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This study aims to address the low learning process and outcomes of students in mathematics in grade IV of State Elementary School 138/II Daya Murni. The type of research used is classroom action research (CAR), which is carried out in two cycles, each consisting of planning, implementation, observation, and reflection stages. The subjects in this study were 13 students, and the implementation was carried out in the second semester of the 2025 academic year. Data were collected through observation, field notes, documentation, and learning outcome tests. Based on the results of the study, the Take and Give Type Cooperative model was proven to be able to improve the learning process and outcomes of students. In the first cycle, the involvement of educators in teaching was recorded at 66.66%, while in the second cycle it increased to 73.33%. Likewise, student involvement in the learning process increased from 46.61% in the first cycle to 69.23% in the second cycle. A significant increase was also seen in the completeness of student learning outcomes. In cycle I, the learning achievement rate reached 76.92%, and in cycle II, it increased to 84.61%. The implementation of the Take and Give Cooperative Model has proven effective in improving the quality of learning, both in terms of process and outcomes. Therefore, this model can be a useful alternative for educators in increasing student engagement and learning outcomes in grade IV.  

Profit growth serves as a primary benchmark for evaluating financial standing, particularly within the healthcare industry which demands elevated levels of efficiency and superior financial stewardship. As healthcare companies face increasingly competitive environments and high operational costs, the ability to generate sustainable profits becomes a critical determinant of long-term viability. This study aims to examine the impact of Return on Equity (ROE) and Total Asset Turnover (TATO) on the profit growth of healthcare companies registered on the Indonesia Stock Exchange (IDX) during the 2019–2023 period. The research employed a quantitative approach using secondary data, with a sample of 10 companies selected through purposive sampling. Data analysis was conducted using multiple linear regression, supported by classical assumption testing, t-tests, F-tests, and the coefficient of determination (R²). The results revealed that ROE had a positive and partially significant effect on profit growth, while TATO showed a positive but not significant influence. However, when tested simultaneously, both variables demonstrated a significant relationship, with the model explaining 23.9% of the variance in profit growth. These findings suggest that profitability ratios, particularly ROE, play a more decisive role in determining financial performance in healthcare companies compared to activity ratios. The study highlights the importance for healthcare firms to optimize equity utilization in order to enhance sustainable profit growth and shareholder value.

Background: Stroke is a health condition that significantly impacts quality of life and causes physical and mental disability, as well as death, in both productive and elderly individuals. The loss of bodily functions in stroke patients can hinder productivity and reduce the fulfillment of ADL (Activities of Daily Living). Dependence in ADL is the inability to perform all or some activities and the need for assistance from others. The high incidence of stroke in patients and its role as a leading cause of disability makes it difficult for stroke patients to perform daily activities, causing mental and emotional disturbances, reducing productivity and quality of life. The loss of independence and mobility in stroke patients necessitates family support, as they play a crucial role in the care and rehabilitation of their loved ones. Objective: The purpose of this study was to determine the relationship between family support and the fulfillment of daily living (ADL) in stroke patients. Methods: This study employed a correlational analytic method with a cross-sectional approach. A purposive sampling technique was used for the sample, employing 89 respondents. Data analysis used the Spearman rank sum. Results: The Spearman rank sum analysis yielded a ρ value of 0.000, less than 0.05, and an r value of 0.827 (very strong). Therefore, it can be concluded that there is a very strong relationship between family support and the fulfillment of daily needs (ADL) in stroke patients at Sunan Kalijaga Regional General Hospital, Demak.

Basic literacy issues remain a global challenge, as evidenced by the results of the Programme for International Student Assessment (PISA), which place Indonesia at a low rank in reading proficiency. This condition highlights the urgency of literacy as a fundamental competency for elementary school students, particularly in Indonesia. A similar phenomenon is observed in the city of Semarang, where students demonstrate low reading interest, limited access to reading materials, and reliance on conventional teaching methods. In this context, the presence of the SOUL Literacy Community holds strategic potential to support the enhancement of students’ reading and writing skills. This community service initiative aims to empower the SOUL Literacy Community by strengthening the capacities of teachers, students, and the community in developing literacy programs. The methods employed include Participatory Action Research (PAR) and Participatory Community Appraisal (PCA), implemented through preparation, training, mentoring, and evaluation stages. The program results indicate increased community capacity in formulating literacy agendas, improved student interest and skills in reading and writing, and enhanced teacher confidence in applying interactive literacy strategies. Furthermore, the program successfully established a participatory literacy model that strengthens school–community collaboration and can be replicated in other regions. In conclusion, this initiative contributes to the development of a sustainable literacy ecosystem and supports the achievement of SDG 4 on quality education.

