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Jurnal Rakat Sehat : Pengabdian Kepada Masyarakat
Published by Poltekkes Kemenkes Banjarmasin
ISSN : -     EISSN : 29630258     DOI : 10.31964 J
Core Subject : Health,
Dentistry Medicine & Pharmacology Nursing Public Health Veterinary
Jurnal Rakat Sehat (JRS) Pengabdian Kepada Masyarakat diterbitkan oleh Pusat Penelitian dan Pengabdian kepada Masyarakat Poltekkes Kemenkes Banjarmasin adalah peer-reviewed journal yang memuat artikel-artikel ilmiah dari berbagai disiplin ilmu yang diadopsi dalam berbagai aktivitas pengabdian kepada masyarakat dan penelitian terapan lainnya. Artikel-artikel yang dipublikasikan di JRS Pengabdian Kepada Masyarakat Pusat PPM Poltekkes Kemenkes Banjarmasin meliputi hasil-hasil penelitian ilmiah asli, artikel ulasan ilmiah yang bersifat baru, atau komentar atau kritik terhadap tulisan yang ada dimuat di JRS Pengabdian Kepada Masyarakat maupun dalam terbitan berkala ilmiah lainnya. JRS Pengabdian Kepada Masyarakat menerima manuskrip atau naskah artikel dalam bidang riset terapan dan hilirisasi hasil penelitian ilmiah kuantitatif maupun kualitatif berbasis komunitas kedalam format pengabdian masyarakat yang mencakup bidang keilmuan yang relevan FOKUS ILMU KESEHATAN.
Arjuna Subject : Profesi Kesehatan - Profesi Kesehatan (Lain-Lain)
Articles 80 Documents
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Edukasi Kesehatan Reproduksi terhadap Remaja di SMA IT Ar-Rahman Banjarbaru Nurul Hekmah; Nisa, Ainun; Fathullah, Desya Medinasari; Fajrina, Nur
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.15

Abstract

Teenagers are residents in the age range of 15-21 years. Physically, adolescent women need to be prepared in terms of knowledge regarding the beginning of pregnancy to birth. The nutritional problem that often arises in adolescents is the fulfillment of nutrition before marriage. Through the 1000 First Days of Life (HPK) movement, it is hoped that it can provide interventions to provide knowledge about pre-marital nutrition. Good nutritional status in expectant mothers during the preconception period is a determinant of the quality of human resources. Having good and proper knowledge about nutrition before marriage, as well as how to maintain their health, is expected to make teenagers more responsible. Educational activities are carried out by first asking questions to respondents before the implementation of education (pre-test) and returning questions after the implementation of education (post-test). The results of the educational activities showed that there was a change in adolescent knowledge regarding reproductive health, in this case regarding pre-marital nutrition, when viewed from the average scores obtained by students before and after the educational activities. The results achieved experienced an increase in knowledge as seen from the results of the pre test and post test. The increase in the percentage of students' knowledge before being given education by 52.1% increased to 78.5% after being given education. Educational activities regarding reproductive health like this are best given to teenage students and can be carried out periodically by school teachers to class X students in fulfilling the knowledge of adolescent students in preparation for entering the reproductive period.
Peningkatan Pengetahuan Masyarakat Melalui Pendidikan Kesehatan Tentang Protokol Pencegahan Covid-19 Di Kelurahan Sungai Tiung Banjarbaruealth Education About the Covid-19 Prevention Health Protocol In Sungai Tiung Village, Banjarbaru City Mariana, Evi Risa; Sajidah, Ainun; Fauziah, Erna
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.34

Abstract

Based on data from the Ministry of Health, which was published by BNPB Public Relations, Tuesday (26/1/2021), the cumulative total of Corona cases in Indonesia is 1,012,350. Looking at the 1 million figure, the Minister of Health stated that the public and government must work hard to overcome the pandemic. In order to stop the transmission of Covid 19, the Indonesian government will also vaccinate the Indonesian population. Even though the vaccine has been given, other efforts continue to be made by health experts and the public to end the increase in the Covid-19 virus. In several countries including Indonesia, the government has made health guidelines and protocols to deal with the Covid-19 virus. The results of research conducted by Fauziah, E. et al. In 2021, in Sungai Tiung Village, data was obtained that some people had a positive perception of administering the Covid-19 vaccine, but from the questionnaire questions, many respondents answered incorrectly on matters relating to health protocols for preventing Covid-19. Based on the results of this research and given the importance of health protocols for preventing Covid-19, it is necessary to increase knowledge through health education to the public about health protocols for preventing Covid-19.
Kolesterol dan Tekanan Darah Lansia di Posyandu Abiyoso Polkesbaya Christyaningsih, Juliana; Rusyadi, Luthfi; Minarti, Minarti; Mamik, Mamik; Pestariati, Pestariati; Mutiarawati, Diah Titik; Suliati, Suliati; Sasongkowati, Retno; Woelansari, Evy Diah; Suhariyadi, Suhariyadi; Istanto, Wisnu; Endarini, Lully Hanni; Museyaroh, Museyaroh
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.35

