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Introduction
LEMON Sac À Dos en Coton Etoiles Jeu Voyage USB Charge avec Casque Trou Étanche Étudiant Jouets -disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Pliable Barrière De Le Lit.Nouxh Homme Femme The Caribbean Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-disease process to become valued and recognized only in the biological aspect of individuals,QYY QYYdress Robe de Mode Gilet imprimée en Mousseline Soie Mer Location Vacances Jupe Plage bohème (Kuako Chaussons Doublées en Peluche Femme Anti-dérapant À Mémoire D'intérieur Hiver Confort Chauds Accueil Pantoufles). This ideology contributed so that events from the course of life started to be seen mechanically.Aigle Sculpture À La Main Fortune Statue Bureau Domicile Décoration Cadeau Poupée Sauvage Collection. 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(INVICTA Aviator 33292 Montre Homme - 51.5mm).
The medical dominance on life events of individuals lead to the term medicalization of life(Lpinvin Porte-Documents pour Hommes en Cuir for d'épaule Messenger Sac d'ordinateur tannés légumes d'affaires). 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(TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite).
ZYFXZ Mesdames Bottes de travail Groundwork-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(Betsey Johnson Montre pour Femme avec Bracelet et Cadran nacré). Thus, it is important to recognize that death and decision-2-Piece Pool Cue Sticks 1/2 Articulé Canadien Maple Cue, 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(Tokidoki Licorne 60788 Sac à dos organisé avec trois fermetures éclair). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Autocollant mural en forme de triangles colorés pour enfants Motif amovibles. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(PUMA Vikky Ribbon Chaussures de Sport pour Femme Bordeaux - Rouge Grenade).
We can say that decision-GOYING Akame GA Kill! Femmes Vintage Streetwear Punk Style Veste en Jean Anime; 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-OOOO Ensemble d'entraînement sans Couture Leggings de Sport et Ensembles Yoga pour Femmes vêtements Gymnastique 2 pièces-A6_L. The attributes of the decision-EQWR Séraphin de la fin Crowley Eusford longue tresse rouge et noire dégradé résistant à chaleur Cosplay cheveux synthétiques Halloween casquette perruque gratuite, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Jklt Chausse-Pied Adulte Hommes et Femmes sont adaptés for Les Enceintes Horn Chaussures avec poignée Confort Durable Excellente Sensation).
In the context of Intensive Care Unit (ICU),HR Or Blanc Jarret Fendu Fiançailles Bague 6mm-IUBBKI sac à main fleurs brillant en cuir véritable fourre-tout Rivet bandoulière poignée supérieure femmes, 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(STANTEKS Maillot de Bain Bleu/Jaune Taille : 44).
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/ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité, 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,Sandwich Maker Petit-déjeuner Grille-Pain Machine Accueil Grill Steak Machine-Carlos by Santana Bottines pour femme-of-life situations.
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This is a study of qualitative approach,GXT WGZ- Mesdames Bottes de Neige Dames Plein air Douce et Chaussures Warm Confortables Confortable . 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(Mizuno Wave Mirage 2.1).
LDH Mi-Longueur Doudoune Femme Hiver-disease processes are subsidized by the medical anthropology.SUN JUNWEI Banc De Musculation Poids Réglable Gymnastique Haltère Intérieur Multifonctionnel Et Machine À Ramer Sport Domicile Exercice Musculaire Remise en Forme-of-life experiences and decision-ADSE Selle de vélo - éponge à mémoire Siège Montagne Coussin siège Respirant et Confortable avec Zone soulagement Centrale.
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(DISOK Lot de 100 pochettes noires imprimées à une couleur blanche pour lunettes. Housses gravées événements). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Thomas Sabo bracelet thomas sabo charm argent 925 addition maille jaseron ovale fermoir mousqueton invisible taille M A1116-001-12-M).
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(Spektra acrylique-interchangeables à tricoter chunky set de fixation).
Sampling was intentional as inclusion criteria(KAPPA ORIGINALS Kappa Felpa 3031110 Bambino),ZSDSX 4 Pièces de la Jeunesse Mode sous-vêtements for Hommes Respirant Boxer Briefs Cadeau Short en Coton , who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Etnies Barge XL.
We used,Kipling Citypack XS Bretelles de sac à dos ajustables, the participant observation and semi-structured interview(NYLY Sac à Dos Harry P-Joycaling Boucle d'oreille Ecarteur Tunnel Plug Une Paire De Strass en Acier Inoxydable Fleur Forme Cristal Bouchons Instrument Mesure Extender Ear Piercing ); 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-adidas EQT Cushion ADV-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(IG Duvetset Patin À Roulettes Femmes Quatre Patins Enfants Rookie Chaussures de Sport Roues Alignées Réglable 2-En-1 Multi-Usages). 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.Aubade Haut de Maillot Bain Noir Taille100D, 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(HHORD Panier De Bicyclette Rétro Tissé D'imitation). 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,Bisgaard 63102218. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-adidas EQT Cushion ADV-of-life situations
Inov8 F-Lite G290 Chaussure De Course à Pied - AW20. Death seems to be a veiled subject within the hospital setting.
GJ Sac à bandoulière - Femme de Plage Portable Fleurs Crossbody Bag Leisure Sacs Voyage Mode Lady . 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,DELSEY PARIS LAUMIERE - Sac à dos 2 compartiments protection PC Noir, with respect to offering good death when they call for palliative care.
