The Science Midwifery is a peer-reviewed open access bi-monthly Intitute of Computer Science (IOCS). This journal is published bi-monthly (August, October, December, February, April, June) since August 2022. This professional journal provides a venue for the publication of research relevant to midwifery and reproductive health practice by specialists and researchers in various disciplines including midwifery, reproductive health, maternal and child health, obstetrics and gynecology, sexual health promotion, women's health and nursing. It publishes quantitative and qualitative original articles, review articles, short communications, case reports and letters to the editor in a broad range of clinical and interdisciplinary topics. (Look at the scope)
Artificial intelligence in cardiac nursing practice: A systematic review of applications, challenges, and patient outcomes
Cardiovascular diseases remain the leading cause of global mortality, requiring innovative approaches to improve cardiac care. This systematic review aimed to examine the applications of Artificial Intelligence (AI) in cardiac nursing practice, identify implementation challenges, and assess its impact on patient outcomes. The review was conducted in accordance with PRISMA 2020 guidelines, using PubMed, ScienceDirect, CINAHL, and Web of Science. Original studies published between 2020 and 2025 that explicitly addressed nursing roles in cardiac care were included. Eleven studies met the inclusion criteria and were appraised using the Joanna Briggs Institute (JBI) tools. The results show that AI applications, including ChatGPT and machine learning models, support cardiac nursing through clinical decision support, patient education, risk prediction, and home-based monitoring. These applications were associated with improved nursing efficiency, enhanced patient self-management, early detection of clinical deterioration, and potential reduction in hospitalization. However, challenges such as data accuracy, ethical concerns, algorithm transparency, and limited digital literacy among nurses were consistently reported. In conclusion, AI has strong potential to enhance evidence-based and patient-centered cardiac nursing practice. Successful integration requires ethical governance, adequate training, and interdisciplinary collaboration to ensure safe and effective implementation.
Implementation of the qanun no smoking area regulation at SMP Negeri 32 Takengon
Smoke-free areas are (SFA) an important policy in creating a healthy environment, especially in schools. This study aims to analyze the implementation of Takengon City Regulation No. 10 of 2013 on smoke-free areas at SMP Negeri 32 Takengon, identify the monitoring mechanisms applied, and examine the factors that hinder the effectiveness of the policy. This study uses a qualitative descriptive approach. The research was conducted at SMP Negeri 32 Takengon from January to June 2025. There were 10 informants in this study, consisting of 1 school principal, 1 homeroom teacher, 1 guidance counselor, 6 students, and 1 parent. The data collection techniques used in this study were in-depth interviews, observation, and documentation. The data were analyzed through data reduction, data presentation, and conclusion drawing. Data validity was tested using source triangulation to ensure the accuracy of the research results. The results showed that the implementation of the Qanun KTR had a positive impact on the school environment. Supervision was carried out through routine patrols, the installation of no smoking signs, and periodic inspections. However, there are still obstacles such as the absence of Standard Operating Procedures (SOPs), inconsistency in the application of sanctions between students and staff, and a lack of involvement from parents and external parties in supervision. It is necessary to develop SOPs, apply fair sanctions, and increase cooperation with parents and relevant agencies to strengthen the effectiveness of the smoke-free zone policy.
The potential of trigona honey as a hemoglobin booster and immunomodulator in pregnant women with iron deficiency anemia
Background: Iron deficiency anemia in pregnancy constitutes a significant public health issue, as it elevates the likelihood of adverse pregnancy outcomes, including pregnancy complications. In West Lombok, the prevalence of anemia among pregnant women was reported to reach 18.6%. Despite government efforts through iron supplementation programs, challenges remain, including low adherence and limited bioavailability. Therefore, alternative natural supplements are needed. Trigona honey contains micronutrients and bioactive compounds with hematopoietic and immunomodulatory properties, making it a potential natural agent to improve hemoglobin levels and immune function. Objective: To examine the impact of Trigona honey supplementation on the hemoglobin levels of pregnant women with IDA. Methods: This true experimental research employed a pretest–posttest control group design and was carried out within the service area of the Jembatan Kembar Community Health Center. Thirty pregnant women were recruited using purposive sampling and divided into two groups: intervention (Trigona honey + iron) and control (iron only), each with 15 participants. Data were collected using questionnaires and Touch GCHB tests to measure hemoglobin levels. Statistical analyses were performed using paired and independent t-tests with a significance thresholdof p < 0.05. Results: Hemoglobin levels increased significantly in both groups; however, the intervention group demonstrated a more substantial improvement (mean = 2.89; p = 0.000) compared to the control group (mean = 0.65; p = 0.010). Conclusion: Trigona honey significantly enhanced hemoglobin levels compared to iron supplementation alone. It may serve as a promising non-pharmacological complementary therapy for preventing and managing iron deficiency anemia in pregnant women.
