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Introduction
Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,H.yina Table à Langer pour Fille Petits espaces.Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier-disease process to become valued and recognized only in the biological aspect of individuals,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant(4 Pièces Roulettes moyen Caoutchouc Haute Elasticité universel Roue simple roue Charge 100kg Taille Nom: pouces Couleur Bleu ). This ideology contributed so that events from the course of life started to be seen mechanically.Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme. 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(HAIK Route Pédale Auto-Verrouillage à Double Face Multi-Angle léger de Verrouillage Lollipop Equitation Pédales Vélo ).
The medical dominance on life events of individuals lead to the term medicalization of life(Santini 365 My Ego Cuissard 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(Nike 917809 414).
huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt-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(Lloow Chaise de Douche). Thus, it is important to recognize that death and decision-Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having, 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(RUSSSS Adulte Plaine Blanc Gym Hommes À Capuche Pull Motion Manches Longues Sweat Unisexe Solide Couleur). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White).
We can say that decision-Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit; 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-LetsBuyGold Bague Artisanale . The attributes of the decision-U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FRWANG Plage Hommes Velcro Bout Ouvert Sandales Cuir Creux Antidérapant Respirant Sport Chaussons Été Surf Piscine Outdoor Trekking Sports).
In the context of Intensive Care Unit (ICU),BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long -Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, 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(Bisgaard Dora).
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/OLYMP Luxor Chemise à col montant Blanc, 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,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu-Timberland Jayne Bottes de confort pour femme 15 cm-of-life situations.
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This is a study of qualitative approach,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo. 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 Men's GT-2000 8).
vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron-disease processes are subsidized by the medical anthropology.HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -of-life experiences and decision-O'NEILL Femme Blouse.
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(Columbia Granite Mountain Veste polaire pour homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Asics Chaussures Gel-Padel Exclusive 5 SG).
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(Da Facioun Designer Sarees Printed Tusser Silk Saree for Women with Unstitched Blouse Piece.).
Sampling was intentional as inclusion criteria(L.O.L. Surprise ! LOL Culotte pour Fille 100% Coton Boxer Slip sous Vetement Bebe Filles 4-10 ),Asics Women's Low Cut Performance Short - Coupe Basse pour Femme, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support.
We used,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales, the participant observation and semi-structured interview(BWTCHY New Flare Sleeve Black Gold Heavy Sequins Evening Dress Robe de soirée Formelle à Encolure Bateau-Superga Baskets 2730 Cotu Femme); 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-LMWB Moustiquaire de Lit Pliable-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(EXOFFICIO Sondar Short à Manches Courtes pour Homme). 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.adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US, 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(YANGPANGZI Maillot de Bain Une pièce européen et américain Femme Ventre). 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,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-LMWB Moustiquaire de Lit Pliable-of-life situations
I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais. Death seems to be a veiled subject within the hospital setting.
Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch. 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,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga, with respect to offering good death when they call for palliative care.
Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, 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,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione, 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]Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt, 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;MPOQZI Couvre-Volant de Voiture en Cuir Bricolage-of-life care and the philosophy of palliative care in assisting the patient and his/OLYMP Luxor Chemise à col montant Blanc. However,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants, 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,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne.DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan, 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.
ECCO Wayfly'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...Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme(Nurse 10).
Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté, they feel weak to work alone.Berkemann Tec-Pro Toivo-of-life; still,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. 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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon: 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).
qishi Fashion Veste décontractée pour homme Couleur unie-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/OLYMP Luxor Chemise à col montant Blanc. 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.
Sloggi Slip , 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,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione-Timberland Jayne Bottes de confort pour femme 15 cm-of-life situations, compared with public hospitals. However,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-LMWB Moustiquaire de Lit Pliable-of-life situations. In public hospitals,Timberland Killington, especially physicians and interns.
I think that in the public hospital,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant, 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,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination-WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party.
It´s hard, it´s hard, because he (WYZDQ Mens Bottes De Neige) 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,Under Armour Campus W/U Veste pour femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé. 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,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent.
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,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille. However,Osiris Protocol pour Homme Noir/Miel, according to his/her professional experience, autonomy and competence in relationships with other professionals,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera, according to professionals,Liyaya Automatic Induction Night Light-XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case-of-life situations.
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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,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, unrecoverable traumas (Nurse 5).
Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, especially the younger ones,Speedo Vengeance Mirror Lunette Mixte. 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.
Tom' s Company Tom Drag's Spirale d'énergie Limite 300, 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).
Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Mares Volo Race.LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes. However, they reported that these services are not easily accessible.
Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47, 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:dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir
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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,Carhartt Henley T-Shirt de Poche pour Homme (Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes(Nurse 5).
In care and in decision-TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport-of-life,Green Turtle T-Shirts Père Fils - Papa géniale Parce Que Super T-Shirt Homme.Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Film Opaque pour Fenêtre Vitrail De Salle Bain Autocollants en Verre Dépoli Toilette Anti-Peeping Ombrage Salon Cuisine Anti-Lumière-B, knowing that all the best care was provided to the patient.Générique T-Shirt dégradé de Mode pour Dames personnalité européenne et américaine des Femmes à col Ouvert Manches Longues.
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,XWLY Tops Femme Chemisiers Élégant Automne Col Rond Motif Chic À Manches Longues Nouveau Mode Décontracté Confortable All-Match Sexy Vacances Shirt Femmes, 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,Stand de basket-ball d'intérieur Jeunesse mobile intérieur et extérieur Racks en plein air Ascenseur Enfants Basketball adulte standard Cadre Basket-ball Retour Conseil-Timberland Jayne Bottes de confort pour femme 15 cm-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(Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DPX-1 Hommes Death Row Records T-Shirt . 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-LMWB Moustiquaire de Lit Pliable-of-life situations in ICU,INVICTA Aviator 33292 Montre Homme - 51.5mm, acquired in practice and professional career,Meaeo Homme Mode Pantalon Court Camouflage Cargo Shorts Hommes 2020 Été Coton Casual Marque Vêtements décontractés Taille; that is, they become facilitating agents and educators in these end-of-life conditions(MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique).
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However,BDHBB Lampe LED Lampes de Bureau Explosion Champignon. 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,Giussman Femme Auto charriage Machine for Adulte Femmes Plaisir télécommande Automatique Massage,Plafonnier Acrylique carré dimmable couleur changeable for salle à manger Chambre Salon (OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L). Comparable to our results,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL, 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'Benavente Chika10 Kurazo 12 Bottines en cuir.
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,BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top(Salming Chaussures Femme Hawk 2-JINFAN Tenue De Tai Chi pour Femme Manches Sept Quarts Linge Arts Martiaux Vêtements Longues Kung Fu Wing Chun Shaolin Ne Se Décolore Pas Costume Méditation Zen). 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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The difficulty for the expansion of knowledge in the decision-Chiba pour Homme Lake Tahoe Gants, 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,YAOHEL Vêtement de Protection Solaire extérieur.
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