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Public service is a tangible manifestation of the state's function in meeting the needs and basic rights of the community but, in practice, public services in Indonesia still face various challenges such as rigid bureaucracy, low quality of services, and weak coordination between institutions. The ecological approach to administration exists as a new paradigm that emphasizes the interrelationships between bureaucratic structures, the social environment, culture and Natural Resources.The development of public services through an ecological perspective in Indonesia emphasizes the importance of conformity between the bureaucratic system and the conditions of the social environment in order to create adaptive, participative, and sustainable public services. This method used is a descriptive qualitative study by examining a variety of legal literature, as well as the practice of service innovation in some in Indonesia.Public service innovation based on ecology administration is able to create harmony between government, society and the environment and encourage the creation of adative governance and responsive to local needs through this application to strengthen collaboration across several sectors.

This research examines the role of Corporate Social Responsibility (CSR) in supporting the economic empowerment of fishing communities in Tanjungpinang. The study is motivated by the persistence of economic vulnerability among fishermen despite the availability of marine resources and ongoing CSR initiatives. Using a qualitative approach with library research methods, this study analyzes academic literature, government documents, and CSR program reports to understand how CSR has been implemented and its implications for community empowerment. The findings show that CSR programs in coastal areas generally remain charitable in nature, focusing on the provision of temporary assistance rather than strengthening the capacity and autonomy of fishermen. As a result, the programs have not significantly contributed to sustainable economic resilience. This study argues that CSR needs to be reoriented toward participatory empowerment, capacity building, and alignment with sustainable development and blue economy principles to support long-term welfare. The study also suggests the importance of further empirical research to validate implementation outcomes.

Early mobilization is an important component of postpartum care that may influence the speed of uterine involution. Delayed uterine involution can increase the risk of postpartum complications, including hemorrhage and prolonged recovery. This study aimed to analyze the relationship between early mobilization and uterine involution among postpartum mothers at Gandasuli Public Health Center. An analytical observational study with a cross-sectional design was conducted from September to November 2025. The study population consisted of 56 postpartum mothers, selected using a total sampling technique. The independent variable was early mobilization, categorized based on the type of activity performed, while the dependent variable was uterine involution assessed through uterine fundal height reduction. Data were analyzed using descriptive statistics and Kendall’s tau-b correlation test. The results showed that most respondents practiced early mobilization, particularly standing and walking, and the majority experienced rapid uterine involution. Bivariate analysis revealed a statistically significant relationship between early mobilization and uterine involution (τ = -0.321; p = 0.010). In conclusion, early mobilization is significantly associated with faster uterine involution among postpartum mothers. Promoting early mobilization should be emphasized as part of routine postpartum care to support maternal recovery.

Premature birth remains a major public health concern due to its strong association with increased neonatal morbidity and mortality. One of the contributing factors identified is maternal stress during pregnancy, which can negatively affect fetal development and potentially trigger early labor. Previous studies have shown that high stress levels in pregnant women may lead to hormonal imbalances, increased uterine activity, and other physiological changes that elevate the risk of preterm birth. Therefore, understanding the relationship between maternal stress and premature birth is essential for developing effective preventive strategies and improving maternal and neonatal outcomes. This study aimed to examine the relationship between stress levels in pregnant women and the incidence of premature birth in the working area of Dr. Hi Zainal Umar Sidiki Regional Hospital, North Gorontalo Regency. The research used an analytical observational design with a cross-sectional approach. A total of 30 pregnant women were selected using purposive sampling techniques. Maternal stress levels were measured using a validated questionnaire, while premature birth incidence was determined based on gestational age at delivery. Data were analyzed using the Wilcoxon signed-rank test with a significance level of p < 0.05. The results showed a significant relationship between maternal stress and premature birth (p = 0.000), indicating that higher stress levels increase the risk of preterm delivery. These findings highlight the importance of stress management, counseling, and comprehensive antenatal care.

