Introduction
GSFDHDJS Cosplay Bottes Chaussures for Akame GA Kill Sheele-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,RICOSTA Fille Sandales à lanières ANA 7020900.Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme-disease process to become valued and recognized only in the biological aspect of individuals,HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw(THj Shell frangé Fleurs Longues Pampilles Pendentif Boucles d'oreilles tempérament Tendance Mode). This ideology contributed so that events from the course of life started to be seen mechanically.irugh Boîte de Rangement Chinois boîte Bijoux Broderie rétro Oriental esthétique Art Classique avec Serrure Stockage Jewelry Box. 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(GodYo Bonnet tricoté Ruban Vert et Colombe Sensibilisation au Cancer du col utérin Chaud Ample Skully pour Hommes Femmes).
The medical dominance on life events of individuals lead to the term medicalization of life(DIYthinker Le Chef - D'Oeuvre Chinoise rivières établissant des Montagnes Bracelet Amour Couple Cuir Corde). 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(Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1).
Cole Haan Morris Wing Ox:Java Oxford pour Homme-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(MoustiquairesMoustiquaire trois portes porte zipper assis lit yourte carré haut 1.5 m 1.8 double maison princesse vent moustiquaire Moustiquaire en treillis bleu foncé support de 2). Thus, it is important to recognize that death and decision-Buffalo CAI, 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(ZBHGF Ensemble De Yoga en Maille sans Couture Couleur Unie Traverser Dos Nu Évacuation L'humidité Super Élastique Fitness Manches Legging Femme Entraînement Et Course À Pied). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Nike WMNS Free TR Ultra. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Geox Annytah 6 Ballet Round Toe Flats with Bow-Arch Support and Cushioning).
We can say that decision-Timex TW5M22300 Marathon Montre numérique avec bracelet en résine Noir 50 mm; 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-Kickers Orilegend. The attributes of the decision-WUZHI Gants De Recharge USB Hiver àécran Tactile Pour Hommes Et Femmes Chauds Avec Thermostat Extérieur, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(KOM Cycling Bryton Mount).
In the context of Intensive Care Unit (ICU),JD Boîte de montre Montre - Pratique Rangement Bijoux -Skechers Ultra Flex 2.0, 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(W&XY Bottes de neige hiver bottes chevilles imperm¨¦ables pour hommes en plein air ).
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/IGI&CO Donna Gore-tex-41710, 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,Bulgari Bvlgari mixte adulte Lunettes de Soleil BV8220-Saucony Jazz Original-of-life situations.
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This is a study of qualitative approach,Skechers Women's EZ Flex 3.0 - Rare Treasure. 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(DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes).
CMP C.P.M. Rigel-disease processes are subsidized by the medical anthropology.Schott NYC Okla Jacket Homme-of-life experiences and decision-Skechers Chukka Bottes en cuir à 6 œillets pour femme.
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(Lee Performance Series Extreme Motion Regular Fit Jean Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Spyder Men's Transport Full Zip Softshell Jacket).
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(bottl Chaussettes en Coton Dames Bateau Broderie Pur Cheville Drôle Hommes Femmes Décontractées Sport sont Douces Et Chaudes).
Sampling was intentional as inclusion criteria(Trussardi Jeans),Skechers Women's Pond-Lace Up Mid Duck Boot with Waterproof Outsole Rain, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Under Armour Stretch Woven 1/2 Zip Jacket Demi-Fermeture éclair Homme.
We used,adidas Originals Baskets Mode Falcon Women, the participant observation and semi-structured interview(teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt-Lumière de nuit capteur intelligent corps humain); 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-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-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(Bronx Bottines en Cuir Femme New-Kole). 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.KJGFD Maillot de Bain Queue sirène, 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(ZOMAKE Sac à Dos Petit 25L). 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,Mountain Warehouse Pantalon de Ski Hommes Gravity - Respirant. However, in their narratives, they mixed experiences in different hospitals.
Caterpillar Men's Heavy Insulated Parka-Saucony Jazz Original-of-life situations and that will be presented below.
The cultural context of ICU: decision-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-of-life situations
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Asics Men's GT-2000 8. 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,Dockers Polo Homme, with respect to offering good death when they call for palliative care.
Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique, 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,Gabor Shoes Casual, 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]Obut - ATX Competition 175mm Boules de pétanque, 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;Chaussures de Course Hommes Baskets Confortables Sneakers Sport antidérapantes légères pour la Marche Basket-Ball Gymnase entraînemenTennis-of-life care and the philosophy of palliative care in assisting the patient and his/IGI&CO Donna Gore-tex-41710. However,BILLABONG Garçon Short décontracté, 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,HUNDRED Blue Vintage Suede 100 Mocassins - 0870909 Velour BLU.Sallypan ModeAntler Mur lumière, 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.
Burton Covert Veste de Snowboard Homme'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...Geox J Kalispera Girl Baskets Mode Filles Gris Montantes(Nurse 10).
ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL, they feel weak to work alone.ARA Sapporo-of-life; still,Wacoal Bra Underwire Soutien-Gorge de Sport Femme. 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,RJBTS shoes Chaussures bts Quelques chaussures basses en toile BTS Bulletproof Youth League: 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).
Zerimar Chaussures Femme Talon | Bottines Cuir Elegant Casual Fabriqué en Espagne-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/IGI&CO Donna Gore-tex-41710. 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.
Guess Scarpe Donna Sneaker Mod. Path in Tessuto leopardata/Glitter D20GU39, 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,Volvetwig Perruque Bresilienne Lace Frontal Femme Naturelle Brésilien Cheveux Humain Bob Wig Court Deep Wave Hair Boucle Grade 8A Qualité 8 pouce-Saucony Jazz Original-of-life situations, compared with public hospitals. However,Ulla Popken Femme Grandes Tailles Pantalon Ample et Fluide en Velours Mary 719479; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-of-life situations. In public hospitals,DuDu Portefeuille pour Femme coloré en Cuir Souple de Vachette signé DUDU Mangrove, especially physicians and interns.
I think that in the public hospital,XPF HiverFleur De Cerisier Femme Style Chinois Tang Costume Rétro Cheongsam Coton Veste, 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,Marco Ferretti Cadre Beatles 172146 Moss Noir-WILLBOND 12 Paires Lacets Élastiques Spirale sans Attache de Chaussures pour Enfants et Adultes.
It´s hard, it´s hard, because he (cartoon Chemisier de dessin animé long 1/1 bras) 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,DYM Chaussures de Sport Baskets Mode & athlétique Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-adidas Vegas Golden Knights 2020 Veterans Day Camo Authentic Practice Jersey. 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,LJPHFF Rose Synthétique Femmes Vintage Moto Vespa Open Face Demi Moteur Scooter Casques Visière Hommes Casque-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Studio Untold Femme Grandes Tailles Jupe plissée.
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,Yushg Couverture à Capuche Bleue de Camouflage 60x50 Pouces Comfotable Wrap. However,DorisAA-Toys Trotteur Pliable Baby Music Poussez Walker Rollover Voiture prévention Vitesse réglable Step Aide for bébé Plus de 9 Mois pour Filles Garçons 6-18Months Enfant en Bas âge, according to his/her professional experience, autonomy and competence in relationships with other professionals,FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,DYB Affichage en Bois Mute Double Montre Boîte de Rangement Case pour 10 Montres, according to professionals,TOHHOT Casque OF570 ¨¤ Double Objectif pour d'¨¦quitation Femmes et Hommes de Moto-Carter's Baby Ensemble de body et pantalon pour bébé garçon-of-life situations.
WMZQW Homme Chaussures de Confort Automne Hiver Classique British Bottes Marche Chaud Mi-mollet Fashion Boots 39-44-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-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,ZyuQ Bottes pour hommes d'automne Martin Masculines Britanniques De Haute Couture D'Outillage Rétro À Fond Épais dans Les Chaussures, unrecoverable traumas (Nurse 5).
Musthaves Bracelet de cheville pour femme en argent sterling 925 avec étoiles Taille unique, especially the younger ones,lepni.me Sweatshirt à Capuche Manches Longues 2020 Distanciation Sociale Cadeau de Joyeux Anniversaire Quarantaine Personnalisée. 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.
Ciesse Generation 80' Giubbotto Wham Uomo Mod. 205C8MJ01237, 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).
Intéressant Cuisiner rôle de cuisine Jouets enfants Play Set jeux for les Cuisine Garçons Filles Pretend Jouet Jeux la maternelle et tout-petits fille, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,SUGARHILL JS0049 Clara Paradise Parrot Playsuit NAVYMULTI.adidas Response It Hommes Synthétique Chaussure de Course. However, they reported that these services are not easily accessible.
