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All Journal International Journal of Public Health Science (IJPHS) Archive of Community Health International Journal of Biosciences and Biotechnology Buletin Udayana Mengabdi Jurnal Kesehatan Masyarakat Jurnal Farmasi Klinik Indonesia Jurnal Biometrika dan Kependudukan (Journal of Biometrics and Population) ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Keluarga Berencana Journal of Health Sciences and Medicine OISAA Journal of Indonesia Emas Public Health and Preventive Medicine Archive Jurnal Ilmu Kesehatan Masyarakat Jurnal Ekonomi Kesehatan Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)

Putu Ayu Indrayathi

Program Studi Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Udayana, Bali

Author-ID : 2921159

Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences

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Penilaian mutu asuhan keperawatan sebelum dan sesudah penerapan clinical pathway di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia I Made Artana; Putu Ayu Indrayathi; I Made Ady Wirawan
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Hospitals implement clinical pathways in an effort to improve the quality of health services, especially the quality of nursing care. This study aims to determine whether the quality of nursing care after the application of the clinical pathway is better than the quality of nursing care prior to the clinical pathway application.Methods: This study used 180 inpatient medical records in January 2017-May 2019 with five priority medical diagnoses namely cerebral concussion and epidural hematoma (conservative therapy), conservative treatment of preterm premature rupture of membranes, ablation of atrioventricular nodal reentrant tachycardia (AVNRT) , atrioventricular reentrant tachycardia (AVRT), atrial tachycardia, atrial fibrillation, premature ventricular contractions (PVC), ventricular tachycardia (VT), junctional tachycardia and intracerebral haemorrhage (hemorrhagic stroke) as well as post-Lapastomy frozen section in the selected cystic ovary with a selective curative cyst . The variables studied were the application of clinical pathway, quality of nursing care, quality of assessment, diagnosis, planning, implementation and evaluation of nursing. Data were analyzed with the Pearson Chi-Square Test on SPSS version 17 for Windows.Results: The quality of good nursing care before and after the application of clinical pathway was 15.2% versus 50.9% (p = 0.00); good quality of nursing assessment before and after clinical pathway application of 6.7% versus 64.9% (p = 0.00); good quality of diagnosis before and after clinical pathway application of 72.7% versus 73.7% (p = 0.889); the quality of the nursing plan which consisted of good quality of goal formulation before and after the application of clinical pathway was 75.8% versus 73.7% (p = 0.759); good quality determination of interventions before and after clinical pathway application of 75.8% versus 79.8% (p = 0.523), good quality of implementation before and after clinical pathway application of 100% versus 100% and good quality of nursing evaluation before and after the application of clinical pathway is 100% versus 100%.Conclusion: The quality of nursing care and nursing assessment after the implementation of clinical pathway is significantly better than before the implementation of clinical pathway, while no significant difference was found in the quality of diagnosis, planning, implementation and evaluation of nursing.Â Latar Belakang: Rumah sakit menerapkan clinical pathway dalam upaya meningkatkan mutu pelayanan kesehatan khususnya mutu asuhan keperawatan. Penelitian ini bertujuan untuk mengetahui apakah mutu asuhan keperawatan sesudah penerapan clinical pathway lebih baik daripada mutu asuhan keperawatan sebelum penerapan clinical pathwayMetode: Penelitian ini menggunakan 180 rekam medis pasien rawat inap pada bulan Januari 2017-Mei 2019 dengan lima diagnosis medis prioritas yaitu cerebral concussion dan epidural hematoma (terapi konservatif), penanganan konservatif ketuban pecah dini preterm, ablasi padaÂ atrioventricularÂ nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), atrial takikardi, atrial fibrilasi, premature ventricular contractions (PVC), ventricular tachycardia (VT), junctional takikardi dan intracerebral haemorrhage (stroke hemoragik) serta post laparatomi frozen section pada kista ovarii curiga ganasyang dipilih dengan purposive sampling. Variabel yang diteliti adalah penerapan clinical pathway, mutu asuhan keperawatan, mutu pengkajian, penegakan diagnosis, rencana, implementasi dan evaluasi keperawatan. Data dianalisis dengan Uji Pearson Chi-Square pada SPSS versi 17 untuk Windows.Hasil: Mutu asuhan keperawatan yang baik sebelum dan sesudah penerapan clinical pathway sebesar 15,2% versus 50,9% (p=0,00); mutu pengkajian keperawatan yang baik sebelum dan sesudah penerapan clinical pathway sebesar 6,7% versus 64,9% (p=0,00); mutu penegakan diagnosis yang baik sebelum dan sesudah penerapan clinical pathway sebesar 72,7% versus 73,7% (p=0,889);Â mutu rencana keperawatan yang terdiri mutuÂ perumusan tujuan yang baik sebelum dan sesudah penerapan clinical pathway sebesar 75,8% versus 73,7% (p=0,759); mutu penentuan intervensi yang baik sebelum dan sesudah penerapan clinical pathway sebesar 75,8% versus 79,8% (p=0.523), mutu implementasi yang baik sebelum dan sesudah penerapan clinical pathway sebesar 100% versus 100% dan mutu evaluasi keperawatan yang baik sebelum dan sesudah penerapan clinical pathway sebesar 100% versus 100%.Simpulan: Mutu asuhan keperawatan dan pengkajian keperawatan sesudah penerapan clinical pathway secara signifikan lebih baik daripada sebelum penerapan clinical pathway, sedangkan mutu penegakan diagnosis, rencana, implementasi dan evaluasi keperawatan tidak terdapat perbedaan yang signifikan.