Hypertension is one of the most prevalent non-communicable diseases and a major risk factor for heart disease, stroke, and kidney disorders. The high prevalence of hypertension cases in the community, particularly in the working area of Puskesmas Kota Rantau Prapat, highlights the urgent need for more effective early detection efforts to prevent severe complications in the future. However, the limited capacity of healthcare workers in utilizing data analysis technologies has resulted in hypertension risk detection being dominated by conventional methods, which are often less accurate and inefficient. To address this issue, this community service program was conducted through training on the application of the Random Forest algorithm to analyze patients’ medical history data in order to detect hypertension risks. The training method included an introduction to the fundamentals of machine learning, data pre-processing stages, implementation of the Random Forest algorithm, and interpretation of prediction results. The outcomes of the program demonstrated that healthcare workers were able to understand the use of data analysis technologies to support more accurate early detection of hypertension. Furthermore, the participants gained practical skills in utilizing medical datasets to produce predictions that can serve as a decision-support tool for preventive medical actions.Thus, this training contributed to enhancing the capacity of community healthcare workers in integrating machine learning-based technologies into preventive healthcare services. This program is expected to serve as an initial step toward developing more effective, efficient, and sustainable data-driven health systems.

A 60-year-old male patient presented with the chief complaint of numbness in both legs, which had been experienced for the past two years and had worsened over the last three months. This complaint was accompanied by persistent fatigue, even without engaging in strenuous physical activity. In addition, the patient reported frequent urination, especially at night (nocturia), and excessive thirst that had occurred for the past five years. The patient denied symptoms such as fever or disturbances in bowel movements. Regarding his medical history, the patient regularly consumed Glimepiride as part of his treatment for diabetes mellitus. Primary data were obtained through auto-anamnesis and physical examination during a home visit. During the visit, the family physician also completed the family folder and patient records to comprehensively document the patient’s health condition. Case assessment was carried out based on an initial holistic diagnosis, followed by continuous monitoring and final evaluation using both quantitative and qualitative approaches. The interventions provided included health education for the patient and his family regarding the causes and pathophysiology of diabetes mellitus. The physician also emphasized lifestyle modifications, such as adopting a balanced diet, engaging in light but regular physical activity, and maintaining adherence to prescribed medication. Furthermore, the patient was educated on the long-term management of diabetes mellitus and the importance of regular medical check-ups. The family physician also explained the potential complications that could arise, such as neuropathy, nephropathy, and retinopathy, so that the patient would be more compliant with treatment and preventive efforts. This comprehensive approach was expected to improve the patient’s quality of life while preventing further disease progression.

Hypertension in the elderly is one of the common and significant health problems. The purpose of this study was to determine the effect of elderly exercise on hypertension in the working area of ​​the Krueng Barona Jaya Aceh Besar Community Health Center. The study method applied was a quasi-experimental design through a pre-test-post-test approach with a total population of 413 hypertension sufferers and a total sample of 15 people. The sample collection method was through Snowball Sampling. This research was conducted on April 20-24, 2025 in Meunasah Village, Papeun, with the research instrument in the form of an observation sheet with a measuring instrument using a sphygmomanometer. First, blood pressure was measured before the intervention, using a blood pressure monitor. Next, the elderly were given 20 minutes of exercise, followed by another 30-minute evaluation to assess changes in blood pressure. The results showed that before being given elderly exercise activities, the average systolic blood pressure of respondents was 179.60 mmHg and diastolic blood pressure was 102.73 mmHg, while after being given elderly exercise activities, the average systolic blood pressure of respondents was 170.80 mmHg and diastolic pressure was 92.80 mmHg with a difference of 8.8 mmHg systolic blood pressure and 10.13 mmHg diastolic blood pressure using a paired t-test of ρ value 0.000 (ρ <0.05). The conclusion is that there is an effect of elderly exercise on hypertension. It is hoped that hypertension sufferers and researchers will carry out routine elderly exercise activities, educational institutions will provide books on hypertension and complementary materials to increase students' knowledge and insight, and further research will be able to use the findings of this study as reference material and can improve this study through different variables.

