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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a widely used class of medications for managing pain and inflammation. However, long-term use of NSAIDs has been associated with an increased risk of gastrointestinal disorders, including Gastroesophageal Reflux Disease (GERD). This study aims to analyze the impact of NSAID use on GERD patients based on recent research findings. The literature search was conducted through national and international databases such as Elsevier, Google Scholar, and the National Institutes of Health (NIH) National Library of Medicine, using keywords including GERD, NSAID, LES (Lower Esophageal Sphincter), gastric acid, reflux, and regurgitation. A total of 25 journal articles published between 2016 and 2024 were used as data sources. The findings indicate that NSAIDs inhibiting cyclooxygenase-1 (COX-1) can reduce prostaglandin production, which plays a protective role in the gastric mucosa, thereby increasing the risk of irritation and acid reflux. Conversely, selective COX-2 NSAIDs have a lower risk of gastrointestinal side effects, making them a safer alternative for patients with chronic pain and inflammation. This study highlights the importance of selecting the appropriate type of NSAID and monitoring its long-term use to minimize the risk of gastrointestinal disorders, particularly in patients with a history of GERD. By considering these factors, it is hoped that complications related to NSAID use in patients with digestive issues can be reduced.

Bouquets have evolved from mere flower arrangements into a work of art that combines elements of aesthetics, creativity, and innovation. This study aims to examine bouquets as an art form by highlighting aesthetic elements, arrangement techniques, and their role in the creative industry. The method used in this study is descriptive qualitative with a literature study approach from various relevant journal references and articles. The results of the study indicate that bouquets not only have aesthetic value but also reflect artistic expression through the selection of colors, shape compositions, and various arrangement techniques. Innovations in making bouquets, such as the use of flannel, snacks, and recycled materials, are expanding the scope of bouquet art in the creative industry. In addition, bouquet art also contributes to the development of the community's economy through increasing business opportunities. Although bouquet art faces challenges such as market competition and fluctuations in raw material prices, its prospects remain promising with the development of technology and product personalization trends. Therefore, continuous innovation is needed so that bouquet art remains relevant and can continue to develop as part of the wider creative industry.

Mustofa Bakery is one of the businesses in Sukoharjo that operates in the food sector. The purpose of this study is to analyze product quality control using the Statistical Quality Control (SQC) method to reduce the number of damaged products and analyze the factors that cause product damage at Mustofa Bakery. The type of data used in this study is quantitative data. The data source used in this study is secondary data. Data collection methods by interview and observation. The data analysis technique used in this study uses the Statistical Quality Control (SQC) method. Based on the results of the research that has been done, it can be concluded that in March, April, and October it still exceeds the standard limit of production damage that has been set by Mustofa Bakery in Sukoharjo by 2%. The application of quality control with SQC can reduce the number of damaged products at Mustofa Bakery in Sukoharjo, proven to be true. The results of the Pareto Diagram of the types of damage that often occur are damage due to burning, 1,719 breads or 35.25%, damage due to inappropriate shape, namely 1,607 breads or 32.96%, and damage due to inappropriate texture as much as 1,550 breads or 31.79%. The results of the cause-and-effect diagram (fishbone) of the factors of product damage that occurred at Mustofa Bakery in Sukoharjo occurred due to machines, humans, methods, and raw materials.

MSMEs play a key role in the national economy, especially in increasing economic growth and creating new jobs. However, in the digital era, MSMEs face major problems, such as low levels of digital literacy, limited access to the internet, and fierce competition with large companies that have used technology before. This study examines the variables that influence the sustainability of MSMEs amidst digital challenges and finds methods that can be used so that MSMEs can survive and grow. The research method was carried out through surveys and direct interviews with MSME actors at Pasar Pagi Setia Budi, Medan, North Sumatra. The results of the study showed that most MSME actors did not utilize digital platforms for marketing and transactions, which resulted in decreased income. To increase competitiveness, MSMEs need to improve their digital knowledge, adopt online marketing strategies, and optimize the use of e-commerce and social media. Support from the government, financial institutions, and technology companies is also very important. In the increasingly competitive digital era, by implementing the right digitalization strategy, MSMEs can improve operational efficiency, expand market reach, and maintain the sustainability of their business.

