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In the Wairarapa region, in the south-eastern corner of New Zealand's North Island, health
officials have struck upon a novel yet effective way to treat often wary members of the local
Maori population.cDi wilayah Wairarapa, di sudut timur selatan Selandia Baru North Island,
pejabat kesehatan telah melanda pada sebuah novel belum cara yang efektif untuk
mengobati sering anggota waspada terhadap penduduk Maori setempat.cHolly Else reports.c
Holly Else laporan.cc

Many Maori perceive hospitals and general-practice surgeries as unfriendly environments


and can be reluctant to seek health care at these institutions.cMaori Banyak rumah sakit dan
melihat-praktek bedah umum sebagai tidak ramah lingkungan dan dapat enggan untuk
mencari pelayanan kesehatan di lembaga tersebut.cTo combat this, one of the primary
health care facilities, the Te Rangimaire clinic, is located on the    , or sacred meeting
place, so that Maori feel more at ease.cºntuk mengatasi hal ini, salah satu fasilitas
pelayanan kesehatan primer, Te Rangimaire klinik, terletak di    atau tempat
pertemuan suci, sehingga Maori merasa lebih nyaman.cThe clinic has two general
practitioners, who are well trusted in the Maori communitycKlinik ini memiliki dua dokter
umum, yang dipercaya baik di komunitas Maoricc

The Reverend Marie Collin, a member of the Ngati Kahungunu tribe, one of the largest Maori
tribes in the Wairarapa region, speaks glowingly of the clinic at Te Rangimaire    .c
?endeta Marie Collin, seorang anggota suku Kahungunu Ngati, salah satu suku Maori
terbesar di kawasan Wairarapa, berbicara bersahabat dari klinik di    Rangimaire Te.c
She said that the service had become so popular that it was necessary to extend the hours
and relocate the clinic from an old homestead on the    to larger rooms in a new
building housing the    communal dining room.cDia mengatakan bahwa layanan telah
menjadi sangat populer sehingga itu perlu untuk memperpanjang jam dan relokasi klinik
dari sebuah rumah tua di    untuk kamar yang lebih besar di sebuah perumahan
bangunan baru komunal makan      itu.cc

c
c

´ lthough the doctor, Cath Becker, is of European ancestry she is culturally sensitive,
understands Maori protocol and is well respected by the community. Our 2 
 (Maori
elders) are very comfortable coming here,´ says Collin.c´Meskipun dokter, Cath Becker,
adalah keturunan Eropa dia peka budaya, mengerti protokol Maori dan dihormati oleh
masyarakat. › 
 kami (Maori tetua) sangat nyaman datang ke sini,´ kata Collin.c´The
doctor knows how to handle our people and what we do differently.´c´Dokter tahu
bagaimana menangani orang-orang kami dan apa yang kita lakukan dengan cara berbeda.´cc

s an example she cites a relaxed attitude to appointments.cSebagai contoh, ia mengutip


sebuah sikap santai untuk janji.c´If our people are running late it is no big deal. It's not an
issue. ?eople just arrive and take their turn.´c´ika orang kita terlambat itu bukan masalah
besar.. Ini adalah bukan masalah. Orang-orang hanya datang dan mereka mengambil
gilirannya´cc

Clinics such as the one at Te Rangimaire are the result of a cultural shift in the way health
services are delivered to Maori.cKlinik seperti yang di Te Rangimaire adalah hasil dari
pergeseran budaya dalam cara pelayanan kesehatan dikirim ke Maori.cc

Helen Kjestrup, a member of the ?rimary Health Care Nursing dvisory Committee for the
Wairarapa region, is helping develop relations between Maori and the ?rimary Health
Organisation.cHelen Kjestrup, anggota ?uskesmas ?erawatan Komite ?enasehat untuk
wilayah Wairarapa, membantu mengembangkan hubungan antara Maori dan Organisasi
Kesehatan ?rimer.c´It has been slow, but it is happening,´ she says.c´Sudah lambat, tetapi
ini terjadi,´ katanya.cc

To do this, she attends ÷ , Maori community meetings.cºntuk melakukan ini, dia


menghadiri ÷  pertemuan masyarakat Maori.cKjestrup believes that establishing health-
care clinics in places where the Maori people feel comfortable has improved their access to
health care.cKjestrup berpendapat bahwa membangun klinik perawatan kesehatan di
tempat-tempat di mana orang-orang Maori merasa nyaman telah meningkatkan akses ke
perawatan kesehatan.cc

New Zealand's primary health care system has undergone dramatic changes since 2000 ±
changes that government officials say have already improved access to its services for Maori
and other groups.cTeman-dasar kesehatan Selandia Baru sistem pelayanan telah mengalami
perubahan dramatis sejak 2000 - perubahan yang pejabat pemerintah mengatakan telah
meningkatkan akses terhadap pelayanan untuk Maori dan kelompok lainnya.cc

