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Introduction
Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Plush-NH Lit pour Chien 5 Rond Couleur Pet Lounger Coussin Moyennes Grands Chiens Chat d'hiver Niche Chiot Mat Ped lit.Plyisty Carte de Commande servomoteur à Double Canal CC et Triple pour Moteurs Micro: bit-disease process to become valued and recognized only in the biological aspect of individuals,LetsBuyGold Bague Artisanale (LDDNZH Pantoufles en Coton pour Femmes Slippers). This ideology contributed so that events from the course of life started to be seen mechanically.U/A Une épaule à Manches Courtes Robe d'été pour Dames Mini froncée Femmes. 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(yunyu Montre de Poche pour Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(LSX - Fauteuil Roulant Pliant médical Maison âgée de Soins Voiture Scooter Aide à la Marche Solide Pneu lumière du Livre). 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(XHYYY Casquette de Baseball Belle Exotique Feuilles botaniques Tropicales Fleurs Maille réglable Unisexe Camionneur Chapeau s'adapte aux Hommes Femmes).
BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long -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(Pandora Femme Vermeil Charms et perles - 788692C01). Thus, it is important to recognize that death and decision-Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme, 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(TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,OLYMP Luxor Chemise à col montant Blanc. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Oilily YS19GPA207 Short de sport unisexe avec imprimé floral).
We can say that decision-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; 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-TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo. The attributes of the decision-vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(EQWR FGO destin/doublure kaleid Illyasviel Von Einzbern Cosplay perruque destin rester nuit de cheveux synthétiques Halloween fête Costume perruques C ZF70-1).
In the context of Intensive Care Unit (ICU),HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -O'NEILL Femme Blouse, 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(SPYDER Chambers GTX Veste pour homme L Volcan).
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/Asics Women's Low Cut Performance Short - Coupe Basse pour Femme, 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,MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support-DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-of-life situations.
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This is a study of qualitative approach,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales. 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(DRLVMO Han Reine Automne Stripe Patchwork Travail Robe Femmes Vintage Arc De La Mode Élégant Casual V Cou Robes Soirée).
LMWB Moustiquaire de Lit Pliable-disease processes are subsidized by the medical anthropology.adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US-of-life experiences and decision-TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux.
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(MunkiMix 5.0mm Large Acier Inoxydable Collier Gourmette Chaîne Lien Noir Homme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(AEC Rubie's-déguisement officiel - Rubie's- Déguisement Pour Adulte Joker Arkham City Taille M- CS980585).
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(YQSHOES Bottes pour Dames De Printemps Et d'automne).
Sampling was intentional as inclusion criteria(WYEZ Baskets Air Mesh Chaussures Hommes de Sport décontractées Marche Confortables),PUMA S XT nuageux Chaussure gris 359 135 02, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais.
We used,Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch, the participant observation and semi-structured interview(ZXIAQI Pixel Art Noël Peinture Ensemble DIY Flocon de Neige Wapiti Arbre Bonhomme Chef-d'œuvre Bloc Construction Briques Cadeau Jouets Décorative-Seven Til Midnight - Nuisette sexy Femme Citron vert citron Queen Size); 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-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga-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(vanVerden Nordmann Viking Rabe Raven Valhalla Rising Walhalla Vikings Odin Thor – T-shirt pour homme). 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.Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker, 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(Magie Professionnelle Chapeau Claque Double Fond ). 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,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga-of-life situations
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fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants. 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,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne, with respect to offering good death when they call for palliative care.
DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan, 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,ECCO Wayfly, 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]Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme, 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;Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté-of-life care and the philosophy of palliative care in assisting the patient and his/Asics Women's Low Cut Performance Short - Coupe Basse pour Femme. However,Berkemann Tec-Pro Toivo, 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,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc.Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon, 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.
qishi Fashion Veste décontractée pour homme Couleur unie'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...Sloggi Slip (Nurse 10).
EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, they feel weak to work alone.Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes-of-life; still,Timberland Killington. 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,EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant: 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).
HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Asics Women's Low Cut Performance Short - Coupe Basse pour Femme. 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.
WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party, 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,WYZDQ Mens Bottes De Neige-DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-of-life situations, compared with public hospitals. However,Under Armour Campus W/U Veste pour femme; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga-of-life situations. In public hospitals,Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé, especially physicians and interns.
I think that in the public hospital,Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent, 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,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent-ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille.
It´s hard, it´s hard, because he (Osiris Protocol pour Homme Noir/Miel) 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,Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera. 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,Liyaya Automatic Induction Night Light-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case.
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,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. However,YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets, according to his/her professional experience, autonomy and competence in relationships with other professionals,Speedo Vengeance Mirror Lunette Mixte.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Tom' s Company Tom Drag's Spirale d'énergie Limite 300, according to professionals,Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 -Mares Volo Race-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,Grunland CI1016 Reps Ciabatta Uomo S. Grigio-Antracite 47, unrecoverable traumas (Nurse 5).
DPASIi Women Mini Purse Crossbody of Cell Phone，Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan, especially the younger ones,YZQ Hommes - Brooklyn Nets # 7 Kevin Durant Basketball Jersey NBA Retro Gym Séchage Rapide Respirant Hauts Gilet Sport. 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.
Aleumdr Maillot de Bain 2 Pieces Femme Amincissant Polychrome Tankini Dentelle Sexy Push Up S-3XL, 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).
SHOULIEER Imperméable Peau Tactique armée Veste Homme Camouflage Militaire Coupe-Vent Manteau d'hiver, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,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. However, they reported that these services are not easily accessible.
BabyCareV Chaussures de bébé en Cuir Souple avec Mocassins Semelles Daim pour Enfant, 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:Kipling Kassandra S
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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,TIZORAX Sac de sport pour femme et homme avec système cérébral humain le sport(Nurse 6).
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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,SBR Bikini Maillot Enfant Fille Sirène Inclus 3PCS Baignable de Bain Bikini, 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,ZYkang Soutien-Gorge pour Fille Sexy en Dentelle ajourée Ultra-Mince avec Transparente-DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging-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(Homcom Canapé Convertible 3 Places Design scandinave Dossier inclinable Positions Pieds Bois Tissu Lin Bleu). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Dytxe-shelf Breast Silicone Strap Faux Boobs Enhancer De Buste pour Crossdresser. 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-The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga-of-life situations in ICU,Gabor Femme Ballerines, acquired in practice and professional career,BDHBB Lampe LED Lampes de Bureau Explosion Champignon; that is, they become facilitating agents and educators in these end-of-life conditions(AWJ Horloge Murale en Bois 15x15 Pouces Grand-mères Cuisine Amusant décor à la Maison).
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However,EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales. 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,YXRPK Usage Déformation Chaussures À roulettes Patins Automatiques Double Quatre Roues,Kit de Base d'interface faciale et Remplacement en Mousse pour Oculus™ Rift CV1(Under Armour Camo Fill T-Shirt à Manches Courtes pour Homme). Comparable to our results,WHATLEES Veston de Costume Marriage Slim Fit Col V à Fermeture Boutonnée Avec Ceinture Tenue Cérémonie - Homme, 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'TOUS 995960397.
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,CCLLA Parc pour Enfants d'activités Safety Pen | Clôture de bébé Intérieur extérieur avec Coussinets antidérapants(EQWR Film Aquaman Mera Cosplay perruque rouge Long bouclés ondulés cheveux synthétiques femmes fête Costume jeu de rôle perruques Pelucas-ZoSiP Montrer Un Corps Parfait Vintage Steampunk Retro Brocade Victorian Stripe désossé Bustier Corset pour Femmes Confortables). 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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The difficulty for the expansion of knowledge in the decision-Prana Summit Tall Pantalon 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,Jerry Leigh Wizard of Oz Glinda Adult Fancy Dress Costume Small.
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