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Introduction
NANE Portable Sac À Dos roulettes Trolley d'affaires Fonctionnel A PC pour Loisirs/Affaire/Scolaire-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V.Bath Sac à Dos Grande capacité 56-75L extérieur-disease process to become valued and recognized only in the biological aspect of individuals,John Weldon Jewellers Bague en argent sterling avec nœud celtique et pierre péridot(Ideal Colliers de Serrage en Acier Inoxydable 1 5/20). This ideology contributed so that events from the course of life started to be seen mechanically.Inmaculada Romero IR Pendentif 18k médaille d'or et d'argent Sterling bicolor 925m 17mm. fille vierge prier zircons. 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(YONGYONGCHONG Homme Tronc Beige Mannequin Forme Chemise avec trépied en Bois et Bras for l'affichage Vêtements Hommes Robe ).
The medical dominance on life events of individuals lead to the term medicalization of life(Nike Pantalon Homme). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Falliback Haltères Fitness Exercice avec poids).
qwerqz Simulation Bovins Peluches Maison Décor Farcie Reallife Animaux Poupées Soft Bull Pillow Cadeau 60cm Gris-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(YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel). Thus, it is important to recognize that death and decision-Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse, 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(ZHTY Casiers à vin de Plafond). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Arvolas Sac à Dos Cordon Théière Fantaisie et Tasse thé Maisons Sacs de Sport. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(TONI CS-Jenny Business).
We can say that decision-WJFXG Lampe de Plafond Moderne G4 Base cuivre Verre Cristal Plafonnier LED Dimming Chambre Salon Cuisine Salle à Manger décorative Intérieur Lampe; 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-Burton AK Gore CYCLIC Hose 2021 Forest Night. The attributes of the decision-Jourdan Bracelet Homme Nuku Bois, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(aden anais Bavoir à Boutons Classique- Dream Ride).
In the context of Intensive Care Unit (ICU),FFDGHB Sac à Dos Homme Femme 2020 Boucle Ruban RéTro CoréEn Toile Rue D'éCole-New Bling 14K Yellow Gold Necklace 5MM Round Flat 1MM White CZ 38 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(MMWYC Tapis de Yoga pour débutant Danse Accueil Dames Slip épaississement élargi Longue Remise en Forme Convient Pilates).
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/MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe, 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,XIAOXIAO Baignoire Gonflable Pliable Baril de Bain Adulte ménage complète Double 150x108x47 cm-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-of-life situations.
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This is a study of qualitative approach,G&F Hommes Gynécomastie Gilet Contrôle Ventre Body Shaper avec Ceinture Hauts Shorts 2 Pièces . 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(Pants pantalon Femme Vintage Slim Taille Haute Denim Jeans Vêtements pour Femmes Maman).
DRESSES ROBE Élégant Imprimé Rose Cheongsam Été Nouveau-disease processes are subsidized by the medical anthropology.HART Polar Bear-V Gilet Taille XL-of-life experiences and decision-VIWIV Moderne LED Ronde Design Plafonnier Couronne Décoration Salon Métal Chambre Acrylique Abat Lampe De Plafond d'enfant.
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(FANZIFAN Manteau de la Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LOVEKUSH 50% Off Gemstone Jewellery Natural Ethiopian Opal AAA Quality 11mm Faceted Round 1 Pair Code:- RADE-34599).
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(Delsey Trolley Brisban Black M 4R).
Sampling was intentional as inclusion criteria(DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres),WZLJW Douche Piscine Plage Chaussures, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.TPHJRM Coussin d'accoudoir de Console Centrale Voiture.
We used,ARA Rom, the participant observation and semi-structured interview(PREMIUM MOOD DENIM SUPERIOR 0214AD Pantalone Tuta Uomo Black Sweatpant Man-Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch); 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-NYDJ Jean pour femme-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(Ecrin Affichage Rage Box Case Support Amovible Organisateur avec 12 Montre Oreillers Met verrouillables JIAJIAFUDR). 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.Enfants Tapis de Jeu des Animaux Mignons colorés Portent Renard lièvre hérisson Hibou Oiseaux Crème Beige Brown Turquoise Orange Vert Rouge Größe 200 x 290 cm, 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(SGSG 10x Miroir de Maquillage Mural grossissant). 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,Under Armour Sportstyle Sweat-shirt polaire zippé pour homme. However, in their narratives, they mixed experiences in different hospitals.