The performance of a company is highly influenced by its employees. Therefore, human resources deserve substantial attention from management, particularly regarding employee discipline, work quality, and the potential to improve work discipline. This study employed a quantitative descriptive method with a sample of 95 respondents. Data were collected through observation, interviews, questionnaires, and documentation. The findings reveal a significant partial effect between work discipline and employee performance, as demonstrated by the results of the t-test (probability value 0.000; t-value 3.369 > t-table 1.66159). Furthermore, there is a significant partial influence between work motivation and employee performance, as evidenced by the t-test results (probability value 0.000; t-value 4.251 > t-table 1.66159). In addition, a significant simultaneous effect of work motivation and work discipline on employee performance was identified at the Head Office of Export and Trade Services Human Resources Training. This was confirmed by the F-test results (probability value 0.000; F-value 9.598 > F-table 2.70). These results indicate that both work discipline and work motivation play a critical role in shaping employee performance. Strengthening employee discipline and motivation can therefore enhance organizational effectiveness and lead to improved performance outcomes. This study underscores the importance of human resource management practices focused on discipline and motivation as key drivers of organizational success and sustainable performance improvements in service-oriented institutions.

Background: Diabetes mellitus (DM) is a chronic disease and a global health problem with an increasing prevalence that often leads to serious complications if not well controlled. Optimal self-care behavior, including diet regulation, physical activity, blood glucose monitoring, and adherence to medication, plays a crucial role in maintaining stable blood glucose levels and improving quality of life. Objective: This study aims to investigate the relationship between self-care behavior and blood glucose levels among individuals diagnosed with diabetes mellitus who are receiving treatment at Kedungwuni 1 Public Health Center. Methods: This research employed an observational analytical design with a cross-sectional approach. A total of 109 respondents diagnosed with DM were selected through total sampling. Data on self-care behavior were collected using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire, while blood glucose levels were measured using a glucometer. Data were analyzed using the Spearman correlation test with a significance level of α = 0.05. Results: The findings showed that most respondents demonstrated poor self-care behavior (72.5%) and almost half were within the diabetes range of blood glucose levels (49.5%). Bivariate analysis revealed a significant positive correlation between self-care behavior and blood glucose levels (p = 0.000; r = 0.547). Conclusion: Better self-care behavior is associated with better blood glucose control. These results emphasize the importance of strengthening health education and self-management programs to improve self-care practices in diabetic patients.

Learning Indonesian for Foreign Speakers (BIPA) requires structured, communicative, and internationally standardized teaching materials. One widely used teaching material is Sahabatku Indonesia Level 4, which is intended for the intermediate level. The urgency of this research lies in the importance of ensuring that the teaching materials not only convey language formally, but also align with the needs of learners' communicative competence and recognized standards, such as the Common European Framework of Reference (CEFR) level B2 and the Indonesian Language Proficiency Test (UKBI). The purpose of this research is to evaluate the structure and linguistic aspects of the Sahabatku Indonesia Level 4 teaching materials by reviewing the integration of the material, clarity of discourse, vocabulary diversity, and grammatical accuracy used. The research method used is descriptive qualitative. Data were analyzed using an evaluation rubric based on CEFR B2 and UKBI components. The focus of the analysis includes the integration of presentation between units, the logical flow of learning, and the consistency of language use in supporting receptive and productive skills. The results show that the material presentation structure reflects a logical, progressive learning sequence and supports language skill mastery. The language elements used are generally appropriate for the intermediate level, although discrepancies were still found, such as the use of irrelevant illustrations and inconsistent language style. Furthermore, the syntactic complexity in some sections still needs to be adjusted to align with the abilities of B2 learners. 