Public knowledge about smoking as a triggering factor for oral cavity cancer
Smoking habits in Indonesia are still very high. Approximately 80-90% of oral cancers are caused by smoking, cigars, pipes, and chewing gum. Ignorance of the negative impacts of smoking is considered to be the root of this contradictory situation. The purpose of this study was to determine how the knowledge of rural communities about smoking as a cause of oral cancer has changed. This study aimed to determine how the knowledge of rural communities about smoking as a triggering factor for oral cancer. This study was descriptive and observational with a cross-sectional design. Respondents totaling 171 residents of Margaluyu Village, Pangalengan District, Bandung Regency were selected based on inclusion and exclusion criteria. Data were collected using questionnaires completed during the study and processed using SPSS. The study showed that the majority of residents had low knowledge about smoking as a triggering factor for oral cancer. This can be seen from 92.4% of respondents having a score below 55%, 6.4% of respondents having a sufficient score of 56% - 74%, and 1.2% of respondents having a score above 75%. This study concludes that in Margaluyu Village, Pangalengan District, Bandung Regency, public knowledge about cigarettes as a cause of oral cancer is generally still low.
Late-pregnancy anxiety as a distinct multidimensional construct: Psychometric evidence from a community-based sample
Anxiety during pregnancy was recognized as a common maternal mental health concern with important implications for maternal well-being and perinatal outcomes. Evidence suggested that anxiety experienced in late pregnancy was more context-specific and qualitatively distinct from general anxiety, yet its underlying structure remained insufficiently examined. This study examined whether anxiety in late pregnancy constituted a distinct multidimensional psychological construct using a theory-driven psychometric approach. A community-based cross-sectional study was conducted among 280 women in late pregnancy between 28 and 40 weeks of gestation. A structured self-report instrument was developed through conceptual analysis and expert review, and its latent factor structure was evaluated using confirmatory factor analysis within a structural equation modeling framework. The analysis supported a three-domain multidimensional structure encompassing childbirth-related anxiety, fetal health anxiety, and maternal mental readiness and self-confidence. The model demonstrated acceptable overall fit (χ²/df = 3.15; RMSEA = 0.088; CFI = 0.97; TLI = 0.96), with all indicators loading significantly on their respective latent dimensions (standardized loadings ≈ 0.94–1.01). These findings indicated that anxiety in late pregnancy represented a distinct multidimensional construct, supporting dimension-specific assessment in antenatal and perinatal mental health research.
Literature review of the cytotoxic activity of faloak (sterculia quaddrifida r.br) against t47d and mcf-7 breast cancer cells and its active compounds
Faloak (Sterculia quadrifida R.Br) is one of the plants used by the community as a multipurpose drug. Faloak bark herb has long been used by the people of East Nusa Tenggara as a medicinal plant. Empirically, boiled water from the bark of the faloak plant is used by the people of East Nusa Tenggara as a cure for hepatitis, typhus, ulcers, and stamina recovery. The data extraction method used is narrative by grouping similar data from the literature review results according to the size of the results to be presented. The flow of the journal search is about testing the cytotoxic activity of faloak (Sterculia quadrifida R.Br) against T47D and MCF-7 breast cancer cells and the content of their active compounds. From these data, screening, journal eligibility, and monitoring of conformity with inclusion and exclusion criteria were carried out to obtain appropriate journals to conclude the cytotoxic activity of faloak. The results of a literature review showed that faloak (Sterculia quadrifida R.Br) had cytotoxic activity against T47D and MCF-7 breast cancer cells. Chemical compounds that have cytotoxic activity are alkaloids, flavonoids, terpenoids, tannins, naphthoquinone, apigenin, and puerarin. Naptaquinone derivatives 2,3-dihydro-6hydroxy-2-methylenenaphtho [1,2-b] furan-4,5-dione and 2-iminoethyl 2-(2-(1-hydroxypentan-2-yl) phenyl) acetate obtained from the extract or active fraction of faloak bark (Sterculia quadrifida R.Br) showed cytotoxic activity against T47D breast cancer cells. Apigenin compounds were found to be the most effective phytoestrogens in inhibiting the growth of breast cancer cells. Apigenin also has apoptotic effects and induces autophagy in breast cancer cells. an effective proteasome inhibitor in breast cancer cell culture and breast cancer xenografts, and puerarin can increase DUSP1 expression by increasing the expression level of miR-133a-3p in breast cancer cells.