The Wairarapa region, a sparsely populated agricultural valley between the Tararua
mountains on the west and the ?acific Ocean on the east, can claim to have successfully
implemented many of these changes.cWilayah Wairarapa, sebuah pertanian lembah yang
jarang dihuni antara pegunungan Tararua di barat dan Samudra ?asifik di sebelah timur,
dapat mengklaim telah berhasil menerapkan banyak perubahan ini.cc

The valley's population is a mix of European, Maori and ?acific Islanders, whose health-care
needs vary enormously.clembah ?opulasi adalah campuran dari Eropa, Maori dan kepulauan
?asifik, yang membutuhkan perawatan kesehatan sangat berbeda-beda.cThe Wairarapa
?rimary Health Organisation is addressing these demands by working with the different
communities to address the disparities in health between the different groups.cThe
Wairarapa Organisasi Kesehatan ?rimer yang menangani tuntutan ini dengan bekerja
dengan masyarakat yang berbeda untuk mengatasi kesenjangan di bidang kesehatan
antara kelompok-kelompok yang berbeda.cc

c
c

´?rimary Health Organisations are enormously different beasts,´ says oy Cooper, general
manager of the Wairarapa District Health Board.c´?uskesmas Organisasi adalah binatang
sangat berbeda,´ kata oy Cooper, general manager dari Wairarapa Dewan Kesehatan
Kabupaten.c´There is a huge variety of styles and sizes.´c´ da berbagai macam gaya dan
ukuran.´cc

In Masterton, one of the main towns in the valley, there is a community centre for ?acific
Islanders, Cameron Community House, which local general practitioner Dr David Nixon visits
for one hour a week.cDalam Masterton, salah satu kota utama di lembah, ada pusat
komunitas untuk Kepulauan ?asifik, Cameron Komunitas House, yang lokal umum praktisi
Dr David Nixon kunjungan selama satu jam seminggu.c primary care nurse also visits the
centre for four hours a week.cSeorang perawat kesehatan primer juga mengunjungi pusat
selama empat jam seminggu.cc

Cameron Community House and Te Rangimaire are just two of the many primary health
care services and facilities in the Wairarapa region; others include general-practice surgeries
and hospital-based services such as community nursing.cKomunitas Cameron House dan Te
Rangimaire hanya dua dari perawatan kesehatan primer banyak layanan dan fasilitas di
wilayah Wairarapa; lain meliputi-praktek bedah umum dan layanan berbasis rumah sakit
seperti perawatan masyarakat.cMost primary care providers are coordinated by the
Wairarapa ?rimary Health Organisation, which is overseen by the district health board.c
Kebanyakan penyedia layanan primer dikoordinasikan oleh Wairarapa Organisasi Kesehatan
?rimer, yang diawasi oleh dewan kesehatan kabupaten.cc

The ?rimary Health Organisations are the local structures for implementing New Zealand's
?rimary Health Care Strategy that was launched in 2001.cKesehatan ?rimer Organisasi
adalah struktur lokal untuk melaksanakan ?rimer Selandia Baru ?erawatan Kesehatan
Strategi yang diluncurkan pada tahun 2001.cThe core of the strategy is to reduce health
inequalities, engage communities and improve the prevention and management of chronic
illnesses.cInti dari strategi ini adalah untuk mengurangi kesenjangan kesehatan, melibatkan
masyarakat dan meningkatkan pencegahan dan pengelolaan penyakit kronis.cc

The strategy was based on the Declaration of lma- ta, says Dr Tim Kenealy, a senior
lecturer at the Department of General ?ractice and ?rimary Care at the ºniversity of
uckland.cStrategi tersebut didasarkan pada Deklarasi lma- ta, kata Dr Tim Kenealy,
seorang dosen senior di Departemen ?raktek ºmum dan ?erawatan ?rimer di ºniversity of
uckland.cc

series of policy and legislative reforms, which included the primary care strategy, was
formulated after a change in national government in 1999.cSerangkaian reformasi kebijakan
dan legislatif, yang mencakup strategi perawatan primer, dirumuskan setelah perubahan
dalam pemerintahan nasional pada tahun 1999.cThe strategy was developed after it was
decided a re-emphasis on primary care could reduce the disease burden and rising costs of
secondary care.cStrategi ini dikembangkan setelah diputuskan ulang-penekanan pada
layanan kesehatan primer dapat mengurangi beban penyakit dan meningkatnya biaya
perawatan sekunder.cc

In 2002, soon after the launch of the strategy, ?rimary Health Organisations were
established across New Zealand, each responsible for the primary health care in a region or
for a group of people, sometimes with a focus on a particular ethnic group.c?ada tahun
2002, segera setelah peluncuran strategi, Organisasi Kesehatan ºtama didirikan di Selandia

c
c

Baru, masing-masing bertanggung jawab atas perawatan kesehatan primer di suatu daerah
atau sekelompok orang, kadang-kadang dengan fokus pada kelompok etnis tertentu.cc