Public Company (Perum) BULOG is a business entity engaged in food logistics and has a strategic role in national food security. However, the company faces obstacles in the implementation of the Total Quality Management (TQM) system which is not fully in accordance with the applicable Standard Operating Procedures (SOP), as well as low work motivation for some employees. This study aims to analyze the influence of TQM implementation and work motivation on employee performance at the Perum BULOG head office. The research method used was a quantitative approach with data collection techniques through interviews and questionnaire distribution to 97 respondents selected using purposive sampling techniques. The research will be carried out in May 2025. The results of the analysis showed that partially, the implementation of TQM did not have a significant effect on employee performance (tcount = 1,533 < ttable = 1,985; sig. = 0.129 > 0.05). On the other hand, work motivation has a significant influence on employee performance (tcount = 5,411 > ttable = 1,985; sig. = 0.00 < 0.05). Simultaneously, TQM and work motivation had a significant effect on employee performance (Fcal = 16,602 > Ftable = 3,093; sig. = 0.00 < 0.05). These findings indicate that increasing work motivation is a key factor in encouraging employee performance, while the implementation of TQM needs to be adjusted to SOPs to be more effective in supporting organizational productivity.

The pregnancy period is a crucial time for ensuring the health of the mother and fetus through the provision of balanced nutrition. However, nutritional issues such as anemia and chronic energy deficiency (CED) are still commonly found among pregnant women. The use of local nutritious foods, such as moringa leaves (Moringa oleifera), can be a potential solution to support nutritional needs. This community service activity aims to improve the knowledge and skills of pregnant women in preparing healthy menus and balanced eating patterns using moringa leaves. The activity was carried out through interactive lectures, coaching on menu preparation, cooking demonstrations of moringa leaf dishes, and evaluation through pre-tests and post-tests. The participants were pregnant women in the working area of the Wara Selatan Health Center in Palopo City, totaling 25 people. The results showed an increase in participants' nutritional knowledge, with an average pre-test score of 55 rising to 82 in the post-test. Participants were also able to prepare a balanced daily menu based on moringa leaves and produce several processed products, including moringa soup, moringa fritters, and moringa pudding. It can be concluded that the healthy menu coaching activity using local moringa leaves effectively improves the knowledge and skills of pregnant women regarding balanced nutrition. The use of local foods such as moringa leaves has the potential to support the improvement of maternal nutritional status in a simple, economical, and sustainable manner.

Improving caregiver literacy regarding early childhood development is a strategic step to ensure optimal child growth and development. This educational activity was conducted at the Mawar Integrated Health Post (Posyandu Mawar), Tampingan Village, Boja District, involving 20 caregivers as active participants. The series of activities were systematically arranged, including a pre-test to determine the level of initial understanding, counseling through a lecture method accompanied by comprehensive material delivery, interactive discussions that allowed participants to exchange experiences, practice of child development stimulation as a form of direct skills, and a post-test to assess improvements in learning outcomes. The analysis results showed that the educational activity had a significant impact on improving caregiver literacy. The average pre-test score of 53.25 (SD = 9.54) increased to 69.60 (SD = 10.30) in the post-test. The average difference of 16.35 (SD = 5.84) with a 95% confidence interval between 13.62–19.08 indicated a significant increase. The paired t-test yielded a value of t(19) = 12.515 with p < 0.05, confirming a significant difference between the scores before and after the program. The percentage increase of 30.7% indicates the effectiveness of the applied educational method. The recommendation from this activity is the need to develop an educational program that is carried out in a sustainable and structured manner, accompanied by mentoring involving health workers, PAUD educators, and support from the village government, so that caregiver literacy can continue to increase and optimal child growth and development can be guaranteed from an early age.

