scholarly journals Factors Related To Anxy Events In Diabetes Mellitus Type 2 In Public Health Center

2020 ◽  
Vol 4 (3) ◽  
pp. 149-158
Author(s):  
Ira Inayah ◽  
Aszrul AB ◽  
Edison Siringoringo ◽  
Nurlina

Tuberculosis is a contagious disease caused by the bacteria Mycobacterium Tuberculosis which is spread through droplets of people who have been infected with tuberculosis bacilli. Pulmonary tuberculosis is still a challenge in public health problems both regionally, nationally, and globally. According to the World Health Organization (WHO) in 2015, there were 10.4 million new TB cases and nearly 75% of pulmonary tuberculosis patients were economically productive age groups. . The purpose of this study was to determine the physical environmental factors of the house with the incidence of pulmonary tuberculosis at the Bonto Bahari Health Center in 2020. The research method used was using analytical research methods with a case-control approach (case-control) where subjects, namely cases and controls were known and selected based on the output ( out came), then looked back (backward) about the history of the research exposure status experienced by the subject. The population in this study was about 40 people and the sample in this study amounted to 80 because the researcher took 40 controls. The results of the analysis using the Wilcoxon and Mc Nemar tests, with the results obtained by the value of ventilation (p-value = 0.001) then Ho is rejected and Ha is accepted. The type of floor obtained value (p-value = 1,000) then Ho is accepted and Ha is rejected. The type of wall obtained value (p-value = 0.002) then Ho is rejected and Ha is accepted. Occupancy density obtained value (p-value = 0.582) then Ho is accepted and Ha is rejected. The conclusion of this study There is a relationship between ventilation and the incidence of pulmonary tuberculosis, there is a relationship between the type of wall and the incidence of pulmonary tuberculosis and there is no relationship between floor type and occupancy density with the incidence of pulmonary tuberculosis.

2020 ◽  
Vol 4 (3) ◽  
pp. 116-129
Author(s):  
Arum Dani ◽  
Andi Suswani ◽  
Asri

Tuberculosis is a contagious disease caused by the bacteria Mycobacterium Tuberculosis which is spread through droplets of people who have been infected with tuberculosis bacilli. Pulmonary tuberculosis is still a challenge in public health problems both regionally, nationally, and globally. According to the World Health Organization (WHO) in 2015, there were 10.4 million new TB cases and nearly 75% of pulmonary tuberculosis patients were economically productive age groups. . The purpose of this study was to determine the physical environmental factors of the house with the incidence of pulmonary tuberculosis at the Bonto Bahari Health Center in 2020. The research method used was using analytical research methods with a case-control approach (case-control) where subjects, namely cases and controls were known and selected based on the output ( out came), then looked back (backward) about the history of the research exposure status experienced by the subject. The population in this study was about 40 people and the sample in this study amounted to 80 because the researcher took 40 controls. The results of the analysis using the Wilcoxon and Mc Nemar tests, with the results obtained by the value of ventilation (p-value = 0.001) then Ho is rejected and Ha is accepted. The type of floor obtained value (p-value = 1,000) then Ho is accepted and Ha is rejected. The type of wall obtained value (p-value = 0.002) then Ho is rejected and Ha is accepted. Occupancy density obtained value (p-value = 0.582) then Ho is accepted and Ha is rejected. The conclusion of this study There is a relationship between ventilation and the incidence of pulmonary tuberculosis, there is a relationship between the type of wall and the incidence of pulmonary tuberculosis and there is no relationship between floor type and occupancy density with the incidence of pulmonary tuberculosis.


