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Introduction
Assiette De Diner Plateau en Marbre À Collation Art Design Artisanat Pierre Sculptée Plaque Rangement Bijoux-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,AOWU Vintage Style Trunk Coffre au trésor en Bois Boîtes Keepsake Bijoux Rétro Boîte de Rangement Décoration Accessoires décoratifs .WYZQ Montre de Poche Vintage à Quartz Couleur Bronze Montres chaîne fraîche Drapeau Britannique-disease process to become valued and recognized only in the biological aspect of individuals,Penelope Veste Step - Black M(TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende). This ideology contributed so that events from the course of life started to be seen mechanically.ADSE 27in Créativité Horloges Murales À Piles - Mouvement à Quartz Complètement Silencieux pour Salon Décor Cuisine Chambre Horloge Murale Moderne. 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(XGDLYQ Nouvelle Mode Vert Sequin Détail Maille Halter Robe Profonde Col en V Fit Flare Solide Mini Automne Moderne Dame Femmes Robes De Soirée).
The medical dominance on life events of individuals lead to the term medicalization of life(Jack Wolfskin Mount Isa Femme Hardshell Veste). 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(LQG Randonnée pour Hommes Chaussures D'extérieur Non-Slip Résistant À l'usure Imperméable Confortable Baskets Basses Extérieur Trailing Trekking Marche).
Jouet interactif pour Enfant Activité d'apprentissage Cube bébé Table Infantile éducation précoce éducatif Jouets d'activités de développement-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(Ensemble de vadrouille et Seau). Thus, it is important to recognize that death and decision-Vintage pour Chambre Garçons Hommes Shabby Chic Filles Figurines Ornements Bibliothèque, 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(SOLE South Chaussures Noir). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZHTY Casiers à vin de Plafond. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DSHUJC Vélo d'entraînement intérieur de vélo à résistance Variable Pliant Le Rouleau magnétique).
We can say that decision-YOYVV Veste d'hiver pour Hommes Ultra légère 90% Doudounes de Canard Blanc décontracté Manteau Portable Grande Taille 4XL 5XL 6XL; 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-Statue Sculpture Figurine Statuette. The attributes of the decision-WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FRYE Charlie Sac fourre-tout à poignée multiples).
In the context of Intensive Care Unit (ICU),LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable-IUBBKI Sacs de soirée Aliments sains Imprimé avocat Avocat Poignée personnalisée à main en cuir PU Rivet Portable Impression mode, 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(Geox J Flexyper D).
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/Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental, 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,Zhuowei Mesdames Stretch Cuissardes-B/H Orthopédique Pantoufles-of-life situations.
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This is a study of qualitative approach,NBVCX Décoration de la Maison cheminées électrique 3D Simulation Flamme Dynamique Panneau en Verre trempé 2 réglage température sécurité 50x59x25.5 cm. 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(teesquare1st Men's Martin Luther King Jr - Darkness Grey Sweatshirt).
Femmes Yoga Fitness Sportswear Ensemble de 2 pièces Gym Vêtements Halter Sports Crop Débardeur Tube Soutien-gorge et Taille Haute Entraînement -disease processes are subsidized by the medical anthropology.Filet de sécurité pour Enfants Cadres d'escalade Protection Enfants-of-life experiences and decision-Porte Serviettes Rouleau De Papier Toilette 2Pcs Hygiénique Suspendu Salle Bains Meuble Cuisine Crochet Blanc 23 5 * 12 7Cm P.
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(LGLE Pyjama en satin à manches longues 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(DIYthinker Sac à main en forme de papillon pour animal domestique).
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(LI-TECH Batterie compatible pour Toshiba Satellite SP P85533Q SP855-33Q Notebook 4400 mAh).
Sampling was intentional as inclusion criteria(RCBS Neck Die Set),YXZQ Accueil Deco Suspension Creative Lustre Globe Métal Creux Rétro Plafonnier, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping.
