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Background: Gout arthritis is a metabolic disease caused by excessive uric acid levels in the blood (hyperuricemia), which leads to monosodium urate crystal deposition in the joints. Globally, the prevalence of gout arthritis ranges from 1–4% of the general population. In Indonesia, the national prevalence reaches approximately 7.3% based on medical diagnosis, and in Brebes Regency, cases reach 62.4%. At the Tonjong Health Center service area, the prevalence of gout arthritis in Karanganyar Hamlet, Tonjong Village, reaches 2.04%. Gout arthritis requires comprehensive nursing care including pain management and health education to prevent recurrence. Objective: To implement nursing care for Ny. S, family of Tn. S, with musculoskeletal system disorder: gout arthritis in Karanganyar Hamlet, Tonjong Village, Tonjong District, Brebes Regency. Method: This study used a case study design with a single patient/family subject. Data collection was conducted through interview, observation, physical examination, and study documentation on December 26–27, 2025 at the patient's home. Results: Assessment revealed Ny. S (72 years) experienced acute pain in the right knee joint with a pain scale of 3/10 and uric acid level of 7.3 mg/dL, along with knowledge deficit regarding gout arthritis. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management education, non-pharmacological therapy (turmeric decoction), pharmacological therapy (allopurinol), and health education. Implementation was conducted over two visits. Evaluation results showed that acute pain was partially resolved (pain scale reduced to 2/10, uric acid 7.2 mg/dL) and knowledge deficit was resolved. Conclusion: Nursing care for patients with gout arthritis through pain management and health education can reduce pain intensity and improve family knowledge about the disease. Non-pharmacological intervention with turmeric decoction contributed to decreasing uric acid levels and pain. Keywords: gout arthritis, acute pain, knowledge deficit, family nursing care, non-pharmacological therapy

This study aims to analyze in-depth cognitive learning theory and its implications for improving the effectiveness of Islamic Religious Education (PAI) teaching at the elementary school level. The adopted methodological approach is qualitative through library research, with the application of content analysis and theoretical synthesis techniques. Primary data sources were obtained from academic literature including textbooks, scientific journals, and the latest empirical research relevant within the last decade. The results of the analysis indicate that cognitive learning theory positions cognitive processes as the core of learning activities, allowing students to function as active agents in constructing knowledge through understanding, analysis, memory representation, and integration with pre-existing cognitive schemas. In the context of PAI, this approach enables meaningful learning through interactive pedagogical strategies such as collaborative discussions, problem-solving, case studies, and metacognitive reflection, which are empirically adapted to the stages of students' cognitive development. The implementation of cognitive theory significantly contributes to strengthening conceptual understanding, increasing learning engagement, developing critical thinking skills, transferring knowledge, and internalizing Islamic values. Thus, cognitive learning theory makes a substantial contribution to optimizing the effectiveness of PAI teaching in elementary schools through an interactive, systematic, and understanding-oriented approach.

Balanced nutrition intake is an important factor in supporting the performance of young athletes, especially during the growth period that requires optimal nutrition for intense physical activity. However, the lack of nutritional knowledge among parents of young athletes often leads to nutritional imbalances that have a negative impact on athlete health and performance. This study aims to measure the effect of balanced nutrition education on improving the knowledge and attitudes of parents of athletes at the Kancil Mas Football School (SSB), Karawang. The method used was a quasi-experiment with a pre-test and post-test design involving 20 respondents who were parents of U-13 athletes. Education was provided in the form of direct counseling sessions and group discussions, which were supplemented with supporting materials such as leaflets. The Wilcoxon signed rank test was used to analyze changes in parental knowledge and attitude scores before and after the intervention. The results of the analysis showed a significant increase in parents' understanding and positive attitudes towards balanced nutrition after education (p < 0.05). The results showed a significant increase in the level of parents' understanding and positive attitudes towards nutrition after the education intervention. These findings highlight the importance of active parental involvement in ensuring that young athletes' nutritional needs are met, as well as providing a basis for developing nutrition education programs in other sports schools.

