374 10 6491 https://repository.poltekkespalembang.ac.id/files/original/6207561064fa1865345fd34f60132d06.pdf 58a3162609f28d081685a1123aabd81b Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Analis Kesehatan Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource IDENTIFIKASI DAN PENETAPAN KADAR PEMANIS SIKLAMAT PADA MINUMAN RINGAN YANG DIJUAL DI KECAMATAN BUKIT KECIL KOTA PALEMBANG TAHUN 2023 Subject The topic of the resource Pemanis Siklamat, Minuman Ringan, Gravimetri Description An account of the resource Siklamat adalah salah satu jenis pemanis buatan yang memiliki tingkat kemanisannya kurang lebih 30 kali dari pada sukrosa dengan jumlah kemanisan yaitu 3,94 kkal/g. Penggunaan pemanis buatan yang berlebihan akan menimbulkan efek negatif yang merugikan. Creator An entity primarily responsible for making the resource NAFILA AGITA NATASYA Publisher An entity responsible for making the resource available POLTEKKES KEMENKES PALEMBANG JURUSAN TEKNOLOGI LABORATORIUM MEDIS Date A point or period of time associated with an event in the lifecycle of the resource 2023 Contributor An entity responsible for making contributions to the resource Abdul Mutholib ST., MT Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource INDONESIA Type The nature or genre of the resource KARYA TULIS ILMIAH MAHASISWA https://repository.poltekkespalembang.ac.id/files/original/c4a80a6b9e337d9520ea894a46541d06.pdf 9fe0a499b87d87817f45b35824cf545f Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Keperawatan Palembang Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource IMPLEMENTASI KEPERAWATAN TERAPI BERMAIN PLASTISIN PADA ANAK DEMAM TIFOID DENGAN ANSIETAS AKIBAT HOSPITALISASI DI RS MUHAMMADIYAH PALEMBANG TAHUN 2023 Subject The topic of the resource Typhoid Fever, Anxiety, Hospitalization, Anxiety Reduction, Play Therapy Plasticine Description An account of the resource Children with typhoid fever require children to undergo hospital treatment. This condition is a threatening situation and can cause feelings of anxiety if the child is not able to adapt. One way to reduce the impact of hospitalization is by playing plasticine therapy. The type of research used in this research is descriptive in the form of a case study to explore the implementation of nursing in children with typhoid fever with anxiety due to hospitalization. Case study subjects were two pediatric patients aged 3-6 years with the same nursing problem, namely typhoid fever patients with anxiety and willing to be respondents by signing an informed consent represented by the patient's family. The time of this research was carried out in March 2023. The results of this study indicate that anxiety reduction through plasticine play therapy is effective in reducing anxiety experienced by pediatric patients during hospitalization. Creator An entity primarily responsible for making the resource NAMIRA GUSTIANY PUTRI MAYANA Publisher An entity responsible for making the resource available POLTEKKES KEMENKES JURUSAN KEPERAWATAN PALEMBAG Date A point or period of time associated with an event in the lifecycle of the resource 2023 Contributor An entity responsible for making contributions to the resource REHANA, S.Pd, S.Kep, M.Kes Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource BAHASA INDONESIA Type The nature or genre of the resource KTI MAHASISWA https://repository.poltekkespalembang.ac.id/files/original/567510870a0358827ba8480d461bf231.pdf 940c964d60f78c49049adbfa880ded86 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Gizi Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource PEMANFAATAN TEPUNG UMBI GANYONG DAN PENAMBAHAN TEPUNG KACANG MERAH DALAM PEMBUATAN SNACK COOKIES TINGGI ENERGI DAN PROTEIN Description An account of the resource Kurang Energi Protein (KEP) merupakan keadaan kurang gizi yang disebabkan oleh rendahnya konsumsi energi dan protein dalam makanan sehari-hari sehingga tidak memenuhi kecukupan yang dianjurkan. Salah satu upaya perbaikan gizi yang dapat dilakukan untuk mengatasi masalah KEP tingkat ringan yaitu dengan memberikan makanan tinggi energi dan tinggi protein. Contoh bahan pangan yang dapat digunakan dalam mengatasi defisiensi energi dan protein diantaranya adalah Umbi ganyong dan kacang merah. Penelitian ini bertujuan untuk mengetahui formulasi terbaik, mengetahui daya terima, serta