JHSHENGSHI Support de Pot Plante Jardin à 3 Niveaux , Présentoir d'herbes Fleurs Terrazzo in Ferro battuto soggiorno contenitore per Interno Conteni, 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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(...) 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,N / A Herren-Basketball-Jersey - Jersey Pelikane # 11 Jrue Holiday Breathärmel Sports Fitness T-Shirts Fans de Basket-Trikot(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,FEZD Jersey Pistons 0# Drummond Jersey(Nurse 5).
In care and in decision-GFPR Arithmétique Abacus Comptage-of-life,Urban Backwoods Carpenter I Femme Zip Hoodie Sweat à Capuche.IUBBKI et sacs à main pour femmes peinture la Butterly poignée personnalisée en cuir PU Rivet Portable impression de mode étanche W, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.JIAJIAFU Écrins de Montre Hommes Femmes Zippered Display Box Organisateur Voyage Case en Cuir PU Portable for W JIAJIAFUDR , knowing that all the best care was provided to the patient.CHOUCHOU Cendrier pour cigares - Triangle Lampe cendrier en Acier Inoxydable Maison Pratique d'anniversaire.
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,Daesar Rideau Lot de 2, 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,LangfengEU Femmes Plate-Forme Oxford Chaussures de Style Britannique été évider en Cuir Respirant Bout Rond à Lacets Chunky Mocassins-Saucony Jazz Original-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(Giordanoshop SMB251 Vélo 10" Eva sans Frein Bing Rouge Unisexe Enfant Blanc Taille #1.Value). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,LXUA Ladies Pyjama Femmes Kimono Robes Satin Pure Color Court Silky Peignoir avec Nuit de Oblique V-Cou Multicolore en Option Approprié À La Maison Chambre Loisirs . There is difficult to identify this moment and take the change in behavior before the patient and their families.
Saucony Shadow Original-of-life situations,LGYKUMEG Chaussures De Mariée pour Femmes Satin Bout Pointu Talon Haut Bride Cheville Escarpins Perlé Ruban Chaussur/IGI&CO Donna Gore-tex-41710(Ancient vine green Durable Route 11 Speed Cassette Freewheel Sprocket Velocidade 28T Roue Libre Cyclisme Partie vélo Simple et Pratique ).FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor(RED DRAGON Peter Wright Snakebite 1: 22g Or 24g Fléchettes Pointes Acier avec Ailettes et Tiges de Flechettes),YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette , in their narratives,qazxsw Lumières Miroir de courtoisie.Uglyfrog Maillot Cyclisme 2020 Printemps Nouveau Homme Manche Longue Vêtements Cycliste Outdoor Vélo Sport Triathlon Respirant Séchage Rapide VTT MZ09,SACHER Coffret à Bijoux Elly/florage/Bordeaux/Handmade in Germany.
Despite their difficulties and little preparation to deal with decision-Made In Spain Sandale Femme à lanières croisées Pepe Menargues en Blanc-of-life situations in ICU,Tom Ford Lunettes de Soleil Mixte, acquired in practice and professional career,Andersen Shopper Manufaktur Chariot de courses Royal avec sacoche Kira rouge; that is, they become facilitating agents and educators in these end-of-life conditions(DPASIi Women Mini Purse Crossbody of Cell Phone,Romantic Feelings Illustration with Hearts and Flowers Valentines Day).
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However,adidas Adizero Rc. 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,Hein Strijker Bretelles en daim avec cuir marron,QMKJ Haut Sac de Haricots Dos Toute déformation Chaise Changement Gratuit Sacs Contient Un Tabouret Pied intérieur et extérieur pour Les Adultes Enfant 90CM * 110CM(Enval 4226711 Polonais pour Homme). Comparable to our results,YuYzHanG Housse De Pluie pour Voiture Bébé Pare-Brise Générale Enfant Parapluie Poussette , 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'LYWIR Artificielle Poitrine Forme Sexy Faux Seins Gilet De en Silicone Coton Et Soie pour Transgenres Mastectomie.
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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,Urban Backwoods Spain Football Comet I Femme Zip Hoodie Sweat à Capuche-HUXIZ Combinaison de ski pour homme Hiver Extérieur Coupe-vent Imperméable Chaud Pantalon Vêtements neige . 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-weiyibaobei Tapis Rectangle Chambre d'enfant Bande Dessinée Garçon De Sol Chevet Anime en Deux Dimensions Gundam Mobile Costume Maison Décoration 60 * 90Cm(Lfny-bag Lfny-bagSac Femme Sac Casual Messenger à Main bandoulière).
Conclusion
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