The Effect of Breastfeeding Calendar Training on Knowledge and Attitudes of Mothers in Exclusive Breastfeeding

2021 ◽  
Vol 10 (1) ◽  
pp. 80-87
Author(s):  
Ari Indra Susanti ◽  
Aminarista Aminarista ◽  
Neneng Martini ◽  
Nur Rahmah ◽  
Sri Astuti

Background: Lactating mothers were successful in giving exclusive breastfeeding as much as 42% based on SDKI (Survei Demografi Kesehatan Indonesia) in 2012. This is depend on the support of husbands and families as well as health workers. Thus, the husband or family should remind and motivate mothers as well as monitor the breastfeeding activity every day for 6 months using breastfeeding calendar.Objectives: This study aimed to determine the increase in knowledge and attitudes of mothers in providing exclusive breastfeeding after the exclusive breastfeeding calendar training.Materials and Methods: The research design used a quasi-experimental one group pre-test post-test design. This research was conducted on mothers who had babies (age 0-12 months) in Pasawahan Village and Pasawahan Kidul Village, Pasawahan District, Purwakarta Regency in April to November 2018, with 96 respondents. The sampling technique was conducted by purposive sampling. Data were collected by giving questionnaires to respondents, before and after the breastfeeding calendar training were given. The Wilcoxon test was used for the analysis of the data in this study.Results: The results showed that there were differences in the knowledge of mothers before and after training on breastfeeding calendar (p <0,000) and there were differences in the attitudes of mothers before and after the training on breastfeeding calendar (p <0,000).Conclusions: There was an increase in knowledge and changes in the attitude of mothers towards exclusive breastfeeding after being given the breastfeeding Calendar training. Therefore, suggestions for health workers, especially midwives and nutrition workers, can use the breastfeeding calendar as an educational medium to increase husband and family support in exclusive breastfeeding.

2018 ◽  
Vol 1 (2) ◽  
pp. 62-77
Author(s):  
Tunggul Sri Agus Setyaningsih ◽  
Hesti Wahyuni

The aimed of study to analyze theinfluenced of puzzle game stimulation on socialization and independence development in preschoolers.This research was a quantitative research with Quasi experimental one group pre test post test design. The samples were 5 years old 60 months children with development in doubt on socialization and independence aspects which amounted to 17 people by purposive sampling technique. The instrument of this research was using a puzzle and Pre-screening Children Development Questioner. The statistical test used wilcoxon test for the children development status before and after the intervention showed a significant value 0,000 pvalue smaller than 0,05 so it can be concluded that there is a significant effect between puzzle stimulation to socialization and independence development. Keywords: Development Area, Puzzle, Quasi eksperimental    


2020 ◽  
Vol 3 (1) ◽  
pp. 8
Author(s):  
Oktavia Bryan Trianita ◽  
Wiwn Renny Rahmawati ◽  
Susi Tentrem Talib