Abstract

As people age, the physical state of the human body will gradually deteriorate due to a decrease in the quantity of cells present, leading to a gradual reduction in functionality referred to as the aging process. In elderly humans (aged more than 60 years) excessive cholesterol levels and high blood pressure are one of the causes of diseases such as heart disease which has been recognized by WHO as the number one cause of death in the world. The buildup of fatty deposits on the linings of blood vessels has the potential to lead to obstructions within the blood vessels. The objective of this initiative is to enhance understanding regarding the hazards associated with cholesterol. This outreach effort took place in July 2023, conducted at Posyandu Abiyoso, Surabaya Health Polytechnic. The activity consists of several processes 1). conducting a survey of the location of the Abiyoso posyandu of the Surabaya Health Polytechnic, 2). Opening registration and taking participants' personal data, 3) conducting participant health interviews, 4). Checking cholesterol levels and blood pressure of participants. From the community service activities carried out, it was found that 42 of the 65 (64.6%) participants who took part in the examination at the integrated service post had high cholesterol levels, and 60 of the 65 (92.3%) participants had high blood pressure or hypertension. By conducting health checks on cholesterol levels and blood pressure, there is an expectation that the society will come to realize and comprehend. the dangers of hypertension and hypercholesterolemia so that the community can prevent the occurrence of sustainable diseases.
Kontrol Kesehatan, Promkes dan Aktifitas Fisik Pada Lansia Wilayah Puskesmas Banjarbaru Utara Dan Martapura1 Ilmi, Bahrul; Fauziah, Erna; Rizani, Akhmad
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.39

Abstract

Angka tertinggi Covid-19  kelurahan Banjarbaru Utara, sebanyak 2237 kasus,  dipantau 110, dirawat 24 orang sumber data Dinas Kesehatan Kota Banjarbaru (2022) Hipertensi dan Diabetes merupakan komorbid yang dapat memperparah infeksi virus Covid-19, dan menjadi penyebab kematian tertinggi pada penderita Covid-19 berdasarkan laporan CNN Indonesia (2020). Tujuan melaksanakan peningkatan kapasitas Lansia melalui Kontrol kesehatan, promosi kesehatan; konsep Era Normal Covid-19, pentingnya menjaga imun tubuh, dan penyakit komorbid Hipertensi serta melakukan aktifitas fisik.   Abstract: The highest number of COVID-19 cases in the North Banjarbaru sub-district is 2,237 cases, 110 monitored and 24 people treated (Banjarbaru City Health Office, 2022). Elderly health problems include rheumatoid arthritis due to increased uric acid, high blood pressure, and diabetes mellitus. This is because it is said that hypertension and diabetes are co-morbidities that can exacerbate infection with the Covid-19 virus and are the highest cause of death in sufferers of Covid-19. (CNN Indonesia, 2020). The aim of carrying out capacity building for the elderly through health control, and health promotion, the concept of the Covid-19 Normal Era, the importance of maintaining the body's immunity, and comorbid hypertension and physical activity. Results of community service: hypertension in the elderly is quite high, as much as 47%, with the risk of comorbid COVID-19, heart disease, and stroke. Elderly examination results for Glucose increased up to 19%, Cholesterol increased to 88%, and Uric Acid up to 33%. Health control, counseling, gymnastics for the elderly, and anti-stroke do not necessarily reduce blood pressure in the elderly, but they can still maintain their health so that blood pressure is within normal limits.
Edukasi tentang Senam Ibu Hamil di Wilayah Puskesmas Perumus dalam Kota Banjarmasin Tahun 2023 Prihatanti, Nur Rohmah; Isnaniah, Isnaniah; Yuliastuti, Erni; Maslani, Noorhayati
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.40

