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Hypertension has become a chronic disease known as the silent killer because it often does not show symptoms but can cause serious complications such as stroke, heart disease, and kidney failure. According to WHO, hypertension is one of the leading causes of death worldwide and its prevalence continues to rise. Sleep disturbances can increase sympathetic nervous system activity and stress hormones, which impact blood pressure elevation. Depression is characterized by prolonged feelings of sadness, loss of interest, and decreased energy. Physiologically, depression can increase stress hormones and cause autonomic nervous system imbalance, leading to elevated blood pressure. To determine the relationship between sleep pattern disturbances and depression levels with blood pressure in hypertensive patients in the outpatient department of RS Permata Medika Semarang. Quantitative research with a correlational design using a cross-sectional approach. The sampling technique used was consecutive sampling with a sample size of 79 respondents. The instruments used are the PSQI questionnaire for sleep pattern disturbances and the DASS-42 for depression levels. Ethics test no 03/EC-LPPM/UWHS/II-2026. Data analysis used the Spearman Rank test. The research results show that there is a significant relationship between sleep pattern disturbances and blood pressure in hypertensive patients (p=0.000; rho=0.826). Respondents with poor sleep patterns mostly have high blood pressure, indicating a very strong and positive relationship, where the worse the sleep pattern, the more uncontrolled the blood pressure tends to be. Additionally, there is a significant relationship between the level of depression and blood pressure (p=0.000; rho=0.808). Respondents with severe and very severe depression mostly have high blood pressure, which means that the higher the level of depression, the more the blood pressure increases or becomes uncontrolled. There is a relationship between sleep pattern disturbances and depression levels with blood pressure in hypertensive patients in the outpatient department of Permata Medika Hospital Semarang.

Digital transformation in healthcare services is a strategic approach to improve access, efficiency, and service quality, particularly within Indonesia’s National Health Insurance (JKN) system. BPJS Kesehatan has introduced an online queue feature through the Mobile JKN application to minimize manual queuing and reduce waiting times in outpatient services. However, despite the widespread ownership of the application, its actual utilization for online queuing remains relatively low, including in a regional public hospital (RSUD) in West Bandung. This condition reflects a gap between the availability of digital health technology and patients’ actual usage behavior, highlighting the need to examine factors influencing adoption.This study aims to analyze the effects of perceived ease of use, social influence, and facilitating conditions on the actual use of the Mobile JKN online queue, with behavioral intention as an intervening variable among outpatients. A quantitative cross-sectional design was applied, involving 255 JKN outpatient participants selected through purposive sampling. Data were collected using structured questionnaires and analyzed using Structural Equation Modeling (SEM) with AMOS version 24, based on the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT). Data analysis included descriptive statistics, validity and reliability testing, normality assessment, goodness-of-fit evaluation, Three Box Method, and hypothesis testing.

Ship berthing and departure planning is one of the crucial aspects in supporting the operational effectiveness of shipping companies. This study aims to analyze the important role of planners in ship berthing and departure activities in supporting marketing activities at PT. Nusantara Pasifik Sentosa Belawan. The method used in this research is a descriptive qualitative approach through observation and documentation study. The findings indicate that well-planned and coordinated ship berthing and departure activities provide a significant contribution to customer satisfaction, delivery punctuality, and the company’s image in the eyes of business partners. Effective planning also helps the company maintain service reliability and improve operational efficiency in port activities. However, several obstacles were identified, including lack of coordination between departments, limited information flow, and schedule disruptions caused by external factors such as weather conditions and port congestion. These challenges can affect the smoothness of operational activities and indirectly influence the company’s marketing performance. Therefore, strategies are required to improve human resource competencies, enhance digital communication systems, and strengthen cross-sector collaboration. With a well-structured planning system, PT.Nusantara Pasifik Sentosa is expected to improve its service quality and increase its competitiveness in the national shipping industry.

