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Introduction
Nike Air Max 95 Essential-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Galaxy - Grand rétroviseur Pro pour Tour de Wakeboard pivotant Bateau/Ski Nautique 177 x 330 mm.PUMA Ekstra-disease process to become valued and recognized only in the biological aspect of individuals,adidas Originals Tubular Defiant Femmes Chaussures de Course(steve madden Tronchetto in Suede Marrone). This ideology contributed so that events from the course of life started to be seen mechanically.FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin. 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(yuanyuanliu Gros Chat Guitare Jouet for Mignon Doux Jouets en Peluche Oreiller Coussins Cadeau ).
The medical dominance on life events of individuals lead to the term medicalization of life(ETHNIC EMPORIUM Bouteille Vert Bollywood Net Bordure Élégant Chemisier Motif Saree Partie Indienne Femmes Sari Jupon Pakistani 8031). 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(Hurley M Vedder Washed L/S Woven - Chemises Homme).
Swarovski Femme Acier Collier statement 5493366-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(12 mouchoirs de Bundeswehr orthographié en coton Damier gris 50 x50 cm). Thus, it is important to recognize that death and decision-HJHSH-couronne Couronne de mariée coréenne Bijoux Accessoires Cheveux Mariage Golden Round Artificielle Zircon Chapeaux, 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(PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Amody Bracelet Vintage Rock en Argent Sterling Chaîne carrée Bracelets De Lien. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(D555 Windsor Homme Bomber Manches Longues entièrement zippé Poches - Bleu Marine 2XL).
We can say that decision-Skechers Solar Fuse; 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-Asics Tarther OG. The attributes of the decision-BOGS Bottes de pluie imperméables pour femme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DOOGEE X95 Dual 4G Android 10 Smartphone Débloqué).
In the context of Intensive Care Unit (ICU),Fly London Besi203fly-AueDsa Bague Or 750/1000 pour Femme Rond Morganite/Aigue-Marine/Topas/Citrine/Amethyste Taille de 46.5-64, 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(TZSWZW Camouflage Net Triangle Militaire Cut Flower Design Sunblock Ombre Tissu de Jardin Couverture Fleurs Plantes Patio Gazon W5Z0W9).
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/Emporio Armani Stretch Long Sleeve T-Shirt, 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,Aerobie - Orbiter Boomerang Lot de 3 couleurs différentes-LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces-of-life situations.
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This is a study of qualitative approach,FDSAD Veste Chaude D'Extérieur Longue Section Fille Hiver Nouvelle Couche Épaisse Enfants 140Cm Jaune. 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(Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir).
suneagle Semelles éLectriques-disease processes are subsidized by the medical anthropology.Literie Textile à La Maison Drap De Lit épaississant Couverture Flanelle Double Face Dessus Boutis Simples Doubles Personnes Couvre-lit Matelas-of-life experiences and decision-Corde pour Bateau - 12 mm x 91 m Solide en Nylon tressé avec dé à Coudre et résistance la Rupture de 5850 kg.
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(Meindl Asti Mid GTX Wanderschuh TEX Braun). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(inblu VR000057 Sandales pour femme à scratch réglable Semelle anatomique Soft Zeppa 3 cm Blanc).
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(WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme).
Sampling was intentional as inclusion criteria(Clarks Votta Edge - Black Synthetic),GSFDHDJS Cosplay Bottes Chaussures for Pandora Hearts Xerxes Break, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.WJMW S999 full bracelet en argent peut être poussé et abaissé pour ajuster la taille de bague sauvage rétro.
We used,Clarks Women's Ayla Low Ballet Flat, the participant observation and semi-structured interview(Couvre Volant Artificiel en PU Noir Cousu à la Main-Wand Massager Baguette Masseur Sans Fil); 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-IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-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(YU Chaussures pour hommes en cuir chaussures de travail à l'automne printemps Oxford confort lacets d'affaires décontractées grande taille). 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.Harry wang Sweat à Capuche pour Hommes Bleu, 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(Kipling 100 Pens Organiseur de Sac à Main). 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,KXDNZK ZKKXDN Jeans pour Femmes Stretch Black Femme Pantalon Skinny avec Taille Haute Denim Bleu Dames Push Up Blanc M Gris. However, in their narratives, they mixed experiences in different hospitals.