A balanced diet is a daily dietary pattern that contains nutrients in types and amounts appropriate to the body's needs. Knowledge of balanced nutrition and healthy eating habits is an important factor in preventing nutritional problems among adolescents. A lack of understanding regarding appropriate food choices can lead to unhealthy eating behaviors. Therefore, nutrition education is needed to improve students’ knowledge and awareness of the importance of implementing a balanced diet in daily life. This counseling activity aimed to increase students’ knowledge regarding balanced dietary patterns. The activity was conducted on June 4, 2025, at State Junior High School 5 Kendari and involved 30 seventh-grade students as respondents. The counseling methods included lectures using PowerPoint media, an ice-breaking session in the form of the WHO six-step handwashing simulation, question-and-answer sessions, and interactive quizzes. Evaluation was carried out using pre-tests and post-tests to measure students’ knowledge levels before and after the counseling activity. The results showed an increase in the mean knowledge score from 68.40 in the pre-test to 89.67 in the post-test. The paired t-test analysis showed a Sig. (2-tailed) value of 0.000 (p < 0.05), indicating a significant difference between pre-test and post-test results. In addition, students gave positive responses to the counseling activity, stating that the material was interesting, easy to understand, and enjoyable. These findings indicate that balanced diet counseling was effective in improving students’ knowledge regarding the implementation of healthy eating habits in daily life.

Amidst rising global pressure regarding sustainability and cross-border trade, customs agencies are no longer viewed merely as gatekeepers but as strategic actors in global environmental governance through the Green Customs Initiative (GCI). This research aims to uncover the evolutionary patterns of GCI research within the context of adaptive policy, map its intellectual structure, and identify future thematic directions. The methodology employs a bibliometric analysis of documents sourced from the Web of Science database, utilizing VOSviewer software to perform co-authorship, bibliographic coupling, and co-word analysis.The results demonstrate that the dominance of scientific actors in this field is determined more by the strength of collaboration networks than by the mere volume of publications. The findings identify that the primary intellectual foundations of GCI research rest upon the critical relationship between environmental regulation, international trade, market responses, and eco-innovation. Furthermore, country-level analysis highlights the central roles of China, the United States, and the United Kingdom in shaping the knowledge structure of this domain. Overall, these findings underscore that the GCI has evolved into a multidisciplinary field that requires an adaptive policy framework to respond to the dynamics of ecological risks and global trade demands through institutional flexibility and cross-actor collaboration. By integrating environmental protection into border management and risk assessment, this study provides a strategic reference for customs authorities to move toward a more responsive and knowledge-based green customs administration.

In Islam, prayer (salat) is a fundamental obligation that must be performed under all circumstances, including during illness. Muslim patients have high spiritual needs, in which religious practices serve as a source of strength in coping with disease. Although Islam provides concessions (rukhsah) in performing prayer for the sick, limitations in patients’ understanding of how to perform prayer according to their health conditions are still found. This lack of knowledge may affect the proper practice of prayer during hospitalization. Therefore, this study aims to identify patient characteristics related to the practice of prayer, to examine the level of knowledge of the five daily prayers in relation to their practice among patients, and to analyze patients’ overall level of knowledge regarding prayer. This study employed a quantitative method with a cross-sectional design. The results show that patient characteristics, particularly productive age and higher educational level, contribute to their ability to perform prayer during hospitalization. A significant relationship was found between the level of knowledge of prayer and its practice, where better understanding was associated with more optimal religious practice. Overall, most patients had a high level of knowledge of prayer, although a small proportion still had low knowledge, indicating the need for spiritual education. It can be concluded that the level of knowledge of prayer is associated with the quality of prayer practice among Muslim patients at RSUD Haji Makassar. Strengthening spiritual education is needed to support the fulfillment of patients’ religious needs during hospitalization.

