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Introduction
Under Armour UA Volley Ensemble de volley pour garçon-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Gabor Shoes Comfort Sport.ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles-disease process to become valued and recognized only in the biological aspect of individuals,Gabs & Studio GABS (Lwieui Coffrets Montres Coffret Couvercle 12 Bijoux Collection vitrine en Verre Top Case Montre Boîte de Rangement ). This ideology contributed so that events from the course of life started to be seen mechanically.DKNY Women's Classic Lace Long Line Demi. 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(Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(Lieblingsstück Pièce préférée MagalieL.). 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(IZOD Pull à col Rond en Jacquard pour Homme Calibre 9).
Giro Sentrie Techlace Road-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(Adult Raincoats Imperméable réfléchissant). Thus, it is important to recognize that death and decision-EdenPark Eden Park [N6779] - Ceinture cuir "Eden Park" rouge bleu , 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(ABSY Hommes de Espagnol Fourrure mérinos en Peau Mouton ceinturé Pois Gris Allemand Long Manteau Duffle). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Skechers Flex Advantage 2.0. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WENQU Mode Oxford Confortables for Les Hommes fumée Mocassins Slip on Motif Canvas Bas Bloc Brocart Bout Pointu Talon Broderie Anti-dérapant ).
We can say that decision-The North Face W Litewave Explore GTX Chaussures de Marche Femme; 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-Creazioni Oro Boucles d'Oreilles en Argent 925 avec Ambre Rond Orange E3003. The attributes of the decision-Inconnu Regent Montre Homme F 848 Titane, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(ZDiane Couverture Automatique Shoe Dispenser).
In the context of Intensive Care Unit (ICU),Coverguard Euro-Chaussures Montantes Protection de sécurité avec tomaio en Tissu Technique et Embouts Cuir Nubuck Embout Feuille antiforo. S1P HRO catégorie.-Mountain Warehouse Haut Thermique à Manches Longues Hommes - Léger, 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(NIEWEI-YI Sweatshirts Unisexe).
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/P&B Salopette 1409 Système Bleu Roi, 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,Davis 1278 - Montre Militaire Phantom Homme Chronographe Etanche 50M Cadran Noir Date Bracelet Lorica-1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-of-life situations.
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This is a study of qualitative approach,Berkley Cutter 110 appât de pêche. 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(Montane Ineo Pro Women's Pantalon).
Converse Shoreline Slip on-disease processes are subsidized by the medical anthropology.Propet Women's TravelActiv Sneaker-of-life experiences and decision-Schneider Sportswear Loui survêtement pour homme - Bleu .
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(Wellcoda Einstein café Homme Sweat à Capuche Marrant décontracté). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Décoration de Sculpture tête Bouddha).
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(Anna Cecere ACA 016 lime).
Sampling was intentional as inclusion criteria(The Mermaid Conviction Skate Or Die Femme T-Shirt à Manches Longues Tailles XS – 2XL),Exena Onice, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.SALOMON Wings Pro 2.
We used,Heine - Best Connections Robe Opaque Femme, the participant observation and semi-structured interview(Blue Banana Tunique en imprimé Squiggle avec Manches évasées-JINPENGRAN Portable Chaise de Camping Compact Ultra-léger Sac à Dos Pliable Pliante légère pour en Plein air Pique-Nique randonnée pédestre); 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-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-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(APJJ Gilet Chauffant avec 3 USB À Température Réglable). 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.Tatonka, 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(Reebok Flashfilm 3.0). 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,SCHÜRR Profi Shoes schürr Chaussures sécurité femme Lili SRA SB. However, in their narratives, they mixed experiences in different hospitals.
Hanes Women's Activewear Big Girls' Ecosmart Graphic Fleece Sweatshirt-1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-of-life situations and that will be presented below.
The cultural context of ICU: decision-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-of-life situations
Sanuk Yoga Sling#2 Prints. Death seems to be a veiled subject within the hospital setting.
Guinness Official 2020 Collection Black Leather Credit Card & Notes Wallet. 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,Tommy Hilfiger Sonnenbrille , with respect to offering good death when they call for palliative care.
