ANALISIS TERHAMBATNYA KEGIATAN SHIP TO SHIP MFO 380 CST DI SITE PROJECT MVPP. KARPOWERSHIP ZEYNEP SULTAN, AMURANG SULAWESI UTARA

Hefa Kurniawan Eko Santoso, 2018, 51145508.K, “Analysis of Inhibition Activity Ship To Ship MFO 380 Cst at Site Project MVPP. Karpowership Zeynep Sultan, Amurang North Sulawesi”Mini Thesis Port and Shipping Department, Diploma Program IV, Semarang Merchant Marine Polytechnic, Supervisor I: Nur Rohmah, S.E., M.M., Supervisor II: Dwi Prasetyo, M.M, M.Mar.E. In site project MVPP.Karpowership Zeynep Sultan, amurang North Sulawesi there are operational activities that is activities loading and unloading MFO 380 Cst with the methods a ship to a ship. A ship to a ship is the operation by which charge oil transferred on a ship that moor in bersebelahan.tujuan of this study is to find factors anything that block in the process of a ship to a ship, what kind of influence of activities the process of a ship to a ship mfo 380 cst in site project MVPP.Karpowership zeynep Sultan, Amurang North Sulawesi, and all effort for the process of a ship to a ship MFO 380 Cst in site project MVPP.Karpowership Zeynep Sultan, Amurang North Sulawesi run in smoothly and effective. Was used in the study a method of descriptive of qualitative .Collecting data which used in this research was primary and secondary data .The primary data was was the data as of bni offered for its shares directly by a researcher of the main source of including cure the patients directly to the field .In the long term the , of secondary data obtained center of the book manual subsidy as well as from buku-buku who relating to objects of research or that deals with the problems that will be discussed and necessary move away from being based on theory as a guideline as well as the provisions of formal from a state of in such a manner that observation .Researchers used the direct observation of and indirect. The results showed that, the inhibiting factor in the ship to ship MFO 380 Cst activity in the site project MVPP. Karpowership Zeynep Sultan, Amurang North Sulawesi, namely, there are crew members who do not understand the demolition procedure, there is no good coordination between the parties involved in the implementation of ship to ship activities, unloading equipment is not in normal conditions. The effect of the obstruction is the supply of fuel to MVPP. Karpowership Zeynep Sultan ceased, ship to ship activities became longer, increased operational costs and fines imposed by PT. PLN (Persero) in the event of a power outage. Efforts to overcome these obstacles, PT. Adhya Bahtera Shipping as a marine contractor from PT. Karpowership Indonesia is increasing knowledge of crew about demolition standards and procedures, increasing coordination between parties involved in the implementation of ship to ship activities, carrying out maintenance and checking unloading equipment on a regular basis. Keywords: Analysis, Ship to ship, Site project, MFO 380 Cs

Penerapan Media Pembelajaran Ular Tangga Untuk Meningkatkan Keaktifan Pembelajaran Siswa pada Siswa Kelas X SMK Sudirman 1 Wonogiri

The purpose of this research is to know: Increased Student Activity by using learning of snake ladder. This type of research isqualitative. The population in this study are students of class X of Accounting skill program of SMK Sudirman 1 Wonogiri. Samples were taken from 4 students. Data obtained through interviews, observation, and documentation. The validity of the data in this study used triangulation of data sources and techniques.Data analysis techniques used are data collection, data reduction, data presentation, and then withdrawal conclusions(interactive models). The results showed that: 1) In the application of instructional media by using snake ladder learning media is more able to increase the activity in students when receiving the material in the lesson. 2) Activity of accounting learning by using game media of snake ladder more varied and not make the students become bored when receiving lesson. 3) By applying snake ladder media, students are more leverage in problem-solving involvement, in collaboration with their group mates, and training themselves in solving problems and problems they face

HUBUNGAN ANTARA TINGKAT PENGETAHUAN DAN ASPEK PERILAKU DENGAN STATUS KONTROL GLIKEMIK PASIEN DIABETES MELITUS DI RSUP DR. KARIADI