Pre-menopause is a transitional phase before menopause characterized by physiological and psychological changes, including physical changes of body shape. These changes often trigger anxiety, especially when body image is perceived negatively. This study aims to determine the relationship between body image and anxiety levels in premenopausal women in Dham Ceukok Village, Ingin Jaya, Aceh Besar, 2025. This research used a quantitative method with a cross- sectional design. The population consisted of all women aged 40–50 years in Dham Ceukok Village, totaling 35 women, chosen using a total sampling technique. The instruments used were a body image questionnaire and an anxiety level questionnaire based on the Hamilton Anxiety Rating Scale (HARS). The data were analyzed using univariate and bivariate analysis with the Chi-square test. The study was conducted from May 5 to May 10, 2025. The results showed a significant relationship between body image and anxiety among premenopausal women in Dham Ceukok Village, with a value of 0.035 (p < 0.05). The results indicate that there is a relationship between body image and anxiety in premenopausal women in Dham Ceukok Village, Ingin Jaya, Aceh Besar District. It is recommended that health workers collaborate with the village to be more active in providing counseling or educational activities to maintain physical and mental health, especially for women in the premenopausal stage.

Exclusive breastfeeding, sometimes known as ASI, is the practice of giving infants only breast milk, along with vitamins, supplements, and prescription medications for illnesses, and no other liquids or solid foods, either directly from the breast or expressed. The purpose of this study was to determine the relationship between maternal awareness of pumping and the effectiveness of exclusive breastfeeding at the Lampulo Community Health Center. This study used a cross-sectional methodology and an analytical quantitative design. 53 breastfeeding mothers constituted the study population. There were 53 respondents in total, and the sampling strategy used the total sampling method. A 20-question survey taken from Desriati Sinaga's 2024 study served as the instrument. The Lampulo Community Health Center in Banda Aceh conducted this study from May 19 to June 25, 2025. The Chi-square test results showed a p-value of 0.001 < 0.05. Based on the research findings, maternal awareness of expressing breast milk is related to the success of exclusive breastfeeding at the Lampulo Community Health Center. These findings are expected to form the basis for more comprehensive instructions for breastfeeding mothers to improve the success of exclusive breastfeeding with expressed breast milk.

Gout can be triggered by several interconnected factors, such as genetic predisposition, family history, obesity, hypertension, heart disease, age, being overweight, and insufficient fluid intake. Recommended exercises for gout sufferers include regular exercise, stretching, and gymnastics. Ergonomic exercise is important for lowering uric acid, especially among elderly people with hyperuricemia. Hyperuricemia is a condition where blood uric acid levels are elevated. This study aims to determine whether ergonomic exercise lowers uric acid levels in the elderly at the Peukan Bada Public Health Center. The study used a quasi-experimental design with a one-group pretest-posttest approach. The sample included all 17 elderly with gout, selected using the total sampling method. Uric acid was measured using a Uric Acid measuring device. Data were analyzed using the Paired t-test. The results showed a p-value of 0.000. This proves ergonomic exercise affects uric acid levels in the elderly at the Peukan Bada Public Health Center. In conclusion, ergonomic exercise influences uric acid levels in the elderly at the Peukan Bada Public Health Center. Patients should regularly perform ergonomic exercises, using correct movements and staying within their physical abilities. Ergonomic exercises can be done 3-4 times a week to improve metabolism, maintain joint flexibility, and reduce uric acid in the body.

