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Organ Transplantation: Scarcity or Ethics?..

Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient’s own body, for the purpose of replacing the recipient’s damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be re-grown from the patient’s own cells (stem cells, or cells extracted from the failing organs). Organs and/or tissues that are transplanted within the same person’s body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

Organs that can be transplanted are the heartkidneys, eyes, liverlungspancreasintestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed closely by the liver and then the heart. The cornea and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold.

Organ donors may be living, or brain dead. Tissue may be recovered from donors who are cardiac dead – up to 24 hours past the cessation of heartbeat. Unlike organs, most tissues (with the exception of corneas) can be preserved and stored for up to five years, meaning they can be “banked”. Transplantation raises a number of bioethical issues, including the definition of death, when and how consent should be given for an organ to be transplanted and payment for organs for transplantation. Other ethical issues include transplantation tourism and more broadly the socio-economic context in which organ harvesting or transplantation may occur. A particular problem is organ trafficking. Some organs, such as the brain, cannot yet be transplanted in humans.

According to the Washington Post, in recent years:

“… in the hopes of obtaining more organs, federal health officials, transplant surgeons and organ banks have been intensely promoting ‘donation after cardiac death,’ or ‘DCD.’ DCD usually involves patients who have devastating and irreversible brain damage but are not actually brain-dead. Their families consent to removing life support, and their organs are removed minutes after the patients’ hearts stop beating.”

That is, there may be some brain activity when life support is removed. It would not be enough to maintain bodily functions like heart beat and breathing. The patient has no chance of ever regaining consciousness. But, since the end of a person’s life is defined as the permanent cessation of brain activity, they may be theoretically still alive.

In many cases the desire to donate an organ may be based on the wish to save the
life or improve the health of a relative with whom there are already bonds of
affection and love. This may even be an overwhelming concern.
In other cases, a person may wish to do something to save the life or improve the
health of an unknown person in the community, based on more impersonal ideas
of helping others or giving to the community. For example, this may be a
consideration for those who volunteer to be placed on a register of potential bone
marrow donors (or who volunteer to donate blood).
Such donors may consider that the potential personal disadvantages or discomforts
of donating are more than outweighed by the potential benefits to the person
needing a transplant. (example from micro teachers :D)

“Despite continuing advances in medicine and technology, the demand for organs drastically outstrips the number of organ donors,” states a United Network for Organ Sharing (UNOS) fact sheet. UNOS is a nonprofit charitable organization that, under the authority of the federal government, maintains the United States’ organ transplant waiting list and works to develop organ transplantation policies and raise awareness about organ donation. According to UNOS, the chronic shortage of organ donors is the most critical issue facing the field of organ transplantation. While 22,854 lifesaving organ transplant operations were performed in 2000, over fifty-eight hundred people died while waiting for a transplant— an average of more than fifteen every day. I

Ironically, the increasing success rate of organ transplant procedures is one reason that organ transplant waiting lists have risen so dramatically since the late 1980s. The first organ transplants, performed in the late 1950s and 1960s, were characterized by high mortality rates; a major problem was that patients’ immune systems often rejected the foreign organ. The introduction of the drug cyclosporine in the 1980s helped mitigate this problem, and organ transplants subsequently became less experimental and more routine. Statistics indicate that in 1998 organ transplant procedures were successful 70 to 95 percent of the time, depending on the organ being transplanted. With these increasing success rates, more doctors have recommended the procedures.

Another factor behind the organ shortage is that, according to UNOS, “relatively few deaths occur under circumstances that make [cadaveric] organ donation possible.” There are two main types of organ donation: living-donor donation and cadaveric donation. Kidney transplants make up 95 percent of living-donor donations; the other 5 percent are largely from liver donations, a rare procedure in which an adult donates a portion of his or her liver to an infant. But the majority of kidney and liver donations, and virtually all pancreas, heart, and lung transplants, are removed surgically from donors shortly after their death. (By law, organs are only removed if the deceased carried an organ donor card or if family members give permission.)

