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Nursing care in hospitals is still below the established standard of 80%, thus reflecting suboptimal nurse performance. This condition is thought to be influenced by factors such as rewards, workload, length of service and supervision. This study aims to analyze the relationship between rewards, workload, length of service, and supervision with nurse performance in the Inpatient Unit of Ratu Zalecha Martapura Regional Hospital. This study used a quantitative method with an observational analytical design using a cross-sectional approach. The study sample consisted of 152 nurses selected using cluster proportional random sampling technique. Data were collected using a questionnaire and analyzed using the chi-square test and multiple logistic regression. The results showed a significant relationship between rewards and nurse performance (p-value=<0.001), workload and nurse performance (p<0.001), and supervision and nurse performance (p-value=<0.001). Length of service did not show a significant relationship with nurse performance (p-value=0,968). Multivariate analysis showed that supervision was the most dominant factor related to nurse performance. Thus, compensation, workload, and supervision are related to nurse performance, while length of service is not related to nurse performance in the Inpatient Unit of Ratu Zalecha Regional Hospital, Martapura. The hospital is expected to improve supervision, workload management, and training and recognition for nurses to improve the quality of nursing services.

Dental caries is one of the most common oral health problems among young children. Preschool-aged children are highly dependent on their parents, especially mothers, for dental health care. A mother's level of knowledge is expected to influence the incidence of caries in children. Purpose: This study aims to determine the relationship between maternal knowledge and the incidence of dental caries among children at Qalby Play School, Bogor Regency. Method: This research employed a cross-sectional design with an analytic survey approach. The population consisted of all mothers and their children at Qalby Play School, totaling 30 participants, selected using total sampling. Data were collected using questionnaires to assess maternal knowledge and odontogram sheets to measure caries incidence. Data were analyzed using univariate and bivariate analysis with the Chi-square test. Result: The results showed a significant relationship between maternal knowledge and the incidence of dental caries in children, with a p-value 0,047 < 0,05. Conclusion: There is a statistically significant relationship between maternal knowledge and the incidence of dental caries in children. Therefore, it is important for parents, especially mothers, to pay close attention to their children's oral health by ensuring proper and regular tooth brushing and scheduling dental check- ups every six months.

The rapid growth of the global halal economy has positioned halal products and services as important contributors to international trade, economic development, and evolving consumer markets. This study investigates the role of halal consumer protection law in supporting the advancement of the halal economy from both legal and economic perspectives. Employing a qualitative approach with a juridical normative framework, this research examines regulatory structures, halal certification mechanisms, consumer protection principles, and the broader economic implications of halal governance. The findings indicate that effective halal consumer protection frameworks are essential for establishing legal certainty, preserving product authenticity, strengthening consumer trust, and improving market transparency. From an economic perspective, comprehensive halal regulations contribute to enhancing product competitiveness, expanding global market access, encouraging industrial innovation, attracting investment, and promoting sustainable economic growth. Nevertheless, this study highlights several ongoing challenges, including the lack of harmonization among international halal standards, limited regulatory enforcement capacity, the financial burden of certification processes for micro, small, and medium enterprises (MSMEs), and the increasing complexity of digital trade and cross-border e-commerce.

Introduction: The Beyond Use Date (BUD) is the expiration date for a drug product after its primary packaging has been opened, mixed, or prepared. The BUD differs from the expiration date printed on the manufacturer's packaging and is not always listed on the drug, so many people still don't fully understand this concept.Objective: To evaluate the level of knowledge of Prolanis patients regarding the Beyond Use Date (BUD) at the Purwokerto Utara I Community Health Center before and after being given counseling. Methods: A quantitative descriptive method with a cross-sectional design was used on 20 Prolanis patient respondents. Primary data collection consisted of questionnaires administered before (pretest) and after (posttest) the lecture-based counseling using flyers. Data analysis was performed using univariate analysis. Results: The level of knowledge of Prolanis patients regarding Beyond Use Date before counseling showed that the majority were in the poor category with 16 respondents (80.0%) and the sufficient category with 4 respondents (20.0%). After being given counseling, there was an increase in the good category with 6 respondents (30.0%), but the majority were still in the poor category with 14 respondents (70.0%).Conclusion: The level of knowledge of Prolanis patients regarding Beyond Use Date (BUD) at Purwokerto Utara I Health Center before counseling was mostly in the poor category, and after counseling there was an increase although most were still in the poor category.

