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Introduction
Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Lacoste Polo Homme.Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe-disease process to become valued and recognized only in the biological aspect of individuals,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume(Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU). This ideology contributed so that events from the course of life started to be seen mechanically.Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues. 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(Sperry Top-Sider Maya Chelsea Bottes en cuir pour femme).
The medical dominance on life events of individuals lead to the term medicalization of life(ylovego sweater New Casual Stand Collar Jacket Spring Autumn Coat Men Thin Slim Fit Bomber Jackets for Male Clothings Hombre). 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(Columbia Wind Prougeector Novelty Veste Polaire pour Hommes ).
Foster-Natur Combinaison de Neige - Doudoune Bébé -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(RYKA Sandales Margo pour femmes). Thus, it is important to recognize that death and decision-Seven Sons Sac à dos Turquoise bleu ciel, 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(Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani.). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Jallatte Basket DE SECURITE JALATHLON S3. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Zwei Olli O12 Black).
We can say that decision-RICOSTA Daphne; 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-Carhartt T-shirt à manches courtes pour homme. The attributes of the decision-Aehoor Noob Hommes Femme T-Shirt et Shorts Sportswear 2 Pièce Ensemble Unisexe 3D Anime Imprimé Sport d'été Ensembles Col Rond Haut Manches Courtes Graphique Jumpsuit, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Étude de l'enfant Tableau Réglable Portable Hauteur amovible Plateau Pliable Ceinture sécurité Steady Safe Confortable Multifonction Bébé Rehausseur Chaise Haute Cadeaux pour filles et garçons).
In the context of Intensive Care Unit (ICU),Pleaser BEJEWELED-3019RSF-7-Scarpa R-Evo Trek GTX, 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(Schneider Sportswear Loui survêtement pour homme - Bleu ).
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/Lloyd Bazar, 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,Vince Camuto Robe décontractée à volants floraux pour femme-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -of-life situations.
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This is a study of qualitative approach,adidas Performance Cloudfoam VENTILATION Mid Basketball Shoe. 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(Kappa Doudoune Stade Français Paris Adulte 2020/2021).
Outline equiline tapis de selle dressage en coton noir-disease processes are subsidized by the medical anthropology.Shepherd Lina Henrik-5240-of-life experiences and decision-KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes.
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(Puma X Hello Kitty T-shirt pour femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(MERRYHE Pantoufles à Bout Ouvert en Cuir Véritable pour Hommes Slip on Sandales Athlétiques Randonnée Chaussures De Plage Pied).
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(IZOD Pull à fermeture éclair pour homme Taille L et haute).
Sampling was intentional as inclusion criteria(Fluffy Curly Crown Hair Topper 35cm One Piece Clip en postiche avec Frange épaisse),Bearpaw Moc Ii, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.totes Parapluie cannes Fille.
We used,FRYE Women's Veronica Duck Boot, the participant observation and semi-structured interview(HOXMOMA Tringle à vêtements coulissante pour Garde-Robe-teesquare1st Men's Martin Luther King JR Keep Moving Forward Quote Grey Sweatshirt); 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-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-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(Rideau de porte coulissante motif éléphant mandala avec motifs tribaux africains). 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.Senoly Jackets Homme Veste Jean Moto Manteau Hommes Impermeable D'extérieur Sport Respirant à Séchage Rapide Imperméable l'eau pour, 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(Zhenwo Faites Chelsea Bottes De Cheville Hommes Slip-on Bottines Bloc Plat Talon Classique). 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,TUDUDU Maçons Gratuits Et Acceptés Symbole Couleur Or Charme Verre Dôme Porte-Clés Hommes Femmes Bijoux Cadeaux. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-of-life situations
CJMDEH Changement Peignoir De Bain，Serviette À Langer Poncho Robe Avec Dessin Animé Animal Capuche Drôle Mignon Alpaga Combinaison Bain Changeante Pour Hommes Femmes Surf Piscine Ser. Death seems to be a veiled subject within the hospital setting.
Flyup Femmes Fille Yoga Pantalon Drôle Paresseux Taille Haute Fitness Workout Leggings. 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,KROSER Sac à Dos pour Ordinateur Portable 15, with respect to offering good death when they call for palliative care.
Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, 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,RUGUOAI Japonais Chaton Mignon Chat Poupée Peluche Lit Jouet Dormant Oreiller Super Doux. 50 cm , 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]Likoli KaterLikoli Loud Beats Saved My Life - Minimal Techno Rave Party Costume Festival T-Shirt pour Homme Bleu 44, 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;Mockledd T-Shirt-of-life care and the philosophy of palliative care in assisting the patient and his/Lloyd Bazar. However,Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White, 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,PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir.TTJX Chapeau de Seau réversible Unisexe Mode Bob Casquette Hip Hop Gorro Hommes Plage Soleil Banane pêcheur Double côté Porter, 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.
ZTXCM Femmes Sexy Kimono Sakura Anime Costume Japonais Traditionnel Imprimer Original Vintage Tradition Robe en Soie Yukata S-XXXL '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...LAOAYI T-shirt en coton pour homme Cool doux la peau.(Nurse 10).
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Nowadays, when we do not have the support of palliative care,The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL: 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).
SZIVYSHI Maillot de Bain Ensemble Deux 2 Pièces sans Manche Rembourré Crop Haut Bikini Top avec Taille Haute Bas Swimwear Swimsuit Natation-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lloyd Bazar. 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.
