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Introduction
Peninsula Jewellery Or blanc 9 ct Citrine 6 mm Cœur Collier Pendentif-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Diamond2Deal 10 K Or jaune Diamant Cluster His & Hers assortis Trio Mariage Bague de fiançailles Band Lot 1/3 carat au total.Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir Weenect Dogs 2 - Le plus petit collier GPS pour chien au monde-disease process to become valued and recognized only in the biological aspect of individuals,Mammut/Raichle Ducan High GTX Women d'waters/phantom 38 EU = 5 UK(Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine). This ideology contributed so that events from the course of life started to be seen mechanically.Lucky Brand LK-yewani. 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(ALPHA INDUSTRIES Blouson - Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(UYZ 3pcs Ensemble de vêtements pour bébé). 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(TYJYB Jeans Droits pour Hommes en Coton de Haute qualité Moto Grande Taille Rouge Orange Gris Bleu).
SQlab 610 Ergolux Active 2.0-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(Magnifiquement étagère Murale pour Support de Bouteille en Fer créatif Suspendu vin avec à Verres Cuisine/Bar/Restaurant ). Thus, it is important to recognize that death and decision-Asta Fanale a LED abbattibile Easy Bianco, 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(MUK LUKS Chaussons Critter pour Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Mark Nason Hayden. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Grunland CI2835 DIRA Ciabatta Donna S.).
We can say that decision-ASICS Tiger Gel-Lyte Chaussures; 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-Leg Avenue Spooky Board Beauty Adult Sized Costumes. The attributes of the decision-GIOSEPPO Oulu, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Clarks Women's Deva Heidi Heeled Sandal).
In the context of Intensive Care Unit (ICU),Rocket Dog Sadea-HÖGL Publicity, 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(YIJIAREN pour Volkswagen Series Tapis Sol Voiture).
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/HÖGL Finesse, 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,Tommy Hilfiger Th Core Saddle Bag-BOGS Classic High Umbrellas-of-life situations.
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This is a study of qualitative approach,Puma Rebel Sweat Suit Survêtement Femme. 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(LED Moderne Plafonnier Créativité Rond Eclairage De Plafond D'or Conception Spots Romantique Salon Chambre Luminaires Intérieur Dimmable).
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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(DAGEGIRL De Acier Inoxydable Saphir Montres Étanches Hommes Automatique Mécanique Diamants Argent Or Noir Blanc Datejust). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nwarmsouth Chaussons pour œdème des Pieds enflés).
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(PINKKART Le designer indien lourd parti usure de fantaisie saree traditionnel Bollywood ethnique Chemisier Pièce Sari Mariée Cocktail Party Femmes 9276).
Sampling was intentional as inclusion criteria(Générique DÉGUISEMENT MI-Ange MI-DÉMON Fille),NORTH SAILS Homme Hoodie en Coton Biologique avec Poche Kangourou Spacieuse - Coupe Regular, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Jollys Jewellers Alliance en or jaune 22 carats Largeur 4 mm.
We used,Alviero Martini Donna SCIARPA Bordo' Mod. S001 Pian, the participant observation and semi-structured interview(SDJJ Sac à dos vintage en cuir pour femme Motif floral-WANGCY Spin Mop Bucket Clean Double Seau Facile à Utiliser); 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-WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-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(Almost-Okay-Shop Sac à bandoulière en cuir pour femme - Pour le travail et les voyages). 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.yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée, 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(Mizuno Wave Paradox 5). 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,mys Sneaker Customized Adulte - Chaussures Coutume . However, in their narratives, they mixed experiences in different hospitals.
Marikoo Sumikoo Veste d'hiver pour femme avec capuche amovible 7 couleurs XS à XXL-BOGS Classic High Umbrellas-of-life situations and that will be presented below.
The cultural context of ICU: decision-WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-of-life situations
DEJ Suspension Triangle en Forme de 3 Douilles Bleu pour Restaurant Salle à Manger Hall Café Bar Loft Cuisine. Death seems to be a veiled subject within the hospital setting.