Latar Belakang : Rasa nyeri pada persalinan disebabkan oleh kombinasi peregangan segmen bawah rahim (selanjutnya serviks) dan iskemia (hipoksia) otot-otot rahim. Reaksi terhadap nyeri merupakan respons yang sifatnya sangat individual. Reaksi ini tergantung pada kepribadian, kondisi emosional serta tingkat pemahaman pasien, latar belakang kultural, keluarga serta pendidikannya, dan pengalaman sebelumnya. Penanganan secara non-farmakologis yaitu pijat dan relaksasi nafas dalam.Tujuan : Mengetahui perbedaan pijat counterpressure dan relaksasi nafas dalam terhadap adaptasi nyeri ibu bersalin.Metode Penelitian : Penelitian ini menggunakan rancangan quasi-eksperiment dengan desain metode penelitian 2 group pre and post-test design, yang mana penelitian ini melibatkan 2 kelompok 1 (kelompok pijat counterpressure) dan kelompok 2 (kelompok relaksasi nafas dalam). Teknik sampling yang digunakan adalah accidental sampling.Hasil : Hasil analisis penerapan pada kelompok pijat counterpressure terhadap penurunan nyeri ibu bersalin dengan uji Wilcoxon didapatkan hasil p = 0,001 (p < 0,05) dan pada kelompok relaksasi nafas dalam dengan uji Wilcoxon didapatkan hasil p = 0,083 (p > 0,005). Sehingga pada kelompok pijat counterpressure (p < 0,05) Ha diterima yang mengartikan bahwa ada perbedaan yang bermakna pada perlakuan pijat counterpressure dan relaksasi nafas dalam.Kesimpulan : pijat counterpressure lebih efektif dalam adaptasi nyeri ibu bersalin. Background: pain in labor is caused by a combination of stretching of the lower uterine segment (hereinafter the cervix) and ischemia (hypoxia) muscles of the uterus. Reaction to pain is a response that is very individual. This reaction depends on the personality, emotional state and the level of patient understanding, cultural background, family and education, and previous experience. Handling of non-pharmacological namely relaxation massage and deep breathing.Objective: To determine differences in massage counterpressure relaxation and deep breathing against maternal adaptation pain.Methods: This study used adesign quasi-experimental with the design of research method 2 group pre and post-test design,which this study involved two groups 1  massage (counterpressure group)and group 2 (deep breathing relaxation group). The sampling technique used was accidental sampling.Results: Analysis of the application of the massage group counterpressure against maternal pain reduction with the Wilcoxon test showed p = 0.001 (p <0.05) and the deep breathing relaxation group with the Wilcoxon test showed p = 0.083 (p> 0.005). So that the massage group counterpressure (p <0.05) Ha accepted which means that there are significant differences in treatment counterpressure massage and relaxation massage deep breath.Conclusion: counterpressure be more effective in pain adaptation birth mothers.


2021 ◽  
Vol 7 (4) ◽  
pp. 634-641
Author(s):  
Ayunin Syahida ◽  
Nanda Mirani

Background: During pregnancy, mothers experience physical and psychological changes that occur due to hormonal changes.The process of adjusting to new conditions experienced by pregnant women can then cause anxiety. To overcome anxiety during pregnancy, non-pharmacological options. Interventions that are often used and proven effective to reduce anxiety are breathing relaxation techniques.Purpose: This study aims to determine the analysis Breathing Relaxation on Anxiety in Pregnant Women in Trimester III in the Work in Puskesmas Langsa Baro.Methods: The designs used in this study were quasi-experimental designs with a one-group pre-test and post-test design approach. The number of research samples was 15 third trimester pregnant women, the sampling technique used was purposive sampling technique. Data analysis was carried out univariate and bivariate using the Paired T-Test.Results: The results showed that the level of anxiety was known to have a p value (sig) (0.000) < 0.05, which means that there is an effect of breathing relaxation on anxiety in  trimester III pregnant women.Conclusion: There is an effect of breathing relaxation on anxiety in trimester III pregnant women. It is hoped that health workers will increase counseling about pregnancy, especially about problems that can occur during pregnancy so that mothers can be more relaxed in dealing with pregnancy and childbirth.  Keywords: Breathing Relaxation, Anxiety, Pregnant ABSTRAKLatar Belakang: Selama kehamilan ibu mengalami perubahan fisik dan psikis yang terjadi akibat perubahan hormon. Proses penyesuaian diri terhadap keadaan baru yang dialami ibu hamil ini kemudian dapat menimbulkan kecemasan. Untuk mengatasi kecemasan pada saat hamil, pilihan non farmakologis. Intervensi yang sering di gunakan dan terbukti efektif untuk mengurangi kecemasan adalah teknik relaksasi pernafasan dan dzikir.Tujuan: Penelitian ini bertujuan untuk menganalisis Relaksasi Pernafasan Terhadap Kecemasan Pada Ibu Hamil Trimester III di Wilayah Kerja Puskesmas Langsa Baro Tahun 2021.Metode: Desain yang digunakan dalam penelitian ini adalah quasi eksperiment designs (eksperimen semu) dengan pendekatan one group pre test and post test design. Jumlah sampel penelitian sebanyak 15 ibu hamil trimester III. Teknik sampling yang digunakan teknik purposive sampling. Analisis data dilakukan secara univariat dan bivariat menggunakan uji Paired T-Test.Hasil:Hasil penelitian didapatkan bahwa tingkat kecemasan diketahui nilai p (sig) (0,000) < 0,05 yang artinya terdapat pengaruh relaksasi pernafasan terhadap kecemasan pada ibu hamil trimester III.  Kesimpulan: Ada pengaruh kombinasi relaksasi pernafasan dan dzikir terhadap kecemasan pada ibu hamil trimester III. Diharapkan agar tenaga kesehatan lebih meningkatkan penyuluhan tentang kehamilan  terutama tentang masalah-masalah yang dapat terjadi pada masa kehamilan sehingga ibu dapat lebih santai dalam menghadapi masa kehamilan dan persalinan. Kata Kunci: Relaksasi Pernafasan, Kecemasan, Kehamilan