2021 ◽  
Author(s):  
Maria Cecília de Souza Minayo ◽  
Camila Alves Bahia

This text focuses on the situation of suicide in Brazil, defines and quantifies information, and presents a description of the main risk factors, as well as a reflection on the phenomenon and the possibilities for prevention. Fatal suicide is a serious public health problem. In 2012, 172 member states of the World Health Organization registered 804,000 self-inflicted deaths, representing an annual rate of 11.4/100,000, of which 15/100,000 men and 8.0/100,000 women. Consummate suicide rates are unevenly distributed globally, within countries, according to sex and according to age groups. The mortality rate is highest in Asia (17.7/100 thousand inhabitants), followed in Europe (12/100 thousand inhabitants). The Americas have a mortality rate of 7.3/100 thousand inhabitants (WHO, 2014). In Brazil, with an unevenly distributions between the regions, gender and ages, the total rate is 4.5/100,000. In the country and everywhere, risk factors are classified as medical, psychiatric and psychological, micro social, social and environmental. The history of the occurrence of suicides shows that it is possible to prevent them and to reduce the incidence rates. This requires investment in local diagnostics and multidisciplinary action. Given the delicacy of the problem and the taboos that surround it, the protection network for people at risk for suicide needs to be constantly in the process of training and taking action. As national and international surveys show, at least two-thirds of the individuals who tried or committed suicide had somehow communicated to friends, family, acquaintances or health professionals their intention to kill themselves.


Author(s):  
Dini Kesumah Dini Kesumah

ABSTRACT According to World Health Organization Health Organization (WHO) in 2005 showed 49% of deaths occur in children under five in developing countries. Nutritional problems can not be done with the medical and health care approach alone. Causes related to malnutrition that maternal education, socioeconomic families, poor environmental sanitation, and lack of food supplies. This study aims to determine the relationship between education and socioeconomic status of families with nutrition survey using a cross sectional analytic approach, with a population of all mothers of children under five who visited the health center in Palembang Keramasan Accidental sampling Sampling the number of samples obtained 35 respondents. Variables include the study independent and dependent variables and univariate analysis using Chi-Square test statistic with a significance level α = 0.05. The results from 35 respondents indicate that highly educated mothers earned as many as 16 people (45.7%), and middle and upper income families as many as 12 people (34.3%) and bivariate test results show that highly educated respondents toddler nutritional status good for 81.3% (13 people) is larger than the less educated respondents balitanya good nutritional status 26.3% (5 persons) as well as respondents who have middle and upper socioeconomic families with good nutritional status of children at 91.7% ( 11 people) is larger when compared to respondents who have family socioeconomic medium with good nutritional status of children at 30.4% (7 people). Statistical tests show that education has a significant relationship with nutritional status of children P value = 0.004 and socioeconomic families have a meaningful relationship with nutritional status of children P value = 0.002. Based on the results of the study suggested the health professionals in the health center should further improve the education, information about the importance of nutrition to the development of the child in the mothers through the selection and processing of good food and a good diet through health centers and integrated health.   ABSTRAK  Menurut badan kesehatan World Health Organization (WHO) tahun 2005 menunjukkan 49% kematian yang terjadi pada anak dibawah umur lima tahun di negara berkembang. Masalah gizi ini tidak dapat dilakukan dengan pendekatan medis dan pelayanan kesehatan saja. Penyebab yang berhubungan dengan kurang gizi yaitu pendidikan ibu, sosial ekonomi keluarga, sanitasi lingkungan yang kurang baik,dan kurangnya persediaan pangan. Penelitian ini bertujuan untuk mengetahui hubungan antara pendidikan dan sosial ekonomi keluarga dengan status gizi balita dengan menggunakan metode survei analitik pendekatan secara Cross Sectional, dengan populasi semua ibu yang memiliki anak balita yang berkunjung ke Puskesmas Keramasan Palembang dengan pengambilan sampel secara Accidental Sampling diperoleh jumlah sampel 35 responden. Variabel penelitian meliputi variabel independen dan dependen serta analisis univariat menggunakan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian ini menunjukkan dari 35 responden didapatkan ibu yang berpendidikan tinggi sebanyak 16 orang  (45,7%), dan keluarga yang berpenghasilan menengah keatas sebanyak 12 orang (34,3%) dan hasil uji bivariat menunjukkan bahwa responden yang berpendidikan tinggi status gizi balitanya baik sebesar 81,3% (13 orang) lebih besar bila dibanding responden yang berpendidikan rendah status gizi balitanya baik 26,3% (5 orang) serta responden yang mempunyai sosial ekonomi keluarga menengah keatas dengan status gizi balita baik sebesar 91,7% (11 orang) lebih besar bila dibanding responden yang mempunyai sosial ekonomi keluarga menengah kebawah dengan status gizi balita baik sebesar 30,4% (7 orang). Uji statistik menunjukkan bahwa pendidikan mempunyai hubungan yang bermakna dengan status gizi balita P value = 0,004 dan sosial ekonomi keluarga mempunyai hubungan yang bermakna dengan status gizi balita P value = 0,002. Berdasarkan hasil penelitian disarankan pada petugas kesehatan di Puskesmas hendaknya lebih meningkatkan penyuluhan-penyuluhan tentang pentingnya gizi terhadap tumbuh kembang anak pada ibu-ibu melalui cara pemilihan dan pengolahan bahan makanan yang baik serta pola makanan yang baik melalui kegiatan Puskesmas dan Posyandu.


