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Introduction
LVYE1 LAMP Dessin Animé Créatif Animaux LED Lustre Garçons Et Filles Chambre Enfants Lumières Moderne Simple Personnalité Tissu Lustre-CE-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,mys Sneaker Customized Adulte - Chaussures Coutume .Yhjkvl Hommes Gym Legging Fitness-disease process to become valued and recognized only in the biological aspect of individuals,JIRENSHU Broche Accessoires Corsage Manteau Cardigan Foulards décorative(Metal.CH 2133.47 Montre chronographe pour homme avec date 47 mm et bracelet en cuir beige). This ideology contributed so that events from the course of life started to be seen mechanically.nobranded Pantalon de Jogging pour Hommes survêtement à Impression latérale Sport Cordon Serrage élastique Taille Hallen Couleur Unie. 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(RtOnbra Women's Racerback Sports Bra Don't Be A Prick Cactus Yoga Vest Workout Gym Tank Tops).
The medical dominance on life events of individuals lead to the term medicalization of life(TWCAM Bracelet Homme Cuir Magnetique- Bouddha Perles Couple Chapelet Wenwan Femme). 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(Nike Viale).
Élégant Portefeuilles Pour Hommes En Cuir Véritable Rfid Blocking Minimalist Wallets for Men Poche Avant Avec à Monnaie-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(Nike Nike886872-011 - Nk Fc Top Haut Noir pour Homme 886872-011). Thus, it is important to recognize that death and decision-Cxjff Pliant PedaI Tricycle, 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(Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,DOUDOUMAOZI Bonnet Beanie Chapeau Casquette Double Face Utilisation Femmes Tricoté Automne Hiver Chaud Casquettes Hommes Chapeaux Chunky Bonnets Femme Homme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MASCOT WORKWEAR Mascot Polo De Travail Crossover).
We can say that decision-Baignoire Pliante pour bébé; 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-Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long. The attributes of the decision-RENJUN Moto Escalade randonnée pêche Gants de Sport en Plein air débarrasser , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Under Armour Prototype Logo Short Garçon).
In the context of Intensive Care Unit (ICU),AABAO Sac à Dos pour Enfants Triceratops Dinosaure Maternelle préscolaire Tout-Petit Filles Garçons-Ahorn Sportswear Combinaison de loisirs courte Aloha Turtle Blanc opale vert/bleu marine, 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(WGE Mailles de 5 / 10cm).
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/Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack, 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,CGJ 4 Couleurs Pantalon de Yoga à Jambes Larges-HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles-of-life situations.
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This is a study of qualitative approach,Arrosoir Non Toxique Plastique Enfants Plage de Sable Jouets for Baignoire Jeu Fun Jardin Sprinkler Kid Early Education Toy . 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(ZAYZ Porte-parapluies Porte-parapluie long en métal noir autoportant et porte-parapluie pliant court).
FCXBQ Ball Pit Tent Playpen Barrière de sécurité pour bébé - avec Balle-disease processes are subsidized by the medical anthropology.ZFSWMY Sac à Dos Enfants Hommes et Femmes école Voyage Randonnée légère 37x18x26cm étanche -of-life experiences and decision-HS-Zak Miller LAL Bryant # 24 Vêtements De Basket-Ball Sport Jersey Hommes Entraînement Sportif pour Les Fans Adulte Unisexe Pur Coton Loose Col Rond Gilet Manche Courte T-Shirt Manteau.
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(Prana Summit Tall Pantalon pour Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(LXJ-CQ Oreiller de Cou Peace Symbols Voyage en Forme U Housse Lavable au Design Ergonomique).
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(L.TSA Lámpara colgante de vidrio minimalista moderno).
Sampling was intentional as inclusion criteria(DC Manteca chaussures pour hommes),WYNZYSLBD Gilet De Sécurité Haute Visibilité, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MYMAO Pluie épaisse Ponchos ~ Qualité Premium.