This study uses a quantitative associative approach to analyze the influence of exports, imports, inflation, and exchange rates on economic growth in five ASEAN member countries: Indonesia, Malaysia, Singapore, Thailand, and Vietnam. The data used are secondary data obtained from the World Bank for the period 2013–2023. The analysis technique used is the Panel Autoregressive Distributed Lag (Panel ARDL) Model, which begins with stationarity and cointegration tests. Results The ARDL Panel Model estimation in this study is declared valid because it meets the main requirements, namely having a cointegrated lag with a negative coefficient value of -0.831550 and significant at the 5% significance level (probability 0.0000 < 0.05). The long-term estimation results indicate that only the inflation variable has a significant influence on Gross Domestic Product (GDP) in the 5 ASEAN countries studied. Meanwhile, in the short term, no variables were found to have a significant influence on GDP in the 5 countries. Furthermore, country-level estimations show varying results. Indonesia is the only country that shows a significant influence of exports, imports, inflation, and exchange rates on GDP. Thailand shows a significant influence of exports and exchange rates, while Malaysia, Singapore, and Vietnam do not show any significant influence of exports, imports, inflation, and exchange rates on GDP. These findings reflect that the relationship between macroeconomic variables and economic growth in ASEAN countries is heterogeneous and is strongly influenced by the structural characteristics of each country.

Stroke patients often experience mobility impairments, which increase the risk of developing pressure ulcers (decubitus). Pressure ulcers are a common complication for patients with limited mobility, especially in the ICU. One intervention that can be used to reduce the risk of pressure ulcers is back massage using olive oil. This study aims to analyze the effect of back massage using olive oil on reducing the risk of pressure ulcers in stroke patients in the ICU at Sultan Agung Hospital. This study used a pre-experimental design with a one-group pretest-posttest approach, involving 17 respondents who received back massage using olive oil. The results showed that most respondents were aged 56-65 years (35.3%), the majority were male (70.6%), with comorbidities such as diabetes mellitus (52.9%), and the length of hospitalization was 3-5 days. Before the intervention, most respondents were categorized as being at moderate risk based on the Braden scale; however, after the intervention, the majority were no longer at risk of pressure ulcers. The Wilcoxon test showed a p-value of 0.001, indicating that back massage using olive oil had a significant effect on reducing the risk of pressure ulcers. In conclusion, back massage using olive oil is effective in reducing the risk of pressure ulcers in stroke patients in the ICU. Therefore, this technique can be used as an alternative intervention to prevent the occurrence of pressure ulcers in stroke patients.

Elderly individuals are a group vulnerable to sleep disorders, with over 50% of them reporting a decline in sleep quality. Sleep disturbances in the elderly can affect their quality of life, which in turn impacts their physical and mental health. One non-pharmacological intervention considered safe, simple, and effective for improving sleep quality in the elderly is foot soaking in warm water. This study aims to evaluate the effect of foot soaking in warm water on the sleep quality of elderly individuals in the working area of Slawi Health Center. The research design used was pre-experimental with a one-group pre-test post-test design. A total of 34 elderly participants were selected using total sampling technique. The intervention consisted of soaking feet in warm water at a temperature of 37°C–39°C for 10 minutes before sleep, conducted for three consecutive days. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The data obtained were analyzed using Paired Sample T-test for normally distributed data. The results showed that the average sleep quality score before the intervention was 10.12, which decreased to 7.85 after the intervention. Statistical analysis showed a significant difference in the mean scores before and after the intervention with a significance value of 0.0001. This indicates that foot soaking in warm water significantly impacts the improvement of sleep quality in the elderly. This intervention can be recommended as an effective, practical, and easy-to-implement independent nursing action to improve sleep quality in the elderly. Based on these findings, foot soaking in warm water can be a good option to improve sleep quality in the elderly, especially in community healthcare services.

This study explores in greater depth the effect of online promotions on airline ticket purchasing decisions through e-ticketing applications, emphasizing the mediating role of the digital era. Adopting a quantitative research design, data were collected from 491 respondents who had experience purchasing airline tickets via leading digital platforms such as Traveloka, Tiket.com, Agoda, and Booking.com. Five core online promotional strategies were investigated—discounts and vouchers, email marketing, social media promotions, influencer marketing, and push notifications—each representing distinct digital touchpoints. Partial Least Squares (PLS) analysis was used to test the relationships among variables and to evaluate the mediating effect of the digital era. The results indicate that all five promotional strategies significantly influence purchasing decisions, with influencer marketing and social media promotions emerging as the strongest drivers of consumer behavior. Furthermore, the digital era was shown to enhance consumer trust, accessibility, and engagement, thereby strengthening the impact of online promotions on purchase decisions. These findings highlight the need for airlines and e-ticketing platforms to develop integrated digital marketing strategies that align with evolving consumer behaviors and technological trends. This research contributes to the growing body of literature on digital marketing in the aviation sector and provides practical recommendations for optimizing promotional effectiveness.

