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Anxiety before childbirth is a common psychological condition experienced by pregnant women, particularly those who are primigravida. Such anxiety can be influenced by various factors, including lack of knowledge, fear of pain, and uncertainty about the childbirth process. Prenatal classes are educational programs designed to improve pregnant women’s understanding, confidence, and readiness in facing labor. These classes typically provide information about pregnancy, childbirth, postpartum care, and newborn care. However, the extent to which prenatal classes effectively reduce anxiety before childbirth requires further investigation. This study aimed to determine the relationship between the implementation of prenatal classes and labor anxiety levels among pregnant women. A quantitative research design with a cross-sectional approach was used. The sample consisted of 30 pregnant women selected through purposive sampling. Data were collected using standardized anxiety questionnaires administered before and after participants attended prenatal classes. The data were analyzed using the Chi-Square statistical test with a significance level set at p < 0.05. The findings revealed a significant relationship between participation in prenatal classes and a reduction in labor anxiety, with a p-value = 0.000 (p < 0.05). These results indicate that prenatal classes can play an important role in preparing pregnant women mentally and emotionally for the childbirth process. The interactive education and supportive environment provided during these sessions help participants gain confidence and reduce fear. It is recommended that healthcare providers in health facilities continue to optimize the delivery of prenatal classes by incorporating more interactive methods and involving family members. Family support, in combination with structured prenatal education, can further enhance the effectiveness of these programs in reducing childbirth-related anxiety.

Anxiety before childbirth is a common psychological condition experienced by pregnant women, particularly those who are primigravida. Such anxiety can be influenced by various factors, including lack of knowledge, fear of pain, and uncertainty about the childbirth process. Prenatal classes are educational programs designed to improve pregnant women’s understanding, confidence, and readiness in facing labor. These classes typically provide information about pregnancy, childbirth, postpartum care, and newborn care. However, the extent to which prenatal classes effectively reduce anxiety before childbirth requires further investigation. This study aimed to determine the relationship between the implementation of prenatal classes and labor anxiety levels among pregnant women. A quantitative research design with a cross-sectional approach was used. The sample consisted of 30 pregnant women selected through purposive sampling. Data were collected using standardized anxiety questionnaires administered before and after participants attended prenatal classes. The data were analyzed using the Chi-Square statistical test with a significance level set at p < 0.05. The findings revealed a significant relationship between participation in prenatal classes and a reduction in labor anxiety, with a p-value = 0.000 (p < 0.05). These results indicate that prenatal classes can play an important role in preparing pregnant women mentally and emotionally for the childbirth process. The interactive education and supportive environment provided during these sessions help participants gain confidence and reduce fear. It is recommended that healthcare providers in health facilities continue to optimize the delivery of prenatal classes by incorporating more interactive methods and involving family members. Family support, in combination with structured prenatal education, can further enhance the effectiveness of these programs in reducing childbirth-related anxiety.

Traditional medicine has been believed for generations to be effective in treating various diseases and is recognized for its safety. One reason people opt for herbal medicine is its affordability compared to chemical drugs. Additionally, herbal medicine is required to be free of medicinal chemicals (BKO). However, a public warning issued between 2020 and 2025 indicated that some herbal preparations still contained substances like sildenafil citrate and caffeine. The aim of this research is to establish a validated analytical method to detect the presence of sildenafil citrate and caffeine in stamina-enhancing herbal medicines using Thin Layer Chromatography (TLC) with densitometry. This method was selected due to its cost-effectiveness and its ability to separate two compounds. In this study, category II validation was conducted to identify impurities in the preparations, focusing on test parameters such as selectivity and Limit of Detection (LOD). The selected mobile phase for this study was a mixture of chloroform and ethanol (9.5:0.5 v/v). The TLC plate was analyzed with a densitometer at a wavelength of 254 nm. The Rf value for sildenafil citrate was found to be 0.32, while the Rf value for caffeine was 0.52, resulting in a separation (Rs) value of 2. The LOD for sildenafil citrate was determined to be 8.5418 μl/ml (equivalent to 0.0854 mg in a 600 mg sample), whereas the LOD for caffeine was 4.7987 μl/ml (or 0.0959 mg in a 600 mg sample).