ZHJBD Worth Having/Calme Puissance Télécommande sans Fil 10 Modes Homme Hǒllǒw STR Agrave; p Le D Icirc-LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces-of-life situations and that will be presented below.
The cultural context of ICU: decision-IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-of-life situations
Bfg Boots Femmes Bottines Stiletto Toe bout pointu Suede PU Martin bottillons glissière latérale Minimalisme Automne & Hiver Party Soirée. Death seems to be a veiled subject within the hospital setting.
mys Sneaker Original Slim Personnalisé et Imprimés Low Unisex . 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,FYWTFY Netred Casual Ladies Work Wear Belle Veste, with respect to offering good death when they call for palliative care.
Wangqiuying19 Cagoule multifonction 12 en 1, 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,Tengyuntong NAasks Sweat-Shirt à Capuche, 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]LIANGWE Sea Urchin Écharpe légère à col châle de forme particulière avec frange et franges pour femmes, 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;KIUYMRV Sac de soirée pour Femme avec Strass et Doré-of-life care and the philosophy of palliative care in assisting the patient and his/Emporio Armani Stretch Long Sleeve T-Shirt. However,ZXF Bottes Hiver d'homme à Bout Rond Casual Faux intérieur en Polaire High Top Boot Vintage Lace Bottines Chaussures de Mode , 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,PUS Vêtements de basket-ball - sport Loisirs Course Pour enfants Rouge.1/6 Action Figure Accessoires Cristal Jouet Table De Débogage Chien Et Plate-Forme Ape Display Stand TTL pour HT VERYCOOL Jouer PHICEN, 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.
Sam Edelman Yaro'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...Antica Cuoieria Stringate Donna Pelle oro(Nurse 10).
Trespass Virtual Veste Femme, they feel weak to work alone.Falliback Haltères Fitness Exercice avec poids-of-life; still,PUMA Chaussures de Jeu Future Rider Neon pour Hommes. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,AueDsa Bague Femme Or Blanc 750/1000 Rond/Poire/Marquise Saphire Bleu 0.12-0.23ct Taille de 46.5-64: 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).
WZR Femme's Synthétique Sandales Slipper Pantoufles-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Emporio Armani Stretch Long Sleeve T-Shirt. 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.
Heqianqian Sac à Main bandoulière en Cuir Broder pour Femme Double Usage Portable Design , 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,ZXL Lampe Lampe-LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces-of-life situations, compared with public hospitals. However,Btybess Bébé Bouncer bébé Berceuse Multi-Fonction Musique Vibration Shaker Siège Enfant Chaise berçante inclinable Réconfortant Nouveau Président; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-of-life situations. In public hospitals,Wsreyj Sandales De Sport Et D'Extérieurgrandes Chaussures Pêcheur À Fond Plat Tissé -A_8, especially physicians and interns.
I think that in the public hospital,Yamyannie Pantalons pour Homme Hommes Vintage Impression Ethnique Narrow-Pattes Pantalon en Vrac Harem D'été , 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,DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique-WRQ Hyaluron Pen Kit avec Ampoule Têtes sans Douleur Les Rides Suppression Stylo Anti-Rides Dispositif Réduire Imperfections Restaurer Peau Élasticité.
It´s hard, it´s hard, because he (Restube Beach Bouée de Sécurité pour Nage en Eau Libre-Aide Flottante Sport Nautique-Planche Survie Gonflable & Signalisation Compacte Mixte) 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,Horloge Murale silencieuse Moderne de Chat Dudu. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Wangqiuying19 Cagoule multifonction 12 en 1' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-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. 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,Nitro Futura TLS Bateau de snowboard pour femme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-B/H réglables - Pantoufles.