Association between transformational leadership, organizational commitments, and application of Total Quality Management (TQM) to employee performance in Sanglah General Hospital, Bali, Indonesia Fery Dwiyanto; I Putu Ganda Wijaya; Putu Ayu Indrayathi
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Employee performance results from work achieved by an employee in quality and quantity in carrying out tasks in accordance with the responsibilities given. Good employee performance increases hospital customer satisfaction. This study aims to determine the relationship between transformational leadership, organizational commitment, and the application of Total Quality Management (TQM) with employee performance at Sanglah Central General Hospital.Methods: A cross-sectional study was conducted among 87 samples. Samples in each installation/unit that fulfilled inclusion criteria were selected using proportional random sampling. Data were analyzed using univariate, bivariate (chi-square), and multivariate (logistic regression) by SPSS version 20 for Windows.Results: Most employees perceived good in transformational leadership (67.8%), good organization commitment (55.2%), good application of TQM (75.9%), and good employee's performance (65.5%). The bivariate analysis shows a significant association between transformational leadership (p=0.001), organization commitment (p=0.001), and application of TQM (p=0.010) with employees' performance in Sanglah General Hospital. However, according to the multivariate analysis, a statistically significant association variable is organizational commitment (OR=547.96; 95% CI=4.922-613.673; p=0.001).Conclusion: Factors associated with the employee's performance in Sanglah Hospital are transformational leadership, organizational commitment, and TQM. Therefore, stakeholders in the hospital should consider the loyalty of employees in determining policies to improve service quality continuously.

DETERMINANT FACTORS COUPLES TO AVOID HAVING MORE CHILDREN IN BALI PROVINCE Putu Ayu Indrayathi; Istiana Marfianti; Putu Erma Pradnyani; Luh Putu Sinthya Ulandari; Anastasia Septya Titisari; Luh Kadek Ratih Swandewi
Jurnal Biometrika dan Kependudukan (Journal of Biometrics and Population) Vol. 11 No. 02 (2022): JURNAL BIOMETRIKA DAN KEPENDUDUKAN
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbk.v11i02.2022.184-193