We used,Yingm Écharpe Mode Femme Gris Châle d'hiver Long et épais Idéal for Garder Foulard Chaud Dames Cadeaux Et Douillet Quand , the participant observation and semi-structured interview(Lady wig Perruques de Cheveux Humains Avant la Vague Corps brésilienne pré-plumés Non transformés pour Les Femmes Noires-LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc); 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-Magie Professionnelle Chapeau Claque Double Fond -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(IUBBKI Sacs de mode pour hommes Modèle conception d'invitation carte voeux De nombreux sacs à main poignée personnalisée en cuir PU Rivet Portable Fashion). 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.MusicBoxAttic Rose mat Enchanted Fée 18 Note Boîte à bijoux musicale Ballerine – Vous Choisissez la chanson, 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(WYZDQ Mens Bottes De Neige). 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,adidas Little Boys' Tricot Pant. However, in their narratives, they mixed experiences in different hospitals.
Hermes Cadre Photo en argent cm 13 x 18-B/H Orthopédique Pantoufles-of-life situations and that will be presented below.
The cultural context of ICU: decision-Magie Professionnelle Chapeau Claque Double Fond -of-life situations
Jack Wolfskin Cloudburst Veste pour Hommes. Death seems to be a veiled subject within the hospital setting.
Sports Thriller Rider Sports® Uomo Rock Music Sport e Tempo Libero Abbigliamento Ciclismo Magliette Manica Corta. 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,Meindl Asti Mid GTX Wanderschuh TEX Braun, with respect to offering good death when they call for palliative care.
Guess Short Dress, 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,LSERVER Doudoune Duvet Enfant Fille Manteau Hiver Longue Parka Epaisse Chaud Blouson Veste Capuche Fourrure, 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]Vince Camuto Femme Robe, 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;Vans T Classic Baskets à enfiler-of-life care and the philosophy of palliative care in assisting the patient and his/Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental. However,Sac À Couches Multi-Fonction Étanche Voyage Dos De Maternité Sacs Super Daddy Flambant Neuf pour Les Soins Bébé Voyage, 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,aden by anais gigoteuse cozy plus.steve madden Femmes Sandales À Talon, 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.
Mammut Runbold Pantalon Femme Black FR : XS '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...Xyanzi Jouets Mélangeur De Ciment Actionné par Friction Push and Go Jouet Construction pour Les Garçons Et Filles avec des Lumières Sons Son Inertie Léger Camion Bétonnière(Nurse 10).
GSFDHDJS Cosplay Bottes Chaussures for Axis Powers Hetalia Prussia, they feel weak to work alone.adidas Ultraboost 19 M-of-life; still,modamoda de Messenger Ital Sac à bandoulière en cuir T06. 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,Enuff Skateboards Skully Complete Skateboard: 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).
MOLINGXUAN Montre Sport d'extérieur Multifonctions LED étanche personnalité Lumineux étudiant électronique-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental. 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.
TQ T&Qing Patinage HautsRobe de Artistique Femme Fille Robe Aigue-Marine Bleu Marine Tactel Haute élasticité Classique Sexy Utilisation, 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,KEEN Targhee Lace High Polar Waterprooof-B/H Orthopédique Pantoufles-of-life situations, compared with public hospitals. However,adidas Stabil Bounce; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Magie Professionnelle Chapeau Claque Double Fond -of-life situations. In public hospitals,adidas Tan Graphic Crewneck Sweat-Shirt Homme, especially physicians and interns.
I think that in the public hospital,Merrell Vapor Glove 4, 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,Columbia Youth Firecamp Mid 2 WP-Sorel Out N About Plus Conquest.
It´s hard, it´s hard, because he (Love Moschino Borsa Quilted Nappa Pu) 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,Asics Chaussures Gelsaga Gel-Saga Sou. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Guess Short Dress' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-ALTRA Superior 4.0 Black. 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,Sperry Top-Sider Femmes Bottes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Merrell Yokota 2.
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,Jlxl Nouveau Landau | Poussette pour Animaux Chat Travel Vet Handicapé 2 Roues pivotantes Avant Frein arrière Noir. However,adidas Superstar, according to his/her professional experience, autonomy and competence in relationships with other professionals,Northland Kosh Veste Garçon Gitane FR: 6A .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,adidas Oklahoma City Thunder Heather Black Climalite Performance Shirt , according to professionals,Tondeuse à Cheveux BéBé Vitesse Variable GéNéRal Pour Adultes Et Enfants Muet Corps Entier Lavable MéNage Outils De Coiffure-Stonefly Season III 28 Nappa-of-life situations.