The relationship between diabetes mellitus (DM) risk factors and random blood sugar levels (RBSL) in managerial and non-managerial positions in the local government of Bener Meriah Regency
Fasting Blood Sugar Level (FBSL) as one of the efforts to detect DM. The study aims to determine the risk factors of DM on FBSL in managerial and non-managerial positions (civil servants) in Bener Meriah Regency. The study used a cross-sectional design. The research sample consisted of 81 managerial and 102 non-managerial respondents. Purposive sampling was used. The study period was from February 20 to June 7, 2024. Data collection involved measurements (height, weight to calculate BMI), blood pressure checks, and KGDS. A questionnaire (IPAQ) was used for interviews on physical activity, and a questionnaire (Riskesdas) from 2018 was used for interviews on risk factors for low fiber consumption and high sugar, salt, and fat consumption. Analysis of Mann Whitney Test and Multiple Logistic Regression data. The results showed that there was a relationship between KGDS and BMI (OR= 2.48; 95%CI=2.48; p-value=0.007). There was no relationship between KGDS and blood pressure (OR= 1.66; 95%CI=0.82-3.35; p-value=0.1520). There is no relationship between KGDS and physical inactivity (OR=1.80; 95% CI=0.82-3.93 p-value=0.1307). There is no relationship between KGDS and low fiber consumption (OR=1.15; 95% CI=0.50-2.61 p-value=0.74). There was no association between KGDS and high sugar, salt, and fat intake (OR=0.90; 95% CI=0.41-1.94; p-value=0.7828). There was no association between group and KGDS occurrence (OR=1.39; 95% CI=0.76-2.53 p-value=0.272). There was no association between random blood glucose levels (KGDS) and blood pressure, physical activity, and dietary patterns. Regular KGDS testing and the implementation of physical activity and balanced nutrition are still recommended.
Descriptive study of pregnant women's knowledge level about high-risk pregnancy
Pregnancy is a physiological process, beginning with egg fertilization and culminating in child birth, although pregnancy is a natural process, not every pregnancy proceeds without problems. Some women encounter difficulties that could lead to pregnancies with a high risk. The objective of this research is determining the degree of knowledge expectant women have on high-risk pregnancies. For this investigation, a descriptive research methodology was used. The participants comprised 41 pregnant women chosen using overall sampling techniques. The main instrument used to gather data was a questionnaire. Uni-variate methods were used to conduct data analysis. According to the results, most participants lacked enough knowledge regarding high-risk pregnancies; 36 people (88%) displayed little understanding; only 4 individuals (10%) had great understanding; and only one person (2%) was fairly informed. Regarding participant demographics, almost all were in their twenties to early 30s; nevertheless, many still showed inadequate knowledge. Nearly all participants in every evaluated subject matter showed a low degree of knowledge. The study finds that awareness of high-risk pregnancies among pregnant women is still fairly low, therefore stressing the need of better and more enduring maternal health education programs.
Determinants of obesity risk factors in pre-seniors and seniors in Central Java: 2023 survey analysis
Background: Overweight and obesity are increasing globally and in Indonesia, particularly among pre-seniors and seniors. Age-related changes and behavioral factors heighten obesity risk. Data from the 2023 Indonesian Health Survey (SKI) show a high burden of obesity among older adults in Central Java. Objective: To identify determinants of overweight and obesity risk factors among pre-seniors and seniors in Central Java based on the 2023 SKI data. Methods: A cross-sectional study using secondary data from 23,602 respondents aged ≥45 years in Central Java. Nutritional status was assessed using Body Mass Index (BMI). Sociodemographic characteristics, consumption patterns, and physical activity were analyzed using chi-square tests and multivariate logistic regression to estimate Adjusted Odds Ratios (aOR). Results: 42.2% of respondents were overweight or obese. Risk factors included age ≥60 years (aOR=1.695), urban residence (aOR=1.349), and daily sweet beverage consumption (aOR=1.374). Protective factors included male sex (aOR=0.414), low education (aOR=0.628), marital status (married/widowed), and heavy physical activity (aOR=0.808). Moderate physical activity was not significant after adjustment. Conclusion: Obesity among pre-seniors and seniors in Central Java is influenced by demographic, social, and behavioral factors, indicating the need for tailored prevention strategies for older adults.