Parenting patterns play an important role in children's self-confidence. Parents are the main figures who raise and educate their children, because children who have self-confidence will dare to try new things and are not afraid of failure. The purpose of this study was to determine the relationship between parenting patterns and the self-confidence of early childhood children in Bungong Reudeup Baitusalam Kindergarten, Aceh Besar. This type of research is quantitative research with a descriptive analytical design using the Cross Sectional Study method. Data collection used the PSDQ questionnaire. which was carried out on February 22, 2025 for 1 day. The population used in this study were all early childhood children in Bungong Reudeup Baitusalam Kindergarten, Aceh Besar, totaling 30 people with a sampling technique using the total sampling technique. Data analysis using the Fisher Exact Test showed that there was a significant relationship between parenting patterns and the self-confidence of early childhood children in Bungong Reudeup Baitusalam Kindergarten with a P value = 0.033 <0.05. The results can be concluded that parenting patterns have a significant relationship with the self-confidence of early childhood children at Bungong Reudeup Baitusalam Kindergarten, Aceh Besar 2025. promising parents to apply positive and responsive parenting patterns, loving, consistent and open parenting patterns will increase self-confidence in children because children feel accepted and appreciated.

Background: Hemorrhagic stroke is a critical condition caused by the rupture of cerebral blood vessels, which leads to intracranial bleeding, increased intracranial pressure (ICP), and decreased adaptive capacity of the brain. One of its main impacts is a significant disturbance of consciousness. Nurses have applied non-pharmacological approaches, such as bimodal sensory stimulation, as innovative interventions to stimulate neurological function and indirectly stabilize intracranial pressure. Objective: This study analyzed the implementation of bimodal sensory stimulation in improving intracranial adaptive capacity in patients with hemorrhagic stroke. Methods: This case study involved a patient with a hemorrhagic stroke and impaired consciousness in an intensive care unit. The intervention was conducted for three consecutive days by providing auditory stimuli (voices of family members and nurses) and gustatory stimuli (lemon) five times daily. Measurements included the Glasgow Coma Scale (GCS) and neurological response observations. Results: After receiving bimodal sensory stimulation therapy, the patient showed improved consciousness, as indicated by a consistent increase in GCS scores from 9 to 11 over the three days. The patient's responses to auditory and gustatory stimuli also improved, including mild motor movements, pupil reflexes, and simple interactions such as blinking or opening the eyes in response to sounds. Conclusion: Bimodal sensory stimulation effectively facilitated the recovery of consciousness and enhanced intracranial adaptive capacity in patients with hemorrhagic stroke. Nurses can integrate this intervention into evidence-based nursing practice in intensive care units with active family involvement.

Background: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system and often leads to fatigue, mobility impairments, and psychological issues such as anxiety and depression, all of which significantly reduce the quality of life of those affected. Yoga therapy, as a holistic non-pharmacological approach, has gained attention as an alternative rehabilitative intervention for MS patients. Objective: The aim of this review is to literatureally examine the effectiveness of yoga therapy on the physical and psychological aspects of individuals with MS, with a particular focus on the duration, frequency, and forms of yoga practice used. Methods: The method employed in this study was a literature literature search across databases including Google Scholar, PubMed, ScienceDirect, and ResearchGate, using clearly defined inclusion and exclusion criteria. A total of 15 articles with experimental and quasi-experimental research designs published within the past 10 years were analyzed in this review. Result: The results indicate that yoga is effective in reducing fatigue levels, improving balance and muscle strength, and enhancing daily physical functioning. Psychologically, yoga has been shown to significantly reduce anxiety, stress, and depression, while also improving self-efficacy, focus, and emotional quality of life. Conclusion: In conclusion, yoga is a safe and effective intervention that can serve as a complementary rehabilitative strategy in the management of MS, both physically and psychologically, although further research with stronger methodologies is needed to support its implementation in clinical practice.

