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Anemia is a condition with hemoglobin and erythrocyte levels lower than normal, which is 12 grams/dl for adolescents. Iron deficiency anemia in adolescent girls is at higher risk because it causes a decrease in immunity, making them susceptible to health problems. One of the causes is the lack of knowledge of adolescent girls about healthy lifestyles and self-motivation regarding the importance of balanced nutrition in preventing anemia. The purpose of this study was to determine the effect of education on the level of knowledge of adolescent girls about anemia. The type of research used was quantitative research with a quasi-experimental research design with a pre-test-post-test research design. The sample consisted of 90 adolescent girls. The results showed that before being given education, the majority of respondents were in the sufficient category (45.6%), while after being given education, the majority were in the good category (84.4%). The results of this study showed that there was a significant difference in the level of knowledge of adolescent girls about anemia before and after being given education with a significance value of 0.000, which means there was a significant effect of education on the level of knowledge of adolescent girls about anemia.

Anemia is a condition with hemoglobin and erythrocyte levels lower than normal, which is 12 grams/dl for adolescents. Iron deficiency anemia in adolescent girls is at higher risk because it causes a decrease in immunity, making them susceptible to health problems. One of the causes is the lack of knowledge of adolescent girls about healthy lifestyles and self-motivation regarding the importance of balanced nutrition in preventing anemia. The purpose of this study was to determine the effect of education on the level of knowledge of adolescent girls about anemia. The type of research used was quantitative research with a quasi-experimental research design with a pre-test-post-test research design. The sample consisted of 90 adolescent girls. The results showed that before being given education, the majority of respondents were in the sufficient category (45.6%), while after being given education, the majority were in the good category (84.4%). The results of this study showed that there was a significant difference in the level of knowledge of adolescent girls about anemia before and after being given education with a significance value of 0.000, which means there was a significant effect of education on the level of knowledge of adolescent girls about anemia.

Laparotomy is a major surgical procedure associated with a high risk of acute postoperative pain. According to Gan (2017), if pain is not properly managed, it can progress to chronic pain. (Toro et al., 2018) reported that severe pain on the first postoperative day is still commonly found in laparotomy patients, while (Small & Laycock, 2020) indicated that moderate to severe pain within the first 24 hours following major surgery remains a significant clinical issue. This study aims to evaluate the effectiveness of pharmacological pain management following laparotomy under general anesthesia, specifically to identify the types of opioid analgesics used, analyze their effectiveness in reducing pain intensity, identify side effects, and examine administration techniques and routes. This study employed a Systematic Literature Review (SLR) method following the PRISMA guidelines. Literature searches were conducted in the PubMed, ScienceDirect, and SpringerLink databases covering the years 2015–2026. The included studies comprised randomized controlled trials (RCTs), cohort studies, and retrospective studies addressing opioid pharmacological pain management in adult patients following laparotomy under general anesthesia. Study quality assessment was performed using the Joanna Briggs Institute (JBI) instrument. A total of 11 studies met the inclusion criteria. The results of the systematic literature review indicate that opioids are effective in reducing postoperative pain following laparotomy under general anesthesia. The most commonly used opioids are morphine, fentanyl, and oxycodone. Of all the opioids reviewed, oxycodone provided the best pain control, while intrathecal morphine was most effective in reducing the need for supplemental opioids during the early postoperative period. Other opioids, such as extended-release dinalbuphine sebacate and tegileridine, are also effective, but the number of studies is still limited. The most common side effects are nausea, vomiting, pruritus, sedation, and dizziness. Pharmacological pain management using opioids is effective in reducing the intensity of postoperative pain following laparotomy under general anesthesia. Morphine, fentanyl, and oxycodone are the most commonly used opioids. Oxycodone and intrathecal morphine have shown good results in improving pain control and reducing the need for supplemental opioids. The selection of opioid type, dosage, and administration technique must be tailored to the patient’s clinical condition to achieve optimal analgesia with minimal side effects.

