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Chronic kidney failure is a pathophysiological condition that can arise due to various etiologies. Hemodialysis patients with chronic kidney failure who experience problems and clinical difficulties can affect anxiety levels, one of the non-pharmacological treatments that can be given to patients is Intradialytic exercise because the movements are simple, do not interfere with the hemodialysis procedure, and are useful in reducing anxiety levels. This study aims to determine the effect of intradialytic exercise on anxiety levels in patients with chronic kidney failure in the hemodialysis room of Tanjungpinang City Hospital. This study uses a quantitative research method with a quasi-experimental design without control design, the design form used is pre and post test. The sample in this study of patients treated at Tanjungpinang City Hospital amounted to 30 people with random sampling techniques. The anxiety level measurement instrument uses the Hamilton Anxiety Rating Scale (HARS) questionnaire. The statistical analysis used was a normality test with a sig value. > 0.005, t paired sample t test and independent t test. There was a significant influence between the average anxiety level score at the pre-test and post-test in the intervention group (intradialytic exercise) (mean pre-test = 24.60 to mean post-test = 18.33) with a p-value of 0.000. Conclusion this study found the effect of intradialytic exercise on anxiety levels in patients with chronic kidney failure in the hemodialysis room of Tanjungpinang City Hospital. Suggestion for Tanjungpinang City Hospital, intradialytic exercise therapy can be considered as a non-pharmacological management in patients with chronic kidney failure in the Hemodialysis room to reduce anxiety levels

Individuals who experience GGK and have undergone hemodialysis will experience many changes in their lives. This can affect the patient's psychological condition. Changes that occur can have an impact on individual perceptions related to their lives including the quality of their lives and perceptions about themselves including self esteem. To find out the relationship of self esteem with the quality of life in chronic kidney failure patients who are undergoing hemodialysis in the hemodialysis room of RSUD R Syamsudin SH Sukabumi City in 2025. Research uses correlational design. The number of samples was 219 people. The instruments used were the CSEI and KDQOL-S questionnaire. The statistical test used is Chi Square's correlation. There is a relationship between self esteem and the quality of life of chronic kidney failure patients who are undergoing hemodialysis, the results of the chi square test with a p-value of 0.00 or smaller than the alpha value (a = 0.05). The results of this study can provide information for RSUD R Syamsudin SH to increase health knowledge and insight to improve the quality of life of chronic kidney failure patients in hemodialysis. One step that can be taken is to provide education to increase the patient's self esteem.

Hemodialysis (HD) is the main therapy for end-stage chronic kidney failure (CKF) patients. Various factors, including age and gender, influence HD patients' quality of life (QoL). Studies on the relationship between these two factors and the QoL of HD patients in the RI-RDTL border area are still limited. This study aims to analyze the relationship between age and gender and HD patients' quality of life at Mgr. Gabriel Manek Hospital, SVD Atambua. This study used an observational analytical design with a cross-sectional approach. The study sample consisted of 50 HD patients who met the inclusion and exclusion criteria. QoL was measured using the WHOQoL instrument, and data were analyzed using the chi-square statistical test. The results showed no significant relationship between age and the quality of life of HD patients (p = 0.245). In addition, gender also had no significant relationship with the quality of life of HD patients (p = 0.643). Age and gender were not significantly related to the quality of life of HD patients. Other more influential factors need to be studied further to improve the quality of life of HD patients.