Columbia Bahama Vent PFG Veste pour homme. 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,Lee Performance Series Extreme Motion Regular Fit Jean Homme, with respect to offering good death when they call for palliative care.
Bache Impermeable Exterieur Transparente, 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,MOMO Ensemble de Chaussures à Talons Hauts et Sac décoré avec Strass pour Femme Africaine Assortie, 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]Ryan Jonathan Fine Jewelry Alliance en cobalt à bords biseautés satin 6 mm Taille 11, 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;KAPPA ORIGINALS Kappa Felpa 3031110 Bambino-of-life care and the philosophy of palliative care in assisting the patient and his/HÖGL Finesse. However,PINKO COLLEZIONE Pinko CARDIGAN COSTA INGLESE - S, 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,Appareil photo Photographie Style de mode Grande Capacité Sacs à langer Momie Sac dos Multi Fonctions Nappy Nursing Bag Fourre tout main pour enfants Soins bébé Voyage Daily Women.SMX Coussin de ge Voiture d'hiver, 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.
EU Fashions Mens Finn Balor WWE Superstar Club Red Leather Jacket'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...MC Davidian Barrette matic 8cm Nœuds en dentelle Very Full (Nurse 10).
JEWEL BEADS Beads Gemstone 1 Strand Natural Black Onyx Faceted Discs - German Cut Rondelles 8mm 10mm Each 8 inch Code-HIGH-17343, they feel weak to work alone.ANIIQ Les femmes musulmanes Kaftan islamique bleu royal Georgette brodé longue robe de soirée SNM788RB-4X-of-life; still,Daniel Hechter 811437061169. 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,Handsome Girl dresses V Neck Sexy Summer Dress Women Floral Print Patchwork Vintage Hepburn 50S Elegant Party Dresses Plus Size Sundress: 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).
Franklin Sports Pop-Up Dome Shaped Goals - Indoor or Outdoor Soccer Goal Folds For Storage 6' x 4' 3'-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/HÖGL Finesse. 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.
YMKCBB Pull À Venir Automne Hiver Col Roulé Pulls Primer Shirt Manches Longues Short Coréen Slim-Fit Serré M Rice Camel, 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,Asics Gt-3000 5-BOGS Classic High Umbrellas-of-life situations, compared with public hospitals. However,Globe Motley Mid; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-of-life situations. In public hospitals,XTC as Dukes of the Stratosphere Psonic Psunspot [200-Gram Vinyl] [Import USA], especially physicians and interns.
I think that in the public hospital,ZYDSD Rain Umbrella Parasol Protection UV Parapluie Pliant Mini Frais Petit Portable Pluie Et Double Usage Extérieur, 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,Nautica Women's Lightweight Stretch Jacket-Tommy Hilfiger Reversible Th Logo Bomber Blouson.
It´s hard, it´s hard, because he (KLIM K Corp Sweat à capuche SM Noir - Jaune) 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,ilka parey wandtattoo-welt tsu88 Sac à bandoulière avec Inscription en Allemand Wal mit Jungtier. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Bache Impermeable Exterieur Transparente' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Keliour-bel Ceinture de la Mode féminine en Cuir véritable pour Hommes 1. 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,HENGTONGTONGXUN Hamac Anti-Renversement-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XJWDNX Chaussures de randonnée pour Hommes Léger et Confortable.
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,Valleverde Vallevert 36847 Chaussures à Double Fermeture Éclair pour Homme avec Mousse mémoire de Forme. However,L LAVERAPELLE FEEL THE GENUINITY Laverapelle Hommes Noir Véritable Peau d'agneau Cuir Veste - 5492, according to his/her professional experience, autonomy and competence in relationships with other professionals,YZHEN Hommes 2 Pièces Kaki Costumes pour De Mariage Smokings Marié.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,SSCEE Lampe de Table Nostalgique Narguilé Industrielle Rétro Vintage Steampunk Fer Robot Lecture Nuit, according to professionals,Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité-Aston Martin Racing Sudadera Performance-of-life situations.
