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Indonesian fashion SMEs have significant export opportunities, but their export performance remains suboptimal as not all businesses are able to convert innovation, digitalisation, and market orientation into tangible international competitiveness. This study aims to analyse the determinants of Indonesian fashion SMEs’ export performance from the perspectives of the Resource-Based View and Internationalisation Theory. The study employs an explanatory quantitative approach using a cross-sectional survey design involving 200 owners or key managers of fashion SMEs in East Java, selected through purposive sampling. Data were analysed using SEM-PLS. Simulation results indicate that internal capabilities, international market orientation, and access to international networks have a positive influence on competitive advantage, whilst competitive advantage has a positive influence on export performance. Internal capabilities and access to international networks also demonstrate a significant direct influence on export performance, whilst international market orientation is not directly significant but operates through competitive advantage. The implication is that strategies to boost fashion SME exports should focus on strengthening innovation, quality, brand differentiation, and international market networks, rather than merely on symbolic digital adoption.  

The internationalisation of SMEs in the era of the global economy is still faced with low strategic readiness, limited innovation capacity, and sub-optimal digital transformation. This study aims to test a model of SME internationalisation strategy based on innovation and digital transformation. The study employs a quantitative approach using a cross-sectional survey design involving 200 owners or key managers of SMEs in East Java, selected through purposive sampling. Data were analysed using SEM-PLS through measurement model evaluation, structural model evaluation, and bootstrapping tests. The results indicate that innovation has a positive effect on digital transformation and internationalisation strategy, whilst digital transformation has a positive effect on internationalisation strategy. The indirect effect of innovation on internationalisation strategy via digital transformation is also significant, indicating partial mediation. These findings confirm that the internationalisation of SMEs becomes more effective when innovation and digital transformation are coherently integrated into business models and external market orientation. Implicitly, strengthening the global competitiveness of SMEs requires simultaneous intervention in business model renewal, digital capabilities, and policy ecosystem support.

The international competitiveness of Indonesian fashion SMEs still faces challenges, despite the sector having a large business base, strong export opportunities, and increasingly widespread access to digital technology. In this context, product innovation and digital capabilities are viewed as strategic resources that can strengthen SMEs’ ability to adapt and compete in broader markets. This study aims to analyse the influence of product innovation and digital capabilities on the international competitiveness of Indonesian fashion SMEs. The research employs an explanatory quantitative approach with a cross-sectional survey design. The sample consists of 200 owners or key managers of SMEs in East Java, selected via purposive sampling. Data were collected using a structured questionnaire and analysed using SEM-PLS. The results indicate that product innovation and digital capabilities have a positive and significant effect on international competitiveness, with digital capabilities acting as the dominant predictor. The implication is that efforts to strengthen the international competitiveness of fashion SMEs should be directed towards the integration of market-based innovation and strategic digital transformation.

Global business environmental uncertainty, triggered by "Black Swan" phenomena, demands that organizations transform beyond passive resilience toward anti-fragility capabilities, where Human Resource (HR) systems actually grow stronger through market disruptions. This study aims to analyze the concept of anti-fragility within organizational leadership, explain the role of transformational leadership in shaping anti-fragile employees, and identify organizational strategies for navigating market uncertainty. The approach employed is a narrative literature review using content analysis techniques across various reputable scientific journals, anti-fragility theory, and organizational case studies such as Disney+, Zoom, and Tractor Supply. Research findings indicate that transformational leadership acts as a primary catalyst that builds anti-fragility through intellectual stimulation, decentralized autonomy, and the creation of a culture that learns from failure. Organizational strategies prioritizing resource flexibility, cross-skilling, and optionality have proven effective in converting crisis stressors into opportunities for innovation and performance growth. The contribution of this article lies in the development of an "Anti-Fragile Leadership" conceptual framework that integrates the philosophical principles of anti-fragility into strategic HRM practices. The practical implications provide a guide for organizational leaders to design work systems that are adaptive and proactive toward market volatility, ensuring that organizations not only survive but thrive from chaos.