Traditional medicine has been believed for generations to be effective in treating various diseases and is recognized for its safety. One reason people opt for herbal medicine is its affordability compared to chemical drugs. Additionally, herbal medicine is required to be free of medicinal chemicals (BKO). However, a public warning issued between 2020 and 2025 indicated that some herbal preparations still contained substances like sildenafil citrate and caffeine. The aim of this research is to establish a validated analytical method to detect the presence of sildenafil citrate and caffeine in stamina-enhancing herbal medicines using Thin Layer Chromatography (TLC) with densitometry. This method was selected due to its cost-effectiveness and its ability to separate two compounds. In this study, category II validation was conducted to identify impurities in the preparations, focusing on test parameters such as selectivity and Limit of Detection (LOD). The selected mobile phase for this study was a mixture of chloroform and ethanol (9.5:0.5 v/v). The TLC plate was analyzed with a densitometer at a wavelength of 254 nm. The Rf value for sildenafil citrate was found to be 0.32, while the Rf value for caffeine was 0.52, resulting in a separation (Rs) value of 2. The LOD for sildenafil citrate was determined to be 8.5418 μl/ml (equivalent to 0.0854 mg in a 600 mg sample), whereas the LOD for caffeine was 4.7987 μl/ml (or 0.0959 mg in a 600 mg sample).

The digital revolution in global health presents great opportunities and challenges through the integration of artificial intelligence (AI), big data and telemedicine. However, the absence of a transcendent ethical foundation in the development of medical technology risks undermining human values and justice. This study aims to critically examine the direction of digital health development by integrating the ethical and spiritual values of the Qur'an. The method used is a critical qualitative approach based on library research, with normative analysis of verses related to health principles, information ethics, and maqāṣid al-syarī'ah. The results of the study show that in QS. Al-Isrā': 70 emphasizes human dignity as the basis for medical data protection; likewise in QS. Al-Syu'arā': 80 emphasizes that healing is divine and should not be separated from spiritual values; while in QS. Al-Baqarah: 286 provides guidance on the limits of responsibility and human capabilities in the utilization of technology. The critical discussion underlines the importance of building Qur'anic-based digital ethics that emphasize justice ('adālah), trustworthiness, and compassion (raḥmah) in designing equitable and inclusive artificial intelligence (AI) systems and remote health services. It is hoped that this study will provide recommendations for the development of Qur'anic Digital Ethics as a future normative framework for global digital health innovation.

Stroke is one of the leading causes of death globally and is particularly prevalent in Indonesia. Early prediction of stroke is critical to reducing the risk of long-term disability and mortality. This study aims to build a stroke prediction model using the Support Vector Machine (SVM) classification method. The dataset used is sourced from Kaggle, containing 5,110 records with class imbalance. To address the imbalance, the Synthetic Minority Over-sampling Technique (SMOTE) was applied during preprocessing. The study evaluates model performance across multiple data splits (70:30, 80:20, 90:10) and k-fold cross-validation values (k=5, 7, 10). The SVM was tested with various kernel types—linear, polynomial, and radial basis function (RBF)—along with parameter tuning for C, gamma, and degree. The results show that the polynomial kernel yielded the highest prediction accuracy of 92%. The model performance was evaluated using accuracy, precision, recall, and F1-score metrics.

The digital revolution in global health presents great opportunities and challenges through the integration of artificial intelligence (AI), big data and telemedicine. However, the absence of a transcendent ethical foundation in the development of medical technology risks undermining human values and justice. This study aims to critically examine the direction of digital health development by integrating the ethical and spiritual values of the Qur'an. The method used is a critical qualitative approach based on library research, with normative analysis of verses related to health principles, information ethics, and maqāṣid al-syarī'ah. The results of the study show that in QS. Al-Isrā': 70 emphasizes human dignity as the basis for medical data protection; likewise in QS. Al-Syu'arā': 80 emphasizes that healing is divine and should not be separated from spiritual values; while in QS. Al-Baqarah: 286 provides guidance on the limits of responsibility and human capabilities in the utilization of technology. The critical discussion underlines the importance of building Qur'anic-based digital ethics that emphasize justice ('adālah), trustworthiness, and compassion (raḥmah) in designing equitable and inclusive artificial intelligence (AI) systems and remote health services. It is hoped that this study will provide recommendations for the development of Qur'anic Digital Ethics as a future normative framework for global digital health innovation.