Today, there are 82 ?rimary Health Organisations across New Zealand, with an average
94% of the country's population enrolled in one of them.cSaat ini, ada 82 ?uskesmas
Organisasi di Selandia Baru, dengan 94% rata-rata negara penduduk terdaftar dalam salah
satu dari mereka.cEnrolment rates for ?acific Islanders are well above the average for the
total population, but Maori have a lower rate of enrolment, at around 83%.cTingkat
?endaftaran untuk Kepulauan ?asifik dengan baik di atas rata-rata jumlah penduduk,
namun Maori memiliki tingkat yang lebih rendah pendaftaran, sekitar 83%.cc

The ?rimary Health Organisation helps to coordinate and support the primary health care
providers for its enrolled population, bringing together doctors, nurses, Maori health
workers, health promotion workers, dieticians, pharmacists, physiotherapists, psychologists
and midwives.cOrganisasi Kesehatan ?rimer membantu untuk mengkoordinasikan dan
mendukung penyedia layanan kesehatan utama bagi pembangunan terdaftar penduduk,
membawa bersama-sama dokter, perawat, petugas kesehatan Maori, promosi petugas
kesehatan, ahli diet, apoteker, fisioterapi, psikolog dan bidan.cc

´They do not all follow the same blueprint,´ says Kenealy.c´Mereka tidak semua mengikuti
cetak biru yang sama,´ kata Kenealy.cInnovation is encouraged, enabling some
organizations to customize their services to patients.cInovasi didorong, memungkinkan
beberapa organisasi untuk menyesuaikan layanan mereka kepada pasien.cc

This customization is crucial to the success of the Wairarapa ?rimary Health Organisation,
launched in 2004 after two-and-a-half years of preparation.ckustomisasi ini sangat penting
untuk keberhasilan Wairarapa Organisasi Kesehatan ?rimer, diluncurkan pada 2004 setelah-
dan-a-dua setengah tahun persiapan.cIts arrival has transformed relations between the
seven general practices in Masterton, improving communications and fostering cooperation.c

c
c

kedatangan Its telah mengubah hubungan antara tujuh praktik umum di Masterton,
meningkatkan komunikasi dan mendorong kerjasama.c?reviously, the practices had been
run as independent businesses.cSebelumnya, praktik telah dijalankan sebagai bisnis
independen.cToday, although still run independently, they share information and systems.c
Hari ini, meskipun masih berjalan secara independen, mereka berbagi informasi dan sistem.cc

n in-house software system enables surgeries to identify high-risk patients; those, for
example, who smoke, are overweight or have high blood pressure.cSebuah software house-
in memungkinkan sistem operasi untuk mengidentifikasi pasien yang berisiko tinggi;
mereka, misalnya, yang merokok, kelebihan berat badan atau menderita tekanan darah
tinggi.cThe information is used by a team of nurses, who then phone the often reluctant
patients to recommend they come in for a check-up.cInformasi ini digunakan oleh tim
perawat, yang kemudian telepon enggan pasien sering untuk merekomendasikan mereka
datang untuk cek-up.cc

The ?rimary Health Organisation has a strong focus on keeping people well and in the
community.cKesehatan ?rimer Organisasi memiliki fokus yang kuat pada menjaga orang-
orang baik dan di masyarakat.cCooper uses a metaphor to explain their approach: ´We have
become much more focused on preventing people from falling off the cliff of poor health by
building a fence at the top, rather than providing an ambulance to help people once they
have fallen into ill health.´cCooper menggunakan metafora untuk menjelaskan pendekatan
mereka: ´Kami telah menjadi jauh lebih difokuskan pada mencegah orang jatuh dari tebing
kesehatan miskin dengan membangun pagar di atas, daripada menyediakan ambulans
untuk membantu orang-orang setelah mereka telah jatuh ke dalam kesehatan yang buruk .
´cc

She says that the general practices within the ?rimary Health Organisation now also
concentrate on population health, rather than individual patients.cDia mengatakan bahwa
praktek-praktek umum dalam Organisasi Kesehatan ?rimer kini juga berkonsentrasi pada
kesehatan penduduk, bukan pasien.cThe addition of performance indicators, which measure
how each district health board and ?rimary Health Organisation is performing (immunization
rates for example), has helped the health service providers in the Wairarapa region look up
from their daily grind to the bigger picture.c?enambahan indikator kinerja, yang mengukur
bagaimana masing-masing dewan kesehatan kabupaten dan Organisasi Kesehatan ?rimer

c
c

yang bermasalah (tingkat imunisasi misalnya), telah membantu penyedia layanan


kesehatan di wilayah Wairarapa mencari dari menggiling sehari-hari untuk gambaran yang
lebih besar.cc