This study examines the evolving landscape of racket sports and its implications for injury patterns among diverse athlete populations. Over the past decade, traditional sports such as tennis and badminton have remained popular, while emerging sports like padel, pickleball, and beach tennis have experienced rapid growth, attracting participants across a wide age spectrum. However, the high-speed, repetitive, and multidirectional demands of these sports increase the risk of musculoskeletal injuries, making it essential to understand their epidemiology for effective prevention. This systematic literature review followed PRISMA 2020 guidelines, analyzing peer-reviewed studies published between January 2020 and early 2025 from databases including PubMed, ScienceDirect, Europe PMC, and Open Alex. A total of 22 studies met the inclusion criteria, comprising randomized controlled trials, cohort studies, and cross-sectional surveys. Methodological quality was assessed using the Cochrane Risk of Bias Tool (RoB 2) and the Newcastle-Ottawa Scale (NOS). The findings reveal significant variation in injury prevalence across sports, ranging from 34.2% in recreational pickleball to 92% in competitive padel. Badminton injuries were predominantly acute and affected the lower limbs, while tennis showed a higher incidence of overuse injuries in the upper limbs and trunk. Padel players frequently experienced elbow overuse injuries, with higher rates reported among females. In contrast, pickleball injuries were largely associated with falls among older adults. Preventive interventions involving supervised, sport-specific functional training and structured warm-up programs were found to be most effective. In conclusion, injury burden in racket sports is substantial and influenced by both intrinsic and extrinsic factors, highlighting the need for targeted, sport-specific prevention strategies.

The quality of nursing services is not solely determined by nurses’ technical competence in providing clinical care, but is also influenced by their ability to establish therapeutic communication with patients. Therapeutic communication is a professional interaction process aimed at helping patients understand their health conditions, express their feelings, and develop a trusting relationship with nurses. Effective communication between nurses and patients can increase patients’ comfort during hospitalization and may influence their level of satisfaction with the nursing services provided. This study aimed to determine the relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital in 2025. This study used an observational analytic design with a cross-sectional approach. The sample consisted of 182 patients selected using a purposive sampling technique. Data were collected using a therapeutic communication questionnaire and the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) to assess patient satisfaction with nursing care. Data analysis was conducted using the Spearman Rank correlation test to determine the relationship between the two variables. Most respondents assessed nurses’ therapeutic communication as good (87%). However, the majority of patients reported poor satisfaction levels (79.7%). The results of the Spearman Rank analysis showed a Sig. (2-tailed) value of <0.001 with a correlation coefficient of rs = −0.438, indicating a statistically significant relationship with a moderate correlation strength between nurses’ therapeutic communication and patient satisfaction. There is a significant relationship between nurses’ therapeutic communication and patient satisfaction in the inpatient ward of Grha Permata Ibu Hospital.

Chronic Kidney Disease (CKD) is a growing global health concern that significantly affects patients’ quality of life. At Bhakti Asih General Hospital, Tangerang, the number of hemodialysis patients increased by 20.42% and dialysis procedures by 25.06% between 2023 and 2024. Despite this service expansion, preliminary findings revealed that 32% of patients reported poor quality of life, 31% experienced low engagement in care, 34% demonstrated low self-efficacy particularly in dietary and fluid management and 32% faced accessibility barriers. These findings indicate a gap between increased service volume and patient-centered outcomes. This study aimed to analyze the effects of patient engagement and self-efficacy on the quality of life of hemodialysis patients, with healthcare accessibility as a mediating variable. A quantitative cross-sectional design was employed. Active hemodialysis patients were selected using purposive sampling. Data were collected through structured questionnaires and analyzed using Structural Equation Modeling (SEM).The results demonstrated that patient engagement and self-efficacy had significant positive effects on quality of life, both directly and indirectly through accessibility. Accessibility also significantly influenced quality of life and strengthened the relationships between patient engagement, self-efficacy, and quality of life.These findings highlight the importance of integrating patient engagement strategies, strengthening self-efficacy through education, and improving service accessibility to enhance quality of life among hemodialysis patients

