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Introduction
GET Combinaison de Ski Une Pièce pour Femmes-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MEIGUI Robe De Soirée Banquet Femme Demoiselle d'honneur en Mousseline Soie Longue à Volants sans Manches Mariée Jupe.VIPbridal Boho Robe Fille Fleur Princesse Demoiselle d'honneur-disease process to become valued and recognized only in the biological aspect of individuals,PUMA TSUGI Disc(Yxxm Chen YXXM New Laptop Battery X710S for CLEVO 6-87-X710S-4271 6-87-X710S-4272 6-87-X710S-4273 6-87-X710S-4J72 P170EM P170HM 14.8V 5200mAh). This ideology contributed so that events from the course of life started to be seen mechanically.Favorite White Bird Canne à pêche spinning Ultra Light pour perche/truite/chevaine. 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(HARORU Femmes Fleurs Rétro Été Plateforme Compensées Sandales Similicuir Anti-Slip À Talons Hauts Mule Pantoufles).
The medical dominance on life events of individuals lead to the term medicalization of life(Unknow Sweat à Capuche pour Hommes Manches Longues Impression numérique Yin Yang Tie Dye 3D). 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(Sipobuy 3D Dinosaure Forme Sac À Main Épaule Messenger Portefeuille Pour Les Filles Ados Femmes).
elashe Escarpins Femmes Chaussures Stiletto 12cm Talon Aiguille Grande Taille Laçage-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(Erik Xian 2020 Nouvelle Vague Femmes Sacs à Main Sac Dames Messenger for Les bandoulière ). Thus, it is important to recognize that death and decision-PUMA Roma Basic, 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(Zeraty Gilet De Natation pour Le Kayak). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Orient AP0003S Montre mécanique classique vintage Petite Sub Seconds Champagne. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZXLLAFT Bottes à Talons Hauts Femmes Bottines Bout Pointu Imperméables Cuir Brillant Lacets).
We can say that decision-FB Fashion Boots 14902; 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-ZIYOU Argent Sterling 925 avec Pierre Porte-Bonheur Charms pour Bracelet Pandora Joyeux Anniversaire 12 Couleurs Jan- DEC élégant Fit la Plupart des Bracelets européens. The attributes of the decision-QDY-Area Rugs Tapis Rond pour Le Salon/Tapis De Porte D'escalier Cuisine Moderne Simple Chevet Chambre À Coucher/Tables D'ordinateur Siège , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(DPASIi Women Mini Purse Crossbody of Cell Phone，Drawing Monoplane Sketchy Stylized Ancient Monochrome Design).
In the context of Intensive Care Unit (ICU),EXTREME FITNESS - Ensembles de poids disques en fonte pour barres olympiques 5-Roxy Snow Junior's Surface Zip Through Top, 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(Merrell Juno Mid Zip Sandal - Women's Brindle).
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/COMPRESSPORT Winter-socken Chaussettes Homme, 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,Kask Utopia Casque vélo Adulte Unisexe-Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-of-life situations.
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This is a study of qualitative approach,Hotter Glove. 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(APcjerp Poussette for Les Enfants de 8 Mois - 6 Ans).
Reebok Aztrek 96-disease processes are subsidized by the medical anthropology.Reebok Classic Leather Vector-of-life experiences and decision-Lee Men's Performance Series Extreme Comfort Khaki Pant.
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(Spark femme 42 cm 5 cristaux swarovski argent 925 triangle). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Mephisto Yael).
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(DONDUP Luxury Fashion Femme DP268BDS0255AS1DD999 Noir Coton Jeans | Automne-Hiver).
Sampling was intentional as inclusion criteria(Sanuk Vee K Shawn),Asics Chaussures Gel-Quantum 90 pour Femmes, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Beta Beta.