Latar belakang: Jumlah kasus diabetes melitus di indonesia sebanyak 8,4 juta jiwa tahun 2010. Jumlah kasus di Jawa tengah tahun 2013 sebesar 9,376 kasus. Penyakit diabetes termasuk 10 besar kasus di RSUP Dr. Kariadi. Komplikasi diabetes melitus mencakup mikrovaskular dan makrovaskular yang berhubungan dengan morbiditas dan mortalitas pasien DM. Ketidakpahaman pasien terhadap terapi yang sedang dijalaninya menjadi penyebab kegagalan terapi. Tujuan: Menganalisis hubungan antara tingkat pengetahuan dan aspek perilaku dengan status kontrol glikemik pada pasien diabetes mellitus di Poliklinik Penyakit Dalam RSUP Dr. Kariadi Semarang. Metode penelitian: Observasional analitik dengan rancangan cross sectional. Pengambilan subjek dilakukan dengan cara purposive sampling. Penelitian ini menggunakan data sekunder dari rekam medis RSUP Dr. Kariadi dan data primer menggunakan instrumen kuesioner pengetahuan dan perilaku. Subjek penelitian sebanyak 45 pasien DM yang dirawat inap maupun rawat jalan di RSUP Dr. Kariadi. Analisis statistik menggunakan uji chi square dan Rasio Prevalensi. Hasil: Rata-rata usia responden adalah 57 tahun, 23% responden berjenis kelamin perempuan, tingkat pendidikkan respoden dengan jumlah terbanyak adalah SD, 29% responden bekerja, dan 27% responden terkena DM selama > 5 tahun.Hasil uji hipotesis hubungan tingkat pengetahuan dengan status kontrol glikemik didapatkan nilai signifikansi p = 1,00 (p> 0,05), ini menunjukkan hubungan yang tidak bermakna. Hasil uji hipotesis hubungan aspek perilaku dengan status kontrol glikemik didapatkan nilai signifikansi p = 0,35 (p> 0,05), menunjukkan hubungan yang tidak bermakna. Simpulan: Tidak ada hubungan yang bermakna antara usia, jenis kelamin, tingkat pendidikkan, pekerjaan, lama menderita, pengetahuan, dan perilaku dengan status kontrol glikemik (p> 0,05). Kata kunci: DM tipe II, pengetahuan, perilaku, status kontrol glikemi

Estimating household air pollution exposures and health impacts from space heating in rural China

Exposure to and the related burden of diseases caused by pollution from solid fuel cooking, known as household air pollution (HAP), has been incorporated in the assessment of the Global Burden of Diseases (GBD) project. In contrast, HAP from space heating using solid fuels, prevalent in countries at middle or high altitudes, is less studied and missing from the GBD assessment. China is an ideal example to estimate the bias of exposure and burden of diseases assessment when space heating is neglected, considering its remarkably changing demands for heating from the north to the south and a large solid-fuel-dependent rural population. In this study, based on a meta-analysis of 27 field measurement studies in rural China, we derive the indoor PM2.5 (fine particulate matter with an aerodynamic diameter smaller than 2.5 μm) concentration for both the heating and non-heating seasons. Combining this dataset with time-activity patterns and percentage of households using solid fuels, we assess the population-weighted annual mean exposure to PM2.5 (PWE) and the health impacts associated with HAP in mainland rural China by county for the year 2010. We find that ignoring heating impacts leads to an underestimation in PWE estimates by 38 μg/m3 for the nationwide rural population (16 to 40 as interquartile range) with substantial negative bias in northern provinces. Correspondingly, premature deaths and disability-adjusted life years will be underestimated by approximately 30 × 103 and 60 × 104 in 2010, respectively. Our study poses the need for incorporating heating effects into HAP risk assessments in China as well as globally

Awareness of Final-Year Medical Students of Omdurman Islamic University on Their Career Choices

Background: Medical students undergo a complex process as a student to make a career decision and pursue further specialization. This study explores the factors that influence the career choices of the two genders studying in the final year of medicine at Omdurman Islamic University.Methods: This institution-based cross-sectional study was conducted on 194 male and female fifth-year medical students studying at Omdurman Islamic University. The questionnaire contains 15 multiple-choice questions to determine the factors affecting students’ career choices – lifestyle, income, family impact,…etc. – and the association between gender and the specialties they choose to pursue.Results: The specialties were preferred in the following order: surgery by 22.9%, internal medicine by 18.3%, obstetric gynecology by 13.8%, and pediatric by 10% (limited to the four major specialties). The least chosen specialties were histopathology, emergency medicine, psychiatry, and anesthesia (all were 0.9%). Family medicine and forensics were not chosen by any participant. Females significantly preferred dermatology, obstetrics and gynecology, otolaryngology, and pediatrics compared to their male counterparts. Whereas, males compared to females significantly preferred orthopedics and surgery. The factors influencing change in students’ specialties based on their gender were family views and family obligations. Nearly 80% of students choose a career based on personal interest; lifestyle and financial reward were also seen to play an important role in choosing a specialty. About 91% of participants agreed that there is a need for guidance. A great proportion of final-year students (62%) preferred to specialize abroad and related it to a good lifestyle and financial stability.Conclusion: This study showed that the students’ awareness about specialty choices was limited to certain specialties as seen in the literature. The most preferred specialties were surgery (22.9%), internal medicine (18.3%), obstetrics and gynecology (13.8%), and pediatric (10%). There are many factors influencing the selection of specialties, however, the most common one is personal interest followed by lifestyle issues and financial reward. Additionally, there is a significant gender difference in career-choice decisions

