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Khariri; Lina Farikha

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Background: Non-communicable diseases (NCDs) are diseases caused by changes in human organs or degenerative diseases (age factor). Rheumatoid arthritis is a chronic autoimmune disease that occurs when the body's immune system mistakenly attacks joint tissues. According to WHO 2025, rheumatoid arthritis sufferers reach 355 million people worldwide. Method: This scientific paper uses a descriptive narrative method, namely by providing an overview of family nursing care to patients through a nursing process approach. The general objective of this paper is to understand and apply family nursing care to patients with Musculoskeletal System Disorders: Rheumatoid Arthritis. Results: Nursing diagnoses that appear in patients with Musculoskeletal System Disorders: Rheumatoid Arthritis include chronic pain and knowledge deficit. Conclusion: After nursing implementation for 2 days, the chronic pain diagnosis was partially resolved and the knowledge deficit was resolved, so the author performed routine discharge planning by doing warm compresses using ginger.

Lestari Lestari; Nur Asiah; Safrizal Safrizal

Perspektif: Jurnal Pendidikan dan Ilmu Bahasa 2026 STAI YPIQ BAUBAU, SULAWESI TENGGARA

The urgency of this research stems from the knowledge gap regarding contextual factors contributing to the underuse of learning media in rural elementary schools, which has not been adequately addressed in previous research, which has tended to focus on urban contexts. This study aims to examine teachers' perceptions at Sugayang Public Elementary School regarding the underuse of learning media in the learning process, as well as the factors that contribute to it. The method used was a descriptive qualitative method, utilizing in-depth interviews as a data collection technique. The data were then analyzed using data reduction, data display, and conclusion drawing techniques according to Miles and Huberman. The results showed that teachers experienced difficulties in using technology, difficulties in creating learning media, and the perception that using media was time-consuming. This reveals an important pattern that the underuse of learning media is a systematic problem rooted in the TPACK gap that is not supported by practical time management solutions. These findings imply that changes in learning practices will not occur simply through the provision of generic technology tools or training; rather, bottom-up and contextual solutions are needed. The novelty of this research lies in the in-depth qualitative approach applied to the under-researched context of rural elementary schools, which has not been studied before. This research contributes through recommendations for the implementation of a peer-mentoring program and the development of a ready-to-use digital learning media bank, thus offering valuable insights for future research with relevant stakeholders.

Irma Agustin; Mawardi Mawardi; Ferry Perdiansyah

Bhinneka: Jurnal Bintang Pendidikan dan Bahasa 2026 Universitas Palan

This study aims to analyze the strategies applied by teachers in shaping students' green behavior in grade IV of SDN Sarakan III, Sepatan District, Tangerang Regency. The approach used is descriptive qualitative. The research subjects include grade IV teachers, students, and the school principal. Data collection was carried out through observation, interviews, and document studies. Data analysis used the Miles and Huberman model, which includes data reduction, data presentation, and drawing conclusions. The research results show that teachers implement five main strategies, namely: (1) designing learning according to the objectives and characteristics of students; (2) encouraging active student participation; (3) presenting material contextually; (4) using Project Based Learning (PjBL) methods and the Contextual Teaching and Learning (CTL) approach; and (5) habituating environmentally caring behavior in everyday school life. The implementation of students' green behavior has been observed in the aspects of knowledge, attitude, and action, although consistency still needs to be improved, especially due to limited school facilities and differences in students' levels of awareness.

Risma Septiani; Esti Nur Janah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Vomitus is the forceful expulsion of gastric contents through the mouth, commonly occurring in children as a clinical manifestation of gastrointestinal diseases. Based on medical records of RSUD dr. Soeselo, Tegal Regency, vomitus cases increased to 355 cases in 2025. Therefore, comprehensive nursing care is needed to address problems arising from vomiting in children. This study used a descriptive method in the form of a case study through a nursing process approach, aimed at describing nursing care for a pediatric patient with vomitus. Three nursing diagnoses were identified in An. A with vomitus: Nausea related to gastric irritation/stimulation of the vomiting center, Risk of Fluid Imbalance related to repeated vomiting, and Knowledge Deficit related to lack of information exposure. Nursing interventions provided included Vomiting Management, Fluid Management, and Health Education. After three days of nursing implementation, all three nursing diagnoses were resolved, marked by the disappearance of nausea, improved appetite, normal hydration status (moist mucosa, good skin turgor, pulse 88x/minute), and the patient's mother and patient being able to understand and re-explain health education material about vomitus.

