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This paper is to determine the Role of PBM Wahana Intradermaga Niaga in the Dry Bulk Unloading Process at PT. Pelabuhan Belawan. Unloading activities are activities to unload goods from the ship's hold to the dock in the ship's hull or vice versa (stevedoring), activities to move goods from the dock using a conveyor to the warehouse/stacking yard or vice versa (cargodoring) and activities to pick up goods from the warehouse/yard carried onto a truck or vice versa (receiving/delivery). A dry bulk carrier is a ship specifically designed to be able to transport various dry bulk loads. In the distribution of dry bulk cargo there is an unloading process. Unloading aims to lower and raise goods from the ship to the port or vice versa. And in supporting this goal requires unloading equipment. The unloading equipment in question comes from the port. In carrying out the unloading process, MV. S Grace has obstacles in carrying out unloading. So that the purpose of unloading is not achieved optimally. Therefore, an analysis is needed to determine the factors that inhibit the productivity of dry bulk unloading so that unloading activities can run optimally. From the results of reading and observing this paper, the author states that the implementation of unloading has inhibiting factors, namely external factors. Crane breakdown and bad weather are inhibiting factors in the dry bulk unloading process. Based on these factors, it has an impact on unloading delays that are not according to schedule and increase ship queues. Therefore, the author suggests that port operators or ship crews carry out routine maintenance on the equipment used for loading and unloading so that dry bulk loading and unloading can run optimally. This paper uses the field research method and the library research method (data collection from the library).  

The development of information technology has had a significant impact on the healthcare sector, particularly in improving the efficiency and quality of services. Technologies such as Big Data and the Internet of Things (IoT) enable the collection and analysis of large volumes of medical data as well as real-time patient monitoring. This study aims to analyze how the integration of Big Data and IoT can enhance the quality of healthcare services, with a focus on their impact on patient care and hospital operational efficiency. The research method used is a literature review, involving the collection and analysis of data from various sources such as scientific journals, articles, and related research reports. The results indicate that hospitals that have implemented these technologies have experienced significant improvements in several aspects, including increased diagnostic accuracy, reduced service delays, and more efficient resource management. Real-time patient monitoring through IoT devices enables faster medical decision-making, while Big Data analytics helps predict disease patterns and medical needs. However, the challenges faced include data security issues, infrastructure limitations, and shifts in healthcare practice paradigms. In conclusion, the integration of Big Data and IoT can improve the quality of healthcare services, but addressing the existing challenges is essential to optimize its implementation in the healthcare sector.

Manual inventory management at Toko Terang Abadi presents various challenges, including delays in reporting and high recording errors. This study aims to improve accuracy and efficiency in stock management by creating a web-based inventory information system using the Waterfall method. Data collection was conducted through interviews, direct observation of store activities, and literature review. The system was designed and implemented using PHP and MySQL, and tested using black-box testing methods to ensure all functions work according to user needs. Implementation results show that recording efficiency increased by 50% and input errors decreased by 90%. These findings support previous research highlighting the importance of digitalizing inventory systems in the SME and retail sectors to improve effectiveness and accuracy in managerial decision-making.

Generator Set Service Management is the process of organizing maintenance, repair, and upkeep activities of generator sets, starting from planning, implementation, evaluation, control, and improvement of services to ensure the generator machine continues to operate effectively and efficiently. The research was conducted at PT. Sigma Quantum Insani, located in Balikpapan, East Kalimantan. The problem addressed in the research is the frequent delays in completing scheduled tasks within the generator set service management activities. The purpose of the study is to determine the critical path of activities and identify the duration of the critical path. From the analysis using the Critical Path Method (CPM) assisted by MS Project software, the identified critical path activities are: A1-B1-B2-B3-B4-B5-B6-B7-B8-B9-B10-B14-B16-B17-C1-C2-D1-D2-D3, which include DO approval, engineering scope, painting scope, and delivery scope. The total time obtained for the critical path is 38 days, resulting in a time efficiency of 8 days in the generator set service process.