Analysis of hospital costs and insurance reimbursement systems for pneumonia patients: A literature review
Pneumonia has remained one of the leading causes of global morbidity and mortality and has imposed a substantial clinical and financial burden on healthcare systems. The high cost of pneumonia care was influenced by disease severity, comorbidities, length of hospital stay, and the use of therapeutic and diagnostic interventions. The implementation of prospective payment systems, such as Diagnosis Related Groups (DRGs) and INA-CBG’s, aimed to improve cost efficiency; however, it often resulted in gaps between actual hospital costs and reimbursement tariffs. This literature review aimed to analyze hospital costs and insurance reimbursement systems for pneumonia patients. A Systematic Literature Review was conducted following PRISMA guidelines through searches of PubMed and Google Scholar for publications from 2020 to 2025. Eleven articles met the inclusion criteria and were analyzed narratively. The findings indicated that length of stay, clinical complexity, and the use of broad-spectrum antibiotics were the main determinants of high costs. Package-based payment systems improved efficiency but continued to face underfunding challenges. This study concluded that optimizing pneumonia cost management required clinical efficiency, accurate claims coding, and technological support to ensure hospital financial sustainability.
Woolwich massage and back rolling are effective in increasing breast milk production in mothers with post-cesarean section indications of premature rupture of membranes (prom) in hospitals
Introduction: Premature rupture of the membranes (KPD) is one of the conditions that is a factor that causes the procedure to be performed by sectio caesarea because the prematurely ruptured membranes increase the risk to the mother and fetus. Cesarean delivery can lead to ineffective breastfeeding due to pain, stress, and separation between the mother and the baby in the NICU. Efforts are made to increase breast milk production, namely with Woolwich massage and back rolling. Objectives: The purpose of this study is to determine if the effectiveness of Woolwich massage and back rolling can increase breast milk production of post-cesarean section mothers with KPD indications in hospitals. Methods: This research method uses a descriptive method with a case study approach using postpartum nursing care carried out on April 28-Mei 3, 2025, for post-SC mothers on the indication of KPD. Results: The evaluation was carried out for 3 days, with the administration of Woolwich massage and back rolling twice a day for ±20 minutes. On the first day before the action was taken, the breast milk had not come out. After the massage, there began to be changes even though there was still very little breast milk. On the second day, breast milk production began to look more stable and was seen dripping until the fifth day, when the milk had begun to flow smoothly. Conclusion: this study shows that the action of Woolwich massage and back rolling is proven to increase breast milk production in post-SC mothers with ineffective breastfeeding problems.
Serum 25-hydroxyvitamin D is associated with body fat percentage and skeletal muscle mass in adults: A cross-sectional study
Background: Vitamin D is widely recognized for its role in bone and musculoskeletal health, yet accumulating evidence suggests it may also influence body composition through regulatory effects on adipose and skeletal muscle tissues. This study aimed to evaluate the association between serum vitamin D status and body composition parameters in adults. Methods: A cross-sectional study was conducted in 77 adults. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured using an enzyme-linked immunosorbent assay (ELISA), while body composition (percent body fat and skeletal muscle mass) was assessed using bioelectrical impedance analysis (BIA). Participants were categorized based on vitamin D status, and group comparisons as well as Pearson correlation analyses were performed. Results: The mean age of participants was 35.8 ± 9.6 years, and 40.2% were men. The prevalence of vitamin D deficiency (<20 ng/mL) was 36%, while 68% of participants had suboptimal vitamin D levels (deficiency or insufficiency). Individuals with vitamin D deficiency showed significantly higher body fat percentage and lower skeletal muscle mass compared with the non-deficient group (p < 0.05). Serum 25(OH)D was moderately inversely correlated with body fat percentage (r = −0.41, p = 0.018) and positively correlated with skeletal muscle mass (r = 0.29, p = 0.012). Conclusion: Lower vitamin D status was associated with increased adiposity and reduced skeletal muscle mass in adults. These findings highlight the potential importance of maintaining adequate vitamin D levels as part of strategies supporting healthier body composition. Longitudinal and interventional studies are needed to clarify causality and clinical implications.
The effect of giving pumpkin pudding (curcubita moschata) on sleep quality postpartum
The postpartum period is a period of recovery of reproductive organs which is a period vulnerable to discomfort after childbirth, one of which is sleep disorders. In Indonesia, around 53.9% of postpartum mothers experience sleep disorders that can reduce the quality of life and increase the risk of fatigue or postpartum blues (Rofiasari, 2024), so there is a need for safe intervention efforts to improve sleep quality, such as non-pharmacological interventions, namely pumpkin (Cucurbita moschata) where its content is important in sleep regulation, so it has the potential to improve the quality of sleep of postpartum mothers (Ariani, 2023). The purpose of the study was to determine the effect of giving pumpkin pudding (Cucurbita moschata) to postpartum. This research method used a one-group pre-test and post-test design, with sample 44 participants using independent t-test analysis. The results showed that sleep quality was categorized low in 39 participants (88.6%) before the pre-test and good in 38 participants (86.4%) after the intervention. There was also an effect of pumpkin (Curcubita moschata) pudding on sleep quality postpartum (p-value 0.000 <0.05). The conclusion of this study that pumpkin affects changes in sleep quality in postpartum. Therefore, it is necessary to prioritize rest and sleep quality through foods that support physical recovery and sleep regulation, such as pumpkin. This study recommends that social support and health education by healthcare professionals regarding good nutritional choices are needed to support postpartum adaptation.