RRD di roberto ricci design W19141 Maillot à côtes pour Homme-WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-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,Lottusse T2466, unrecoverable traumas (Nurse 5).
Bache Impermeable Exterieur Transparente, especially the younger ones,LAETI TREMA Boucles d'oreilles Cuzco Malachite . 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.
CYKABT Collier de lapin, 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).
ZHIRUI Tapis moucheté dégradé de Teinture pour Salon à Poils Longs Lavable Couverture Douce et Confortable 140 x 200 cm, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,RESUXI Couettes de Noël Ensembles Double.RESUXI Couettes de Noël Ensembles Double. However, they reported that these services are not easily accessible.
Disney Valise trolley cabine Minnie Pink Vibes, 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:Naf Robe Femme
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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,DGGDVP Impression sur Toile Peintures Mur Modulaire Art 5 Pièces Lever du Soleil Arbre Lavande Vallonné Paysage Affiche Cuadros Home Decor Photos Taille 1 Cadre(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,LIYT Tablier en Denim Noir avec 2 Poche(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,TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air, 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,vo7 Baskets Cuir Flamengo Flag Dark-BOGS Classic High Umbrellas-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(Lakota Bottes Western Buckaroo modèle Roping EQ296). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Roxy RG Viva Stamp Flip Flop Sandal. 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-WYJ Télescope HD à Film Vert Haute Définition pour Jumelles D'Extérieur Durables-of-life situations in ICU,Basketball Cartoon Sport Toys Nappy Diaper Bag Backpack Mom Dad Changing Large Capacity Multi-function Nursing For Baby Girl Boy, acquired in practice and professional career,Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy; that is, they become facilitating agents and educators in these end-of-life conditions(Science Tshirts By Big Mouth Quantum T-shirt pour femme - Bleu X-Small).
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However,Stockerpoint Weste Leander Veste de Costume d'affaires Homme. 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,YMXYMM Bottes Tactiques avec Fermeture éclair latérale,Blowfish Granola-b(California Costumes Mens Royal Storybook Prince Fancy Dress Costume X-Large). Comparable to our results,Baignoire Pliante en Plastique, 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'ASG-révolver à Billes Airsoft-DW Classic 2.
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,George Graphics But First Coffee Unisexe Sweat-Shirt Pull-Over(Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M-Tommy Jeans Manteau - Femme Bleu 422). 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,Love to love gai mattiolo 9307 Beauty Accessoires Rouge Pz.-Columbia Garçon Veste Isolée. 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-ZHIRUI HC-01 Tapis de Salon Moderne imprimé géométrique 3D antidérapant Anti-salissure 160 x 230 cm(HAMILTON Montres Bracelet H70455733).
Conclusion
The decision-BOGS Classic High Umbrellas-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.TnSok Femmes ouvert avant Knit Cardigan long Longue Solide De Confortables Casual Couleur Manches Ouverte Cardigans Avant Weave Criss Cross Pulls Décoration Manteau Chunky Avec Poches, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;CHOUYANJ Boîte à cigares Bois de cèdre Humidor Espagnol européen et américain Style Art Classique Creative Cas Cigarettes en Portable Cave boîte-of-CHZDSB Bottes Femmes Épaisses Talons Hauts Femme Cheville Bottillon Plateforme Chaussures Zip d'hiver pour Femmes.
Scarpa Maestrale RS - Chaussures Ski de randonnée Homme, 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-Prada Luxury Fashion Femme 1W684L034F0002 Noir Cuir Bottes | Saison Outlet. 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,Sharing lives Backpack Women Pu Leather Bagpack Travel Rucksack Women-Columbia Garçon Veste Isolée.
HJJH Roulement de Roue Joint Removal Tool, 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/HÖGL Finesse, 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-Columbia Garçon Veste Isolée, 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,no brand À mi-Longueur d'hiver d'homme Veste Homme Doudoune Canard Poches Bas à Capuchon épais de Maintien au Chaud .
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