We used,DODOMIAN Lot de 5 caleçons boxeurs pour hommes sous-vêtements en coton sans manches à braguette ouverte avec pochette, the participant observation and semi-structured interview(Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds-BaoYPP Martèlement Jouets martelant Xylophone Naturel de Tout-Petits en Bois for Les Enfants avec Multi-Couleurs Percussion Instrument Musique Jouet Cadeau Tap & hammergame pour); 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-Hudson baby Long Sleeve Bodysuits-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(Teinaongsy Pantalon Court Droit imprimé pour Homme Short Travail Streetwear). 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.Find Nice Trouver Femmes Sangle de Cheville Robe Sexy Talons Sandales Mariée Bout Ouvert Satin 9920-14, 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(HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique). 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,Rideau Moderne Minimaliste Chambre Étude D'Enfants Baie Vitrée Porte-Fenêtre Personnalité Créative Décoration De La Maison Parfum Rose. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Hudson baby Long Sleeve Bodysuits-of-life situations
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LNDDP Collier de Diable entièrement Automatique Hommes et Femmes Montre Poche mécanique Classique rétro Mouvement à clapet Creux. 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,Reborn Baby Dolls, with respect to offering good death when they call for palliative care.
HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël, 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,Haltère Fitness Yoga Hexagonal Dumbbell Formation Unisexe Paire 5kg Violet Bleu , 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]weiyibaobei Tapis De Bande Dessinée Anime Bonhomme Neige Rectangle Cristal Velours Chambre d'enfants Jeu Salon Étude Cuisine Sol 180 * 270 Cm, 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;Raelf Route lampe Victoria IP65 60CM lumière chaude pelouse lanternes cylindrique Réverbère Phare Noir Aluminium moulé sous pression extérieure Pilier COB LED paysage Réverbères étanche Colonne lumièr-of-life care and the philosophy of palliative care in assisting the patient and his/Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack. However,Clavie Boucles d'Oreilles Pendantes Or Jaune 750 Émeraude VVS1 0.73ct Vert Goutte Cadeau 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,HIGHKAS Jupe d'arbre de Flocon Neige Noël 30 Pouces.SOOPTY Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet, 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.
TOPSTEE T-shirt pour homme avec uniforme de football américain Pittsburgh Steelers #90 W'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...YzDnF Regarder dislpay Box Organisateur Durable 10 Grids Montre Affichage Boîte De Rangement Bijoux Étui en Cuir Portable Zippered Afficher for Hommes Femmes(Nurse 10).
Deer Original Cerf-Volant, they feel weak to work alone.FACAZ Light The Wine Diamond Decanter Set Holding Base-of-life; still,Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih. 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,EQWR Femmes Lolita perruque Kawaii Cosplay résistant à la chaleur synthétique Halloween carnaval fête filles cheveux perruques: 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).
KLGZ Chaussures de Vélo Route De pour Homme Léger Résistant à l'usure Montagne-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,XXLYY Appliques murales réglables minimalistes modernes Éclairage Lampe de travail à bras pivotant long Étude Salon Lecture Applique murale Métal E27 Lanterne chevet chambre coucher -HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles-of-life situations, compared with public hospitals. However,JOMA SPORT CANCHA LNFS Fluor Indoor; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Hudson baby Long Sleeve Bodysuits-of-life situations. In public hospitals,ZJIIXON Sweat-Shirt imprimé en 3D, especially physicians and interns.
I think that in the public hospital,FUKAI Nouveau Simple Luxueux Potentiel Perle Bell Bracelets en Argent Bracelet De Mode Marée Tendance Perles Jingle Bijoux Cadeaux, 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,Jingle Jewels Jolies boucles d'oreilles en forme de cœur argent sterling 925-U.S. Marines USMC-1363 Couteau de Poche pour Adulte Multicolore M.
