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Introduction: Non-Hemorrhagic Stroke (NHS) or ischemic stroke is the most common type of stroke resulting from blood vessel blockage that inhibits oxygen supply to brain tissue. The prevalence of stroke in Indonesia was recorded at 10.9 cases per 1,000 population in 2013 and increased to 70 cases per 1,000 population (equivalent to 7.0%) in 2017. At RSUD dr. Soeselo, Tegal Regency, the prevalence of stroke cases was recorded at 647 people (3.74%) in 2023, 682 people (3.94%) in 2024, and 1,120 people (6.48%) in 2025. These cases frequently cause impairments in physical, emotional, cognitive, and social functioning, necessitating comprehensive care and management. Writing Method: This scientific writing used descriptive narrative methods through a nursing process approach, aiming to describe nursing care in patients with Non-Hemorrhagic Stroke. Results: Four nursing diagnoses were identified in Ny. M with Non-Hemorrhagic Stroke: ineffective cerebral perfusion risk, impaired physical mobility, knowledge deficit, and fall risk. Nursing interventions included intracranial pressure increase management, neurological monitoring, intravenous medication administration, mobilization support, health education, and fall prevention. Conclusion: After two days of nursing implementation, 2 nursing diagnoses were resolved and 2 others were partially resolved: ineffective cerebral perfusion risk via discharge planning delegated to the ward nurse, and impaired physical mobility with discharge planning including recommendations for gradual passive range of motion exercises and continued family involvement in patient care.

Background: Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood effectively due to structural or functional disorders, commonly manifesting as dyspnea, fluid retention, and peripheral edema. Globally, cardiovascular disease is the leading cause of death, with CHF affecting more than 55-65 million people worldwide. Objective: To perform comprehensive nursing care on patient Ny. A with cardiovascular system disorder: Congestive Heart Failure (CHF) in the Mawar I Ward of RSUD dr. Soeselo, Tegal Regency. Methods: This study used a descriptive method through a case study approach. Data were collected via interview, observation, and physical examination. Results: Four nursing diagnoses were identified: ineffective breathing pattern, hypervolemia, activity intolerance, and knowledge deficit. Interventions included respiratory monitoring, hypervolemia management, energy management, and health education on disease process. After two days of nursing implementation, three diagnoses were resolved and one (hypervolemia) was partially resolved. Conclusion: Nursing care for Ny. A with CHF was carried out through assessment, nursing diagnosis, intervention, implementation, and evaluation. Continued interventions are recommended, including fluid balance monitoring, diuretic collaboration, and edema and ascites monitoring.

Background: Schizophrenia is a psychiatric disorder characterized by positive psychotic symptoms (such as hallucinations) and negative symptoms accompanied by cognitive decline. Auditory hallucinations represent the most common positive symptom, occurring in more than 75% of patients with schizophrenia. Objective: This study aimed to describe the comprehensive nursing care for Mr. F with a primary problem of perceptual sensory disorder: auditory hallucinations due to undifferentiated schizophrenia at Gatot Kaca Ward, RSJD dr. Amino Gondohutomo, Central Java Province. Method: This study used a descriptive method with a nursing process approach, including assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Data collection was carried out through interview, observation, and literature study. Results: Nursing problems identified were: perceptual sensory disorder (auditory hallucinations) as the core problem, social isolation (withdrawal) as the causa, risk of violent behavior as the effect, and self-care deficit as an accompanying problem. Nursing interventions were conducted using the implementation strategy (SP) 1, 2, and 3 for hallucinations and SP 1 for self-care deficit. Conclusion: After 4 days of nursing implementation, 2 out of 4 nursing diagnoses were resolved: perceptual sensory disorder (auditory hallucinations) and self-care deficit, while social isolation (withdrawal) and risk of violent behavior remained unresolved. Patients with hallucinations are expected to be able to control hallucinations using the methods that have been taught.