Stroke is one of the leading causes of death globally and is particularly prevalent in Indonesia. Early prediction of stroke is critical to reducing the risk of long-term disability and mortality. This study aims to build a stroke prediction model using the Support Vector Machine (SVM) classification method. The dataset used is sourced from Kaggle, containing 5,110 records with class imbalance. To address the imbalance, the Synthetic Minority Over-sampling Technique (SMOTE) was applied during preprocessing. The study evaluates model performance across multiple data splits (70:30, 80:20, 90:10) and k-fold cross-validation values (k=5, 7, 10). The SVM was tested with various kernel types—linear, polynomial, and radial basis function (RBF)—along with parameter tuning for C, gamma, and degree. The results show that the polynomial kernel yielded the highest prediction accuracy of 92%. The model performance was evaluated using accuracy, precision, recall, and F1-score metrics.

The use of hormonal contraception is a common method used by women of childbearing age to prevent pregnancy. However, this method is often associated with side effects, one of which is spotting or light bleeding outside the menstrual cycle. This study aims to analyze the relationship between the type of hormonal contraception and the incidence of spotting in the Sonuo Village Health Center  area. This study used a quantitative design with a cross-sectional approach. The sample consisted of 37 respondents selected by total sampling. Data were collected through questionnaires and analyzed using the chi-square test with the help of SPSS software. The results showed that the majority of respondents used injectable contraception (62.2%), followed by implants (24.3%) and pills (13.5%). Most injectable users experienced spotting (82.6%), while implant users more often experienced amenorrhea (77.8%). The chi-square test showed a significant relationship between the type of hormonal contraception and the incidence of spotting (p-value = 0.000). The conclusion of this study is that the type of hormonal contraception affects the incidence of spotting, where injectables cause spotting more often than other methods. Education about the side effects of hormonal contraception needs to be increased so that users can choose a method that suits their body condition.

This study examines strategies for enhancing community participation in regional development planning by implementing bottom-up approaches. As democratic governance evolves, the need for meaningful citizen engagement in development planning becomes increasingly critical for ensuring sustainable and equitable outcomes. This research analyzes the effectiveness of participatory planning mechanisms, identifies barriers to community engagement, and proposes innovative strategies for strengthening bottom-up development planning processes. Using a comparative case study methodology across six regional governments, this study evaluates various participatory instruments including citizen forums, participatory budgeting, community mapping, and digital engagement platforms. The findings reveal that successful bottom-up planning requires institutional commitment, capacity building, cultural sensitivity, and sustained dialogue between government and communities. The study provides a framework for designing and implementing effective participatory planning systems that genuinely incorporate community voices in regional development decisions.

This paper examines the implementation of translanguaging pedagogies within digital learning environments and their effectiveness in developing multilingual competence among Generation Z learners. Through a mixed-methods study involving 186 students and 14 educators across six higher education institutions, this research investigates how strategic integration of translanguaging practices in digital spaces supports linguistic flexibility, metalinguistic awareness, and cross-cultural competence. Findings reveal that digitally-mediated translanguaging approaches resulted in significant improvements in learners' willingness to communicate across languages (p<.01), metalinguistic awareness (p<.001), and cross-cultural communication efficacy (p<.01) compared to monolingual instructional approaches. The research further identifies five key digital translanguaging strategies that effectively leverage Generation Z's technological aptitude and multimodal literacy. This study contributes to the growing field of multilingual digital pedagogy by demonstrating how translanguaging can be systematically integrated into digital learning environments to foster linguistic repertoire expansion that aligns with the communicative needs of increasingly globalized contexts. The pedagogical framework presented offers practical guidance for educators seeking to implement translanguaging approaches in various digital learning modalities while accommodating Generation Z's learning preferences and multilingual development.

