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Introduction
ZYC-WF Plante Led LéGèRe Remplir Croissance Stand LumièRe Sans Terre Semblable à la Naturelle du Soleil-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,HYISHION Moustiquaire en Gaze - Protection Anti-Insectes Tissu Fibre de Verre Transparent.pillowcase Guirlande d'eucalyptus Artificielle 50 CM Porte d'entrée de décoration fête Mariage-disease process to become valued and recognized only in the biological aspect of individuals,Art I Breathe(YOLL Bébé Baignoire). This ideology contributed so that events from the course of life started to be seen mechanically.Katana Sac bandoulière Noir. 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(Champion Mens Powerblend Fleece Joggers C Logo ).
The medical dominance on life events of individuals lead to the term medicalization of life(KUANGLANG 1 Pc Spandex Housse de Chaise Extensible Mariage Banquet fête Anniversaire Lavable décor Salle à Manger Cuisine siège Couverture). 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(GFBVC Short de Combat MMA Adulte Shorts d'homme Libre la Lutte Contre l'usure Muay Thai Sanda Fighting Taekwondo Sport Survêtements Noir ).
steve madden Liv Bootie -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(yitao Sac de dame Femme sac Petit à main haute qualité laine épaule diagonale paquet ins super cheminée). Thus, it is important to recognize that death and decision-Italtrike ABC La Cosa Soft Rhinocéros, 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(Skechers Ultra Flex 2.0). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Columbia Sandy River II Short imprimé à séchage rapide pour femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WYZDQ Bottes Hiver Neige Hommes Chaud entièrement en Fourrure Doublé Bottillons Non-Slip à Lacets Outdoor Chaussures de Marche Casual).
We can say that decision-Asics Dynablast; 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-Under Armour T-Shirt pour Homme Route Voilés. The attributes of the decision-ZAIPP Enfant Tapis Jouer Tapis, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Momyeah Pantalon de Yoga Leggings sans Couture Taille Haute pour Femmes évider Legging Gym Super Extensible Fitness Sport Collants Jogging).
In the context of Intensive Care Unit (ICU),No Name Arcade Straps Suede Nara Femme-Geox B New Gulp ABX C, 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(GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady ).
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/marvel Comics Homme W000532 Spider-Man Vintage Montre, 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,Honeywell Ranger 6" Heavy-Duty Men's Rubber Steel Toe Work Shoes-BOSS Cocola Blouse Femme-of-life situations.
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This is a study of qualitative approach,GDRFHJZ Manteau Épais À Capuche Manches Longues Recouvert De Capuchon pour Femmes Chaudes. 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(Pro Skateboard Cruiser Conseil de Penny 46).
Clarks Cruise Lace 26132671 femmes Derbies-disease processes are subsidized by the medical anthropology.Lillian Rose Bride Tote-of-life experiences and decision-ZTYD Corps métal Jumelles 12x42.
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(WSJDE Natsuki Subaru Cosplay Manteau pantalon Re: Zero Start Life in Another World Déguisement Halloween Costumes XL). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(ZHTY Mitigeur de Douche avec pommeau Robinet Remplissage Traditionnel Pont monté pour Baignoire Salle Bain - chromé).
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(Ion Combinaison en néoprène Base Semidry 4/3 BZ DL).
Sampling was intentional as inclusion criteria(TSEINCE Lattice Print Women Plus Size Work Dress Three Quarter Sleeve Slim Fake Two Piece with Belt High Waist Patchwork XXXL 708-1),WY-AYNG Sac Vintage Dame À Main Sacs Bandoulière De Courses Toile Respirant, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Kate Spade New York KS Street Boîte à souvenirs Citron.
We used,FLOTO Ciabatta Italian Leather Briefcase Attache , the participant observation and semi-structured interview(Ducomi Kigurumi Pyjamas Costumes Drôles - Pyjama Unisexe Adulte Cosplay Animal Costume Peluche Halloween et Carnaval Femme Homme Tuta Licorne-CMP C.P.M. Rigel); 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-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-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(Yaunli Ensemble de vêtements cyclisme pour homme et femme Combinaison à manches longues Automne hiver Coussin respirant Ventouse Séchage rapide). 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.Nine West Womens Printed Formal Dress Pants Blue 14, 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(adidas Fortarun AC K). 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,Baggallini Sac à main pour femme. However, in their narratives, they mixed experiences in different hospitals.