Emotional intelligence and caring behavior among nurses at Dr. M. Djamil General Hospital Padang
Emotional intelligence (EI) is crucial in nursing education to develop competencies such as communication, decision-making, and empathy. In Indonesia, 70.5% of patients perceived hospital staff as lacking empathy, and 61.4% felt consultation times were shorter compared to those abroad. The purpose of this study was to describe nurses' caring behaviors and examine their relationship with emotional intelligence. The research method used was a cross-sectional analytic study conducted on 119 nurses from various hospital units. Emotional intelligence and caring behaviors were measured using a validated questionnaire. Data were analyzed using descriptive and bivariate statistics. The results showed that most respondents were aged ≥30 years (88.2%), female (88.2%), and had a Bachelor's degree in Nursing (62.2%). More than half had high emotional intelligence (56.3%), and most demonstrated good caring behaviors (95.8%). Age, gender, and education did not significantly influence emotional intelligence or caring behaviors (p > 0.05). Emotional intelligence showed a strong and significant relationship with caring behavior (OR = 7.412; 95% CI: 3.292–16.690; p < 0.001), with a moderate positive correlation (R = 0.518). Emotional intelligence explained 26.8% of the variance in caring behavior (R² = 0.268). Emotional intelligence significantly influenced nurses' caring behavior. Nurses with higher emotional intelligence tended to provide more empathetic and compassionate care, thereby improving patient satisfaction and service quality.
Fissure tongue condition in a patient with down syndrome: A case report
Fissured tongue is a normal variation of the tongue in which the surface of the dorsum of the tongue has fissures, with varying depths. This condition is commonly found in patients with Down's syndrome. The patient comes with complaints of increasing tongue sensitivity to spicy and sour tastes. In general, patients do not feel any complaints or pain if the fissures are not too deep but there is a risk of food ingesting in these cracks. Fissured tongue will become a pathological condition if the depth reaches >5mm, causing the patient to seek treatment. The purpose of this case report is to provide an overview of patients who have Down's syndrome accompanied by fissured tongue. The patient in this case report was not given any medication and was only given oral health education and oral hygiene instructions both directly and to the patient's guardian.
Development of a web-based poedji rochjati score information system for early detection of high-risk pregnancy
Maternal mortality remains a critical public health issue that can be reduced through effective early detection of high-risk pregnancies. In Indonesia, the Poedji Rochjati Score Card (KSPR) is widely used as a screening tool; however, its implementation is predominantly manual, leading to inefficiencies in data management, risk classification, and continuity of antenatal care. This study aims to develop a web-based Poedji Rochjati Score to support early detection of high-risk pregnancies at the primary healthcare level. This research employed an applied research and development design using the Rapid Application Development (RAD) method. The results indicate that the developed system successfully automates KSPR scoring and pregnancy risk classification based on standardized criteria. The system improves the accuracy and consistency of risk assessment, enhances maternal health data management, and supports longitudinal monitoring of pregnancy risk status. Implementation findings show that the system facilitates more efficient antenatal care services and provides structured risk reports to support clinical and referral decision-making. This study contributes to applied health informatics by demonstrating how standardized maternal risk screening can be effectively digitalized at the primary healthcare level. In conclusion, the web-based Poedji Rochjati Score information system offers an effective and innovative solution for strengthening early detection of high-risk pregnancies. The integration of a standardized screening tool with digital technology enhances screening accuracy, service efficiency, and data continuity in antenatal care. This study provides a practical foundation for further development and wider implementation of digital maternal health screening systems to support improved maternal healthcare quality.