Stunting, also known as growth failure in children, is a condition caused by a child's nutritional needs not being met for a long time, specifically during the first 1,000 days of life. The first 1,000 days of life are the first 270 days (nine months) in the mother's womb plus the first 730 days (two years) of a baby's life after birth. Education is a learning process aimed at developing the potential or quality of thought patterns and knowledge of an individual or group. One of the goals of education is to increase public knowledge. The target group for the first 1,000 days of life is pregnant women. The purpose of this study was to determine the effect of education on pregnant women's knowledge about the first 1,000 days of life at the Tombulilato Community Health Center, Bone Raya District, Gorontalo City. The type of research used is Quasi Experiment with a two group pretest and posttest design approach. The sample in this study were 32 pregnant women in the intervention group and 32 in the control group. Data collection was done through a questionnaire. Data were analyzed using a paired T test with a 95% confidence interval (CI) and α <0.05. The results of the study showed that Educational Intervention had a significant effect on the knowledge of pregnant women (p = 0.000) in the First 1000 Days of Life in the Tombulilato Health Center area, Bone Raya District. It is hoped that more practical information will be provided to the community, especially prospective mothers, in preparing a quality next generation, especially in the First 1000 Days of Life. As well as optimizing Posyandu services, and involving the participation of families such as husbands and parents when socialization and information provision are carried out.

Pastoral ministry is a divine calling that demands faithfulness, vigilance, and wholehearted love in caring for God’s flock. However, in the reality of ministry, many church shepherds face complex and burdensome challenges in fulfilling this responsibility. A failure to understand and implement authority based on the character of Christ often becomes the root problem in pastoral ministry. This study aims to explore the dynamics of pastoral ministry in the context of today’s church, particularly in light of 1 Peter 5:1–4. The approach used is qualitative descriptive, based on a literature review, with a focus on relevant theological and pastoral works. The findings reveal that many pastors experience spiritual and emotional exhaustion, especially when their ministry lacks support from an adequate organizational structure, or when the congregation’s expectations are misaligned with the church’s mission. In this context, true shepherding—as explained by figures such as Bill Lawrence and Phil Pringle—must be rooted in Christ as the Head of the Church. A pastor is called to serve with humility, not to dominate or pursue personal interests. Furthermore, a deep understanding of the biblical metaphor concerning the relationship between shepherd and sheep is essential to avoid distortions in meaning and deviant ministry practices. An emphasis on love, responsibility, and exemplary conduct becomes the foundational framework for building an integrous pastoral ministry. This study concludes that pastoral ministry will be more effective when supported by clear church organizational policies, a deep theological foundation, and pure ministry motivations. Thus, pastoral ministry is not merely an administrative task, but a manifestation of God's love expressed through the lives of His servants.

Degenerative diseases are chronic diseases that can affect a person's quality of life in the future. One example of degenerative diseases is diabetes mellitus and hypertension. Hypertension is defined as one of the most dangerous health problems worldwide because hypertension is a major risk factor that can cause cardiovascular diseases such as heart attack, heart failure, stroke. The purpose of this study was to determine the relationship between family history, type of work, and stress level on the incidence of hypertension in Kebonkalapa hamlet, Kutapohaci. The research method used a nonparametric test technique using the chi square statistical test and was processed using the IBM SPSS 25 application. The results of the analysis obtained from this study found that family history, type of work, and stress level were not associated with the incidence of hypertension in Kebonkalapa hamlet, Kutapohaci because the p-value was greater than 0.05.    

This study aims to examine the effect of idle time on the productivity of dry bulk loading and unloading activities at the Java Integrated Industrial and Port Estate (JIIPE). The research employed a quantitative correlational approach, with data collection techniques including observation, documentation, and company records. The research sample consisted of 12 vessels engaged in loading and unloading at Java Integrated Industrial and Port Estate (JIIPE) port during the period from January to July 2024. The analysis revealed a correlation coefficient of -0.16, indicating a very weak negative relationship between idle time and productivity. The coefficient of determination, at 2.56%, suggests that idle time contributes only marginally to productivity, while the remainder is influenced by other factors. The factors affecting idle time include weather conditions, equipment failures, and truck delays. The conclusion indicates that while idle time does impact productivity, the effect is not statistically significant..    