Rheumatoid arthritis (RA) is a daily disease seen in rheumatology clinics. It predominantly involves the appendicular skeleton. The axial skeleton is mostly spared except for the cervical spine where instability can occur and can be carefully assessed with cervical spine radiographs in flexion and extension. Radiographs may show erosion at the C1-C2 level with destruction of the transverse ligament that can result in atlantoaxial subluxation. Diagnosis is based on clinical, laboratory, and radiographic findings. Conventional radiography has been the mainstay for diagnosis of joint damage and subsequent follow-up. Radiography can provide only indirect information on synovial inflammation, however, and the technique is insensitive to early bone damage. Hand radiographs are frequently ordered as the first imaging modality in the assessment of patients presenting with peripheral arthritis. They can provide invaluable information about the bones, joints, mineralization, soft tissues and the distribution of abnormalities. Given the wide spectrum of rheumatic diseases, it might be challenging to make the diagnosis solely based on the clinical findings and imaging plays an important role in narrowing the differential diagnosis. Having the knowledge of the common radiographic manifestations of inflammatory arthritis is of paramount importance for clinicians and radiologists to diagnose the underlying disease in early stages of disease in order to start treatment. The purpose of the article is to review the key radiographic findings of common rheumatic diseases in the hands.

Antibiotic resistance is a global health problem that requires international efforts to prevent the ineffectiveness of existing antibiotics and support the development of new antimicrobial agents. The increasing use of antibiotics in the community must be accompanied by proper understanding regarding rational antibiotic use to minimize the risk of resistance. This community service activity aimed to provide education on rational antibiotic use and the dangers of antibiotic resistance to undergraduate nutrition students at STIKes Adila, Bandar Lampung. The activity was conducted through educational sessions using flyers, presentation slides, and interactive discussions to encourage active participation and improve understanding of the topic. Evaluation was carried out using pre-test and post-test assessments to measure changes in participants’ knowledge levels. Descriptive analysis showed an improvement in participants’ knowledge, with the high knowledge category increasing from 0% during the pre-test to 85% in the post-test, while the low knowledge category decreased from 35.5% to 0% after the intervention. These findings indicate that educational interventions can effectively enhance awareness and understanding of rational antibiotic use and the prevention of antibiotic resistance. Therefore, continuous educational programs are important to promote responsible antibiotic use and support public health efforts in combating antibiotic resistance.

Stunting remains a major public health challenge in Indonesia, requiring systematic early detection and community-based interventions. This community service activity aimed to implement early stunting detection through parental health education and anthropometric measurements of children under five at Posyandu Pasir Putih, Kelurahan Baurung, Kecamatan Banggae Timur, Kabupaten Majene, West Sulawesi. A participatory approach was used, combining interactive health education sessions with standardized anthropometric screening (weight, height/length, mid-upper arm circumference, and head circumference) for 35 toddlers aged 0–59 months. Parental knowledge was assessed using pre-test and post-test questionnaires administered to 38 parents. Results showed a significant increase in parental knowledge, from a mean pre-test score of 52.4 (poor category) to 81.6 (good category) on post-test. Anthropometric assessment revealed that 13 out of 35 toddlers (37.1%) were identified as stunted (25.7% stunted; 11.4% severely stunted). All identified cases were referred to the local health center (Puskesmas) for specific nutritional interventions including supplementary feeding and intensive nutrition counseling. These findings indicate that integrated anthropometric screening combined with targeted parental education is an effective strategy for early stunting identification at the community level. Posyandu plays a crucial role as a platform for translating anthropometric data into meaningful risk communication and promoting sustained community engagement in child growth monitoring

