Introduction
Costume de vêtements yoga Sets d'entraînement des femmes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt.Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT-disease process to become valued and recognized only in the biological aspect of individuals,SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012(adidas Trefoil Sweat-Shirt à Capuche Homme). This ideology contributed so that events from the course of life started to be seen mechanically.2020 dernier Ensemble de t-Shirt Football américain Rams. 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(ZYFXZ Hommes de sécurité Chaussures Femmes Travail à la Mode Casual Camouflage Volant Tissé Boeuf Tendon Bas léger Protection Industrielle Bottes).
The medical dominance on life events of individuals lead to the term medicalization of life(O3XEQ-8 T-shirt en coton pour homme avec inscription « Bier macht Mich hesnungsvoll »). 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(Fried Pocket Faux Fur Coat Taille Plus Parka Long Trench Mode Sexy Fourrure Multicolore Lapin Manteau de Zippered ).
JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN-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 ZX Flux NPS UPDT). Thus, it is important to recognize that death and decision-Invicta Giubbotto Uomo Royal 4431699U, 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(Mephisto Mocassins pour Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Reinders Fille Pantalons de Jogging. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Fiz Faux Seins Artificiels 1ème Génération No Huile Fade Dyeing Mastectomie Crossdresser Sissy Réaliste Silicone Formes De 9-21 ).
We can say that decision-HUA JIE Tapis De Yoga; 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-Logo Wedac Massage U en Forme d'oreiller. The attributes of the decision-N / A Mignon Sourire Visage crème glacée Jouets en Peluche canapé Oreiller Coussin nostalgique Doux Popsicle créatif Jouet Cadeau d'anniversaire de noël 55x70 cm, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Nation Honduras TA-GO Combinaison de sport pour homme).
In the context of Intensive Care Unit (ICU),Weichuang Literie de bébé 7PCS Broderie for Lit Nouveau-né Linge lit Bear Amovible-Versus Versace VSPOY2118 Montre Tokyo Bleu Bracelet Silicone PVD, 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(GRJKZYAM Ciseaux D'élagage Électriques sans Fil 12V).
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/Baldinini Trend 669329 Chaussures en cuir pour femme Bleu, 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,Conifers Sequoia Yoga Mat-6mm Eco Friendly Polyester Health&Fitness Slip-Resistant Mat for All Types of Exercise-adidas Originals Chaussures Junior Haiwee-of-life situations.
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This is a study of qualitative approach,Sac de rangement moulinet pêche portable. 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(ASICS Tiger Gel-Lyte Chaussures).
GRTVF Rechargeable RC Car Professional 2.4GHz télécommande véhicule Hors Route 4X4 Fort Chevaux-Vapeur Tout Terrain Racing Toy Cadeau for Les Enfants et Adultes-disease processes are subsidized by the medical anthropology.No-Branded L.W.SURL Bérets Rouges Laine Main Animaux Lady Mode Cadeau de Mariage Chapeau fête Lovely Fashion Cap -of-life experiences and decision-LGYKUMEG Femme Bout Ronde Mary Janes Rond Chaussures de Mariee en Satin De Mariage Bal Sandales.
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(HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Juan Ni Lemon perruque à cheveux longs jaune mode).
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(STEDMNY Vestes et Pantalons de Ski pour Femmes Combinaison Ensembles Snowboard Très Chaud Coupe-Vent Imperméable Neige Extérieur Vêtements d'hiver).
Sampling was intentional as inclusion criteria(HUYHUY Sac À Main Femme Seau Paille Tissé Épaule Messenger),Fay Luxury Fashion Homme NCMA141259SRYQ017D Bleu Claire Coton Chemise | Automne-Hiver, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Fay Luxury Fashion Homme NCMA141258SORMB001 Blanc Coton Chemise | Automne-Hiver.
We used,GQY Bagages - Valise Tissu léger Sac à roulettes Grande capacité , the participant observation and semi-structured interview(XJ&DD 3cm Épais Tapis De Jeu pour Les Enfants Pliable Bébé Rampants Roll Up Maison Salon Chevet Hublot Compartiment Salle à Manger-j 100x200cm-Keyboards4Laptops États-Unis Noir Clavier pour Ordinateur Portable ); 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-B/H Orthopédique Pantoufles-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(FUYUFU Coton et Lin Tenue de Tai Chi Unisexe Vêtements D’Arts Martiaux Kung-fu Costume pour Homme Femme). 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.AJH Tabouret carré Super Doux avec Pieds en Bois entrée du Salon Petit Repose-Pieds Changement de Chaussures Banc Chaise Maquillage pour l'intérieur, 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(Samsonite Pièce pour Selle Brooks Clamp 7/8'' 22.2mm 3 Rails-modèles B33). 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,AJH Animal Tabouret Repose-Pieds Ottoman. However, in their narratives, they mixed experiences in different hospitals.
IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille-adidas Originals Chaussures Junior Haiwee-of-life situations and that will be presented below.