Herizal Kurniawanto; Rizqa Arimurti

Jurnal Pelayanan dan Pengabdian Masyarakat Indonesia (JPPMI) 2026 Sekolah Tinggi Ilmu Administrasi Yappi Makassar

Multi Sari MSME, located in Pangkalan Batang Village, Bengkalis Regency, produces traditional local products such as fish crackers, shrimp crackers, and sago crackers. Despite having quality products, legal business permits, halal certification, and stable raw material availability, the enterprise still faced limitations in digital marketing practices, resulting in a limited market reach. This community service program aimed to improve the marketing capacity of the MSME through the implementation of digital marketing strategies. The methods employed included SWOT and STP analyses, Google Business Profile development, social media management, content calendar preparation, promotional content creation, and marketplace utilization. The program also involved mentoring and training activities to enhance the partner’s understanding of digital marketing tools and techniques. The results showed significant improvements in the partner’s knowledge and skills in utilizing digital platforms for marketing purposes. Furthermore, Multi Sari MSME now possesses more structured digital marketing channels, increasing product visibility and creating opportunities to reach a broader market. Therefore, digital marketing has proven to be an effective strategy for enhancing MSME competitiveness, business sustainability, and market expansion in the digital era.

Dewi Ambarwati; Luluk Khusnul Dwihestie; Triani Yuliastanti

Jurnal Riset Rumpun Ilmu Kedokteran 2026 Pusat riset dan Inovasi Nasional

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.

Riris Risca Megawati; Siti Nafisah; Deasy Virka Sari

Jurnal Sains dan Kesehatan (JUSIKA) 2026 Universitas Muhamadiyah Manado

The risk of accidents in the school environment is quite high, but the ability of the School Health Business Team (UKS) to handle emergencies is often still limited to theoretical knowledge without adequate practical skills. This study aims to analyze the influence of the Role Playing and Emergency Simulation (RANGGA) method on the improvement of the knowledge and skills of the UKS Team in junior high school. This study used a quasi-experiment design with a pre-post test with control group design. The research sample amounted to 60 respondents which were taken by purposive sampling technique. The intervention group was given RANGGA training, while the control group was given conventional education. The data were analyzed using the non-parametric Wilcoxon Signed Ranks Test because the data distribution was abnormal. In the intervention group, there was an increase in the average knowledge score from 88.7 to 97.9 and the skill score from 87.99 to 97.98. The results of the Wilcoxon test showed a significance value of p<0.001 for both variables in the intervention group, indicating a very strong influence of the RANGGA method. In contrast, although the control group experienced an improvement, the variation in scores remained higher and the improvement was not as significant as the intervention group. The RANGGA method is significantly effective in improving the emergency competence of the UKS Team through an experiential learning approach. It is recommended for school institutions to integrate simulation and role play methods in the UKS training curriculum to ensure optimal emergency response readiness.

Abdul Hamid; Nurlaila Agustikawati; Lina Eta Safitri

Jurnal Pelayanan dan Pengabdian Masyarakat Indonesia (JPPMI) 2026 Sekolah Tinggi Ilmu Administrasi Yappi Makassar

Complications of Diabetes Mellitus often arise and without being realized have developed to cause acute and chronic complications that make it difficult for DM sufferers to maintain their condition and will affect the condition of DM sufferers that impact the quality of life of sufferers. Consuming too many carbohydrates causes insulin in the body to work extra, so that the insulin's ability to work in the body will be reduced, which can cause blood sugar to rise. Nutritional therapy can be done by replacing carbohydrate intake with tubers that are low in glucose levels, one of which is Ganyong and pharmacological therapy through herbal medicines, one of which is sentalo leaf tea which is easily obtained and inexpensive. The objectives of this community service activity are to improve the knowledge, skills and quality of service of partners in the implementation of family posyandu related to DM. The method used is empowering posyandu groups through educational activities and training. The results of this activity show an increase in knowledge and skills of partners before and after the community service activity was carried out. And an increase in visits to the posyandu after the implementation of PMT using ganyong flour as the raw material.