Pregnancy complications remain a leading cause of maternal morbidity and mortality in Indonesia. Pregnant women's limited knowledge of pregnancy danger signs and suboptimal participation in antenatal care (ANC) services can increase the risk of delayed detection and management of pregnancy complications. The Kinovaro Community Health Center (Puskesmas) in Sigi Regency is one of the areas requiring maternal health information and activities that can increase pregnant women's participation in health education activities. This community service activity aims to improve pregnant women's knowledge and preparedness in preventing pregnancy complications through mentoring based on Pregnant Women's Classes. The activity involved eight pregnant women in their second and third trimesters. The methods used included health education, interactive discussions, simple pregnancy check-ups, pregnancy exercise demonstrations, and evaluation using pre- and post-tests. The results showed that all participants actively participated in the activity and had a good level of knowledge after participating. The average knowledge score increased from 77.5 to 80.0, an increase of 3.2%. In addition, participants were able to identify pregnancy danger signs, understand the importance of standard ANC visits, and practice pregnancy exercise movements independently. This activity demonstrates that mentoring through the Pregnant Women's Class can strengthen maternal health literacy, increase pregnant women's preparedness in recognizing pregnancy complications, and support the strengthening of maternal health services at the community level.

This community service activity is motivated by the increasing volume of household plastic waste that has not been optimally managed, thus potentially polluting the environment. Utilizing inorganic waste, especially used plastic bottles, as a planting medium is a simple solution to reduce pollution while increasing community creativity. This activity aims to increase community knowledge and skills in utilizing used plastic bottles as a useful and economically valuable planting medium container. The Women Farmers Group (KWT) participated in this activity on May 1, 2026 in Gempol Sari Village, Sepatan Timur District, Tangerang Regency, Banten Province. Participatory Action Research (PAR) strategies were used to carry out implementation techniques, which included socialization, training, direct practice, mentoring, and assessment. Pre- and post-activity tests were given and evaluated using Paired Sample T-Tests to assess the activity. After participating in the training, the level of participant understanding increased, in accordance with the results of the activity. Participants' knowledge increased significantly through this exercise, as indicated by a significant increase in their average post-test score from 92.86 to 78.57 (p < 0.05). In addition, participants were able to independently practice making simple planting media from used plastic bottles. This activity has positive implications for increasing environmental awareness and community creativity, as well as supporting economic empowerment and sustainable environmental management efforts.

Antibiotic resistance is a global health problem that requires international efforts to prevent the ineffectiveness of existing antibiotics and support the development of new antimicrobial agents. The increasing use of antibiotics in the community must be accompanied by proper understanding regarding rational antibiotic use to minimize the risk of resistance. This community service activity aimed to provide education on rational antibiotic use and the dangers of antibiotic resistance to undergraduate nutrition students at STIKes Adila, Bandar Lampung. The activity was conducted through educational sessions using flyers, presentation slides, and interactive discussions to encourage active participation and improve understanding of the topic. Evaluation was carried out using pre-test and post-test assessments to measure changes in participants’ knowledge levels. Descriptive analysis showed an improvement in participants’ knowledge, with the high knowledge category increasing from 0% during the pre-test to 85% in the post-test, while the low knowledge category decreased from 35.5% to 0% after the intervention. These findings indicate that educational interventions can effectively enhance awareness and understanding of rational antibiotic use and the prevention of antibiotic resistance. Therefore, continuous educational programs are important to promote responsible antibiotic use and support public health efforts in combating antibiotic resistance.

This community service activity is motivated by the increasing volume of household plastic waste that has not been optimally managed, thus potentially polluting the environment. Utilizing inorganic waste, especially used plastic bottles, as a planting medium is a simple solution to reduce pollution while increasing community creativity. This activity aims to increase community knowledge and skills in utilizing used plastic bottles as a useful and economically valuable planting medium container. The Women Farmers Group (KWT) participated in this activity on May 1, 2026 in Gempol Sari Village, Sepatan Timur District, Tangerang Regency, Banten Province. Participatory Action Research (PAR) strategies were used to carry out implementation techniques, which included socialization, training, direct practice, mentoring, and assessment. Pre- and post-activity tests were given and evaluated using Paired Sample T-Tests to assess the activity. After participating in the training, the level of participant understanding increased, in accordance with the results of the activity. Participants' knowledge increased significantly through this exercise, as indicated by a significant increase in their average post-test score from 92.86 to 78.57 (p < 0.05). In addition, participants were able to independently practice making simple planting media from used plastic bottles. This activity has positive implications for increasing environmental awareness and community creativity, as well as supporting economic empowerment and sustainable environmental management efforts.

