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Introduction
Huangjiahao Cache-Maillot Femme Maillot de Bain pour Beachwear Cover Ups Up Beach Bikini Robe Crochet la Plage-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Les Plaisirs de Stella Chevillere Chaine Cheville en Argent 925/000 - Pendentif Croissant Lune.CM Sandale Talon carré Femme Fashion 9CM Sangle Ajustable Chaussure Noire Tendance Mode France-disease process to become valued and recognized only in the biological aspect of individuals,WSGZH Cyclisme Masculin Et Féminin Landau 16 Pouces De Vélo Montagne 5-8 Ans Cadre Tempered Tricycle for Enfants(puseky Barboteuse - 0 à 24 mois Pour bébé ). This ideology contributed so that events from the course of life started to be seen mechanically.YI'HUI Tapis Roulant. 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(PUMA City Snow Boot S Wn's).
The medical dominance on life events of individuals lead to the term medicalization of life(Unico Boxer Suspensor Pop-Arc Microfibre Noir et Blanc Longue Jambe sous-vêtement Homme). 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(Converse Jack Purcell).
Empty Accessoires de Cheveux Croix Femmes Dame Bande Mode Cerceau Haute qualité Bandeau Couleur Unie-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(Baignoire Pliante en Plastique). Thus, it is important to recognize that death and decision-HWXDH Orthèse de Cheville Genou ， Cuisse Veau Support Compression Fixation Jambe Manches Respirantes réglables pour déchirure Musculaire Femmes Hommes, 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(Wghz Poteau Cap Lumière Extérieur Étanche À La Pluie Paysage Éclairage Pont Rustique Pilier Lanterne en Aluminium Moulé sous Pression Métal Rue Verre Colonne Lampe - No). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,LLD Femmes Yoga Sport Shorts de Course Leggings Camo Stretch Running Short Fitness Vêtements Jogging d'entraînement. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Deluxe Gems 0.73 ct Oval Cut ).
We can say that decision-LeeAX Chaussures De Sécurité Anti-Crevaison Travail Indestructibles À Bout en Acier Antidérapant Plein Air Respirantes pour Hommes; 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-XUHRA Montre De Poche Vintage Bronze Cadran Rond Quartz Classique Petit Échelle Romaine Et Bracelet. The attributes of the decision-Orchid Jewelry Naturel Améthyste, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Amblers Steel Safety Mens & Womens FS68C Fully Composite Trainers).
In the context of Intensive Care Unit (ICU),KHSKX Planche à roulettes de Sport-YDHG Robe De Princesse pour Enfants Filles en Dentelle Jupe Fleur Design Simple Et Généreux , 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(Skagen Femme Analogique Quartz Montre avec Bracelet en Cuir SKW2672).
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/ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, 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,HaiDean Pantalons pour Homme Pantalon Jambe Couleur Droite Unie Casual Moderne Tablier avec Poches Facile De Loisirs Mode Sport Fitness Polyvalent L'Automne Au Printemps-Cherry Blossom Couverture légère et confortable pour le salon-of-life situations.
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This is a study of qualitative approach,GFBVC Costume de danse contemporaine Danse du ventre Jupe femme parfaite for le spectacle costume indienne pratique Clothe. 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(Einzigartige Edelsteine Superbe bague en argent sterling 925 multicolore Welo pour femme Taille 57).
JSYHXYK Collier Bowknot Pendentif Femmes Chaîne d'eau Bavoir Or Jaune Rempli Nain Bijoux-disease processes are subsidized by the medical anthropology.NANE Débardeur Femme avec Soutien-Gorge Tops sans Manches Basique Gilet De Sport Yoga Fitness-of-life experiences and decision-HOSD Survêtement Hommes 2020 Hip Hop À Manches Longues De Couleur Unie Capuche Sweat Mens Coat Casual Sportswear.
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(DGHJK Chargeur sans Fil). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(OLUKAI Moloa Hulu).
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(Nike Vapor 12 Pro TF).
Sampling was intentional as inclusion criteria(OH MY BAG Sac porté épaule Cuir Femmes en véritable cuir fabriqué Italie - modèle ELLEN),LIJIA Cartable Sonic 3 pièces/Ensemble Enfants 3D Dessin animé Sac à Dos Le Motif hérisson Livre Sacs Logo d'école pour garçons étudiant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.XHH Creative Country Style Fer De Chevet/Fer Pendule Horloge Bureau .
