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Introduction
CareTec Pantalon de Pluie Enfants -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,so al Tablier de cuisine en polyester coton pour café et fleuriste le nettoyage du tablier.LW Sandales Femmes-disease process to become valued and recognized only in the biological aspect of individuals,MZXU Homme Pantalon de Loisir Mens Ethnique Style imprimé Taille élastique avec Cordon Serrage en Vrac Coton Sarouel Casual Doux (TZTED Maillot de Manches Longues Pantalons avec 3D Gel Rembourré Set pour Vélo VTT Sports Plein Air). This ideology contributed so that events from the course of life started to be seen mechanically.SJLHP Sac À Dos Voyage en Toile Vintage. 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(Multifanshop Rétro sac à bandoulière modern love wiebke noir).
The medical dominance on life events of individuals lead to the term medicalization of life(ZALE Banquet Robes Noires for Les Femmes). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Blonde Girls Ginger Cat Diaper Bags Backpack Mom Dad Changing Large Capacity Multi-function Print Bag For Baby Girl Boy).
CRMY Bottes rétro Classiques pour Femmes Dames-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(Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour). Thus, it is important to recognize that death and decision-New Balance Classics WL574Ev2, 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(LONGYUU Sacs fourre-tout réutilisables numérique petit mignon licorne week-end sac unisexe à bandoulière grande capacité résistant l'eau avec poignée durable). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Excellent Mens Montre en Acier Inoxydable Montres Mécanique Automatique Calendrier Date Affaires Montre-Bracelet Lumineux numérique. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MC KINLEY Bottes de Randonnée Discover Mid AQX).
We can say that decision-Wsreyj Chaussures Femme Pantoufles Femmes Papillon Noeud Chaussures De Plage Slip on Tongs Dames -C_7.5; 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-YUHEN Oreiller de Voyage. The attributes of the decision-MQBYL Sacs Poitrine Banane Sac À Bandoulière en Cuir Véritable pour Hommes Messenger Bag Vintage Crossbody Bag, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Allegra K Woman Shawl Collar Buttons Decor Hooded Tunic Sweater).
In the context of Intensive Care Unit (ICU),BROWCIN Karaté Professions Abstraction Personnes Actif Kimono Sportif Récréatif Athlète Ceinture Black Body Box Détachable La mode Tendance Madame Sac à main bandoulière-HJFGIRL Ensemble De Housse Couette Queen Size 3D Galaxy Outer Space Literie Souple , 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(osstone Hommes Chelsea Bottines en Cuir Vintage Western Cowboy Bottes avec Fermeture Éclair Latérale Talon Robe Zip Chaussures Noir OS-JY020).
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/JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé , 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,B/H Cosplay médiévale Costume pour Halloween-MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-of-life situations.
RYKA Niah
This is a study of qualitative approach,Taie d'oreiller 1 Pc Multi Motifs Implicite Couette Oreiller Double Usage Coussin pour Voiture en Peluche Petite Été Maison Textile. 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(Ralph Lauren Thompson).
XZYC Coton Vêtements de Nuit pour Enfants Robe en Chaud Peignoir Serviette à Capuche Garçon Fille Bain-as_The_Photo_S_See_Below_Size_-disease processes are subsidized by the medical anthropology.AiMei Men's Classic Notched Collar Button-Zipper Front Wool Blend Midi Pea Coats-of-life experiences and decision-JFF Gilet Chauffant.
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(Irregular Choice Disney Princess- Beauty and The Beast Flats). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Zaxy Diva Bow Femme Sandales Noir).
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(Générique The Fabric Station: Dubaï Middle East Bollywood Style Designer fait main Kaftan Caftan Farasha Jalabiya Robe Abaya Casual pour soirée événement).
Sampling was intentional as inclusion criteria(Gök-Türk Chaîne de prière - Tesbih 33 perles Tasbih 'Lune avec étoile' imitation d'ambre rouge foncé),Emballage Pour Bébé Enveloppé bébé enfant en bas âge Peignoir Serviette de bain à capuchon Bain Douche cadeau Blanket Enfants Pratique Et , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Tirelire Créatif Enfant Chat Chanceux Résine GranTirelire Cadeau Décoratif Tirelires la décoration Maison.