The number of married women and men who no longer want children in Bali Province is consistent with a relatively high contraceptive prevalence rate (CPR) of 67%, higher than the national average of 64%. The large proportion of couples of reproductive age (CRA) who no longer want children either at the national or provincial level in Bali is an interesting thing to be analyzed further to see the factors that influence it. This study investigated secondary data of the 2017 Indonesia Demography and Health Survey (IDHS) in Bali Province. The variables studied included socio-demographics and desire to have children. The sample size was 271 married women (15-49 years). We found that the age of women of reproductive age (WRA), occupation of WRA, number of children alive, and ideal number of children are the four significant factors that influence the desire to have no more children in married couples. Based on these findings, a better family planning program can hopefully be made in the Bali province.

DETERMINANT FACTORS FOR UNINTENDED PREGNANCY IN BALI PROVINCE Putu Ayu Indrayathi; Putu Erma Pradnyani; Ngakan Putu Anom Harjana; Luh Putu Sinthya Ulandari; Anastasia Septya Titisari; Luh Kadek Ratih Swandewi
Jurnal Biometrika dan Kependudukan (Journal of Biometrics and Population) Vol. 11 No. 1 (2022): JURNAL BIOMETRIKA DAN KEPENDUDUKAN
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbk.v11i1.2022.36-44

Bali Province has the lowest unmet need achievement, namely 8.1%, meaning that it has a low-value gap between the availability of contraceptive services and the needs of the community. This study analyzed the factors that influence the incidence of unintended pregnancy among childbearing-age women in Bali. This research is a secondary data analysis from the Program Performance and Accountability Survey (PPAS) of the National Population and Family Planning Board in 2019. The variables studied were selected from the PPAS’s Women data, with 1,214 samples of married fertile women aged 15-59 years in Bali. Multivariate analysis in the form of a logistic regression test is carried out to estimate factors that affect unintended pregnancy incidence in childbearing-age women in Bali. Factors influencing unintended pregnancy are age and having heard of family planning, understanding birth control, understanding population issues, and having listened to adolescent reproductive health. The multivariate analysis shown that age and having heard of family planning are two factors that significantly influence unintended pregnancy. Two factors that influence unintended pregnancy in Bali are age and having heard about family planning. Therefore, cross-sector engagement is required to provide a family planning program to the targeted fertile women's age found in this research to improve women's exposure to the program.

Perceived importance of structural factors are associated with the selection of primary care by national health insurance participants Putu Nitya Nirmala; Pande Putu Januraga; Putu Ayu Indrayathi
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p05

Background and purpose: Primary care are the entry point for health services in an insurance-based health financing system, including the National Health Insurance Program or Jaminan Kesehatan Nasional (JKN) in Indonesia. This study aims to understand the association between structural factors in health service management with primary care selection among JKN participants. Methods: The study used a cross sectional analytic design, conducted with 273 self-paid JKN participants in Denpasar as respondents. The samples were selected using multistage random sampling. Data was collected from April to May 2018 with interviews using a questionnaire covering the characteristics of respondents and perceptions on the importance of health care facilities, the capabilities of health providers, service distance, operational time, availability of drugs and medical equipment. Data analysis was carried out with multinomial logistic regression to determine the structural factors of health service management associated with the selection of primary care. Results: Most respondents (65.9%) chose private clinics, 21.3% chose public health centres (PHCs) and 12.8% chose individual practicing physicians. Multivariate analysis showed that the variables which significantly associated with the selection of primary care among JKN participants were the perceived importance of the health care facilities at PHCs and private clinics, each with AOR=7.83 (95%CI: 2.72–22.54) and AOR=7.18 (95%CI: 2.76–18.68), the perceived importance of the capability of health workers in private clinics with AOR=0.29 (95%CI: 0.12–0.77), the perceived importance of health service time in private clinics with AOR=2.67 (95%CI: 1.05–6.74) and history of health services utilization at private clinics with AOR=4.51 (95%CI: 1.86–10.96). Conclusion: Structural factors are associated with the selection of primary care among JKN participants. Attention to the quality and quantity of structural factors in the management of health services is important to improve the equitable distribution of JKN membership in the registered primary care.