2020 ◽  
pp. 1-11
Author(s):  
Robin ROOM ◽  
Jenny CISNEROS ÖRNBERG

This article proposes and discusses the text of a Framework Convention on Alcohol Control, which would serve public health and welfare interests. The history of alcohol’s omission from current drug treaties is briefly discussed. The paper spells out what should be covered in the treaty, using text adapted primarily from the Framework Convention on Tobacco Control, but for the control of trade from the 1961 narcotic drugs treaty. While the draft provides for the treaty to be negotiated under the auspices of the World Health Organization, other auspices are possible. Excluding alcohol industry interests from the negotiation of the treaty is noted as an important precondition. The articles in the draft treaty and their purposes are briefly described, and the divergences from the tobacco treaty are described and justified. The text of the draft treaty is provided as Supplementary Material. Specification of concrete provisions in a draft convention points the way towards more effective global actions and agreements on alcohol control, whatever form they take.


Author(s):  
Brain Guntoro ◽  
Kasih Purwati

Hypertension is one of the number one causes of death and disability in the world. Hypertension contributes nearly 9.4 million deaths from cardiovascular disease each year. Hypertension can cause undesirable effects, it needs good handling, one of them is by doing a hypertension diet. To carry out a hypertension diet requires knowledge, lack of knowledge can increase risk factors for hypertension. This study aims to determine the relationship of the level of knowledge about hypertension diet to the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City. This research method is an analytic observational with a cross-sectional approach conducted at the Baloi Permai Public Health Center Batam City 2018. Sampling technique is a total sampling with a sample of 64 people in 2018 determined by inclusion and exclusion criteria. The results of the study were analyzed with frequency distribution and then tested with the Chi-square test. Based on the results of this study indicate that of the 64 respondents found elderly who have a good level of knowledge are 41 people (64.1%), 48 people (75.0%) have an age range between 60-70 years. 27 people (42.2%) elderly have the last high school education and 40 people (62.5%) have jobs as entrepreneurs. Elderly people who have normal blood pressure are 40 people (62.5%), and those affected by hypertension are 24 people (37.5%). The elderly who have a family history of hypertension is 21 people (32.8%) and those who do not have a history of hypertension are 43 people (67.2%). Chi-Square Test analysis results show the significance value p = 0.009. This number is significant because the p-value is smaller than the significance level (α) ≤ 5% (0.05), so H0 is rejected and Ha is accepted. Therefore it can be concluded that there is a significant relationship about the level of knowledge about the hypertension diet to the incidence of hypertension in the elderly. From the results of this study it was concluded that there was a relationship between the level of knowledge about the hypertension diet and the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City in 2016.


2019 ◽  
Vol 10 (2) ◽  
pp. 46-51
Author(s):  
Peppy Octaviani

ABSTRACT Pulmonary tuberculosis (TB) is a contagious pulmonary infectious disease that is still a health problem in the world, especially developing countries. Tuberculosis has been proclaimed by WHO (World Health Organization) as Global Emergency since 1992. The purpose of this study is to find out what physical characteristics are at risk of tuberculosis in DKT Hospital Purwokerto. The research design used in this study was a descriptive study with a cross-sectional approach to determine the characteristics of pulmonary TB patients who were adherent to treatment and those who did not comply with treatment at the DKT Hospital in Purwokerto. This research was conducted at the DKT Purwokerto Hospital in May 2018. The samples studied in this study were pulmonary TB patients who were obedient to treatment and non-compliance with treatment at the DKT Purwokerto Hospital for the period of 1 January - 30 December 2017 that met the sample criteria. The results of the study have no relationship between age and the results of sputum examination at the Purwokerto DKT Hospital (p value = 0.286), there is no relationship between sex with the results of sputum examination at DKT Purwokerto Hospital (p value = 0.261).                                                                                                                           Keywords: Pulmonary TBC, Characteristics, Phlegm Examination  