The effect of coping strategies on flourishing with self-compassion as a mediator in teachers with functional dyspepsia
The inability of teachers to manage stress effectively can worsen their health and trigger functional dyspepsia. This study aims to understand how teachers can achieve flourishing despite experiencing work-related stress. It examines the coping strategies used to manage stress and how these strategies contribute to achieving flourishing. This study also investigates the role of self-compassion in the relationship between coping strategies and flourishing. The purpose of this study is to examine the effect of coping strategies on flourishing, the effect of coping strategies on self-compassion, the effect of self-compassion on flourishing, and the effect of coping strategies on flourishing with self-compassion as a mediating variable among teachers with functional dyspepsia. This study employed a quantitative method by distributing questionnaires to 200 teacher respondents diagnosed with functional dyspepsia who met the screening criteria of the R4-FDDQ Functional Dyspepsia Diagnostic Questionnaire. Data analysis was conducted using JASP version 0.19.3.0 through Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results indicate that the respondent data were reliable, valid, and the model demonstrated good fit. The findings reveal a significant relationship between coping strategies and flourishing, as well as between coping strategies and self-compassion. However, self-compassion did not have a significant effect on flourishing, nor did it significantly mediate the relationship between coping strategies and flourishing among teachers with functional dyspepsia. In coping with problems, teachers with functional dyspepsia tended to prioritize emotion-focused coping in achieving flourishing. Religiosity and mindfulness were identified as the most prioritized strategies compared to other aspects.
The effect of ramadan fasting in maintaining blood sugar and cholesterol stability in diabetes mellitus patients 2
Introduction: Fasting is a practice of abstaining from food and drink for 11–18 hours each day over a full month and is known to have benefits in controlling blood glucose and cholesterol levels. Type 2 diabetes mellitus (T2DM) is characterized by hyperglycemia and metabolic disorders that may increase the risk of complications, including those related to hypercholesterolemia. Ramadan fasting has the potential to provide positive effects on metabolic control in patients with T2DM. Objective: This study aimed to determine the effect of Ramadan fasting on random blood glucose (RBG), fasting blood glucose (FBG), and cholesterol levels in patients with T2DM in Jompo Kulon Village. Methods: This study employed a quasi-experimental design with a Pretest–Posttest Control Group. Samples were obtained using a purposive sampling technique and consisted of patients with T2DM in Jompo Kulon Village. Result: The study was conducted during the month of Ramadan in 2025. Data analysis was performed using the Paired T-Test and Mann–Whitney Test. The results showed a decrease in RBG, FBG, and cholesterol levels in the fasting group compared to the control group, with a p-value > 0.001. Conclusion: It can be concluded that Ramadan fasting can reduce RBG, FBG, and cholesterol levels in patients with T2DM compared to those who do not fast.
Effectiveness of health services through the mobile-JKN application for the elderly: A case study at the Gunung Tua BPJS health office, North Sumatra
This study aims to analyze the effectiveness of healthcare services delivered through the Mobile JKN application for elderly participants at the BPJS Kesehatan Gunung Tua Office, North Padang Lawas Regency. A descriptive qualitative approach was applied, with data collected through interviews, observations, and literature review. The findings indicate that the utilization of Mobile JKN among the elderly has not yet reached an optimal level due to low digital literacy, limited smartphone ownership, unstable internet access, and difficulties in using application features. Family support plays a crucial role in improving service effectiveness, particularly through assistance from children or grandchildren in accessing digital services. Based on the SERVQUAL dimensions, Mobile JKN shows adequate reliability and empathy but still requires improvement in interface simplicity, responsiveness, and accessibility for elderly users. Overall, Mobile JKN has strong potential to enhance healthcare service efficiency if supported by continuous socialization, digital literacy strengthening, improved infrastructure, and family-based assistance.
Modern traditional games improve early childhood social-emotional skill: A systematic review
Problems in social and emotional development in children have been increasing in recent years Children with social emotional problems will become more introvert, experienced sleep disturbances, solitary violent behavior, lack of creativity, and the threat of cyberbullying, from this phenomenon, the right intervention is needed, one of which is play. intervention that has proven effective in developing social-emotional aspects is play. Play is not just a recreational activity, but has high therapeutic and educational value. Through play, children learn to manage emotions, resolve conflicts, empathize, and build cooperation skills.The purpose of this systematic review is to analyse the types of games and the success of games in improving social emotional development. This study uses a systematic review based on the Preferred Reporting Items for Systematic Review And Meta-Analysis (PRISMA) stage, articles were collected from PubMed, Google Scholar, ProQuest, Science Direct databases, from 2017 to 2024, Articles were selected according to the inclusion and exclusion criteria and critical appraisal was carried out using the JBI Instrument on the selected articles.The results of the review of articles from 2017-2024 obtained eight articles, five articles discuss modern games in improving early childhood social emotional development, three articles discuss traditional games in improving social emotional development, all articles agree that both modern and traditional games can improve social and emotional development with their respective advantages. It can be conclude that both traditional and modern games can enhance the social emotional development in early childhood.