This study examines strategies for enhancing community participation in regional development planning by implementing bottom-up approaches. As democratic governance evolves, the need for meaningful citizen engagement in development planning becomes increasingly critical for ensuring sustainable and equitable outcomes. This research analyzes the effectiveness of participatory planning mechanisms, identifies barriers to community engagement, and proposes innovative strategies for strengthening bottom-up development planning processes. Using a comparative case study methodology across six regional governments, this study evaluates various participatory instruments including citizen forums, participatory budgeting, community mapping, and digital engagement platforms. The findings reveal that successful bottom-up planning requires institutional commitment, capacity building, cultural sensitivity, and sustained dialogue between government and communities. The study provides a framework for designing and implementing effective participatory planning systems that genuinely incorporate community voices in regional development decisions.

This paper examines the implementation of translanguaging pedagogies within digital learning environments and their effectiveness in developing multilingual competence among Generation Z learners. Through a mixed-methods study involving 186 students and 14 educators across six higher education institutions, this research investigates how strategic integration of translanguaging practices in digital spaces supports linguistic flexibility, metalinguistic awareness, and cross-cultural competence. Findings reveal that digitally-mediated translanguaging approaches resulted in significant improvements in learners' willingness to communicate across languages (p<.01), metalinguistic awareness (p<.001), and cross-cultural communication efficacy (p<.01) compared to monolingual instructional approaches. The research further identifies five key digital translanguaging strategies that effectively leverage Generation Z's technological aptitude and multimodal literacy. This study contributes to the growing field of multilingual digital pedagogy by demonstrating how translanguaging can be systematically integrated into digital learning environments to foster linguistic repertoire expansion that aligns with the communicative needs of increasingly globalized contexts. The pedagogical framework presented offers practical guidance for educators seeking to implement translanguaging approaches in various digital learning modalities while accommodating Generation Z's learning preferences and multilingual development.

The use of hormonal contraception is a common method used by women of childbearing age to prevent pregnancy. However, this method is often associated with side effects, one of which is spotting or light bleeding outside the menstrual cycle. This study aims to analyze the relationship between the type of hormonal contraception and the incidence of spotting in the Sonuo Village Health Center  area. This study used a quantitative design with a cross-sectional approach. The sample consisted of 37 respondents selected by total sampling. Data were collected through questionnaires and analyzed using the chi-square test with the help of SPSS software. The results showed that the majority of respondents used injectable contraception (62.2%), followed by implants (24.3%) and pills (13.5%). Most injectable users experienced spotting (82.6%), while implant users more often experienced amenorrhea (77.8%). The chi-square test showed a significant relationship between the type of hormonal contraception and the incidence of spotting (p-value = 0.000). The conclusion of this study is that the type of hormonal contraception affects the incidence of spotting, where injectables cause spotting more often than other methods. Education about the side effects of hormonal contraception needs to be increased so that users can choose a method that suits their body condition.

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.

Anxiety during pregnancy is an issue that is increasingly receiving attention in the field of maternal health. Anxiety can harm fetal development and maternal mental health. High anxiety can lead to complications such as premature labor and low birth weight. Aromatherapy, especially the use of lavender essential oil, has been shown to have a calming effect that can help relieve anxiety. Previous studies have shown that lavender can reduce levels of stress hormones, such as cortisol, which contribute to feelings of anxiety. to measure the effect of lavender aromatherapy on anxiety levels in primigravida pregnant women. The research method used in this study was a pre-experiment with a pre-post group test. The study sample consisted of 20 primigravida pregnant women. Measurement of anxiety levels was carried out using the HARS Anxiety Scale measuring instrument before and after treatment. Lavender aromatherapy was given for 30 minutes every day for two weeks. The data obtained were analyzed using a paired t-test. Results: differences in anxiety levels of pregnant women in the third trimester between before and after being given lavender aromatherapy, this is evidenced by the mean value of the pre-test results of 25.5 but the mean value of the post-test results of 23.2. This is reinforced by the results of the t-test obtained to count 7.254. Furthermore, based on the results of the calculation of the level of significance, it shows that the value of

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.