Strategic management plays a crucial role in ensuring the operational sustainability and competitiveness of PT Karya Giri Palma, a manufacturing company specializing in springbed and furniture production. In an increasingly competitive market environment and amid ongoing production challenges, the company is required to implement well-structured and adaptive strategic management practices. This study employs a qualitative research approach to explore the implementation of strategic management within the organization and to identify obstacles that arise during its integration into daily operational activities. Data were collected through in-depth observations and interviews to obtain a comprehensive understanding of managerial practices and employee involvement. The findings reveal that the active participation of both management and employees in the formulation and implementation of strategies significantly contributes to improved employee motivation, higher productivity levels, and enhanced work quality. Strategic alignment between organizational goals and employee roles encourages a stronger sense of responsibility and commitment among employees. However, several challenges remain, particularly in cross-divisional coordination and the consistent execution of strategies at the operational level. Therefore, this study recommends strengthening interdepartmental communication, optimizing the use of management information systems, and enhancing human resource capabilities through continuous training. These findings may serve as a valuable reference for similar manufacturing companies seeking to optimize strategic management practices in order to achieve sustainable performance and long-term competitiveness.

Increasingly digitalised and globally integrated market competition demands that micro, small and medium-sized enterprises (MSMEs) no longer merely excel in local markets, but are also capable of building sustainable competitiveness in broader markets. Recent literature indicates that innovation, digital capabilities, and international networks are increasingly viewed as strategic determinants of MSME competitiveness, although the relationships between these variables are often examined in isolation and are not always consistent. This study aims to analyse the influence of innovation, digital capabilities, and international networks on the global competitiveness of MSMEs. The research employs an explanatory quantitative approach with a cross-sectional design. The sample consists of 200 owners or principal managers of SMEs in East Java, selected using purposive sampling. Data were collected via a structured questionnaire and analysed using Structural Equation Modelling–Partial Least Squares (SEM-PLS). The results of the analysis indicate that innovation, digital capabilities, and international networks have a positive and significant influence on the global competitiveness of SMEs. The path coefficient values indicate that digital capabilities are the strongest predictor, followed by international networks and innovation. These findings confirm that strengthening the global competitiveness of MSMEs requires an integrated strategy that links value renewal, digital transformation, and the sustainable development of external networks.

Baby blues syndrome can have negative implications both in the short and long term, this has the potential to cause a tendency for passive attitudes in pregnant women, and result in neglect of the baby's needs, including a lack of attention and touch from the mother. This study aims to analyze the relationship between the contribution of husbands and the role of health workers with the level of understanding of pregnant women regarding Baby blues syndrome at the Lueng Bata Community Health Center, Banda Aceh. The study applied an analytical method with a cross-sectional approach, and involved all 73 pregnant women registered at the study location, with a total sampling technique. The data collection tool used was a questionnaire. The study took place from May 3 to 25, 2025. Based on the findings, there was a significant relationship between husband's support and pregnant women's knowledge regarding Baby blues syndrome (p = 0.001), and a significant relationship was also identified between the role of health workers on pregnant women's knowledge regarding the condition (p = 0.003). From the results obtained, it can be concluded that husband's support and the involvement of health workers mutually contribute to increasing pregnant women's understanding regarding Baby blues syndrome in the service area of ​​the Lueng Bata Community Health Center. It is recommended that health workers be more proactive in providing education and counseling regarding this syndrome so that pregnant women's knowledge regarding Baby blues syndrome can be maximized.

Patient safety is a top priority in healthcare services in hospitals. One of the critical elements is the accuracy of patient identification to prevent incidents such as procedural errors or medication administration. The purpose of this study was to determine the relationship between nurses' compliance in implementing SBAR communication with the accuracy of patient identification at Hospital X, West Jakarta. This study is a quantitative analytical study. The research design used was a cross-sectional study. The population in this study were nurses working at Hospital X, West Jakarta with a sample of 50 respondents taken using the total sampling technique. The data collection technique used an instrument in the form of an observation sheet for SBAR compliance and patient identification accuracy. Data analysis used the Chi-Square statistical test method. Based on the results of the study, it was found that most nurses were not compliant in implementing SBAR communication, namely 27 people (54%) and the majority were not accurate in identifying patients, namely 30 people (60%). The results of the statistical test showed a p value = 0.000 (p <0.05), which means there is a significant relationship between nurses' compliance in implementing SBAR communication with the accuracy of patient identification at Hospital X, West Jakarta. This study indicates that the better nurses' adherence to SBAR communication, the better the accuracy of patient identification. Hospitals are recommended to increase routine supervision and ongoing training to strengthen a culture of patient safety through effective communication.  