Analgesic effectiveness test of kitolod leaf ethanol extract (isotoma longiflora l.) against male white mice (mus musculus)
This study aims to evaluate the analgesic effectiveness of ethanol extract of Kitolod leaves (Isotoma longiflora L.) in male white mice (Mus musculus). Kitolod leaves are traditionally used as herbal remedies for pain, yet scientific evidence regarding their analgesic potential remains limited. This true experimental research employed a pre- and post-test with control group design, involving five groups: negative control (Na-CMC 1%), positive control (diclofenac sodium 50 mg), and three treatment groups administered Kitolod leaf extract at doses of 56 mg/kgBW, 112 mg/kgBW, and 224 mg/kgBW. Extract preparation was carried out using maceration with 96% ethanol, followed by phytochemical screening which confirmed the presence of flavonoids, alkaloids, tannins, and steroids. Analgesic activity was assessed using the tail flick method by measuring latency response to thermal stimuli at intervals of 30, 60, 90, 120, 150, and 180 minutes post-treatment. The results showed that Kitolod leaf extract increased pain response latency, with the 112 mg/kgBW and 224 mg/kgBW doses demonstrating the strongest analgesic effects comparable to diclofenac sodium. Statistical analysis using independent sample t-test and one-way ANOVA indicated significant differences (p < 0.05) between treatment and control groups. These findings suggest that Kitolod leaf ethanol extract possesses promising analgesic properties and may serve as a potential natural alternative for pain management.
Analysis of the effect of hospital management information system implementation on clinical decision-making at PKU Muhammadiyah Purbalingga hospital
Hospital Management Information Systems (HMIS) play an important role in supporting clinical decision making by providing accurate, timely, and integrated information. However, challenges related to system quality, information quality, and workflow efficiency may hinder the optimal utilization of HMIS. This study aimed to analyze the effects of system quality, information quality, and workflow efficiency on clinical decision making at PKU Muhammadiyah Purbalingga Hospital. The research employed a quantitative method with a causal associative design, using a total sampling technique involving 60 respondents consisting of physicians, nurses, and midwives. Data were collected using structured questionnaires and analyzed through multiple linear regression with I BM SPSS Statistics version 26, accompanied by classical assumption tests. The results showed that all variables were categorized as good and that the regression model met all analytical assumptions. Partial test (t-test) results indicated that system quality, information quality, and workflow efficiency had a positive and significant effect on clinical decision making (p < 0.05), with information quality identified as the most dominant variable (β = 0.402). The F-test results showed Fcount = 25.324 > Ftable = 2.70 with p = 0.001, indicating that the independent variables simultaneously had a significant effect. In conclusion, HMIS system quality, HMIS information quality, and workflow efficiency significantly affect clinical decision making at PKU Muhammadiyah Purbalingga Hospital, with information quality as the strongest predictor.
Analysis of psychological and academic factors related to anxiety about entering the workforce among final semester students Payung Negeri Aceh Darussalam Health Sciences Institute 2025
Anxiety about entering the workforce is an emotional condition characterized by feelings of tension, worry, and uncertainty about one's ability to cope with the demands and transition to a new work environment. The purpose of this study is to examine the intellectual and psychological aspects of final-year STIKes Payung Negeri Aceh Darussalam students' worry about starting a career in 2025. The investigation was carried out during October 1–3, 2025, using a cross-sectional study design and a quantitative analytical approach. The Slovin algorithm and simple random sampling were used to choose 60 responders from the 152 final-year students that made up the study population. Data were collected through interviews using a structured questionnaire and analyzed using SPSS with the Chi-Square test (p < 0.05). The results of the study show a significant relationship between self-confidence (p=0.045), social support (p=0.033), work experience (p=0.006), work readiness (p=0.021), and sources of information (p=0.006) with anxiety about entering the workforce. These results confirm that anxiety is more influenced by psychological factors and personal experiences than academic achievement alone. Therefore, universities need to develop career development programs, soft skills training, counseling, and internships to improve students' mental readiness for the world of work.
