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The Emergency Room (ER) is a hospital service unit that plays a strategic role in treating patients with critical and emergency conditions. The high number of patient visits and limited resources require an effective triage system to ensure quality of service and patient safety. The Emergency Severity Index (ESI) is a five-level triage system that classifies patients based on the level of severity and resource requirements. This study aims to analyze the relationship between the implementation of triage based on the Emergency Severity Index and the improvement of EAD service quality at Sari Asih Cipondoh Hospital. This study used a quantitative design with a cross-sectional approach. The study sample consisted of EAD patients who met the inclusion criteria. Data were collected through observation of triage implementation and patient satisfaction questionnaires, then analyzed using univariate and bivariate analysis. The results showed that the proper implementation of ESI triage was significantly associated with improved quality of ED services, particularly in terms of speed of service and patient satisfaction. The conclusion of this study confirms that the implementation of ESI triage is an important factor in efforts to improve the quality of ED services.

Skin diseases are common health problems in boarding school environments due to communal living conditions. The implementation of Clean and Healthy Living Behavior (PHBS) plays an important role in preventing skin diseases and can be strengthened through pharmaceutical education. This study aimed to determine the relationship between PHBS knowledge based on pharmaceutical education and skin disease prevention behavior among Islamic boarding school students. This study employed an analytic observational design with a cross-sectional approach. A total of 31 students were included using a total sampling technique. Data were collected using structured questionnaires and analyzed using appropriate bivariate statistical tests. The results showed that most respondents had a high level of PHBS knowledge (61.29%) and good skin disease prevention behavior (58.06%). Bivariate analysis revealed a significant relationship between PHBS knowledge and skin disease prevention behavior (p < 0.05). This study concludes that PHBS knowledge based on pharmaceutical education is associated with skin disease prevention behavior among boarding school students. Continuous pharmaceutical education is recommended as a promotive and preventive strategy to improve students’ health in boarding school settings.

Dermatitis is a common skin disease that can be influenced by various internal and external factors. According to the Puskesmas Sungai Iyu report for 2023-2024, there were 180 cases of dermatitis. This study aims to analyze the factors associated with dermatitis symptoms among shrimp pond workers in Seneubok Aceh Village, Bendahara District, Aceh Tamiang Regency. The independent variables studied include contact duration, years of employment, personal hygiene, and the use of Personal Protective Equipment (PPE), while the dependent variable is dermatitis symptoms, including itching, redness, and rashes. The method used was a correlational analytic study with a cross-sectional design, involving 54 respondents from a total of 112 shrimp pond workers in the village as samples. The population in this study consists of all shrimp pond workers in Seneubok Aceh Village, Bendahara District, Aceh Tamiang Regency. The results show that there is no significant relationship between  the use of PPE (p-value = 0.047) and personal hygiene (p-value = 0.002) with dermatitis symptoms. In conclusion, factors associated with dermatitis symptoms in shrimp pond workers are personal hygiene, and the use of PPE. It is recommended that shrimp pond workers increase the use of PPE, practice good personal hygiene, and limit the duration of contact with pond water to reduce the risk of dermatitis.  

Background: Three-monthly injectable contraception is one of the most commonly used hormonal contraceptive methods due to its effectiveness, practicality, and high acceptance among women of reproductive age. However, its use is frequently associated with menstrual changes, particularly amenorrhea, which may affect user satisfaction and continuity of contraceptive use. Objective: This study aimed to analyze the relationship between the use of 3-monthly injectable contraception and the incidence of amenorrhea among women of reproductive age. Methods: This study employed a quantitative approach with an analytical observational design using a cross-sectional method. The study was conducted at a primary healthcare facility providing family planning services. A purposive sampling technique was applied to select respondents who met the inclusion criteria. Data were collected using a structured questionnaire and supported by a review of medical records. The Chi-square test was used to analyze the relationship between contraceptive use and the incidence of amenorrhea, with a significance level set at p < 0.05. Results: The results showed that more than half of the respondents experienced amenorrhea. Amenorrhea was more frequently observed among women who had used 3-monthly injectable contraception for more than one year. Statistical analysis revealed a significant relationship between the duration of 3-monthly injectable contraceptive use and the incidence of amenorrhea (p < 0.05). Conclusion: There is a significant relationship between the use of 3-monthly injectable contraception and the occurrence of amenorrhea. These findings emphasize the importance of providing comprehensive counseling regarding potential menstrual changes to improve contraceptive acceptance and continuity.