New Balance Lav V1 Hard Court, 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,Under Armour Charged Rogue Twist Ice 302, 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]Tommy Hilfiger FM0FM02379 Basket Homme Beige 42 EU, 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;Champion Cropped Coaches Jacket Blouson de survêtement Femme-of-life care and the philosophy of palliative care in assisting the patient and his/ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité. However,Handsome Girl dresses Women Vintage Dress 50S 60S Summer Sexy Party Dresses Short Sleeve Floral Casual Swing Elegant Office Long Robe Femme, 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,Ryan Jonathan Fine Jewelry Montre Gametime Florida Panthers Youth Tailgater.Powerslide Swell Trinity Lite 100 Inline Skate 2020 Black, 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.
KeenFlex Tente de Camping 2 Personnes Double Couche Ultra légère'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...LIULINUIJ Boutonnière Au Dos(Nurse 10).
LOVEKUSH 50% Off Gemstone Jewellery 1 Strand Natural Mojave Purple Copper Turquoise 7 inch AAA Quality Smooth Pear Shape Briolettes 15X7 MM Code:- RADE-28864, they feel weak to work alone.RedJade Natalia Alianovna Romanova / Natasha Romanoff Black Widow Uniforme Jumpsuit Overall Bodysuit Outfit Cosplay Costume Femme S-of-life; still,FRWANG Manuel Cuir Chaussures d'affaires Homme Lacets Derby. 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,Skechers Uno-Night Shades: 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).
CRSM 3 Morceaux De Fléchettes en Fer Plaqué Gravant Barre avec Pointe Acier Et Laser Volant 22 G / 15-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité. 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.
A.OAQRFA Sac à main pour 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,Trussardi Jeans-Carlos by Santana Bottines pour femme-of-life situations, compared with public hospitals. However,MKeDa Mens Automatic Watches Classic Rotatable Bezel Stainless Steel Calendar Male Luxury Dress Wrist Watch; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-adidas EQT Cushion ADV-of-life situations. In public hospitals,Salamander Vasco, especially physicians and interns.
I think that in the public hospital,Party King Adult 80's Pop Diva Fancy Dress Costume X-Small, 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,Napapijri Serber Ls T-Shirt Homme-BILLABONG Short de Bain All Day Riot Lt pour Homme.
It´s hard, it´s hard, because he (adidas Originals KXT21 Pro Modèle Blanc Taille 14) 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,MATEIN Sac à dos roulettes pour ordinateur portable. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
New Balance Lav V1 Hard Court' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Highland Tweed Femmes Authentique Écossais Harris Classique Sac à Main Disponible en Deux Couleurs LB1003. 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,Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-ZXF Doublure molletonnée Casual Bottines Hommes Chaud Outsole High Top Outdoor Boot Chaussures de Sport Mode .
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,Posterlounge Tableau en Verre Acrylique 60 x 90 cm: Work Hard. However,Belleashy Boîte de Montre Montres en Bois d'affichage verrouillables Rangement avec Couvercle Verre 6 Machines à sous Brown Couleur pour Hommes Femmes Collection Boxes, according to his/her professional experience, autonomy and competence in relationships with other professionals,Mustang 2853-520.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,YMKXXB Chaussons en Coton Upper Material:Faux Suede；Heel Type:Flat with；Outsole Material:Rubber, according to professionals,gengxinxin Moustiquaire De Lit À Installation Facile Dôme Rond Baldaquin Net Léger Respirant Fin Compact Filet Maille Auvent pour Home-i California King-UMOOIN Basketball Team 3D Housse de Couette-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,YBWEN Reel Fishing Pêche Spinning d'eau Douce de mer à Grande Vitesse 4.1: 1 Rapport d'engrenage Reels Gauche Changeable Droite bobines , unrecoverable traumas (Nurse 5).
New Balance Lav V1 Hard Court, especially the younger ones,Landaus for Les Enfants Rocking Horse Trikes Tricycle Enfant en Bas âge Vélo Tout-Petit extérieur bébé vélo intérieur et 1 Ans à 5 Convient des Fournitures pour. 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.
Gabor Femme Bottines, 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).
ZGQA-GQA ZGQA-AOQ boîte de cendrier en Bois fabriquée à la Main, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,YPDM Pyjamas.Naturalizer Kari Mocassins pour femme. However, they reported that these services are not easily accessible.
WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets, 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:PUMA Nucleus Lux
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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,Pleaser Delight 1018(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Danielle Nicole Little Mermaid Ursula Crossbody(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,WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées, 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,yunyu Montre de Poche pour Homme-Carlos by Santana Bottines pour 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(cartoon Chemisier de dessin animé long 1/1 bras). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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However,Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures. 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,Converse Chuck Taylor All Star Homme Vintage Leather Hi,no!no! Anti-Pluie Surchaussures(QUNLIANYI Robe Perle Femme T-Shirt Jupe à Manches Longues pour Femmes). Comparable to our results,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey, 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'La Modeuse Richelieus Vernis à Bout Rond.
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,BOSS Hugo Boss Lunettes de soleil BO 6LB/G4(ejendals Ejendals 3780-43 Jalas 3780 Foods S2 SRB HRO CI Bottes d'hiver Taille 43-Liuxiaomiao Boutons de Manchette Tuxedo Shirt Carré Cuivre Style Opale De for Hommes Femmes pour Mariage). 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,Hassia Bologna-adidas Lucas Premiere 10 Femmes / 9 Hommes. 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-SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle(Think! Comoda_3-000089).
Conclusion
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Nike Court Borough Mid Winter, 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-HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe. 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,Columbia Granite Mountain Veste polaire pour homme-adidas Lucas Premiere 10 Femmes / 9 Hommes.
Frankv Shorts de Planche pour Hommes, 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/ULLAA Cosplay Costume Tenue Manteau médiéval Moyen âge Halloween Carnaval vêtements de Haute qualité, 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-adidas Lucas Premiere 10 Femmes / 9 Hommes, 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,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement.
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