Getting the primary health care providers to work together like this ´has not been easy´,
says Nixon.cMendapatkan penyedia layanan kesehatan primer untuk bekerja sama seperti
ini ´tidak mudah´, kata Nixon.cThe process has been ´evolutionary´.c?roses ini telah
´evolusi´.cc

?rior to the new strategy, the quality of New Zealand's health services was high, but they
were disjointed and ´poorly integrated´, says Kenealy.cSebelum strategi baru, kualitas
layanan kesehatan Selandia Baru tinggi, tapi mereka terputus-putus dan ´buruk terpadu´,
kata Kenealy.cThere was no integration, for instance, of the multitude of health services a
particular patient might need.cTidak ada integrasi, misalnya, dari banyak pelayanan
kesehatan pasien tertentu mungkin perlu.cThe first key component of the strategy, the
creation of the ?rimary Health Organisation, aimed to combat this.cKomponen kunci
pertama dari strategi, penciptaan Organisasi Kesehatan ?rimer, bertujuan untuk memerangi
ini.cc

Furthermore, the system only worked well if you could afford to access primary health care
services, a factor that was driving health inequalities.cSelanjutnya, sistem hanya bekerja
dengan baik jika nda mampu mengakses layanan kesehatan primer, faktor yang
mendorong ketidaksetaraan kesehatan.cThe government hopes that the second key
component of the primary care strategy, an approach known as capitation funding, can help
to remove this financial barrier.c?emerintah berharap bahwa komponen kunci kedua dari
strategi layanan kesehatan primer, suatu pendekatan yang dikenal sebagai dana kapitasi,
dapat membantu untuk menghapus hambatan keuangan.cc

The government has invested significant new funding in ?rimary Health Organisations in the
form of capitation funding to reduce the cost of accessing general practice services and
strengthen primary health care.c?emerintah telah menginvestasikan dana baru yang
signifikan dalam Organisasi Kesehatan ?rimer dalam bentuk dana kapitasi untuk
mengurangi biaya mengakses layanan praktek umum dan memperkuat pelayanan
kesehatan primer.cºnder this scheme, the district health board provides funding for each

c
c

?rimary Health Organisation based on the number of people enrolled and not on the number
of times the ?rimary Health Organisation provider sees patients.cDalam skema ini, dewan
kesehatan daerah menyediakan dana untuk masing-masing Organisasi Kesehatan ?rimer
berdasarkan jumlah orang yang terdaftar dan bukan pada berapa kali Organisasi Kesehatan
?rimer penyedia melihat pasien.cSimilarly, District Health Boards are funded by the
government for their resident population ´We get a bucket of money based on our
demographics,´ says Cooper.cDemikian pula, Dewan Kesehatan Kabupaten yang didanai
oleh pemerintah untuk populasi penduduk mereka ´Kami mendapatkan seember uang
berdasarkan demografis kami,´ kata Cooper.cc

This system is ´intended to provide an incentive to manage population-group risks over


time´, says Kenealy.cSistem ini adalah ´dimaksudkan untuk memberikan insentif untuk
mengelola risiko-kelompok populasi dari waktu ke waktu´, kata Kenealy.cHe says there is
´widespread agreement that the intentions of the new system are sound´ and an
improvement on the past.cDia mengatakan ada ´kesepakatan luas bahwa tujuan dari sistem
baru suara´ dan perbaikan pada masa lalu.cBut although access to services has improved, it
is still too early to measure any improved health outcomes associated with the new system.c
Tapi walaupun akses ke layanan telah membaik, masih terlalu dini untuk mengukur dampak
kesehatan yang membaik apapun yang terkait dengan sistem baru.cc

He believes the changes will most benefit those who currently face the highest barriers,
such as cost and cultural alienation, to enjoying the benefits of primary health care services.c
Ia yakin perubahan yang akan paling bermanfaat bagi mereka yang saat ini menghadapi
hambatan tertinggi, seperti dan budaya keterasingan biaya, untuk menikmati manfaat
pelayanan kesehatan primer.c c

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c
c
c c c 
cc
c  c

cc

c cc  c   c cccc c  c  cc


cc

8 c c ccc  c  c c c c c" cc ccc  c
 cc c c  c8 c c  cc  c  c  c
 c c"  ccc c  c   ccc c+cc

8"c c cccc  cc cc  c c c"c c c


+ c;  c; cc=c c c c cc c
c c  c c+ c;  c; ccc

-"   cc=c>c "c cc  <  cc  cc ? c cc
  c c c c cc  c-"   ccc c  c   c
   cc c  <  c   cc c c  c c cc
c  c c cc

$c c  "c"cc @c  c  c c c  c c$ cc
+  cc- c c c cc c   c  c+c  c
 c+   c
c ccc

               


       À  !