mengetahui kandungan gizi pada cookies tepung umbi ganyong dan tepung kacang merah berdasarkan analisis proksimat. Penelitian ini dilakukan dari bulan Januari-April 2022 Penelitian ini merupakan penelitian eksperimen dengan rancangan acak lengkap non factorial. Hasil penelitian menunjukkan bahwa cookies terpilih yaitu cookies F3 (70 gram tepung umbi ganyong, 130 gram tepung kacang merah, 50 gram tepung terigu). dengan kandungan kandungan energi 458,28 kkal, protein 8,94 %, lemak 20,80 %, karbohidrat 58,83 %. Perlu dilakukan penelitian lanjutan mengenai pengaruh pemberian cookies tepung umbi ganyong dan tepung kacang merah terhadap Remaja/WUS KEK. Creator An entity primarily responsible for making the resource Nanda Azhara Publisher An entity responsible for making the resource available Poltekkes Palembang Date A point or period of time associated with an event in the lifecycle of the resource 30 Mei 2022 Contributor An entity responsible for making contributions to the resource Eliza, S.Gz,M.Si Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource Bahasa Indonesia Type The nature or genre of the resource KTI https://repository.poltekkespalembang.ac.id/files/original/f1c646b126a090a54a6324806f7108c7.pdf c997f6c8b17f583cf64ab5fd592ba8d6 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Gizi Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource GAMBARAN INTAKE ZAT GIZI DAN STATUS GIZI PADA PASIEN TUBERKULOSIS PARUDI RUMAH SAKIT KHUSUS PARU PROVINSI SUMATERA SELATAN TAHUN 2018 Subject The topic of the resource Pulmonary TB, Intake and Nutritional Status Description An account of the resource Pulmonary Tuberculosis (Pulmonary TB) is a contagious disease directly caused by the bacterium Mycobacterium tuberculosis and is a contagious chronic infectious disease. Infection conditions will lead to increased nutritional needs in the body and may decrease nutritional status. Nutritional status will affect the immune mechanism. Macro and micro intake in tuberculosis patients is an important factor for the recovery of tuberculosis patients to keep the patient's nutritional status well. The purpose of this study is to know the description of the intake and nutritional status of patients with pulmonary TB at the Hospital of Special Lung South Sumatra Province in 2018. This research is descriptive with cross sectional study design. The sample of this research is 46 people that conducted at Special Hospital of Lung of South Sumatera Province. Data collection using Nutrisurvey program. Data analysis was done by univariate analysis (frequency distribution). The result showed that most of nutrition status of KEK 93,5% and anemia was 84,7% while macro intake was classified as less than 65.2%, 73.9% intake of carbohydrate as much as 80,4% while the level of its micro intake classified less category like intake of vitamin B6 as much 80,4%, vitamin C intake as much as 60,9% and iron intake as much as 71,7%. References: 58 (2000-2016) Creator An entity primarily responsible for making the resource NANDA DWI TAMARA Publisher An entity responsible for making the resource available Poltekkes Palembang Jurusan Date A point or period of time associated with an event in the lifecycle of the resource 2018 Language A language of the resource Indonesia Type The nature or genre of the resource KTI Mahasiswa https://repository.poltekkespalembang.ac.id/files/original/a91a150e9eb512627b9a59d4035c1cf6.pdf 7b224429b925d4c9e79e80d48c983260 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Kebidanan Muara Enim Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Asuhan kebidanan komprehensif pada ny''S'' di praktik mandiri bidan dwie ayu kartini muara enim tahun 2021 Subject The topic of the resource Asuhan Kebidanan Komprehensif, Kehamilan, Persalinan, Nifas, dan Bayi Baru Lahir Description An account of the resource Angka Kematian Ibu (AKI) merupakan permasalahan kesehatan di Indonesia terkait ibu dan anak yang masih belum terselesaikan hingga saat ini. Kesehatan Ibu dan Anak (KIA) sendiri merupakan salah satu target dalam tujuan pembangunan Sustainable Development Goals (SDGs). Angka Kematian Ibu (AKI) merupakan jumlah kematian ibu selama masa kehamilan, persalinan, atau pengelolaannya, bukan karena sebab lain seperti kecelakaan atau terjatuh di setiap 100.000 kelahiran hidup (Maharani, dkk 2018).Tujuan