Riska Meilina; Esti Nur Janah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Submandibular Abscess is an accumulation of pus in the neck space resulting from the spread of infection, most commonly originating from dental infection. This condition requires surgical incision and drainage along with comprehensive nursing care to prevent serious complications. This study used a descriptive method in the form of a case study approach through the nursing process, aimed at describing nursing care for patients with Pre and Post Op Submandibular Abscess. Nursing diagnoses that emerged in Ny. T consisted of five diagnoses: Pre-op: Acute Pain related to physiological injuring agent and Anxiety related to situational crisis. Post-op: Acute Pain related to physical injuring agent, Risk of Infection evidenced by invasive procedures, and Knowledge Deficit related to lack of information exposure. Interventions provided included Pain Management, Relaxation Therapy, Infection Prevention, and Health Education. After nursing implementation for four days (February 12-15, 2026), out of the five diagnoses, two were fully resolved: anxiety and knowledge deficit, while three others were partially resolved due to time constraints, requiring continuous follow-up of nursing care.

Annisa Nikmatul Hasanah; Esti Nur Janah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Introduction: Febrile seizures are seizure episodes that occur due to an increase in body temperature above 38°C without evidence of central nervous system infection such as meningitis or encephalitis. In Indonesia, the prevalence of febrile seizures is approximately 2–5% among children aged 6 months to 3 years, and around 30% of these cases experience recurrence or recurrent febrile seizures. Therefore, an appropriate nursing care plan is required to manage patients with febrile seizures. Methods: This scientific paper employed a descriptive narrative method to illustrate the provision of nursing care to patients through the nursing process approach. The general objective of this study was to understand and implement nursing care for patients with febrile seizures. Results: The nursing diagnoses identified in patients with febrile seizures were hyperthermia, risk for injury, and knowledge deficit. Nursing interventions included hyperthermia management, safety management, and health education. Conclusion: After two days of nursing implementation, two nursing diagnoses were resolved and one was partially resolved. Discharge planning included monitoring the patient's condition, particularly for seizure signs, maintaining a safe environment, educating the family about injury prevention during seizures, and encouraging family members to continuously supervise the patient.

Bunga Ramadhani; Esti Nur Janah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Stroke is a neurological condition caused by disruption of blood flow to the brain due to blockage or rupture of blood vessels, leading to nerve cell death. WHO (2022) recorded more than 12 million new stroke cases annually, with a prevalence in Brebes Regency reaching 27.83 per mil. The high incidence of stroke accompanied by physical mobility impairment and the family's lack of knowledge about its management highlights the importance of comprehensive family nursing care. This study aims to apply a complete nursing care process including assessment, diagnosis, intervention, implementation, and evaluation to the family of Mr. K with a stroke case. The method used is descriptive with a case study approach through family nursing care. Assessment findings revealed that the patient had experienced stroke for approximately 7 years with a history of hypertension, weakness of the right extremities, decreased muscle strength, blood pressure of 160/90 mmHg, and the family did not understand how to care for stroke at home. Two nursing diagnoses were established: ineffective health maintenance in the family and impaired physical mobility. Interventions included health education about stroke, Range of Motion (ROM) exercises, and rubber ball grip therapy involving the family as caregivers. After 2 days of implementation, both nursing diagnoses were resolved: ineffective health maintenance in the family was resolved and impaired physical mobility was resolved.