Abstract

Pregnancy exercise is a fitness program for pregnant women. Therefore, pregnancy exercise has special movement principles that are adapted to the conditions of pregnant women. Pregnancy exercise is very important for pregnant women 22 weeks after pregnancy so that it can reduce the incidence of low birth weight and premature birth. The results of the research conducted showed that 100% of pregnant women experienced back pain, although the levels were different and regular pregnancy exercise was proven to reduce back pain. The results of other studies also show that there is an effect of pregnancy exercise on the sleep quality of third-trimester pregnant women. The goal to be achieved through this service activity is to increase the knowledge of pregnant women about pregnancy exercise in the Pemurus Community Health Center Area in the City of Banjarmasin in 2023. The method for this community service activity is a form health promotion and community empowerment programs through counseling and IEC for pregnant women. The results of the community service activities carried out showed an increase in knowledge from before and after counseling by increasing from 45% to 85% being good. The conclusion from this counseling activity is that efforts that can be made to reduce back pain are increasing knowledge through education about pregnancy exercise. Health education or health promotion is carried out from the beginning of pregnancy, it is hoped that this information can change the understanding and knowledge of pregnant women so that pregnant women understand the purpose and indications of pregnancy exercise so that mothers can prepare for pregnancy physiologically.
Pemanfaatan Buku Kia Untuk Optimalisasi 1000 Hari Pertama Kehidupan Di Wilayah Kelurahan Palam Prihatanti, Nur Rohmah; Hapisah; Daiyah, Isrowiyatun; Megawati; Rizani, Ahmad; Ismarini, Novi
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.41

Abstract

1000 Hari Pertama Kehidupan merupakan masa periode emas dimana terjadi proses tumbuh kembang yang sangat pesat dimulai sejak masa janin  sampai  anak  usia  dua  tahun dan tidak terjadi pada  kelompok  usia  lain. Upaya kesehatan ibu dan anak, bayi yang sehat dan bertumbuh kembang optimal serta untuk menjaga kualitas sumber daya manusia Indonesia, produktifitas, dan daya saing bangsa diperlukan media Komunikasi, Informasi dan Edukasi serta pencatatan yang efektif dan efisien. Sehingga Kementerian Kesehatan menetapkan bahwa Buku Kesehatan Ibu dan Anak (Buku KIA) menjadi alat pencatatan pelayanan kesehatan ibu dan anak sejak ibu hamil, melahirkan, nifas, dan bayi yang dilahirkan mencapai usia 5 tahun, termasuk pelayanan imunisasi, gizi, tumbuh kembang anak dan KB. Kementerian Kesehatan telah mencetak dan mendistribusikan Buku KIA ke daerah sejumlah 94% dari jumlah sasaran ibu hamil, dan seluruh Puskesmas telah menerima Buku KIA yang didistribusikan Dinas Kesehatan Kab/Kota. Data survei kesehatan nasional (2016) menunjukkan sebanyak 81,5% ibu hamil menyatakan memiliki Buku KIA, namun hanya 60,5% di antaranya yang bisa menunjukkan buku KIA. Metode pada kegiatan pengabdian masyarakat ini adalah bentuk program promosi kesehatan dan pemberdayaan masyarakat melalui penyuluhan kepada ibu hamil dalam memanfaatkan buku KIA. Penyuluhan tentang pemanfaatan buku KIA untuk optimalisasi 1000 hari pertama kehidupan di Kelurahan Palam didapatkan hasil bahwa terjadi peningkatan pengetahuan pada ibu hamil setelah dilakukan penyuluhan. Pengetahuan yang baik dapat meningkatkan pemanfaatan Buku KIA menjadi lebih efektif dan optimal. Perlu adanya evaluasi lanjut terkait pengetahuan Ibu hamil tentang pemanfaatan buku KIA.     Abstract: The First 1000 Days of Life is a golden period in which a very rapid process of growth and development occurs, starting from the fetus until the child is two years old, and does not occur in other age groups. Efforts for maternal and child health, healthy babies, and optimal growth and development and to maintain the quality of Indonesia's human resources, productivity, and national competitiveness require Communication, Information and Education media as well as effective and efficient record keeping. So the Ministry of Health stipulates that the Maternal and Child Health Book (KIA Book) is a tool for recording maternal and child health services since pregnant women, childbirth, postpartum, and babies born reach the age of 5 years, including services for immunization, nutrition, child growth and development and family planning. The Ministry of Health has printed and distributed the KIA Book to the regions as much as 94% of the target number of pregnant women, and all Community Health Centers have received the KIA Book distributed by the District/City Health Office. Data from the National Health Survey (2016) showed that 81.5% of pregnant women said they had a KIA Book, but only 60.5% of them could show a KIA Book. The method for this community service activity is a form of health promotion program and community empowerment through counseling to pregnant women by utilizing the KIA Book. Counseling on the use of the KIA book for optimizing the first 1000 days of life in Palam Village resulted in an increase in knowledge of pregnant women after counseling was carried out. Good knowledge can increase the utilization of the KIA book to be more effective and optimal. There is a need for further evaluation related to pregnant women's knowledge about using the KIA Book.
Penerapan PHBS dalam Perawatan Kebersihan Diri Santriwati Mahdalena, Mahdalena; Rifqoh, Rifqoh; Syarifuddin, Syarifuddin; Maulana, M. Nurfajrin; Rahman, M.Aulia; Yatma, M. Ady; Sadzaly, Alfaridzi Rizqi
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.44