Background: Recurrent Aphthous Stomatitis (RAS) is a common disorder characterized by recurrent ulcers limited to the oral mucosa. The etiology of RAS itself is not yet known for certain, but it is suspected that there are several predisposing factors, including hormonal changes, trauma, malnutrition, stress. Purpose: This study aims to determine the description of RAS in patients at the Oral Medicine Department of Dental Hospital University of Jember based on classification, general condition, suspected predisposing factors, and management. Method: This research is a descriptive observational study with a research population of 722 data from the Department of Oral Medicine, Dental Hospital of University of Jember. The number of samples that met the researchers' criteria was 171. Results: RAS patients is more common in women, 64.91% . RAS occurs in 69.60% of patients aged 21-30 years. RAS were mostly found in patients who did not experience symptoms of systemic factors, in 91.22%. The type of RAS that often occurs is the minor type in 78.37%. 68.42% RAS patients had no suspected predisposing factors. Based on RAS management, pharmacological therapy is divided into two parts, topical pharmacological therapy 59.07% and supportive pharmacological therapy 40.93%. Communication, information and education service was done for all 171 RAS patients. Conclusion: Based on the research conducted, that minor RAS is more prevalent in female 21-30 age group, with absence of underlying diseases, and the most frequently therapeutic modality is topical agents.

The purpose of this study was to determine the direct effect of personality characteristics and intellectual abilities on employee performance in the digital era and competence, the effect of competence on performance, and the indirect effect of personality variables and intellectual abilities on employee performance in the digital era through competence as an intervening variable in BPSDM Jambi Province. The type of research used is quantitative research with primary and secondary data. Sampling used a simple random sampling technique so that 65 employees were selected as respondents. Data collection used a questionnaire and data analysis used Smart PLS. The results of the analysis showed that personality characteristics directly affect performance and competence with a significance value of P <0.05, intellectual abilities do not affect performance and competence with a significance value of P>0.05, and competence does not affect the performance of BPSDM Jambi Province employees in the digital era with a significance value of P>0.05. Furthermore, the direct effect shows that employee competence does not mediate the influence of personality characteristics and intellectual abilities on employee performance. This shows that personality characteristics and intellectual abilities do not affect performance through employee competence as an intervening variable.

Background: Recurrent Aphthous Stomatitis (RAS) is a common disorder characterized by recurrent ulcers limited to the oral mucosa. The etiology of RAS itself is not yet known for certain, but it is suspected that there are several predisposing factors, including hormonal changes, trauma, malnutrition, stress. Purpose: This study aims to determine the description of RAS in patients at the Oral Medicine Department of Dental Hospital University of Jember based on classification, general condition, suspected predisposing factors, and management. Method: This research is a descriptive observational study with a research population of 722 data from the Department of Oral Medicine, Dental Hospital of University of Jember. The number of samples that met the researchers' criteria was 171. Results: RAS patients is more common in women, 64.91% . RAS occurs in 69.60% of patients aged 21-30 years. RAS were mostly found in patients who did not experience symptoms of systemic factors, in 91.22%. The type of RAS that often occurs is the minor type in 78.37%. 68.42% RAS patients had no suspected predisposing factors. Based on RAS management, pharmacological therapy is divided into two parts, topical pharmacological therapy 59.07% and supportive pharmacological therapy 40.93%. Communication, information and education service was done for all 171 RAS patients. Conclusion: Based on the research conducted, that minor RAS is more prevalent in female 21-30 age group, with absence of underlying diseases, and the most frequently therapeutic modality is topical agents.

