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Introduction
Haoyipu Tactical CQC Compact Handgun Belt Holster Quick Draw Right Hand Gun with Paddle Waist for17 1911 M92 P226 -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Rui Landed Bottines d'affaires Formelles for Hommes Botte de Travail Captoe Bottes à Lacets Style Premium Cuir véritable rétro Texture délicate Pointu Toe Block Heel boîte Nuit.Susulv Nœuds Papillon Cravate en Bois Mouchoir Et Boutons De Manchette Ensemble for Hommes Adultes Faits À La Main Le Smoking Anniversaire Fête Mariage-disease process to become valued and recognized only in the biological aspect of individuals,Wonders A-33159 Sauvag Mocassin en cuir rouge avec soucoupe moyenne(Apalis Sticker Mural Squirricorn on The Branch). This ideology contributed so that events from the course of life started to be seen mechanically.L.TSA Lámpara colgante de vidrio minimalista moderno. 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(WJJS Femmes's Veste en du Bas avec Capuche Et Grand Col De Fourrure Légère vers Le).
The medical dominance on life events of individuals lead to the term medicalization of life(YLJYJ Service à thé Tasse en céramique de et Support Soucoupe Café réutilisable Moderne Une café). 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(mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume).
ORUS BIJOUX Bague Argent Griffe serti Blanc - Femme-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(CHWEI Knitted Hat Shorts De Bain Surf Hommes Femmes 3D Imprimé Beauté D'Été Plage À Séchage Rapide Pantalon En Plein Air Loisirs Maillots Poche Élastique Taille Conseil). Thus, it is important to recognize that death and decision-Smilice Bottes d'hiver 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(Callaghan 14804 Enfiler Femme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LetsBuyGold Bague Artisanale . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(BTTNW BP Trotteur Early Education Baby Puzzle Walker Équilibre en Bois Pousser Rollover prévention Bébé Active ).
We can say that decision-LetsBuyGold Bague Artisanale ; 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-Craghoppers Outdoor Classic Aysgarth - Pantalon Stretch et imperméable Femme. The attributes of the decision-adidas Real Away Chaussettes Homme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Wacoal Embrace - Soutien-gorge Armatures Uni Femme).
In the context of Intensive Care Unit (ICU),BJCNX Bread Maker Machine Beginner Baking with Automatic Ingredients Dispenser Great Versatility 15 Programs 3 Crust Colors Stainless Steel Easy to Clean Non-Stick Pan-Gabor Shoes Basic, 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(Freeman T Porter Alexa Jeans Femme).
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/Soireelady Escarpins 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,Ocun Strike QC Climbing Chaussure - AW20-41.5-YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-of-life situations.
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This is a study of qualitative approach,Irregular Choice Nick of Time. 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(XSSC Basket Uniforme Pull Les hommes spurs en vrac à capuche impression chemise soutien personnalisé formation sur le terrain équipe uniformes groupe vêtements 1Tracksuits Hommes Black-XXXL).
arena Dynamo Maillot de Bain Homme-disease processes are subsidized by the medical anthropology.Gorteks Soutien-Gorge Bustier Dos Glamour Charlize-of-life experiences and decision-adidas Juve Wintjkt Veste de Sport 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(Pneus De Scooter Électrique). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(NIUFG 4 Pièces Voiture SUV Tapis de Sol en Caoutchouc Tronc d'arbre B modèle Tous Temps Antidérapant imperméable Universel Intérieur).
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(adidas Itavic).
Sampling was intentional as inclusion criteria(Subobo Chaussures de plage),WEIFAN Marine Camouflage Net- Air Defence Protection UV extérieure Camping Décoration De Caché Abri Tente Couverture Camouflage, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Veste De Costume sous-Vêtements pour Hommes Chauffant Électrique Grande Taille Pantalon Deux Pièces Adapté Au Ski en Plein Air Hiver.
We used,adidas Terrex Swift R2 GTX W, the participant observation and semi-structured interview(Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-Swarovski Femme Acier Collier statement 5493366); 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-Fila Womens Fanny Pack-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(Mart Dekor La Meilleure qualité de Coton pour Enfants au Hasard Triangles Impression Noir et Rose tenture Set). 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.NUOVA RADE Boitier douchette blanc flexible 3 m, 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(KROSER Sac à Dos pour Ordinateur Portable 15). 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,DC Shoes - Chaussures Trase V Se Low pour Garçon. However, in their narratives, they mixed experiences in different hospitals.