This research focuses on the development and evaluation of an Adaptive Edge-AI framework designed to optimize real-time data processing and decision-making in resource-constrained environments, specifically within smart city infrastructures. The primary problem addressed is the challenge of minimizing latency, reducing energy consumption, and ensuring the reliability of Cyber-Physical Systems (CPS) when using Internet of Things (IoT) devices. The objective of the study is to assess the effectiveness of this framework in real-world smart city applications such as traffic monitoring, environmental sensing, and smart utilities management. The proposed method integrates lightweight AI models, edge computing, and adaptive resource management techniques, including Federated Learning and Neural Architecture Search, to ensure optimal performance while addressing hardware constraints. The main findings reveal that the framework significantly improves real-time inference speed, reduces energy consumption of IoT devices, and enhances CPS reliability by minimizing communication delays and ensuring continuous system operation despite network disruptions. The application of this framework to smart transportation and urban utilities further demonstrates its potential to optimize city management processes. The study concludes that the Adaptive Edge-AI framework offers a promising solution for smart cities, enhancing operational efficiency, sustainability, and resilience. It is recommended for integration into smart city infrastructures to enable better resource management and decision-making in real-time applications.

The BPNT problem which eventually became the background of the research problem began when researchers were visiting one of the food distribution places in Sangiasseri Village in early February 2020, this market is one of the places where the community receives assistance, when researchers conducted research at the place where the community received assistance, researchers listened to residents' complaints where the assistance they received varied, some received IDR 300,000 and some received IDR 600,000. The community explained that the non-cash food assistance program received was usually charged by the management, there were also delays in disbursement where residents received once every three months which became a problem in the BPNT program. In its implementation, the Non-Cash Food Assistance (BPNT) program experienced inaccurate targeting where financially capable families received assistance, while poor families did not. So that the socio-economic welfare of beneficiaries has not increased Non-Cash Food Assistance (BPNT) in the socio-economic welfare of beneficiaries, researchers discuss the running of the implementation of BPNT from the Sub-district, Village, RW and RT, BPNT Facilitators, and E-Warong and present findings on obstacles in the BPNT implementation system in the welfare of underprivileged families in Sangiasseri village.

E-Puskesmas is a solution to problems caused by manual systems. It was created to streamline the method of reporting data to the Health Office and digitize the process of providing health services to the community at the Puskesmas. In addition, the online reporting system facilitates the dissemination of information effectively and efficiently. This study aims to determine the impact of using E-Puskesmas in improving the effectiveness of health services at the Pancur Community Health Center in Tanjungpinang City. The research method used is descriptive research with a qualitative approach conducted through observation, interviews, and documentation. The results of the study indicate that the implementation of E-Puskesmas has brought significant improvements in managing patient data, appointment scheduling, and reporting processes to the Health Office. Health workers find the system beneficial for storing accurate data, reducing paperwork, and enabling faster coordination with other health facilities. However, the use of the system is still hampered by unstable or slow internet or Wi-Fi networks, which often delay data input and retrieval during busy operational hours. This issue not only reduces efficiency but also causes frustration among staff who rely on the system for daily activities. The conclusion of this study highlights that the use of E-Puskesmas is effective in supporting digital health services but remains suboptimal due to technical challenges. Improving internet connectivity is critical to ensuring seamless operation and maximizing the benefits of the system. The study recommends that the local government and relevant stakeholders enhance the quality of network infrastructure and provide regular technical support and training for Puskesmas staff. By addressing these challenges, the Pancur Community Health Center can improve the stability of its operations and ensure that the E-Puskesmas application delivers optimal results in supporting high-quality, efficient, and technology-driven health services for the community.

In the digital era, savings and loan cooperatives are required to manage their finances efficiently and accountably through the implementation of effective accounting information systems (AIS). AIS plays a crucial role in producing accurate, timely, and reliable financial reports. However, many cooperatives in Denpasar City continue to face challenges such as delayed reporting and low-quality financial information, despite having adopted information technology. This study aims to examine the influence of information technology sophistication, skills, and work experience on the effectiveness of accounting information systems. The sample consists of 98 cooperative employees who use accounting information systems in their work, selected using purposive sampling. Data were collected through questionnaires, and the analysis was conducted using multiple linear regression. The results of the study indicate that information technology sophistication, skills, and work experience have a significant positive effect on the effectiveness of accounting information systems. This research provides empirical evidence supporting the Technology Acceptance Model (TAM), which emphasizes two main factors influencing technology adoption: perceived ease of use and perceived usefulness. The findings are expected to contribute to cooperative management development and encourage improvements in human resource capacity and the use of technology to support better financial governance.  