Postpartum depression is a mood disorder that occurs in mothers after childbirth, with symptoms that can appear from pregnancy until 4 weeks postpartum. This condition negatively impacts the psychological health of the mother and the development of the baby. This study aims to analyze factors associated with the risk of postpartum depression. The method used was quantitative with an analytical survey design through a cross-sectional approach. Data collection was carried out using the Edinburgh Postnatal Depression Scale (EPDS) questionnaire consisting of 10 questions. The results of the validity test showed a calculated r value of > 0.3610 and the reliability test obtained a Cronbach's alpha value of 0.67. The study sample consisted of 42 respondents selected using a total sampling technique, with inclusion criteria of mothers aged ≥18 years, in the period <6 weeks postpartum, and willing to be respondents. Data analysis used the chi-square test. The results showed that all variables had a significant relationship with the risk of postpartum depression (p < 0.05). These variables include age (p=0.040), education (p=0.018), occupation (p=0.011), history of depression (p=0.024), complications (p=0.017), economic status (p=0.048), parity (p=0.016), type of delivery (p=0.006), husband's support (p=0.000), and family support (p=0.028). Therefore, it can be concluded that demographic, obstetric, and social support factors play an important role in the risk of postpartum depression. These results are expected to form the basis for prevention efforts and early intervention to improve postpartum maternal mental health.

Gastritis is a common gastrointestinal disorder that is influenced by both behavioral and psychological factors, including dietary patterns and stress. This study aimed to examine the association between dietary patterns and stress levels among patients with gastritis at a primary healthcare center in West Halmahera Regency. A quantitative analytical study with a cross-sectional design was conducted in November 2025. A total of 60 gastritis patients were recruited using a total sampling technique. Data were collected using structured questionnaires to assess dietary patterns and stress levels. Statistical analysis was performed using SPSS version 26. Descriptive analysis was used to summarize respondents’ characteristics, while the Chi-square test or Fisher’s exact test was applied to analyze the association between variables. The results showed that most respondents had unhealthy dietary patterns and experienced high stress levels. Dietary pattern was significantly associated with stress level (p = 0.038), whereas demographic characteristics were not significantly related to stress level. Patients with unhealthy dietary patterns were more likely to experience high stress. In conclusion, dietary pattern is significantly associated with stress levels among gastritis patients. These findings highlight the importance of promoting healthy eating behaviors as part of stress management strategies in primary health care settings.

Bullying is a form of aggressive behavior commonly experienced by adolescents and has significant impacts on both physical and mental health. Schools, as primary social environments for teenagers, often become settings where bullying occurs. Several factors contribute to this behavior, particularly peer influence, family roles, and social media use. This study aimed to analyze factors related to bullying behavior among adolescents in a junior high school, including respondent characteristics, peer influence, family roles, and social media usage, as well as their relationships with bullying behavior. This research used a quantitative approach with a cross-sectional design involving 71 eighth-grade students as respondents. Data were collected using structured questionnaires and analyzed with the Chi-Square test. The results showed significant relationships between peer factors (p=0.003), family roles (p<0.001), and social media use (p=0.001) with bullying behavior. A large proportion of respondents reported high social media usage (45.1%) and low family involvement (45.1%), while more than half (53.5%) were categorized as being at risk of engaging in bullying behavior. These findings indicate that adolescents are strongly influenced by their social environment, both offline and online. Negative peer interactions and limited family supervision can increase the likelihood of bullying behavior. In conclusion, peer factors, family roles, and social media use are significantly associated with bullying among adolescents. Therefore, collaboration between families, schools, and communities is essential through psychosocial assessments, increased family involvement, and character education programs to prevent and reduce bullying behavior.

Since the coach is the absolute core element in the process of success in training and the sport-specific goals, this study has been conducted in order to develop a scale to assess the football coaches based on the perspectives of the players. Given the nature of the study, the researcher used the descriptive method significantly the survey approach. Football players were used as the study population. The sampling method was non-random and involved a total of 80 players, 20 in the pilot and 60 in the main study. It was designed based on the scientific rules of scale-building. It had various dimensions associated with some aspects of the coach's job. Content validity was ensured and test–retest method was employed to establish reliability. Faialdani and Aleem 2020. The objective of this study was to develop the scale for assessing the performance of football coaches and to determine its validity and reliability as well. Methods: The scale was handed out to886 football coaches who have either bachelor graduation degree or higher from 16 provinces in Iran, covering the entire country.