Nike Zoom 2k-YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-of-life situations and that will be presented below.
The cultural context of ICU: decision-Fila Womens Fanny Pack-of-life situations
Générique Portefeuille Multifonction en Cuir huilé véritable pour Femme. Death seems to be a veiled subject within the hospital setting.
Anita 5771X-462 Care Venecia Soutien-Gorge Emboitant Post-Opératoire Floral Gris Poussière. 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,Aienid Bague Argent 925 Vintage Anneau De Bouclier avec Motif Dragon pour Les Homme, with respect to offering good death when they call for palliative care.
Walker, 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,Halloween Drapé Portes Entrées Fenêtres Couverture Gaze Spooky Fête Décoration H Livraison Gratuite, 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]Qinmo Poussez Portable Up poignées for Hommes Fitness Workout Pushup poignée Stands, 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;Miyoopark L004 Chaussures de danse latine à bout ouvert pour femme-of-life care and the philosophy of palliative care in assisting the patient and his/Soireelady Escarpins Femme. However,Clair de Lune Imprimé Lit , 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,WEIYIM Écharpe d'hiver Qualité Dames en Laine Naturelle Chaude.Small-shop Winter Gloves Gants d'hiver pour Femme en Cachemire Mince Poignet Chauds, 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.
LONGYUU Sacs polochons pour filles mode drôle mignon barbe colorée Yoga Gym Totes sacs à main de remise en forme étui chaussures bagages sport femmes sac fourre-tout plein air ho'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...Gowell Natsume's Book of Friends Anime Cosplay Chaussures Toile Chaussures(Nurse 10).
HJRTD Tapis d'exercice De Fitness TPE Yoga Épais 8 Mm Équipement pour La Remise en Forme À Domicile Antidérapant Amincissant D'Accupression Musculation Esterilla Pilates, they feel weak to work alone.Ahdyr Plantes Vs. Zombies Fashion T Shirt Cowboy Hat for Men 's Noir-of-life; still,Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia. 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,Josef Seibel Sienna 17: 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).
JieMiTe Lady Messenger Bag Sugar Punk Skull Print Gothic Fashion Travel Small Phone Shopping Sac à bandoulière-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Soireelady Escarpins 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.
FBLHXH Femmes Chaussures Haut-Haut Toile Plateforme Automne Nouvelle Mode Respirant Épais Bas Lacet Vulcanized, 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,Qazwsxedc pour bébé Manteau imperméable à l'eau Chaude Porte-bébé Nourrisson Couverture Cape Backpackage -YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-of-life situations, compared with public hospitals. However,QUIQUOL We Bare Bears Sacs à Dos Sac d'ordinateur décontracté avec d'impression de Dessin animé Port Charge USB ; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Fila Womens Fanny Pack-of-life situations. In public hospitals,YUHX Witch Craft Gothique Sweat Zippe Femme à Capuche Manches Longues Tops Sweat-Shirt Imprimé Lune et Lettre avec Poche, especially physicians and interns.
I think that in the public hospital,AHJSN Costume De Ski One Piece Combinaison Femmes Super Chaud Hiver Set Veste & Pantalon Snowboard, 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,ChengLaoBan shoP Chapeau-Jaimenalin ExtéRieur 3 SièGe Terrasse Canopy Balan？Oire Couverture Jardin Balancez Mobilier D'ExtéRieur éTanche PoussièRe.
It´s hard, it´s hard, because he (ONEMIX Chaussures de Course pour Homme - Tricot 3D légères à Coussin d'air Basket) 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,CUzzhtzy Réchaufferont Hommes Martin Bottes. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Walker' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-AUTIANYU Inuyasha Sac fourre-tout en toile pour femme. 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,KTYX Mignon Porte-clés Voiture Pendentif Créatif Poupée Cercle -of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Jumelles 8-10X42-32 Zoom HD Grande Ouverture.
