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Background: Early Breastfeeding Initiation (IMD) is the practice of allowing newborns to breastfeed within the first hour after birth. This practice is not only beneficial for establishing mother-infant bonding but also plays a crucial role in stimulating uterine contractions through the release of oxytocin, which can accelerate uterine involution in postpartum mothers. Uterine involution is an important physiological process that prevents postpartum hemorrhage and supports maternal recovery. Despite the known benefits, not all mothers practice IMD immediately after delivery, which may affect the process of uterine involution. Objective: This study aimed to analyze the relationship between Early Breastfeeding Initiation (IMD) and the incidence of uterine involution in postpartum mothers at the Benao Community Health Center Work Area. Methods: A quantitative, observational study with a cross-sectional design was conducted involving 30 postpartum mothers selected through purposive sampling. Data were collected on IMD practices and uterine involution assessments. The Wilcoxon signed-rank test was used to analyze the relationship between IMD and uterine involution. Results: The study found a significant relationship between IMD and uterine involution (p = 0.000). Mothers who practiced IMD within the first hour postpartum showed a faster and more effective uterine involution process compared to those who did not. Conclusion: Early Breastfeeding Initiation (IMD) is significantly associated with the incidence and speed of uterine involution in postpartum mothers. Promoting IMD immediately after birth is essential for supporting maternal recovery and preventing postpartum complications

Pregnancy is a crucial period that requires special attention to maternal nutritional status, including the prevention of anemia through the consumption of Multiple Micronutrient Supplements (MMS). Compliance with MMS consumption remains a challenge due to physical, psychological, and social factors. This study aims to analyze the role of Posyandu cadres as peer support in improving compliance with MMS consumption and preventing anemia in pregnant women in the Bongo II Community Health Center, Boalemo Regency. The study used a pre-experimental one-group pretest-posttest design with a total sample of 20 pregnant women. Peer support interventions in the form of education, motivation, reminders, and routine monitoring were carried out for 4 weeks. Data were collected through questionnaires, MMS consumption records, and hemoglobin level examinations, then analyzed using the Wilcoxon test and paired t-test. The results showed a significant increase in the mean score of MMS consumption compliance from 61.2 to 80.5 (p = 0.002) and the mean hemoglobin level from 10.7 g/dL to 11.4 g/dL (p = 0.014). This finding confirms the effectiveness of peer support by Posyandu cadres in increasing compliance with MMS consumption and improving anemia status.

This experimental study investigated the effectiveness of Process Oriented Guided Inquiry Learning (POGIL) based Student Worksheets in enhancing metacognitive skills among eleventh grade students learning Chemical Equilibrium. Utilizing a one group pretest posttest design with 36 participants, the intervention implemented specially designed worksheets integrating POGIL's inquiry cycle with explicit metacognitive scaffolding. Metacognitive skills comprising planning, monitoring, and evaluating components were measured through validated essay instruments before and after four instructional sessions. Statistical analysis using the Wilcoxon Signed Rank Test revealed a significant improvement in overall metacognitive skills (Z = -5.197, p < 0.001, large effect size d = 2.47). Notably, 94.44% of students demonstrated measurable progress, with normalized gain scores indicating high improvement in planning (g = 0.82), moderate improvement in evaluating (g = 0.51), and moderate improvement in monitoring (g = 0.48). These findings substantiate that POGIL based worksheets, when designed with intentional metacognitive prompts, effectively foster the development of higher order regulatory skills essential for mastering complex chemical concepts. The study contributes to science education literature by demonstrating how inquiry based pedagogies can be optimized for metacognitive skill development.