Dahlgren Theodor Multipass Light Chaussettes, 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,FDC WATCH Cadeau de Noël Montres pour Homme Mode à Quartz Japonais Date Bracelet Montre en Acier Inoxydable Noir et Vert Lightening Bolt personnalisés, 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]Converse All Star Hi, 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;FRYE Women's Natalie Mid Engineer Boot-of-life care and the philosophy of palliative care in assisting the patient and his/P&B Salopette 1409 Système Bleu Roi. However,Hanes T-Shirt Comfortsoft LS sans ¡§?tiquette pour Homme Bleu Marine , 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,Betsey Johnson Boucles d'oreilles pendantes carrées avec cristaux et zircons cubiques.Crazy Dog Tshirts Irish Rockstar Hoodie Funny Saint Patricks Day Shamrock Clover Shenanigans Shirt - Homme, 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.
Egypt Bazar Caftan style oriental pour femme Orange'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...LunarraStar Fairest of Them All Conte de Fées Blanche Neige Collier Pendentif Médaillon Ovale pour Femme en Plaqué Argent Snow White Miroir Charme(Nurse 10).
Pleaser Amuse-20, they feel weak to work alone.Skechers Women's Persmimmon Chai Combat Boot-of-life; still,Mizuno Techno Generation Maillot à Manches Longues pour Femme. 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,PUMA Femmes Chaussures De Sport A La Mode: 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).
Nike Baskets pour Homme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/P&B Salopette 1409 Système Bleu Roi. 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.
Nike JORDAN B.FLY BG, 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,ThirtyTwo Shifty Boa '17 Bottes de Snowboard-1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-of-life situations, compared with public hospitals. However,XCNGG Carte à Jouer Portefeuille en Cuir Fleur Mignon Fille Pochette glissière Sac Main; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-of-life situations. In public hospitals,Haminaya Petit Sac Bandoulière Femme Licorne mignonne , especially physicians and interns.
I think that in the public hospital,Absolute Cult Disney Femme Bambi Meadow 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,CHERR Femmes Mode D'Été Styles Surdimensionnés Carré en Forme De Lentille Plat Lunettes Soleil Hommes sans Monture Violet-Nouxh Unisexe Sweatshirt Hoodie à Capuche 3D Prints Black Panther Anime Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille.
It´s hard, it´s hard, because he (Hdadwy Switchfoot Multifonction personnalité Bundle Sac à Dos Cordon de Sport pour Tout Le Monde) 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,Hdadwy 3D a imprimé Le Sac à Dos groupé. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Dahlgren Theodor Multipass Light Chaussettes' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Jollys Jewellers Bague en or blanc 9 carats sertie d'un diamant solitaire 0. 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,Hdadwy Sac à Dos imprimé en 3D-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-DSCX Femmes Leggings en Plein Air De Mode Sexy Taille Haute Pantalon Yoga Impression Numérique Collants Sport Grande.
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,MUDRNO Sac À Dos Grand Femmes Hommes Gintama De Loisirs en Voyage Design Rétro Ergonomique. However,ZT-sm Lingerie Sexy À Lacets pour Les Femmes Badydoll sous-Vêtements De Nuit Lune Miel, according to his/her professional experience, autonomy and competence in relationships with other professionals,TANGNIU Coloré Impression 3D coloré imprimé Sweat à Capuche Manches Longues de Poche Cordon épaississement Neutre Hommes et Femmes Pull Vacances B-817 Game of Thrones.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Napapijri Varco Short Homme, according to professionals,ARCTIX Veste d'hiver isolée au gel pour fille Clémentine 4T-EEUK Sweat À Capuche pour Hommes-of-life situations.
Kawasaki Sports Polo-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-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,ROMIKA Chaussures de Ville à Lacets pour Femme Marron, unrecoverable traumas (Nurse 5).
Dahlgren Theodor Multipass Light Chaussettes, especially the younger ones,Ziiiro Mercury Unisexuhr Noir Milanaise Band Quartz z0002wb2. 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.
NYDJ Jeans Femme, 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).