Distinguishing Emission-Associated Ambient Air PM2.5 Concentrations and Meteorological Factor-Induced Fluctuations

Although PM2.5 (particulate matter with aerodynamic diameters less than 2.5 μm) in the air originates from emissions, its concentrations are often affected by confounding meteorological effects. Therefore, direct comparisons of PM2.5 concentrations made across two periods, which are commonly used by environmental protection administrations to measure the effectiveness of mitigation efforts, can be misleading. Here, we developed a two-step method to distinguish the significance of emissions and meteorological factors and assess the effectiveness of emission mitigation efforts. We modeled ambient PM2.5 concentrations from 1980 to 2014 based on three conditional scenarios: realistic conditions, fixed emissions, and fixed meteorology. The differences found between the model outputs were analyzed to quantify the relative contributions of emissions and meteorological factors. Emission-related gridded PM2.5 concentrations excluding the meteorological effects were predicted using multivariate regression models, whereas meteorological confounding effects on PM2.5 fluctuations were characterized by probabilistic functions. When the regression models and probabilistic functions were combined, fluctuations in the PM2.5 concentrations induced by emissions and meteorological factors were quantified for all model grid cells and regions. The method was then applied to assess the historical and future trends of PM2.5 concentrations and potential fluctuations on global, national, and city scales. The proposed method may thus be used to assess the effectiveness of mitigation actions

Impacts of air pollutants from rural Chinese households under the rapid residential energy transition

Rural residential energy consumption in China is experiencing a rapid transition towards clean energy, nevertheless, solid fuel combustion remains an important emission source. Here we quantitatively evaluate the contribution of rural residential emissions to PM2.5 (particulate matter with an aerodynamic diameter less than 2.5 μm) and the impacts on health and climate. The clean energy transitions result in remarkable reductions in the contributions to ambient PM2.5, avoiding 130,000 (90,000-160,000) premature deaths associated with PM2.5 exposure. The climate forcing associated with this sector declines from 0.057 ± 0.016 W/m2 in 1992 to 0.031 ± 0.008 W/m2 in 2012. Despite this, the large remaining quantities of solid fuels still contributed 14 ± 10 μg/m3 to population-weighted PM2.5 in 2012, which comprises 21 ± 14% of the overall population-weighted PM2.5 from all sources. Rural residential emissions affect not only rural but urban air quality, and the impacts are highly seasonal and location dependent

Substantial transition to clean household energy mix in rural China

The household energy mix has significant impacts on human health and climate, as it contributes greatly to many health- and climate-relevant air pollutants. Compared to the well-established urban energy statistical system, the rural household energy statistical system is incomplete and is often associated with high biases. Via a nationwide investigation, this study revealed high contributions to energy supply from coal and biomass fuels in the rural household energy sector, while electricity comprised ∼20%. Stacking (the use of multiple sources of energy) is significant, and the average number of energy types was 2.8 per household. Compared to 2012, the consumption of biomass and coals in 2017 decreased by 45% and 12%, respectively, while the gas consumption amount increased by 204%. Increased gas and decreased coal consumptions were mainly in cooking, while decreased biomass was in both cooking (41%) and heating (59%). The time-sharing fraction of electricity and gases (E&G) for daily cooking grew, reaching 69% in 2017, but for space heating, traditional solid fuels were still dominant, with the national average shared fraction of E&G being only 20%. The non-uniform spatial distribution and the non-linear increase in the fraction of E&G indicated challenges to achieving universal access to modern cooking energy by 2030, particularly in less-developed rural and mountainous areas. In some non-typical heating zones, the increased share of E&G for heating was significant and largely driven by income growth, but in typical heating zones, the time-sharing fraction was <5% and was not significantly increased, except in areas with policy intervention. The intervention policy not only led to dramatic increases in the clean energy fraction for heating but also accelerated the clean cooking transition. Higher income, higher education, younger age, less energy/stove stacking and smaller family size positively impacted the clean energy transition

Outcomes of delivering a fertility preservation service for women with cancer over a 12-year period at a UK assisted conception unit.

