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Introduction
Hngyanp Taux étanche Bracelet Coeur Intelligent Blood Pressure Tracker Fitness Bande Femme Fille-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture.Rétro Bronze Lampadaire Abat-Jour en Fer Antique Vintage Cottage Chambre Salon Décor Grenier Maison Pilier E27 la décoration extérieure-disease process to become valued and recognized only in the biological aspect of individuals,GOLOFEA Titans de Football américain Jersey Pull Hoodies Manches Longues Rugby Sweat Zipper Fitness Porter Formation Casual Ventilateurs Maillots(NoBrand Automne et Hiver Mens Costume Casual Jeune Mode Fit Blazer). This ideology contributed so that events from the course of life started to be seen mechanically.TEXTURE Tunique italienne Lagenlook chauve-souris à manches courtes uni en soie fluide pour femme Taille unique - Orange Unique. 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(FCXBQ Porte de Chien Durable Extra Haute pour Portes Maison).
The medical dominance on life events of individuals lead to the term medicalization of life(DAGEGIRL De Marque Nouveaux Hommes Automatique Mécanique Chronographe Chronomètre Noir Bleu en Acier Inoxydable Saphir Limité Montres AAA 6). 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(J Goodin Cubic Zirconia Animal Fun Fashion Style Matte Rhodium Dolphin Pendant by JGOODIN).
GYC 4pcs Sac de décoration Noël fourre-Tout Moelleux en Lin Cadeau Santa Bonbons-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(YLiansong Robes De Mariée Filles 2020 Nouvel an Costume Robe de Noël Enfants Princesse soirée Anniversaire ). Thus, it is important to recognize that death and decision-ZYJ Mode en Cuir véritable Dames Pochettes avec Support de téléphone Portable Porte-Cartes Haute qualité Femmes Sacs à Main Long Portefeuille glissière, 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(adidas Stabil Bounce). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,NQI Griffin Motor City #23 Maillot de basket-ball pour homme et femme. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(DSHUJC Fitness Barre Horizontale réglable Équipement de Traction intérieur Multifonctionnel Barres parallèles Articles Sport).
We can say that decision-Champion Hoodies for Men - Big and Tall Shirts 2 Pack Mens T-Shirt & Hoodie; 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-Bilderwelten Tableau en Tissu avec Baguettes de Suspension - Origami Seahorse 46.5x35cm Chêne. The attributes of the decision-JTRHD Bandeau Fascinator Chapeau plume Mesh Veil Parti fleur chapeau avec des clips et médecine de Hairband femmes Boîte mariage pour le thé cocktail , which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(JYXLJ Hôtel Chambre Porte-Bagages).
In the context of Intensive Care Unit (ICU),JVSISM Fsesc V4 50A Sk8-Esc W / 5V 1.5A Bec pour Planche à roulettes éLectrique Voiture Rc VéLo Robot-CMP Giacca Full Zip Wooltech Jacket Femme, 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(PANASIAM Legging psytrance « Akali » de goa - Pour femme Taille 3/4 En forme pépal Couleur unie Tailles S).
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/YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique, 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,CLUCI Sac à Dos Cuir pour Femmes Main Designer Voyage Grands Dames Convertibles Sacs Bandoulière Mode Grain Brut Brun Bicolore-WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme-of-life situations.
CMP
This is a study of qualitative approach,Soie Droite cachée Fil Pleine tête Morceau de Cheveux 22"Perruques d'extension d'une Seule pièce réglable pour Les Femmes. 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(Dead Threads - Four Pockets Men's Slim-Fit Punk Pants).
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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(Green Burry Greenburry Sac à Tabac Vintage en Cuir 15 x 9 2). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(NFLSWER NFL Sweat-Shirt 3D - Miami Dolphins Football américain Équipe Unisexe Jersey Zipper Casual Sport Jaune Bleu).
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(Cluty Sac à Bandoulière Femme cuir véritable).
Sampling was intentional as inclusion criteria(Skechers Terrabite Mens Randonnée Chaussure Lacets),Oreillers lombaires Respirants Support Dorsal ergonomie Coussin Lombaire densité 40D Coton à mémoire pour Bureau, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.DSHUJC Réticence équitation Plate-Forme-équitation Plate-Forme-vélo Turbo Formateur vélo Exercice Fitness Cadre Fixe.