Health risk stratification is crucial for preventive healthcare, yet existing models often rely on binary classification generalized disease prediction, neglecting personalized health indicators and graded risk levels. Many studies apply feature selection techniques like Relief and Univariate Selection without quantifying the weighted impact of features. To address these gaps, this study introduces a Big Data-driven Health Index (HI) framework using PySpark for scalable health risk stratification. The HI is computed as a weighted sum of health-related features using SHAP Analysis, XGBoost, Random Forest, and Correlation Analysis. PySpark enables efficient processing of large-scale health data, and individuals are classified into Low and High Risk. Optimal classification thresholds are determined using the Youden Index from the ROC curve to balance sensitivity and specificity. Personalized health recommendations are generated based on risk categories to guide preventive interventions. Performance evaluation reveals that Correlation Analysis achieves 100% precision and 98.90% recall, outperforming other methods. SHAP prioritizes recall but has low precision, while XGBoost and Random Forest improve precision but struggle with recall. By leveraging Big Data techniques with PySpark, this study enhances computational efficiency, scalability, and classification accuracy, addressing prior research limitations and providing a robust data-driven approach to personalized health monitoring.

Inclusive education in North Sumatra faces various challenges in efforts to achieve educational equality for all children, including children with special needs. This study aims to analyze the challenges and solutions applied in the implementation of inclusive education in the region. The results of the study indicate that the main challenges in inclusive education include limited facilities that support the needs of children with disabilities, the lack of teachers with special competencies, and minimal public understanding of the importance of inclusive education. Additionally, the limitations in resources and the lack of training for educators are also significant barriers to providing quality education for all children. However, several solutions have been implemented to address these issues. These solutions include improving teacher training to ensure educators have sufficient skills and knowledge in handling children with special needs, providing more supportive facilities and infrastructure such as disability-friendly classrooms, and efforts to socialize the importance of inclusive education to the community to reduce stigma against children with special needs. This study emphasizes that collaboration between the government, schools, and the community is essential to strengthen the implementation of inclusive education, in order to create a more inclusive and equitable learning environment for all children in North Sumatra.

Inclusive education in North Sumatra faces various challenges in efforts to achieve educational equality for all children, including children with special needs. This study aims to analyze the challenges and solutions applied in the implementation of inclusive education in the region. The results of the study indicate that the main challenges in inclusive education include limited facilities that support the needs of children with disabilities, the lack of teachers with special competencies, and minimal public understanding of the importance of inclusive education. Additionally, the limitations in resources and the lack of training for educators are also significant barriers to providing quality education for all children. However, several solutions have been implemented to address these issues. These solutions include improving teacher training to ensure educators have sufficient skills and knowledge in handling children with special needs, providing more supportive facilities and infrastructure such as disability-friendly classrooms, and efforts to socialize the importance of inclusive education to the community to reduce stigma against children with special needs. This study emphasizes that collaboration between the government, schools, and the community is essential to strengthen the implementation of inclusive education, in order to create a more inclusive and equitable learning environment for all children in North Sumatra.

This study analyzes the human development index, regional minimum wage, and labor force participation rate on poverty in North Sumatra in 2001-2023. The data used is secondary data in the form of time series obtained from the publication of the Central Bureau of Statistics. The analysis method used is multiple regression with E-Views software. The results showed that the human development index has no effect, the regional minimum wage has a negative effect and the labor force participation rate has a negative and significant effect on poverty, which indicates that an increase in the human development index tends to not affect poverty because it has a positive value. In contrast, the regional minimum wage and labor force participation rate show a negative and significant effect on poverty. Simultaneously, the human development index, regional minimum wage and labor force participation rate have a significant effect on poverty.

Micro, Small, and Medium Enterprises (MSMEs) play an important role in the Indonesian economy, contributing 61.07% to Gross Domestic Product (GDP) and absorbing 97% of the workforce. However, this sector still faces various challenges, both from internal factors such as limited capital, human resources, and access to technology, as well as external factors such as a less conducive business climate, inadequate infrastructure, and technological development. This study uses a qualitative method with a literature study approach to analyze the problems faced by MSMEs and find strategic solutions. The results of the study show that government support, optimization of access to financing, and utilization of digital technology are needed to increase the competitiveness of MSMEs so that they can continue to grow and make a greater contribution to national economic growth.