Since the organs must be removed so quickly after death, cadaveric donors usually are individuals who have died in circumstances that make a swift determination of death possible: Among cadaveric donors in 1999, head trauma and cerebrovascular stroke accounted for 85 percent of all deaths. Thus, even if the number of people willing to donate organs in- creased at the same level as the demand for organ transplants, demand would outpace supply since only a minority of people die in circumstances that make cadaveric donation possible.

A final explanation for the organ shortage is Americans’ general reluctance to become organ donors. In a 1993 Gallup poll, 85 percent of those surveyed said that they support organ donation, but only 37 percent said that they were “very likely” to donate their own organs, and 25 percent said they were “not at all likely.” There are a variety of reasons that people may be uncomfortable with organ donation, but the Gallup poll zeroed in on a major one: 36 percent of respondents agreed that “thinking about your own death makes you uncomfortable.” Organizations such as UNOS are dedicated to encouraging Americans to overcome this reluctance to become organ donors. To this end they often stress that organ donation is a lifesaving act, not one that should be associated with death.

One of the most controversial proposals is to provide individuals with some type of incentive to become organ donors. Such incentives could range from straight cash payments for living-donor organs to government assistance with funeral expenses for the families of cadaveric donors. Currently, proposals for compensated donation would likely be in violation of the 1984 National Organ Transplant Act, which makes it illegal to buy or sell human organs. Critics also charge that payment for organ donation could lead to a black market for human organs. In fact, such a black market already exists in India, where, according to a 1998 investigative report in the New York Review of Books, wealthy foreigners with end-stage renal disease pay thousands of dollars for human kidneys “donated” by impoverished Indians.

Although tissue engineering, artificial organs, and xenotransplantation provide hope for the future, the thousands of people currently on organ transplant waiting lists are counting on altruistic organ donation. As bioethicist Arthur Caplan explains,

What is truly distinctive about transplantation is not technology but ethics. Transplantation is the only area in all of health care that cannot exist without the participation of the public. It is the individual citizen who while alive or af- ter death makes organs and tissues available for transplantation. If there were no gifts of organs or tissues, transplantation would come to a grinding halt.

The field of organ transplantation is one of the miracles of modern medicine, but its power to save lives depends directly on the availability of organs. The authors in At Issue: Organ Transplants debate the various ways to increase the number of organs available for transplant and thus reduce the number of patients who die every day waiting for a new heart, liver, or kidney.

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Posted by on March 9, 2012 in Uncategorized

 

My Decisions You Have to Respect

It’s not new for us, nursing students of PLM, to go home late at night. We know how dangerous places like Carriedo, Blumentritt, Divisoria, In front of Planetarium and even inside the walls which is the common route of the PLMayers. It is not just the place we need to be afraid of, but also the people we might encounter during our journey from PLM to our house and vice versa.

One night as the jeep stopped in front of Odeon Mall I noticed a man standing. Then there’s a girl, around 40’s in age, talked with him and asked if he likes to spend a night with a girl that is 16 years old at the price of 300. The said “16 year old girl” went beside the man after the old lady said the word “300” as if it is her cue that she needs to introduce herself to their customer. I was very eager to know how the transaction will end, but to my dismay the stop light turned green and so i failed to hear the live transaction I only read in news paper, pocket book and watched in television.

We can not change the fact that there are lots of teenagers who sell their body for a very low price. There are some, who are as pretty as the holly wood stars, who can price their service wherein only the upper society can afford. But there are things they have in common no matter how they price themselves and those things are: (1) having a multiple partner ; (2) do this to support their family; (3) they have bills to pay; (4) do this to support their education; and (5) this is the only job they know. They know the fact that being in this job is hard because aside from having multiple partner they are misjudged by the people not just in our society, but people around the world.

Girls, like the one I saw at the Odeon mall, who are a very active individuals having a multiple partner know that they prone on having HIV. It is very surprising how the HIV cases rises its number everyday. From a single positive HIV girl having 3 partners in a day  then her past partners who got HIV from her will also commit having multiple partners and those third parties who got HIV from than man will also have multiple partner and they will also got HIV and so on and so forth.

