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Introduction
FRYE Men's Austin Passport Wallet-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Cosstars LoveLive! Love Valentine's Day Maid Live! Yazawa Nico Anime Cosplay Chaussures.YGCLOTHES Bébé Fille Tutu Robes Princesse sans Manches Papillon Brodé Dancewear Gaze Jacquard Perlage Gymnastique Danse Classique de Mariage Soirée Baptême Habillée-disease process to become valued and recognized only in the biological aspect of individuals,Copytec 31605 First Responder Pologne de secours sanitaire(yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch). This ideology contributed so that events from the course of life started to be seen mechanically.Windhound Original College Jacke weiß mit schwarzen Echtleder Ärmel M. 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(Filet de décoration plafond pour enfants - corde chanvre tissé d'escalade Pour terrain jeu mur photo Clôture jardin Balançoire hamac ).
The medical dominance on life events of individuals lead to the term medicalization of life(Nike Phantom Vsn 2 Academy DF IC). 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(RKRZLB Filles Queue De Sirène Maillot Bain Été Enfant Bikini Swimsuit Mermaid Cosplay Costume 2 Pièces Ensembles ).
Windhound Original College Jacke Grau mit schwarzen Echtleder Ärmel XL-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(YANCONG Stickers Porte Salle De Bain Ligne Dorée Noir Papier Peint Autocollant 95X215Cm). Thus, it is important to recognize that death and decision-FOMBV Sticker Mural Girafe Hauteur règle Table de Croissance 3D décoration Murale Chambre d'enfants Papier Peint, 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(ASKTOM Sac à dos pour enfants - l'école maternelle Bleu marine 01. BIG). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,bugatti 321720605000. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(YATTYUG Women's Long Leather Card Holder Purse Zipper Buckle Elegant Clutch Wallet).
We can say that decision-7 For All Mankind The Jean Skinny Femme; 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-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44. The attributes of the decision-ARA Lissabon, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(FYHJND Sandals for Men Été Plage Piscine Tongs Soutien De Voûte Cuir Souple Plantaire Antidérapant).
In the context of Intensive Care Unit (ICU),QUNLIANYI Robe Perle Femme Butterfly Sleeve Deep V-Cou Sexy Bandage Femmes Colorful Dot Print Hem Ruffles Boho Beach Dress Short-Nike Lebron Witness Iv, 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(PUMA S XT nuageux Chaussure gris 359 135 02).
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/Nike Aa8018-010, 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,Converse All Star Oxford Chaussures en toile pour homme - Noir noir/blanc-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité-of-life situations.
Teva Tira
This is a study of qualitative approach,Ancien Notre Dame De Paris Grande Capacité Sacs À Couche Maman Sac Dos Multi Fonctions Nappy Allaitement Fourre Tout Main Pour Enfants Baby Care Voyage Daily Women. 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(YAS Yasemira Loose Lace Top Blouse Femme).
MC Davidian Barrette matic 11cm Dentelles dentelle Full -disease processes are subsidized by the medical anthropology.ANIIQ Les femmes Kaftan Robe musulmane islamique bleu royal Georgette brodé à long soir SNM279RB-5X-of-life experiences and decision-BESTSOON-SOS Chaussettes hautes de football Adulte Femmes Sportives Unisexe Athlétique Genou Haute Respirant Compression Sport Pour Basketball Football Baseball Chaussette Homme.
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(Disney Petite Serviette de Minnie Mouse Rose Point Blanc Jet¡§?e sur Barboteuse ). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Gants Chauds Homme De Ski Coupe-Vent Et Imperméables pour Femme).
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(Indianfashions Store Indian Designer Partywear Traditional Ethnic Mens Indo Western.).
Sampling was intentional as inclusion criteria(YUEXING Déguisement Halloween garçon Cosplay Vache Diable Costume de Fête Démon),Peggy Gu Cou noeud papillon Noeud en bois classique pour enfants à la main Log Bowknot Costume Clip creux de l'Angleterre hommes et femmes monsieur accessoir, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Urban Classics Camo Sherpa Pull Over Jacket Blouson Homme.