2021 ◽  
pp. 758-769
Author(s):  
Lisbet Octovia Manalu ◽  
Budi Rustandi ◽  
Budi Somantri

Thalassemia is one of the top eight catastrophic diseases. Data from Yayasan Thalasemia Indonesia dan Perhimpunan Orang tua Penderita Thalasemia Indonesia (YTI/POPTI) have shown that in Indonesia the number of cases of this disease increased from 2011 to 2015. Preschool-aged children who experience thalassemia every month are subjected to invasive measures such as blood transfusions. Repeated blood transfusions make children feel threatened and can trigger various responses, one of which is anxiety. Anxiety is an emotional response to something dangerous, closely related to feeling uncertain and helpless. Puppet play therapy can reduce anxiety in children with thalassemia who undergo blood transfusions. This study aims to determine the effect of puppet play therapy on anxiety of preschool children (3-6 years) with thalassemia at the Thalassemia Polyclinic at Al-Ihsan Hospital, Bandung. The design used in this study used a quasi-experimental study with a one group pre-post test design without control approach using the Wilcoxon test. The number of samples in this study were 30 respondents who were taken by total sampling technique. The instrument used refers to the content / research theme developed from the Spence Children Anxiety Scale. The results of the Wilcoxon statistical test obtained a significance figure, namely p = 0.009, thus p <α (0.009 <0.05), then H0 is rejected. It can be concluded that there are differences in the level of anxiety of children with thalassemia before and after being given puppet play therapy.   Keywords: puppet play therapy; worry; preschool; Thalassemia


2019 ◽  
Vol 10 (2) ◽  
pp. 856-866
Author(s):  
Srilina Br Pinem ◽  
Astaria Br Ginting ◽  
Lasria Simamora

Latar Belakang: Tingginya  angka  stunting  dan  AKB  di  Indonesia  merupakan  masalah  nasional.  Khususnya  di Sumatera Utara. ASI merupakan makanan yang paling tepat untuk mengatasi kedua masalah tersebut. Faktor utama ibu tidak memberikan ASI kepadaanaknya dikarenakan ibu berasumsi ASI yang diberikan tidak cukup dan produksi ASI tidak lancar hal ini terlihat dari capaian nasional pemberian ASI ekslusif masih jauh dari target 80 % .Tujuan: Tujuan penelitian ini untuk mengetahui pengaruh konsumsi biskuit katuk terhadap keberhasilan pemberian ASI Eksklusif pada ibu menyusui di Puskemsmas Simalingkar Tahun 2019.Metode: Jenis Penelitian yang digunakan adalah quasi eksperimen dengan design pre test post test one group design. Hasil:  Hasil penelitian menunjukkan nilai p= 0,000 dimana terdapat hubungan tidur tenang 2 jam akibat pemberian biskuit  katuk dan pijat oksitosin dengan pemberian ASI eksklusif, dan menunjukkan   nilai p=0,000 artimya terdapat hubungan penuruann berat badan 8%  akibat pemberian biscuit  katuk dan pijat oksitosin dengan pemberian ASI eksklusif. menunjukkan bahwa nilai p=0,000 artimya terdapat perbedaan tidur tenang sebelum dan sesudah diberi biskuit katuk dan pijat oksitosin. Terjadi peningkatan tidur tenang 2 jam setelah diberikan biskuit katuk dan pijat oksitosin setelah  hari  keempat.Simpulan: Sehingga dapat disimpulkan pemberian biskuit katuk dan pijat oksitosin efektif dalam kelancaraan pemberian ASI yang mendukung keberhasilan pemberian ASI Eksklusif. Diharapkan kepada tenaga kesehatan untuk memberikan motivasi kepada ibu untuk mengkonsumsi biskuit katuk pada ibu nifas. Kata Kunci: Katuk, ASI, Pijat Oksitosin Background: The high rate of stunting and IMR in Indonesia is a national problem. Especially in North Sumatra. Breast milk is the most appropriate food to overcome these two problems. The main factor of mothers not giving ASI to their children is because mothers assume that breast milk is not enough and production of ASI is not smooth, it can be seen from the national achievement of exclusive breastfeeding which is still far from the target of 80%.Objective: The purpose of this study was to determine the effect of katuk biscuit consumption on the success of exclusive breastfeeding in breastfeeding mothers in Puskemsmas Simalingkar in 2019.Method: This type of research is a quasi-experimental design with pre-test post test one group design.Results: The results showed a value of p = 0,000 where there was a relationship of calm sleep2 hours due to the administration of cough biscuits and oxytocin massage with exclusive breastfeeding,and showed a value of p = 0,000. exclusive breastfeeding. shows that p = 0,000 means thatthere is a difference in calm sleep before and after being given a katuk biscuit and oxytocin massage. An increase in calm sleep 2 hours after given katuk biscuits and oxytocin massage after the fourth day.Conclusion: So it can be concluded that the administration of katuk biscuits and oxytocin massage is effective in the smoothness of breastfeeding which supports the success of exclusive breastfeeding.It is expected that health workers will motivate mothers to consume katuk biscuits for postpartum mothers.Keywords: Katuk, ASI, Oxytocin Massage