Public transportation is a primary necessity for supporting daily activities in Denpasar City. One mode of transport that plays a strategic role is the Trans Sarbagita Bus. As a mass transportation service, this bus system is expected to provide effective, efficient, and affordable mobility. This study aims to analyze: (1) public perception of the effectiveness of the Trans Sarbagita Bus service; (2) the simultaneous effect of accessibility, punctuality, and ticket price on service effectiveness; (3) the partial effect of each of these variables; and (4) the strengths, weaknesses, opportunities, and threats (SWOT) of the Trans Sarbagita Bus system. A quantitative method with an associative approach was employed. Data were collected from 105 active respondents through observation, interviews, and a five-point Likert scale questionnaire, and analyzed using multiple linear regression via SPSS. The findings show that: (1) public perception is generally positive, especially in terms of comfort and safety, although accessibility and punctuality remain suboptimal; (2) accessibility, punctuality, and ticket price simultaneously have a significant effect on service effectiveness; (3) each of these variables also has a positive and significant partial effect; and (4) strengths lie in low fares and safety, while key weaknesses include limited access and delays. Opportunities stem from policy support and rising public awareness, whereas threats include the dominance of private vehicles and low intermodal integration. It is recommended that the government enhance public transport campaigns through media and community partnerships, as well as expand bus stop access and intermodal connectivity to improve service effectiveness.

Various factors influence pregnant women's knowledge of pregnancy danger signs, including age, education level, occupation, previous pregnancy experience, socioeconomic status, and access to health information. Insufficient knowledge of these signs, often due to limited access to health services and information, increases the risk of delays in managing pregnancy complications, which can negatively impact both maternal and fetal health. The purpose of this study was to explore the relationship between maternal characteristics, specifically age, and awareness of pregnancy danger signs. This quantitative study employed a correlational approach, using a questionnaire as the data collection tool. The study was conducted at the Tapa Health Center in Bone Bolango Regency, from April to August 2024, with 40 participants included. The Spearman statistical test was used to assess the relationship between maternal characteristics based on age and the knowledge of pregnancy danger signs before and after an intervention. The results showed a significant change in the knowledge levels of pregnant women, with the p-value of 0.852 indicating no direct relationship between maternal age and awareness of pregnancy danger signs. Although a positive change was observed in the knowledge levels after the intervention, the study concluded that there was no significant relationship between maternal age and knowledge of pregnancy danger signs. The findings suggest that while interventions can improve awareness, age alone does not appear to be a significant factor influencing knowledge levels. This highlights the importance of focusing on other factors such as education, health access, and targeted health interventions to enhance maternal awareness of pregnancy risks. Further studies with larger sample sizes and additional variables are recommended to provide a more comprehensive understanding of the factors that influence pregnancy-related knowledge.

Gross motor and fine motor development are critical aspects of early childhood growth, yet a significant proportion of infants and toddlers continue to experience delays in these areas. According to the World Health Organization (WHO) in 2016, approximately 20–40% of infants aged 0–2 years face delays in developmental processes, with 5–25% experiencing gross and fine motor disorders. Delays in gross motor skills can reduce adaptability and creativity during the adaptation period, while delays in fine motor skills may hinder a child’s learning process. Beyond adequate nutrition provided by the mother, stimulation is an essential strategy to optimize growth and development. One promising approach is the combination of baby massage and lavender essential oil, which may offer both physical stimulation and relaxation benefits that support motor skill advancement. This study aims to determine the effect of combined baby massage stimulation and lavender essential oil application on the improvement of gross and fine motor skills in infants aged 3–12 months. A pre-experimental quantitative design with one-group pretest–posttest was applied to a sample of 40 infants. Data analysis employed the Wilcoxon signed-rank test to assess changes in motor development scores before and after the intervention. Results indicated a probability value (p-value) of 0.02 (<0.05), suggesting a statistically significant improvement in both gross and fine motor skills following the intervention. These findings highlight the potential of integrating tactile and aromatherapy-based stimulation into infant care routines to enhance motor development. Further research with larger and more diverse samples is recommended to validate these results and explore the underlying mechanisms of action.