"  "# 

=c>c cc < c  ccccc ! ! c c


"c c c c ccc c cc < cc<cc
c  c!c c!c cccc c c c c cc

%ccc "cAc cc=c>ccc cc c c cc


c cc

c
c

( c8c c; ccc  c; cc c c c c c


 c  c "cc  c cc c  cc  cccc @ c
c
 c8c+  c% cc8c c
  cc c c c
c cc  c  c  c c    cc c cc
   cc

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  c c c cc=c>c c cc  c  c
 c cc c c c<c  c c c ccc cc

  $ 

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c c "c  c cc  c"   cc<c
  c cc c c cc
 cc c
cc

+ c c"   c  c c   cc"c c ccc cc
 c c"   c c c cc cccc
 cc

   cc; cc

C"c0..cc c "cc c c c c* cc


0..c cc cc  c  cc ccD  c
 c cc ccc   c  c  cc  c
 c(c  ccc  cc   c c c c
  cc   c cc

*ccc c c c c  c c cc c "c


 c c cc  c c
 cc  cc
 cc:c cc ccc
c c  cc   c%  cc c  cc  c cc c
c" cc ? c c cc%  ccc cc  c
 c cc  cc ccc<c cc
(  c c c c c"c  c  cc c c cc  cc" c
8ccccc cc c c  c
 c cc ccccc

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% c   ccc  c  c cc c cc
c c8 c cc  c c c c c" cc
 " c c  cc c  c  c<ccc c c
  c c c c c ccccc c  ccc
cc

c
c

 c ? c c c c "cc ? ccc c"cEc(cc c c


  c ccccEcc

c"c A c ccc ? c" ccc "cc c"  c
 cccc c   cc ccc < c c
<cc  cc c c  cccc  c cc

D  c c   ccccc  c ccc"c(c  c


c  c:c cc<c c c(  c; cc;  cBc8 cFc
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c c  c  c c   c%c+<cc
  c<c
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G cc cc   c c  cc<ccc c
  cc ccc c cc

c
%c; c;c cc   c c; c%  c%c
 c c+c; c  cc
c

G  %&  $ ' cG%


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 cc

( cc cc c cc" c


  cc c c44. cc ccccc%? c
 c  cc  c  c
  c
c  cc  c" ccc44.<c
 cc cc  c c
%c  c   c   cCc@c cc
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 c c   c c<cc ccc
c
%c% c
( c%cc=c>c%  cc8 c c %c% cc
 cDcG c  c c ccc c"c c &%c; c
  c cc   c   cc- c; c( c%c ;c 'c&%  c
cc c c
   c c c c c c%'cc
DcG cc cc  c c c
 cc c  ccc- c
 c8c  cc"c c  c
cc   ccc cc cc c c cc:c
 cccc

( c; c;cc   c c; c c  c   c c c
   c  c"  c< c    c  cc c c c;c

  c c c+c; c  c  c c c  c c   c
 c   cc  ccccc  cHc c
c c"c  c  c ccc cc  c cc
c c cc  cc c  cc cc

c
c

+c  c cc c c c c c c cc  cc c cc
c  cc c ? c<  c c c c c cc c
c c c c c  c cc c c
 cc   c <  cc<ccc  c
( c c  cc "c  c  c  c  cc%c ccc
c c  c c  cc%cc

 c c c  c"  c c cc"  cc c c c cc
"cc  ccc" cc ccDcG c c c
c  ccc  c ccccccc
cc c cccc  cDcG cc

( c cc cc ccccc%cc  c cc@ c c c

 cc  c c  ccc%ccc c c  c


cc c c c c  c  cc c ccc  cc
   c ccccc%c8cc c cc
 c   cc

8 cc  c


   cc; cc

C"c0..cc c "cc c c c c* cc


0..c cc cc  c  cc ccD  c
 c cc ccc   c  c  cc  c
 c(c  ccc  cc   c c c c
  cc   c cc

*ccc c c c c  c c cc c "c


 c c cc  c c
 cc  cc
 cc:c cc ccc
c c  cc   c%  cc c  cc  c cc c
c" cc ? c c cc%  ccc cc  c
 c cc  cc ccc<c cc
(  c c c c c"c  c  cc c c cc  cc" c
8ccccc cc c c  c
 c cc ccccc