This study aims to analyze the differences between various extraction techniques and their relationship to the yield and biological activity of phytochemical compounds derived from natural materials. A systematic literature review was conducted by analyzing relevant and reliable scientific publications published within the last five years. The findings indicate that extraction methods such as maceration, soxhletation, microwave-assisted extraction (MAE), and ultrasound-assisted extraction (UAE) demonstrate varying levels of effectiveness depending on the type of material, solvent polarity, extraction temperature, and duration of the process. Modern extraction methods, particularly sonication, MAE, and UAE, have been shown to produce higher yields with enhanced biological activity while offering greater efficiency in terms of reduced time and solvent consumption. On the other hand, conventional techniques such as maceration and soxhletation remain relevant, particularly for thermolabile compounds that are sensitive to high temperatures. The selection of an appropriate extraction method plays a crucial role in obtaining high-quality extracts that can serve as potential raw materials for phytopharmaceuticals, functional foods, dietary supplements, and other natural products. This review not only highlights the advantages and limitations of each technique but also emphasizes the importance of aligning method selection with specific research objectives and compound characteristics. Overall, this study provides a theoretical foundation for future experimental research and serves as an initial guideline for determining extraction strategies based on efficiency, effectiveness, and sustainability.

Diabetes Mellitus (DM) is a chronic metabolic disorder that is rapidly increasing globally and is associated with a high risk of peripheral arterial complications. The Ankle Brachial Index (ABI) is a simple and reliable tool for screening peripheral arterial disease, while foot exercise represents a practical, low-cost, and non-pharmacological intervention to improve peripheral perfusion. This study aimed to evaluate the effectiveness of foot exercise in improving ABI values among hospitalized patients with DM. A pre-experimental one-group pretest-posttest design was implemented with 26 purposively selected inpatients with DM. Participants performed standardized foot exercises once daily for 15 minutes over two consecutive days. ABI values were measured using a sphygmomanometer and vascular Doppler before and after the intervention, and data were analyzed using a paired t-test. The mean ABI significantly increased from 0.707 (SD = 0.031) to 0.884 (SD = 0.027) (p < 0.001), indicating a clinically meaningful improvement from moderate impairment to near-normal circulation. These results demonstrate that foot exercise is effective in improving ABI values among hospitalized DM patients. The study highlights foot exercise as a safe, simple, and non-pharmacological nursing intervention that can be recommended in inpatient care settings to improve peripheral perfusion and prevent further complications related to peripheral arterial disease. This intervention offers a promising approach to managing peripheral arterial complications in diabetic patients

Dental and oral health is still a significant problem in Indonesia. Riskesdas 2018 data shows that 57.6% of the population has dental and oral problems, while only 2.8% brush their teeth properly. This condition is a serious concern because untreated dental caries can develop into pulp necrosis and subsequently radical gangrene. Both conditions have the potential to cause infections that can interfere with people's quality of life if not treated immediately. This study aims to compare the prevalence of visits to pulp necrosis and radical gangrene based on gender and age at the UPTD Baturiti II Tabanan Health Center during January-March 2025. The research uses a quantitative descriptive method with a purposive sampling technique based on secondary data from the E-Puskesmas system. The results showed that the prevalence of gangrene radicals (7.2%) was higher than that of pulp necrosis (5.9%). Female patient visits were more dominant in both cases, namely 52.7% in pulp necrosis and 56.5% in radical gangrene. The age distribution showed that the age group of 20–44 years dominated in cases of pulp necrosis (42.1%), while gangrene radicals occurred more in the age group of 45–59 years (34.8%). These results indicate a delay in dental care that contributes to the progression of the disease. The high number of these incidents cannot be separated from behavioral factors and the low level of public knowledge in maintaining dental and oral health. Therefore, increasing communication, information, and education efforts at the level of primary health care facilities is essential to encourage public awareness. Early detection and timely treatment are key in preventing serious complications such as pulp necrosis and radical gangrene.