2018 ◽  
Vol 10 (02) ◽  
pp. 103
Author(s):  
Kartika Sari ◽  
Isri Nasifah ◽  
Anggun Trisna

Kartika Sari 1) , Isri Nasifah2), Anggun Trisna3)1), 2), 3) DIII Kebidanan, Fakultas Ilmu Kesehatan,Universitas Ngudi WaluyoE-mail : [email protected],[email protected],[email protected] menstruasi datang, wanita kadang mengalami nyeri haid (disminore) dimana sifat dan tingkat rasa nyeri yang bervariasi dapat mengganggu aktifitas sehari-hari.  Prevalensi dismenore di Indonesia sebesar 64, 25% yang terdiri dari 54,8% dismenore primer dan 9,36% dismenore sekunder.  Pada umumnya 50-60% wanita diantaranya memerlukan obat-obatan analgesic untuk mengatasi masalah dismenore ini, dimana penggunaan obat dalam jangka panjang akan menyebabkan penderita mengalami ketergantungan obat. Yoga merupakan salah satu teknik non farmakologi untuk menangani nyeri haid yang  memberikan efek distraksi sehingga dapat mengurangi kram abdomen. Penelitian ini dilakukan dengan menggunakan desain Quasi Experimental (Pre Post Test Design).  Penelitian ini dilaksanakan di Program Studi D3 Kebidanan Universitas Ngudi Waluyo dengan sampel remaja putri yang mengalami nyeri haid yang dibagi menjadi 2 kelompok,  yang terdiri dari 1 kelompok perlakuan dan 1 kelompok kontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan intensitas nyeri haid antara sebelum dan sesudah perlakuan pada kelompok yoga berdasarkan hasil uji Wilcoxon dengan perbandingan nilai p=0.001<0,05.  Sedangkan pada kelompok kontrol intensitas nyeri sebelum dan sesudah perlakuan tidak mengalami perbedaan dengan nilai p=0.492 >0,05.  Terdapat perbedaan durasi nyeri antara sebelum dan sesudah perlakuan pada kelompok yoga berdasarkan hasil uji Wilcoxon dengan  nilai p=0.000<0,05.  Sedangkan pada kelompok kontrol durasi nyeri sebelum dan sesudah perlakukan tidak mengalami perbedaan yang ditunjukkan dengan nilai p=0,298>0,05.  Masyarakat hendaknya memanfaatkan senam yoga sebagai salah satu cara untuk mengurangi nyeri haid karena tehnik tersebut murah dan dapat dipraktikkan sendiri tanpa bantuan orang lain.Kata Kunci : Nyeri Haid, YogaTHE INFLUENCE OF YOGA EXERCISES ON MENSTRUAL PAIN IN YOUNG WOMENABSTRACTWhen menstruation comes, women sometimes experience menstrual pain (dysmenorrhea) where the varying nature and level of pain can interfere with daily activities.  The prevalence of dysmenorrhea in Indonesia is 64, 25% consisting of 54.8% primary dysmenorrhea and 9.36% secondary dysmenorrhea.  In general 50-60% of women need analgesic medication to overcome this dysmenorrhea problem, where in the long-term drug use will cause the patient to experience drug dependence.Yoga is one of the non-pharmacological techniques to deal with menstrual pain which gives a distraction effect, so it can reduce abdominal cramps.This research was conducted using Quasi Experimental design (Pre Post Test Design).  This research was carried out in the Ngudi Waluyo University Midwifery D3 Study Program, with a sample of young women who experienced menstrual pain which was divided into 2 groups, which is consists of 1 treatment group and 1 control group.The results showed that there was a difference in the intensity of menstrual pain between before and after treatment in the yoga group based on the results of Wilcoxon test with a comparison of p = 0.001 <0.05.  Whereas in the control group the intensity of pain before and after treatment did not experience a difference with a value of p = 0.492> 0.05.  There is a difference in the duration of pain between before and after treatment in the yoga group based on the results of Wilcoxon test with p = 0.000 <0.05.  Whereas in the control group the duration of pain before and after treatment did not experience a difference indicated by the value of p = 0.298> 0.05Keywords: Pain in Menstruation, Yoga