Laporan Tugas Akhir ini adalah mampu memberikan asuhan kebidanan komprehensif pada Ny.”R” mulai dari kehamilan, bersalin, bayi baru lahir dan nifas, postpartum dengan cara melakukan pengkajian dengan menggunakan pendokumentasian SOAP. Creator An entity primarily responsible for making the resource Nanda Febiola Publisher An entity responsible for making the resource available Poltekkes Kemenkes Palembang Prodi D-III Kebidanan Muara Enim Date A point or period of time associated with an event in the lifecycle of the resource 2021 Contributor An entity responsible for making contributions to the resource Dahliana, SKM.,M.Kes Nia Clarasari, MP.SST.,M.Keb Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource Bahasa Indonesia Type The nature or genre of the resource LTA https://repository.poltekkespalembang.ac.id/files/original/38e928edc963c7d1cc6393894224d721.pdf cf272729031719401a20f4ead8f56eaa Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Pengaruh Pemberian Edukasi Gizi Melalui Media Video dan Leaflet Terhadap Pengetahuan, Asupan Serta Perubahan Berat Badan Pada Mahasiswa/I Obesitas Description An account of the resource Obesitas merupakan masalah kesehatan yang bersifat global dan terus menerus mengalami peningkatan setiap tahunnya yang berdampak terhadap peningkatan risiko kesakitan dan kematian. Dalam menyikapi angka obesitas diperlukan intervensi yang bersifat edukasi gizi, Seiring berkembangnya teknologi edukasi gizi melalui video dan leaflet merupakan media yang efektif untuk membantu proses pembelajaran. Penelitian eksperimen semu dengan rancangan penelitian pre and posttest control group design bertujuan untuk mengetahui adanya pengaruh edukasi gizi melalui media video dan leaflet terhadap pengetahuan, asupan serta perubahan berat badan pada mahasiswa/i obesitas di Poltekkes Kemenkes Palembang. Pengumpulan data menggunakan kuisioner dan food record 2 x 24 jam. Analisis data yang digunakan analisis univariat dan bivariat. Hasil uji statistik pada uji t-independent didapatkan p-value pengetahuan sebesar 0,004 (p-value <0,05), asupan energi 0,026 (p-value <0,05), asupan protein 0,966 (p-value >0,05), asupan lemak 0,041 (p-value <0,05), asupan karbohidrat 0,049 (p-value <0,05) dan asupan serat 0,288 (p-value >0,05). Sedangkan, terkait perubahan berat badan responden sebesar 0,000 (p-value <0,05). Edukasi gizi melalui media video dan leaflet ada pengaruh terhadap pengetahuan, asupan energi, asupan lemak, asupan karbohidrat serta perubahan berat badan responden namun tidak ada pengaruh terhadap asupan protein dan asupan serat responden obesitas di Poltekkes Kemenkes Palembang dan STIKES Kebidanan Budi Mulia. Daftar Pustaka : 50 (2012-2023) Kata Kunci : Edukasi, Obesitas, Pengetahuan, Asupan, Berat Badan Creator An entity primarily responsible for making the resource Nanda Haryanti Publisher An entity responsible for making the resource available Poltekkes Palembang Date A point or period of time associated with an event in the lifecycle of the resource 2023 Contributor An entity responsible for making contributions to the resource Afriyana Siregar, S.Gz, M.Biomed Manuntun Rotua, SKM, M.Kes Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource Bahasa Indonesia, Bahasa Inggris Type The nature or genre of the resource Skripsi https://repository.poltekkespalembang.ac.id/files/original/8287434f0195db704ff05379baed6399.pdf 905581f24f03e9e100a3d79f015a4fd8 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Analis Kesehatan Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource GAMBARAN KEBERADAAN TELUR CACING Soil Transmitted Helminths (STH) PADA KUKU ANAK DI TPA KARYA JAYA KOTA PALEMBANG 2023 Subject The topic of the resource Soil Transmitted Helminths, kuku anak, TPA Description An account of the resource Kecacingan adalah suatu penyakit yang ditandai dengan ditemukannya telur cacing pada feses yang menimbulkan gejala-gejala tertentu. Seringnya anak-anak bermain ditempat yang kontak langsung dengan cacing merupakan salah satu faktor penyebab mudahnya terinfeksi cacing. Creator An entity primarily responsible for making the resource NANDA KLIMA RAMA Publisher An entity responsible for making the resource available POLTEKKES KEMENKES PALEMBANG JURUSAN TEKNOLOGI LABORATORIUM MEDIS Date A point or period of time associated with an event in the lifecycle