Gross motor and fine motor development are critical aspects of early childhood growth, yet a significant proportion of infants and toddlers continue to experience delays in these areas. According to the World Health Organization (WHO) in 2016, approximately 20–40% of infants aged 0–2 years face delays in developmental processes, with 5–25% experiencing gross and fine motor disorders. Delays in gross motor skills can reduce adaptability and creativity during the adaptation period, while delays in fine motor skills may hinder a child’s learning process. Beyond adequate nutrition provided by the mother, stimulation is an essential strategy to optimize growth and development. One promising approach is the combination of baby massage and lavender essential oil, which may offer both physical stimulation and relaxation benefits that support motor skill advancement. This study aims to determine the effect of combined baby massage stimulation and lavender essential oil application on the improvement of gross and fine motor skills in infants aged 3–12 months. A pre-experimental quantitative design with one-group pretest–posttest was applied to a sample of 40 infants. Data analysis employed the Wilcoxon signed-rank test to assess changes in motor development scores before and after the intervention. Results indicated a probability value (p-value) of 0.02 (<0.05), suggesting a statistically significant improvement in both gross and fine motor skills following the intervention. These findings highlight the potential of integrating tactile and aromatherapy-based stimulation into infant care routines to enhance motor development. Further research with larger and more diverse samples is recommended to validate these results and explore the underlying mechanisms of action.

The application of safety is an important matter in carrying out activities inland transportation including railroad transportation. Jabodetabek travel routes are handled directly by PT. Kereta Komuter Indonesia. This activity certainly requires a lot of human labor so safety is very important in this regard. With the existence of safety arrangements, it will avoid any related things from accidents or losses due to the delay in the completion of work caused by the inaccurate company safety management system. Therefore each element involved in each activity requires further knowledge and understanding of the core factors that are in accordance with the safety management system used. Referring to this approach, research is carried out on the railroad industry in Indonesia by developing a safety model in the railway industry. The research was conducted by finding the right literature and then developing a model for the factors considered appropriate to be applied to the safety management system in railroad transportation in Indonesia. After the model was developed, the model was confirmed by the Confirmatory Factor Analysis (CFA) approach with the Structural Equation Modeling (SEM) method. The results of the study will prove that the factors developed in the safety model are positively related to the implementation of commuter train safety management in Indonesia.  

Bacground : The 0–12 month period is a critical phase in infant development, covering motor, cognitive, and emotional domains. Early stimulation has been proven to prevent developmental delays that may affect later life stages. Complementary therapies such as infant massage and baby gym are widely applied as non-pharmacological, safe, low-cost interventions that can be practiced at home by parents. Objective: To systematically review the scientific evidence regarding the effectiveness of complementary therapies in stimulating the development of infants aged 0–12 months. Methods: This literature study involved a review of articles published between 2018–2024 from PubMed and Google Scholar. Inclusion criteria included experimental and quasi-experimental studies evaluating the effect of complementary therapies (infant massage, baby gym, or others) on infant development. Results: Six relevant studies were identified, including four on baby gym and two on infant massage. All studies reported significant improvements in gross motor development following intervention. Infant massage also showed additional benefits such as increased weight gain and enhanced mother-infant bonding. Conclusion: Complementary therapies such as infant massage and baby gym are effective and practical strategies for stimulating infant development. However, further research with more robust experimental designs is needed to strengthen the evidence base.  