In addition to being programmatically successful in lowering TFR and slowing population growth rates, the Long-Term Contraceptive technique (MKJP) is an affordable technique of preventing conception. This study's objective was to examine variables associated with long-term contraceptive (MKJP) selection at the Gandasuli Community Health Center. The study design is cross-sectional and the research methodology is quantitative. The investigation was carried out in the workspace of the Gandasuli Community Health Center. 300 women of reproductive age made up the study's population, and a straightforward random selection procedure was used to choose 45 participants. A questionnaire was used to gather the data, which were then subjected to univariate and bivariate analysis using the Chi-Square statistical test. Age and MKJP choice did not correlate, according to the data (p- value = 0.09 > 0.05). The choice of MKJP was correlated with education (p-value = 0.003 < 0.05). The choice of MKJP was correlated with occupation (p-value = 0.003 < 0.05). The choice of MKJP and the husband's support are related, with a p value of 0.004 < 0.05. Parity and MKJP selection are related, with a p value of 0.003 < 0.05. Knowledge and MKJP selection are related, with a p-value of 0.003 < 0.05.

The dimensions of healthcare service quality are a concept for measuring service quality. This study aims to determine the effect of the dimensions of healthcare service quality on the satisfaction of inpatients at Cut Nyak Dhien General Hospital in Langsa City. This study uses a quantitative design of the Survey Analytic type with a cross-sectional approach. The population consisted of 121 inpatients with a sample size of 55 respondents using purposive sampling technique. Analysis used multiple logistic regression test (α=0.05). The research results show that there is an influence between Responsiveness p<0.042 with an EXP (B) value of 11.361, Assurance p<0.008 with an EXP (B) value of 20.163, Empathy p<0.018 with an EXP (B) value of 13.547, Reliability p<0.033 with an EXP (B) value of 6.896 on inpatient patient satisfaction (p<0.05), while the Tangible variable shows no influence with p<0.088 and an EXP (B) value of 4.967. Among these variables, the one that significantly affects inpatient patient satisfaction is the Assurance variable with p<0.008 and an EXP (B) value of 20.163. It is recommended to continuously improve the quality of service comprehensively in every dimension of service quality, strengthen the competence and professionalism of healthcare personnel, enhance the speed and accuracy of service, and build good communication to improve the quality of inpatient services and maintain patient trust in the hospital.  

The implementation of Clean and Healthy Living Behavior (PHBS) begins at an early age, particularly among school children, who learn extensively from their surrounding environment through the School Health Program (UKS). Although the family is the primary unit in shaping PHBS habits, parents’ busy schedules often lead children to interact more with teachers and peers at school. This study aims to determine the effectiveness of the UKS program on students’ PHBS at SD Lambaro Angan, Darussalam District, Aceh Besar Regency in 2024. This research employed a cross-sectional design with a population of 321 students and a sample of 76 respondents. Data collection was conducted on March 4, 2024. The results indicate that the UKS program has a significant effect on students’ PHBS, including habits such as washing hands with running water and soap, purchasing healthy snacks at the school canteen, disposing of waste properly, participating in physical exercise, not smoking at school, eliminating mosquito larvae, and using school sanitation facilities (p < 0.05). However, no significant effect was found on activities such as weighing body weight and measuring height. In conclusion, the UKS program is effective in improving students’ PHBS. These findings are expected to provide input for schools to optimize the implementation of UKS and enhance PHBS promotion so that students can apply clean and healthy living behaviors in their daily lives.

Pulmonary Tuberculosis (TB) is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis through droplets from patients diagnosed with TB. Based on the Global TB Report 2024, WHO reported that Indonesia ranks second in the world, where 81% of cases were confirmed and 90% of them had received treatment, where there was an increase in the number of cases compared to 2023 with 77% of confirmed cases and 88% of them received treatment. The increase in the number of pulmonary TB cases is inseparable from factors that determine the transmission of M. tb such as the concentration of organisms in the air related to ventilation and the length of time a person inhales contaminated air. To determine the relationship between ventilation conditions and home lighting to the incidence of pulmonary TB in the working area of ​​the Glugur Darat Health Center in 2025 This study is an analytical study with a cross-sectional study design. Sample selection used the consecutive sampling method with 56 patients who met the inclusion criteria. Of the 56 people who met the criteria, 30 people (53.6%) were pulmonary TB sufferers and 26 people (46.4%) were not pulmonary TB sufferers. The majority of respondents were male (38 people) and the highest number was found in the 18-59 age range (48 people) (85.7%). Regarding ventilation conditions, 34 people (60.7%) did not meet adequate ventilation requirements, and 29 homes (51.8%) did not meet adequate lighting requirements. There was a relationship between ventilation conditions and the incidence of pulmonary tuberculosis in the Glugur Darat Community Health Center work area, but there was no relationship between home lighting and the incidence of pulmonary tuberculosis in the Glugur Darat Community Health Center work area.