Luviana Nur Maulida Ardati; Tati Karyawati

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Hypertension is a condition in which systolic blood pressure exceeds 140 mmHg and diastolic blood pressure is above 90 mmHg. Hypertension is the leading chronic non-communicable disease among adults in Indonesia, with a prevalence of 26.5%, and tends to increase with age. Family nursing care plays an important role in helping patients manage hypertension through education, pharmacological and non-pharmacological interventions, and ongoing monitoring. This case study aimed to describe comprehensive nursing care for Ny. K, a 66-year-old patient from the family of Tn. I, diagnosed with hypertension in Desa Tonjong RT 02 RW 04, Kecamatan Tonjong, Kabupaten Brebes. Nursing care was conducted from December 27 to 29, 2025, using interview, physical examination, observation, and documentation methods. Two nursing diagnoses were identified: (1) Risk of ineffective cerebral tissue perfusion, and (2) Knowledge deficit related to hypertension. Nursing interventions included vital sign monitoring, oral medication administration (Amlodipine 10 mg), health education on hypertension, and non-pharmacological therapy using bay leaf (Syzygium polyanthum) decoction. Evaluation results showed that the knowledge deficit was resolved after one session of health education, while the risk of ineffective cerebral tissue perfusion was partially resolved, with blood pressure decreasing from 180/100 mmHg to 165/90 mmHg over three home visits. It is recommended that families continue the bay leaf decoction therapy for one week and maintain regular blood pressure monitoring at the nearest health facility.

Ayu Pujiati; Ahmad Zakiudin

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Soft Tissue Tumor (STT) is an abnormal lump or swelling caused by new cell growth originating from connective tissue. Post-operative STT presents major nursing problems including acute pain, knowledge deficit, and risk of infection that require comprehensive nursing care. This scientific paper aims to describe nursing care for Mr. R with post-operative Soft Tissue Tumor (STT) Gluteal Sinistra in Mawar 2 Ward of RSUD dr. Soeselo Tegal Regency. The writing method used is descriptive with a case study plan through interviews, physical examination, observation, and documentation. Assessment was conducted on February 8, 2026 on Mr. R, a 37-year-old male, who underwent left gluteal tumor removal surgery on February 7, 2026. Assessment results identified three nursing diagnoses: acute pain related to physical injury agent (D.0077), knowledge deficit related to lack of information exposure (D.0111), and risk of infection evidenced by invasive procedure effects (D.0142). After nursing interventions for 2x24 hours on February 8–9, 2026, evaluation showed all three nursing diagnoses resolved: pain scale decreased from 6 to 2, the client was able to re-explain the tumor disease, and the surgical wound was clean without signs of infection. The conclusion of this nursing care shows that the application of deep breathing relaxation techniques, health education, and proper wound care are effective in addressing nursing problems in post-operative Soft Tissue Tumor patients.

Sefila Meilda Naifah; Ahmad Zakiudin

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Background: Lymphadenopathy is an enlargement of the lymph nodes commonly caused by infection or inflammatory processes, which may lead to pain and risk of postoperative complications. This study aims to provide a comprehensive description of nursing care for a patient following left-sided lymphadenopathy surgery. Method: This case study used a nursing process approach, encompassing data collection through interviews, observation, physical examination, and documentation review of medical records conducted in Mawar 2 Ward at RSUD dr. Soeselo, Tegal Regency. Results: Based on assessment, three primary nursing diagnoses were identified: acute pain, knowledge deficit, and risk of infection. Following standard nursing interventions, pain was reduced, patient knowledge improved, and the wound was maintained without signs of infection. Conclusion: The systematic application of nursing care can help reduce patient complaints and prevent postoperative complications of lymphadenopathy.

Merimbi Gita Yunia; Siti Fatimah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Introduction: Hypertension is an increase in systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg that has the potential to cause serious complications. The prevalence of hypertension in Indonesia is 34.11% (Riskesdas, 2018), in Central Java 37.57%, and in Tonjong Village 15,951 patients aged ≥15 years were recorded (Tonjong Health Center, 2025). Purpose: To provide direct and comprehensive family nursing care to Ny. T, the family of Tn. D, with hypertension in Tonjong Village, Dukuh Kauman RT 03 RW 04, Tonjong District, Brebes Regency. Method: Case study with a nursing process approach. Data were collected through interviews, observation, physical examination, and documentation, conducted on December 26–29, 2025. Results: Assessment revealed that Ny. T complained of dizziness, neck pain, difficulty sleeping, and soreness in both legs with blood pressure of 167/100 mmHg. The family had no knowledge about hypertension. Two diagnoses were established: Acute Pain (D.0077) and Knowledge Deficit (D.0111). Interventions included complementary foot massage therapy to address acute pain and health education on hypertension. After three visits, the Acute Pain diagnosis was partially resolved with a decrease in pain scale from 3 to 2 and blood pressure from 167/100 mmHg to 150/95 mmHg, while the Knowledge Deficit diagnosis was fully resolved. Conclusion: Family Nursing Care with the SDKI, SLKI, and SIKI approach had a positive impact on improving the condition of Ny. T. It is recommended that the client continue foot massage independently, implement the five family health tasks, and routinely utilize health facilities.

