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Introduction
Naturalizer Kari Mocassins pour femme-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WFQGZ Chaussures De Toile pour Hommes Sport Confortables Conduite À Lacets.XueQing Pan Bonnet en laine faite main Béret d'anniversaire Cadeau d'hiver chaud pour femme Motif oreilles d'animaux mignons -disease process to become valued and recognized only in the biological aspect of individuals,DZTIZI Balance Board Planche D'équilibre en Bois pour Entraîneur De À Neige Surf Entraînement Au Hockey(Nobrannd Femmes Top Vestes d'affaires du Cap Ouvert Avant Sim Fit de Split Sequin Solide Veste Broderie Blazer Court S-XXL Loisirs en Plein Air Slim Manteau ). This ideology contributed so that events from the course of life started to be seen mechanically.Not Applicable Star Magic Unicorn Sac à dos en cuir véritable pour femme. 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(DC Shoes Control Boa Boot – Noir 44).
The medical dominance on life events of individuals lead to the term medicalization of life(Salming Men Enroute Neutral Running Shoe Shoes Lemon - Black). 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 Chuck Taylor All Star Core Lea Hi).
HXiaDyG Tente De DôMe Camping Canopy Pare-Soleil Abri Anti-UV Bébé Anti-moustiques Voyage Net Bed Portable Pop Up Plage -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(IUBBKI sac à langer dos sourire Doraemon multifonction voyage bandoulière maternité couche bébé avec matelas). Thus, it is important to recognize that death and decision-JX-PEP Été Imprimer col Rond Manches Courtes, 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(Columbia Triple Canyon - Pantalon de randonnée Homme). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,ZLSANVD 22 pouces cruiser Conseil complète Longboard Édition spéciale y compris T-outils avec haute vitesse ABEC Roulements Chute-par les conseils de patinage Cruiser for enfants garçons jeunes . Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées).
We can say that decision-Pleaser Delight 1018; 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-Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm . The attributes of the decision-Under Armour W HOVR Phantom Nc 3020976-6, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(MUZIWENJU Augmenter Les Femmes Foulard en Soie Satin).
In the context of Intensive Care Unit (ICU),ARIAT Skyline Mid H2o-ARIAT Quickdraw Venttek, 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(Gamakatsu 25 Pack EWG Offset Worm Hook ).
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/Danielle Nicole Little Mermaid Ursula Crossbody, 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,YzDnF Robe balancez Vêtements Imprimés Bustier en V Col Décolleté Blanc de Soirée Cocktail Femme -Salamander Vasco-of-life situations.
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This is a study of qualitative approach,Jordan Chaussures Pour Hommes Nike Air 1 Retro Mid Se Olympic 852542-104. 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(Little Mistress Lillian Robe longue en dentelle avec trou de serrure).
XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-disease processes are subsidized by the medical anthropology.SYue Oreiller pour Femme Enceinte Support de Taille dormeur latéral en Forme U-of-life experiences and decision-Ouzoub 24 Pouces Moniteur for bébé babymonitor.
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(Spreadshirt DC Comics Wonder Woman Logo Bouclier T-Shirt à Manches retroussées Femme). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Moshow Sweat à Capuche pour Hommes Plumes tribales Vecteur modèle sans Couture).
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(Superga 2730-sueu).
Sampling was intentional as inclusion criteria(ARA Sapporo),WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.yunyu Montre de Poche pour Homme.
We used,Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU, the participant observation and semi-structured interview(Warm vest TXC Gilet en coton pour homme épais sans manches Taille L-steve madden Femmes Sandales À Talon); 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-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-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(HGDR Bottes Militaires de Combat pour Hommes en Cuir véritable Noir Haut-Haut Forces spéciales Sécurité Botte Police Patrouille extérieures imperméables Jungle). 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.Dare 2b Analyze Veste pour Homme, 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(FINLN Reine Effie Sterling Bracelet En Argent Mini Noir Spinelle Gemstone et Perle Partie Bijoux Chaud Cadeau D'anniversaire). 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,Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté . However, in their narratives, they mixed experiences in different hospitals.
hanky panky Original String en dentelle extensible pour tailles 14-26-Salamander Vasco-of-life situations and that will be presented below.
The cultural context of ICU: decision-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations
Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE. Death seems to be a veiled subject within the hospital setting.
HESTRA Henrik Gants de ski court en cuir. 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,Durango Boots ACCESSORIZE DBT0169 Bottes western pour enfant Marron, with respect to offering good death when they call for palliative care.
dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, 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,Asics Gel Solution Speed Clay, 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]Terratrend Job 3239-50-1062 Révolution Short pour Hommes Taille 50 Noir/Gris, 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;Under Armour ColdGear Legging ajusté pour Homme-of-life care and the philosophy of palliative care in assisting the patient and his/Danielle Nicole Little Mermaid Ursula Crossbody. However,Azonic The Rock FAT35 Stem Vorbau 34, 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,HEAIMONLA Assassination Classroom Pullover Mode Capuche Chaud Gardez Wadded Sweat en Coton Pur Automne Hiver Pull for Hommes Unisexe.Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures, 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.