Mergers and acquisitions have served as a primary strategy for global banking consolidation over the past three decades, including in Indonesia, which is currently undergoing one of its most massive consolidation waves—one notable example being the emergence of Bank Syariah Indonesia. This article aims to provide a narrative review of the literature on the operational impacts of mergers on bank performance, with a particular focus on implications for the Indonesian context. Based on a systematic search of the Scopus database, 52 peer-reviewed articles published between 2000 and 2025 were analyzed using a narrative thematic synthesis approach. Five main themes were identified: cost efficiency, service quality, risk management, human resource and cultural integration, and information systems and technology integration. The key findings indicate that although 73.1% of studies report post-merger improvements in cost efficiency, these benefits are highly contingent upon the quality of post-merger integration especially in the areas of human resources, organizational culture, and information technology with IT integration failure rates reaching as high as 75%. Domestic mergers consistently achieve efficiency gains more rapidly than cross-border mergers, whereas risk implications depend heavily on the type of merger and the quality of integration. Policy implications include the need for the Financial Services Authority (Otoritas Jasa Keuangan) to monitor post-merger integration quality, provide integration guidelines for smaller banks, take into account the specific characteristics of Islamic banks, and ensure a streamlined, non-burdensome licensing process. Further research particularly empirical studies on banking mergers in Indonesia—is urgently needed to test the generalizability of global findings to the local context.

This study examines how environmental, social, and governance issues shape the impact of financial success on firm value. To understand the link between the variables, the legitimacy theory and signal theory are employed. The population used includes non-financial enterprises from 2019–2023 that are listed on the Indonesia Stock Exchange (IDX) and are part of the Refinitiv database. Secondary data was gathered from the Indonesia Stock Exchange, official corporate websites, and the Refinitiv database in the form of sustainability reports, annual reports, and ESG scores. The sample size is 176 company data points over 5 years, selected using the purposive sampling method. Firm value is positively and significantly impacted by financial success, according to the research findings. ESG also improves the link between firm value and financial performance, according to the study. Lastly, the study's results also show that ESG increases business value, while not significantly. These findings suggest that the study's ESG variable is a pure moderator variable. Furthermore, the implications of the research both theoretically and practically have been discussed.

The digestive system is one of the most abstract and complex topics in high school biology because it involves physiological processes that occur inside the body and cannot be observed directly. This situation calls for the use of instructional media that can help students understand concepts in a more concrete, systematic, and engaging way. This study aims to analyze the effect of interactive multimedia on student learning outcomes regarding the digestive system and to identify the most effective type of multimedia. This study employs a meta-analysis method using secondary data from 20 relevant scientific articles published between 2021 and 2026. Data were collected through a literature review and systematic review, then analyzed using effect size calculations with Cohen’s and Hedges’ g formulas to determine the effectiveness level of each medium. The results indicate that the use of interactive multimedia generally has a positive effect on student learning outcomes, with most media falling into the high to very high effect size category. Interactive multimedia based on Articulate Storyline was the most effective medium with the highest effect size value of 2.730, followed by Augmented Reality-based E-Magazine at 2.634. These findings indicate that interactive multimedia is effective in facilitating the visualization of concepts and increasing student engagement.  

The development of fine motor skills in elementary school-aged children is crucial for academic achievement and daily activities. However, some children still experience delays in fine motor skills due to lack of stimulation, a lack of varied teaching methods, and the impact of technology use and learning after the pandemic. This study aims to improve fine motor skills in elementary school children through Educational Activities Using LEGO Bricks. The method used is a play-based learning approach integrated into thematic learning. The activities were conducted in several structured sessions, including an introduction, core activities, and reflection and evaluation. Participants were elementary school students who actively participated in LEGO assembly activities both individually and in groups. The results showed improvements in fine motor skills, evident in improvements in hand-eye coordination, accuracy, concentration, and manipulative abilities. Students also demonstrated great enthusiasm and progress in creativity when creating various types of works. The discussion indicates that playing with LEGO is beneficial for training small muscles in the hands through pinching, pressing, and arranging activities, as well as supporting cognitive development and a passion for learning. In other words, the LEGO Brick Educational Play Movement has proven to be an innovative and fun learning medium, as well as effective in developing the fine motor skills of elementary school students.