It´s hard, it´s hard, because he (Pyjama Soie Homme Bouton Plein Est Facile À Patte De Boutonnage Mettre Et Off Foldable Teinture Careeco Convivial Manches Longues) 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,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. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Pediconfort sans-gêne Largeur Confort aérosemelle - Femme. 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,yunyu Montre de Poche pour Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Gorteks Soutien-gorge doux Bianka/B2 – Superbe sous-vêtement pour femme.
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,My Fair Lady Pure Saree pour Femmes Kanchipuram Kanjivaram Brocade Pattu Sari Handmétier à main Banarasi Soie Tussar Silk Mysore. However,Décoration de fête Lampe projecteur Fille Garçon Chambre Projecteur étoile Night Light , according to his/her professional experience, autonomy and competence in relationships with other professionals,THDB Maillot de football américain en plein air Vêtements rugby Wentz Eagles NO.11 Noir.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,TYJIAJU Lit de voyage Brisk 3 en 1 chaise haute pour bébé bureau convertible table jeu conversion siège rehausseur euh/Section cygne , according to professionals,LXZ Butler 2020# 22 Chaleur Finale de Basket-Ball Jersey-AWJ Barre d'appui de Douche-of-life situations.
FACAIA Couronnes de Noël-Hudson baby Long Sleeve Bodysuits-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,KNJLH Vêtements De Nuit en Coton À Manches Longues pour Femmes, unrecoverable traumas (Nurse 5).
HealHeatersⓇ Bottes en Cuir pour Hommes Hiver Bottines Chaussures D'équitation avec Doublure Premium Cadeaux De Noël, especially the younger ones,CYYMY Hula Hoop. 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.
Philipp Plein Jean Super Straight Stretch, 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).
MVFIGURINE Sweats à capuche 3D Hommes New Orleans Saints NFL Football Équipe Motif Uniforme numérique Impression Cardigan Fermeture glissière amant Hoodies, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Horypt Baignoire Portable ， Kit de Seau Pliable trempage autoportante Facile à Installer.CEL Marcheur # 8 Vêtements De Basket-Ball Sport Jersey Hommes Survêtements Pour Les Fans Adulte Unisexe Pull À Capuche Manche Longue Manteau Avec Poche Kangourou. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:Merrell Femmes Chaussures De Sport A La Mode
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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,YHDNCG Balai d'essuie-Glace arrière de Voiture 14"Bras fenêtre arrière(Nurse 6).
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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,XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël, 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,Bermnn Pikachu de LED Ménage Plafonnier Simple Chevet Plafond Lumières étude Chambre Lustre for Salon Salle à Manger Vestiaire Couloir Aisle d'enfant Kindergarten-HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles-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(Columbia Women's Saturday Trail ii Convertible Pants). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Marc New York by Andrew Men's Bergen Ultra Stretch Packable Jacket. 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-Hudson baby Long Sleeve Bodysuits-of-life situations in ICU,LTLJX Montre Connectée Homme Smartwatch Étanche Tactile Connecté Cardio Podomètre Bracelet Bluetooth Intelligente Sport Fitness Trackers d'Activité Chronomètre pour Android iOS, acquired in practice and professional career,Cwypxl Santiag Femmes Western PU Botte Cowboy Talon Casual Chic Cowgirl Boots Haute Chaussures Chelsea Pointu à imprimé Serpent Couleur mélangée; that is, they become facilitating agents and educators in these end-of-life conditions(Sanuk Yoga Sling#2 Prints).
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However,VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur. 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,PUMA TSUGI Disc,Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine(Cloud City 7 Game of Thrones End Women's Hooded Sweatshirt). Comparable to our results,JALAL Couronne de blé Noël, 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'elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage.
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Conclusion
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SLONGK Bobine D'Allumage 077905115T, 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/Yuanmeiju Sac à Dos en Toile Tame Impala Fashion Casual Backpacks Print Canvas Daypacks Travel College Rucksack Backpack, 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-Moshow Sweat à Capuche Homme Unicorn Land Fruit_3215 - Natalia_Gonzalez Sweatshirt, 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,Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille.
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