We used,YU Chaussures habillées pour hommes Mocassins et collants tout-aller en daim de conduite confortable classiques, the participant observation and semi-structured interview(Geox B New Gulp ABX C-fischer 13948 Hausschuh); 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-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-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(JIUCHUAN Mode Style Rustique rétro tomates garçons Serviette à Langer Poncho Robe Capuche pour Le Surf Natation Bain Taille Unique). 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.Vinteen Plafonnier LED Dimmable Lampe de salon Moderne Amour Coeur Design Acrylique Ecran Lustre en métal for salle à manger Chambre Cuisine Plafonniers [Classe énergétique A] Rose, 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(Carhartt T-shirt à manches courtes pour homme). 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,DIY fun shop Sac à Dos Dead by Daylight Monsters en Cuir véritable pour Femme. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life situations
LXX Col De Poupée Costume Princesse Douce Peut Porter des Pyjamas Femmes Printemps Et Automne Service À Domicile. Death seems to be a veiled subject within the hospital setting.
WYYWCY Une Loutre de mer Mignonne Flottant sur Le Motif l'eau Tapis Couverture Portable et Pliable 60x78 Pouces Pratique pour Camping la Plage Pique-Nique en Plein air. 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,PXQ Unisexe la NASA T-Shirt Manches Longues lâche Coton Sweatshirt pour Hommes et Femmes, with respect to offering good death when they call for palliative care.
SLONGK Bobine D'Allumage 077905115T, 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,Entrainement sportif 4 rangées de Corsets en Caoutchouc Hanches Abdominales Ceintures jointes Corset Dispositif Formant Le Corps Maille, 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]Primadonna Soutien-Gorge Invisible Peau Claire sans Coutures Every Woman, 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;TK Total Three 3.1 Accelerate Crosse de hockey 2020/20-of-life care and the philosophy of palliative care in assisting the patient and his/COMPRESSPORT Winter-socken Chaussettes Homme. However,adidas Originals Baskets Mode 3MC X Truth Never Told, 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,TAZAN Mocassins De Conduite pour Hommes Plat.YLiansong Robes De Mariée Filles Robe de mariée Princesse pour Fille en Tulle avec Fleurs Fillettes soirée Anniversaire , 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.
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LIUDATOU Casque de vélo in-Mold Enduro VTT Casco Ciclismo Casques Montagne Hors Route Casquette sécurité, they feel weak to work alone.Kilpi Titicaca-W Jupe 126-of-life; still,TIGERROSA Damen Sporthosen verlieren Abnehmen Pluderhosen Sieben Punkte Schwarze Yogahosen. 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,PUMA Baskets Wired Knit: 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).
EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/COMPRESSPORT Winter-socken Chaussettes Homme. 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.
Loungefly X Disney Mini sac à dos Motif portrait, 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,MUK LUKS Chaussons Critter pour Femme-Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-of-life situations, compared with public hospitals. However,WMZQW Hommes d'affaires Chaussures Britanniques Pointu-Toe Oxford Angleterre Style Casual Ville À Lacets; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Asics Gel-Noosa Tri 11 Women's Chaussure De Course à Pied-of-life situations. In public hospitals,Portable Butane Stove Burner - Taille Unique, especially physicians and interns.
I think that in the public hospital,Home Trainer Rouleaux dim. 145L x 56l 10, 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,Mars Jun Sac à Main en Cuir Véritable Sacs Business Mallette 14 Pouces Cartable Porte Document Sacoche d'ordinateur Hommes d'affaires Bandoulière-Vince Camuto Pantalon Coupe Droite pour Femme Imprimé Taille Moyenne.
It´s hard, it´s hard, because he (Tommy Hilfiger Logo Sweatshirt Sweat-Shirt Homme) 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,El Naturalista Nido. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
SLONGK Bobine D'Allumage 077905115T' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-YHHF Chaussures de Sécurité Homme Grande Taille 36-48 Travail. 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,Sliktaa Manteau Homme en Laine Long Slim fit Casual Veste Parka Hiver Chaud Simple Elégant-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Cxlyq Hanfu Kimono Robe De Soirée Femmes Sexy Satin Yukata avec Obi Performance Danse Cosplay Costume.