This experimental study investigated the effectiveness of Process Oriented Guided Inquiry Learning (POGIL) based Student Worksheets in enhancing metacognitive skills among eleventh grade students learning Chemical Equilibrium. Utilizing a one group pretest posttest design with 36 participants, the intervention implemented specially designed worksheets integrating POGIL's inquiry cycle with explicit metacognitive scaffolding. Metacognitive skills comprising planning, monitoring, and evaluating components were measured through validated essay instruments before and after four instructional sessions. Statistical analysis using the Wilcoxon Signed Rank Test revealed a significant improvement in overall metacognitive skills (Z = -5.197, p < 0.001, large effect size d = 2.47). Notably, 94.44% of students demonstrated measurable progress, with normalized gain scores indicating high improvement in planning (g = 0.82), moderate improvement in evaluating (g = 0.51), and moderate improvement in monitoring (g = 0.48). These findings substantiate that POGIL based worksheets, when designed with intentional metacognitive prompts, effectively foster the development of higher order regulatory skills essential for mastering complex chemical concepts. The study contributes to science education literature by demonstrating how inquiry based pedagogies can be optimized for metacognitive skill development.

ABSTRACT Background: Pain is the most common complaint and can interfere with patient comfort. Pain management can be done pharmacologically and non-pharmacologically. Acupressure that can reduce pain is Li 4 acupressure. Objective: The purpose of this study was to determine the difference in pain intensity of post-cesarean section wounds before and after acupressure point Li 4. Method: The research method used was Pre Experiment using the One Group Pretest Postest Design research design approach. The number of samples in this study was 50 people using purposive sampling techniques. The pain measurement instrument used a numeric scale and the statistical test used was the Wilcoxon test. Results: Based on the Wilcoxon test, the difference between the average value of pain intensity before and after therapy was 1.3 points, a p-value of 0.00 or <0.05. Conclusion: Li 4 acupressure therapy can reduce pain intensity.

Lower back pain is one of the most common discomforts experienced by third-trimester pregnant women due to increased uterine size, postural changes, and musculoskeletal strain. Complementary therapies such as effleurage massage offer a non-pharmacological, safe, and easily applicable technique to reduce pregnancy-related pain. This study aimed to examine the effect of effleurage massage on reducing lower back pain among third-trimester pregnant women at TPMB Lina Contesa. This research employed a quasi-experimental one-group pretest–posttest design. The study was conducted from October to November 2025 involving 32 third-trimester pregnant women selected through purposive sampling. Pain intensity was measured before and after the intervention using the Visual Analog Scale (VAS). Effleurage massage was administered for 15–20 minutes on the lower back region following standard midwifery procedures. Data were analyzed using the Wilcoxon test. The findings showed a significant reduction in lower back pain intensity after the intervention (p < 0.001). The proportion of respondents in the moderate-pain category decreased from 65.6% to 21.9%, while those in the mild-pain category increased from 34.4% to 78.1%. The mean VAS score dropped from 5.81 ± 1.12 before intervention to 2.47 ± 1.03 after effleurage massage. Effleurage massage is effective in reducing lower back pain among third-trimester pregnant women and can be recommended as a complementary therapy in midwifery care to improve maternal comfort.

Stress among early adolescent girls in junior high school is an increasing health concern due to academic demands, social pressure, digital exposure, and menstrual related discomforts. Complementary interventions such as deep-breathing techniques offer a simple method that can be implemented in school settings to rapidly reduce stress. This study aimed to examine the effect of deep-breathing techniques on menstrual related stress among ninth-grade female students at SMPN 2 Rambutan, Banyuasin Regency.  A pre-experimental one-group pretest–posttest design was used. The sample consisted of 60 students selected from the ninth-grade population. Stress levels were measured using the Perceived Stress Scale (PSS-10) focusing on stress during menstruation before and after a single deep-breathing session. Data were analyzed using the Wilcoxon test. The results showed a significant reduction in stress scores after the intervention (p < 0.001). The proportion of students in the high-stress category decreased from 20% to 6.7%, while those in the low-stress category increased from 10% to 30%. The mean stress score decreased from 21.35 ± 4.82 to 15.42 ± 4.11. This study concludes that deep-breathing techniques are effective in reducing menstrual-related stress in female students within a single session and can be recommended as a complementary strategy that is easy to implement in schools for adolescent menstrual stress management.