The development of information and communication technology has significantly transformed consumer behavior, particularly in the process of searching for information prior to making a purchase. One rapidly growing phenomenon is Electronic Word-of-Mouth (eWOM), which refers to informal communication among consumers through digital platforms such as social media, online forums, and product review websites. eWOM is considered more credible than traditional advertising because it originates from real user experiences. This study aims to analyze the impact of eWOM on consumer purchase intention with trust as a mediating variable. A quantitative approach with a cross-sectional survey design was employed, involving active users of digital platforms who accessed product reviews before purchasing. Data were collected via online questionnaires and analyzed using multiple regression and mediation testing (Baron and Kenny approach with Sobel test). The findings reveal that eWOM has a positive and significant effect on consumer trust (β = 0.72) and directly influences purchase intention (β = 0.31). Trust demonstrates a stronger effect on purchase intention (β = 0.56) and serves as a significant mediator in the relationship between eWOM and purchase intention (indirect effect = 0.40). These results highlight that the quality, credibility, and consistency of eWOM information are crucial in building consumer trust, which subsequently enhances purchase intention. Theoretically, this study enriches digital marketing literature, while practically it provides implications for companies to manage online reviews transparently and foster consumer trust to drive purchasing decisions.

Nursing documentation is an essential part of healthcare services, playing a key role in communication, care continuity, and serving as legal evidence. The introduction of the Hospital Management Information System (SIMRS) aims to improve the efficiency of documentation processes. However, high workloads in critical areas such as the Emergency Department (IGD) and Intensive Care Unit (ICU) may influence nurse compliance with documentation protocols. This study investigates the relationship between workload and nursing documentation compliance during the implementation of SIMRS at RSUD Haji Makassar's IGD and ICU. A quantitative cross-sectional design was used, with 30 nurses participating (total sampling). The workload was assessed using the NASA Task Load Index (NASA-TLX), while compliance was evaluated through a questionnaire. The data were analyzed using Chi-Square and Fisher’s Exact Test. The results showed that the majority of respondents experienced heavy workloads (83.3%), and most had compliant documentation (96.7%). However, the statistical analysis yielded a p-value of 1.000, indicating no significant relationship between workload and documentation compliance. Based on these findings, the study recommends optimizing SIMRS usage and providing ongoing training to ensure improved compliance with nursing documentation practices.

Entamoeba histolytica is an intestinal protozoan that can cause diarrhea through fecal–oral transmission due to the consumption of food or water contaminated with parasitic cysts. Based on data from the Badan Pusat Statistik in 2017–2019, Simpang Keramat District, particularly Paya Leupah Village, still had limited access to clean water and low ownership of permanent sanitary latrines, which may increase the risk of environmental contamination. This study aimed to analyze the characteristics of dug wells and the risk factors associated with Entamoeba histolytica contamination in community well water. An observational analytic study with a cross-sectional design was conducted on 50 dug wells selected using purposive sampling. Data were obtained through field observations and laboratory examinations of well water samples. The results showed that most wells had distances to septic tanks that did not meet health standards (58%) and inadequate well floor conditions (82%), while the majority of wells had depths that fulfilled the recommended standard (76%). All well water samples tested negative for Entamoeba histolytica cysts; therefore, the association between risk factors and contamination could not be determined.

Phishing is a form of cybercrime that has experienced a significant increase in frequency within Indonesia. This fraudulent practice aims to deceive victims into surrendering personal data or sensitive financial information by impersonating trusted institutions. Such crimes result in substantial losses for both individuals and the business sector, particularly concerning personal data protection and digital transaction security. This research aims to analyze the legal regulations and the role of supervisory institutions in addressing phishing threats in Indonesia using a normative legal research method. The legal analysis encompasses the implementation of the Electronic Information and Transactions Law (UU ITE), specifically Article 28, paragraph (1), and the Personal Data Protection Law (UU No. 27 of 2022), which serves as the primary foundation for privacy rights. Furthermore, this study examines the Consumer Protection Law and the Indonesian Criminal Code (KUHP) as enforcement instruments. The strategic roles of the Financial Services Authority (OJK) and Bank Indonesia (BI) are also discussed in the context of risk mitigation within the financial sector. The findings indicate that law enforcement effectiveness is still hindered by low digital literacy, limited forensic technology infrastructure, and jurisdictional challenges in tracking cross-border perpetrators. Consequently, a synergy between regulatory strengthening, international collaboration, and massive public education is required to comprehensively suppress these cybercriminal activities.