Sleep disturbances in third trimester pregnant women are common and can be caused by factors such as increased fetal weight, shortness of breath, back pain, and fetal movements. These factors often disrupt the mother’s sleep, leading to inadequate rest. Lack of sleep during pregnancy can have significant consequences, affecting physiological aspects like activity levels, fatigue, body weakness, delayed recovery, instability in vital signs, and a weakened immune system. Furthermore, sleep disturbances may increase the risk of low birth weight babies and other complications. The aim of this study was to investigate the effect of lavender aromatherapy on sleep quality in third trimester pregnant women. The study utilized a pre-experimental method with a one-group pretest-posttest design to measure changes in sleep quality before and after the intervention. A quota sampling technique was used to select 20 participants, all of whom were in their third trimester of pregnancy. The Hamilton Anxiety Rating Scale (HARS) questionnaire was employed to assess sleep quality as the research instrument. Data analysis was conducted using the Wilcoxon rank test. The results showed a significant effect of lavender aromatherapy on sleep quality, with the Wilcoxon test yielding a p-value of 0.000 (p < 0.05). This indicates a significant improvement in sleep quality after the intervention. The findings suggest that lavender aromatherapy helps in enhancing sleep by calming and soothing the limbic system in the brain, which creates a sense of comfort, allowing pregnant women to sleep longer and more soundly. In conclusion, lavender aromatherapy is an effective intervention to improve sleep quality in third trimester pregnant women, as evidenced by the significant improvement in the study participants’ sleep quality after using the therapy.

This study aims to analyze the accuracy of ICD-9-CM coding in Cathlab procedure claims submitted to BPJS Kesehatan under the INA-CBGs reimbursement system at RSI Aisyiyah Malang. Accurate coding is critical for determining appropriate claim grouping and tariff calculation within Indonesia’s national health insurance scheme. The research employed a mixed-methods approach, combining quantitative analysis of 244 Cathlab claims from 2024 with qualitative insights obtained through document review, interviews, and direct observation. The results showed that 182 claims (74.59%) were accepted as accurate and complete, while 62 claims (25.41%) were returned as pending. Common causes of claim inaccuracy included missing supporting documents (37.10%), incorrect ICD-9-CM codes (27.42%), and nonspecific diagnoses (19.35%). Procedural miscoding, such as omitting dual catheterization codes or stent-related procedure codes, was identified as a frequent issue, significantly impacting claim grouping and reimbursement. The study highlights systemic challenges related to documentation quality, coder competency, and institutional claim verification processes. These challenges result in delays, incorrect payments, and administrative inefficiencies, posing barriers to effective reimbursement. The findings underscore the importance of implementing Clinical Documentation Improvement (CDI) strategies, improving coder training, and transitioning to newer coding systems such as ICD-10 or ICD-11. Upgrading to these systems will support better coding accuracy, enhance claim processing efficiency, and ensure more appropriate reimbursement. Strengthening these components is essential to ensure the integrity of Indonesia’s health financing system, improve operational workflows, and ensure that healthcare providers receive timely and accurate reimbursement for services rendered. This study provides a comprehensive evaluation of the current state of coding practices in Indonesian healthcare institutions and offers actionable recommendations for improving coding accuracy and claims processing.

Sleep disturbances in third trimester pregnant women are common and can be caused by factors such as increased fetal weight, shortness of breath, back pain, and fetal movements. These factors often disrupt the mother’s sleep, leading to inadequate rest. Lack of sleep during pregnancy can have significant consequences, affecting physiological aspects like activity levels, fatigue, body weakness, delayed recovery, instability in vital signs, and a weakened immune system. Furthermore, sleep disturbances may increase the risk of low birth weight babies and other complications. The aim of this study was to investigate the effect of lavender aromatherapy on sleep quality in third trimester pregnant women. The study utilized a pre-experimental method with a one-group pretest-posttest design to measure changes in sleep quality before and after the intervention. A quota sampling technique was used to select 20 participants, all of whom were in their third trimester of pregnancy. The Hamilton Anxiety Rating Scale (HARS) questionnaire was employed to assess sleep quality as the research instrument. Data analysis was conducted using the Wilcoxon rank test. The results showed a significant effect of lavender aromatherapy on sleep quality, with the Wilcoxon test yielding a p-value of 0.000 (p < 0.05). This indicates a significant improvement in sleep quality after the intervention. The findings suggest that lavender aromatherapy helps in enhancing sleep by calming and soothing the limbic system in the brain, which creates a sense of comfort, allowing pregnant women to sleep longer and more soundly. In conclusion, lavender aromatherapy is an effective intervention to improve sleep quality in third trimester pregnant women, as evidenced by the significant improvement in the study participants’ sleep quality after using the therapy.