Introduction: Dental and oral health problems in school-age children are still a major public health concern. The Little Doctor Program is a school-based health promotion approach that involves the active role of students as agents of change. This study aims to analyze the effectiveness of Small Doctors in promoting dental health in elementary schools. Methods: This study used a quasi-experimental design with a one group pretest–posttest approach. The subjects of the study were elementary school students who participated in dental health promotion activities by Small Doctors. Interventions include counseling, demonstrations of proper brushing of teeth, and the use of educational media. Data were collected using a questionnaire of dental health knowledge, attitudes, and behaviors before and after the intervention. Data analysis was carried out using the paired t-test or Wilcoxon test with a significance level of p < 0.05. Results: There was a significant improvement in students' dental health knowledge, attitudes, and behaviors after the intervention (p < 0.05). Conclusion: The Small Doctor Program is effective as a strategy for promoting dental health in elementary schools and has the potential to support promotional and preventive efforts for children's dental health.

Infections caused by pathogenic microorganisms remain a major health challenge. One preventive promotive effort to reduce infection incidence is through the use of traditional medicinal plants, such as celery (Apium graveolens L.) which is known to have antimicrobial activity. This community service program aimed to increase the knowledge of PKK cadres in Klender Urban Village regarding the antimicrobial benefits of celery through educational outreach. The activity was held on June 12, 2025, involving 14 PKK cadres as participants. Evaluation was carried out using pre-test and post-test questionnaires, analyzed using the Wilcoxon test. The results showed a significance value of 0.002 (p<0.05), indicating a significant increase in knowledge after the intervention. The average percentage of correct answer increased by 37.2%. Additionally, all of participants demonstrated  good knowledge levels in the post-test and none were in the poor category. These findings indicate that education through outreach is effective in improving community understanding of celery’s antimicrobial potential. Local plant-based education is expected to be a sustainable preventive strategy to improve public health.Keywords: education, celery, antimicrobial, knowledge PKK cadres

Hypertension is one of the major health problems among the elderly and poses a risk of serious complications if not properly controlled. Slow deep breathing is a relaxation technique that can be used as a non-pharmacological intervention to reduce blood pressure. This study aimed to determine the effect of slow deep breathing on blood pressure in elderly patients with hypertension at the nursing home X Jakarta. The study employed a quasi-experimental design with a pretest-posttest control group approach. A total of 26 respondents were divided into two groups: intervention and control, each consisting of 13 people. The slow deep breathing intervention was performed for 10 minutes with a breathing frequency 6-10 breaths per minute. The results showed a significant reduction in systolic and diastolic blood pressure in the intervention group after the slow deep breathing exercise. Data analysis using the Wilcoxon and Mann-Whitney tests showed a p-value <0.05, indicating a significant difference before and after the intervention. Slow deep breathing proved to be effective in reducing blood pressure and can serve as a safe, simple, and affordable non-pharmacological therapy for elderly individuals with hypertension. This intervention also has the potential to improve quality of life and reduce dependence on antihypertensive medication.

Benson Relaxation Technique on improving cognitive function in elderly with Hypertension. Using a Quasi-Experimental design with a One-Group Pretest-Posttest Design approach. The research sample of 10 elderly with Hypertension who showed indications of mild cognitive impairment, was taken through a Purposive Sampling technique. The Benson Relaxation Technique intervention was given 3 times a week for 2 consecutive weeks (a total of 6 sessions), with a duration of 15-20 minutes per session. Cognitive function was measured using the Mini-Mental State Examination instrument. Analysis used the Wilcoxon Signed Rank Test. The Pretest results showed all respondents were in the Mild Cognitive Impairment category. After the intervention, there was a significant increase in cognitive function: 40% of respondents experienced an increase in status to the Normal category while the other 60% remained in the Mild Cognitive Impairment category. The bivariate test Mann-Whitney U test showed a significance value of p = 0.001 (<0.05). These results prove a significant difference between cognitive scores after the Benson Relaxation intervention. Research results show that the Benson Relaxation Technique effectively improves cognitive function. Benson Relaxation activates the parasympathetic nervous system, improving memory and attention in elderly people with hypertension.