Gout arthritis is a disease characterized by sudden inflammation of the joints due to high levels of uric acid in the body (hyperuricemia). This condition is marked by acute episodes of joint inflammation, often affecting a single joint and preceded by asymptomatic periods of varying duration. Older adults represent the final stage in the human lifespan and experience the natural aging process. This study employed an analytic survey design with a cross-sectional approach. The purpose of this study was to determine the relationship between gout arthritis pain and the level of independence in activities of daily living among patients at the Helvetia Public Health Center. The results showed that the majority of older adults in the working area of UPT Puskesmas Helvetia experienced high levels of pain, with 73 respondents reporting severe pain. Meanwhile, most respondents demonstrated independence in their daily activities, with 72 categorized as independent. The findings indicate a significant relationship between gout arthritis and the level of independence in activities of daily living among older patients at the Helvetia Public Health Center.

Verbal sexual harassment among adolescents is a form of non-physical violence that is often overlooked, yet it has significant impacts on psychological health and social development. Parenting style is suspected to be one of the factors influencing adolescents' vulnerability to verbal sexual harassment. This study aims to examine the relationship between parenting styles and the occurrence of verbal sexual harassment among adolescents at SMKN Widang. This study employed a quantitative design with a cross-sectional approach. The sample consisted of 166 participants selected using a simple random sampling technique. Data were collected using questionnaires on parenting styles and verbal sexual harassment. Data analysis was conducted using the Contingency Coefficient test with a significance level of 0.05. The results showed that the majority of respondents experienced democratic parenting (70.5%). The incidence of verbal sexual harassment was most frequently reported in the “often” category (43.4%) and “sometimes” category (42.2%). Statistical analysis yielded a p-value of 0.001 (p < 0.05), indicating a significant relationship between parenting styles and the occurrence of verbal sexual harassment. Permissive parenting was associated with a relatively higher risk. Therefore, the implementation of democratic parenting and open communication is recommended as preventive efforts.

This study aimed to analyze the effect of infant massage on growth and development among infants attending Puskesmas Bongo II. Infant massage is recognized as a form of sensory stimulation that enhances neural function, improves blood circulation, and strengthens maternal–infant bonding, thereby potentially supporting optimal physical growth and developmental progress. This research employed an analytic cross-sectional design involving infants aged 0–12 months, with a total sample of 50 infants selected using purposive sampling based on predefined inclusion criteria. Information regarding infant massage practices was collected through structured maternal interviews and categorized into routine massage (≥3 times per week) and non-routine massage. Infant growth was assessed using the weight-for-age (W/A) indicator based on WHO growth standards, while development was measured using the Developmental Pre-Screening Questionnaire (KPSP). Data were analyzed using the chi-square test with a 95% confidence level (p < 0.05). The results showed that infants who received routine massage demonstrated significantly better growth status and developmental outcomes compared to those who did not receive massage routinely. These findings suggest that infant massage is a simple, safe, and practical intervention that can be recommended to support growth and development and may be integrated into maternal and child health services at Puskesmas Bongo II.

The management of expired medications in community health centers (Puskesmas) is crucial because it directly relates to the quality of healthcare services, patient safety, and environmental impact. Medications that have passed their expiration date no longer guarantee effectiveness and safety, and therefore require proper handling in accordance with applicable regulations. Furthermore, improper management can lead to waste and the risk of misuse. This study was conducted to describe the expired medication management system in community health centers (Puskesmas) in Pemalang Regency, specifically regarding separation, recording, reporting, and destruction. This study used a descriptive method with a cross-sectional approach to describe the conditions in the field. The data used were primary data obtained through direct observation and interviews with pharmacists at the community health centers. Sampling was conducted using purposive sampling at five community health centers: Losari, Purwoharjo, Sarwodadi, Rowosari, and Kebandaran. The instrument used was an observation sheet as an interview guide, while the collected data was analyzed descriptively to provide an overview of the implementation of expired medication management. The study results indicate that all community health centers (Puskesmas) have properly separated, recorded, and reported expired medications in accordance with regulations. Overall, the management of expired drugs in health centers in the Pemalang Regency area has been running well and in accordance with the guidelines of the Indonesian Food and Drug Supervisory Agency (BPOM) Regulation Number 20 of 2025 concerning Good Distribution Practices for Medicines (CDOB), reaching 100%.