2021 ◽  
Vol 7 (4) ◽  
pp. 851-856
Author(s):  
Yosintha Dilina Wanda ◽  
Fardila Elba ◽  
Didah Didah ◽  
Ari Indra Susanti ◽  
Fedri Ruluwedrata Rinawan

Background: According to the World Health Organization (WHO) 2018, the prevalence of stunting in Indonesia is the third country with the highest prevalence in the Southeast Asia Region (SEAR). The average prevalence of children under five in Indonesia in 2005-2017 was 36.4%. In West Java the incidence of stunting is 29.9% and in Sumedang Regency the figure is still quite high at 36%, and based on data from the Jatinangor Health Center in 2020 there are 60 stunting toddlers.Purpose: The purpose to analyze the relationship between the history of basic immunization status and the incidence of  in toddler in Hegarmanah Village, Jatinangor District in 2020.Methods: This research design is a quantitative research conducted in Hegarmanah Village in November. This study use a case control design with a ratio of 1:1. The case group of this study was stunting and the control group was non-stunted. The groups of stunting and non-stunted toddlers were determined by a matching system of age and gender categorization. Sampling used proportionate stratified random technique. The sample in this study were stunted and non-stunted toddlers with a total sample of 120 respondents, 60 case groups and 60 control groups. The research instrument is a questionnaire and a microtoise to measure height. Bivariate analysis was carried out with Chi-Square and Odds Ratio testsResults: The results showed that 30 (25%) stunting toddlers aged 24-<36 months, 23 (19%) toddlers aged 24-<36 months and 19 (16%) boys with a history of incomplete basic immunization status . Bivariate analysis was carried out with Chi-Square and Odds Ratio tests with a 95% confidence level obtained (p = 0.000) with OR and CI (4.958 (2.074-11.852)). This states that there is a relationship between the history of basic immunization status on the incidence of stunting under five in Hegarmanah Village, Jatinangor District.Conclusion: There is a relationship between the history of basic immunization status on the incidence of stunting in toddlers in Hegarmanah Village, Jatinangor District with a value of p<0.05 (p=0.00<0.05) and there is a risk of stunting in toddlers with incomplete immunization 4.9 times compared to toddlers with complete immunization.Suggestion Future researchers are expected to be able to further investigate what types of immunization can affect stunting. Keywords: Relationship, Stunting, Basic Immunization, Toddler ABSTRAK  Latar Belakang: Menurut World Health Organization (WHO) data prevalensi kejadian stunting Indonesia termasuk negara ketiga dengan prevalensi tertinggi di regional Asia Tenggara /South-East Asia Regional (SEAR). Rata-rata prevalensi balita di Indonesia tahun 2005-2017 adalah 36,4%. Di Jawa Barat angka kejadian stunting yaitu 29,9% dan di Kabupaten Sumedang angkanya masih cukup tinggi yaitu sebesar 36%, dan berdasarkan data Puskesmas Jatinangor pada tahun 2020 terdapat 60 balita stunting.Tujuan: Menganalisis hubungan riwayat status imunisasi dasar dengan kejadian balita stunting di Desa Hegarmanah Kecamatan Jatinangor Tahun 2020.Metode: Rancangan penelitian ini merupakan penelitian kuantitatif yang dilakukan di Desa Hegarmanah pada Bulan November. Penelitian ini menggunakan desain case control dengan perbandingan 1:1. Kelompok kasus penelitian ini yaitu stunting dan kontrol yaitu non stunting. Kelompok balita stunting dan non stunting ditentukan dengan sistem matching kategorisasi usia dan jenis kelamin. Pengambilan sampel menggunakan teknik proportionate stratified random. Sampel dalam penelitian ini adalah balita yang stunting dan non stunting dengan jumlah sampel 120 responden, sebanyak 60 kelompok kasus dan 60 kelompok kontrol. Instrumen penelitian ini yaitu kuisioner dan microtoise untuk mengukur tinggi badan. Analisis bivariate dilakukan uji Chi-Square dan Odds RatioHasil: Hasil penelitian didapatkan 30 (25%) balita stunting dengan usia 24-<36 bulan, 23 (19%) balita usia 24-<36 bulan dan 19 (16%) balita laki-laki dengan riwayat status imunisasi dasar yang tidak lengkap. Analisis bivariate dilakukan uji Chi-Square dan Odds Ratio dengan tingkat kepercayaan 95% didapatkan (p=0,000) dengan OR dan CI (4,958 (2,074-11,852)).Kesimpulan: Terdapat hubungan antara riwayat status imunisasi dasar pada kejadian balita stunting di Desa Hegarmanah Kecamatan Jatinangor dengan nilai p<0,05 (p=0.00<0.05) serta terdapat risiko kejadian stunting pada balita dengan imunasi tidak lengkap 4,9 kali dibanding balita dengan imunisasi yang lengkap.Saran Peneliti selanjutnya diharapkan dapat meneliti lebih lanjut mengenai jenis imunisasi apa yang dapat mempengaruhi stunting. Kata kunci : Hubungan, Stunting, Imunisasi Dasar, Balita