Background: Anemia in pregnancy is a significant public health problem that can increase the risk of maternal and fetal complications. One of the main strategies to prevent anemia is the administration of Multiple Micronutrient Supplements (MMS), which provide essential vitamins and minerals during pregnancy. However, the effectiveness of MMS in preventing anemia is closely related to the level of knowledge pregnant women have about its use. Therefore, understanding the relationship between knowledge about MMS and anemia incidence is crucial to improving maternal health outcomes (Rahmawati et al., 2023). Objective: This study aims to determine the relationship between pregnant women’s knowledge level about Multiple Micronutrient Supplements (MMS) and the incidence of anemia among pregnant women in the working area of Dr. Hi. Zainal Umar Sidiki Hospital, North Gorontalo. Methods: This research employed an analytical observational design with a cross-sectional approach. A total of 30 pregnant women were selected as the sample using purposive sampling techniquesResults: The study found that the majority of participants who had high knowledge levels about MMS had a lower incidence of anemia, while those with low knowledge levels had a higher incidence. These results highlight that knowledge about MMS strongly influences pregnant women’s adherence and effectiveness in preventing anemia. Conclusion: There is a significant relationship between pregnant women’s knowledge level about Multiple Micronutrient Supplements (MMS) and the incidence of anemia. Improving maternal knowledge about MMS through health education, counseling, and guidance from healthcare providers is essential to prevent anemia and support optimal pregnancy outcomes.

Corporate crime is one of the important developments in modern criminal law that emerged as a response to the increasingly complex economic and business activities in society. The research method is normative legal research with a statutory and conceptual approach. This study uses primary, secondary, and tertiary legal sources. The research results show that the regulation of corporate crime in Law Number 1 of 2023 concerning the Criminal Code is regulated in Articles 45, 46, 47, 118, and 119 of Law Number 1 of 2023 concerning the Criminal Code. Implementation challenges corporate crimes in the 2023 Criminal Code include difficulties in proving corporate fault, disharmony with sectoral laws, the complexity of corporate structures, limitations of law enforcement officers, dominance of an individual approach, and the development of cross-border digital crimes. Therefore, it is recommended that the effectiveness of the 2023 Criminal Code not only rely on existing legal norms but also on institutional readiness, regulatory harmonization, and strengthening law enforcement capacity.

This study aimed to analyze the relationship between nurses’ interpersonal conflict and job satisfaction at Hospital X Depok in 2025. Interpersonal conflict in the workplace may negatively affect nurses’ psychological well-being, performance, and quality of healthcare services, thereby reducing job satisfaction. This research employed a correlational analytic design with a cross-sectional approach. The study population consisted of all nurses working at Hospital X Depok, totaling 151 individuals, with a final sample of 121 respondents selected using purposive sampling. Data were collected using three instruments: a demographic questionnaire, an interpersonal conflict questionnaire based on Wexley’s theory, and the Minnesota Satisfaction Questionnaire (MSQ) short form to measure job satisfaction. Data analysis was conducted using univariate statistics and the Chi-Square test with a significance level of 0.05. The results showed that 55.4% of respondents experienced low interpersonal conflict, while 44.6% experienced high interpersonal conflict. Job satisfaction levels were relatively balanced, with 50.4% of nurses reporting high satisfaction and 49.6% reporting low satisfaction. The Chi-Square test indicated a significant relationship between interpersonal conflict and job satisfaction (p = 0.000). Nurses experiencing low interpersonal conflict tended to have higher job satisfaction, whereas those experiencing high interpersonal conflict predominantly reported low satisfaction. These findings highlight the importance of effective conflict management strategies, supportive leadership, and strengthened interpersonal communication to enhance nurses’ job satisfaction and improve the quality of healthcare services.