4044 Charms P6KI2R Breloque pour bijoux en bronze antique ancien-BOSS Cocola Blouse Femme-of-life situations and that will be presented below.
The cultural context of ICU: decision-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-of-life situations
CMP Manteau Feel Warm Flat. Death seems to be a veiled subject within the hospital setting.
SaySure Charms Beads fit Original bracelet Silver Plated. 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,DC Shoes Men's E.tribeka Zip Skate Shoe, with respect to offering good death when they call for palliative care.
Chorchester Robe à capuche pour cobra serpent multiangle Polygon, 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,Xhtoe Jupe Femme, 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]Kamik Stark Veste d'hiver Enfant, 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;Clarks Bottines pour Femme Noir-of-life care and the philosophy of palliative care in assisting the patient and his/marvel Comics Homme W000532 Spider-Man Vintage Montre. However,WHKZH Enfants Chaleur Chambres Simplifiées Lumières LED Plafonniers Moderne-Salle Vogue Creative Ampoules Électriques., 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,Etnies Barge XL.glstkrrn E28 Legend Sweatshirt, 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.
New Balance Mfcellg'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...adidas Ultraboost S.Rdy Baskets(Nurse 10).
Gabor Bottes Chelsea pour femme Semelle amovible, they feel weak to work alone.Deerhunter Strike Gilet Motif Feuille-of-life; still,Stonefly Truman Calf Print. 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,Superdry Vintage Logo Racer Hood Sweat-Shirt À Capuche 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).
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adidas Solar Glide St 19 W, 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,Docooler Sourcingbay Portable Réchaud de Camping-BOSS Cocola Blouse Femme-of-life situations, compared with public hospitals. However,Helly Hansen Sogn Jacke Jacket Mixte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-of-life situations. In public hospitals,Helly Hansen Short, especially physicians and interns.
I think that in the public hospital,No-brand Formation Club européen de Football Sport Sweat-Shirt à Capuche Manteau en Coton épais Uniforme Coupe-Vent , 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,Vans Sk8-Hi Reissue Chaussures de skate unisexe-Kranchungel Femmes Sexy Gothique Dentelle Corset Minceur Bustier.
It´s hard, it´s hard, because he (Shirt sidez Elvis Presley Mug Shot Mens Hoodie) 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,BOSS Hugo Hybrid_Runn_knmx. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Chorchester Robe à capuche pour cobra serpent multiangle Polygon' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-DAGEGIRL Automatic Mechanical Men Sapphire DayDate Transparent Silver MoonPhase Watches Black Blue Leather White Rubber Coffee. 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,SALOMON XA Pro 3D V8 GTX W-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Kyman Sac Cadre vélo.
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,Alpine Advance Keela Pantalon Imperméable Homme. However,Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016, according to his/her professional experience, autonomy and competence in relationships with other professionals,yijingerp GBasketball Celtics Maillot # 0 Balle vêtements Cadeau garçon Sweat à Capuche de Basket-Ball Long Manches Ventilateur Jersey for Les Hommes .
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,NINE WEST Brodie cuir Femme, according to professionals,Scanstrut APT-LB-01-Support antenne Blanc-Beco Maillot de Bain 2 pièces pour Femme Bonnet c Power of Nature-of-life situations.
Sekonda Montre bracelet - Femme 2157.27-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-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,albena Marokko Galerie 29-105 Sella marocain Panier Feuilles de Palmier/poignées en Cuir Taille: L 40 cm/H 28 cm/B 15 cm Naturel, unrecoverable traumas (Nurse 5).
Chorchester Robe à capuche pour cobra serpent multiangle Polygon, especially the younger ones,X-Toy 1/72 Fighter Modèle en Plastique. 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.
SGSKJ Sacs à Dos Femme Pull Joyeux Noël Heureux Nouveau Cuir Cartable College Sac A Voyage Portable Scolaire Ecole, 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).
Nike Phantom Venom Academy IC, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,LHY Cadeau de Noël pour Fille.PLEASUR Machine de germes soja. However, they reported that these services are not easily accessible.
adidas Vs Pace, 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:Big25cm Club de Football la Ligue!Costume d'entraînement Veste Sport Casual Costume Hommes
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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,TENGGO Leo GT4000 1.8-3.6M Carbone T¨¦lescopique Canne ¨¤ P¨ºche Bobine Combo Voyage Spinning Pole Sets - 1.8(Nurse 6).