"c c  cc c cc   cc cc c c c" c
% c   ccc  c  c cc c cc
c c8 c cc  c c c c c" cc
 " c c  cc c  c  c<ccc c c
  c c c c c ccccc c  ccc
cc

 c ? c c c c "cc ? ccc c"cEc(cc c c


  c ccccEcc

c
c

c"c A c ccc ? c" ccc "cc c"  c
 cccc c   cc ccc < c c
<cc  cc c c  cccc  c cc

D  c c   ccccc  c ccc"c(c  c


c  c:c cc<c c c(  c; cc;  cBc8 cFc
  cDcG c cc ccA c  c c cc ccc
c c  c  c c   c%c+<cc
  c<c
   cFc cDc
G cc cc   c c  cc<ccc c
  cc ccc c cc

c
%c; c;c cc   c c; c%  c%c
 c c+c; c  cc

½  


c%  c())*c"c   c  c c   cc$ c


c%  c())*c"c   c c
   c c$ ccc

   c  c cc cc$c   c cc   cc$ c+c$  c%,!c  cc
  c c  cc c  c   c c c c c cc$cc   c
 c$ c+c c%,!c cc c ccc  ccc

c%  c())*c"c-c c c


)c c%  c. c c'  c
c%  c())*c"c-c c
)c. c
%  c cc'  ccc

c c c c  c cc cc  c ccc/c c! c0 c


c c c-c c c
)c  c  c1  c c  c   c  c0c c c
c-c c
)c  c  c1  cc c   c  ccc

2c%  c())*c"c$c


c$ c c c c  c  c2c%  c())*c"c$c
c
% cc  c c  c  ccc

$c
c$c
c, c& c, c& c  cc c c c   cc   c
 c c  c  c  cc  cc   cc$ c+c$  c%,!c  c c
 c cc  c  c c  c  c cc  c c
  c c$ c+c c%,!ccc

c
c

2c 1 c())*c"c$ c c  3c4 1ccc4 cc! c2c 1 c())*c"c c  3c! c4 c
c! cc

 0 cc    c  c& c  c 1cc,c


  c%1 c$ cc ciiic
 c c  c  c c& c  c c c
 c# c%1 c$ c
 ciiicc

(c 1 c())*c"c c%  c. c    c c c(c 1 c())*c"c%  c c
. ccc%ccc

 c  0c    1 c1c c  c1 c    c c  c  cc


  c c c c  c   c  c  c  c  c0c c  c
 ccccc cc  c cc c  c
 cc c   c  ccc

5
c6   c())*c"c c%  c cc,c
  c5
c6  c())*c"c%  c c
c
 c# c c ccc

 c  c cc c c%1 c$ c ccc,c


  c c  c
 cc%1 c$ c  c
 c# c ccc

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 c7cc
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! c! c,  c!ccc

c 1 cc  cc  c  c ccc cc c c c c c
 cccc  ccc c cc/c c! c c
c c 1c  c  c   1c c c c c  "  c  c
  c  c  c  c c   c   ccc

(c6   c())*c"c,c
  c  c 1   c c(c6  c())*c"c
 c# c
 c c 1   cc

,c
  cc,  c c  c c c 1 c 1  c c c  c cc c
  c  c c c 1c   c c cc c c  c    c
 c
# cc,  c c c c 1  cc   c c c  c
 cc c  "  c  cccc   c   c
c  cccc

c
c
c

( c c())*c"c%,!c c  c c cc c( c c())*c"c%,!c c  c


 c ccc

 c%  c,c!  c c% c$  c  c c cc c c  c  c


 cc   cc  c 1 cc%,!0 c  c c  c c c%c
# c#c c% c$  c  c c c c  c  c c
c c c c c  c c%,!0 c ccc

( c c())*c"c  c8  c


  c c c  c c( c c())*c"c!  c

 c#c c cccc

'c c c c  c  c c c  c% c9 c! c: c 1 c 1  c c c
  c  c8  c
  c$  c$  1c c c  c c,c
  cc,  c
%c c  c c c  c c7 c  c! c' c c 1  c c
 c
 c#c  c$  c$  1c c cc
 c# cc
,  ccc

(5c c())*c"c4 1 cc%,!c c c c(5c  c())*c"c cc


  c%,!c  c ccc

c 1 cc  cc  c c c c cc  c  c cc c c
c   cc  c  c c  c  c c  c c cc
cc  c c " c c  c c cc c  c
c  c  c  ccc

(
c c())*c"c7  c:%c   c c  cc c  c(
c  c())*c"c7  c:%c
c c cc c  ccc

7  c7  c,  c&c  c c c c  c  c  c c  c c
1 cccc cc   c  c c  c  c  ccc  c c
ccc c c cc c c  c  c  ccc

½  

-c% c);c"cc4 1 0 c  c  c-c% c);c"c c  c  c! cc

( cc7" ? c  c c c  c  c cc;   c


c c  c c  c  c  c  c c  <  ccc

c
c

 c( c  cc c c<ccc c


= cc  cc c  c c c c c
<  c ccc c  ccc

(
c 1c);c"c c%  0 ccc,c
  c(
c 1c);c"c%  c c cc

 c# c! cc

c  cc c ccc8 c% c( c ccc c


 c6.c  cc cc  c c c  c c cc cc c c c
  c c c%c;c ccc  cc% c
   c( c
 c cc   c  c6.cccc   c c
c c c c c c c c
 c
 ccc