This study discusses the leadership values reflected in the folklore of Panglima Wangkang in Marabahan as a representation of the local wisdom of the Banjar-Bakumpai community. Panglima Wangkang is recognized as a prominent figure who played a significant role in resisting Dutch colonialism in the Barito region. This research aims to examine Panglima Wangkang not only as a war hero but also as a symbol of cultural unity, religious values, and traditional leadership that still lives in the collective memory of society today. The study employs a qualitative historical method with a postcolonial approach. The data were collected through library research involving historical archives, scientific journals, books, and documented folklore. The research stages included heuristics, source criticism, interpretation, and historiography. The findings reveal that Panglima Wangkang’s leadership reflects the values of courage, strategic intelligence, loyalty, religiosity, and social concern. His well-known military strategy, referred to as the “Trojan Horse” technique, demonstrates his tactical ability in confronting colonial forces. In addition, religious values are reflected in his message to always maintain ablution and in the belief regarding martyrdom. The story of the golden bullet also symbolizes the community’s respect for the struggle and honor of local heroes. Panglima Wangkang’s cross-ethnic identity as both Banjar and Bakumpai further strengthened community unity in facing colonialism. This study shows that folklore functions not only as a cultural heritage but also as a medium for transmitting leadership values and local identity that remain relevant in the social life of the Marabahan community today.

This literature review synthesizes findings from fifteen peer‑reviewed studies published between 2020 and 2026 to examine the determinants of sustainable competitive advantage in the furniture industry. The analysis reveals that green innovation, environmental performance, and market orientation interact as core drivers of competitiveness, supported by theoretical perspectives including the Resource‑Based View, Natural Resource‑Based View, Institutional Theory, Circular Economy, and Strategic Management frameworks. The review highlights how internal capabilities, regulatory compliance, and responsiveness to consumer preferences collectively shape the ability of micro, small, and medium enterprises to adapt to sustainability demands in global markets. Evidence shows that eco‑innovation practices, waste recovery strategies, and clustering models enhance efficiency and legitimacy, while indicators of green growth and brand performance provide practical tools for evaluating sustainability outcomes. The synthesis underscores that competitive advantage in this sector is not determined by isolated variables but by systemic integration across resources, operations, and market dynamics. This study contributes theoretically by consolidating fragmented insights into a coherent conceptual model and practically by offering guidance for enterprises and policymakers to foster green transformation. The findings emphasize the urgency of aligning industrial practices with ecological integrity and suggest that future research should examine cross‑country variations, longitudinal impacts, and the integration of digital technologies with sustainability strategies to strengthen the resilience of furniture enterprises in the global economy.

Background: Adolescence is often characterized as a period of puberty. Early menarche is associated with increased mortality and morbidity risks in later life among girls who experience menarche at an early age. Menarche is the first menstrual event in girls, marked by the shedding of the uterine lining and vaginal bleeding. The tendency to consume unhealthy foods, particularly fast food, as well as sugar-sweetened beverages (SSBs), may have adverse effects on health and potentially influence the timing of menarche. Objective: This study aimed to analyze the relationship between healthy food selection, sugar-sweetened beverage consumption, and the incidence of early menarche. Methods: This study employed a cross-sectional design. The sample consisted of 30 female students. Data were analyzed using the Spearman Rank correlation test. Results: The results showed that healthy food selection was significantly associated with the incidence of early menarche (p = 0.005) with a moderate correlation strength (ρ = 0.449). Similarly, sugar-sweetened beverage consumption was significantly associated with the incidence of menarche (p = 0.000) and demonstrated a very strong correlation (ρ = 0.841). Conclusion: There was a significant relationship between healthy food selection and sugar-sweetened beverage consumption with the incidence of menarche. Sugar-sweetened beverage consumption showed a stronger relationship with menarche incidence compared to healthy food selection.