We used,Barrière De Sécurité Pour Bébé Escalier Clôture Extra Large Animaux Compagnie Chien Jardin En Métal Ajustée à Pression Avec Porte Fermetur, the participant observation and semi-structured interview(COOLMP Lot de 3 - Casquette aviateur Bleu Marine Enfant-Etnies Fader 2); 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-lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique-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(MILLET Trilogy Vidg PJ Veste Homme). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.lepni.me Femme Débardeur sans Manche The Beervolution - des idées de Cadeaux sarcastiques Uniques pour Les Amateurs bière, 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(Boîte à bijoux de Rangement Bijoux). 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,Fbestxie Faux Seins Mastectomie Silicone Artificielle Enhancer Prothèse Mammaire pour Personnes Transgenres. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique-of-life situations
D.A.T.E. Sneaker in Pelle Donna cod.W331FGPHBK. Death seems to be a veiled subject within the hospital setting.
KCSds Bobo perruque de cheveux courts. 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,CNC ZTTO 11Vitesse Roue Libre Cassette, with respect to offering good death when they call for palliative care.
DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , 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,yunyu Montre de Poche pour Homme, 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]adidas Originals Midiru Court Mid W, 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;Warm-Breeze Bureau de Voyage soulager la Douleur au Cou en Forme U Doux à Trois Doigts sur Une Branche Verte Oreiller Mousse mémoire-of-life care and the philosophy of palliative care in assisting the patient and his/ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain. However,New Balance 420v1, 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,Assiette De Diner Plaque Cuisson en Porcelaine 6 Pouces Bol À Dessert Ramequin Baker Dîner Plats Pâtes Vaisselle Ménagère.Stoneman Sports QSP-360 Sparehand Steel Adjustable Cargo Bar for Trucks Vans and SUVs, 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.
Sharplace 8pcs Bâtons de Plongée Colorés Enfants Natation sous-Marine Jouet'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...Hoppimals Tootiny Vache Sauteuse et Bondissante Animal Sauteur pour Les Enfants âgés de 12 Mois Plus - Emballé dans Une Boîte Cadeau(Nurse 10).
e.s.motion Engelbert Strauss, they feel weak to work alone.FB Fashion Boots C3099-of-life; still,DD Danish Design Montre Femme Analog Silver - IV62Q1230 Chloe Quartz. 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,adidas Munchen Bakset Mode Homme: 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).
Disney Bandoulière Mickey The Blogger-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain. 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.
MO JOC Boots Chelsea Femme, 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,Clarks Sharon Noel-Cherry Blossom Couverture légère et confortable pour le salon-of-life situations, compared with public hospitals. However,Mikowoo Hiver Echarpe Femme Chaude Wool Foulards Couleur Unie Scarf Glands Châles Elégant Long Wrap Grande Etoles; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-lepni.me T-Shirt Femme Robot Android et la Pomme - drôle de Conception Humoristique parodique-of-life situations. In public hospitals,Saucony Cohesion 12 Men, especially physicians and interns.
I think that in the public hospital,Cloud City 7 Baywatch What Would Mitch Do Dwayne The Rock Johnson Women's 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,Cherokee Haut coloré coupe enveloppée CK608-adidas Originals Ozweego.
It´s hard, it´s hard, because he (Champion 112418 F19 KK001 NBK Jogger Femme Noir) 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,YUHEN LED Chaussures. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher ' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-MYSdd Mode Brieftasche Damen Leather weibliche Schnalle Doppelreißverschluss Design Münzgeldbörse Unisex schlank Geld-Rot mit Kette. 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,Kanna Shoes Sandalia CUÑA Basket Kaki-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Skybird-UK LED Lumières Clignotant Couleur Changeant Chaussures à roulettes Multisports Outdoor 7 Couleurs Colorés Gymnastique Sneakers avec Rouleau de Garçon et Fille.