Author(s):  
Martina Astari Martina Astari

ABSTRACT According to the World Health Organization (WHO 2010) approximately 99% of cases of maternal deaths occur during labor and postpartum. One of the causes of maternal death due to preeclampsia. Country - developing countries maternal mortality rate of 450 / 100,000 live births, this is a very high number. In the hospital Palembang obtained Muhammaddiyah severe preeclampsia incidence by 2013 as many as 85 cases. Many things that cause severe preeclampsia include maternal age, parity, educational level, employment. The purpose of this study was to determine the relationship of maternal age, parity, educational level, work simultaneously with perinatal death. This type of research is a case control study conducted retrospectively. The population in this study were all women giving birth in hospital Muhammadiyah Palembang in the year 2013 that berjumlah2565. The study sample totaled 225 respondents. In this study conducted univariate, bivariate and multivariate analyzes. From the analysis we found no association with maternal age incidence of severe preeclampsia (P Value 0.043 OR 1.799), no parity relationship with the incidence of severe preeclampsia (P Value 0.010 OR 0.617), no correlation with the incidence rate of severe preeclampsia education (P Value 0.027 OR 1.394) , there is a relationship how to work with the incidence of severe preeclampsia (P Value 0.024 OR 0.576), the most dominant variable is the age of the mother. It is suggested to the leadership of Muhammadiyah hospital Palembang is hoped to be able to further improve health care programs for women giving birth so as to prevent the occurrence of complications during labor and to increase outreach programs about the importance of prenatal care and provide knowledge about the complications - complications during childbirth to facilitate the birth process. References       : 16 (2002-2013)     ABSTRAK Menurut World Health Organization (WHO 2010) sekitar 99 % kasus kematian ibu terjadi pada masa persalinan dan pasca persalinan. Salah satu penyebab kematian ibu karena preeklamsia. Dinegara – negara berkembang angka kematian ibu sebesar 450/100.000 kelahiran hidup, ini merupakan angka yang sangat tinggi. Di Rumah Sakit Muhammaddiyah Palembang didapatkan kejadian preeklamsia berat pada tahun 2013 sebanyak 85 kasus. Banyak hal yang menyebabkan preeklamsia berat diantaranya umur ibu, paritas, tingkat pendidikan, pekerjaan. Tujuan penelitian ini untuk mengetahui hubungan umur ibu, paritas, tingkat pendidikan, pekerjaan secara simultan dengan kematian perinatal. Jenis penelitian ini merupakan penelitian case control study yang dilakukan secara retrospektif. Populasi dalam penelitian ini adalah semua ibu bersalin di rumah sakit Muhammadiyah Palembang pada Tahun 2013 yang berjumlah2565. Sampel penelitian ini berjumlah 225 responden. Dalam penelitian ini dilakukan analisis univariat, bivariat dan multivariat. Dari hasil analisis didapatkan ada hubungan umur ibu dengan kejadian preeklamsia berat (P Value 0,043 OR 1,799), ada hubungan paritas dengan kejadian preeklamsia berat (P Value 0,010 OR 0,617), ada hubungan tingkat pendidikan dengan kejadian preeklamsia berat (P Value 0,027 OR 1,394), ada hubungan cara pekerjaan dengan kejadian preeklamsia berat (P Value 0,024 OR 0,576), Variabel paling dominan adalah umur ibu. Disarankan kepada pimpinan rumah sakit Muhammadiyah Palembang Diharapkan untuk dapat lebih meningkatkan program pelayanan kesehatan kepada ibu bersalin sehingga  mencegah terjadinya komplikasi selama persalinan serta meningkatkan program penyuluhan tentang pentingnya pemeriksaan kehamilan  dan memberikan pengetahuan mengenai komplikasi – komplikasi selama masa persalinan untuk memperlancar proses persalinan.