Health and social burdens of TB-HIV co-infection in Indonesian risk populations
This systematic literature review aims to examine the health and social burdens of TB-HIV co-infection among at-risk populations in Indonesia. The review analyzed four quantitative primary studies published between 2021 and 2024, including three from Indonesia and one from Ethiopia as a comparative reference. Literature was identified from electronic databases using defined inclusion criteria and screened through PRISMA guidelines. Data were extracted on sample characteristics, quantitative instruments, and statistical findings relevant to TB-HIV prevalence, risk factors, treatment challenges, and public health interventions. Results showed that TB-HIV co-infection poses significant burdens, especially among populations with low socio-economic status and limited access to healthcare. Key challenges include poor treatment adherence, stigma, psychological distress, and fragmented health services. Although some interventions have been implemented, they remain inconsistent and unequally distributed. This review highlights the need for integrated, community-based, and multi-sectoral approaches to address TB-HIV co-infection in Indonesia’s vulnerable populations effectively.
Preliminary study of blood pressure and arterial stiffness monitoring using the niva device (non-invasive vascular analyzer)
Introduction: Measuring vascular parameters using the NIVA (Non-Invasive Vascular Analyzer) is an important step in assessing the health of blood vessels in the community, especially in groups at risk of hypertension. Objective: This study aims to describe the results of baseline blood pressure and vascular parameter examinations in respondents before further intervention. Methods: Respondents underwent an initial screening process including informed consent, anamnesis, and baseline blood pressure measurement. Results: The graph shows a balanced gender distribution and a dominance of the 31-40 and 41-50 age groups, which are age groups at high risk of experiencing increased arterial stiffness. The hand and foot blood pressure graphs show variations in systolic and diastolic values ​​​​in the mild to moderate hypertension range, indicating that the hemodynamic condition of the respondents is stable and safe for NIVA examination. NIVA measurements were performed by attaching a cuff to the upper arm and left ankle to obtain parameters such as baPWV, ABI, MAP, PP, and Vascular Age. Blood pressure variations in the baseline graph support accurate reading of vascular parameters, especially because there was no indication of peripheral stenosis based on the comparison of hand and foot blood pressure. The data recording and validation process was performed by comparing the measurement results to the baseline, which was consistent with the initial graph. Conclusion: The examination results indicate that the respondents' initial condition met the requirements for non-invasive vascular evaluation and provided a representative picture of blood vessel health status prior to clinical intervention.
Routine hematological profile in tuberculosis patients undergoing treatment at Bakunase Community Health Center, Kupang City
Tuberculosis is a disease caused by the bacterium Mycobacterium tuberculosis (M. tuberculosis). Anti-tuberculosis drugs are effective in killing Mycobacterium tuberculosis but may also have side effects on various organs, particularly the hematological system. Monitoring through laboratory examinations, particularly hematological tests, can help prevent complications of other diseases. This descriptive study aimed to determine the hematological profile of tuberculosis patients undergoing treatment at the Bakunase Public Health Center in Kupang City. The population in this study comprised TB patients receiving anti-tuberculosis therapy at the Bakunase Public Health Center in Kupang City, with a total sample of 30 patients. The sampling technique used was purposive sampling. The results showed that TB patients at Bakunase Public Health Center were predominantly male (56.7%), in the productive age group of 19–59 years (83.3%), and mainly in the intensive phase of treatment (0–2 months) (60%). In the productive age group, most hematological parameters were within normal limits, particularly erythrocytes, platelets, hemoglobin, and MCHC. Meanwhile, in the non-productive age group, fewer patients had normal hematological values. Based on treatment duration, patients in both the intensive and continuation phases generally had hematological values within normal limits, although percentages varied.
Understanding barriers and enablers of tuberculosis prevention in high-risk boarding school settings
Tuberculosis prevention remains a significant challenge in high-risk boarding school settings due to overcrowding, prolonged close contact, and limited institutional health governance. At the same time, existing Research has largely emphasised epidemiological and individual-level factors with limited attention to contextual and institutional dynamics, particularly among adolescents in congregate educational environments. This qualitative exploratory study aimed to examine barriers and enablers to tuberculosis prevention from the perspectives of adolescents, caregivers, school administrators, and health professionals, using in-depth interviews and focus group discussions with purposively selected participants involved in boarding school health management and tuberculosis prevention. Thematic analysis revealed that the availability of basic environmental facilities, caregiving support, and strong institutional cohesion served as key enablers of tuberculosis prevention; however, these were constrained by overcrowded living conditions, the absence of formal tuberculosis-specific procedures, tuberculosis-related stigma among adolescents, limited financial and health system support, informal governance practices, and fear of social consequences, which collectively hindered early reporting and preventive behaviors. Overall, tuberculosis prevention in boarding schools is shaped by a complex interplay of environmental, institutional, and sociocultural factors, underscoring the need for context-sensitive, institution-based prevention strategies that address stigma, strengthen governance, and enhance collaboration with health systems to reduce tuberculosis risk among adolescents in boarding schools.