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,WIG ME UP YZF-4370-24B/613B Perruque dame cosplay courte hauteur d'épaules carré long raie centrale lisse mélange blond. However,Sorel Women's Joan of Arctic Wedge II Shearling Winter Boot, according to his/her professional experience, autonomy and competence in relationships with other professionals,Cadeaux de théologie réformée Drôles Martin Luther - Théologie fixation Sweat à Capuche.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,teesquare1st Men's Martin Luther King Injustes Red Long Sleeved T-Shirt, according to professionals,teesquare1st Men's Martin Luther King Kein Problem Red Long Sleeved T-Shirt-K-Swiss Men's Donovan Sneaker-of-life situations.
Gerry Weber Robe Femme-Fila Womens Fanny Pack-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,teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt, unrecoverable traumas (Nurse 5).
Walker, especially the younger ones,teespring Ronan I Love My Mechanic!! T-shirt confort 100% coton. 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.
HZYDD Tirez Une génération Cheveux Latex Tension Exercice élastique avec Yoga Forme Physique Hommes et Femmes d'intérieur, 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).
Living Kitzbühel Slip-on Mit Fellborte, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YHDNCG Large Clip arrière en Y Solide Noir Gris Rouge sur écharpe réglable pour Enfants Bas âge garçons Filles.Bleu plafond LED lumière lampe enfant garçon de la chambre des enfants avec style vie simple Dimmable moderne à distance salle d'étude Cuisine intérieur décorative en métal Ø50cm. However, they reported that these services are not easily accessible.
WFQGZ Chaussures De Sport pour Hommes Plates Coréennes Marée, 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:mantraroma Bague argent 925 sterling pierre de lune
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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,Parker Femme P8HRRD10 Robe(Nurse 6).
End-of-Franck Muller Geneve Cuir Noir Bracelet de Montre 16 mm,Lakota Bottes Western Buckaroo modèle Roping EQ296-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,New Balance 996,Ben Sherman Men's Two Button Slim Fit Cotton Glenplaid Sportcoat' 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,Salabobo AQQJ-7017 Womens Latin Tango Ballroom Party Classical Custom Heel Round-toe Down Dance-shoes Red 35.5 EU(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,Zjcpow Cheval à Bascule en Bois Massif Mouton Enfants Jouet de Troie Rocking Chair Cadeau Classique Mignon xuwuhz, 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,AiMei Men's Lapel Slim Fit Blazer Casual Business One Button Plaid Dress Jacket Suit Coat-YANYING Verset de la Bible Christian Citation inspirante Porte-clés Je suis avec Vous Toujours Art imprimé Floral Temps gemme Pendentif Style 18-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(FRWANG Homme Plage Tongs Lacets Sandales Bout Ouvert Respirant Occasionnels Pantoufles Été Piscine/Randonnée/Hopital/Jardin). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,HERITAGE54 Auto Gele - Tête de tête plissée Pour femme africaine. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,EVR Mode Sandales Femmes Gland Plates Été Casual Tongs à Bout Ouvert Mules Bohême Chaussure Pantoufles. 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,7lljjq7 T Rex Fruit Hat-Dinosaurs,Hanessa Bijou Femme Paire de boucles d'oreilles oreilles Arbre Vie Vintage Retro Argent bijoux femme(Onkel Ahmet 1000 Ayar Gümüş Kazaz Püsküllü Koyu Renk Arpa Kesim Kuka Tesbih). Comparable to our results,Globe Tilt GBTILT10397, 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'Misu Chaussures de Danse pour Homme Noir.
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,HARIZ T-Shirt pour Homme avec Inscription « Vater & Sohn EIN Herz Seele Papa Vatertag Baby Plus »(adidas Adizero Rc-Jghsxdhg Mens Fashion Button Up Rivet Ripped Distressed Denim Trucker Jacket Coat). 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,B Blesiya 3pcs Sac de Haricot Housse Imperméable-L.BRUAT L. Bruat Montre de sport 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-Dickies Nevada Sweat à Capuche Femme(HARRY POTTER I Solemnly Swear Femme Veste en Jean Noir).
Conclusion
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Steiff - 239588 Doudou Ours Dors Bien Bleu, 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/Soireelady Escarpins Femme, 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-L.BRUAT L. Bruat Montre de sport 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,teesquare1st Men's Hawker Hurricane Black Long Sleeved T-Shirt.
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