Utilization of the smoking cessation clinic at Public Health Centre 1 North Denpasar: A qualitative study Sri Idayani; Putu Ayu Indrayathi; Dyah Pradnyaparamita Duarsa; Dinar Lubis
Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v6.i2.p13

Background and purpose: The incidence of morbidity and mortality due to tobacco use is very high. There are several strategies to help smokers quit, one of which is counseling to stop smoking in a clinic setting. The purpose of this study was to explore in depth the utilization of smoking cessation clinics at a Public Health Centre (PHC). Methods: A qualitative study through in-depth interviews was conducted with 14 informants who had been provided with a counseling at a smoking cessation clinic, consisting of five informants who had quit smoking and nine informants who were still smoking. Triangulation of data was carried out by conducting in-depth interviews with the head of PHC and one counselor on duty at the smoking cessation clinic. The information collected includes the utilization of the clinic, strategy of PHC in recruiting patients, knowledge about smoking cessation and the benefits of attending counseling. Data collection was carried out at the home of each informant during March-April 2018. The results of the interviews were analyzed thematically after a verbatim transcription being conducted. The data presented in a narrative to provide an in-depth description of the utilization of smoking cessation clinics in a PHC. Results: The results of interviews with PHC staff showed that in order to increase the utilization of the smoking cessation clinic, the services are integrated into the general polyclinic. Interviews with informants who have not stopped smoking indicate that to improve the utilization of the clinic, promotion and service variations are needed and not only focus on counseling. Interviews with informants who have stopped smoking show that counseling at the clinic can increase their willingness to stop smoking. Conclusion: To improve the utilization of smoking cessation clinics, in addition to integrating services into the general polyclinic, promotion and variations in services are also required.

Barriers to Encourage Motivation in Relation to Work Performance of Nurses in Buleleng District Hospital Budiastri; Ayu Indrayathi; I Putu Ganda Wijaya
Public Health and Preventive Medicine Archive Vol. 2 No. 1 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2014.v2.i1.p06

Background and purpose: Nurses at hospitals regularly receives criticism from the general public, negatively commenting on their lack of patient care, lack of professionalism and diminished quality of service. Survey findings on patient satisifaction at Buleleng Public Hospital from 2011 indicate that 2.03% of patients remained unsatisfied with staff workplace attitudes and 6.39% felt that nursing service overall was unsatisifactory. Preliminary interviews with ward nurses on 24 November 2012 exposed a number of issues: a lack of career support and development for nurses, including opportunities to expand their skills, and a lack of workplace satisifaction from patient supplementary income. Weakness regarding technical support and motivation from ward supervisors evidently also has an impact on nurses workplace motivation and therefore quality of service. This research investigates the influence of supervision, career development, supplementary income support, and administrational records on the workplace attitude of nursing staff. Methods: Research was formulated using qualitative and phenomenology methods. Informants were purposively selected. Data was collected through in-depth interviews and administration documentation study and analysed using thematic analysis. Results and conclusion: Findings indicated that little monitoring and evaluation of nurse workplace attitudes, a lack of support and motivational direction from supervisors, administrational documentation issues, minimun supplementary income support, as well as career development had a large impact on nurse quality of care. Most dominant variables included supervision, career development and supplementary income support.