This study aims to identify the factors that influence the first antenatal visit (K1) among pregnant women. The study employed a descriptive design with a cross-sectional approach, utilizing a total sampling technique. A total of 49 respondents, all of whom made the K1 visit, were included in the study. The variables examined in this research included maternal age, parity, and gestational age at the time of the K1 visit. Secondary data obtained from medical records were used for analysis. The results revealed that the majority of pregnant women who made the K1 visit were in the non-risk age group (20–35 years), accounting for 84% of the respondents. Regarding parity, most participants were multiparous, making up 53% of the total sample. In terms of gestational age, 43% of respondents made their K1 visit during the first trimester of pregnancy (0–12 weeks). The study found that the first antenatal visit was predominantly conducted by pregnant women in the non-risk age group (20–35 years) and the multiparous group. Additionally, the K1 visits were most frequently made when the gestational age was in the first trimester, reflecting early engagement with antenatal care. These findings highlight the importance of maternal age, parity, and gestational age in influencing the timing of the first antenatal visit, which plays a critical role in ensuring early and adequate prenatal care for pregnant women. These insights can be used to improve strategies for encouraging timely K1 visits, particularly for pregnant women who may be at risk of delayed prenatal care.

This study aims to analyze the accuracy of ICD-9-CM coding in Cathlab procedure claims submitted to BPJS Kesehatan under the INA-CBGs reimbursement system at RSI Aisyiyah Malang. Accurate coding is critical for determining appropriate claim grouping and tariff calculation within Indonesia’s national health insurance scheme. The research employed a mixed-methods approach, combining quantitative analysis of 244 Cathlab claims from 2024 with qualitative insights obtained through document review, interviews, and direct observation. The results showed that 182 claims (74.59%) were accepted as accurate and complete, while 62 claims (25.41%) were returned as pending. Common causes of claim inaccuracy included missing supporting documents (37.10%), incorrect ICD-9-CM codes (27.42%), and nonspecific diagnoses (19.35%). Procedural miscoding, such as omitting dual catheterization codes or stent-related procedure codes, was identified as a frequent issue, significantly impacting claim grouping and reimbursement. The study highlights systemic challenges related to documentation quality, coder competency, and institutional claim verification processes. These challenges result in delays, incorrect payments, and administrative inefficiencies, posing barriers to effective reimbursement. The findings underscore the importance of implementing Clinical Documentation Improvement (CDI) strategies, improving coder training, and transitioning to newer coding systems such as ICD-10 or ICD-11. Upgrading to these systems will support better coding accuracy, enhance claim processing efficiency, and ensure more appropriate reimbursement. Strengthening these components is essential to ensure the integrity of Indonesia’s health financing system, improve operational workflows, and ensure that healthcare providers receive timely and accurate reimbursement for services rendered. This study provides a comprehensive evaluation of the current state of coding practices in Indonesian healthcare institutions and offers actionable recommendations for improving coding accuracy and claims processing.

This study investigates the relationship between intraoperative blood loss and the incidence of hypothermia in patients undergoing general anesthesia at PKU Muhammadiyah Yogyakarta Hospital. General anesthesia, while commonly used for its effectiveness and patient comfort, is associated with various physiological changes, including postoperative hypothermia. Hypothermia can lead to serious complications such as delayed recovery, increased bleeding, infection risk, and impaired wound healing. One contributing factor is blood loss during surgery, which reduces the body’s ability to regulate temperature. This research employed an observational analytic method with a cross-sectional approach involving surgical patients who received general anesthesia. Data were collected on the volume of intraoperative bleeding and the presence of hypothermia in the recovery phase. The findings indicate a significant correlation between the amount of blood lost during surgery and the occurrence of hypothermia. These results suggest that early identification and management of blood loss are essential to prevent hypothermia and its associated risks. The study emphasizes the importance of temperature monitoring and bleeding control in improving patient safety and outcomes during surgical procedures involving general anesthesia