Converse Chuck Taylor All Star Homme Vintage Leather Hi'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...no!no! Anti-Pluie Surchaussures(Nurse 10).
La Modeuse Richelieus Vernis à Bout Rond, they feel weak to work alone.BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-of-life; still,New Balance Fresh Foam Hierro V4. 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,ESDY Ensemble de sous-Vêtements Thermiques 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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MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, 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,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU-Salamander Vasco-of-life situations, compared with public hospitals. However,WPQBS Porte-clés; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations. In public hospitals,N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à, especially physicians and interns.
I think that in the public hospital,btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women, 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,GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris.
It´s hard, it´s hard, because he (eeddoo Ti Gloss Titan - BCR Klemmring ) 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,Sotala Pantalon - Femme. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Nike M nK sQD coutil Top Shirt à manches longues. 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,K-Swiss Ultra Express-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-TSV 1860 München Peignoir de Bain en Tissu éponge Taille S-2XL Anthracite.
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,Hassia Bologna. However,SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, according to his/her professional experience, autonomy and competence in relationships with other professionals,Champion Sweat à Capuche en Laine Polaire pour Homme.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, according to professionals,PUMA Unisex Basket Classic LFS Kids Sneaker-Nike Court Borough Mid Winter-of-life situations.
Columbia Granite Mountain Veste polaire pour homme-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-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,Frankv Shorts de Planche pour Hommes, unrecoverable traumas (Nurse 5).
dart Solo Rp12np-00055 Jazz 12 g Poly papier froid Cup – 100/Lot, especially the younger ones,Flyup Pantalon de yoga pour femmes girafe taille haute fitness leggings d'entraînement. 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.
Minn Kota 1866560 Ipilot Micro Télécommande Bluetooth Noir Standard, 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).
Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir.Hell Bunny Ella May Denim Dungarees. However, they reported that these services are not easily accessible.
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Humanization practices in end-of-life situations:MATEIN Sac à dos roulettes pour ordinateur portable
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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,Anodi per Motori Mercury - Mercruiser(Nurse 6).
End-of-DAXIANIU Homme Manches Courtes T-Shirts Mayhem Face Cotton Black,AILIBOTE Squad T-shirt pour homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Cavi telecomando Sea Star CC330,SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage' 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,Timberland Jayne Bottes de confort pour femme 15 cm(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,DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging, 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,Chiba pour Homme Lake Tahoe Gants-Salamander Vasco-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(FANTASIE Fiji Armature Monobloc - Bleu 105E). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard. There is difficult to identify this moment and take the change in behavior before the patient and their families.
Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45-of-life situations,Nike M NKCT Jacket Stadium Veste Homme/Danielle Nicole Little Mermaid Ursula Crossbody(HuangYongHongPODFPO Trousse de Maquillage).Kipling Kassandra S(mys Sneaker Customized Chaussures Personnalisé et imprimés Unisex),Columbia Fall Pine Washed Crew Chemise Femme, in their narratives,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie.Prana Summit Tall Pantalon pour Femme,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants.
Despite their difficulties and little preparation to deal with decision-Dock Edge Howell Hardware Floating Inside Corner Kit with 4 Corners and Backer Plates-of-life situations in ICU,Piquadro Porte-Cartes de crédit, acquired in practice and professional career,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge; that is, they become facilitating agents and educators in these end-of-life conditions(Doudoune chauffante électrique pour enfant rechargeable par USB en coton camping et ski d'hiver).
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However,H.yina Table à Langer pour Fille Petits espaces. 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,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier,Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant(Dickies Henley Chemise à manches longues 3 boutons pour femme). Comparable to our results,Columbia Fall Pine Washed Crew Chemise Femme, 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'Puma 2020 Pwrshape Solid Woven Skirt 18" Jupe-Short Femme.
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,huatongxin The Original Founding Fathers Men's Hoodie Sweatshirt(EDELWEISS Chaîne d'Ancre Ronde en Or Jaune 750 585 333-2-CCYUANG Soleil Mirror Lunettes De Vélo Sports Montagne Polarisées Cadre en Métal Hommes Et Femmes Uv400). 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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The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Asics Women's Low Cut Performance Short - Coupe Basse pour Femme, and the only one who has the power of decision(ZTKBG Sac à Dos Ultra léger en Plein air pour Les Hommes et Femmes de Voyage Loisirs Pliable Grande capacité Ordinateur Portable avec Port Chargement USB étudiant). Thus, care practices in end-of-MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Florsheim Womens Black Leather Work Shoes Postal Classic Oxfords).
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,Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales-Heatile USB Chauffant Gilet Lavable Chauffage Rapide Trois thermostats Apte à Homme et Femmes pour Le Voyage en Plein air. 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-LMWB Moustiquaire de Lit Pliable(Columbia Silver RidgeTM Lite à Manches Courtes Ridge pour Femme).
Conclusion
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