The Kepus Pungsed ritual, a Balinese Hindu life-cycle ceremony performed in Menyali Village, embodies a set of culturally and spiritually significant lexicons that function as a medium for transmitting traditional knowledge. This study aims to (1) describe the level of perceived understanding of the Kepus Pungsed ritual lexicons among adults, (2) describe the level of perceived understanding among elders, and (3) determine whether there is a significant difference between the two groups. This research employed a quantitative comparative cross-sectional design. Data were collected through a structured questionnaire consisting of 36 ritual lexicons administered to 100 respondents, comprising 50 adults and 50 elders in Menyali Village. The data were analyzed using descriptive statistics and inferential analysis through the Mann–Whitney U test. The findings reveal a substantial generational gap in perceived understanding. Adults demonstrate a low level of perceived understanding, with 76% categorized as very low and 24% as low. In contrast, elders show a high level of perceived understanding, with 72% categorized as very high and 28% as high. The inferential analysis confirms that there is a statistically significant difference between adults and elders in their perceived understanding of the ritual lexicons. These findings indicate that the lexicons of the Kepus Pungsed ritual are in a vulnerable state due to the decline in comprehension among the younger adult generation. This study highlights the urgency of strengthening intergenerational transmission and suggests the integration of cultural and linguistic elements, particularly through English language education, to support the preservation and revitalization of endangered ritual lexicons.

World Health Organization (WHO) reports that immunization is able to prevent approximately 3–5 million deaths each year; however, a number of children still do not receive optimal immunization coverage due to insufficient parental knowledge. This study aimed to analyze the effect of health education on improving mothers’ knowledge regarding early childhood immunization in RW 04, Kertamaya Subdistrict, Bogor City, in 2026. This study employed a pre- experimental design with a one-group pretest–posttest approach involving 30 respondents. Knowledge levels were measured using a questionnaire before and after the health education intervention and analyzed using the Paired Sample T-Test. The results indicated a statistically significant difference in mothers’knowledge levels before and after the health education intervention (p = 0.029). In addition, the proportion of respondents with good knowledge increased from 76.7% in the pre-test to 93.3% in the post-test. These findings demonstrate that health education has a significant effect on improving mothers’ knowledge and can serve as an effective promotive intervention to support the success of community-level immunization programs.

Hypertension is a condition where blood pressure increases above normal limits as indicated by systolic and diastolic values ​​during examination. In Karanglangit Village, the community's low level of knowledge regarding risk factors, prevention and treatment of hypertension is an obstacle in controlling this disease. This service activity aims to increase public understanding so that they are able to implement efforts to prevent and manage hypertension independently. The method used is direct counseling with the help of presentation media and educational posters. The activity stages include completing a pre-test, providing material about hypertension, an interactive discussion session, and a post-test. The activity was carried out in January 2026 at the Karanglangit Village Hall, Lamongan District, with 26 PKK women participating. The results show an increase in participants' knowledge, marked by an increase in the average score from 76.92% in the pre-test to 100% in the post-test. The paired t-test showed a significant difference before and after the counseling (p<0.001), so that the activity was considered effective in increasing community knowledge. Apart from that, participants also better understand the importance of a healthy lifestyle, regular check-ups, and compliance in maintaining stable blood pressure.