Background: Community nursing is a specialty field that combines nursing science skills, public health sciences, and social assistance in addressing individual and family health problems, including non-communicable diseases such as gout arthritis. Gout arthritis is a metabolic disease characterized by pain and joint inflammation due to the accumulation of purine crystals (hyperuricemia). The WHO reports a prevalence of gout arthritis reaching 3.74% globally, while in Indonesia the prevalence reaches 11.9% based on health worker diagnosis. In Brebes Regency, the prevalence reaches 13.67%, with 3,078 sufferers out of 22,550 productive-age population. Objective: To provide comprehensive community nursing care to Ny. R with musculoskeletal system disorder: gout arthritis in Tonjong Village, Tonjong District, Brebes Regency. Method: This study uses a case study approach with data collection through interview, observation, physical examination, and documentation study conducted on December 26–28, 2025. Results: Assessment findings showed that Ny. R, a 60-year-old woman, had a history of gout arthritis for 3 months with uric acid levels of 9.6 mg/dL, complaining of pain and aching in the left foot with pain scale 3. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management, uric acid level monitoring, lemongrass stem decoction foot soak complementary therapy, and health education using leaflets. After 2 days of implementation, uric acid levels decreased to 8.2 mg/dL and pain scale decreased to 2. Conclusion: Community nursing care through complementary therapy (lemongrass stem decoction foot soak) and health education effectively reduced pain and improved knowledge about gout arthritis in Ny. R.

Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels due to insufficient insulin production or ineffective insulin utilization. The prevalence of DM in Indonesia reached 11.7% in the 2023 National Health Survey, with Brebes Regency recording 568 DM cases in 2025 and increasing to 157 cases in Tonjong Village in January 2026. This case study aims to describe comprehensive nursing care for Ny. M, a 52-year-old patient diagnosed with endocrine system disorder (diabetes mellitus), in the family of Tn. I at Karang Anyar Village, Tonjong District, Brebes Regency. The method used was a case study with data collection through interview, observation, physical examination, blood glucose measurement, and literature review conducted on December 26–28, 2025. The assessment found subjective data: the patient frequently felt fatigue, tingling in both legs, excessive thirst, and increased urination frequency. Objective data: pale and fatigued face, blood pressure 150/100 mmHg, pulse 95x/min, respiration 22x/min, temperature 36.7°C, and random blood glucose (RBG) 155 mg/dl. Two nursing diagnoses were established: blood glucose instability and readiness for enhanced knowledge. Interventions implemented included hyperglycemia management (monitoring blood glucose, dietary education, complementary herbal therapy with ginger and honey), and health education regarding DM complications. Evaluation results showed that after 2 days of nursing visits, fatigue decreased, blood glucose improved (RBG 130 mg/dl), and the patient's knowledge about DM complications was resolved.

High consumption of sugar-sweetened beverages (SSBs) has become an increasing public health concern, particularly among adolescents. Excessive SSB intake is a major risk factor for various non-communicable diseases, including type 2 diabetes mellitus, cardiovascular diseases, obesity, dental caries, and certain types of cancer. This study aimed to analyze the factors associated with the level of sugar-sweetened beverage (SSB) consumption among adolescents. This study employed a descriptive literature review approach. Data were obtained from national and international journals relevant to the topic of SSB consumption among adolescents. The selected articles were analyzed to identify factors associated with SSB consumption. The findings indicated that SSB consumption among adolescents is influenced by several factors, including individual factors (gender and knowledge), socioeconomic factors (peer influence and pocket money allowance), environmental factors (mass media exposure and beverage availability), and psychological factors (stress level and preference for sweet tastes). This study highlights that SSB consumption is a multifactorial behavior influenced by various interacting determinants. Therefore, comprehensive interventions targeting both individual and environmental factors are needed to reduce SSB consumption among adolescents.

Background: Congestive Heart Failure (CHF) is a condition characterized by the inability of the heart to pump blood optimally, resulting in the accumulation of fluid in the lungs and other organs. This condition frequently causes ineffective airway clearance due to hypersecretion of the airway. Objective: This study aims to describe the comprehensive nursing care provided to Ny. R with Cardiovascular System Disorder: Congestive Heart Failure (CHF) with the main nursing problem of ineffective airway clearance at the Melati Ward of RSUD Banyumas. Method: This study used a descriptive method through a case study approach. Data were collected through interviews, physical examination, observation, and documentation. Results: Two nursing diagnoses were identified: (1) ineffective airway clearance related to airway hypersecretion, and (2) activity intolerance related to an imbalance between oxygen supply and demand. Nursing interventions included airway management and energy management. After two days of implementation (January 27–28, 2026), the first diagnosis was resolved and the second was partially resolved, with continued interventions recommended including monitoring of physical and emotional fatigue, advising bed rest, and monitoring vital signs. Conclusion: Comprehensive nursing care with appropriate interventions can effectively address ineffective airway clearance in CHF patients.