of the resource 2023 Contributor An entity responsible for making contributions to the resource Dr. Erwin Edyansyah, SKM, M.Sc Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource INDONESIA Type The nature or genre of the resource KARYA TULIS ILMIAH MAHASISWA https://repository.poltekkespalembang.ac.id/files/original/649ff2bfccbc218c56a0a9e9c66782e8.pdf 069c846f9c2f1192c1d54a4c21c17c9b Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Keperawatan Gigi Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Hubungan Pengetahuan dan Perilaku Orang Tua dengan Status Karies Gigi Anak di TK Liko Palembang Subject The topic of the resource Pengetahuan, Perilaku, Karies, Anak, Orang tua Description An account of the resource Pengetahuan dan perilaku orang tua berperan penting dalam mempengaruhi status kesehatan gigi anak. Cukupnya pengetahuan mempengaruhi perilaku kesehatan terutama kesehatan gigi dan mulut sedangkan kurangnya pengetahuan menimbulkan masalah penyakit gigi dan mulut termasuk karies. Tujuan penelitian ini adalah diketahuinya hubungan pengetahuan dan perilaku orang tua dengan status karies gigi anak di TK Liko Palembang. Metode penelitian ini menggunakan survei analitik melalui pendekatan Cross sectional dengan teknik total sampling. Sampel dalam penelitian ini berjumlah 45 orang tua dan 45 anak TK Liko Palembang. Analisis data dalam penelitian ini menggunakan analisa univariat dan analisa bivariat dengan Uji chi square. Hasil penelitian menunjukkan bahwa pengetahuan dan perilaku orang tua yang baik tentang kesehatan gigi, sebagian besar memiliki anak dengan karies sangat rendah. Demikian sebaliknya, pengetahuan dan perilaku orang tua yang kurang tentang kesehatan gigi, sebagian besar memiliki anak dengan karies sangat tinggi. Selanjutnya, jumlah rata-rata karies gigi anak adalah 4,9. Pada uji chi square dengan p-value = 0,004 untuk pengetahuan dan p-value = 0,016 untuk perilaku. Kesimpulannya adalah terdapat hubungan pengetahuan dan perilaku orang tua dengan status karies gigi anak di TK Liko Palembang, yaitu bila orang tua memiliki pengetahuan baik maka anaknya memiliki status karies rendah, demikian juga bila orang tua memiliki perilaku baik maka anaknya memiliki status karies rendah. Creator An entity primarily responsible for making the resource Nanda Maharani Publisher An entity responsible for making the resource available Politeknik Kesehatan Palembang Jurusan Kesehatan Gigi Date A point or period of time associated with an event in the lifecycle of the resource 2023 Contributor An entity responsible for making contributions to the resource drg. Nur Adiba Hanum, M.Kes Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource Indonesia Type The nature or genre of the resource Karya Tulis Ilmiah https://repository.poltekkespalembang.ac.id/files/original/b299c45c56609f864826f83254a9aebc.pdf 43914bcd0936f4c32adec65b6d572489 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Keperawatan Palembang Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Implementasi Keperawatan Pada Pasien Post Sectio Caesarea Dengan Mobilisasi Dini Terhadap Intoleransi Aktivitas di Rumah Sakit dr. AK Gani Palembang Tahun 2021 Subject The topic of the resource Keywords: Sectio Caesarea, Early Mobilization, Health education Description An account of the resource Sectio Caesarea is a method of giving birth to a fetus by making an incision in the uterine wall through the front wall of the abdomen and which causes the continuity of the tissue to be interrupted so that usually there is a disturbance of comfort due to pain and weakness resulting in activity intolerance. The general objective of this study was to obtain an overview of the implementation of nursing performed on post-cesarean section patients with activity intolerance problems. This research design uses a descriptive method in the form of a case study through a nursing implementation approach. The subjects of this case study were patients who had caesarean section patients with activity intolerance problems in the obstetrics room of Rs. AkGani Palembang, on April 15, 2021-17 April 2021. The results of the implementation in the form of early mobilization and health education to both patients could reduce intolerance. activity with the results of patient 1 (Mrs. A) with a state of intolerance to the patient's activity can