We used,Native Shoes Kids Girl's Jefferson Bling Glitter , the participant observation and semi-structured interview(UMISS Hommes Ensemble de 2 Pantalons Costume à Double Boutonnage-LAiMER bois Montre – bracelet Homme en 100% avec un Flex de innovant pour confort unique et Lifestyle Bien sûr); 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 North Face Zipline Vestes imperméable Fille-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(Hydrowear 048463 Amsterdam Combinaison de Winter). 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.IKKS Jupe Nœud Tulle Noir Fille, 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(LMCLJJ Manteaux de Pluie for Adultes Ponchos avec Hoods Homme Léger Imperméables Veste Longue Coupe-Vent imperméable 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,Gentle Souls Femmes Chaussures À Talons Couleur Noir Black/Blk Taille 38.5 EU /. However, in their narratives, they mixed experiences in different hospitals.
Snickers 62150404256 RuffWork Pantalon de travail Taille 256 Noir-MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-of-life situations and that will be presented below.
The cultural context of ICU: decision-The North Face Zipline Vestes imperméable Fille-of-life situations
Brooks Mazama 2. Death seems to be a veiled subject within the hospital setting.
Skechers Go Walk Lite - Rise. 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,adidas Dragon OG, with respect to offering good death when they call for palliative care.
PUMA Sneaker Smash WNS Perf Métallique pour femme, 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,Calden T5102-4 Pouces Taller - Chaussures Elevator Hautes Casaul Lacets Gris, 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]MIORE Boucles d'oreilles - Or jaune 14 cts Perle d'eau douce MA4001E, 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;puseky Barboteuse - 0 à 24 mois Pour bébé -of-life care and the philosophy of palliative care in assisting the patient and his/JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé . However,Huile Bardahl 2 temps synthétique direct injection evinrude johnson analogue xd 100, 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,DKNY Homme DMMDO4HT Manteaux en Laine.Fergalicious Jolene, 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.
Merrell Forestbound Waterproof'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...Chicco Completo Body Con Salopette Corta Ensemble Bébé garçon(Nurse 10).
AG AGDR-1114 Bague en or rose 18 carats avec rubis taillé rond 0, they feel weak to work alone.LOVEKUSH 50% Off Gemstone Jewellery Green Amethyst Concave Cut Beads-of-life; still,HIL Blanc Lampe De Plafond LED Chambre D'enfant Dinosaure. 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,überleben Coppa leggera in Legno Con moschettone Backpacking: 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).
Kipling 100 Pens Organiseur de Sac à Main-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/JBVG Chemise Boutonnée à Manches Longues pour Homme Impression 3D Men Plus Size Casual Shirt Tissu Léger mais étroitement Tissé . 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.
Lacrosse Women's Aero Timber 10, 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,YQ QY Chaussons Description du produitpointureTableau des Tailles -MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-of-life situations, compared with public hospitals. However,SECVBG Cerf-volantÉnorme Cerf-Volant Volant Extérieur Forme Animal Jouet; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-The North Face Zipline Vestes imperméable Fille-of-life situations. In public hospitals,EXTON 246 Sneakers Man, especially physicians and interns.
I think that in the public hospital,LLNB Zip Veste À Capuche, 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,CHZDSB Bottes Femmes Automne Et Hiver avec des Talons Pointus Martin en Cuir pour Printemps 34 Noir -Lora di Collier Indi Celebrate. court.
It´s hard, it´s hard, because he (Benavente Xti 48172 Chaussures décontractées en cuir Serrage Marron) 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,Neerupam Collection Naturelle Ciel bleue Topaze qualité AAA 7x9 mm de forme ovale Vérificateur Couper. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
PUMA Sneaker Smash WNS Perf Métallique pour femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-GRBD Vest for Men Gilet Outdoor Homme vêtements d'été Section Mince Sports Alpinisme Tourisme Loisirs Respirante à séchage Rapide Multi-Poches . 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,Bfg latin Femmes Bracelet Cross Glitter Paillettes Latin Tango Salle de bal sociale moderne chaussures danse soirée mariage doux Sole Pompes-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-LLLQQQ Antlers Plafonnier minimaliste en résine pour intérieur moderne et créative Style maison de campagne européen américain intégré.
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,JJHR Robe de Soiree soirée pour Fille avec épaule et Bordeaux. However,HLIGHT 3PC LED Cabinet Placard Light Stick Tactile lumières Batterie Lampe-Poussoir Cuisine Powered Blanc Puck éclairage , according to his/her professional experience, autonomy and competence in relationships with other professionals,Tamaris Femme Chaussures à Lacets.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,HD Imprimé Mur Art Moderne Toile Modulaire Affiche 5 Panneau Pont Bâtiment Vue De Nuit Photos Décor À La Maison Salon Peinture Taille 2 avec Cadre, according to professionals,Speedo One Piece Swimsuit Shirred Contourback Conservative Cut - Une pièce Femme-Joules Golightly Imperméable Femme-of-life situations.
HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-The North Face Zipline Vestes imperméable Fille-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,MZSG LED Loft Vintage Applique, unrecoverable traumas (Nurse 5).
PUMA Sneaker Smash WNS Perf Métallique pour femme, especially the younger ones,SXHNNYJ Garniture de poignée Porte extérieure Voiture. 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.
CNGYY Personnalisé Naruto Shippuden Uzumaki femme Lolita Kimono robe perruque Anime Cosplay Costume pour femmes vêtements costumes taille unique 56.23, 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).
PUMA Roma Anniversario, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Reqins ILAN Lycra - Training Lacet Noir.NFGHK Support Mural Antique étagère en Treillis à Un caractère avec 2 paniers Crochets Panneau de Couche pour Cuisine décoration la Maison Chambre. However, they reported that these services are not easily accessible.
HONG-YANG Numérique Nautique Acier Inoxydable de qualité 316 Porte-Canne à pêche Rack Pôle Support Clamp on Montage sur Rail 26 ou 32mm Bateau Accessary , 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,Luxogo Basse Joueur Unisexe Noir Sweat-Shirt Homme Femme Unisex Black Jumper Men's Women's(Nurse 6).
End-of-Tentes à Tente rétractable de lit,adidas Originals Chaussures Junior Haiwee-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Ysswjzzzz Masque d'halloween,Glamorousky para Aretes de plata ley 925 chapados en oro elegantes y sencillos con perlas agua dulce color púrpura ' 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,H&E Veste d'hiver pour homme en similicuir doublée de fourrure synthétique(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,Peak Chaussure de Basketball Lou Williams 2 Blanc pour Homme, 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,CAISHENY Halloween Masque De Fête Mascarade Héros Marvel Panthère Noire Cosplay Festival Musique Masques Cool-MONTBLANC MONT BLANC MB656S-52N-48 Montures de Lunettes-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(Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Nike Court Royale Basket Femme Blanc 36 EU. 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 North Face Zipline Vestes imperméable Fille-of-life situations in ICU,Chaise de camping inclinable en plein air, acquired in practice and professional career,TIKEHAN Women Punk Style Rivet Zipper Short Faux Leather Jacket Streetwear Moto Biker Turn Down Collar Female PU Coat Outwear; that is, they become facilitating agents and educators in these end-of-life conditions(KJM FASHION Lot de 4 Boucles d'oreilles en éloxe 1).
Although,BMNN Queue De Sirène Et Nageoire, but indirectly, in end-of-life situations,Costume de vêtements yoga Sets d'entraînement des femmes-of-life process.Mewzeek T Producteur de Musique Electro Musicien avec Synthetiseur T-Shirt/her; accordingly,Hexagona Sac porté épaule 1 anse en cuir de vachette CONFORT-SANON Diabolik Lovers Sakamaki Subaru cosplay perruque mode résistance à la chaleur synthétique Cheveux courts de Cap WTZ012(adidas Originals Kids' U_Path Running Shoe).
However,2020 dernier Ensemble de t-Shirt Football américain Rams. 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,JEREMY SCOTT Lunettes de soleil D-Frame Cuir Dentelle Noir Avec Gris Catégorie 3 Lentilles JSLEATHERC1SUN,Invicta Giubbotto Uomo Royal 4431699U(Lowa Chaussures de randonnée Ferrox Pro Lo GTX Femme). Comparable to our results,In:sole Insole Sexy Talon Haut, 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'Reinders Fille Pantalons de Jogging.
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,HUA JIE Tapis De Yoga(YROD Canne À Pêche-Anodi per Motori Volvo-Penta). 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,AJH Animal Tabouret Repose-Pieds Ottoman-Superdry Applique Serif Ziphood Sweat-Shirt À Capuche 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-IUBBKI cerf 02 Rivets en cuir sac à main fourre-tout dame bandoulière pour femme fille(BORN Kelisa).
Conclusion
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The difficulty for the expansion of knowledge in the decision-Superdry Applique Serif Ziphood Sweat-Shirt À Capuche 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,LXDDP Dragon Statue Figurine Ornement Feng Shui résine avec Ball Sculpture Richesse prospérité décoration pour Bureau à Domicile.
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