The rapid development of information technology drives various business sectors, including the beauty and health industry, to adopt digital systems in their operational management. A Beauty Clinic, a medium-scale aesthetic clinic, faces significant operational challenges in managing human resources, finance, and digital marketing in an integrated manner. This study aims to analyze the existing manual operational system of A Beauty Clinic using the PIECES framework (Performance, Information, Economy, Control, Efficiency, Service), design and configure an Odoo ERP Community Edition implementation integrating the HR, Invoicing/Point of Sale, and Social Marketing modules, and evaluate the operational efficiency improvements achieved. The research employed a qualitative descriptive approach with a case study method and Rapid Application Development (RAD) as the system development methodology. Data was collected through direct observation and semi-structured interviews. The results show that the manual system experienced critical problems across all six PIECES dimensions. Post-implementation evaluation indicates an estimated 80% reduction in the secretary's administrative workload (from 20–25 hours to 3–5 hours per month), over 90% reduction in payroll error frequency, and an 87% reduction in transaction processing time per cashier transaction. The implementation of role-based access control and complete audit trails fundamentally addressed the security vulnerabilities identified in the as-is analysis. This study demonstrates that Odoo Community Edition is an effective, comprehensive, and cost-efficient ERP solution for small and medium-scale beauty clinics seeking to transform from fragmented manual systems to integrated, data-driven information systems.

Indonesia is currently experiencing an emergency situation regarding sexual violence, which compromises national social resilience. The enactment of the Sexual Violence Crimes Law (UU TPKS) creates new legal mandates for healthcare professionals. Midwives, serving as frontline providers in primary care and remote areas, act as the first professional contact for survivors, yet they lack adequate legal certainty regarding medico-legal duties and preparedness within the midwifery educational framework. Objectives: This study aims to analyze the regulatory synchronization concerning the limited medico-legal authority of midwives in implementing the UU TPKS and to formulate reconstruction strategies for professional standards and the national midwifery curriculum. Methods: This normative juridical (doctrinal) research utilizes statute, conceptual, analytical, and comparative approaches. Data analysis was conducted qualitatively-normatively through systematic and teleological interpretations, evaluated using coherence and prescriptive frameworks. Results: The study reveals a significant disharmony of norms between the UU TPKS and Minister of Health Regulation (Permenkes) No. 2 of 2025, which imposes bureaucratic barriers on safe abortion access for rape victims. Additionally, the Midwife Professional Standards (Kepmenkes No. 320/2020) fail to integrate basic clinical forensic authorities, compounded by a national techno-centric curriculum that overlooks Trauma-Informed Care (TIC). Conclusions: Legal certainty for midwives and comprehensive justice for survivors can only be accomplished by reconstructing inclusive competency standards, eliminating administrative boundaries through the "Medical First" principle, and integrating primary health law and trauma-sensitive care modules into the national midwifery curriculum.

This study aims to analyze the implementation of quality control in the carbonated beverage filling process using an automated filler machine and to identify critical control points that influence product conformity and production efficiency. A descriptive quantitative approach was employed through production line observation, machine monitoring, and quality control documentation review. The study focused on the filling process of carbonated beverages packaged in 330 mL aluminum cans and the associated quality control activities throughout the production line. The findings show that the filling process is the key quality control stage, supported by the automated filler machine, Fill High Detector (FHD), seaming, temperature stabilization, and traceability systems to maintain product conformity. The study was limited to a descriptive evaluation of a single production line and did not include statistical process capability analysis or quantitative measurements of filling variation. Therefore, the findings primarily provide operational insights rather than statistical validation of process performance. The findings may assist beverage manufacturers in improving filling accuracy, strengthening inspection systems, and enhancing production reliability through effective quality control practices. This study provides a comprehensive overview of quality control implementation in an automated carbonated beverage filling system and highlights the integration of filling, inspection, and supporting production processes in maintaining product quality and operational efficiency.