Micro, Small and Medium Enterprises are one of the most important pillars of the economy in Indonesia. MSMEs contribute significantly to Gross Domestic Product, employment, and regional development through income equality. This study attempts to obtain relevant answers regarding the strategic role of MSMEs in sustainable economic development in Indonesia, as well as the obstacles faced by this sector. Despite the government's role in sustainably encouraging MSMEs, this study shows that MSMEs still have difficulty accessing capital, government policies, and digitalization. This study uses a descriptive method to identify data that produces a good understanding of the factors that build the success of MSMEs. The results of the study show that the contribution of MSMEs to GDP is around 61.07%, employing 97% of the total number of jobs, namely MSMEs are quite important for the government and other stakeholders in supporting the role of MSMEs in inclusive and sustainable economic development.

Penelitian ini dilakukan untuk mengevaluasi asuhan kebidanan yang diberikan kepada Ny. "L" terkait kurangnya pengetahuan tentang jenis-jenis alat kontrasepsi di Desa Mantang, Kabupaten Lombok Tengah. Ny. "L" mengeluhkan pusing dan ketegangan pada leher yang disebabkan oleh gangguan sirkulasi darah, yang diduga merupakan efek samping penggunaan alat kontrasepsi. Selain itu, keterbatasan pengetahuan baik dari pasien maupun keluarganya mengenai jenis-jenis alat kontrasepsi turut menjadi faktor penyebab utama permasalahan ini. Penelitian ini menggunakan metode studi kasus dengan pendekatan deskriptif kualitatif. Data dikumpulkan melalui wawancara mendalam, observasi langsung, studi dokumentasi, dan pemeriksaan fisik. Hasil penelitian menunjukkan bahwa faktor lingkungan, sosial budaya, serta kondisi masyarakat sekitar turut memengaruhi tingkat pemahaman pasien terhadap alat kontrasepsi. Asuhan kebidanan yang diberikan meliputi edukasi mengenai berbagai jenis alat kontrasepsi, efek samping yang mungkin terjadi, serta cara mengatasi ketidaknyamanan akibat penggunaan kontrasepsi. Hasil evaluasi menunjukkan adanya peningkatan pemahaman Ny. "L" dan keluarganya mengenai alat kontrasepsi, serta berkurangnya keluhan fisik setelah diberikan edukasi dan pendampingan dalam pemilihan metode kontrasepsi yang lebih sesuai. Kesimpulan dari penelitian ini adalah bahwa edukasi mengenai alat kontrasepsi sangat penting untuk meningkatkan kesadaran dan pemahaman ibu serta keluarganya dalam memilih metode yang tepat. Pendekatan berbasis komunitas dalam pemberian asuhan kebidanan dapat membantu mengurangi efek samping penggunaan alat kontrasepsi serta meningkatkan kualitas kesehatan reproduksi ibu.