Chronic energy deficiency (CED) in pregnalnt women is al problem thalt still occurs todaly. Chronic energy deficiency in pregnalnt women caln halve aln impalct on the heallth of the mother during pregnalncy, childbirth alnd the heallth conditions of the child who will be born. The purpose of this study is to determine the relaltionship between the level of knowledge albout nutrition alnd the incidence of chronic energy deficiency (CHD) in pregnalnt women alt the Siko Heallth Center. This study used al descriptive correlaltion design with al cross sectionall alpproalch. Daltal alnallysis used the Chi Squalre test method. This study wals conducted with al salmple of 1l0l4 people. The results showed al relaltionship between the level of knowledge The results showed thalt there wals al relaltionship between the level of knowledge albout nutrition alnd the incidence of chronic energy deficiency (CHD) in pregnalnt women alt the Siko Heallth Center, with al p-vallue of 0l.0l0l0l <0l.0l5. Nurses als palrt of heallth workers plaly aln importalnt role in efforts to increalse pregnalnt women's nutritionall knowledge so thalt the nutrition of pregnalnt women caln be fulfilled. nutrition of pregnalnt women caln be fulfilled optimallly to prevent the occurrence of SEZ.  

Primary dysmenorrhea is menstrual discomfort that begins during menarche and is not associated with any underlying pelvic pathological disorders. It is a common condition that can significantly affect daily activities and lower the quality of life. The pain often associated with dysmenorrhea may be alleviated by improving blood circulation and utilizing pleasant aromas. One of the most widespread gynecological conditions, dysmenorrhea affects women of all ages and is frequently characterized by painful menstruation. Aromatherapy, particularly with lavender flowers, has been traditionally used to treat a variety of conditions including pain, postpartum depression, anxiety, and discomfort following cesarean sections. It has also been used to reduce dysmenorrhea. According to the World Health Organization (WHO), 90% of women experience some form of dysmenorrhea, with 10–15% of these cases classified as severe. Pain management strategies for dysmenorrhea can be categorized into pharmaceutical and non-pharmacological methods, with aromatherapy being one of the prominent non-pharmacological techniques. This study aimed to assess the impact of lavender flower aromatherapy (Lavandula angustifolia) on the severity of dysmenorrhea in teenage females residing in Iloheluma Village, Patilanggio District, Pohuwato Regency. A quantitative, quasi-experimental approach was utilized in this research, employing a purposeful sampling method. The severity of dysmenorrhea discomfort before and after the lavender aromatherapy sessions was evaluated using the paired t-test. Of the respondents, 55% were aged 15–19 years. Prior to the aromatherapy treatment, 100% of participants reported moderate pain intensity. Following the aromatherapy session, the most common pain level reported by the participants (100%) was mild pain. These results suggest that lavender flower aromatherapy has a significant effect in reducing the severity of dysmenorrhea and can be considered an effective non-pharmacological intervention for menstrual discomfort.

Anxiety in third trimester primigravida is a common problem and can have an impact on maternal and fetal health. One method that can be used to reduce anxiety is prenatal gentle yoga, which is known to provide a relaxing effect and improve the emotional well-being of pregnant women. The aims to analyze prenatal gentle yoga as Non-pharmacological on the anxiety level in the third trimester of pregnancy. Using quasi-experimental design and pretest-posttest design with a control group. The study sample consisted of third trimester primigravida who were divided into an intervention group (prenatal gentle yoga) and a control group. Anxiety levels were measured before and after the intervention using validated instruments. Data analysis was performed using the Wilcoxon Signed Ranks test to test for differences in anxiety before and after the intervention in each group. The results showed a significant difference in anxiety levels before and after prenatal gentle yoga in the intervention group with a p value = 0.000. Meanwhile, in the control group, there was no significant difference in anxiety levels with a p value = 0.180. Prenatal gentle yoga has a significant effect in reducing the anxiety level of third trimester primigravida. Therefore, prenatal gentle yoga can be recommended as one of the non-pharmacological methods to reduce anxiety in pregnant women.