Misconceptions on the topic of waves are a systemic problem in high school physics learning that requires a comprehensive diagnostic instrument. Conventional diagnostic instruments up to the four-tier generation have limitations in revealing the conceptual structure behind students' thinking errors. This study aims to develop a five-tier multi-representation diagnostic instrument on the topic of waves using the 4D model (Define, Design, Develop, Disseminate). The main innovation of this instrument lies in the integration of multi-representations (verbal, pictures, graphics, mathematical) in Tier 1 and the addition of a paraphrase tier (Tier 5) that asks students to rewrite their understanding in their own words. The development process includes needs analysis, designing a grid of 16 questions, validation by two experts, and a limited trial on 34 grade XI students of SMAN 13 Kota Jambi. The results of expert validation showed an average percentage of 91.25% (Very Good) from both validators. Content validity was met with a percentage of False Positive (FP) of 6.80% and False Negative (FN) of 4.41%, both below the 10% threshold. Construct validity was confirmed through a significant Product Moment correlation (r = 0.342–0.348; sig. < 0.05) and factor analysis with six significant factors (eigenvalue > 1). The instrument's reliability was high, with a Cronbach's Alpha of 0.726. This instrument is expected to help physics teachers diagnose students' misconceptions more precisely and thoroughly on the topic of waves.

This study aims to obtain a comprehensive understanding of the Juz ‘Amma memorization strategy implemented at Madrasah Diniyah Takmiliyah Baitul Azhar, evaluate its effectiveness, and examine the assessment mechanisms applied in Qur’anic learning. The research employed a qualitative field-study approach, focusing on learning activities as the primary object of investigation. Data were collected through direct observation of the learning process, in-depth interviews with the madrasah principal and teachers (ustadz/ustadzah), and documentation analysis related to the memorization program. The data were analyzed through data reduction, data presentation, and conclusion drawing to generate accurate and in-depth findings. The results indicate that the memorization program utilizes a combination of talaqqi, takrir (repetition), sima’i, and small halaqah methods. These strategies have proven effective in improving students’ memorization abilities, as reflected in increased reading fluency, better tajwid accuracy, and the achievement of memorization targets. In addition, the madrasah implements a structured and continuous evaluation system consisting of daily assessments, weekly reviews, and final examinations for each juz. The evaluation focuses on memorization fluency, recitation accuracy, and overall memorization quality. The study concludes that integrating diverse memorization methods with systematic evaluation significantly enhances the effectiveness of Qur’an memorization learning in Islamic educational institutions.  

This study aims to analyze environmentally based science learning as an effort to enhance ecological awareness among elementary/Islamic elementary school (SD/MI) students through a literature review approach. The method employed is a Systematic Literature Review (SLR) by examining reputable scientific articles published between 2020 and 2026. Data were collected through documentation, with literature selected using purposive sampling based on topic relevance, while data analysis utilized content analysis techniques to identify patterns, characteristics, and key findings across studies. The results indicate that environmentally based science learning is characterized by the integration of scientific concepts with real environmental contexts, the use of contextual approaches, and the application of active learning models such as problem-based learning, project-based learning, and inquiry learning. This approach has been proven to play a significant role in enhancing students’ ecological awareness, including knowledge, attitudes, and environmentally responsible behaviors. However, its implementation still faces several challenges, such as limited facilities, teacher competencies, and suboptimal integration into the curriculum. Additionally, research gaps remain, particularly regarding the lack of studies examining long-term impacts on students’ ecological behavior. Therefore, more innovative learning strategies and more comprehensive future research are needed.