Masa nifas merupakan periode krusial bagi ibu pasca melahirkan, di mana komplikasi seperti abses payudara dapat terjadi akibat infeksi bakteri, teknik menyusui yang tidak tepat, atau perawatan payudara yang kurang optimal. Jika tidak ditangani dengan baik, abses payudara dapat menyebabkan nyeri hebat, demam, gangguan pemberian ASI, serta komplikasi serius yang memerlukan tindakan medis lanjutan. Tujuan: Penelitian ini bertujuan untuk menganalisis asuhan kebidanan komunitas dalam menangani abses payudara pada ibu nifas dengan pendekatan yang komprehensif di Dusun Mantang, Desa Mantang, Kecamatan Batukliang, Kabupaten Lombok Tengah. Penelitian ini menggunakan metode studi kasus dengan pendekatan deskriptif kualitatif. Subjek penelitian adalah Ny. "N" sebagai ibu nifas dengan abses payudara dan keluarga binaannya. Data dikumpulkan melalui wawancara mendalam, observasi langsung, studi dokumentasi, serta pemeriksaan fisik. Analisis data dilakukan secara kualitatif dengan pendekatan deskriptif melalui reduksi data, penyajian data, dan penarikan kesimpulan. Asuhan kebidanan komunitas yang diberikan meliputi edukasi mengenai perawatan payudara, teknik menyusui yang benar, serta tindakan klinis dalam penanganan abses payudara. Evaluasi menunjukkan adanya perbaikan signifikan pada kondisi Ny. "N", ditandai dengan berkurangnya nyeri, penyembuhan luka, serta peningkatan produksi ASI. Selain itu, pemahaman keluarga mengenai perawatan ibu nifas juga meningkat, yang berdampak positif pada dukungan terhadap proses pemulihan. Asuhan kebidanan komunitas berperan penting dalam menangani abses payudara pada ibu nifas dengan pendekatan yang sistematis dan holistik. Intervensi yang tepat tidak hanya mempercepat pemulihan ibu, tetapi juga meningkatkan kesadaran keluarga tentang pentingnya perawatan payudara dan pencegahan komplikasi. Oleh karena itu, pendekatan komunitas perlu terus dikembangkan dalam praktik kebidanan untuk meningkatkan kualitas kesehatan ibu dan bayi.

Green tea (Camellia sinensis) belongs to the genus Camellia from the Theaceae family. This plant has been used as traditional medicine for generations and is known to have various pharmacological activities. The purpose of this review is to discuss the benefits of green tea in reducing the risk of obesity by reviewing its botanical characteristics, phytochemical content, use and bioactivity to treat obesity obtained and compiled from literature searches through search engines such as Google Scholar, Science Direct, and PubMed. then discussed narratively. The results obtained indicate that green tea extracts and drinks can reportedly help increase the body's metabolism, which contributes to the reduction of body fat. Many studies report that this plant contains phytochemical compounds such as flavonoids, alkaloids, steroids, triterpenoids and carbohydrates. Epigallocationchin-3-gallate, L-theanine, and caffeine, which are respectively classified as flavonoids, amino acids, and alkaloids, are considered responsible for their pharmacological activity in treating obesity. EGCG has a hypocholesterolemic effect and suppresses cholesterol absorption in the intestine, L-theanine itself has physiological effects such as relaxation activities, and caffeine is useful in reducing food intake and has a thermogenic effect which can encourage weight loss.

Nikah siri is a marriage conducted without official state registration, resulting in significant legal implications for women and children. Religiously, this type of marriage is considered valid; however, from the perspective of state law, the lack of official registration causes women to lose their rights as wives, such as financial support, inheritance rights, and legal protection within the household. Additionally, women in nikah siri marriages do not have a strong legal basis to file for divorce or claim their rights in court. Meanwhile, children born from nikah siri marriages only have a civil relationship with their mother, making it difficult for them to obtain a birth certificate that includes their father's name, inheritances, and rights to care and education from their father. This study aims to analyze the impact of nikah siri on women's and children's rights from a legal perspective and examine the role of itsbat nikah as a legal instrument in providing certainty and protection for affected women and children. This research employs a literature study method with content analysis of various legal texts and related regulations. The findings indicate that the absence of official registration for nikah siri leads to legal uncertainty, resulting in the loss of various rights for women and children. Itsbat nikah serves as a crucial solution to provide legal recognition and protection for those affected. Therefore, official marriage registration is essential to prevent various legal issues that could harm women and children within Indonesia’s legal system.

Online gambling has emerged as a significant cause of divorce in modern society. This study aims to analyze the impact of online gambling addiction on marital relationships. Using qualitative methods, data were collected through interviews with couples who experienced divorce due to online gambling. The findings indicate that online gambling leads to significant financial problems, loss of trust, and prolonged emotional conflicts. This research highlights the importance of raising awareness about the risks of online gambling and the need for support for affected individuals. Thus, this study provides insights into how online gambling can undermine family structure and interpersonal relationships.