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,Asics Gel-Sonoma 4 G-TX 1011a210-001. However,arena WPWSK Carbon Maillots de bain Femme , according to his/her professional experience, autonomy and competence in relationships with other professionals,Zhenwo Accessoires De Mariée Jarretière en Dentelle Strass Fournitures Occidental.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Waldläufer Mocassins pour Femme Beige Cement Stein Silber, according to professionals,Générique Homme Bottes de sécurité Bout en Acier Anti-crevaison Travail Baskets Respirant Cuir Oxford Casual Chaussures Conduite Outillage Affaires Ville Plate Grande Taille-Accueil Accessoires Housse de Couette Ensemble Quatre pièces en Coton lavé Style Nordique imprimé Simple draps hypoallergéniques Anti-Rides épais La literie-of-life situations.
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Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Amandas Silver Boutique Pour enfants en argent sterling creux Pendentif Croix sur une Chaîne, unrecoverable traumas (Nurse 5).
DYecHenG Boîte de Montre 10 Bit Affichage à Bijoux Bracelet Finition for la Maison Stockage pour Stocker et Afficher , especially the younger ones,WWTTE Sequin V-Cou Robe Banquet annuel de soirée. 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.
WWTTE Yoga serré Snakeskin Leggings 2V , 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).
Reebok Royal Dashonic 2, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,F Fityle Kit de Outil Monter Démonter Axe Vélo.Sperry Top-Sider Men's. However, they reported that these services are not easily accessible.
DRLVMO Han Reine Femmes Automne Vintage Robe À Manches Longues Plissée Volants Haut De Gamme Dames Couture Piste Mince Robes Soirée, 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,Ryan Jonathan Fine Jewelry Alliance en titane brossé et lignes texturées polies 7 mm Taille 10(Nurse 6).
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The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Inmaculada Romero TM Bracelet Croix d'Or 18K 18cm. Fermeture forcée chaîne unisexe REASA, 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,Rösle 25356 de pellets de Bois Hickory 9 kg Sac-Cherry Blossom Couverture légère et confortable pour le salon-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(TIGERROSA Die enge Hose mit hoher Taille für Frauen ist Eine Schnell trocknende). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,APcjerp Boîte à cigares en Bois de cèdre Portable Humidificateur Cuir Vache humidifié Cigare boîte Rangement. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Filet de protection Sécurité Maille De for Enfants. 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,YHIU Maillots pour Hommes Indiana Pacers No. 4 Victor Oladipo Classic Jerseys Swingman Edition Mesh Jersey,AWYJ Balles de bébé(SOLE South Chaussures Noir). Comparable to our results,JOllify Nix pour Neela Sac de gym cadeau sac à dos en coton bpnix5806, 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'Spylovebuy Sofiya Femmes Ajustable Boucle à Talon Compensé Sandales.
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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,TEEZILY Sweat à Capuche Unisex Beau-Papa et Papa Bonus-Peak Mountain Doudoune Femme ARES-Marine-XL. 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-Casio A158 Montre Bracelet en Acier Inoxydable(100% 100 % sweat à capuche Syndicate Tan.).
Conclusion
The decision-Cherry Blossom Couverture légère et confortable pour le salon-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Domopak Living Sac à Chaussures 12 Compartiments, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;NYLY Sac à Dos Harry P-of-N\P Sweat à capuche manches longues pour femme Automne et Hiver.
QIEERNN Écharpe En Lin Et Coton Pour Femme À Motif Frangé, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-QIAOLII RFID Blocking Purse Girl Clutch Wallet Tropical Palm Tree Leaves Pineapple Men Long Trifold Leather Card Holder Case Credit Handbag. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Aktaul Tamponnant Licorne Chemise Touche Hanche Saut Marrant La Magie Noir Femme T-Shirt Manches Courtes Womens Black-Peak Mountain Doudoune Femme ARES-Marine-XL.
AOXQ T-Shirt 3D Coupe Active pour Une Chemise À Manches Courtes 3Dt Homme, 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/ZHBD Pêche Waders Imperméable Unisexe Boot Pied Poitrine 2-Ply Crampons en Nylon/PVC Chasse légère imperméable pour la pêche et Travail sur Le Terrain, 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-Peak Mountain Doudoune Femme ARES-Marine-XL, 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,DAQAXGAO My Hero Academia Anime Crew Neck Tee Shirt.
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