Adolescent drug abuse remains a major public health concern with adverse consequences for health, social functioning, and educational attainment. Limited knowledge and poor refusal skills in the face of environmental pressure are key risk factors. This study assessed the outcomes of a school-based Participatory Action Research (PAR) intervention aimed at improving students’ knowledge and preventive attitudes toward drug abuse. The program was implemented at Madrasah Aliyah Manaratul Islam, Jakarta (August 2025), involving 57 students. The educational intervention combined interactive counseling, small-group discussions, and role-play simulations, followed by pre–post evaluation using the same questionnaire and quantitative analysis with the Wilcoxon signed-rank test. Results demonstrated a statistically significant improvement in post-test scores compared with pre-test scores (Z = −3.506; p < 0.001; r = 0.46), with a mean paired difference (pre–post) of −0.877 indicating a positive shift after the intervention. Descriptively, the proportion of students classified with high awareness increased to 87.7% after the program, while mean knowledge scores rose from 63.2% to 85.5%. Qualitative feedback further suggested better understanding of physical and psychological harms, increased confidence to refuse illicit substances, and more active communication with peers and teachers. Overall, the PAR-based school intervention effectively strengthened students’ drug-abuse prevention literacy and readiness and may be scalable to similar school settings.

This study aims to analyze the effect of the use of Health Information Media in the form of leaflets on the level of patient knowledge about influenza in pharmacies Ngudi Waluyo, Ungaran. Leaflet Media is used as an educational tool to improve patient understanding related to influenza, including aspects of causes, symptoms, complications, and management and treatment. The type of research used is quasi experiment with pre-test and post-test design, involving 94 respondents who meet the inclusion criteria. Data analysis was conducted using the Wilcoxon statistical test to determine the difference in the level of knowledge of patients before and after education. The results showed a significant increase in the level of knowledge of patients after obtaining education using leaflets. Before being given education, respondents with a good knowledge level category were 56.7%, and increased to 96.8% after providing education, with a value of p = 0.001 (p < 0.05) which showed a significant difference between the two measurements. Thus, the Health Information media in the form of leaflets proved effective in increasing patient knowledge about influenza and can be used as an alternative educational media that is simple, practical, and efficient in supporting pharmaceutical services in pharmaceutical service facilities.

One of the business strategies used by companies to strengthen their business and reduce competition is through acquisitions. This study was conducted to determine changes in financial performance after the acquisition process, measured using liquidity, activity, solvency, and profitability ratios. The population of this study was companies that made acquisitions in 2022. The sampling technique used purposive sampling, and four companies that conducted acquisitions in 2022 and were listed on the IDX were obtained. The research period was two years before and two years after the acquisition. The hypothesis was tested with a non-parametric test using the Wilcoxon signed rank test. Based on the results of the study, it is known that of the four financial ratios, only the activity ratio had a significant difference before and after the acquisition. Meanwhile, there were no significant differences in the liquidity, solvency, and profitability ratios. This is because the impact of the acquisition process cannot be seen in the short term. It takes integration and a long time to create synergy or change after an acquisition.  

Knee osteoarthritis is one of the most prevalent musculoskeletal disorders in the elderly, characterized by progressive degeneration of articular cartilage, chronic pain, joint stiffness, and reduced functional capacity. In Indonesia, the prevalence of knee osteoarthritis is notably high, affecting over 30% of individuals aged above 60 years. This condition leads to significant health burdens, impaired quality of life, and increased economic costs. Non-pharmacological management strategies such as hydrotherapy and quadriceps exercise are widely recommended to relieve pain and improve joint function. Hydrotherapy utilizes the physical properties of water including buoyancy, hydrostatic pressure, viscosity, and warmth to reduce joint loading, enhance circulation, and promote relaxation. Quadriceps exercise, on the other hand, focuses on strengthening the quadriceps muscle to stabilize the knee joint, thereby reducing pain and improving functionality. The combination of these two interventions is expected to provide greater benefits than a single modality. Research Design: This study employed a quasi-experimental design with a one-group pre-post test approach on 12 elderly respondents with knee osteoarthritis at OSF Magdalena Daemen BSB Convent. Pain was measured using the Visual Analogue Scale (VAS) before and after the intervention, which consisted of hydrotherapy and quadriceps exercise administered twice a week for four weeks. Results: The findings showed a decrease in the mean pain score from 4.42 to 3.08, with the Wilcoxon test yielding p = 0.001 (p < 0.05), indicating a significant difference in pain levels before and after the intervention. Conclusion: The combination of hydrotherapy and quadriceps exercise is effective in reducing pain in patients with knee osteoarthritis.