Electrolytes are essential minerals that play a critical role in various physiological processes within the body, including the maintenance of fluid balance, proper neuromuscular function, and the transmission of nerve impulses. They are vital for the stability of the heart and other crucial organs. When electrolyte levels become imbalanced, as seen in conditions such as hyponatremia (low sodium), hypernatremia (high sodium), hypokalemia (low potassium), hyperkalemia (high potassium), and hypocalcemia (low calcium), serious health issues can arise. These imbalances can result from factors like malnutrition, excessive losses through the kidneys or gastrointestinal tract, hormonal disorders, and certain systemic diseases. Understanding the underlying pathophysiological mechanisms and clinical manifestations of these disturbances is essential for effective diagnosis and treatment. Healthcare providers must identify the root causes of electrolyte imbalances while assessing their severity to implement appropriate management strategies. This often involves gradually correcting electrolyte levels to mitigate the risk of life-threatening complications such as arrhythmias, cerebral edema, and neurological impairment. By fostering a comprehensive understanding of electrolyte imbalances, healthcare professionals can improve diagnostic accuracy and therapeutic effectiveness, ultimately leading to better patient outcomes. This knowledge is crucial in minimizing morbidity and mortality associated with these disruptive conditions, ensuring that individuals receive prompt and effective care to restore balance and maintain overall health.

This study aims to evaluate the effectiveness of the Structural Analytic Synthetic (SAS) method in enhancing the early reading skills of first-grade students in Catholic Religious Education at SD YPPK Yohanes Paulus II Obaa, Mappi Regency, South Papua Province. The study employed a Classroom Action Research approach using a cyclical model comprising the stages of planning, implementation, observation, and reflection, conducted over two cycles. The research subjects consisted of 25 students, and data were collected through reading tests, classroom observations, and documentation. The results indicated a significant improvement in students’ early reading skills, with learning mastery increasing from 61% in the first cycle to 100% in the second cycle. This success was associated with the implementation of the SAS method through structured learning stages, progressing from sentences to words, syllables, and letters, accompanied by the use of varied media and intensive teacher guidance. In addition to improving reading skills, the SAS method was also found to enhance students’ interest, participation, and learning motivation. Therefore, the SAS method is recommended as an effective strategy for teaching early reading to young elementary school students, particularly within the context of Catholic Religious Education.

Work engagement is a crucial factor that supports organizational effectiveness, particularly within public institutions that bear significant responsibilities in delivering public services. This study aimed to examine the relationship between Perceived Organizational Support (POS) and Work Engagement among Civil Servants (Pegawai Negeri Sipil PNS) at the Medan Center for Drug and Food Control (Balai Besar Pengawas Obat dan Makanan BBPOM). A quantitative approach with a correlational research design was employed. The study population consisted of 127 civil servants, all of whom were included as research participants using a total sampling technique. Data were collected using the Survey of Perceived Organizational Support (SPOS) and the Utrecht Work Engagement Scale (UWES). Data analysis was conducted using the Pearson Product-Moment Correlation test. The findings revealed a positive and significant relationship between Perceived Organizational Support and Work Engagement (r = 0.266; p = 0.002). These results indicate that higher levels of perceived organizational support are associated with higher levels of employee work engagement. Descriptively, the majority of respondents reported high levels of POS (66.9%) and high levels of work engagement (73.2%). The findings suggest that organizational support manifested through fairness, concern for employee well-being, supervisory support, and recognition of employee contributions plays an important role in enhancing employees’ vigor, dedication, and involvement in their work. This study provides practical implications for BBPOM Medan to continuously strengthen organizational support as a strategic effort to improve employee work engagement and optimize the performance of civil servants.

College represents a critical transitional period requiring high adaptation, where students often face escalating academic demands triggering psychological pressure. This study aims to deeply analyze the reciprocal relationship between sleep patterns and academic stress levels, and identify their subsequent impacts on cognitive function (concentration) and students' physical health. This study employs a qualitative method with a Systematic Literature Review approach. Data were collected through comprehensive searches of accredited national and reputable international scientific articles published within the last five years (2020–2025). Literature selection was conducted rigorously using specific keywords to screen empirical studies relevant to stress, sleep, and student health variables. Data synthesis reveals a strong and consistent negative correlation. High levels of academic stress whether stemming from the adaptation phase of new students (initiation), thesis preparation workload, or role conflicts in working students are significantly associated with decreased sleep quality. Physiologically, stress triggers increased cortisol levels causing insomnia, shortened sleep duration, and prolonged sleep latency. Subsequent impacts are proven to drastically reduce learning concentration and trigger physical health disorders, including an increased risk of primary dysmenorrhea in female students. This study concludes that academic stress and sleep disturbances form a destructive cycle that exacerbates one another. Therefore, holistic institutional interventions in the form of sleep hygiene education and stress management training are needed to break this chain for the sake of student well-being and academic performance.