Once the positive HIV was admitted to the hospital, we are the one who is responsible for the patients health. Whatever decision the patient has we must know how to respect it. If ever the patient wants her diagnosis to be in secret to certain group of people we must know how to respect their right to confidentiality. We must see to it that the autonomy of the patient is for their best interest. We must know how to communicate with them properly to build rapport at the same time they will tell you things that are sensitive. In order to be a good nurse we must know the art of communicating for us to better assess the patient and to know what the real problem is in association with her medical diagnosis. Doing this things we will be able know what is the best nursing intervention we can give to the patient for them to attain better health and better life. Patient should trust us so that when they have decisions and we know it is not good for the patient we, nurses, are responsible on how to handle such situation. If ever there are things the patient don’t know, we should be responsible enough to tell them what is that for and how it can help for their health. If the patient decides something that might have bad effect on their health given that we already what is best for them we should clarify things with them in a way we will not insist what we want, rather we will tell them how they will benefit to the procedure and what are the possible consequences if they will not take the said procedure. We must tell things in a truthful manner, we should not lie because we want them to do things which we know right. We must always consider the patients best interest, but if there are certain situation wherein the patient can not decide from themselves so we must know what their best interest is. Sometimes we might be against the autonomy of the patient and we might appear doing some paternalistic act, but then we have to implement things for the betterment of the patient as long as their health is in our hands.

 

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Posted by on February 5, 2012 in Uncategorized

 

Couples Child From Other

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Many feel that having a child is one of God’s greatest gifts. Well, who doesn’t want to have a cuddly, hug gable, lovable and a very cute being?, I bet  everyone wants to touch it. Can you just imagine baby’s soft skin, significant smell and temporary innocence that are desired by potential parents. But sad to say that in some cases the joy of parenthood cannot be achieved naturally, but all hope is not lost due to Artificial Insemination

ImageYes, a baby is born  and it is the mother and the father who decides to undergone this procedure. They cannot conceive the child and they wanted to raise a baby from their own, this procedure is just perfect for them to have their own child. The child may not be born in a way it should be but the point is that the child came from the sperm and egg cell of his parents.

Problem arises when the father has no ability to reproduce a child and the main reason  is due to sperm count of the father. A donor in this situation is needed.  A sperm will come from another man and will be injected to the wife of the husband who wants to conceive the child. An ethical issue will rise like, who is the real father of the child? Is it morally right to conceive a baby not coming from your husband?

Again, it is the mother and the father’s decision to conceive a child using this procedure even if the sperm will came from another man or what we call “donor”.  Biologically speaking, we can consider the donor as the father of the child. It is his autonomy to give his sperm to couples who can not conceive a child as well as it is the couples autonomy to conceive a child in a way they like it to be. Many ethical issues will be violated by this process making it as one of the dilemma in our era.

Been there, done that. A child was born..1 year.. 2 years.. 3 years.. poop!! it has been 15 years when the child was born !! .. The procedure succeed !! The child now was a grown up teenager, One that can think for his own, can decide for himself and can understand things what others try to tell him. But wait I have a question to ask.. “parents,did you ever told your child that he was conceived from this procedure called artificial insemination?.. that he came from other mans sperm?” I bet you didn’t and those who did this thing and was able to explain it in a way the child can accept the fact.. A BIG CONGRATULATIONS on your part.. but for those who didn’t, where is the truthfulness in your part?.. Is it the child you consider your own will be completely happy if he will not now how he has been raised?. I think he has the right to know everything since he has been part of your experiment and he was included in the procedure you made 15 years ago.

Remember what the Bible said in John 8:32

“Ye shall know the truth, and the truth shall make you free.”

It isn’t bad to try tell him what his real identity is. What matters is that you are being true to him. It will only matter once you do things that will make him not to understand it. Like you have been mean to him, of course rebellion will be one of his way to express himself.