2018 ◽  
Vol 5 (2) ◽  
pp. 117-122
Author(s):  
Anastasia Suci Sukmawati ◽  
Ega Pebriani ◽  
Arif Adi Setiawan

Abstract: Older will experiencing physical, psychological, and psychosocial changes will cauthat will lead to the new problem. Anxiety is one of the problems among older people. Complementary therapy is used to reduce a person’s anxiety, namely yoga, meditation, aromatherapy, and relaxation through massage. This study was conducted to determine the effect of Swedish massage on the level of elderly anxiety. Methodology: The design of this study was a quasy experiment with one group pretest-post test design. Respondents in this study were elderly who experienced anxiety by using a total sampling technique in which as many as 15 elderly at the Nursing home of Social Service Center (BPSTW) Budi Luhur Bantul Unit Yogyakarta. The Standard operational procedure of Swedish massage therapy used as a guidance of intervention, while HARS instruments was used to measure the level of anxiety among older people. Respondents measured their level of anxiety before and after a Swedish massage for 1 week. The results of the study were analyzed by Wilcoxon test. Results: There were 8 people (53.3%) in the medium level of anxiety before the Swedish massage given). The anxiety level of older people after intervention was mild level of anxiety as many as 8 people (53.3%). Changes in anxiety levels before and after Swedish massage intervention showed a difference of 2.00. Wilcoxon test results were obtained with a p-value of 0.008 <0.05. Conclusion: Swedish massage therapy able to reduce the level of anxiety among older people at BPSTW Budi Luhur Yogyakarta.Keywords: Swedish massage, anxietyAbstrak: Berbagai macam perubahan akan dialami oleh lansia seperti perubahan fisik, psikologi, maupun psikososial akan menimbulkan masalah baru pada lansia salah satunya adalah kecemasan. Tehnik alternatif yang dapat digunakan untuk menurunkan kecemasan seseorang yaitu seperti yoga, meditasi, aromaterapi, dan relaksasi melalui pijat (massage). Penelitian ini dilakukan untuk mengetahui pengaruh Swedish mas- sage terhadap tingkat kecemasan lansia. Metodologi: Desain penelitian ini adalah quasy experiment dengan one group pretest-post test design. Responden pada penelitian ini adalah lansia yang mengalami kecemasan dengan menggunakan teknik total sampling yaitu sebanyak 15 lansia di Balai Pelayanan Sosial tresna Wredha (BPSTW) Unit Budi Luhur Bantul Yogyakarta. Instrumen penelitian adalah instrument HARS. Responden diukur tingkat kecemasannya sebelum dan setelah dilakukan Swedish massage selama 1 minggu. Hasil penelitian dianalisis dengan uji Wilcoxon. Hasil : Tingkat kecemasan pada lansia di BPSTW Budi Luhur Bantul Yogyakarta sebelum diberikan Swedish massage kategori sedang sebanyak 8 orang (53,3%). Tingkat kecemasan sesudah diberikan Swedish massage kategori ringan sebanyak 8 orang (53,3%). Perubahan tingkat kecemasan sebelum dan sesudah diberikan Swedish massage menunjukkan perbedaan sebesar 2,00. Hasil uji Wilcoxon diperoleh dengan nilai p-value 0,008 < 0,05. Diskusi : Swedish massage berpengaruh terhadap tingkat kecemasan pada lansia di BPSTW Budi Luhur Bantul Yogyakarta.Kata kunci: Swedish massage, kecemasan, lansia