Fatiyah Alya Salsabila; Ahmad Zakiudin

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Tumor Left Scapular Region is an abnormal tissue growth in the left scapular area that can cause pain, mobility disturbances, and decreased upper extremity function. The aim of writing this case study was to obtain a description of the implementation of nursing care for Ny. H with Post-Operative Tumor Left Scapular Region in Mawar 2 Ward, RSUD dr. Soeselo, Tegal Regency. The method used is a case study with a nursing process approach including assessment, nursing diagnosis, intervention, implementation, and evaluation conducted on February 8–9, 2026. The assessment results showed that the patient complained of pain in the post-operative wound of the left scapula with a pain scale of 5, there was a risk of infection due to the operative wound, and the patient lacked knowledge about the disease experienced. Nursing diagnoses established were acute pain, risk of infection, and knowledge deficit. After nursing actions were carried out for 2×24 hours, pain decreased, no signs of infection were found in the operative wound, and patient knowledge increased. It can be concluded that the application of nursing care in patients with Tumor Left Scapular Region was able to help reduce pain, prevent infection, and increase patient knowledge to support the healing process optimally.

Marini Marini; Hesti Setiorini; Lussyefrida Yanti; Andry Sartika

Jurnal Pengabdian Kepada Masyarakat 2026 Sekolah Tinggi Pastoral Kateketik Santo Fransiskus Assisi

Elderly people are a vulnerable group experiencing declining body functions and an increased risk of degenerative diseases, requiring promotive and preventive efforts to maintain their health. One alternative is the utilization of kitchen spices as herbal drinks because they contain various bioactive compounds that are beneficial for health. However, knowledge among the elderly regarding the benefits and processing methods of herbal ingredients is still limited. This community service activity aimed to improve the knowledge and skills of elderly participants in utilizing kitchen spices as herbal drinks at LKS Payung Besurek Bengkulu City. The method used a participatory approach through educational sessions, interactive discussions, and direct practice in preparing herbal drinks. The results showed high enthusiasm from participants during the activities. Around 85% of participants experienced increased understanding of the health benefits of kitchen spices. Participants were also able to independently prepare herbal drinks using easily available local ingredients. In addition, the activity generated positive social impacts, including improved interaction, increased awareness of healthy lifestyles, and greater independence in maintaining health through natural ingredients. Therefore, this education program is an effective community-based health empowerment strategy for the elderly.

Ayu Aminatussyadiah; Rhadika Wahyu Kurnia Ningrum; Adelia Ika Cahyani

Jurnal Pengabdian Bidang Kesehatan 2026 PPNI UNIMMAN

Health education is an effort or attempt to provide information to improve individual abilities in making decisions related to health and health-related skills, especially for adolescents. This activity aims to increase the knowledge of SMKS BIM students about acupressure for adolescents. The counseling activity was carried out on May 26, 2026 with 43 students aged between 15-18 years old, using the pretest-posttest method with leaflet media, powerpoint presentations and practicing with students. The results showed an increase in student knowledge from 70 to 95 after being given education. The majority of students aged 16 years (middle adolescents) were identified as having a risk of physical health problems. The education and mentoring provided to students/me were able to increase their knowledge about the benefits and techniques of acupressure to deal with the health problems they experienced. The counseling method with lectures and leaflet media was proven to be easy for students/me to understand and could improve their skills in acupressure practice.

Santi Puspitasari; Marthia Ikhlasiah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

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.

Salsabiila Roikhatul Janah; Siti Fatimah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

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.