improve the condition of the limbs marked by the patient being able to tilt right and left, sitting and able to walk independently although still slowly and patient 2 (Mrs. Y) with a With the same problem, the patient's activity intolerance can tilt right and left, sit and walk independently and the patient is able to hold his baby. Looking at the results of this study, there is effectiveness in providing nursing implementation to post-section caesarea patients with activity intolerance problems. It is recommended that the implementation be carried out on a scheduled basis for post-cesarean post-sectional patients with activity intolerance problems. Creator An entity primarily responsible for making the resource Nanda Meisinta Publisher An entity responsible for making the resource available POLTEKKES KEMENKES PALEMBANG JURUSAN KEPERAWATAN Date A point or period of time associated with an event in the lifecycle of the resource TAHUN 2021 Contributor An entity responsible for making contributions to the resource Maliha Amin, SKM, M.Kes Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource BAHASA INDONESIA Type The nature or genre of the resource KTI MAHASISWA https://repository.poltekkespalembang.ac.id/files/original/21958bd82ee057827a33106f533a71a9.pdf b802a3d1c544c9c842398b365e43e7a1 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource KTI D-III Kesehatan Lingkungan Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource GAMBARAN PENGETAHUAN, SIKAP DAN TINDAKAN DALAM PENYEDIAAN AIR BERSIH PADA MASYARAKAT YANG TINGGAL DI BANTARAN SUNGAI KELURAHAN NGULAK KECAMATAN SANGA DESA KABUPATEN MUSI BANYUASIN TAHUN 2021 Subject The topic of the resource Penyediaan Air Bersih Di Bantaran Sungai Description An account of the resource ABSTRAK Latar Belakang : Penyediaan air merupakan salah satu kebutuhan utama bagi manusia untuk kelangsungan hidup dan menjadi faktor penentu dalam kesehatan dan kesejahteraan manusia, di Kelurahan Ngulak terkhusus masyarakat di bantaran sungai memiliki kebiasaan yang kurang baik dalam Penyediaan Air Bersih menjadikan sungai sebagai tempat melakukan mandi, mencuci, dan buang air besar, yang mana untuk keperluan tersebut perlu menggunakan air bersih yang memenuhi syarat supaya tidak memicu timbulan Penyakit. Tujuan Penelitian : Penelitian ini bertujuan untuk memperoleh gambaran perilaku masyarakat yang meliputi Pengetahuan Sikap dan Tindakan dalam Penyediaan Air Bersih pada masyarakat yang tinggal di bantaran Sungai di Kelurahan Ngulak. Metode Penelitian : Jenis Penelitian ini adalah Penelitian deskriptif dengan rancangan cross sectional.. Populasi dalam penelitian ini meliputi 140 KK masyarakat yang tinggal di sepanjang bantaran sungai. Jumlah sampel Responden dalam penelitian ini adalah 104 KK. Pengambilan sampel dilakukan secara random. Teknik pengambilan sampel dalam penelitian ini menggunakan metode sample random sampling, yang bertujuan agar sampel dapat mewakili semua KK yang ada di Kelurahan Ngulak. Hasil Penelitian : Dari hasil penelitian tentang Penyadiaan Air Bersih tingkat Pengetahuan dari 104 responden menunjukkan bahwa sebagian besar 50% responden berpengetahuan cukup. Sikap yang didapatkan dari hasil penilitian ada 43,26% memiliki sikap baik hal tersebut lebih besar dari hasil kategori sikap yang cukup sebesar 40,38%. Tindakan yang didapatkan dikategorikan buruk sebesar 72,12%. Dan tingkat Pencemaran Reservoar rendah ada 86,53% melalui hasil observasi lembar ceklist. Kesimpulan : Masyarakat bantaran sungai memiliki pengetahuan dan tindakan yang cukup, sedangkan sikap baik lebih besar 3% dari sikap cukup. Dan tingkat Pencemaran Reservoar rendah akan resiko pencemaran. Kata Kunci : Pengetahuan, Sikap, dan Tindakan dalam Penyediaan Air Bersih Creator An entity primarily responsible for making the resource Nanda Nicola Publisher An entity responsible for making the resource available Poltekkes Kemenkes Palembang Jurusan Kesehatan Lingkungan Date A point or period of time associated with an event in the lifecycle of the resource 2021 Contributor An entity responsible for making contributions to the resource Pembimbing Utama : Yulianto, SKM , M.Kes Pembimbing Pendamping : Hanna Derita L Damanik, SKM., M.K.M Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource Bahasa Indonesia Type The nature or genre of the resource KTI Mahasiswa