Education plays a fundamental role in shaping the quality of human resources and determining national progress. However, many young people still lack awareness and motivation regarding the importance of education due to limited access to information, socioeconomic challenges, and insufficient understanding of its long-term benefits. This Community Service Program aims to increase young people’s awareness of the importance of education through collaboration among multiple universities. The program involved lecturers and students from various higher education institutions who conducted educational outreach activities, motivational seminars, interactive discussions, and mentoring sessions. Methods used included educational counseling, inspirational presentations, question-and-answer sessions, and participant evaluations. The results show an improvement in participants’ understanding, motivation, and awareness of education as an investment in the future. In addition, inter-university collaboration expanded the program’s reach, enriched perspectives shared with participants, and strengthened higher education institutions’ commitment to community engagement. This initiative demonstrates that cross-university synergy can serve as an effective and sustainable model for fostering educational awareness and supporting the development of future generations in diverse communities.

Background: Cesarean section (CS) is a mode of delivery frequently used in women with high-risk pregnancies. Over the past two decades, the rate of CS has increased significantly worldwide. Although CS can be a life-saving intervention when performed based on appropriate medical indications, it may also result in adverse outcomes for both mothers and infants and increase the clinical and economic burden on healthcare systems. Limiting CS rates can be achieved through the control of modifiable risk factors. Purpose: This study aimed to describe the factors contributing to the occurrence of cesarean section. Method: This study employed a descriptive cross-sectional design and was conducted at Singasana Regional General Hospital, Tabanan Regency, from February to May 2025. The study sample consisted of 259 women who underwent cesarean delivery during the period 2020–2024. Data were collected through a review of medical records using a checklist instrument. Univariate analysis was performed to describe maternal characteristics and indications for cesarean section. Result: Most cesarean deliveries occurred in women aged 20–35 years (77.99%) and in multiparous women (48.65%). The most dominant maternal factor was a previous cesarean section (37.6%), while the most common fetal factor was fetal distress (42.7%). Conclusion: Maternal age of 20–35 years, multiparity, a history of previous cesarean section, and fetal distress were the dominant factors associated with cesarean delivery. These findings highlight the importance of early antenatal risk screening and optimal labor management to reduce unnecessary cesarean sections and improve maternal and neonatal safety.

Anxiety during pregnancy is one of the most common psychological problems experienced by pregnant women, particularly during the third trimester when they face childbirth preparation as well as various physical and emotional changes. If not properly managed, anxiety may adversely affect both maternal and fetal health. This study aimed to describe the level of anxiety among third-trimester pregnant women at Mlati II Public Health Center in 2026. This research employed a descriptive quantitative design with a cross-sectional approach. The study involved 40 third-trimester pregnant women selected using a total sampling technique. Data were collected using the Hamilton Anxiety Rating Scale (HARS) questionnaire and analyzed through univariate analysis in the form of frequency and percentage distributions. The results showed that most respondents were of healthy reproductive age (20–35 years) (92.5%), primigravida (67.5%), had a secondary level of education (70%), and were unemployed (70%). The respondents' anxiety levels were categorized as no anxiety (47.5%), mild anxiety (47.5%), and moderate anxiety (5%), while no cases of severe anxiety or panic were identified. The most dominant anxiety indicators were anxious feelings, tension, respiratory symptoms, and sleep disturbances. These findings indicate that some third-trimester pregnant women still experience anxiety, highlighting the need for early detection, health education, and psychological support through antenatal care services to promote maternal mental well-being during pregnancy.