Background: Hyperthermia happened due to the failure of thermoregulatory mechanisms. This condition is particularly dangerous in children because it may cause dehydration, seizures, impaired consciousness, and even damage to vital organs. Data from Riskesdas (2023) show that the highest prevalence of hyperthermia occurred in the 5–14 age group, at 1.9%. Parents, as the primary caregivers, play an essential role in the early detection and management of hyperthermia; therefore, their level of knowledge needs to be examined. Objective: The purpose of this study is to describe the level of parental knowledge regarding the management of hyperthermia in children aged 8–12 years in Gianyar. Methods: This research employed a descriptive quantitative design with a total sampling technique. The sample consisted of 51 parents who met the inclusion criteria. Data were collected using a questionnaire containing 10 items on the definition of hyperthermia, methods of measuring body temperature, signs and symptoms, and management practices. The data descriptively analyzed by using  the SPSS 25 version. Result: The results showed that most respondents were aged 36–45 years (45.1%), female (54.9%), had completed senior high school education (41.2%), and were employed in the private sector (37.3%). The majority of parents’ knowledge regarding hyperthermia management in children was categorized as good (22 respondents, 43.1%), followed by fair (18 respondents, 35.3%), and poor (11 respondents, 21.6%). Conclusion: The findings indicate that most parents possess good knowledge regarding hyperthermia management; however, a portion still requires improved understanding through health education.

Background: Malaria remains a significant public health issue, particularly in endemic areas such as West Nias Regency. Household-based prevention strategies, including the use of bed nets, repellents, and mosquito insecticides, are essential in reducing transmission. However, few local studies have comprehensively analyzed the effectiveness of these interventions. Objective: To determine the relationship between malaria prevention measures (bed net use, repellent use, and mosquito insecticide use) and malaria incidence in the working area of UPT Lahomi Public Health Center, West Nias Regency. Methods: This study employed a case-control design with a quantitative analytic approach. A total of 174 respondents were included, divided into case and control groups. Data were collected through questionnaires and Rapid Diagnostic Test (RDT) results, and analyzed using the Chi-square test and Odds Ratio calculations. Results: No significant relationship was found between malaria incidence and the use of bed nets (p=0.785) or repellents (p=1.000). However, the use of mosquito insecticides showed a statistically significant association with reduced malaria incidence (p=0.021), with a lower infection rate among users (25%) compared to non-users (42.7%). Conclusion: Among the three interventions studied, only the use of mosquito insecticides proved effective in reducing malaria risk in the working area of UPT Lahomi Public Health Center. Education and improved access to proven preventive methods are needed to curb malaria transmission in endemic regions.

Background: Advances in information technology in the health sector have greatly supported services. Applications for health services developed in each health center are e-Puskesmas. The PIECES method is a framework used to classify existing problems based on performance, information, economics, control, efficiency, and service. Objective: Analyze the implementation of the e-Puskesmas system using the PIECES method on satisfaction at the UPTD. Puskesmas I Dinas Kesehatan Kecamatan Denpasar Timur. Method: This type of research is quantitative analytic with a cross-sectional approach. The population in this study are officers who use e-Puskesmas. The sample used is the entire population. Results: The research results showed that the majority of respondents were satisfied with a score of 3.48. The performance, information, economic, efficiency and service components are classified as good, while the control component is classified as moderate. There is a significant relationship between performance and efficiency components on satisfaction while there is no relationship between the information, economic, control and service components. Conclusion: Most of the components are classified as good and information system users are satisfied. The components that have a significant relationship with satisfaction are the performance and efficiency components, while the other components do not have a significant relationship.

Background: A balanced diet is essential for maintaining health and nutritional status, commonly assessed using Body Mass Index (BMI). Dietary habits are influenced not only by physiological needs but also by psychological factors such as Body Image perception. Unrealistic perceptions of one’s body can lead to unhealthy eating behaviors and negatively impact nutritional status. Patisserie students, who are frequently exposed to high-calorie foods, may be particularly vulnerable to such challenges. Objective:  This study aims to examine the influence of Body Image perception on dietary patterns and BMI among patisserie students at the Medan Tourism Polytechnic. Methods: This study is an observational analytical study with a cross-sectional approach to 60 students of Medan Tourism Polytechnic. Body Image and eating pattern data were collected using a questionnaire, while BMI was obtained by measuring the weight and height of the subjects. Result: The data obtained were analyzed using the Chi-square Test. Based on the results of the analysis, a relationship was found between Body Image and eating patterns with a value of p = 0.006 (P < 0.05). However, there was no relationship between Body Image and BMI with a value of p = 0.391 (P> 0.05). Consclusion: There is a relationship between Body Image and eating patterns but there is no relationship between Body Image and BMI.