The loading and unloading process involves moving goods from one place to another, often requiring specialized equipment such as a wire crane. In maritime operations, unexpected incidents like wire crane breakage can occur. Wire crane breakage refers to damage in the sling wire of a ship's crane, reducing its lifting capacity and causing the wire fibres to unravel. During sea-based fieldwork on the MV. Pacific Bulk, researchers observed a wire crane failure during loading and unloading operations, which caused delays and financial losses. This study aims to identify the causes of wire crane breakage on the MV. Pacific Bulk and examine its technical and operational impacts. Using a qualitative descriptive method and fishbone analysis for data interpretation, the study found several contributing factors: wire corrosion, crane age, lack of standard operating procedures (SOPs) for crane maintenance, insufficient crew, inadequate maintenance, lack of routine inspections, and challenging environmental conditions. The research also highlights the technical and operational consequences of such failures, including delays and economic loss. To address the issue, the study suggests implementing scheduled periodic inspections following SOPs, applying regular lubrication, and maintaining data records of the wire crane’s lifespan. These preventative measures aim to improve operational efficiency and avoid future wire crane failures.

The use of lightweight plastic materials is widely applied in the manufacturing of car dashboards. Lightweight plastics or polymers, such as ABS plastic, are not strong enough or can easily crack when impacted. Banana pseudostem fibers have good mechanical properties and are a potential reinforcement for composites. This study aims to analyze the tensile strength of unsaturated polyester-banana pseudostem fiber composites produced through the hand lay-up method at three different angles: 0°/90°, 15°/105°, and 30°/120°. The tensile testing refers to ASTM D638 standards. The results of the tensile tests show that the 0°/90° weaving angle variation had the highest tensile strength value, which was 372.07 MPa. The 30°/120° fiber orientation variation had the lowest tensile strength value at 198.12 MPa. The fractures from the tensile tests were observed through macro photos to understand the failure mode. The macro photo observations showed that all specimens experienced fiber pull-out.    

Pressure vessels are critical components in the energy industry, used to store and process high-pressure fluids. The structural reliability of these vessels plays a pivotal role in ensuring operational safety and system efficiency. This study aims to analyze the design and reliability of pressure vessels using both numerical and experimental approaches to optimize performance and enhance safety factors. The numerical method was conducted through Finite Element Analysis (FEA) using ANSYS software to evaluate stress distribution, stress concentration, and potential failure modes under various operational load scenarios. Meanwhile, the experimental method involved hydrostatic pressure testing, strain measurements using strain gauges, and displacement analysis to validate the numerical simulation results. Data were collected from simulations and laboratory experiments, then analyzed quantitatively by comparing key parameters such as stress distribution, deformation patterns, and safety factors against industry standards. The results indicate that combining numerical and experimental approaches improves the accuracy of pressure vessel behavior predictions, enables more efficient design optimization, and enhances structural reliability. In conclusion, the methods applied in this study can serve as a reference for developing safer, more efficient pressure vessel designs that comply with industrial standards, thereby supporting improved safety and operational efficiency in the energy sector.

The goal in playing handball is to put the ball into the opponent's goal as much as possible and concede fewer goals. This study aims to find out how big the success and failure rate of shooting techniques is and what shooting areas or positions are most often used for shooting in the 2023 IHF World Championship final match. This study is a type of quantitative descriptive research, with an approach through match video analysis which is presented in the form of numerical data to find out how big the success and failure rate of shooting is and what shooting techniques are used. The subjects in this study were the Danish and French teams playing in the 2023 IHF World Championship final match. The results showed that the number of successful shots from the Danish team was 34 times while for France it was 29 times with a percentage of 62.96% and 50.87% successful shooting using the jump shoot technique 20 times with a percentage of 65% for Denmark, while for France the flying shoot technique was most often used, namely 22 times and a percentage of 59.09%. The number of shooting failures from the Danish team was 20 times with a percentage of 37.03% while for France it was 28 times with a percentage of 49.12%, shooting failures using the jump shoot technique were 7 times with a percentage of 35% for Denmark, while for France the failure using the flying shoot shooting technique was 9 times with a percentage of 40.90%. The most frequently used shooting area from both teams was the front area, successful shooting for Denmark 18 times with a percentage of 64% and France 18 times with a percentage of 56%, failed shooting from the front area of ​​the Danish team was 10 times with a percentage of 36% while France was 14 times 44%. The results of this study are expected to be used as a reference for players and coaches to develop the right training program in order to improve the effectiveness of shooting techniques to get better results.  

