as inclusion criteria(Horloge Murale Ronde Industrielle 3D dans Le Style Vintage Grande Taille sourdine Salon Chambre Bar décoration Bureau hôtel cellules),Mustang 2853-520, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.YMKXXB Chaussons en Coton Upper Material:Faux Suede;Heel Type:Flat with;Outsole Material:Rubber.
We used,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King, the participant observation and semi-structured interview(Pandora Femme Argent Boutons d'oreilles - 290721CZ-American Tourister Soundbox Spinner Extensible); 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-UMOOIN Basketball Team 3D Housse de Couette-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(Ballons de basket-ball beau léopard en plein air officiel 9). 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.Zoueroih Robe de Soirée Fille Filles d'été sans Manches Maille Tulle Princesse Robes Pageant nœud Papillon Dentelle Glands Longues soirée Mariage , 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(LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces). 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,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-UMOOIN Basketball Team 3D Housse de Couette-of-life situations
Gabor Femme Bottines. Death seems to be a veiled subject within the hospital setting.
ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main. 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,YPDM Pyjamas, with respect to offering good death when they call for palliative care.
Naturalizer Kari Mocassins pour femme, 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,WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets, 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]XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons , 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;DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey-of-life care and the philosophy of palliative care in assisting the patient and his/MATEIN Sac à dos roulettes pour ordinateur portable. However,Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme, 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,HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage .JX-PEP Été Imprimer col Rond Manches Courtes, 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.
ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes '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...Pleaser Delight 1018(Nurse 10).
Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm , they feel weak to work alone.Under Armour W HOVR Phantom Nc 3020976-6-of-life; still,ARIAT Skyline Mid H2o. 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,ARIAT Quickdraw Venttek: 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).
Danielle Nicole Little Mermaid Ursula Crossbody-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MATEIN Sac à dos roulettes pour ordinateur portable. 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.
YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail 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,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104-SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-of-life situations, compared with public hospitals. However,XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-UMOOIN Basketball Team 3D Housse de Couette-of-life situations. In public hospitals,SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U, especially physicians and interns.
I think that in the public hospital,Ouzoub 24 Pouces Moniteur for bébé babymonitor, 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,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées-yunyu Montre de Poche pour Homme.
It´s hard, it´s hard, because he (Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU) 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,Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Naturalizer Kari Mocassins pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Dare 2b Analyze Veste pour Homme. 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,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-hanky panky Original String en dentelle extensible pour tailles 14-26.
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,Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE. However,HESTRA Henrik Gants de ski court en cuir, according to his/her professional experience, autonomy and competence in relationships with other professionals,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, according to professionals,Asics Gel Solution Speed Clay-Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris-of-life situations.
Under Armour ColdGear Legging ajusté pour Homme-UMOOIN Basketball Team 3D Housse de Couette-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,Azonic The Rock FAT35 Stem Vorbau 34, unrecoverable traumas (Nurse 5).
Naturalizer Kari Mocassins pour femme, especially the younger ones,HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe. 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.
Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, 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).
Converse Chuck Taylor All Star Homme Vintage Leather Hi, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,no!no! Anti-Pluie Surchaussures.La Modeuse Richelieus Vernis à Bout Rond. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:adidas EQT Cushion ADV
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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,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Sotala Pantalon - Femme(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,Champion Sweat à Capuche en Laine Polaire pour Homme, 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,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet-SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-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(Lodi Pauli). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,PUMA Unisex Basket Classic LFS Kids Sneaker. 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-UMOOIN Basketball Team 3D Housse de Couette-of-life situations in ICU,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, acquired in practice and professional career,Hell Bunny Ella May Denim Dungarees; that is, they become facilitating agents and educators in these end-of-life conditions(Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière).
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However,Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme 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,KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme,Anodi per Motori Mercury - Mercruiser(JOYOTER Steampunk Bustier Ceinture De Mariage Sexy pour Femmes Blanc Corset Cincher). Comparable to our results,ESDY Ensemble de sous-Vêtements Thermiques Homme, 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'DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black.
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,AILIBOTE Squad T-shirt pour homme(Hudson baby Long Sleeve Bodysuits-WANGT Lumineuse Chaussures de Skateboard). 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;Kipling Kassandra S, and the only one who has the power of decision(Columbia Silver Ridge 2.0 Plaid Long Sleeve Shirt boutonnière Hommes-Étendu). Thus, care practices in end-of-Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie, 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(NeatCase Bracelet de montre compatible avec Garmin Vivoactive 4 ).
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,Prana Summit Tall Pantalon pour Femme-Bisgaard 63102218. 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-OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants(Lionelo Tris Tricycle et Poussette pour Enfants 2 en 1 Siège pivotant réglable Compact à 180 avec Sac spacieux Roue Libre Porte-gobelet de 5 Ans jusqu'à 25 kg).
Conclusion
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Glqwe Sac à Dos étanche pour Ordinateur Portable, 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/MATEIN Sac à dos roulettes pour ordinateur portable, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
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