Background: Hepatocellular Carcinoma (HCC) is an abnormal cell growth in the liver characterized by increased number of dividing liver cells accompanied by malignant transformation. A common paraneoplastic phenomenon in HCC patients is hypoglycemia, which arises due to hepatic dysfunction impairing gluconeogenesis and glycogenolysis, as well as tumor-mediated IGF-II production. This condition causes hypoglycemia as a primary nursing problem requiring comprehensive nursing care. Objective: To describe the nursing care process for a patient with HCC focusing on blood glucose instability management and knowledge deficit intervention. Methods: This study used a descriptive qualitative method through a case study approach. Data were collected through interview, observation, documentation study, and literature review. Results: Two nursing diagnoses were identified: blood glucose instability related to hepatic dysfunction and knowledge deficit related to lack of information exposure. Nursing interventions performed included hypoglycemia management and disease process education. After 2x24 hours of nursing implementation, both diagnoses were partially resolved, as GDS values remained fluctuating and behavioral change had not been fully achieved. Conclusion: Comprehensive nursing management through routine blood glucose monitoring, dextrose administration, nutritional modification, and health education can improve blood glucose stability and patient knowledge in HCC patients.

Circulating tumor DNA (ctDNA) has emerged as a promising liquid biopsy biomarker for real-time monitoring of tumor dynamics. In urothelial carcinoma (UC), effective monitoring of treatment response remains a clinical challenge due to the limitations of conventional imaging and invasive procedures. This systematic review aims to synthesize the existing evidence on the association between ctDNA dynamics and treatment response monitoring across various stages and therapeutic settings. A comprehensive systematic review was conducted. We included cohort studies, randomized controlled trials, and meta-analyses that evaluated ctDNA in UC patients undergoing treatment. Data were extracted on patient population, methodology, treatment, sampling strategy, clinical outcomes, and statistical associations. The review encompassed 80 studies. Baseline ctDNA positivity was strongly prognostic, associated with a 4- to 6-fold increased risk of recurrence or death (HR 4.23-6.56). Dynamic ctDNA clearances or significants reduction during treatment, were strongly associated with improved outcomes. Showing hazard ratios for adverse events as low as 0.10-0.31. ctDNA demonstrated time advantages of 53-90 days over radiographic detection. ctDNA is a potent tool for monitoring treatment response in urothelial carcinoma. It provides superior prognostic and offers a significant lead time for detecting treatment failure. Future research must focus on standardizing methodologies and validating ctDNA-guided therapeutic.

Fractures are one of the most common musculoskeletal disorders caused by trauma, repetitive stress, or pathological factors. Supracondylar femur fracture is a type of femur fracture occurring at the distal 12 cm of the femur, and Open Reduction and Internal Fixation (ORIF) is the primary surgical intervention. Post-operative ORIF patients commonly experience impaired physical mobility and impaired skin integrity. This study aimed to provide comprehensive nursing care to a patient post-ORIF for right supracondylar femur fracture in the Mawar 2 Ward of RSUD dr. Soeselo, Tegal Regency. A descriptive method with a nursing process approach was used, employing interview, observation, documentation study, and literature study. Nursing assessments conducted on February 8, 2026 revealed that the patient (Ny. S, female, 68 years) experienced pain at the surgical site with a scale of 7, inability to move both lower extremities (muscle strength score 2), and a post-operative wound approximately 10 cm in length with redness and edema. Two nursing diagnoses were established: impaired physical mobility related to neuromuscular disorders and impaired structural bone integrity, and impaired skin/tissue integrity related to invasive procedure effects. Nursing interventions included mobilization support, pain management, wound care, and collaborative administration of medical therapy. After two days of nursing implementation, both diagnoses were partially resolved. Discharge planning focused on gradual mobilization, independent wound care, and high-protein and high-calorie diet to accelerate recovery.

This study investigates the development of Indonesian language literacy among third-grade elementary school students. The primary problems identified were acute classroom passivity and low reading comprehension, evidenced by an initial learning mastery of only 45.16%, which were largely driven by conventional teacher-centered pedagogy. The objective of this research is to enhance early-grade reading literacy and active participation through an innovative instructional intervention. The proposed method employed a two-cycle Classroom Action Research (CAR) design at SDN Jrebeng Kulon 1, integrating the Problem-Based Learning (PBL) model assisted by serial picture media. This approach utilizes chronological visual scaffolding to facilitate narrative comprehension for students in the concrete operational stage. The results demonstrated a highly significant academic progression: classical learning mastery increased to 70.97% (mean score: 80.80) in Cycle I and culminated in an absolute 100% mastery rate (mean score: 94.51) by the end of Cycle II. The synthesis of these findings reveals that transitioning from static visual aids to serial visual stimuli within a problem-oriented framework effectively mitigates cognitive dissonance and eradicates classroom passivity. In conclusion, the integration of the PBL model with serial picture media serves as a comprehensive pedagogical solution that not only maximizes cognitive reading comprehension but also reconstructs students' verbal articulation and social-collaborative skills, offering a highly scalable strategy for early primary education.