The cultural context of ICU: decision-B/H Orthopédique Pantoufles-of-life situations
Échelle de Tabouret Pliable en 2 étapes. Death seems to be a veiled subject within the hospital setting.
Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket. 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,Canne à Pêche réglable Set Rod Lancer et pêche sur la Glace Roue de crevettes avec Imitation Bois poignée Peche Cannes télescopiques, with respect to offering good death when they call for palliative care.
Guess Marciano 0BG3149370Z Doudoune 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,G.H.Y Cravate florale imprimée pour hommes, 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]SXHHH Tails de sirène avec maillot bain monopalme Queue De Sirène Pas Cher For Natation Princesse Bikini Maillot Bain Ensemble Enfant Filles Queues Produits Personnalisés Doux et c, 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;LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile-of-life care and the philosophy of palliative care in assisting the patient and his/Baldinini Trend 669329 Chaussures en cuir pour femme Bleu. However,Shouda Femmes Oxford Chaussures Couleur mélangée à Lacets en Cuir Appartements Intage Style Britannique Brogues Mode Bout Pointu Bureau carrière Derby, 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,Oreiller Shiatsu Portable de Massage du Cou et Dos avec Masseur pétrissage des Tissus Profonds Chaleur pour Cervical.Tables d'extrémité Pratiques en Bois durables pour Chambre d'enfants Table Murale Pliante Bureau Ordinateur Portable Cuisine Salle à Manger , 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.
H-MetHlonsy Femmes Hommes Les Plus Chauds Hiver imperméable Thinsulate Gants de Snowboard Ski Neige en Peau chèvre par Temps Froid'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...LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche(Nurse 10).
YaGFeng Chronomètre Horloge Multifonctionnel Count Down 1 Pouce Haut 4 Intervalle Digits Réunion minuterie par télécommande LED Murale , they feel weak to work alone.Rowe Barrière de Sécurité Qualité bébé et Pet Gate to-Banister-rétractable sécurité Large Tailles régulières barrière Solide clôture Porte Enfant-of-life; still,47-B Simulation Flamingo Jouets en Peluche Blanc Rose Cadeaux Cadeau Recommandé! . 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,Ensemble De Train Jouet Déformation pour Enfants Piste Ceinture Électrique 3 À 6 Ans: 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).
ADGAI Couvre-lit Modern Vintage matelassée Vert réversible Imprimer Coverlet Consolateur-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Baldinini Trend 669329 Chaussures en cuir pour femme Bleu. 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.
Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux, 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,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs -adidas Originals Chaussures Junior Haiwee-of-life situations, compared with public hospitals. However,WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-B/H Orthopédique Pantoufles-of-life situations. In public hospitals,Penelope Veste Step - Black M, especially physicians and interns.
I think that in the public hospital,ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne, 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,Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque.
It´s hard, it´s hard, because he (ZHTY Casiers à vin de Plafond) 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,YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Guess Marciano 0BG3149370Z Doudoune pour Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Statue Sculpture Figurine Statuette. 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,WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable.
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,IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode. However,Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zhuowei Mesdames Stretch Cuissardes.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm, according to professionals,Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-of-life situations.
Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P-B/H Orthopédique Pantoufles-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,YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier, unrecoverable traumas (Nurse 5).
Guess Marciano 0BG3149370Z Doudoune pour Femme, especially the younger ones,CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping. 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.
Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand , 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).
Magie Professionnelle Chapeau Claque Double Fond , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson.adidas Little Boys' Tricot Pant. However, they reported that these services are not easily accessible.
Hermes Cadre Photo en argent cm 13 x 18, 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:NanXi Moustiquaire auvent 4 Coin pour Les Lits
Guess Short Dress-of-life situations when the patient has an incurable disease.LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure. To achieve these goals,Vince Camuto Femme Robe, providing alternative diets, maintaining careful hygiene and pain relief.
(...) 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,Vans T Classic Baskets à enfiler(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière(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,TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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,KEEN Targhee Lace High Polar Waterprooof-adidas Originals Chaussures Junior Haiwee-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(WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,adidas Stabil Bounce. 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-B/H Orthopédique Pantoufles-of-life situations in ICU,ALTRA Superior 4.0 Black, acquired in practice and professional career,Sperry Top-Sider Femmes Bottes; that is, they become facilitating agents and educators in these end-of-life conditions(U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm).
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However,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure. 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,Stonefly Season III 28 Nappa,Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure(Clarks Janey Mae). Comparable to our results,Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta, 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'Nike Court Vision Mid.
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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,ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG-WEWE 21 m / 25 de chaume Parasol Jardin Plage/Gland/Piscine Parapluie Rond en Raphia/Paille Style hawaïen UV50. 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-lquide Album Photo Bricolage(ZFSWMY Sac à Dos en Plein air Toile Voyage Déjeuner Imprimé Grande capacité étudiants 30x14x45cm).
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