In the context of education in Indonesia, education requires many touches from various parties in the formation of its policies. Considering that the moral crisis is increasing, strict education management is needed. Education is a process of instilling and developing implicit values and norms in every subject, including Islamic religious education and also its teachers. Therefore, not only Islamic religious education teachers have the responsibility to educate students' morals and ethics, this responsibility also applies to all educators. Efforts to improve the quality of Islamic religious education have been widely implemented. The goal is none other than to convey the meaning of education that functions to build the character and morals of a dignified nation in order to educate the life of the nation to build the potential of Indonesian people who believe and fear God Almighty, have noble morals , are healthy, knowledgeable, capable, creative and independent. The existence of shortcomings and advantages in each educational institution will have an impact and require different handling. The right policies and handling will have a good impact and be in accordance with the expectations of an institution. On the other hand, if the management and policies are not considered and adjusted to the educational institution , then failure will be encountered. Each educational institution has different needs and objectives according to the needs, interests and goals to be achieved.

As a result of rapid technological progress, increased competition, and the global opening of markets, local markets have been flooded with a large number of foreign products of superior quality compared to local products. This has exposed Iraqi economic units to numerous pressures for various reasons, most notably the high cost of their products and the low quality of their products. This requires these units to seek solutions that lead to the provision of a high-quality product capable of competing with foreign products in terms of price and quality, thereby achieving customer satisfaction. Therefore, the research aims to integrate the two techniques of Attribute Based Costing and process reengineering and to demonstrate their role in improving product quality. The researcher reached a set of conclusions, the most important of which are The weakness of the costing system applied at the research sample factory, its failure to accurately monitor and identify cost elements throughout the product lifecycle, and the management's lack of interest and awareness in implementing contemporary costing techniques and their role in improving the quality of its products, thus ensuring their sustainability. The integration of specifications-based costing with process reengineering technology has added substantial improvements to product specifications, aligning them with customer requirements and needs, and leading to improved product quality.

One of the causes of the high Maternal Mortality Rate (AKI) is long childbirth. If the delivery process lasts a long time, it can cause the mother to be exhausted because she runs out of energy. This results in inadequate uterine contractions (his) so that it can cause failure in the progress of labor. In addition to the inadequacy of uterine contractions (his), psychological conditions are also one of the factors that affect the length of labor progress. The psychological condition in question is the mother's perception of anxiety and pain during the childbirth process. One of the non-pharmacological therapies is self-healing , which is one of the methods used to manage emotions in order to avoid things that cause stress. This study aims to analyze the Effectiveness of Self-Healing to Reduce the Intensity of Pain in Maternal Mothers at PMB Winda Nainggolan, Hutabayu District, Simalungun Regency, North Sumatra Province in 2024. This research method uses a quantitative research approach with a quasi-experimental design research method in one group (one group prestest posttest). The research will be conducted in May 2024-July 2024. The sample size was 16 people with nonprobability sampling techniques. The data analysis used was using the Pairet t Test with an error value of α 0.05. The results of the study based on the output test statistics obtained a significance value of 0.000 which is smaller than the significance level of 5% (p-value = 0.000 < 0.05). The conclusion of the study is that Ha is accepted, which means that there is an effect of self-healing on the reduction of Period I labor pain in Primigravida mothers at PMB Winda Nainggolan, Hutabayu District, Simalungun Regency, North Sumatra Province in 2024. It is hoped that health workers can improve the quality of service, self-healing can be an intervention as one of the non-pharmacological therapies for maternal mothers.