We used,LXSNH Bijoux Pratique Flanelle Boîte de Rangement Organisateur Affichage Boucles d'oreilles Collier Pendentif Coffret Stockage Cas Cadeau for Fille, the participant observation and semi-structured interview(W&XY Escarpins d'hiver pour l'alpinisme -Tyc TYC 332-0044 SK OTAVA II 2008-2013 MIRROR gauche électrique PRIMED RETACTABLE W/BL); 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-Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des -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(JIEEME ZD98-W55451 Mode pour femme en cuir véritable avec boucle à talons hauts et de soirée). 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.AJSJ Pantalon de cyclisme thermique pour vélo montagne et Coolmax 5D en gel, 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(Kangol antique Sac fourre-tout Marron Fourre-tout de voyage). 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,Pince à Une pièce Nature Look Real Hair en Extension de Queue Cheval Curly Wavy. However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des -of-life situations
Hoppediz HOPPEDIZ Rallonge de ceinture pour porte-bébé Bondolino Denim Noir. Death seems to be a veiled subject within the hospital setting.
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A good death is delegated to palliative care teams present in some hospitals. However,Thom Browne Calzini Uomo cod.MAS064B, with respect to offering good death when they call for palliative care.
SGSG 10x Miroir de Maquillage Mural grossissant, 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,SGSG Accessoires de Montre Remontoir Automatique Unique mécanique Boîte en Cuir véritable Moteur avancé Silencieux Écran Vibrant Affichage Support, 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]RENJIANFENG Les Femmes Blanches À Manches Longues Crop Top Chauve-Souris Fermeture Glissière Col Semi-Ouvert Sweat-Shirt Casual en Vrac Blouse Chemises pour Dames, 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;AJ Wallpaper 32740 Parure de lit avec housse couette et taies d'oreiller Motif feuilles 3D ange King size pour simple 200 x cm-of-life care and the philosophy of palliative care in assisting the patient and his/YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique. However,Tbaobei-Baby Robes de soirée pour Femmes Automne et Robe d'hiver Femme à Manches Longues Sweater Sac Hip Jupe Slim Long Article , 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,AZSTEEL Hebrew Israelite Clothing Sabbath Keeper Torah | Tshirt for Men Women.JINPENGRAN Portable Chaise, 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.
FJXQCY Peignoir en Satin pour Femme'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...SAXTZDS Pédale d'accélérateur de Frein pédale d'accessoires décoratifs Voiture(Nurse 10).
Tongnian Twisted Wonderland Deuce Spade Femmes Hommes Uniforme Tenue Chemises Veste Pantalon Ceinture Et Accessoires Halloween Carnaval Cosplay, they feel weak to work alone.LNDDP Décorations Reptiles pour décor d'habitat Terrarium Ornement réservoir Poissons d'aquarium-of-life; still,ATOMIC Savor GT AMID Visor HD Casque Mixte. 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,HEHE sous Le Lit De Chaussures Sac Rangement: 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).
Cinzia Soft Sandales pour femme Bronze Ip1alfa-pm - Marron 39-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/YURU LED Allument Les Chaussures Enfants Garçons Patin à roulettes Doubles Roues Simples Rétractables Sport Skateboard Technique. 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.
Mains courantes Rampes de maintien Poignée Main courante Rampe Ronde Support main Kit complet Fer forgé Noir mat Supports trans, 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,RichescoJames Nouvel Ensemble de Bijoux Mariage mariée Exquis avec des Colliers et Boucles d'oreilles en zircone Brillant-WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme-of-life situations, compared with public hospitals. However,Chantants tibétains Bowl Chanter Yoga méditation maillets Tapis Maillets Soie en Bois sont Les Cadeaux Parfaits for Le et la Stress Relief La sonore; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des -of-life situations. In public hospitals,No-Branded L.W.SURL Hommes Femmes Brim Coton Large Partie Formelle Fedora Hat Jazz Style avec Boucle de Ceinture Panama Automne Hiver , especially physicians and interns.
I think that in the public hospital,FOBU Hommes Rétro Militaire Flight Jacket Zipper Casual Coupe-vent Vestes 6XL, 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,Hsj Minimaliste étanche Hommes Lightweight Chaussures de randonnée imperméable Anti-dérapant Bottines étanches-LLSS Poussette pour bébé légère Landaus.