Background: Decreased kidney function is one of the serious complications of diabetes mellitus, which can develop into chronic kidney disease (CKD). This study aims to reduce kidney function in diabetic patients who are members of the Chronic Disease Management Program (Prolanis) at the Comal Pratama Clinic. Objective: The Prolanis program aims to effectively manage chronic conditions such as diabetes, these results show that most patients continue to experience significant decline in kidney function. Methods: This study involved a longitudinal analysis of Prolanis patient data, focusing on changes in creatinine and urea levels as indicators of kidney function. Clinical data used in this study included creatinine and urea levels, taken from patient medical records in 2023 and 2024. Results: The results showed a significant increase in creatinine and urea levels among the patients studied, indicating worsening kidney function during the study period. This study emphasizes the importance of closer monitoring and more specific interventions to protect kidney function in diabetic patients who are members of Prolanis. Conclusion: Most patients continue to experience significant decline in kidney function.

Background: Section Caesarea (SC) is the process of giving birth through surgery by making an incision in the mother's stomach (laparatomy) and uterus (hysterectomy) to remove the baby. 75% of surgical patients experience moderate to severe pain after surgery. Women experience high levels of pain intensity for 24 hours after SC. Objective: The aim of this research is to determine the effectiveness of lavender aromatherapy to reduce pain intensity in post-section caesarean mothers at Muhammadiyah Kalikapas Hospital. Methods: In this research, researchers used a Quasi Experimental type of research with a one group pre test and post test design. The population was 39 and a sample of 35 patients was obtained using purposive sampling. This research data uses the Verbal Rating Scale (VRS) observation sheet. After tabulating the data, it was analyzed using the Wilcoxon test with a significance level of p= ? ? 0.05. The results of the study showed that before being given lavender aromatherapy, most of the 35 post- SC mothers experienced severe pain, after treatment 19 people (54.3%) experienced moderate pain. Result: The Wilxocon Test results obtained a significant value, namely p-value 0.000, then Ha is accepted so it can be concluded that there is an effect of using lavender aromatherapy to reduce pain intensity in post caesarean section. This means that there is an influence of the use of Lavender Aromatherapy to Reduce Pain Intensity in Post Sectio Caesarea Mothers at Muhammadiyah Kalikapas Hospital in 2024. Conclusion: Lavender Aromatherapy can be a non-pharmacological therapy in reducing pain intensity for post SC Mothers

Background: Hysterosalpingography (HSG) is an examination of infertile women. HSG examination can cause anxiety. Anxiety experienced before the HSG examination includes insomnia, palpitations, fear, feeling tense and even no appetite. Lavender is a plant that can be used to treat anxiety.  Objective: This study to determine the effect of lavender aromatherapy inhalation on reducing the anxiety level of infertile women during HSG examinations in the Radiology Room at Muhammadiyah Hospital Gresik. Methods: The research design uses pre-experiment with a one group pre test-post test approach. The research sample was 34 infertile women who underwent HSG examinations from October to December 2023. The sampling technique used consecutive sampling and the HARS (Hamilton Anxiety Rating Scale) questionnaire to identify anxiety. Data analysis used the Wilcoxon Signed Rank Test. Result: The results of the study showed that almost all (44%) infertile women experienced severe anxiety before being given lavender aromatherapy. Some (50%) infertile women experience mild anxiety after being given lavender aromatherapy. There is an effect of lavender aromatherapy on reducing the anxiety level of infertile women with a value of ? 0.000 < 0.05. Lavender aromatherapy which is rich in linalool can play a role in reducing anxiety. Conclusion: Lavender aromatherapy can be used to reduce anxiety in infertile women undergoing Hysterosalpingography examination.