Internal and External Perspectives on Quality of Healthcare Services at Sanglah General Hospital Denpasar Made Nopy Diah Sundari; Putu Ayu Indrayathi; Raden Ayu Tuty Kuswardhani
Public Health and Preventive Medicine Archive Vol. 2 No. 2 (2014)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2018.v2.i2.p03

Background and purpose: Customer satisfaction is a primary indicator of the quality of public healthcare services. This study investigated internal (hospital staff) and external (hospital clients) perspectives in order to gain insight into the quality of care at Sanglah General Hospital. Methods: The study used both qualitative and quantitative methodologies with 11 informants and 106 respondents. Qualitative data obtained through in-depth interviews with hospital staff were analyzed thematically. Quantitative data obtained through self-administered questionnaire were analyzed using univariate analysis. Results: Informants from the qualitative data collection stated that Sanglah General Hospital has a relatively high level of service and that existing structures to mitigate issues are in place, which act as reinforcing factors. Data from the quantitative survey indicated that clients were satisfied with the quality of service (ServQual), with an overall percentage of 83.82%. Conclusion: Further efforts could be made in order to improve healthcare provision at Sanglah Hospital, particularly from the perspective of hospital facilities, staff support and increased implementation of clinical governance.

Perceptions of Community Health Center’s Workers on National Health Insurance (JKN) Healthcare Services Payment System in Karangasem Regency Ni Wayan Ani Hendrayani; Putu Ayu Indrayathi; I Putu Ganda Wijaya
Public Health and Preventive Medicine Archive Vol. 3 No. 2 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i2.p07

Background and purpose: National Health Insurance (JKN) healthcare services payment system is a financial compensation given to employees of health centers through an allocation system implemented by the Ministry of Health Regulation (Permenkes No. 28 of 2014). This study aims to explore health care workers perception of the JKN health care services payment system. Methods: In-depth interviews conducted among 12 participants selected purposively namely heads of health centers (doctors and public health graduated), medical personnel, paramedics, other health professionals, non-health personnel (both civil servants and noncivil servants). Data were analyzed using thematic analysis approach presented narratively. Results: Participants intimated that the amount of points based on the variable of kind of personnel and/or positions were not proportional/not in accordance with the actual condition of the health center. The use of attendance rates made for an unconducive atmosphere as it was evident that this variable was not applied to all employees but only to the central health centers. The differentiation of employment status with the same workload, and the uneven amount of points and grouping of years of service rather than workload was viewed as unfair and bias by respondents therefore they believed this needs further assessment. Conclusion: The allocation of the JKN health care services payment system was perceived as prejudicial by the employees of the health centers in Karangasem Regency. The amount of points distributed were not proportional to the type of personnel and/or position, and the use of the level of attendance, differentiation of employment status, grouping of years of service not based on workloads were all issues raised by respondents.

HUBUNGAN PAPARAN INFORMASI KAMPUNG KELUARGA BERKUALITAS TERHADAP PENGETAHUAN DAN PENERIMAAN MASYARAKAT KOTA DENPASAR Putu Erma Pradnyani; Putu Ayu Indrayathi; Luh Kadek Ratih Swandewi
Jurnal Keluarga Berencana Vol. 8 No. 1 (2023): Jurnal Keluarga Berencana
Publisher : Badan Kependudukan Dan Keluarga Berencana Nasional