This study aims to examine the influence of inventory intensity, executive compensation, and sales growth on tax avoidance in non-cyclical consumer sector companies listed on the Indonesia Stock Exchange (IDX). This type of research is quantitative research using secondary data during the period 2020–2024. The sampling method used was purposive sampling, and the sample obtained consisted of 7 companies with 35 observation data points. Data processing was carried out using the E-Views 12 statistical program. Based on the results of this study, inventory intensity, executive compensation, and sales growth simultaneously affect tax avoidance. Partially, only executive compensation has an effect on tax avoidance, while inventory intensity and sales growth have no effect on tax avoidance. This study contributes to the development of accounting and taxation literature, particularly regarding the factors influencing corporate tax avoidance practices in the non-cyclical consumer sector. The findings indicate that executive compensation plays an important role in influencing managerial decisions related to tax avoidance, whereas inventory intensity and sales growth do not significantly determine tax avoidance practices individually. Therefore, companies are expected to improve governance and transparency in executive compensation policies to minimize opportunistic actions related to tax management. In addition, future researchers are encouraged to expand the research variables and increase the number of samples in order to obtain more comprehensive results regarding the determinants of tax avoidance.

Type II Diabetes Mellitus is one of the chronic diseases whose prevalence continues to increase and has become a global health issue. A common complication in patients with Type II Diabetes Mellitus is peripheral circulatory disorders, which can be identified through the Ankle Brachial Index (ABI) examination—a non-invasive method used to detect peripheral artery disease. ABI testing is essential for early detection and prevention of serious complications such as diabetic ulcers.This study aims to describe the Ankle Brachial Index values in patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan in 2025. This research used a descriptive quantitative method with purposive sampling technique. The study sample consisted of 52 respondents from a total population of 109 patients diagnosed with Type II Diabetes Mellitus. Data collection was conducted through observation sheets and measurement of systolic blood pressure in the upper and lower extremities using a sphygmomanometer and stethoscope. The ABI value was calculated based on the ratio between the highest ankle systolic pressure and the highest brachial systolic pressure. Data were analyzed using tabulation techniques and presented in tables and diagrams. The results showed that the majority of respondents had normal ABI values (>0.90), totaling 33 individuals (63.5%), while 19 individuals (36.5%) experienced abnormal ABI values (≤0.90).Conclusion:The study concludes that most patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan had ABI values within the normal range. However, a considerable proportion with abnormal ABI indicates the necessity of routine ABI screening as a preventive measure against peripheral vascular complications in diabetic patients. This study is expected to serve as a reference in developing nursing interventions aimed at improving the quality of life for patients with Type II Diabetes Mellitus.

Trade secrets are a type of Intellectual Property Right that plays a crucial role in providing legal protection for business information with economic value and kept confidential by its owner. In the food industry, recipes not only serve as production guidelines but also serve as a business's identity and competitive advantage. Legal issues can arise if the recipe is used or owned by others without permission, especially when conflicts arise within the business or during competition. This situation can trigger trade secret disputes that can be detrimental to business owners, both financially and sustainably. This article discusses the position of fried chicken recipes as trade secrets in culinary business practices in Indonesia and the forms of legal protection available to rights holders. The discussion was conducted based on the provisions of Law Number 30 of 2000 concerning Trade Secrets, using a normative approach. The analysis shows that a fried chicken recipe falls into the trade secret category if it meets the requirements of being unknown to the public, having economic value, and being strictly maintained by the business owner. Therefore, legal protection for trade secrets is crucial to prevent unfair business competition and provide legal certainty and protection for culinary businesses in Indonesia  

This study analyzes visual signs in the Charlie Chaplin animations Safari at The Park and The King in The Ring using Charles Sanders Peirce’s semiotic framework, focusing on icons, indexes, and symbols. Film and animation communicate meaning through visual elements such as gestures, facial expressions, movements, and character interactions, making them rich for semiotic analysis. Using a descriptive qualitative method, the research identified and categorized visual signs in both animations. Results show that icons, which resemble real-world objects, dominate by establishing story settings natural safari environments in one animation and competitive boxing arenas in the other. Indexes reveal cause-and-effect relationships, demonstrating how gestures, expressions, and actions convey danger, fatigue, or emotional shifts. Symbols convey conventional or cultural meanings, such as Charlie Chaplin’s bowler hat and cane representing his comedic identity, a championship belt symbolizing victory, or a rose indicating affection. While both animations use the same types of signs, the intensity and focus vary with the narrative context: Safari at The Park emphasizes situational and natural elements, whereas The King in The Ring highlights competition and emotional reactions. This study confirms that Peirce’s triadic model effectively explains how meaning is constructed in animation through dynamic visual communication.