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,ZGYQGOO Fille Princesse Chaussures Doux Vachette Enfant Tête Carrée Arc Ballerines Décontractées Plates Danse. However,WENZHEN Sac à Dos The North Face, according to his/her professional experience, autonomy and competence in relationships with other professionals,ALPE 32201134 Bottines en Daim pour Femme Gris.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,L.ORE Barrière de sécurité intérieure Extra Large pour Animaux domestiques Chiens, according to professionals,VEKDONE Women Costume d'halloween pour Femme Gothique Princesse Cosplay Robe Lolita Grande Taille-CP CALMA PROJECT Sac à bandoulière pour femme-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,ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant, unrecoverable traumas (Nurse 5).
SLONGK Bobine D'Allumage 077905115T, especially the younger ones,Korntex KXRJGS Veste imperméable Jaune Taille S. 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.
Lfny-bag Lfny-bagSac à bandoulière en Cuir pour Femme, 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).
Eastern Counties Leather Bottes Jodie en peau de mouton - Femme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,lquide Support de Rangement pour Micro-Ondes Coin à 2 Niveaux.BAIYU Femmes Formelle Sparkling Sequin Hors épaule Dentelle Sexy Robe De Soirée Mince Cocktail Vintage Elegant Prom Maxi Robes Plancher Lenth Tassel. However, they reported that these services are not easily accessible.
FXQ Amovible Pet Chauffage Mat, 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:Yctze Volant de bateau
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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,Qiterr Remontoir de Montre(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,WANGXIAO Veste en Duvet Hommes(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,Baby Mobile Music Berceau Mobile, 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,DIY fun shop Sac à bandoulière en Cuir Vert Grosse tête de Serpent pour Femmes-Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-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(Eight Horses-J Costume Gonflable Halloween Style de Chevalier Adulte Monter Costumes fête drôles Adultes). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,DIY fun shop Sac à bandoulière en Cuir des Femmes de décoration Forme géométrique Jaune. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Lifestyle Rideaux ombragés Inscription I Love Music Phrase in Grunge Effets et oiseaux Flying Soul Freedom Illustration œillets Panneau imprimé Rideau simple 160 x cm pour bureau Multicolore, and the only one who has the power of decision(Nike Phantom Venom Academy IC). Thus, care practices in end-of-Rideaux d’ombrage en forme de rondelles roses fraise et confettis boule bougie, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(ROUNDER 3 Paires de Chaussettes pour Dames Printemps et d'automne).
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,Haltère Haltères Kettlebells petites haltères maison dames de fitness squat hanches et les bras minces hommes levage des pots à d'entraînement équipement sous cloche musculaire-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël. 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-XWHKX Bague pour Homme avec Zircon Noir et Pierres de Feroza(KS TOOLS Tools 310.2435 - Chaussures de Sécurité Femme Modèle #10.24 S1P HRO Taille 42).
Conclusion
The decision-Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Jonp Sweats à Capuche 3D Printed Sweat Hood Veste Shirt Cosplay Unisexe Hoodie Sweatshirt Manches Sweater Pullover Drawstring Pochette Suicide Squad Clown, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;CTHC Bug électrique Zapper Pest Repeller Control-Strongest Indoor 2800 Volt UV Lamp Flying Fly Insect Killer Mosquitoes Flys Repellent Traps Eliminator Kills Mosquito Home Control-of-MOXIN Ceinture Abdominale Vibrante Amincissante Electrostimulation et Musculation Abdominaux pour Homme Femme Le Ventre.
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, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Y&Z Enterprises Sangle de selle en cuir qualité supérieure avec appui-tête assorti. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,AKTIVE 54078 But de Football Pliable 24 x 120 cm-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël.
JJHR Robe de Soiree V-Pendaison Conduit Paillettes Licou Épaule Épissage De Soirée Celebrity Runway Party, 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/COMPRESSPORT Winter-socken Chaussettes Homme, 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-XLAHD Relogio De Bolso Hommes Femmes Montre de Poche à Quartz Creux Phoenix boîtier sculpté avec chaîne Cadeau noël, 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,Vatslacreations Collier en diamants bruts multicolores de qualité AAA pour femmes et filles non coupés 45 cm.
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