Stunting remains a major public health problem in Indonesia, particularly in Aceh Province. Family smoking behavior and adherence to exclusive breastfeeding are considered important determinants of child nutritional status. This study aimed to analyze the relationship between family smoking behavior and exclusive breastfeeding adherence with stunting among toddlers in Tuha Village, Trienggadeng District, Pidie Jaya Regency. This study used a quantitative cross-sectional design with a sample of 46 toddlers selected using simple random sampling. Data were collected through structured questionnaires and analyzed using univariate and bivariate analysis with logistic regression tests. The results showed that family smoking behavior was significantly associated with stunting (p = 0.002; OR = 0.12; 95% CI: 0.03–0.47). Meanwhile, exclusive breastfeeding adherence was not significantly associated with stunting (p = 0.940; OR = 0.94; 95% CI: 0.17–5.09). These findings indicate that exposure to cigarette smoke in the household is an important risk factor affecting child nutritional status. Strengthening family-based interventions, especially smoke-free home initiatives, is essential to reduce stunting prevalence.

Injuries represent a common health issue associated with physical activity in both recreational and competitive sports settings. Appropriate initial management is essential to prevent complications and to facilitate optimal recovery. This study aims to describe the management of minor sports injuries at the Surisina Primary Health Center based on observational findings Sports and structured interviews with healthcare professionals. The study employed direct observation and structured interviews involving physicians and nurses at Surisina Primary Health Center on November 24, 2025. The findings indicate that sports injury management at the primary healthcare level involves a systematic initial assessment, comprehensive physical examination, and the implementation of simple immobilization techniques tailored to the type and severity of injury. Common injuries treated include sprains, muscle cramps, contusions, lacerations, ankle injuries, and minor fractures. Despite limitations in the availability of immobilization equipment, healthcare services were delivered effectively, supported by adequate patient education on injury care, warning signs, and activity recommendations during recovery. This study demonstrates the critical role of primary health centers in providing initial sports injury management and serving as practical learning sites for students in physical education and health programs.  

Community service with the theme of Expired Date (ED) and Beyond Use Date (BUD) aims to improve knowledge and understanding of proper medication storage as an effort to enhance the health of the Gagak Sipat community. Knowledge about medication usage limits and checking product expiration dates educates the public to be more cautious and to avoid health risks that may arise from consuming products that have exceeded their usage period or have expired. The use of medicines beyond their ED and BUD indicates that the drugs may have experienced reduced stability related to storage conditions. Decreased stability of pharmaceutical preparations can affect their physical quality, which in turn impacts the effectiveness and safety of the medication. The educational method used in this program included lectures accompanied by the distribution of leaflets, followed by practical simulations on checking ED and calculating BUD for various dosage forms. The results of this educational activity showed that community members were able to determine the ED and BUD for several pharmaceutical preparations such as tablets, powders, capsules, syrups, eye drops, ear drops, and others. The community in Gagak Sipat village gained an understanding of the risks associated with using medications beyond the BUD, including reduced effectiveness, the risk of microbial contamination, and potentially harmful chemical reactions. It was emphasized that some medications that are expired or used beyond their BUD can pose more serious health risks, especially when used to treat severe diseases.

Antibiotics are one of the main pillars in the treatment of bacterial infections and have contributed significantly to increasing human life expectancy. However, long-term use of antibiotics has serious consequences for the balance of the body's microbiome, especially the gut microbiome which plays an important role in maintaining homeostasis through the regulation of the immune system, metabolism, and protection against pathogens. This literature review aims to comprehensively analyze the impact of long-term antibiotic use on the structure, diversity, and function of the human microbiome. The scientific articles reviewed were obtained from PubMed, Scopus, ScienceDirect, and Google Scholar databases, including empirical research, systematic review, and meta-analysis published in the last ten years. The results showed that prolonged exposure to antibiotics consistently decreased microbiota diversity, altered the composition of bacterial communities, and triggered dysbiosis, which is often persistent even when therapy is stopped. Dysbiosis is associated with impaired immune system function, increased systemic inflammation, risk of allergic and metabolic diseases, and potential disorders on the intestinal-brain axis. This impact is more pronounced in vulnerable groups such as neonates and children, especially when exposure occurs during a critical period of development. In conclusion, long-term antibiotic use has broad systemic implications, so a more rational, prudent, and sustainable use strategy is needed to maintain the health of the human microbiome.