Purpose: This study examines the effect of service communication on usage intention of Holistic Homecare for Elderly services, with customer trust serving as a mediating variable. Design/Methodology/Approach: Employing a quantitative explanatory approach with cross-sectional survey design, this research involved 120 family respondents with elderly members (≥60 years) in urban areas of Jakarta and Bandung, selected through stratified purposive sampling. Data were collected using structured questionnaires with 5-point Likert scales that had been tested for validity (Pearson correlation > 0.30) and reliability (Cronbach's Alpha > 0.70). Data analysis utilized Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS 4.0 to examine measurement and structural models, along with bootstrapping mediation tests. Findings: Service communication demonstrated significant positive effects on customer trust (β = 0.712; t = 12.456; p < 0.001) and usage intention (β = 0.324; t = 4.213; p < 0.001). Customer trust significantly influenced usage intention (β = 0.498; t = 6.847; p < 0.001) and functioned as a partial mediator (indirect effect = 0.354; BootCI [0.248; 0.471]). Originality/Value: This research integrates Commitment-Trust Theory and Social Support Theory within the context of home-based elderly care services in a developing country, revealing the critical role of empathetic, responsive, and transparent communication as the foundation for trust-building that subsequently drives service adoption. Practical Implications: The findings emphasize the necessity of therapeutic communication training for caregivers and information transparency to establish a trustworthy homecare service ecosystem in Indonesia.

The management of Indonesia's Border Crossing Posts (Pos Lintas Batas Negara/PLBN) in land border areas presents a critical normative gap between the country's international legal obligations and their actual implementation. This study departs from prior descriptive approaches by offering a critical normative-gap analysis that identifies specific disharmonies between bilateral agreements, international conventions, and national legislation governing PLBN operations. Employing a normative juridical method with statute, conceptual, and case approaches, this research examines three focal issues: (1) the normative gap between Indonesia's international legal commitments under instruments such as the United Nations Charter, Vienna Convention on Consular Relations 1963, Revised Kyoto Convention, International Health Regulations 2005, and the United Nations Convention against Transnational Organized Crime (UNTOC), and their domestic implementation; (2) the legal factors generating regulatory disharmony in PLBN governance, particularly the inconsistency between bilateral Border Crossing Agreements with Malaysia and Timor-Leste and national legislation; and (3) specific case-based evidence of implementation failures, including unauthorized border crossings at PLBN Motamasin and the pending boundary delimitation in the Noel Besi Citrana and Bidjael Sunan Oben segments with Timor-Leste. The findings reveal that regulatory disharmony, institutional fragmentation in the CIQS system, inadequate human resource capacity, and unresolved boundary disputes constitute structural legal deficits that undermine the effective governance of PLBN. This article recommends a comprehensive legal harmonization strategy, strengthened bilateral diplomatic engagement, and institutional reform grounded in international legal standards.  

Tourism regulations play a critical role in shaping destination competitiveness and influencing tourist travel decisions, yet empirical evidence on their effectiveness across different institutional contexts remains limited. This study investigates the impact of tourism regulations on tourist visit performance through a comparative quantitative analysis of Indonesia and Singapore. Using panel data covering the period 2010–2023, this research employs a fixed-effects regression model to examine the relationship between regulatory quality and tourist arrivals, while controlling for economic conditions and transport infrastructure. The findings reveal that tourism regulations have a positive and statistically significant effect on tourist visit performance in both countries. However, the magnitude of the effect is substantially stronger in Singapore, indicating higher regulatory efficiency and institutional effectiveness in translating policy interventions into tourism demand. These results support institutional and tourism demand theories, emphasizing that regulatory quality, rather than regulatory volume, is a key determinant of tourism performance. The study contributes to the tourism policy literature by providing cross-national empirical evidence on regulatory impacts and highlighting the importance of governance capacity in tourism development. From a policy perspective, the findings suggest that countries should prioritize regulatory coherence, administrative efficiency, and adaptive governance to enhance tourism competitiveness and resilience.