Here are some of the quotation that might help:

Truth is the only safe ground to stand on-.

Elizabenth Stanton

All truths are easy to understand once they are discovered; the point is to discover them.

Galileo Galilei

Do not run from the truth. There be nought so hard to live with as a lie.

Kathryn Nelson

I have been truthful all along the way. The truth is more interesting, and if you tell the truth you never have to cover your tracks.

Anonymous

Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened.

Wintson Churchill

 
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Posted by on January 12, 2012 in Uncategorized

 

Abortion

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Getting pregnant at an early stage of life is common in our time, this is called as teenage pregnancy .Teenage pregnancy generally refers to a female who is unmarried and usually refers to an unplanned pregnancy. A pregnancy can take place at any time after puberty, with menarche (first menstrual period) normally taking place around the ages 12 or 13, and being the stage at which a female becomes potentially fertile. Teenage pregnancy depends on a number of societal and personal factors. Teenage pregnancy rates vary between countries because of differences in levels of sexual activity, general sex education provided and access to affordable contraceptive options.

Story:

Cristy, my brother’s girlfriend, had her first pregnancy when she was 16. It was nearly Christmas when she announced the she was pregnant. My brother was shocked but then he asked his girlfriend what she wanted to do with the child. Cristy told him that she wanted the child to be aborted. The child was then 5 months and we know that during this month fetus was well develop and still developing. At first my was against the idea and doesn’t want the child to be aborted, but Cristy insisted to abort the fetus since she is a graduating student of Caloocan High School plus the fact that her parents didn’t know that she has a boyfriend and she was pregnant. My brother has no choice, Cristy’s decision is final the child will be aborted so he went to Quiapo to ask for an abortionist or a medicine to be taken to abort the child. He found an abortionist and the lowest priced offered to them is 12,500 and the result is a 50-50 chance of Cristy to survive in the procedure. My brother don’t have much money since he is a student as well as his grlfriend so they have no choice but to keep the baby alive and to raise it.

I am mad at my brother’s girlfriend when she told us that she wanted the child to be aborted. I was thinking that it is not the life of the pig, dog or monkey that is at risk. It is the life of the child, a creation higher than an animal, a creation said to be a fruit made out of love. I was thinking on how can she tolerate such an idea coming out from her mind. Isn’t she afraid of God? When was abortion consider right or wrong? When we consider the formation of human life? Is it when the egg cell or the sperm cell unite or is there other consideration?

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Dr. Jerome Lejuene, a famous and prominent French geneticist who is also known as the Father of Modern Genetics, made his historically-marked testimony at the court of Maryville, Tennessee regarding the particular activities of zygote indicating the presence of life. he stated authoritatively:

“The very young human being, just after fertilization, after it has split into two cells and there are three cells because curiously we do not split ourselves into two, four, eight and continue like that. No, at the beggining, we don’t do that….After that stage of three cells, it starts again, it comes to four, and it continues by multiple of two…

….It’s probably at the time that a message goes from one cell to the other cells, comes back to the first one and suddenly realizes we are not population of cells. We are bound to be an individual. That is individualization that makes the difference between a population of cells which, is just a tissue culture and an individual which will build himself according to his own rule, is demonstrated at the three cell stage, that is very soon after fertilization has occurred…

….the young individual, in command of his environment and destiny with a tenacious purpose, implants in the spongy lining and with a display of physiological power, suppresses his mother menstrual period. This is his home for the next 270 days and to make it habitable, the embryo develops the placenta and a protective capsule o fluid for himself. he also solves, single-handed, the homo graft problem, that dazzling fat by which fetus and mother, although immunological foreigner who could not exchange  skin grafts nor safely receive blood from each other, tolerate each other in parabiosis for nine months…”

Logically speaking, If it contains human life at the time it is conceived, the zygote existence presupposes the human spiritual soul infused as the very principle of life. In other words, the zygote is a human person.