This study aimed to analyze the influence of workload and burnout on nurses’ sleep quality while controlling for age, gender, and education as potential confounding variables. A quantitative analytic study with a cross-sectional design was conducted among 156 nurses working in a private hospital in Depok City. Data were collected using a workload questionnaire, the Maslach Burnout Inventory (MBI), and the Pittsburgh Sleep Quality Index (PSQI). The data were analyzed using Chi-Square tests and multiple logistic regression. The findings showed that both workload and burnout had significant effects on sleep quality (p < 0.05), with burnout identified as the most dominant factor. Age and gender were also significantly associated with sleep quality, whereas education did not show a statistically significant effect. The regression model demonstrated excellent fit, indicated by a McFadden pseudo R² value of 0.908. These results suggest that occupational factors, particularly burnout, play an important role in determining nurses’ sleep quality. Therefore, effective stress reduction and workload management strategies are needed to support nurses’ well-being and improve sleep quality.

The drainage system is critical infrastructure for managing stormwater runoff in densely built urban areas, including higher education institutions. This study aims to evaluate the capacity performance of the existing drainage channels in the UPN "Veteran" Jawa Timur campus area. The evaluation was conducted through two main stages: hydrological analysis using the rational method to estimate the design runoff discharge for a 10-year return period, and hydraulic analysis using Manning's equation to calculate the channel cross-sectional capacity in accordance with Permen PU No. 12 of 2014. Based on the assessment of 43 drainage channels, the results showed that 33 channels (76.7%) are still functioning optimally and capable of accommodating the design discharge. Conversely, 10 channels (23.3%) were identified as having insufficient capacity. This capacity deficit was triggered by initial designs that did not accommodate the 10-year return period flood discharge, increased runoff coefficients due to massive pavement development, and effective cross-section narrowing caused by sedimentation. To mitigate inundation issues, this study recommends redesigning the failing channels using an economical hydraulic cross-section, accompanied by periodic normalization and dredging for functional channels. The findings of this study are expected to serve as technical guidelines for the optimal and sustainable management of campus drainage infrastructure.

Due to its effect on the caliber of generations to come, iron deficiency anemia in teenage females is one of Indonesia's most pressing reproductive health concerns. Adolescents' awareness to autonomously adopt preventative actions is shaped mostly by their knowledge. The purpose of this research is to determine whether there is a correlation between the prevalence of anemia among teenage females in Boyolali Regency and their degree of education. Using a cross-sectional design, this study employs quantitative correlational analytic methods. An accidental sampling approach was used to obtain a sample size of 80 respondents from the population of seventh grade female pupils. A digital POCT device was utilized to quantify the incidence of anemia variables based on hemoglobin (Hb) levels, while a structured questionnaire instrument was employed to gather data for knowledge variables. The Chi-Square test was used to assess the bivariate data analysis. According to the univariate analysis, 62.5% of the participants (50 respondents) had a decent level of knowledge, and 73.8% of the participants (59 respondents) did not suffer from anemia (Hb > 12 g/dL). With a p-value of 0.000 (p < 0.05), the results of the bivariate test were generated. Anemia is more common among female students at MTs Al Ihsan Doglo who have a higher degree of expertise, according to this study. School districts should keep an eye on students' iron pill use and improve their nutrition education programs.