*c 1c);c"c c cc,c


  c
*c 1c);c"cc
 c# c! cc

D cc  c c  cc( c c c cc% cc8 c cc
 c c cc( c c c% c
   ccc
  cccc

(5c6 c());c"c:< c% c c c%  0c$  c(5c6  c());c"c# c:< c


c0%  c#  c cc

 <7cc8 c  c%


c  ccc@ c cc  c  cc
c c cc c c c c  "c  cc  c
 c)c
   c  c%
c  c c  c  c c  c
cc  cc c c cccc  c c  cc
 ccc

-c6 c);c"c= c# 0 c


 c   c-c6c);c"c# c
  c c= cc

= c cc) c
 ? c c cc   c " ccccc
 c cc c  cc   cc c= c) c
 cc
 "  c c  c cccc  cc c ccc

c= c);c"c cc c c c c=c);c"c c cc c cc

c
c

( c cccccc"c  c "ccc cc= c c  c


 c c(cc ccc  cc c   ccc
c c   c c- ccc

;c=c);c"c9  c 1  c;c=c);c"c 1  c9  cc

8 c% c"c;? c c c"c c* c8 ? c c c
"   cc c c8  c  c c" c  cc  <  c

  c% c


   c"c;c c  c c"   c c8 c
c  c c c c c  cccc   ccc

;c
 c);c"c c%  c c,c
  0 c  c c   c c
;c
 c);c"c
 c%  c
 c# c ccccc

c  cc8 c% c"c;? c cc cc


c "c " c cc" cc  "c  "cc c  c
c% c
   c"c;c  cc c c c
 c c  c  c c  cccc

c
 c);c"c,c
  c   c  c ccc  c c c
 c);c"c
 c
# c  c c   cc  c c c cc

8 c% c"c;? c  c c  c8 c%  ccc cc c  c


c c c c c  c  c cc  c c c c  c8 c
c c c cc#..c c% c
   c"c;cc
 c
   < c  cccc  c   cc cc
 cc c c c   c cc
   c
 c  c
cc  c#..ccc

*c
 c);c"c'c< c  c<  c    c   c  cc, c! c%,!c

*c
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! c%,!cc

( c c@ c c c c c <7cc8 c@  c


  c  c c c c8? c  c  c8 c c*c c
c c  c c c)c
   c c  c
c  cc8? c  cc
   c
 cc

c
c

½  


5c% c)-c"c6 c+c c,c!  c


 c9 c c c c%  c
5c%  c)-c"c
6 c+c! c# c c,  c% c c%  c cc

´C cc c  c8 c  ?c  c c c c c cc c
c  c c c c ccc c8 ´c c%ccc3@ "c
 cc c+  ccc%c c  c´C cc c c
c
   c
 c?  cc  c c c c c
 cccc8 ´c ccc c3  c+   cc
  c
 c ccc

)2c% c)-c"c c%  c. c c  c$   1c  cc$    c2c% c)-c"c%  c
 c. cc  c#   c  cc#cc

Ic  c" c"  c c$ c c cc "cc  c c


  "c  cc  cc  ccc c "c c
   c c  c  c c@ c ccc c c"c c  c
 ccccc  Jc c%ccc3@ "c cc c
+  ccc%c c  c´ c c c  c) cc
 c cccc c  c c  cc ccc
  c c c  c ccc   c c  cc c
 c  ccc  c cc c´c ccc c
3  c+   cc  c
 c ccc

-c 1c)-c"c c  c c  cc c  c


-c 1c)-c"c  c c c
 c  cc cc

c  ccc ccc" c  c c  cc ccc


"  cc  Jc c%ccc3@ "c cc c+  ccc
%c c  cc%cc c c c c@ c  cc c
c6<.2cc+c@ c cc c c  cc  c
cc   c cccccc c´ cc
c c3  c+   cc  c
 c cccc
c c cc   c6c<c.2cc  c+ccc

(
c6 c)-c"c$>c4 1 c c c c    c 1 c  cc     c(
c
6  c)-c"c$>c cc c  c c     c c c
  cc

c
c

IDcc c  c c" c  c c c"cc cc  cc c  c


 c c c% c"c7c&8c 'Jc c%ccc3@ "c
 cc c+  ccc%c c  c´
c c c
  c  cc   cc cccc  c   c c
 c c% c"c7c&(c*'´c ccc c3  c
+   cc  c
 c ccc

(-cc)-c"c,c     c  c   c   cc  c(-cc)-c"c  c


    c   c# c cccc

I8 c  c c c c8c c  c c c c c
c c  cc <Jc c%ccc3@ "c cc c
+  ccc%c c  c´
   c    c c c
 c8c*c  c c c c cc  c
 ccc  ´c ccc c3  c+   c
c  c
 c ccc