2020 ◽  
Vol 9 (1) ◽  
pp. 9
Author(s):  
Ismalia Husna ◽  
Devita Febriani Putri ◽  
Tusy Triwahyuni ◽  
Guntur Batara Kencana

<em>World Health Organization </em>(WHO) melaporkan bahwa terjadi peningkatan jumlah kasus DBD khususnya di negara tropis seperti Indonesia. Di Bandar Lampung terjadi instabilitas pada <em>Incidence Rate </em>(IR) dari tahun 2010-2015 dan Tanjung Senang merupakan wilayah dengan angka kasus tertinggi yaitu 138 kasus. Tujuan penelitian ini untuk mengetahui faktor yang mempengaruhi kejadian Demam Berdarah<em> Dengue</em> (DBD) di Wilayah Kerja Puskesmas Way Kandis Bandar Lampung. Penelitian ini menggunakan desain penelitian <em>case control</em>. Sampel pada penelitian ini sebanyak 100 sampel dari 50 kasus DBD dan 50 kontrol. Teknik pengambilan sampel pada penelitian ini yaitu <em>total sampling </em>pada kelompok kasus dan <em>random sampling </em>pada kelompok kontrol. Analisa data yang digunakan adalah <em>chi-square test. </em>Hasil analisis statistik menggunakan uji <em>Chi-square </em>menunjukan variabel yang berhubungan dengan kejadian DBD adalah pengetahuan (<em>p-value=</em>0,02; OR=0,40; 95% CI:0,35 – 1,72) dan jumlah kontainer (<em>p-value=</em>0,01; OR=3,02; 95% CI:1,26-7,20). Variabel yang tidak berhubungan antara lain pendidikan, pekerjaan, perilaku, ketersediaan tutup kontainer, keberadaan kawat kassa dan jarak antar rumah karena <em>p value</em> &gt; 0,05. Simpulan dari penelitian ini adalah pengetahuan dan jumlah container merupakan faktor yang berpengaruh terhadap kejadian DBD di Kelurahan Way Kandis.


NSC Nursing ◽  
2021 ◽  
pp. 1-19
Author(s):  
Asnidawati Asnidawati ◽  
Wa Ode Salma ◽  
Adius Kusnan

Background: Breast’s milk is an excellent food for the growth and development of infants. The United Nations Children's Funds (UNICEF) and the World Health Organization (WHO) recommend that children only be exclusively breastfed for six months and continued until two years. This study analyzes the effect of family support, health workers, and socio-culture on exclusive breastfeeding in the working area of the Rumbia Health Center, Rumbia District, Bombana Regency. Methods: This study involved 86 mothers who had babies aged 0-6 months who were registered and domiciled in the working area of the Rumbia Health Center spread over 4 Kelurahan and 1 Village, which were selected by purposive sampling using a cross-sectional design from February to April 2021. Data analysis using odds ratio (OR) and logistic regression at significance level < 0.05. Results: The largest age group in the range of 20-35 years, as many as 68 people (79.1%), undergraduate as many as 32 people (37.2%), and income above Rp. 2.552.014, - / month as many as 60 people (69.8%). The results showed an effect of family support on exclusive breastfeeding (p = 0.002<0.05). There is no influence of socio-cultural factors on exclusive breastfeeding (p = 0.282>0.05) and the results of multivariate analysis of the most dominant variables associated with exclusive breastfeeding in the working area of Rumbia Health Center District Rumbia Bombana Regency is supported by health workers with an OR = 9.199 (p-value = 0.039<0.05). Conclusions: This study concludes that the support of health workers plays a very important role in exclusive breastfeeding to infants aged six months, which can impact improving the health of toddlers. Keywords: Determinant, breastfeeding exclusive, toddler, mother


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