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Introduction
OLYMP Luxor Chemise à col montant Blanc-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,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.TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo-disease process to become valued and recognized only in the biological aspect of individuals,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron(WILSON Youth Classic Relaxed Fit Baseball Pant). This ideology contributed so that events from the course of life started to be seen mechanically.HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini . 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(YJHH Baignoire Adulte Portable).
The medical dominance on life events of individuals lead to the term medicalization of life(Susimoda 2815-02 Sandales compensées Femmes). 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(Verre À Whisky Fait Main Real Bullet).
O'NEILL Femme Blouse-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(Wacoal Bra Underwire Soutien-Gorge de Sport Femme). Thus, it is important to recognize that death and decision-Asics Women's Low Cut Performance Short - Coupe Basse pour Femme, 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(Zerimar Bottines Femme | Cuir Chaussures Elegant Classique Bottes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(ZYFXZ Steel Toe Cap Chaussures de travail à haute température résistant sécurité en cuir daim).
We can say that decision-Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales; 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-LMWB Moustiquaire de Lit Pliable. The attributes of the decision-adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Champion T-Shirt Vintage à col Ras du Cou et pour Homme).
In the context of Intensive Care Unit (ICU),TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux-PUMA S XT nuageux Chaussure gris 359 135 02, 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(Rideau de fenêtre hawaïen avec des arbres montagne).
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/I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, 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,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch-Prana Summit Tall Pantalon pour Femme-of-life situations.
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This is a study of qualitative approach,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga. 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(JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé ).
Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker-disease processes are subsidized by the medical anthropology.Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione-of-life experiences and decision-Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt.
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(Denkqi Pyjama Couple d'hiver Ensembles Flanelle de Nuit Hommes Accueil en Vrac élastique Réchauffez Corail Lovers Polaires Survêtement Un Ensemble ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Yxxc Album Photo interstitiel).
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(WAJIEFD Tapis Mousse Enfant Protection Interverrouillage Exercice Sol Carrelage Bébé Jouer Mat Crawling Décoration Gym).
Sampling was intentional as inclusion criteria(Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau),MPOQZI Couvre-Volant de Voiture en Cuir Bricolage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants.
We used,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne, the participant observation and semi-structured interview(Andersen - Chariot de Courses Royal XXL avec Sacoche Vektor Noire-Ouzoub 24 Pouces Moniteur for bébé babymonitor); 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-DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-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(dfff Personne réelle Femme Naturel Blond Pâle Marron Mélange Dégradé Longues Bouclées Synthétiques Perruques Perruque Complète Avant Cheveux Cosplay Party Usage Quotidien). 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.ECCO Wayfly, 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(WYB Female Burrs Hats Bucket Hat Casquette d'extérieur de pêche). 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,Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme. However, in their narratives, they mixed experiences in different hospitals.
Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté-Prana Summit Tall Pantalon pour Femme-of-life situations and that will be presented below.
The cultural context of ICU: decision-DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-of-life situations
Berkemann Tec-Pro Toivo. Death seems to be a veiled subject within the hospital setting.
LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc. 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,Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon, with respect to offering good death when they call for palliative care.
qishi Fashion Veste décontractée pour homme Couleur unie, 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,Sloggi Slip , 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]EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, 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;Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes-of-life care and the philosophy of palliative care in assisting the patient and his/I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais. However,Timberland Killington, 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,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant.HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination, 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.
WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party'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...WYZDQ Mens Bottes De Neige(Nurse 10).
Under Armour Campus W/U Veste pour femme, they feel weak to work alone.Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé-of-life; still,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent. 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,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent: 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).
ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais. 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.
Osiris Protocol pour Homme Noir/Miel, 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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme-Prana Summit Tall Pantalon pour Femme-of-life situations, compared with public hospitals. However,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan-of-life situations. In public hospitals,Liyaya Automatic Induction Night Light, especially physicians and interns.
I think that in the public hospital,XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case, 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,Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets.
It´s hard, it´s hard, because he (Speedo Vengeance Mirror Lunette Mixte) 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,Tom' s Company Tom Drag's Spirale d'énergie Limite 300. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
qishi Fashion Veste décontractée pour homme Couleur unie' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 . 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,Mares Volo Race-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LCFF Patins à roulettes Simple Roue Skate Sneaker Chaussures LED Clignotant Lumineux Rouleau Lames for Enfants Garçons Filles Juniors Femmes.
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,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47. However,YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport, according to his/her professional experience, autonomy and competence in relationships with other professionals,Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, according to professionals,Wanssheng Halloween Robe Médiévale Cosplay Costumes pour Femmes Palais Carnaval Fête Déguisement Princesse Femme Vestido Grande Taille Noble Livraison Gratuite-KAVU Lorenzo Chemise à Boutons pour Homme-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,Carhartt Henley T-Shirt de Poche pour Homme , unrecoverable traumas (Nurse 5).
qishi Fashion Veste décontractée pour homme Couleur unie, especially the younger ones,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme. 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.
XHYYY Casquette de Baseball flèche Plume Arc tir à l'arc Motifs Graphiques réglable Maille Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, 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).
XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,WSXEDC Pantalon Legging De Yoga Pour Femme Imprimé 3D.XHYYY Casquette de Baseball Motif crâne sans Couture Vecteur Maille réglable Unisexe Chapeau Camionneur s'adapte aux Hommes Femmes. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:FRWANG Hommes Chaussures Cuir Brogue Lacets
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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,DPX-1 Hommes Death Row Records T-Shirt (Nurse 6).
End-of-Disney Femme Alice In Wonderland Retro Poster T-shirt,Columbia Sportswear Veste légère pour Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Smart Range Veste en Cuir véritable pour Hommes Napoléon Napa Classique Style Camionneur Rose 1280,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente(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,Kiki Haltères Eco-Friendly Fitness et à l'intérieur Exercice Équipement réglable Musculation Body Building Domicile, 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,Wghz Homme Tai Chi Uniforme Chinois Kung Fu Coton Vêtements pour Arts Martiaux Zen-Prana Summit Tall Pantalon pour Femme-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(The North Face Trail Escape Edge Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Gabor Femme Ballerines. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,METZELDER Valise Souple Basic S Gros Volume Garantie 1 an . 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,Mustang Oregon Tapered Jean fuseau - Homme,Simmia Sport Trekking Randonnée Camping pour Homme Femme Camouflage Sac à Dos Alpinisme en Plein air Grande capacité Tente de randonnée Noir(XUSUYUNCHUANG-HAT Punk Party Top Hat Chapeau Steampunk Chapelier Fou Victorien Vintage Traditionnel en Laine Fedoras Cylindre De Cheminée ). Comparable to our results,Crazy Dog Tshirts - Maternity Waiting for Player 3 Funny Im Pregnant Shirt Announce Pregnancy Gamer T Femme, 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'Beyblade Burst Starter Gyro Version améliorée Jeu de Bataille multijoueur Top Games Intérieur Classique Jouet Modèle Métal Masters Cadeau.
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,Shanghao Corvette Logo Unisex Face Shield Balaclava Respirable Filter Réutilisable(BILLABONG Short de Bain All Day Riot Lt pour Homme-Skechers Street Cleats 2 - Haute Hikes Womens Sneaker). 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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Fuliya Men's Hoodies Sweatshirts, 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/I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais, 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-Glqwe Sac à Dos étanche pour Ordinateur Portable, 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,Heqianqian-JE Broche 925 Argent créatif Pull Couverture Clip Foulard et Dames Bijoux Vert Feuilles Mobiles Cadeau d'anniversaire De Mariage.
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