Anxiety during the third trimester of pregnancy is a prevalent perinatal mental health issue that can adversely affect maternal well-being and preparedness for labor. Psychosocial factors, particularly partner support, are recognized as important in alleviating anxiety; however, empirical evidence at the primary healthcare level in Indonesia is still limited. This study aimed to analyze the relationship between partner support and anxiety levels among third-trimester pregnant women receiving care at the Momalia Community Health Centre. A quantitative analytical approach with a cross-sectional design was employed. The study involved 60 third-trimester pregnant women selected through total sampling. Partner support was assessed using a structured social support questionnaire, while maternal anxiety was measured using a standardized, valid, and reliable instrument. Data analysis included descriptive and inferential statistics, with the relationship between variables tested using the Chi-square test at a significance level of 0.05. The results revealed a statistically significant association between partner support and maternal anxiety (p < 0.05). Women who reported higher levels of partner support tended to experience lower anxiety, whereas those with inadequate support showed higher levels of moderate to severe anxiety. In conclusion, partner support serves as a protective factor against anxiety during late pregnancy. Integrating husbands’ involvement into antenatal care programs is essential to enhance maternal mental health outcomes.

Occupational accidents are unexpected events. Incident of occupational accident often happened to health officer especially nurse. Therefore, it is necessary efforts to foster the implementation of occupational safety and health (OHS) in order to avoid occupational accident. The aim of this research is to analyze the effect of implementation occupational health and safety (OHS) (knowledge, attitude, training, promotion and supervision) of the incidence of occupational accidents for nurses at Hospital X in 2025.The research is quantitative analytic survey research using Cross-sectional Analitics. The Population is all nurses from Outpatient room and  Inpatient room at Hospital X. Its amounted to 164 people, using technique of total population. Data analysis with univariate analysis, bivariate analysis with chi square test, multivariate analysis with multiple logistic regression test. The results of the reaserch showed that effect occupational accidents are attitude p value 0,001, training p value 0,001, promotion p value 0,001 and the confounding is a knowledge variable to training variable. The conlusion of the research is to make the implementation of occupational health and safety become the most important for nurse. Recommended to the Hospital X along with occupational health and safety committee to improve the knowledge of nurses on occupational health and safety through socialization, training, and internal meeting of the periodic.  

College students are often busy completing their assignments. They frequently experience sleep problems that can distort their studies. One of the factors that affects sleep quality is sleep hygiene. Poor sleep hygiene can worsen sleep quality. This study aims to determine the correlation between sleep hygiene and sleep quality among students of the Diploma III Nursing Program at Universitas Abulyatama. This study employs a quantitative correlational-descriptive design applying a cross-sectional approach. The population consisted of 556 students, while the sample was 85 students selected using proportional random sampling. The Sleep Hygiene Index (SHI), with a Cronbach's Alpha of 0.66, measured sleep hygiene. The Pittsburgh Sleep Quality Index (PSQI), with a Cronbach's Alpha of 0.83 of sleep quality. The study took place at Universitas Abulyatama from June 4th to July 3rd, 2025. Bivariate analysis using the chi-square test indicates a significant correlation between sleep hygiene and sleep quality, with a p-value of 0.000 (p ≤ 0.05). The findings reveal that a total of 69.4% of students had good sleep hygiene, and 41.2% had good sleep quality. The results prove that proper sleep hygiene leads to improved sleep quality. Therefore, students should enhance their knowledge on sleep hygiene, as poor sleep hygiene can lead to poor sleep quality.

Menstrual cycle irregularities are a prevalent reproductive health issue among adolescent girls, often linked to dietary imbalances that contribute to hormonal disruption and nutrient deficiencies. This study aimed to analyze the relationship between dietary patterns and menstrual cycles among female students at Ambassador High School. A cross-sectional design was employed with stratified random sampling, involving 30 female students. Data were collected using structured questionnaires covering dietary patterns (frequency, food types, nutritional intake, and eating habits) and menstrual cycle characteristics (regularity, duration, and complaints). The Chi-Square test was used to assess associations between variables at a significance level of p < 0.05. Results indicated that 56.7% of respondents had unbalanced diets characterized by high fast-food consumption, low fruit and vegetable intake, and frequent meal skipping. Menstrual cycle irregularities were reported in 60% of respondents. Statistical analysis revealed a Chi-Square value of 4.420 with a p-value of 0.035, confirming a significant relationship between diet and menstrual cycle. Cross-tabulation showed that 76.5% of students with unbalanced diets experienced irregular cycles compared to 38.5% with balanced diets. These findings highlight the importance of nutrition education and healthy food provision in schools to support adolescent reproductive health.