Kampung Keluarga Berkualitas (KB) adalah satuan wilayah setingkat RW, dusun atau setara, yang memiliki kriteria tertentu dimana terdapat keterpaduan Program Pembangunan Keluarga Kependudukan dan Keluarga Berencana (Bangga Kencana) dan pembangunan sektor terkait yang dilaksanakan secara sistemik dan sistematis. Tujuan dibentuknya Kampung Keluarga Berkualitas adalah untuk meningkatkan kualitas hidup masyarakat di tingkat kampung atau yang setara melalui Program Pembangunan Keluarga Kependudukan dan Keluarga Berencana (Bangga Kencana) serta membangun sektor terkait dalam rangka mewujudkan keluarga kecil berkualitas. Tujuan dari penelitian ini adalah ingin mengetahui hubungan paparan informasi terhadap pengetahuan dan penerimaan masyarakat tentang Kampung KB di Kota Denpasar. Penelitian ini menggunakan rancangan deskriptif kuantitatif dengan pendekatan cross-sectional. Proses penelitian yaitu pengumpulan data dilakukan selama 1 bulan yaitu 26 Juni-26 Juli 2021. Responden dipilih secara consecutive sampling. Jumlah responden sejumlah 138 responden. Variabel dalam penelitian ini terdiri dari karakteristik demografi, paparan informasi, tingkat pengetahuan mengenai Kampung KB, dan penerimaan masyarakat terhadap desa yang dijadikan kampung KB. Analisis bivariat untuk melihat hubungan antara paparan informasi, pengetahuan, dan penerimaan menggunakan uji Chisquare/Fisher Exact. Tidak terdapat hubungan yang signifikan paparan informasi terhadap penerimaan namun terdapat hubungan yang signifikan paparan informasi dengan pengetahuan responden. Ada hubungan pengetahuan dengan penerimaan masyarakat terhadap Kampung Keluarga Berkualitas. Partisipasi masyarakat dalam perencanaan mempunyai sifat sangat penting bagi kepentingan program dan masyarakat itu sendiri. Penelitian lanjutan juga penting dilakukan terkait menggali faktor-faktor yang berpengaruh terhadap penerimaan masyarakat terhadap adanya Program Kampung KB sehingga Program Kampung KB dapat didukung oleh masyarakat setempat.

Co-Authors Adhi, K.T. Anak Agung Sagung Istri Maradi Suryaningrat Anastasia Septya Titisari Benny Tjahjono Budiastri Citra Mutiarahati, Ni Luh Cokorda Bagus Jaya Lesmana, Cokorda Bagus Jaya Coratry Shovariah Premilga Desak Putu Yulita Kurniati Dinar Lubis Dinar Lubis Dyah Pradnyaparmita Duarsa Fery Dwiyanto HARI MULYAWAN Hendrayani, Ni Wayan Ani I Gusti Ayu Agung Putri Krismayanthi I Ketut Suwiyoga I Ketut Tunas I Made Ady Wirawan I Made Artana I Nyoman Gede Budiana I Putu Ganda Wijaya I Putu Ganda Wijaya I Putu Ganda Wijaya Ilyas, Jaslis Istiana Marfianti Istiana Marfianti Ketut Suarjana Kolozsvari, Laszlo Robert Krismayani, Tika Krismayanti, Ni Kadek Ari Kurniati, Desak Putu Y Kurniawati, D.P.Y. Laszlo Robert Koloszvari Laszlo Robert Kolozsvari Luh Kadek Ratih Swandewi Luh Kadek Ratih Swandewi Luh Putu Sinthya Ulandari Luh Seri Ani Made Nopy Diah Sundari Manuaba, I.B.G. Fajar Megayanti, Ni Luh Komang Monika Sri Yuliarti Monika Sri Yuliarti, Monika Sri Murniati, Ni Nengah N.M.U. Dwipayanti Ngakan Putu Anom Harjana Ni Ketut Sutiari Ni Luh Saptiaryati Ni Made Ari Listiani Ni Made Mas Dwi Purwaningrat Ni Made Sri Nopiyani Ni Nengah Murniati Ni Nyoman Intan Widya Sari Ni Wayan Ani Hendrayani Ni Wayan Arya Utami, Ni Wayan Arya Nijyoti, Nitya Nirmala, Putu Nitya Nitya Nijyoti Pande Made Sri Rahayu Pande Putu Januraga Putu Dwiki Damadita Putu Erma Pradnyani Putu Inok Puspaeni Putu Nitya Nirmala Putu Novi Trisna Dewi R. A.T. Kuswardhani Rasmaya Niruri Rasmaya Niruri Rasmaya Niruri Rina Listryowati Rina Listyowati Rina Listyowati Rina Listyowati, Rina Rini Noviyani Sagun Chandra Yowani Santosa, Karina Samaria Sri Idayani Sri Idayani, Sri Suandana, Iwan Abdi Sundari, Made Nopy Diah Ulandari, Luh Putu S WIDARSA WIDARSA Wijaya, I Putu Ganda Yaslis Ilyas

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