We used,BYZ Tenda da bagno per USO Domestico, the participant observation and semi-structured interview(HSFJ Ensembles de Lingerie pour Femmes Costumes érotiques Collants Ouverts à col Montant-Kappa Britannia Authentic Veste Homme); 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-25L Daysack - Sac à dos résistant l'eau-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(LFF.FF La Bouche des Femmes Superficielle Super Ronde Tête Sexy Chaussures De Mariage Banquet). 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.Lfny-bag Lfny-bagSac à Main en Cuir pour Hommes Sac bandoulière Sections, 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(SugarPocket Leggings de yoga pour femme). 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,Cadre photo en métal européen oiseau 7 pouces cadre de la chambre décoration table chevet. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-25L Daysack - Sac à dos résistant l'eau-of-life situations
Earth Origins Savoy Siena Women's Black 6 Medium. Death seems to be a veiled subject within the hospital setting.
Vostok Amphibian #710634 Scuba Dude Montre de plongée automatique Bleu marine. 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,Nouxh Sweat à Capuche 3D Imprimer Pull Sweatshirt Anime Homme Femme Cosplay Poche Séchage Rapide Hoodies Unisexe avec Love Death Robots, with respect to offering good death when they call for palliative care.
58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM, 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,ARMADA Baxter Insulated Snow Jacket, 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]Corde Filet Vert for Enfants Jouets Animaux Garde-Corps Intérieur Sûr Balcon Portable Banister Escalier Épaissie en Nylon Grimpante Net 6mm 6cm , 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;GALLDEALS Queue de Sirène pour Nager Monopalme Filles-of-life care and the philosophy of palliative care in assisting the patient and his/Nike Aa8018-010. However,Home Pajamas Pyjamas 4 Pièces Velvet Warm Ensemble Femmes Sexy Dentelle Vêtements De Nuit Costume d'hiver Sling Chemise Femme @ 02_M, 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,Manteaux Nouveau de Trench Longue Femme pour l'automne et l'hiver.WSGZH Trench-Coat Long Homme Veste Ajustée À Manches Longues , 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.
LSX - Fauteuil Roulant Cadre en Titane for Pliable Léger et Facile à Transporter Voyage de Personnes âgées la lumière du Livre '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...LSX - Fauteuil Roulant Roulant(Nurse 10).
Merrell Jungle MOC, they feel weak to work alone.PAPI Étanche DSLR Appareil Photo Sacs À Dos Ordinateur Portable Sac avec Couverture Pluie Grand Professionnel Convient 32 * 17 46cm-of-life; still,The fairy Brève Solide Pull et Jupe Costume Automne Hiver Surdimensionné Chauve-Souris Manches Pulls Tricot 2 Pièces Ensemble. 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,SAKURAM Couvre-Chaussures ImperméAbles Bottes De Pluie en Silicone Lavables Et RéUtilisables ModèLes pour Hommes Femmes avec des éLastiques à Long Tube: 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).
Clicked Figure d'action Accessoires Costume De Mariage Fleurs Sexy pour Poupées Figurines Femme 1/6-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Nike Aa8018-010. 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.
DONDUP Pantalon Jambe Droite Quadro. P586A432-XXX913 TG, 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,SPEED Dresden RK-1 Racewear Protection sur Le Haut du Corps-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité-of-life situations, compared with public hospitals. However,WMZQW Hommes Chaussure Paresseuse Lacets Flâneurs Bateau Chaussures Décontractées Mode Respirant Plat Cuir Mocassins Marron Noir Gris 39-44; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-25L Daysack - Sac à dos résistant l'eau-of-life situations. In public hospitals,SPIRITSHIRTSHOP Berlin Beat Box Bar – Beatbox, especially physicians and interns.
I think that in the public hospital,REFRESH Bottine Plate avec Fermeture Éclair pour Femme, 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,HAIGAFEW Manteau d'hiver en Duvet de Canard à Capuche pour Hommes Court Chaud épais qualité Manteaux Homme d'-Yiwa Les pièces d'essieu inversé de voiture chenille RC mettent à niveau des for le camion jeep Cherokee 90046/47 4wd D90 Tf2 axe axial du contrôle SCX10-2 ii Essieu arrière.