Abstract

Pada tahun 2020  di Ponpes NU Siti Aisyah ditemukan 21 orang (25,3%) dari total 83 santriwati mengalami gejala gatal terutama pada malam hari. Hasil pemeriksaan mikroskopis 8 (9,63%) santriwati positif skabies dengan area predileksi cukup luas hampir 2% dari seluruh permukaan kulit bahkan di area selangkangan dan areola mammae. Skabies merupakan penyakit menular yang harus ditangani. Kegiatan pengabmas ini mengharapkan santriwati mampu dalam melakukan pencegahan dan pengobatan scabies. Metode yang dilakukan adalah pelayanan kesehatan,  pendidikan dan latihan kesehatan. Hasil kegiatan pengabmas melakukan pemeriksaan Mikroskopis Skabies pada Santriwati Pondok Pesantren Nahdatul Ulama Siti Aisyah Martapura dilakukan dengan metode Adhesive tape ditemukan positif skabies sebanyak 29,2% atau sejumlah 21 orang santriwati dari 72 orang. Sehingga dilakukan penanganan Santriwati yang terinfeksi skabies diberi pengobatan secara medis sampai akhir kegiatan. Pengetahuan santriwati tentang scabies dan penatalaksanaannya ditingkatkan menjadi 90,3%. Santri mampu melakukan Pengelolaan lingkungan Pondok Pesantren yang bersih melalui membuang sampah pada tempatnya, membersihkan ruangan dan halaman setiap hari, menghindari pakaian bergantungan, membuka jendela setiap pagi sampai siang hari serta pengolahan air bersih. Santriwati diharapkan selalu menjaga kebersihan dan kesehatan. Petugas kesehatan hendaknya secara teratur, regular melakukan pelayanan kesehatan dan membina UKS yang ada di Pondok Pesantren kesehatan para santriwati selalu terpantau.     Abstract: In 2020, at the NU Siti Aisyah Islamic Boarding School, it was found that 21 people (25.3%) out of a total of 83 female students experienced symptoms of itching, especially at night. The results of the microscopic examination of 8 (9.63%) female students were positive for scabies with a fairly large predilection area of ​​almost 2% of the entire skin surface, even in the groin area and mammary areola. Scabies is an infectious disease that must be treated. This community service activity hopes that female students will be able to prevent and treat scabies. The methods used are health services, education, and health training. The results of community service activities carrying out microscopic scabies examinations on students at the Nahdatul Ulama Islamic Boarding School, Siti Aisyah Martapura, carried out using the adhesive tape method, found that 29.2% of students were positive for scabies or 21 students out of 72 students. So that students who are infected with scabies are treated medically until the end of the activity. Female students' knowledge about scabies and its management was increased to 90.3%. Students are able to manage a clean Islamic boarding school environment by throwing away rubbish in its place, cleaning the room and yard every day, avoiding hanging clothes, opening windows every morning until noon, and treating clean water. Students are expected to always maintain cleanliness and health. Health workers should regularly provide health services and maintain the UKS at the Islamic boarding school, always monitoring the health of female students.
EDUKASI DAN PELATIHAN KELOMPOK MASYARAKAT TENTANG BANK SAMPAH prayogi, bisepta; Risa Mariana, Evi; Pahruddin, Muhammad
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.46