This study is based on the increasingly rapid development of the knowledge-based economy, where human capital is now regarded as one of the important assets in creating a company’s competitive advantage, especially in the energy and oil and gas sectors in Indonesia. This study aims to determine the effect of human capital and labor intensity on corporate financial performance, which is proxied by Return on Assets (ROA) during the 2021–2024 period. The research method used is a quantitative approach with multiple linear regression analysis. The research data were obtained from sample companies selected using a purposive sampling technique. The results of the study show that human capital, proxied by Value Added Human Capital (VAHU), has a positive and significant effect on corporate financial performance. These findings indicate that good human resource management is capable of increasing the company’s profitability level. On the other hand, labor intensity is proven to have a negative and significant effect on financial performance. This indicates that a high level of company dependence on labor, without being balanced by operational efficiency, can reduce the company’s ability to generate profits. In addition, simultaneously both variables are able to explain 74.5% of the variation in Return on Assets (ROA), so it can be concluded that human capital and labor intensity have a considerable contribution to corporate financial performance. Based on these results, companies need to prioritize improving the quality and competence of the workforce rather than merely focusing on increasing the number of employees. This step is important to maintain the stability of corporate financial performance in the post-pandemic era. In addition, companies also need to effectively control labor costs so that a decline in net profit margins can be avoided.

 This study aims to analyze the use of Google Translate in the process of learning English, highlighting its benefits, limitations, and impact on students’ learning quality. This research employs a qualitative approach using a library research method, where data are obtained from various literature sources such as books, scholarly articles, and relevant online publications. The findings indicate that Google Translate is widely used by students as a tool to quickly and practically understand English texts. However, this high level of usage also leads to several issues, including the inaccuracy of translations in certain contexts, increased dependency on technology, and a limited understanding of language structure. Nevertheless, Google Translate still provides advantages in improving learning efficiency and access to global knowledge resources. Therefore, the use of this technology needs to be guided wisely so that it supports the learning process without reducing students’ cognitive engagement. This study is expected to contribute to a better understanding of the role of technology in language learning in the digital era and to serve as a reference for educators and students in utilizing technology more effectively.  

Islamic religious education at the Madrasah Diniyah level often relies on passive, one-directional teaching methods that reduce madrasah student engagement and long-term retention. This community service study aimed to improve the quality of Fiqh instruction at Madrasah Diniyah Al-Ishlah Kalirejo, Pasuruan, by implementing kinesthetic games, Small Group Discussion (SGD), and visual teaching aids within the framework of Kitab Mabadi’ Fiqhiyyah. A qualitative descriptive approach was employed through four participatory observation sessions, with visual documentation serving as primary data. The program was implemented in four thematic meetings covering funeral prayer procedures, tayammum, hajj simulation (tawaf), and najis classification. Findings indicate that kinesthetic games effectively reduced affective barriers and increased student focus, while the SGD model with a 1:8 mentor-to-student ratio enabled precise procedural correction for motor-based worship practices. The use of concrete teaching aids successfully transformed abstract Fiqh concepts into tangible, memorable knowledge. This study concludes that the integration of active learning methods, small-group mentoring, and visual media within traditional Islamic education settings can significantly enhance student engagement and comprehension. These findings offer a replicable pedagogical model for Madrasah Diniyah educators seeking to modernize instruction while preserving classical curriculum integrity.

Breast tumors are classified into two types, namely benign and malignant tumors, the latter commonly referred to as breast cancer. Breast cancer is one of the major health problems affecting women worldwide, including in Indonesia. According to WHO data in 2022, there were 2.3 million breast cancer cases with 685,000 deaths globally, while in Indonesia, 396,914 cases and 234,511 deaths were reported. The high incidence rate is exacerbated by low public awareness in recognizing early symptoms and performing early detection, resulting in 60–70% of cases being diagnosed at an advanced stage, supported by findings that 65.6% of female students still have a low level of knowledge. Female students were selected as research subjects because they are in a vulnerable reproductive age group and have an important role in increasing awareness of early detection, yet they still have limited knowledge. Based on this, this study aims to design a web-based early detection system for breast tumor risk using the Forward Chaining method, which functions as a tool to identify early symptoms, assess risk levels, and provide information on prevention and initial management. This study employed the method with the Expert System Development Life Cycle (ESDLC) model, consisting of the stages of assessment, knowledge acquisition, design, testing, and documentation, along with the Forward Chaining inference method.