The Independent Curriculum provides thinking in learning, allowing teachers to adjust the material to the needs of students. However, challenges such as limited resources, teacher readiness, and variations in student learning styles are still challenges in its implementation (Kemendikbud, 2022). This study aims to examine the implementation of adaptive learning modules as a solution to improve learning effectiveness. Adaptive modules that integrate technology and personalization of teaching materials are expected to improve students' understanding in a way that is more appropriate to their individual needs (Mayer, 2009). The approach used in this study includes literature studies and field observations, which show that adaptive modules can significantly improve student learning outcomes. However, the implementation of this adaptive learning module still requires support in the form of adequate teacher training and supporting technological infrastructure so that learning can run effectively and efficiently (Batubara, 2019). This study provides recommendations to strengthen teacher readiness and provide the resources needed in the implementation of adaptive modules.

This study will analyze how the implementation of teacher assessment methods for students in the competency-based curriculum (KBK) with a focus on implementation at the primary school level. This study, using a literature review method using a qualitative approach, examined various literature sources from 2019-2023 to identify the characteristics, challenges, and strategies to improve the KBK assessment method. The results showed that the KBK uses extensive and authentic reviews to highlight students' skill attainment, both individually and classically. The main challenges to implementation include teacher time limits, difficulties in determining indicators and defining criteria, lack of training, and differences in student characters. Recommended improvement strategies are to enhance teachers' skills through continuous training, development of standardized assessment instruments, use of technology in the assessment process, and collaboration among stakeholders. This study provides a comprehensive overview of KBK assessment practices and solutions to optimize implementation in schools.

Merdeka Curriculum was created as an effort to increase learning flexibility by tailoring learning materials to the unique needs and characters of each student.  However, there are several obstacles that must be overcome before this curriculum can be implemented at the elementary school level, especially in terms of making learning modules.  The purpose of this study is to find out the challenges that teachers face when creating lesson plans based on Merdeka Curriculum and the solutions that can be done.  The research methodology used is a qualitative study by conducting a literature study.  Based on the findings, the main challenges faced are the teachers' lack of understanding of project-based learning methods, differences in the structure of learning plans, lack of resources, and heavy administrative burdens. Merdeka Mengajar platform, continuous training, and reducing teachers' administrative burden are suggested solutions.  This approach is expected to help teachers to create more creative and innovative teaching modules that are in line with Merdeka Curriculum principles.

Laparotomi is a surgical procedure in which the abdominal wall layer is operated on to remove the part that is experiencing problems. One of the problems that can occur in post laparotomy patients is pain. Pain is a person's emotional experience due to tissue damage that occurs after surgery. Laparotomy postoperative pain management must include all aspects, both in pharmacological and non-pharmacological aspects because pain is not only influenced by surgical wounds but also influenced by emotions. One of the non-pharmacological treatments that can be given to laparotomy postoperative patients is early mobilization. The purpose of this study was to determine the effect of early mobilization on reducing pain intensity in postoperative laparotomy patients at Cengkareng Hospital, Belimbing Room in 2024. This research design is a quantitative study with a quasi experimental method using a one group pre-post test design approach, the sample technique uses total sampling, the samples in this study were 20 intervention group samples, the results of statistical tests with the Wilcoxon Signed Ranks Test obtained the results of the p value = 0.001 or <0.05 there is a difference between the pain scale before and after early mobilization. So it can be concluded that there is an effect of early mobilization on reducing pain intensity in patients post laparotomy surgery  

This study explores the relationship between teacher professionalism and student learning outcomes in Civic Education at SMP Muhammadiyah 1 Medan. It focuses on how teacher participation, teaching activities, and challenges influence the learning process. A qualitative descriptive approach was used, with data collected through interviews and surveys. The findings reveal that teachers' professional competencies, particularly in lesson planning, the use of varied teaching media, and providing remediation, significantly improved students' knowledge acquisition. Despite challenges such as curriculum changes and limited resources, teachers like Ibu Monalisa Tarigan, S.Pd actively engage in professional development programs to enhance their teaching effectiveness. The study highlights the importance of teacher preparation, creativity, and individualized attention in creating a productive learning environment. It concludes that teacher professionalism has a positive impact on both cognitive and creative student outcomes.