Type II Diabetes Mellitus is one of the chronic diseases whose prevalence continues to increase and has become a global health issue. A common complication in patients with Type II Diabetes Mellitus is peripheral circulatory disorders, which can be identified through the Ankle Brachial Index (ABI) examination—a non-invasive method used to detect peripheral artery disease. ABI testing is essential for early detection and prevention of serious complications such as diabetic ulcers.This study aims to describe the Ankle Brachial Index values in patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan in 2025. This research used a descriptive quantitative method with purposive sampling technique. The study sample consisted of 52 respondents from a total population of 109 patients diagnosed with Type II Diabetes Mellitus. Data collection was conducted through observation sheets and measurement of systolic blood pressure in the upper and lower extremities using a sphygmomanometer and stethoscope. The ABI value was calculated based on the ratio between the highest ankle systolic pressure and the highest brachial systolic pressure. Data were analyzed using tabulation techniques and presented in tables and diagrams. The results showed that the majority of respondents had normal ABI values (>0.90), totaling 33 individuals (63.5%), while 19 individuals (36.5%) experienced abnormal ABI values (≤0.90).Conclusion:The study concludes that most patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan had ABI values within the normal range. However, a considerable proportion with abnormal ABI indicates the necessity of routine ABI screening as a preventive measure against peripheral vascular complications in diabetic patients. This study is expected to serve as a reference in developing nursing interventions aimed at improving the quality of life for patients with Type II Diabetes Mellitus.

Burnout syndrome is a condition characterized by emotional exhaustion, depersonalization, and a diminished sense of self-efficacy that nurses often experience due to high workloads. One approach that can be taken to reduce the level of burnout syndrome is through mindfulness-based breathing exercises. The objective of this study is to determine the effect of mindfulness-based breathing exercises on the level of burnout syndrome among nurses in the inpatient ward at R. W. Mongisidi Teling Hospital, a Type II General Hospital in Manado. This study employed a quasi-experimental design using a one-group pretest-posttest approach. The study population consisted of 87 nurses, with a sample of 20 respondents selected using purposive sampling. Data collection was conducted using the Mindfulness-Based Breathing Exercise SOP and a burnout questionnaire. The data were then analyzed using a T-test with a significance level (α) of 0.05. The study results showed that the mean score for the burnout syndrome among nurses in the inpatient ward of R. W. Mongisidi Type II General Hospital before the mindfulness-based breathing exercise intervention was 43.65, and the mean score after the intervention decreased to 40.40. The T-test results yielded a p-value of 0.000 < 0.05, indicating a significant effect of mindfulness-based breathing exercises on the burnout syndrome levels among nurses in the inpatient ward of RS TK II. R. W. Mongisidi in Teling, Manado. Mindfulness-based breathing exercises have a significant effect on burnout syndrome levels among nurses because this intervention helps improve self-awareness, control emotions, and reduce work-related stress. Recommendation: This intervention can be routinely implemented in hospitals as an effort to improve nurses’ psychological well-being and the quality of healthcare services.