Terrorism is a serious threat to the security and unity of the Indonesian nation. Events such as the suicide bombing at the Medan Police Headquarters in 2019 show that acts of terror are increasingly complex and require swift and appropriate handling. For this reason, the government passed Law Number 5 of 2018 concerning the Eradication of Criminal Acts of Terrorism as a legal basis that strengthens the authority of the apparatus, including the Gegana Detachment of the Indonesian National Police Mobile Brigade Corps (Brimob), in carrying out counter-terrorism operations. This study aims to determine and analyze how the implementation of Law No. 5 of 2018 is carried out by the Gegana Detachment in the North Sumatra Regional Police area, identify obstacles faced in operations, and formulate strategies to increase the effectiveness of the implementation of the law. The results of the study show that the implementation of this law has been implemented through preventive, preemptive, and repressive approaches, such as sterilization of places of worship, social activities "Love Sunday", security patrols, and anti-terror training simulations. However, implementation in the field still faces various obstacles, including limited modern equipment, lack of cross-agency coordination, and low public participation. Therefore, personnel capacity building, infrastructure modernization, and strengthening inter-agency synergy are needed to achieve more effective counterterrorism efforts in North Sumatra.

Terrorism is a serious threat to the security and unity of the Indonesian nation. Events such as the suicide bombing at the Medan Police Headquarters in 2019 show that acts of terror are increasingly complex and require swift and appropriate handling. For this reason, the government passed Law Number 5 of 2018 concerning the Eradication of Criminal Acts of Terrorism as a legal basis that strengthens the authority of the apparatus, including the Gegana Detachment of the Indonesian National Police Mobile Brigade Corps (Brimob), in carrying out counter-terrorism operations. This study aims to determine and analyze how the implementation of Law No. 5 of 2018 is carried out by the Gegana Detachment in the North Sumatra Regional Police area, identify obstacles faced in operations, and formulate strategies to increase the effectiveness of the implementation of the law. The results of the study show that the implementation of this law has been implemented through preventive, preemptive, and repressive approaches, such as sterilization of places of worship, social activities "Love Sunday", security patrols, and anti-terror training simulations. However, implementation in the field still faces various obstacles, including limited modern equipment, lack of cross-agency coordination, and low public participation. Therefore, personnel capacity building, infrastructure modernization, and strengthening inter-agency synergy are needed to achieve more effective counterterrorism efforts in North Sumatra.

This study evaluates the implementation and contribution of the Sekolah Peternakan Rakyat (SPR) Program to Brahman Cross cattle farming in Bojonegoro Regency. A mixed-methods approach with a sequential explanatory design was applied, involving surveys, in-depth interviews, field observations, and document analysis of 20 SPR farmers. The results show that the program effectively improved farmers’ knowledge and technical competencies (knowledge scores ranging from 4.35–5.00). However, business expansion aspiration remained very low 1.15, indicating structural constraints beyond individual capacity enhancement. Technical performance of Brahman Cross cattle was fluctuating, particularly in reproductive indicators, and institutional capacity within the farmer group remained limited in managerial coordination and collective decision-making. These findings demonstrate that improvements in individual capacity do not automatically translate into sustainable business performance. Institutional strengthening and alignment between program design and smallholder conditions are essential to ensure long-term program effectiveness.

The implementation of Electronic Medical Records (EMR) has become an important element in improving healthcare service quality, efficiency, and patient safety in hospitals. However, the benefits of EMR depend not only on system availability but also on the quality of the information provided and how actively the system is used by healthcare professionals. This study aims to analyze the influence of electronic medical record content and perceived ease of use on the net benefits of EMR, with actual system use acting as an intervening variable. The research applied a quantitative approach with a cross-sectional design conducted at RSM Hospital. The population consisted of all general practitioners and specialist doctors working at the hospital, totaling 51 respondents, and the study used a total sampling technique. Data were collected through structured questionnaires measured using a Likert scale and analyzed using the Structural Equation Modeling–Partial Least Squares (SEM-PLS) method. The results show that EMR content and perceived ease of use significantly influence the net benefits of EMR. Both variables also significantly affect the actual use of the system, while actual use significantly influences the benefits obtained. Furthermore, actual use mediates the relationship between EMR content, ease of use, and net benefits, indicating that better information quality and usability can encourage greater system utilization and maximize the advantages of EMR implementation.