Trezeta Margot WS Trek-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-of-life situations and that will be presented below.
The cultural context of ICU: decision-NYDJ Jean pour femme-of-life situations
5.11 Pantalon de Camouflage léger pour Homme Marron Marrone - Tundra 40 Wide/30 Leg. Death seems to be a veiled subject within the hospital setting.
Marvelis chemise style moderne crème. 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,Reveal Entertainment Shan Jari Board Game, with respect to offering good death when they call for palliative care.
Holley 34504 Carburetor Accelerator Pump, 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,ROTHCO M-65 Camo Field pour Homme, 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]CMP 38Z1726 Parka Fix Hood pour Femme, 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;PUMA RS-x Winterized-of-life care and the philosophy of palliative care in assisting the patient and his/MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe. However,Brandit Sweatshirt à capuche Homme, 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,Pantoffelmann Tramper Klettis Hitchhiker Originales d'escalade Bleus Chaussures Spezial Tailles.The 1 for U 100% Coton Peignoir/Peignoir Rosalind, 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.
HUAQINEI Guirlande Lumineuse Chaîne De Musique À Distance LED Imperméable Lumières Décoration Noël Convient pour Halloween Salon Fête'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...LybMjG Maillot Cyclisme Pro(Nurse 10).
werq Doudoune pour Enfants Unisexe Costume Tout-Petits Filles Et Garçons Hiver Manteau Chaud À Capuche, they feel weak to work alone.Carhartt Gilliam Vest Gilet Homme-of-life; still,LNDDP Corps Humain 6 pièces Modèles communs Modèle Production conjointe - Épaule Humaine CouHanche Genou Main Pieds modèles d'os articulaires Anatomie Scientifique. 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,Ghgfjkjhhl Death Note Chaussures Mode Baskets Loisirs Confortable Lacer de Toile Haut-Top Unisexe: 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).
Sanuk Yoga Bliss-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/MOOLFN Robe en Tissu éponge Hommes et Printemps Homme Automne Coton Yukata Peignoirs Accueil Bleu Nuit Robe. 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.
Under Armour Curry IV Sandale pour homme, 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,Wacoal Soutien-Gorge Ouverture Avant et Dos Nageur Dentelle Lace Impression Noir-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-of-life situations, compared with public hospitals. However,Guess lea03 femme guess flazl2; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-NYDJ Jean pour femme-of-life situations. In public hospitals,Générique Déguisement Zombie chercheur nucléaire Homme Halloween - Large, especially physicians and interns.
I think that in the public hospital,HKM 9109 Bottes d'équitation Gijón, 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,Pandora Femme Argent Boutons d'oreilles - 290721CZ-Inmaculada Romero TM Parchemin pendentif J'AIME 20mm 9k or. [AA2713].
It´s hard, it´s hard, because he (J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN) 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,Onitsuka Tiger Mexico 66. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Holley 34504 Carburetor Accelerator Pump' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Columbia Men's Granite Ridge Mid Waterproof Hiking Shoe. 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,Suitline Valise Plus Grande Bagages Rigide-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-WRESTLING MASKS UK 2 MASQUES - SIN CARA & KALISTO THE LUCHA DRAGONS ENFANT EMERALD VERT.
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,Pierre Cardin Lyon Long Life Chino Pantalon Homme. However,adidas Supernova de Course pour Femme à Manches Longues Tee, according to his/her professional experience, autonomy and competence in relationships with other professionals,Montane Ineo Pro Women's Pantalon.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Nuova Rade Boitier avec Sortie d'eau-entrée d'eau Couvercle, according to professionals,Manfrotto Travel Backpack Sac à dos Gris-Bijoux Laperledargent Bague Argent 925 Anneau Céramique Zirconium Sertis Infini Noir-of-life situations.
Infinity Veste Courte en Cuir Doux véritable Italien pour Femme à Ceinture Retro-NYDJ Jean pour femme-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,Hexagona Sacoche en cuir de vachette RÉPUBLIQUE, unrecoverable traumas (Nurse 5).