When on receives a soul, life begins since the soul is the principle of life. and if the human zygote at the completion of fertilization manifests life which is necessarily humans (unless it is denied to contain human life which is, of course, absurd), then it presupposes the human soul indicating the existence of human person. Moreover, the development of a human being starting at conception which is commanded with precision by its distinct genetic code takes place in a continuous fashion.

While reminiscing about the abortion thing, An idea strike in my mind and it is about what the priest told us during the mass because of the current issue about the RH Bill.

Serving the pagans’ idols, they found themselves trapped into sacrificing their own sons and daughters to demons. they shed innocent blood, the blood of their sons and daughters offering them to the idols of Canaan, they polluted the country with blood. (Psalms 106: 37-38)

You on the other hand, have eyes and heart for nothing buy your own interests for shedding innocent blood and perpetrating violence and oppression. (Jeremiah 22:17)

If you do not exploit the stranger, the orphan, and the widows, if you do not shed innocent blood…. Then, here in this place, I will stay with you... (Jeremiah 7:6)

A curse on him who accepts a bride to take an innocent life; and all the people shall say: Amen. (Deuteronomy 27:25)

There are some books in our house that tackles about abortion. I remember that there is someone who stated something and this is what I found:

The Donum Vitae exhorts:

The inalienable rights of the person must be recognized and respected by civil society and the political authority. These human rights depend neither on single individuals nor on parents; nor do they represent a concession made by society and the state; they belong to human nature and are inherent in the person by virtue of the creative act from which the person took his origin. Among such fundamental rights one should mention in this regard is every human being’s right to life and physical integrity from the moment of conception until death.

The moment a positive law deprives a category of human beings of the protection which civil legislation ought to accord them, the state is denying the equality of all before the law. When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundation of a state based on law are undermined… As a consequence of the respect and protection which must be ensured for the unborn child from the moment of conception, the law must provide appropriate penal sanctions for every deliberate violation of the child’s rights.

To end this thing, I would like to say I’m happy about the fact that they don’t have money since it has been the reason why they can’t abort the child.  Applying what i have learned in our ethics about the utilitarianism,  I can conclude that maybe they still have this little conscience telling them that “hey don’t abort the innocent child. You both made that child so you should raise him.” They may find pleasure in the sense of them not being bugged by their conscience and living with their cute but malditang daughter. I know that they are not that financially stable, but there is a pleasure that they get when they see their child grow and when they set their plan for their family in the future.

 
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Posted by on January 1, 2012 in Uncategorized

 

Child Abuse: Agony of life

Every time I go to school there are children giving us envelop and asking for us to lend some money. Some of the passenger were irritated, some will give the envelop back immediately and say “sorry wala din kaming pera eh” and worse some will act as if they were sleeping just to be safe in lending some money. So what is the connection of what i’m telling to the blog I’m making?

Maybe some of you were confuse why I’m telling you stuff like this but for me child abuse is not just the definition from the net in which they stated that child abuse is the physical, sexual, emotional mistreatment, or neglect of a child, but for me it is also a deprivation of their human right and anything that is related to this things that happen to someone while they were a child will lead to the negative traits that will affect their moral development.

A child that is just wondering around and were not given enough protection, education, love, support, attention and peace of mind for me are those who were suffering from child abuse because they are too young to experience things like working or things that is not suitable for their age.

Child who were asking from money often here some comments like “ano ba yan nasan ang nanay mo?” or “wala kasing magawa yung ibang nanay anak lang ng anak” which is not good for them to here because they might be affected emotionally, mentally and spiritually. Let us always think that it is just we are lucky enough because we have parents who support us love us and care for us and it is not their fault why they were in that position and if they has a choice they might choose not to be alive rather than experiencing awful things.

The example above can be a common example of this issue since the people who are concern to this problem are the children.  In the first stage of Moral development which is the Preconventional there is what they called self interest orientation in which they will ask to themselves what is it for them? or in what way will they benefit if they will ask money from other.? . Well, I’m not speaking in behalf of them but my conclusion on why they were doing this is because it is the easiest way on asking for someones money and they will benefit from what they get by buying foods, clothes or other necessary things they need. In the second stage or conventional there is what we call Interpersonal accord and conformity and Authority and social-order maintaining orientation. In this the child should respect our law by following them making them a good citizen of our country or the “ good boy/good girl attitude” and lastly the third stage or “Postconventional” which includes Social contract orientation and Universal ethical principles which may state the necessary to meet “the greatest good for the greatest number of people.”