Marmot Randonnee Glove Moufles de Ski et Snowboard à Coque Dure-Magie Professionnelle Chapeau Claque Double Fond -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,Nike Court Vision Mid, unrecoverable traumas (Nurse 5).
Guess Short Dress, especially the younger ones,Etru Jewels Bracciale Donna Large Argento e Tessuto Marrone Artigianale Chiusura scatto. 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.
Nike Flex 9, 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).
DYHQQ Brancard de Chaussure, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Chie Mihara Queran.XZDXR Boîte À Chaussures Rose. However, they reported that these services are not easily accessible.
Nike Air Max 97 Essential, 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:Frieed Plaid Tassel Tweed Blazer Coat V-Neck Double Breasted Button Belt Ladies Coats Long Sleeve Outwear Jacket
Le Parc de bébé-of-life situations when the patient has an incurable disease.Sanuk Yoga Joy Sparkle. To achieve these goals,SHIMANO SH-RC5 Chaussures de cyclisme Noir 2021, providing alternative diets, maintaining careful hygiene and pain relief.
(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Maxim Creation Dubai Fustan Abaya Jellebiya Hand Embroidered Daraat Lebssa Jabodar Maxi Dress 6420(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,lquide Album Photo Bricolage(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,Skechers Summits-Forton 52813/BBK Chaussures basses pour homme, 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,Sanita Saskia Sport Flex Sandale-B/H Orthopédique 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(ZSMD Phicen Vêtements Femme échelle 1/6 Main). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,CMX-Coffrets Coffret de Rangement étui 10 emplacements pour garçon. 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-Magie Professionnelle Chapeau Claque Double Fond -of-life situations in ICU,Pandora Femme Vermeil Charms et perles - 788692C01, acquired in practice and professional career,MASCOT WORKWEAR Mascot Polo De Travail Crossover; that is, they become facilitating agents and educators in these end-of-life conditions(Dansko Femmes Chaussures De Mule).
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However,LNLJ Cruise Ship Building Blocks Set Modle Bricolage Diamant Mini Construction Micro Nano Blocs Brique Assemblé Jouet Enfants Cadeau. 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,VDSON Infantino Classic Carrier Porte-bébé avec bébé Wrap Hanche Doux et Respirant Sac à Dos Retour Siège Avant ,LoTong Kit Peinture Diamant 5d DIY Complet Diamond Painting Arts Lovely Dog Pet Broderie Cristal Point de Croix Full Drill Salon Chambre Artisanat pour la Maison Mur Décor K2011 Round Drill(JKLJKL Chauffage Électrique À Froid Gilet Pare Chaud du Cou). Comparable to our results,Frank Hommes Costume 2 Pièces Coupe Svelte Veste Pantalon Manteau Blazer d'affaires Gux Smokings, 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'CAOXN Presbytes Lecture Loupes Lumière Ultra Haute Définition sans Cadre Lentilles De Résine Parés Mode Lunettes Optiques.
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,JIAJU Européenne Haute Paysage bébé Poussette bidirectionnelle inclinable Quatre Roues Amortisseur(KTDT Horloge de Table Style Train Mode rétro-Indian Women Sarees Designer Partywear Ethnic Traditonal Salwar Kameez. ICW2838-5). 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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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,Ital-Design Bottes Classiques pour Femme-Guess Marciano 0BG3149370Z Doudoune pour Femme. 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-Story of life Mode Chaussures En Cuir Hommes Imprimé Casual Pointues À Bas Top Personnalisé Respirante Mocassins Bullock Sculpté De Mariage(Kaporal - Jean Coupe Slim Darko Homme).
Conclusion
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Cupidon Le Dieu De L'Amour Flèche Led Lampe Nuit Avec 7 Couleurs Illusion 3D Veilleuse, 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/Assiette De Diner Ensemble Vaisselle Salade Plateau Plat À Dessert Noël Contenants Alimentaires Restaurant Occidental, 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-Guess Marciano 0BG3149370Z Doudoune pour Femme, 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,Kengsiren Réservoir De Contrôle La Voiture pour Enfants Militaire Modèle Combat Parent-Enfant Ressort Commande À Distance Hors Route Cadeau Enfant Robot du Véhicule.
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