Background: The increasing number of underage smokers is a problem that needs attention. One effort to reduce the number of underage smokers is by providing knowledge about the dangers of smoking. Objective: This study aims to determine the effect of audiovisual education on elementary school children's knowledge of the dangers of smoking among 5th and 6th graders. Methods: This study used a one-group pre-post test design with a sample of 50 students using total sampling. The instrument used in this study was a questionnaire about the dangers of smoking, and data analysis was performed using the Wilcoxon test. Results: The results of the study showed that before the education was provided, most of the children's knowledge about the dangers of smoking was still lacking (94%), and after the education was provided, most of the students' knowledge became good (80%). Based on the results of the Wilcoxon test, the result was p=0.000, which means that there is an effect of audiovisual education on the knowledge of the dangers of smoking among fifth and sixth grade elementary school children. Conclusion: Educational video media can increase a person's knowledge because videos can be an effective medium for providing information. Thus, educational video media has been proven to influence the knowledge of fifth and sixth grade elementary school children about the dangers of smoking, thereby preventing children from using cigarettes.

Background: Patients with chronic kidney failure must undergo hemodialysis/dialysis therapy. Chronic kidney failure patients undergoing hemodialysis experience several changes in their lives due to the patient's illness. Objective: This study aims to gain an in-depth understanding of the life experiences of chronic kidney failure patients undergoing hemodialysis. Methods: This research uses a qualitative research method with a phenomenological approach. The instruments for this research were the researcher himself, voice recorder, field notes, stationery, interview guide, and informed consent form. The informants used in this research were 7 informants. Results were analyzed using thematic analysis techniques. Results: Based on the results obtained in this study, 4 themes were found, namely (1) physiological, psychological, social, spiritual and economic changes, (2) Coping techniques in overcoming problems or changes due to chronic kidney failure, (3) Experiences in undergoing the hemodialysis process , (4) The hardest experience while suffering from chronic kidney failure. Conclusion: All informants experienced physiological, psychological and spiritual changes, while only a few informants experienced social and economic changes. Coping techniques for dealing with these changes are good except for economic changes where there is no solution for these changes. Experiences in undergoing the hemodialysis process include some being positive and some being negative. Meanwhile, the hardest experiences while suffering from chronic kidney failure vary according to what happens in the informant's life.

Emesis gravidarum, or nausea and vomiting during early pregnancy, is a common condition affecting the health and comfort of first-trimester pregnant women. Persistent symptoms can lead to dehydration, electrolyte imbalance, reduced nutrient intake, and psychological distress, potentially affecting both maternal and fetal health. Although pharmacological treatments are available, many pregnant women prefer non-pharmacological approaches due to concerns about fetal safety. Aromatherapy, using essential oils such as lemon, peppermint, and lavender, has emerged as a complementary therapy that may reduce nausea and vomiting through olfactory stimulation and autonomic nervous system modulation. This study aimed to examine the effect of aromatherapy on reducing emesis gravidarum in first-trimester pregnant women at Puskesmas Pagatan. A quasi-experimental design with pretest-posttest control group was conducted, involving 40 participants divided into an intervention group (n=20) and a control group (n=20) using purposive sampling. The intervention group received lemon essential oil inhalation twice daily for seven consecutive days, while the control group continued standard antenatal care. Data were collected using the Visual Analog Scale (VAS) for nausea severity and a structured diary for vomiting frequency. Results showed that the intervention group experienced a significant reduction in nausea severity (pretest mean 6.8 ± 1.2, posttest mean 3.2 ± 1.0, p < 0.001) and vomiting frequency (pretest mean 5.2 ± 1.0, posttest mean 2.1 ± 0.9, p < 0.001). In contrast, the control group showed minimal, non-significant changes. These findings indicate that aromatherapy is an effective, safe, and culturally acceptable non-pharmacological intervention for managing emesis gravidarum. The study concludes that integrating aromatherapy into routine antenatal care can improve maternal comfort, adherence to nutritional intake, and overall well-being in first-trimester pregnancies, supporting holistic prenatal care practices.