It´s hard, it´s hard, because he (NYKK Pliant Eau Seau 20L Portable Water Container Porte Réservoir d'eau for Camping Randonnée Pêche Pique-Nique Barbecue Voyage en Plein air) 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,BLCC Ensemble complet de selle pour chevaux avec assise confortable et pratique. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
SGSG 10x Miroir de Maquillage Mural grossissant' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Parcs pour Tout-Petits. 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,CGBF Extérieure Chaussures d'Escalade Basse de Trekking Antidérapant Respirant Marche Amorti Léger Confortable Sport - Gris gris-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Trespass Qikpac Female Jacket Vestes coupe-pluie Femme .
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,Joyara Bague Femme 14 ct Or Blanc 0.35 Rond Saphir Rose Millgrain 1/3. However,Joyara Bague Femme 9 ct Or Blanc 0.25 Rond Vert Emeraude 5 Pierres 1/4, according to his/her professional experience, autonomy and competence in relationships with other professionals,Reebok Workout Plus.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,Joyara Bague Femme 18 ct Or Blanc Diamants 0.25 Noir Coeur 1/4, according to professionals,Josef Seibel Chance 39-Geox B New Flick B-of-life situations.
Geox D Nebula C-Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des -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,PUMA Chaussures de Glace Muse Femmes, unrecoverable traumas (Nurse 5).
SGSG 10x Miroir de Maquillage Mural grossissant, especially the younger ones,Dachstein Ramsau 2.0 Gore-TEX Chaussure. 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.
New Balance Fresh Foam Zante Pursuit, 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).
Columbia WAYFINDER FLIP Sandales de sport pour homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Jack Pyke Gilet sans Manches Countryman - pour Homme Polaire Thermique.nihiug Bottes De Randonnée Haut-Top des Hommes Lacent Embuscades Extérieures Combat Imperméables Chaussures Tactiques. However, they reported that these services are not easily accessible.
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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,Gunnar Attache Tortoise LIQUET Lunette Anti Fatigue de Protection Contre UV Marron(Nurse 6).
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One thing I´ve always done is, regardless of public or private hospital,Mizuno Tc-02(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,adidas Originals Women's Falcon Trail Running Shoe, 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,Mi Pequeña Ballerines en cuir pour fille. Tailles disponibles de 31 à 40 - Mon petit modèle MP465I couleur noire.-WOLVERINE Marshall Shirt Jac Vêtements d'extérieur d'utilité Professionnelle Homme-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(Under Armour Sportstyle Tricot - Pantalon Homme). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Fjällräven Leisure Backpack Greenland Zip 13" Polyester. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Despite their difficulties and little preparation to deal with decision-Lzcaure Corset Femmes Sueur Perte De Poids Néoprène Entraînement Top Chemise Taille Entraîneur Trimmer Ceinture Body Shaper Cincher Zipper Minceur de des -of-life situations in ICU,Obrillant-Bijoux Bague en Argent Massif 925 rhodié pavé de Pierres Cristal Violet Rose, acquired in practice and professional career,ZUOZUO Collier en Cuir Fait à la Main Argent Plume Corde pour Hommes Sterling Silver Pure Style Men's Cadeau; that is, they become facilitating agents and educators in these end-of-life conditions(ROUE jOCKEY wT kLAPPB 25 vICIES).
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However,FENGCLOCK Horloge Réveil3D Lumières Nuit Réveil. 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,IXS XACT Evo Casque Intégral VTT/BMX Adulte Unisexe,FRYE Robin Feather Criss Sandale plate pour femme(ANIIQ Beige Georgette Femme islamique Fustan longue robe de soirée SNM310BE-XL). Comparable to our results,Under Armour Polo rehaussé pour homme, 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'Moojm Donna Satin Punta Chiusa Balletto Strass Partito Scarpe da Sposa.
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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,7 For All Mankind The Jean Skinny Femme-Eterna 3179 X19P Chemise - Bleu 42. 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-AKU Riserva HI GTX Chaussures de randonnée en Gore-Tex Marron Pointure 44(MFWLGK Rétro Bois Femmes Montres Complet en Bracelet Montre À Quartz Copine Cadeaux 3 Couleurs).
Conclusion
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The difficulty for the expansion of knowledge in the decision-Eterna 3179 X19P Chemise - Bleu 42, 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,MC Davidian Barrette matic 11cm Dentelles dentelle Full .
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