Some of the child moral aspect might develop negatively like in the first stage in which we might encourage them not to work using their own skill when they grow up- like the guy in the Tayuman- D.Jose station he is a big man with a complete body part but still he asks money from people ..-they will still ask for our money. While in the Conventional They might exhibit the bad boy bad girl attitude because some of the child who were asking for money and were not given are the one who do snatching. Lastly for the Post- Conventional      might be related to those children who grow up as a snatcher from being the “palimos boys” wherein they abide law because of getting something that isn’t your property.

Negative Moral development is commonly seen to these kind of child and it is up to us on how can we help them by developing positive moral development in accordance to our moral issue in our society that we will learn from out subject Ethics

 
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Posted by on December 9, 2011 in Uncategorized

 
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Euthanasia: The Greatest Pain in Mercy

Euthanasia comes from the Greek word “thanatus” which means “easy death.” Euthanasia is understood an action or omission which, of itself or by intention causes death, in order that all suffering may in this way be eliminated in an early way that is intentionally caused in order to get rid of difficult death.

Euthanasia in Omission (passive euthanasia) refers to a negative act of causing death that is geared towards termination of pain and suffering. So far, the strongest argument for euthanasia is its being perceived as an act of “mercy”, which apparently manifest itself in a motive to put an end to the terminal pain and misery of the person.This is why euthanasia is called mercy killing. People use it to get rid for the client who might face possible horrendous agony. And there is no other way by which the patient can definitely be freed from such terrible situation except to cause his earlier death which simply means to kill him. The patients death is seen as the only solution for the problem.

It is also contented that suffering patients, particularly those in coma, unconscious state and like have diminished person hood so that the life principle is violated if such individuals are put to permanent rest. Just as it is cruel to prolong the suffering of the patient by delaying his dying process it is cruel to eliminate his suffering by hastening his death even if he is surely dying after all.

However, we cannot be deny that the ultimate and even the greatest pain or harm that can be inflicted upon another, here on earth, is to be killed. At this juncture, the euthanasia advocates may insist ” but after his getting killed, the patients experiences no more suffering and pain. So it’s still worth the purpose”. Well the cessation of pain will just follow after the death but it cannot erase the reality that the greatest pain is inflicted, which is the act of killing.

 
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Posted by on December 2, 2011 in Uncategorized

 
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Infertility has been one of the major problem a husband and wife may have. In this case a procedure called artificial insemination is being introduce to the couple. Artificial insemination involves injecting collected semen into the woman’s uterus and is performed under a physician’s supervision. The semen may come from his husband himself or from the donor-the third party.

The legal minefield created by artificial insemination continues to erupt with new and unprecedented issues.If the semen came from the father and child has been delivered normally then legal issues will not be a big thing, but people will think differently if the semen came from the donor. Things like legitimacy of the child in many things will be questioned because for other people he will be considered as a child of the other man and not as a child of his father. Also this raises ethical questions about the right of an individual to be informed about his or her heritage. People who inadvertently discover they were conceived through artificial insemination often experience distress and feelings of confused identity.This people may feel the urge to know who their biological father is. They may feel incomplete and sometimes denial because from the start they taught that they are with their real father and suddenly they will know that they came from artificial insemination and came from a donor not from his known father.

In this case the child is not the only one who will suffer but also his family in which he has been raised. The role of the mother and his father, whom he spend his life with, is very important. The child acceptance to this issue may vary from how the parents will explain the things to their child. The parent and child should be open to their feelings so that they may have plan on how to overcome the problem they were facing even if it will take time for the child to accept this things.

 
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Posted by on November 18, 2011 in Uncategorized