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Yuni Astuti ◽  
Tuti Anggarawati

Sectio caesarea is a delivery by making an incision in uterus through the frontwall of the abdomen. Sectio caesarea actions cause pain due to surgery. She also had pain, fatigue and prolonged labor process can cause breast engorgement. Engorgement is a condition where the breasts become full due to static ASI lymphatic flow, increased congestion and vascularity, and can lead toaccumulation of intra-caudal pressure that will affect the segment of the breast so that the whole pressure increased breast. Non-pharmacological management used to overcome this problem is to use cabbage compresses. Cabbage leaves contain an amino acid that is believed to reduce the breast engorgement. This study aims to determine the effect of cabbage compress to decrease breast engorgement scale of post partum section caesarea. This study used a quasi-experimental research design with a one group pre-post test design. Sampling technique with consecutive sampling. Population in this study were post partum section caesarea with breast engorgement in Rumkit Bhakti Wira Tamtama from June to August 2017. The analysis using the Wilcoxon test. Results has difference in scale breast engorgement before and after cabbage compress on postpartum maternal section caesarea with p value 0,001 (<0,05). Conclusion there are significant cabbage compress to decrease postpartum sectio caesarea with breast engorgement after compresses cabbage. This intervention is recommended to increase the comfort of post partum sectio caesarea with breast engorgement.


2020 ◽  
Vol 8 (4) ◽  
pp. 451
Author(s):  
Aric Frendi Andriyan ◽  
Arina Widya Murni ◽  
Rika Fatmadona

Early detection is the first step in breast cancer prevention which targets can be done during adolescence, early detection in adolescents needs to be done through peer educators because adolescents prefer information from peers rather than parents or teachers, so that the material presented can improve BSE knowledge and attitude. This study aims to determine the effect of peer health education regarding knowledge and attitudes of BSE. The research design used a quasi-experimental study with a pre-post approach with a control group. Young women are the population in this study, with the sampling technique using purposive sampling. The sample used was 240 female teenage respondents according to the inclusion and exclusion criteria. Data collection using a questionnaire with Cronbach's alpha is 0.941> 0.7 for knowledge and 0.890 (> 0.361) for attitudes. Data analysis using the Wilcoxon test. The results showed that there was a difference between the pre-test median knowledge score was 14 and increased to 22 after the post-test with a P value of  0.000 <0.05 and the pre-test attitude median value was 17 increasing to 23 after the post-test with P Value 0.000 <0.05. Based on the research, it can be concluded that peers are very influential in increasing BSE knowledge and attitudes so that it is very important in early detection of breast cancer.


2017 ◽  
Vol 4 (2) ◽  
pp. 14
Author(s):  
Putri Megasari

Hepatitis has become a health problem in the world. The hepatitis virus infected many people. According to the teacher of MTsN 02 Bondowoso more than 20 students have hepatitis A viral infection. The purpose of this research was to know the differences of students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study used pre-experimental (pre-post test design). This study used stratified random sampling technique, 127 students from 270 sample involved this research,and 143 students was excluded. We used questionnaires to collect data. The results showed that the mean value of the students 'knowledge about hepatitis A before counseling in MTsN 02 Bondowoso 2015 was 83.96 with the lowest value of 37.5 and the highest value was 100. The mean value of the students' knowledge about hepatitis A after counseling in MTsN 02 Bondowoso 2015 was 93.21 with the lowest value waf 62.5 and the highest value was 100. Paired t test showed that t (-9.07) > t table (1.98), the null hypothesis (H0) was rejected. There was a difference between students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study showed that routine counseling by healthcare provider was important to prevent hepatitis A infection.; Keywords: counseling, knowledge of students, hepatitis


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