Vandalism is a social problem affecting public space quality, urban aesthetics, and the effectiveness of public facilities utilization. Karawang Regency, as a developing industrial area, faces challenges related to increasing acts of vandalism targeting public facilities, open spaces, and government and private assets. This study aims to analyze preventive efforts carried out by the Civil Service Police Unit (Satpol PP) of Karawang Regency using J. Salusu’s public sector strategic management perspective. This research employed a qualitative approach with a descriptive case study method. Data were collected through observation, interviews, and documentation involving Satpol PP officers and public facility users. Data analysis consisted of data reduction, data display, and conclusion drawing with source, technique, and time triangulation. The findings indicate that preventive strategies have been implemented through four strategic management phases. In the identification phase, Satpol PP recognized vandalism patterns but lacked systematic mapping of vulnerable locations. In the development phase, institutional strengths existed alongside limitations in resources and innovation. In the resolution phase, strategies focused on socialization, routine patrols, and cross-sector collaboration. In implementation and evaluation, preventive programs operated adaptively but still encountered limitations in personnel capacity and public participation. Strengthening technology utilization, human resources, and collaborative governance is necessary to improve long-term preventive effectiveness.

Type 2 diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia due to impaired insulin secretion, insulin resistance, or a combination of both. HbA1c levels are used as an indicator of long-term glycemic control in patients with type 2 diabetes mellitus. Insulin therapy is one of the treatment options given to help achieve glycemic control targets. The purpose of this study was to determine the difference in HbA1c levels of type 2 diabetes mellitus patients with insulin and non-insulin therapy at PKU Muhammadiyah Gamping Hospital. This research method used a descriptive study with a cross-sectional approach. The subjects in this study were 80 type 2 diabetes mellitus patients who had used insulin and non-insulin therapy for less than 1 year, using Purposive Sampling techniques and data analysis using SPSS with Chi-Square and Mann-Whitney tests. This study has obtained ethical approval from PKU Muhammadiyah Gamping Hospital. This study shows that the characteristics of gender and age of type 2 DM patients with insulin and non-insulin therapy are dominated by women at 60.0% and 43.3%, while elderly patients at 60.0% and 53.3%. Of the 50 patients using insulin, 45 patients (90.0%) had controlled HbA1c and 5 patients (10.0%) were uncontrolled. Meanwhile, all non-insulin patients, 30 patients (100%), had uncontrolled HbA1c. Based on this study, there is a significant difference in HbA1c levels between type 2 diabetes mellitus patients with insulin and non-insulin therapy with a p-value <0.001. Patients using insulin therapy tend to have better glycemic control than patients not using insulin therapy.

Permasalahan Rute Kendaraan (Vehicle Routing Problem) bertujuan untuk meminimalkan biaya transportasi. Rute adalah serangkaian urutan dari depo menuju beberapa pelanggan kemudian kembali lagi ke depo. Adapun permasalahan normalnya dimodelkan dalam bentuk graf dengan bobot. Karena setiap ruas jalan memiliki jarak/biaya yang harus dikeluarkan ketika menempuh ruas tersebut maka diperlukan penyelesaian agar meminimalkan biaya transportasi ketika menempuh ruas-ruas jalan tersebut dengan tetap melayani semua pelanggan yang ada. Penelitian ini mengembangkan algoritma metaheuristik, khususnya algoritma genetika yang diimprovisasi dengan Route-Based Crossover dan 2-opt untuk meminimalkan total jarak pengiriman. Hasilnya menunjukkan solusi yang 3% lebih buruk dibandingkan algoritma koloni semut, namun 7% lebih baik daripada pencarian tabu.

Type 2 diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia due to impaired insulin secretion, insulin resistance, or a combination of both. HbA1c levels are used as an indicator of long-term glycemic control in patients with type 2 diabetes mellitus. Insulin therapy is one of the treatment options given to help achieve glycemic control targets. The purpose of this study was to determine the difference in HbA1c levels of type 2 diabetes mellitus patients with insulin and non-insulin therapy at PKU Muhammadiyah Gamping Hospital. This research method used a descriptive study with a cross-sectional approach. The subjects in this study were 80 type 2 diabetes mellitus patients who had used insulin and non-insulin therapy for less than 1 year, using Purposive Sampling techniques and data analysis using SPSS with Chi-Square and Mann-Whitney tests. This study has obtained ethical approval from PKU Muhammadiyah Gamping Hospital. This study shows that the characteristics of gender and age of type 2 DM patients with insulin and non-insulin therapy are dominated by women at 60.0% and 43.3%, while elderly patients at 60.0% and 53.3%. Of the 50 patients using insulin, 45 patients (90.0%) had controlled HbA1c and 5 patients (10.0%) were uncontrolled. Meanwhile, all non-insulin patients, 30 patients (100%), had uncontrolled HbA1c. Based on this study, there is a significant difference in HbA1c levels between type 2 diabetes mellitus patients with insulin and non-insulin therapy with a p-value <0.001. Patients using insulin therapy tend to have better glycemic control than patients not using insulin therapy.