( cc)-c"c  c c9  c$   c9c c$  c c( c  c)-c"c
c  c  c9c= c#  c cc

I( c cc c cc cc c c cc c c


8 c% c( c c c  c  c c c  Jc c%ccc
3@ "c cc c+  ccc%c c  c´cc
 cc c c ccc c% c
   c( c c  c
c c c ´c ccc c3  c+   cc  c

 c ccc

½  
 
%  c cccc c c c,c c
c ccc  c
  c c# cc

0c="c#..c0c="c#..cc

I( c cc c% cc8 c cc+c  c8 c c c c


c c c c c cc  c c c c  c Jc c%cc
c3@ "c cc c+%c´
  c% c
   c cc+c
c
   c
 c c ccc c cc cc
  cc  c   ´c ccc c3  c+%cI% c
  c c%ccc ccc c´8c  cc c
c c c ccc cDc c c c  c c c
  c c c  "c
cccc c c c

c
c

  c c  cc c c c  c" c  c  cc c c
 cc   c c c cc"´c c  cc<c   c
 ccc ccc  c c  cc
c´cc

 c%  c  c4 c


c c   cc c,c! c%  c c
 c c4 c
cc c   c! c# cc

/cC c#..c/cC c#..cc

c  c  c  c7c%c


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cc8 cc  c+ c c  cc cc8 c c
"c c c <cA cc c cccK cc c
; cc(  cA c cc cc c c"cc
c "c c ccc  c cc cccc c
c c cc c cc  cc7c%c
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c   cc
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c= cc  c  ccc cc c% cc
c  c  cc
 c
c  c c c c cc
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 c cc   cc

: c9c  c c  c    c1 c c,c c,c
# c c  c c c    cc c# cc

#,c c#..c#,c c#..cc

´( c" ? c c  c c c3  c  c+ c c cc
" cc  cc c  c Jc c%ccc3@ "c cc c
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+ c c&=#'c c c(  cc c  c c; c´ c
c c  cc c8c
c-<-c c
c  cc  c   ´c ccc c3  c+%c c
c
c+   c c c  c c c8c
c&=c#'c c
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 c cc

4 1cc,c! cc8 c4 c! c! c# c! c c c4 cc

6c c#..c6c c#..cc

c
c

I=c <7cc8 cc


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c  c"Jc c%ccc3@ "c cc c+%ccI( cc"  c
c cc <7cc8 ccc  c  c c cc c  cc
c  c c  c c ccc    cc ccccc
cccc c" cc  c cccc  cc
c c  ccccc c  c c=c>Jc´=c c
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c c)c
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 c c c c c   c c  ccccc
ccc ccccc   c cc
cc cc cc ccccc  c c
ccc c´cc

 c%  cc%,! c c c0,  c 0c c c$   1c c    c
%  c cc%,! c  c0,  c 0c c c  c  c! cc

,c c#..c,c c#..cc

Ic  cc c#.c  c  c c "cccc" "c? c ?c
c c   ccc c "c Jc c%ccc3@ "c c
c c+  ccc%c cc% c
c c   cc c#.c
8 c  c´ c cc#.c cc   c  c  ccc? c
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c ccc#.c
8 c ccc

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c cc

5c+ c#..c5c+  c#..cc

I( c " cc c  cc  cc=c>? cc    c  cc


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 cccc c  c  cc  c c c´cc

c
c

À  ½        


     


c cc! ccc! cc

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c å  

  


 
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„c  c
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^^

( c cc c c c cA c" c(cc c c c
 c c  cK c" c  cc cc c  c
) c c cc  c c  ccc c  cc
  c  c  cc c c)c c c cc  c
c  cc c c(  c  c "c cc c  c c
  c   c cc cc cc  cc:  c cc
c  c cc  c  c c cc
cc  c c   c(  c c  c @c  ccc?c
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 cccc  c? c?cc  c  c   cc c
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c? c"? c c c  cc: c cc? ? c"cc
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c c    cc?  c ? c c  c c
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 ccc "c  c"c c c " cccc
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c<c c c c   cccc
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 c  c cc cc  cc c c c  c"c

c
c

   c c"cA c c c  ccc%Lcc cc


 c  c c c  c  c   c  c cc
 c cc cccc  c c
 c  cc c cc c cc%Lcc


  

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C c
C cc
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 c c?c c ?c c "cA c" Mc+ c?  c  cc ?cc c
c c  Mc c c c c"c c c c c c c( c
?A c ?c c  c  cA c cc c c "c c( c?  c?c < c
c  cccc c c$c@c;  cc?"c
   ccA c ?cNccOcc  c;  c c?c  c
c ?cNccOcc c? "c c  ?c  c c c ccc
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c c0c c c   cNc#cOc* c  c c c  c
c* c  c ccc c( c c cc  c cc
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cc cc c  c c< c c c
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cc  c c cc c  c c  c c
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