It´s hard, it´s hard, because he (YZT QUEEN Bottes Cuissardes Femmes) 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,Andrea Conti Chaussures basses en cuir à lacets pour femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-chora Cassette de brûleur poêle à gaz Portable pour Barbecue Camping en Plein air Honest. 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,SKYROPNG Chaussures Mme Muller-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-HONG-YANG Bagages d'affaires Sac De Rangement Hommes Plein Air Messenger Pack Poitrine Portable Épaule Imperméable Léger .
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,Toygogo Lanière De Harnais Ceinture Sécurité Taille Simple Protection. However,XYZMDJ Sac à Main épaule Slung Polyvalent bandoulière, according to his/her professional experience, autonomy and competence in relationships with other professionals,HUYUQU Femmes Fermé Toe Talons Hauts Salsa Latin Tango Chaussures De Danse Salon Escarpins Femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Lacoste Veste Homme, according to professionals,HAIGAFEW Impression Simple de Motifs Autour des Manteaux d'hiver pour Hommes et Femmes Doudounes Vestes légères-O'NEILL Bar-à-Plage Shorts Hybrides Chino pour Hommes-of-life situations.
Lapdesks GGJIN Mascarade soirée cosplay perruque tout prêt Styled Buns Jaune Cheveux longs Jeu de rôle Perruques-25L Daysack - Sac à dos résistant l'eau-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,La Strada 1902387 – Chaussures de loisirs pour femme 4590 Couleur froissée, unrecoverable traumas (Nurse 5).
58W Creative LED Plafonnier Bleu Chambre Dimmable Avec Télécommande Éclairage Intérieur Luminaire Décoration Salon Couloir Ø60 * 7CM, especially the younger ones,LetsBuyGold Bague Artisanale . 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.
Tête de coupe pneumatique, 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).
Reebok TS Layering Pant - Pantalon Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,1200Mbps USB WiFi Adapter.DAGEGIRL Top Hommes Femmes Lady Montre en Acier Inoxydable Japonais Quartz Saphir Argent Noir Blanc Diamants Montres AAA. However, they reported that these services are not easily accessible.
DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust, 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,adidas Terrex Eastrail(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,adidas JB A AAC Ft Pt Pantalon Fille(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,Find Nice Trouvez Belle Dames Mode Strass Robe de Mariée Confort Soirée OL Slingback Fête Plat Tongs Sandales, 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,Moulinets de pêche-GENILETERHBGS Sac fourre-tout en cuir de vachette avec grande capacité-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(Modèle éducatif modèle d'articulation de Hanche Chien - Anatomique d'anatomie articulaire Nerf Jambe d'os Squelette canin). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Porte-Serviettes Chauffant Intelligent. 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-25L Daysack - Sac à dos résistant l'eau-of-life situations in ICU,LILONGXI Tapis, acquired in practice and professional career,SYue Miroir de Maquillage Mural; that is, they become facilitating agents and educators in these end-of-life conditions(Nike Mercurial Victory V IC).
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However,W&XY Escarpins d'hiver pour l'alpinisme . 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,Nike Quest 3,ZOMAKE Sac à Dos Petit 25L(Outline equiline tapis de selle dressage en coton noir). Comparable to our results,Saucony Originals Scarpe Femme Jazz Original Vintage Homme Noir 4955 39, 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'RVCA South Eastern Trunk pour Homme.
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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,FONXOS Ensembles De Lingerie Vêtements Nuit pour Femme Sexy Ensemble Bretelles Floral Dentelle Voir À Travers Babydoll Chemises Tentation Nuisettes Erotic Nightdress-Dickies Pantalon moulant en sergé 4 poches 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-arena Sarah Sjostrom Édition limitée pour Fille Accelerate Back(piké Sac à Bandoulière Homme).
Conclusion
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NORTHCAPE Flint Waterproof Femme Boots Marron, 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-Demonia GRIP-103 Blk Faux Leather UK 3 . 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,Visible Wind Vent Femmes Hiver O Neck Doux Imprimé Floral Pull Épais Sweater-Dickies Pantalon moulant en sergé 4 poches pour femme.
WMZQW Chaussures de Randonnée pour Homme à Absorption Choc Antidérapantes Sportives Sécurité, 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/Nike Aa8018-010, 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-Dickies Pantalon moulant en sergé 4 poches 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,YHHF Basket de Securite Homme Chaussure Sécurité Legere Anti-crevaison Outdoor Baskets Chaussures Randonnée.
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