Burnout syndrome is a condition characterized by emotional exhaustion, depersonalization, and a diminished sense of self-efficacy that nurses often experience due to high workloads. One approach that can be taken to reduce the level of burnout syndrome is through mindfulness-based breathing exercises. The objective of this study is to determine the effect of mindfulness-based breathing exercises on the level of burnout syndrome among nurses in the inpatient ward at R. W. Mongisidi Teling Hospital, a Type II General Hospital in Manado. This study employed a quasi-experimental design using a one-group pretest-posttest approach. The study population consisted of 87 nurses, with a sample of 20 respondents selected using purposive sampling. Data collection was conducted using the Mindfulness-Based Breathing Exercise SOP and a burnout questionnaire. The data were then analyzed using a T-test with a significance level (α) of 0.05. The study results showed that the mean score for the burnout syndrome among nurses in the inpatient ward of R. W. Mongisidi Type II General Hospital before the mindfulness-based breathing exercise intervention was 43.65, and the mean score after the intervention decreased to 40.40. The T-test results yielded a p-value of 0.000 < 0.05, indicating a significant effect of mindfulness-based breathing exercises on the burnout syndrome levels among nurses in the inpatient ward of RS TK II. R. W. Mongisidi in Teling, Manado. Mindfulness-based breathing exercises have a significant effect on burnout syndrome levels among nurses because this intervention helps improve self-awareness, control emotions, and reduce work-related stress. Recommendation: This intervention can be routinely implemented in hospitals as an effort to improve nurses’ psychological well-being and the quality of healthcare services.

This study aims to analyze the integration of policy, curriculum, and school culture in realizing an environmentally friendly school at SDN Tanggul Wetan 2. The study used a qualitative approach with a case study type. The research subjects included the principal, teachers, students, program coordinators, and parents. Data collection techniques were carried out through observation, in-depth interviews, and documentation. Data analysis used the Miles and Huberman model which includes data reduction, data presentation, and drawing conclusions. The results showed that the school policy has integrated environmental care values ​​through the Adiwiyata program supported by external partnerships and periodic evaluations. The curriculum implementation was carried out contextually by integrating environmental materials into various subjects and using project-based learning methods. School culture is realized through habituation of activities such as community service, waste sorting, and energy saving which have an impact on changes in student behavior. Supporting factors include the principal's leadership, teacher participation, parental support, and the school environment, while inhibiting factors include the lack of consistent student habits. Thus, the integration of policy, curriculum, and school culture has proven to be key in building a sustainable environmentally friendly character.

This study aims to analyze the values ​​of Civic Education (PKn) in learning at Madrasah Ibtidaiyah (Islamic elementary schools) through a literature study approach. This study uses a qualitative method with a library research type, utilizing various written sources such as scientific journals, reference books, and academic articles as primary data. Data collection techniques are carried out through documentation studies by reviewing various relevant literature, while data analysis techniques use content analysis to identify, categorize, and interpret the values ​​contained in Civic Education learning. The results of the study indicate that Civic Education learning plays a strategic role in instilling character values ​​in students, such as responsibility, tolerance, cooperation, and love of the homeland. These values ​​are not only conveyed theoretically, but also internalized through a contextual and values-based learning process. This approach has proven effective in increasing students' understanding and awareness of the importance of civic values ​​in everyday life. However, the implementation of Civic Education learning still faces several obstacles, such as a lack of variety in learning methods and limited supporting resources. Therefore, more interactive and creative learning strategy innovations are needed to improve the quality of Civics learning in Madrasah Ibtidaiyah.

According to the American Diabetes Association (ADA), diabetes mellitus is a chronic and complex disease that requires ongoing management and various strategies to control blood sugar levels and reduce associated risks. Patient Mrs. J, a 52-year-old woman and farmer, presented with complaints of numbness and tingling in both legs that began approximately 2 months prior to her current visit and had worsened over the past week. The symptoms felt like being pricked and sometimes felt hot, especially at night, thereby interfering with daily activities. The symptoms were accompanied by frequent urination, especially at night, frequent thirst, frequent hunger, a feeling of weakness, and intermittent blurred vision. The patient had been diagnosed with diabetes mellitus approximately 5 years ago but did not consistently take medication (glimepiride). The patient still frequently consumes sweet, coconut-based, and fried foods. Physical examination revealed reduced sensation in the lower extremities. Laboratory tests showed elevated blood sugar levels. Based on the medical history, physical examination, and supporting tests, the patient was diagnosed with Type 2 Diabetes Mellitus. The patient was advised to record test results and changes in his health status in a health record book, and to involve family members in supporting treatment adherence and a healthy lifestyle. The patient works as a farmer with an irregular income, depending on the harvest. Daily expenses are shared with his son, so his economic condition