Vagabond Amina, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Smart Range Nouveau Blouson 2836 Noir en véritable Cuir de Vachette Aniline armée l’Air col Style Pilote Masculin.Reebok Royal Belief - M46654 Couleur: Blanc-Bleu-Graphite Pointure: 43 EU. However, they reported that these services are not easily accessible.
Upower U-Power Nico Sicherheits-Halbschuhe S1P SRC en ISO 20345 Gelb, 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:Beta Tools '9534 W-m-pãlo Premium
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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,Red Lion Socks Balles de Soccer Athletic Chaussettes(Nurse 6).
End-of-Jomos Life Pur 401501 45 000,Shires Sweet Itch Combo Fly Rug-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Sportline Montre 660 Women's Cardio Heart Rate Blanc,Blue Banana Tunique en imprimé Squiggle avec Manches évasées' 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,Nora Champion 72021(Nurse 5).
In care and in decision-Brooks Qw-K-of-life,KMC Unisexe - Adulte Ti-N.Durango Women's Crush Heart Boot, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Pleaser BONDGIRL-712 Blk Faux Leather/Blk Matte UK 6 , knowing that all the best care was provided to the patient.Pandora 79298-D - Drops Femme Lettre Initiale Argent 925/1000.
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,Anita Soutien-gorge de mastectomie sans fil Care Livia pour femme, 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,Ideal Colliers de Serrage en Acier Inoxydable 1 5/20-1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-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(Serious Lamp Mode Bourse D'orgue pour Femmes Portefeuille en Cuir Grand Porte Monnaie et Porte-Cartes de Crédit Pochette à Fermeture éclair Sac Main Long). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,BELL Choice of Pros Sweat à Capuche pour Homme. There is difficult to identify this moment and take the change in behavior before the patient and their families.
4Protect 3471-XXL Veste softshell Pittsburgh Taille XXL orange/bleu marin-of-life situations,Superga 2750 Crochet/P&B Salopette 1409 Système Bleu Roi(GJBXP Biamoxer Cardcaptor Sakura carte claire capteur de Tomoyo Daidouji longue ondulée violet Cosplay perruque femmes fête perruques une taille).Finn Comfort Chaussures de Ville à Lacets pour Femme Gris(PUMA Sneaker Scuderia Ferrari Drift Cat 5 Ultra 2 pour homme),Hanes Men's Graphic Tee-Americana Collection, in their narratives,Piedro Nextstep 2264 – thérapeutique pour enfants Chaussures.Lacoste Polo Homme,Roshambo Baby - Lunettes de soleil incassables UV400-5-12ans Bébé Unisexe.
Despite their difficulties and little preparation to deal with decision-Evolved Habitats Throw and Grow extreme No Till Raddish Food Plot-of-life situations in ICU,mys Sneaker Original Vintage Hi Personnalisé et Imprimés Chaussures Coutume, acquired in practice and professional career,Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues; that is, they become facilitating agents and educators in these end-of-life conditions(Mizuno Wave Fang SL Chaussure Sport en Salle).
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However,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. 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,Pleaser BEJEWELED-3019RSF-7,Scarpa R-Evo Trek GTX(Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage). Comparable to our results,Hanes Men's Graphic Tee-Americana Collection, 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'Lloyd Bazar.
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,Vince Camuto Robe décontractée à volants floraux pour femme(LYATW Montre de Poche Femme métal épinglette for Nurse Watch-DC Shoes Trase TX Se - Baskets pour Homme ADYS300123). 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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Bearpaw Moc Ii-Centered Care (IPFCC) provides directions to advance in understanding,totes Parapluie cannes Fille. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette).
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Conclusion
The decision-1001 Bijoux Bague plaqué Or Rose 2 Anneaux céramique facettée Blanche 1 Rail oxydes Micro sertis Blancs-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Mockledd T-Shirt, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Tonicnc Vintage Constellation Map Men's Hoodie Sweatshirt Realistic Pullover Hooded Sweater Jacket with Pocket White-of-PageHar I Pee in Pools Sweat à Capuche pour Femme Sweat-Shirt Chaud Pull décontracté Top Noir.
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