process standardization, and system optimization. The study concludes that the HOT-FIT model is This study evaluates the performance of the outpatient registration information system at RSUD Komodo using the Human-Organization-Technology Fit (HOT-FIT) framework. Hospital Information Systems, particularly in the outpatient registration process, are crucial for supporting service efficiency and data accuracy. However, RSUD Komodo has experienced several challenges in the implementation of its SIMRS module, including system slowdowns, sudden monitor failures, and unstable internet connectivity during service hours. These issues hinder operational effectiveness and risk compromising service quality. The objective of this research is to assess system performance comprehensively across human, organizational, and technological dimensions. A qualitative descriptive design was employed, involving in-depth interviews with five key informants: registration staff, IT personnel, coder, head of the medical records unit, and head of the casemix team. The findings show that in the human dimension, users lacked sufficient training and adaptation strategies. In the organizational aspect, weak coordination and the absence of standardized procedures were identified. In the technology dimension, hardware malfunctions and slow system performance significantly disrupted services. These interconnected issues reveal the need for capacity buildingan effective tool for evaluating hospital information systems, offering a structured approach to identifying and resolving performance gaps in outpatient service modules.

The implementation of Electronic Medical Records (EMR) in healthcare institutions aims to improve the efficiency, accuracy, and accessibility of medical data. RSUD Weda, a regional hospital in Indonesia, has adopted an EMR system in its outpatient services to replace conventional manual processes. However, this transition has faced several challenges, including inadequate training, unstable network infrastructure, and inconsistent adherence to Standard Operating Procedures (SOPs). This study aims to evaluate the performance of the EMR implementation using a qualitative descriptive method based on the 5M framework—Man, Material, Machine, Method, and Money. Data were collected through interviews, direct observation, and document analysis involving stakeholders such as medical staff, administrators, and IT personnel. The findings indicate that while users acknowledge improvements in data accuracy and accessibility, key issues remain, particularly in training quality, infrastructure readiness, and system reliability. The study also observed gradual improvements in SOP compliance and reduced system failures over time. These results suggest that successful EMR adoption requires a balance of technical infrastructure, human resource readiness, financial support, and continuous system monitoring. The use of the 5M framework proved effective in identifying multidimensional challenges and offering holistic insights into the implementation process. This study contributes to the broader literature on EMR evaluation by providing contextualized evidence from a district-level hospital and offers practical recommendations for enhancing EMR system performance in similar healthcare settings.    

This study aims to identify the human rights (HR) violations experienced by Palestinian civilians in the context of international law and to evaluate the various conflict resolution efforts that have been undertaken. Based on an analysis of various forms of violations, such as killings, administrative detention without charges, movement restrictions, evictions, and disruptions to education and healthcare services, this research finds that HR violations against Palestinian civilians are widespread and systematic. The study also assesses the effectiveness of the resolution efforts made by the international community, such as the Oslo Accords and various UN resolutions. Although there have been some advancements, these efforts are often hindered by distrust, ongoing violence, and failures to address core issues. To achieve a fair and lasting resolution, this research recommends full respect for human rights, cessation of actions that violate international law, and a genuine commitment from all parties to meaningful negotiations. The type of research used is a library research method with descriptive analysis by collecting data, organizing or classifying it, compiling, and interpreting it. This method is used because it can clearly describe the object of the study.