Abstract

ABSTRACT Waste has always been a difficult problem for people who don't care about the environment. When people don't keep things clean, they can leave behind unpleasant piles of trash. According to the World Bank report "What a Waste: A Global Review of Solid Waste Management", the amount of solid waste in cities around the world will increase by 70% from this year to 2025, increasing from 1.3 billion tons per year to 2.2 billion tons per year. This community service activity aims to change how people dispose of rubbish on the banks of the river in the Astambul Community Health Center Working Area, Banjar Regency and increase residents' income in Jati Baru Village. At the implementation stage, the community service team will start activities by providing training and counselling about waste management and waste banks to community groups. At the evaluation stage, the community service team will assess the level of residents' knowledge about waste management and processing. They will also monitor the waste bank that has been formed. The results of this community service activity include that the level of knowledge of the Jati village community has increased after being educated about managing waste. There were 23 people (76.7%) who had a good level of knowledge, of the formation of a waste bank in Jati Baru village, and the establishment of cooperation between the Jati Baru village waste bank and Sekumpul waste bank for waste management. This community service activity can increase the knowledge of the Jati Baru village community about good waste management. This community service activity provides an alternative solution to handling the waste problem in Jati Baru village by forming a waste bank. This community service activity is a means of transferring technology from educational institutions to the community in the form of educational modules about waste management through waste banks. Keyword: Waste Management, Environmental Health, Waste Bank, Community Service
Empowerment Kader dan Perangkat Desa dalam Peningkatan Kapasitas Pertolongan Gawat Darurat Menggunakan Smartphone Android di Desa Pinggiran Sungai Kabupaten Banjar Hammad, Hammad; Rizani, Khairir; Prayogi, Bisepta; Hamzani, Sulaiman; Kaila, Wafa; Rahma, Adilla Alfina; Mawaranti, Erien Febina; Rahmana, Muhamad Syeikha; Annisa, Farah
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.47

Abstract

The background of this activity is that the community in Pinggiran Sungai Village generally does not have adequate knowledge and skills in providing emergency assistance in emergency situations. The purpose of this activity is to provide training to cadres and village officials on the use of Android smartphone applications for emergency aid. The method used was training and simulation of the use of Android smartphone applications containing information and guidelines for providing cardiopulmonary resuscitation. The result of this activity is the provision of the community with knowledge and skills to provide emergency assistance for cardiac and pulmonary arrest using smartphone applications. It is expected that the community of Pinggiran Sungai Village will have better preparedness in dealing with health emergency situations.
Cara Menyikat Gigi Yang Baik Dan Benar Sebagai Kontrol Plak Gigi Untuk Mencegah Penyakit Karies Gigi Dan Kuratif Sederhana Pada Siswa Smpn 2 Martapura Propinsi Kalimantan Selatan Kisworo Utami, Naning; Amperawati, Metty; Nurwati, Bunga; Miha, Aninun; Askya, Rachima; Ali Akbar, Muhammad
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 2 No 2 (2023): Jurnal Rakat Sehat: Pengabdian Kepada Masyarakat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v2i2.48

Abstract

Dental and oral health problems are still something that needs attention, it can be seen that 90% of the Indonesian population suffers from dental and oral diseases, including dental caries and periodontal disease. In the city of Banjarbaru, only 4.04% of the population goes to medical personnel, the daily brushing behavior is 97.88% and the correct time for brushing teeth is only 2.06%. Currently, the highest prevalence of dental and oral diseases is dental caries and periodontal disease which are caused by dental plaque. The aim of community service is: a) How to brush your teeth properly and correctly b). Carry out a dental plaque examination, c). Mass tooth brushing and d). Simple Curative for students at SMPN 2 Martapura, South Kalimantan Province. The number of community service respondents was 100 students, located at SMPN 2 Martapura, South Kalimantan Province. On the day of the activity, 96 students of SMPN 2 Martapura were present, beforehand they were given a questionnaire, after that there was counseling on how to brush teeth properly and correctly, the right time to brush teeth, examination of DMF-T and plaque to see OHIS, simple curative by means of fillings with ART and re-examined. The results of the activity obtained were as follows: 60% of students filled in the questionnaire correctly, the average DMF-T score = 4.3 and the average OHI-S score = 1.59. The conclusion is that based on the results of the DMF-T and OHI-S examinations, the results were in the moderate category. It is recommended to carry out treatment which includes: cleaning tartar, fillings and extractions at a health center, hospital or independent dental clinic.

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