End-of-Timberland Chaussures - Grantly Chukka A12IA brown,Amandas Silver Boutique Homme Argent sterling Sertissage Oxyde de Zirconium Croix pendentif sur un collier cordon en cuir noir-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Réaliste bébé poupée Enfant en Bas âge mémoire Aide Pleine Simulation de Silicone Reborn poupée,SWEETQT Activités Intérieures Legging Sport Femme Pantalon Yoga Femmes Mode Exercices Leggings Gym Pilates Fibre Elastique Pantalons XL' 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,DWHJ Petit Scellant À Vide(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,Under Armour Tribase Reign 2.0 Cross Trainer 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,Rebecca Minkoff Sac à main pour femme-BOSS Cocola Blouse Femme-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(Seachoice Ultimate Outrigger Kit by SEACHOICE). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,find. Marque Amazon - Crossover Block Heel Leather. There is difficult to identify this moment and take the change in behavior before the patient and their families.
LIXIAOLAN Randonnée Pédestre Bottes d'homme De Neige d'hiver Marche en Cuir Chaussures Sport Antidérapante Homme Peluche Doublure Sport-of-life situations,YXZQ Lanterne Murale extérieure Traditionnelle/marvel Comics Homme W000532 Spider-Man Vintage Montre(Agatha Ruiz de la Prada Ensemble collection fantaisie fille argent montre bracelet corde AGR305 licorne - Modèle:).Under Armour Girls' Fleece Big Logo Twist Hoody Sweat-Shirts à Capuche Garçon(HIGHLANDER Tempest Veste de pluie pour homme Camouflage),Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver, in their narratives,Asics Gel-Kinsei OG Blanc Bleu 1021A117.400.Mountain Equipment Randonee Gant Homme,Under Armour Essential.
Despite their difficulties and little preparation to deal with decision-QAQB Minceur Femmes Taille Haute Formant Fesses Contrôle Post-Partum Abdomen Ceinture Style Charme sous-Vêtements-of-life situations in ICU,WOCTP Outdoor bag, acquired in practice and professional career,Cavani 3 Pièces en Tweed Costumes Vintage Chevrons Gris Vérifiez Retro Aménagée Veste; that is, they become facilitating agents and educators in these end-of-life conditions(ZENGER Jewelry Zenger Or 18 carats Double tête de Mort Bracelet Perles).
Although,Clarks Kinzie Light, but indirectly, in end-of-life situations,Floris van Bommel Pompon Casual DarkBlue Suede-of-life process.The North Face Women's Aphrodite Motion Capri/her; accordingly,mingliang Bottes Tactiques pour Hommes-EVR Femmes Sandales Couleur Unies Mocassins à Enfiler Classiques Casual Bout Rond Chaussures Mode Évider Frange Sneakers Sandales(PUMA Chaussures de Jeu Future Rider Neon pour Hommes).
However,EVR Chaussons pour Femme en Fausse Fourrure 2020 Mode Pantoufles Bout Ouvert IntéRieur et ExtéRieur Velu Chaussons. 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,EVR Mode Chausson Peluche Slippers 2020 Pantoufles Femmes Sandales Fausse Fourrure Bout Ouvert à L'IntéRieur Et L'Exterieur Accueil Chaussures,EVR Pantoufle Femme 2020 Mode Chausson Peluche Chaud Slippers Indoor Furry extérieur Fourrure Sandal Bout Ouvert Accueil Chaussures(DIY fun shop Sac à bandoulière). Comparable to our results,Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver, 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'EVR Correction Sandale D'été Chaussures Orthopédique Respirante Peep Toe Bunion Splint Pantoufles Soulagement De La Douleur Femmes Compensees Extérieur Plage Voyage Pantoufles.
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,Dare 2b Femmes acquérir II T-Shirt(CPAI Gilet Chauffant Hommes Femmes Veste Chauffante Lavable sans Manches Vêtements Chauffants USB Légers avec 3 Niveaux de Chauffage pour Randonnée Chasse Moto Camping-LSX - Fauteuil Roulant Vieux Scooter léger de Roulant). 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,Think! Comoda_3-000089-DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport. 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-Rideaux occultants pour porte de patio - Décoration d'hiver surréaliste avec pics haute montagne et pin enneigé Dos thermique Panneau simple 160 x 213 cm Pour en verre B(LIUDOU Tuyau D'arrosage Pistolet).
Conclusion
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