Breakfast and sleep quality are important factors that can influence students’ concentration and academic achievement. This study aims to analyze the relationship between breakfast consumption levels and sleep quality with the learning achievement of students at SMP Negeri 31 Medan. This research used a quantitative method with a cross-sectional design. The study population consisted of all 192 eighth-grade students, with a sample of 88 respondents selected through simple random sampling. Breakfast intake was measured using a 3x24-hour food recall (breakfast time only), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, while learning achievement was obtained from semester exam scores in Indonesian Language and Mathematics subjects. Data analysis was carried out using the Chi-Square test with a significance level of 0.05. The results showed a significant relationship between breakfast intake and learning achievement in Indonesian Language (p=0.003) and Mathematics (p=0.000). Sleep quality was also proven to be associated with learning achievement in Indonesian Language (p=0.001) and Mathematics (p=0.000). The conclusion of this study is that having breakfast with adequate nutritional intake and maintaining good sleep quality contribute positively to improving students’ learning achievement.

The rapid growth of internet access and digital device usage in Indonesia has made gadgets an inseparable part of students’ daily lives. While smartphones facilitate communication and access to information, excessive use—particularly before bedtime—has been associated with poor sleep quality. This quantitative correlational study aimed to identify the relationship between gadget use before sleep and sleep quality among students of SMK Yapim Sibiru-biru. A total of 110 students were selected purposively and asked to complete a structured questionnaire measuring gadget use duration, activity type, use of “Night Mode,” and various aspects of sleep quality. Data were analyzed using descriptive and Pearson correlation tests at a 0.05 significance level. Results showed that 87.5% of students used gadgets before sleep, with smartphones being the most common device. The majority (46.88%) reported using gadgets for 1–2 hours before bed, primarily for social media and entertainment. Most respondents slept between 10:00 p.m. and midnight, with an average sleep duration of 4–6 hours, lower than the recommended 7–9 hours. Statistical analysis revealed a significant negative correlation between gadget use duration and sleep quality—longer use was associated with poorer sleep. Additionally, low awareness of blue light filtering features exacerbated sleep problems such as insomnia and fatigue. These findings highlight the importance of behavioral interventions and sleep hygiene education to mitigate the adverse effects of nighttime gadget use. Recommended strategies include limiting screen time one hour before sleep, enabling “Night Mode,” and engaging in relaxing pre-sleep activities to promote better sleep quality and overall well-being

This study examines the development of a Crude Palm Oil (CPO) price forecasting model using an artificial neural network algorithm, specifically the backpropagation algorithm. As one of Indonesia’s main export commodities, CPO has a significant economic impact and influences the income of oil palm farmers. The CPO price data used in this study were obtained from CIF Rotterdam, covering the period from January 2019 to December 2023. The research methodology consists of several stages, including data collection, preprocessing, model design, and model implementation using Python programming. The training results of the backpropagation algorithm show an error value of 0.537829578 after 1,000 epochs, while the evaluation using Mean Squared Error (MSE) indicates an MSE of 0.022709 during the training process and 0.017604 during the testing process. The model also produces CPO price predictions for the next three months, namely 932.578 for the first month, 949.568 for the second month, and 774.855 for the third month. These findings indicate that the developed model is capable of predicting future CPO prices with adequate accuracy, which can assist companies in making better financial decisions and managing risks associated with CPO price fluctuations.

Work fatigue is one of the occupational health problems that may affect productivity, concentration, and increase the risk of workplace accidents. Security officers at Ferry Mulia Raja Napitupulu Port, Balige, are at high risk of experiencing fatigue due to shift work systems, physical and mental workload, and poor sleep quality. This study aims to identify factors associated with work fatigue among security officers. A quantitative method with a cross-sectional design was applied. The sample consisted of 45 security officers selected using total sampling technique. Data were collected through questionnaires on individual characteristics, nutritional status, sleep quality, workload, and environmental temperature, and analyzed using bivariate tests. The results revealed significant relationships between age, nutritional status, sleep quality, workload, and temperature with work fatigue levels (p<0.05). It can be concluded that both individual and work environment factors contribute to fatigue among security officers. The study recommends that port management pay more attention to shift arrangements, rest patterns, and occupational health interventions to reduce fatigue risk and enhance officers’ productivity.