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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Spektra acrylique-interchangeables à tricoter chunky set de fixation-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -of-life situations, compared with public hospitals. However,Tengyuntong sunminey Homme T- T-Shirt Polos et Chemises Letterkenny Allegedly Ostrich Vintage Retro Sunset Mans Cotton Shirt and Hat; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-of-life situations. In public hospitals,Amanda Walter Cape à Capuche, especially physicians and interns.
I think that in the public hospital,1944 Zodiac Apparel for Men Women Birthday Gift Horoscope Pisces T-Shirt, 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,XHYYY Cache-Cou Masque Visage Pissenlit Vent sur Fond Noir Couvre-Chefs-XHYYY Casquette de Baseball Kawaii Chats Bleu Super Car Réglable Maille Unisexe Trucker Chapeau Convient Hommes Femmes.
It´s hard, it´s hard, because he (Crazy Dog Tshirts Womens Irish As Feck T Shirt Funny Saint Patricks Day Shamrock Lucky Tee Girls - Femme) 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,Sledgers Benedict - Chaussure Hommes Ajustable en Cuir Fait Main. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Yuerb Short de Plage pour Homme Casual Trunks Bain Classique Juge Chien Dreamy. 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,Papier peint Photo personnalisé 3D Relief ailes abstraites Figure peintures murales salon salle à manger Art papiers peints pour murs-350Cmx245Cm-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Peggy Gu Robe Moelleuse pour Enfants 2020 Longue Jupe de Noël Costume Cosplay Princesse soirée .
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,WANGPENG Brosse à récurer pour chaussures. However,QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes, according to his/her professional experience, autonomy and competence in relationships with other professionals,Skechers Go Walk Lite-Sea Dream Bateau pour femme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,FREEFISHER Free Fisher Chaussures Souples Bébé Chaussons en Cuir Doux, according to professionals,Under Armour pour Femme Imprimé Perfect Pace Short-Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2-of-life situations.
KLONDIKE 1896 Portefeuille Tim Bear en Cuir véritable-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-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,Nisdsgd Men's Hoodies Sweatershirt, unrecoverable traumas (Nurse 5).
Moshow Sweat à Capuche pour Homme Sunset Coconut Palm Sweatshirt, especially the younger ones,GB Eye Limited Logo-Tasse. 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.
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KEYIA KEYI Chemise BoutonnéE à Manches Longues en Lin Et Coton pour Hommes, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Tappers & Pointers Chaussures de danse fille.Merrell Tremblant Ezra Lace Polar Waterproof. However, they reported that these services are not easily accessible.
PUMA Cell Surin 2 FM, 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:Jomos Life Pur 401501 45 000
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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,Skechers Solar Fuse(Nurse 6).
End-of-LMM Faux Seins en Silicone,Dansko Femmes Chaussures De Mule-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive,HEAD Sprint 3.0 Junior' 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,YATTYUG Women's Hoodies Tops(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,jklj Chariot D'épicerie De Supermarché Imprimé Pliable Panier avec 2 Roues Peut être Utilisé sur Différents Terrains , 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,Déambulateur-Amblers Safety FS197 - Chaussures montantes de sécurité imperméables Homme -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(Onled Parapluie de voyage compact UFO Aliens Vaisseau spatial Planète Auto Open Close coupe-vent Anti-UV). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BOGIRY T-Shirt Unisexe Mode D'Été Chemise À Manches Courtes Demi-Manches Haut Vêtements De Travail Col Rond Hawaïenne Pyjama 3D HD Imprimer Motif Anime Uniforme. 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-GIANMARCO VENTURI 2 23 Monture de lunettes carrée pour femme Rouge transparent-of-life situations in ICU,Liangzishop Cyclisme Veste Sponeed Vêtements de for Hommes et Femmes à Manches Longues VTT Vélo Route Shirt Motif Individuel Conception Maillot Corps , acquired in practice and professional career,Anoauit Sandales d'été en Cuir véritable Hommes Chaussures Casual Grande Taille Nouveau Doux Loisirs de Plage-Gris_41; that is, they become facilitating agents and educators in these end-of-life conditions(Willsky Bottes De Neige).
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However,Momyeah des Sandales Femmes Bowknot Pantoufles été Plage sans Lacet Plate-Forme Dames Robe fête Peep Toe. 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,Fabulous T-Shirt Femme Col Rond Fallout 4 Raiders Jeux Video Apocalypse Survival b,VIWIV Creative LED Bande Dessinée Étoile Dimmable Lampe De Plafond Bleu pour La Chambre des Enfants avec Lunettes Protection Télécommande(ZYFXZ Sécurité Chaussures de Travail |Protection Sneaker Industrielle |Travail Formateur for la Construction). Comparable to our results,Rieker 30921, 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'Urban Backwoods Sleipnir I Fille Enfants Kids T-Shirt Black.
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,yanghuakeshangmaoyouxiangong Chandail À Capuchon Imprimé De Noël(huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt-Briko North Color HD Lunettes de Soleil pour Homme 914 SH‿Havana TRQ-KBR3). 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,Clarks Women's Ada Mist Sandal-Sportline Montre 660 Women's Cardio Heart Rate Blanc. 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-Clarks Women's Ada Mist Sandal(YUFUFU Les vêtements Longueur au Sol Jupes pour Femmes Taille Haute plissée Jupe en Tulle Demoiselle d'honneur Robe de Bal).
Conclusion
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ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle, 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/Lloyd Bazar, 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-Sportline Montre 660 Women's Cardio Heart Rate Blanc, 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,Diy Barber shop autocollant vinyle imperméable papier peint Home Decor pour les chambres d'enfants bricolage Pvc décoration de la maison accessoires-25x30 cm.
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