Patient satisfaction with healthcare services remains a major concern in the delivery of healthcare. The behavior of healthcare workers, including friendliness, politeness, and communication skills, plays an important role in improving patient satisfaction. Preliminary data indicated that the number of BPJS patient visits at BLUD UPTD Puskesmas Mokoau had decreased annually, while the results of the patient satisfaction survey were still not optimal because several health programs had not achieved the targeted service standards. This study aimed to analyze the relationship between the quality of healthcare services and BPJS patient satisfaction in the working area of Puskesmas Mokoau in 2025. This research applied a quantitative method with a descriptive-analytic approach using a cross-sectional study design. The study involved 306 respondents selected through a random sampling technique, ensuring that each member of the population had an equal opportunity to be chosen as a research sample. Data were collected using questionnaires and analyzed through the Chi-Square test. The findings revealed significant relationships between facilities, procedures, interaction, and communication with BPJS patient satisfaction, with each variable obtaining a P-value of 0.000 (<0.05). Therefore, the quality of healthcare services is closely associated with the level of patient satisfaction, indicating that healthcare workers need to improve service quality effectively and professionally.

Stunting is a multifactorial public health problem influenced by various risk factors that may emerge during the prenatal period. Early identification of stunting risk during pregnancy is important to support preventive interventions. This study aimed to develop a stunting risk prediction model based on maternal prenatal factors using the Random Forest algorithm. Secondary data from 172 pregnant women, consisting of 83 stunting cases and 89 non-stunting cases, were analyzed. The predictor variables included maternal age during pregnancy, height, hemoglobin level, mid-upper arm circumference (MUAC), smoking history, hypertension, asthma, and diabetes mellitus. The research stages consisted of data preprocessing, model training using Stratified 5-Fold Cross Validation, performance evaluation, external testing, and feature importance analysis. Internal evaluation results showed an accuracy of 60%, precision of 60.6%, recall of 57.3%, F1-score of 58.9%, and AUC of 0.6688. External testing yielded an accuracy of 70% and an AUC of 0.6167. Feature importance analysis identified maternal age during pregnancy as the most influential variable in the prediction process. The findings indicate that maternal prenatal factors have potential for early stunting risk identification, although the predictive performance remains moderate. This approach may serve as a foundation for developing early screening tools to support targeted interventions among high-risk pregnancies.

Work stress is a critical occupational health concern among midwives working at primary healthcare facilities. This cross-sectional study aimed to analyze factors associated with work stress among 30 midwives, including age, marital status, length of service, and dual-role conflict. Data were collected using structured questionnaires measuring work stress (9 valid items) and dual-role conflict (6 items), and analyzed through univariate, bivariate (Fisher's Exact Test and Chi-Square), and multivariate (binary logistic regression) analyses. Results showed that 43.3% of midwives experienced high work stress and 53.3% reported high dual-role conflict. Bivariate analysis revealed significant associations between work stress and marital status (p=0.009) and dual-role conflict (p=0.004), while age (p=0.633) and length of service (p=0.586) were not significant. Multivariate analysis identified dual-role conflict as the primary determinant of work stress (OR=15.762; 95% CI: 2.149–115.631; p=0.007). Healthcare facility management should develop gender-responsive policies and workplace stress intervention programs to reduce dual-role conflict and work stress among midwives.