This service evaluation aimed to appraise the delivery of a fertility preservation service for women with cancer which was established in 2005 as part of an Assisted Conception Unit. First, the ACU-database was interrogated between 08/2005 and 01/2017; revealing 174 women received referrals over the 12-year period with a steady referral increase each year. Demographic analyses revealed factors, such as being partnered, to be strong indicators of whether women would seek FP or not. To improve service provision, women who had consented to be contacted for audit, administrative and research purposes, received questionnaires to ascertain their perspectives on the FP decision-making process, their outcomes and ACU after-care. The majority perceived their experience as excellent due to the care they received from ACU staff, speed and efficiency in service delivery. The increasing number of referrals since 2005 is reassuring. However, this audit also highlighted shortcomings of the service, such as limited awareness of the fertility counselling service and lack of after-care. IMPACT STATEMENT What is already known on this subject? There has been an increase in women diagnosed with cancer undergoing fertility preservation (FP) before starting potential gonadotoxic treatment. Offering FP to these women is essential as the ability to have future children is often perceived as equally as important as survivorship, and a source of hope for the future. What do the results of this study add? This study presents a service evaluation, across a 12-year period, of delivering FP services to women with cancer in one UK Assisted Conception Unit (ACU). Women's experiences of the service were evaluated to enhance service delivery and make recommendations for clinical practice. What are the implications of these findings for clinical practice and/or future research? The current service evaluation demonstrated increased rates of FP referral over a 12-year period for women with cancer. While this increasing number is reassuring and reflecting increased awareness among professionals and patients; shortcomings in the care pathway were also found: women reported limited opportunity to see fertility counsellors and desired better after care. This information may also be of benefit to other ACUs seeking to enhance and improve service provision in the care of women with cancer, contemplating fertility preservation

Downward Communication Strategy Of Leaders In Improving The Work Effectiveness Of Employees At Pt. Pelabuhan Indonesia 1 (Persero)

Penelitian ini dilatarbelakangi oleh adanya hambatan komunikasi dari pimpinan bina usaha terhadap karyawannya. Menurut observasi yang dilakukan peneliti bahwa komunikasi dari Pimpinan Bina Usaha kepada bawahannya masih terlihat adanya batasan antara pemimpin dan bawahan, fenomena inilah yang menjadi alasan kuat peneliti. Informasi yang diterima karyawan akan diterima terlebih dahulu oleh Asisten Senior Manajer Bina Usaha., bukan melalui Pak Arief Pratama selaku pemimpin yang langsung menginstruksikan tugas kepada karyawan. Informasi yang diterima karyawan tersebut juga tidak utuh, karena di bidang bina usaha ini apabila ada pesan yang akan disampaikan oleh pemimpin maka yang menerima pesan tersebut terlebih dahulu adalah Asisten Senior Manajer. Tujuan dari penelitian ini adalah untuk mengetahui bagaimana strategi downward communication pimpinan dalam meningkatkan efektivitas kerja karyawan di PT.Pelabuhan Indonesia I (PERSERO), serta faktor apa saja yang menjadi hambatan strategi downward communication pimpinan bina usaha. Peneliti menggunakan teori situasional dalam penyusunan skripsi. Peneliti memilih Senior Manajer Bina Usaha sebagai informan kunci,s erta didukung dengan lima informan tambahan untuk memperkuat keabsahan sebuah penelitian. Hasil dari proses penelitian ini, peneliti menemukan bahwa dengan adanya intruksi tugas, keterbukaan, kepercayaan, informasi, feedback (balikan) yang dilakukan oleh pemimpin bina usaha kepada karyawannya sudah dilaksanakan dengan baik.This research is motivated by the existence of communication barriers from business leaders to their employees. According to observations made by researchers that communication from business leaders to their subordinates still shows the boundary between leaders and subordinates. This phenomenon is a strong reason for researchers. Information received by employees will be received in advance by a senior assistant manager of business development, not throught Pak Arief Pratama as the leader who directly instructs the task to employees. The information received by employees is also not intact, because in this field of business development if there is a message to be delivered by the leader then the person receiving the message is first a senior assistant manager. The purpose of this study was to find out how the leadership’s downward communication strategy in improving employee work effectiveness at PT. Pelabuhan Indonesia I (PERSERO), as well as any factors that become obstacles to the downward communication strategy of business development leaders. Researhers use situational theory in the preparation of the thesis. The researcher selected the business manager’s senior manager as a key informant, and was supported by five additional informants to strengthen the validity of a study. The results of this research process, the researchers found that with the instruction of task, openness, trust, information, feedback carried out by business leaders to their employees had been well implemented