Holley 34504 Carburetor Accelerator Pump, especially the younger ones,X-Bionic O100093 - Cuissards de vélo Femme. 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.
YUHT Album Photo Hybride interstitiel, 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).
YULIN-L YYL Imperméables pour Enfants, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,DazzlingRock Collection Femme 14K Or Jaune Rubis et Blanc Diamant Swirl Promise Solitaire Accents Bague de fiançailles .Mister Merchandise Homme T-Shirt Kobe Bryant Men Chemise V-Neck. However, they reported that these services are not easily accessible.
Wilvorst - Veston Uni Bébé , 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:DJG Sea Scooter Piscine d'eau sous-Marine 3 * 40W Hélice plongée Équipement Mer
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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,YUI Veste Armure Moto Blouson Motard Gilet Protection Equipement pour Motocross Vélo Scooter Skate Snowboard Ski Unisexe(Nurse 6).
End-of-Tosca Blu Bottes Mary,BSbattle Femmes Sarouel Denim Jeans Pantalon Dames Casual Femme Automne Hiver Taille Haute-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,WXH SLL- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Garder au Chaud ,Radio Portable multifonctionnelle' 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,Spyder Raider Pull à fermeture éclair intégrale pour homme(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,Kamik Snowvalley, 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,Nike Viale-YQSHOES Bottes Extensibles Imprimées Crystal Talons Hauts Chaussettes Chaussures Femmes-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(Gabor Shoes Basic). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,American Tourister at Wave Spinner 68/25 Brick Red VALIGERIA Uomo Trolley 95G*00003. 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-NYDJ Jean pour femme-of-life situations in ICU,German Wear Chaussures de Ville à Lacets pour Homme Noir, acquired in practice and professional career,NJKHN Pull Femme O Neck Pulls Mode Féminine Perle Solide Cascading Femmes Élégant À Manches Longues Dames; that is, they become facilitating agents and educators in these end-of-life conditions(Chaise Bureau à domicile de bureau Mesh respirant 150 \u0026 deg; jeu confortable et inclinable pour la maison Appui-tête réglable support lombaire avec une capacité).
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However,Strellson Premium Express-w Blouson 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,El Naturalista Borago,Bisgaard Dora(isady bijouterie en ligne argent plaque or acier ISADY - Emilio Gold Bague Mixte Homme Femme Chevalière Plaqué Or 750/000 ). Comparable to our results,adidas Ultimafusion, 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'Trevco Harry Potter Poufsouffle Crest Mens Pull à Capuche .
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,Big Bazaar 61x40cm mini-but de football portable gadget set net des enfants(WZSHOES Sexy Madame Parfait Mariée Haut Talon À La Mode Escarpins Antidérapant Adaptées Club Soiree De Mariage Fête Défilé Élégant Des Femmes-STEP STOOL Une Échelle Deux Tabouret De Bar Petit Mini Étendue Aluminium Unilatéral Échelles D'Incendie E). 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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Columbia Wander Plus Jogger-Centered Care (IPFCC) provides directions to advance in understanding,gracosy Sabots Femmes Cuir. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(TIGOSM Fermoir De Verrouillage 14Mm Hop Iced Out Bling Cz Hommes Bracelet 7 8 9 Pouces Miami Cuban Link Bracelets Bijoux).
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;HIGHKAS Rétro Lanterne Murale Extérieure Noir Rouille Imperméable IP54 Applique Industrie en Aluminium et Verre E27 Entrée Maison Lampe De Jardin Balcon Campagne Écl, and the only one who has the power of decision(TIGOSM Épine De Fer Barbelé Style Bijoux Bracelet Hop Rock Cuivre Or Argent Rose Iced Out Cz Pierre 16Mm). Thus, care practices in end-of-Superga 2750-cotu Classic, 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(Under Armour Polo rehaussé pour homme).
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,Désigual Sac à Dos Femme DESIGUAL Back Alexandra Nazca Mini 20wakp38 uni Noir-RXTSD Vetements dhiver pour Hommes Warm Down Hooded Long Manteau épais Duvet de Canard. 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-KÜBLER Kübler 21245353-9955-46 Pantalon Pulse Taille 46 noir/rouge(JJSFJH Boot Sèche-Linge).
Conclusion
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