The imbalance in bargaining position between business actors and consumers frequently places consumers in a vulnerable position to economic exploitation through the inclusion of standard clauses and unfair trade practices. This study aims to analyze the fulfillment of rights and obligations of the parties, identify the comprehensive boundaries of prohibited acts for business actors, and examine the legal binding force of standard clauses in commercial transactions under Law Number 8 of 1999 concerning Consumer Protection (UUPK). The method employed in this research is a normative juridical legal approach with statutory and conceptual analysis, utilizing qualitative analysis of secondary data obtained from library research combined with a deductive reasoning method. The findings underscore two pivotal aspects. First, the weak standing of consumers in the market is driven not only by economic imbalances but also by low legal awareness and minimal information transparency regarding quality standardization. Second, the inclusion of standard clauses that unilaterally transfer liability (exculpatory clauses) is strictly prohibited by Article 18 of UUPK and declared null and void, which aligns with the progressive judicial stance in the landmark Supreme Court Civil Judicial Review Decision Number 124/PK/PDT/2007. The theoretical implication of this study urges a reconstruction of the freedom of contract doctrine bounded by distributive justice, while its practical implication recommends the government, YLKI, and BPKN to tighten preventive oversight through auditing draft standard agreements in public spaces and formulating adaptive regulations toward digital contract disruptions.

This study aims to analyze the role of parents in fostering adolescents' moral development and to identify the supporting and inhibiting factors in this process in Karya Jaya Village, Buton Regency. This research is motivated by the importance of adolescence as a critical developmental stage that is highly vulnerable to environmental influences, thus requiring optimal moral guidance, especially from the family as the first and primary educational institution. This research employs a qualitative descriptive approach. The research subjects consist of 30 parents and adolescents selected through purposive sampling. Data collection techniques include observation, interviews, and documentation to obtain in-depth and comprehensive data. The data analysis technique uses the Miles and Huberman model, which consists of data reduction, data display, and conclusion drawing. The results show that parents play a significant role in moral development through role modeling, habituation of moral and religious values, effective communication, and supervision of adolescents' behavior in daily life. Parental role modeling is a key factor in shaping adolescents’ moral behavior, as adolescents tend to imitate what they observe within the family environment. Supporting factors include harmonious family conditions, active parental involvement, and a positive social environment. Meanwhile, inhibiting factors include parents' busyness, lack of supervision, and the influence of technology and peer environment. Therefore, the role of parents is crucial in shaping positive moral behavior among adolescents.

The development of information technology and the use of social media have increased the potential for defamation against various institutions, including educational institutions. The reputation of schools or educational institutions is an important social asset because it is directly related to public trust, institutional credibility, and the continuity of the educational process. However, the Indonesian legal system still places greater emphasis on protecting individual reputation than institutional reputation, creating a need to reexamine the legal position of educational institutions in responding to attacks on their good name. This study aims to analyze legal protection for the reputation of educational institutions within the Indonesian legal system and to formulate a more comprehensive reconstruction of legal protection that is relevant to the development of digital spaces. This research uses a normative legal method with statutory and conceptual approaches. Data sources consist of primary legal materials, including Law Number 1 of 2023 concerning the Criminal Code and the Electronic Information and Transactions Law, as well as secondary legal materials in the form of legal literature and educational theory. The results show that defamation provisions in the Criminal Code and the ITE Law have not explicitly provided adequate protection for the reputation of educational institutions. Therefore, legal protection reconstruction is needed through affirming educational institutions as legal subjects whose reputation deserves protection, strengthening reputation recovery mechanisms, and integrating educational ethics perspectives into legal regulation.