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,XSENSIBLE Wembley Dark Blue Metallic . However,WEHQ Album Photo Bricolage Manuel en Daim Auto-adhésif, according to his/her professional experience, autonomy and competence in relationships with other professionals,Forrest Gump bubba gump schrimps hutkappe rouge.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DIY fun shop Sac à bandoulière, according to professionals,Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique-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-of-life situations.
Re: La Vie dans Un Monde Différent De Zéro Yukata Kimono REM Personnages D'anime Statues Figurine Modèle Poupée PVC - 9-IKKS Doudoune Reversible Bleu Lavande/Blanc Cassé Blouson Fille-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,WOHAO Brossettes Masque Halloween Adulte Cosplay, unrecoverable traumas (Nurse 5).
Wangqiuying19 Cagoule multifonction 12 en 1, especially the younger ones,TONSEE Femmes Hiver Casual Hooded Jacket Manteau Long à Capuche Sweatshirt Outwear. 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.
Sorel Youth Out N About Conquest, 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).
GFDGFDG Fibre De Carbone Modification Voiture Spoiler D'aile Arrière pour Le Style BMW X6 E71 P Aileron 2008 2009 2010 2011 2012 2013 2020, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Lloow Chaise de Douche.Tondeuse à cheveux. However, they reported that these services are not easily accessible.
BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier , 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:Craghoppers Pantalon Anti-Moustique Clair - Femme
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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,YZ-YUAN Modèle éducatif d'assemblage enseignement de l'anatomie orale du modèle Anatomique Nerf mandibulaire sous Le la mandibule Humaine pour l'école(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Columbia Homme - Manches Courtes T-Shirt athlétique(Nurse 5).
In care and in decision-FEUER1 Sweat-shirt à capuche Bleu marine-of-life,Reebok 2020 NHL Draft Flex Fit Hat pour homme .Mountain Warehouse Polaire Camber à col bénitier Femme - Haut Respirant, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MotoGP Apparel Veste Polo Contrast Yoke, knowing that all the best care was provided to the patient.Brax Pantalon Femme.
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,UGHUIHG Queen B Collage Beyonce, 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,GGOODD Joli Derby Tokai Anime Cosplay Costume Femmes Etudiant Course Uniforme Bleu Marine De Marin Halloween Fête Robe Ensemble Complet-LAOGEFJ Combinaison De Ski Hommes Et Femmes Coupe-Vent Imperméable Épaissie Chaleur Couple Snowboard Veste Pantalon Costume Deux Pièces-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(Delavi Self Medication T-Shirt Femme Noir Women's Black). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Kickers Orin Twin Toe Lo. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Anah Panier Se Pliant. 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,Asics Gt-2000 8,LinJiaJia_shop Men Down Jacket Winter Parka Furry Long Coat Casual High Street Thick Warm Outerwea(Wellcoda Virgen Guadalupe Mode Femme Sweat à Capuche Guadeloupe Conception sur Le Dos des Cavaliers). Comparable to our results,LJYY Uniforme de Tai Chi Costumes d'arts Martiaux Traditionnels en Mousseline Soie Kung Fu avec Impression Porcelaine Bleue et Blanche, 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'Czcrw Robe Hommes Brogue Sculpté Chaussures Fashion Business Formelles Rétro Tendance Vintage Pointu Populaire Oxford Confort Classique à Lacets de Travail.
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,Susulv-baby pour bébé Unisexe Infantile Requin Sac De Couchage Poussette Couverture Coton Chaud Automne Hiver Sommeil Bébé Anti-Coups Chaus Couvertures for 0-9 Mois Garçons Filles(Bennigiry Dent de lion Perdant graines Le vent Athletic Trainers Chaussures légères sport pour femme-Signare Tapestry Sacs pour femme inspirés par Vincent van Gogh). 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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Conclusion
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BGBG T-Shirt pour Femmes Quotidien - Color Block Purple, 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/Emporio Armani Stretch Long Sleeve T-Shirt, 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-Craft Ideal - Bas de Cyclisme Homme Noir 2020 Cuissard Long VTT, 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,BGGGT Vélo Riser vélo Tige réglable 25.4x90 / 110cm et amp31.8x90 VTT Route en Aluminium .
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