The cooling system on the Jupiter MX 135 CC motorcycle functions to maintain a stable engine temperature to prevent overheating. There are two main types of cooling systems on motorcycles: Air Cooling System and Liquid Cooling System. In the Air Cooling System, the working principle involves heat generated by the motorcycle engine being dissipated through cooling fins located around the engine block. Air that flows through the fan or moves as the motorcycle runs will carry away the heat. Meanwhile, in the Liquid Cooling System, the working principle involves coolant (usually a mixture of water and antifreeze) flowing through channels inside the engine to absorb heat. The coolant is then carried to the radiator, where the heat is transferred to the air with the help of a fan. Common problems that occur in the cooling system of the Jupiter MX 135 CC motorcycle can interfere with engine performance and risk causing serious damage if not addressed promptly. Some of the common issues include, Low coolant level, Radiator damage, Water pump failure, Malfunctioning thermostat (thermostat stuck), Leaking or broken radiator hose, Radiator fan malfunction, Dirty or contaminated coolant, Ineffective fan (for air-cooled engines), Overheating due to excessive load. The objectives of this study are to understand how the cooling system on the Jupiter MX 135 CC motorcycle works, to identify damages occurring in the cooling system, and to solve the issue of water pump leakage in the cooling system. The methods used in this research include observation, literature study, interviews, and action methods. The results of problem identification in the cooling system of the Jupiter MX 135 CC motorcycle show, The water jacket gasket is corroded ,The bearing on the water pump is damaged, The water pump impeller is worn out, The radiator pump seal has hardened, causing a squeaking sound around the water pump, Solutions to the problems in the cooling system components include replacing the damaged and worn parts (head gasket, bearing, seal, and impeller) and refilling with new coolant.

Hypertension is a major cause of heart failure, stroke and kidney failure. Prevalence of hypertension in Indonesia in the urban and rural areas ranged between 17-21%. Smoking is one cause that can affect blood pressure. The aim of this research is to discover the relationship between the smoking activity and hypertension on men aged 45 year-old and older in Klinik Pratama Cinangsih Medika Cianjur. This research is a correlative descriptive. The approach used cross-sectional with total samples were 98 respondents. The sampling technique used was purposive sampling. The instrument used in this study was questionnaire. Data was obtained through questionnaires distribution and interviews, and blood pressure measurement. The data collected was processed by using Chi-square statistical test with degree of significance p value < 0.05. The result showed 74 people (75,5%) smoked and those who suffered hypertension were 75 people (76,5%). From bivariate test result showed there is relationship between number of cigarettes taken and hypertension (p = 0,005), there is relationship between way of smoking and hypertension (p = 0,008), there was no relationship between smoking duration and hypertension (p = 0,059), there is relationship between type of cigarette and hypertension (p = 0,027), and there is relationship between the activity of smoking and hypertension (p = 0,007). Suggestions the researcher can propose concerning this research are to reduce hypertension risk as the effect of smoking, cigarette consuming should be decreased gradually to stop smoking in advance, the result of this research can be served as reference in dealing with patients suffering for hypertension, especially, in Cianjur. Keywords: Smoking activity (number of cigarette, way of smoking, smoking duration, sort of cigarette), Hypertension.  

This essay was written to investigate why, in spite of the policies that the Nigerian government has put in place, poverty rates are still high. The main obstacle that every accountable and responsive government must overcome is Regardless matter whether the government is a military dictatorship or a democracy, it must improve and give greater meaning to the lives of its citizens if it is to remain relevant and legitimate in the eyes of the governed. Since independence, every succeeding administration has implemented some kind of plan to lessen the suffering of the populace and make them happy.Prior to and during the Structural Adjustment Program (SAP), it was noted that the majority of these programs were supply-driven, meaning they were unable to address the needs of the impoverished and, as a result, had little impact on reducing poverty. In order to reach the target poor, various programs that were introduced after SAP adopted a demand-driven strategy. The purpose of this study are (i) to critically analyze the several programs, reforms, and policies aimed at reducing poverty that have been implemented by Nigerian governments in succession, as well as the factors that contributed to their success or failure. (ii). expresses profoundly helpful measures that, if properly applied, would help the country escape its current poverty trap and put it on the correct path for sustainable economic development rather than just the steady economic progress it has seen over the years.