Body shaming represents a global issue shaped by social constructions and media portrayals of the human body. Individuals who experience body shaming often feel humiliated and intimidated, leading to low self-image and diminished gratitude for their bodies. This study aimed to examine the effect of body shaming education on adolescents’ knowledge levels at SMP Futuhiyah Mranggen. The research employed a quasi-experimental design with a one-group pretest–posttest approach. The population included all 41 male and female seventh-grade students, selected through total sampling. Researchers used a validated knowledge questionnaire delivered through a PowerPoint presentation as the data collection instrument. Data analysis applied the Wilcoxon test. The conclusion of this study is that there is an influence of body shaming education on the level of knowledge of adolescents at SMP Futuhiyah Mranggen with a p-value of 0.000 because it is less than 0.05. The suggestion that will be put forward is that it is hoped that all adolescents can increase their understanding of body shaming, to find out the level of knowledge about body shaming in adolescents who are given intervention, and awareness of the impact of body shaming and handling of body shaming in adolescents at SMP Futuhiyah Mranggen, adolescents who are given education related to body shaming and surrounding adolescents.

Background: Section Caesarea (SC) is the process of giving birth through surgery by making an incision in the mother's stomach (laparatomy) and uterus (hysterectomy) to remove the baby. 75% of surgical patients experience moderate to severe pain after surgery. Women experience high levels of pain intensity for 24 hours after SC. Objective: The aim of this research is to determine the effectiveness of lavender aromatherapy to reduce pain intensity in post-section caesarean mothers at Muhammadiyah Kalikapas Hospital. Methods: In this research, researchers used a Quasi Experimental type of research with a one group pre test and post test design. The population was 39 and a sample of 35 patients was obtained using purposive sampling. This research data uses the Verbal Rating Scale (VRS) observation sheet. After tabulating the data, it was analyzed using the Wilcoxon test with a significance level of p= ? ? 0.05. The results of the study showed that before being given lavender aromatherapy, most of the 35 post- SC mothers experienced severe pain, after treatment 19 people (54.3%) experienced moderate pain. Result: The Wilxocon Test results obtained a significant value, namely p-value 0.000, then Ha is accepted so it can be concluded that there is an effect of using lavender aromatherapy to reduce pain intensity in post caesarean section. This means that there is an influence of the use of Lavender Aromatherapy to Reduce Pain Intensity in Post Sectio Caesarea Mothers at Muhammadiyah Kalikapas Hospital in 2024. Conclusion: Lavender Aromatherapy can be a non-pharmacological therapy in reducing pain intensity for post SC Mothers

Background: The increasing number of underage smokers is a problem that needs attention. One effort to reduce the number of underage smokers is by providing knowledge about the dangers of smoking. Objective: This study aims to determine the effect of audiovisual education on elementary school children's knowledge of the dangers of smoking among 5th and 6th graders. Methods: This study used a one-group pre-post test design with a sample of 50 students using total sampling. The instrument used in this study was a questionnaire about the dangers of smoking, and data analysis was performed using the Wilcoxon test. Results: The results of the study showed that before the education was provided, most of the children's knowledge about the dangers of smoking was still lacking (94%), and after the education was provided, most of the students' knowledge became good (80%). Based on the results of the Wilcoxon test, the result was p=0.000, which means that there is an effect of audiovisual education on the knowledge of the dangers of smoking among fifth and sixth grade elementary school children. Conclusion: Educational video media can increase a person's knowledge because videos can be an effective medium for providing information. Thus, educational video media has been proven to influence the knowledge of fifth and sixth grade elementary school children about the dangers of smoking, thereby preventing children from using cigarettes.

Complete basic immunization for infants is an important effort in preventing infectious diseases and improving public health. However, certain regions still have subpar vaccination rates, which may be due to parents' ignorance and attitudes. Children who do not receive all recommended vaccinations are more vulnerable to illness and, worse, may die from it. This study was conducted at the Jikohay Community Health Center in the West Obi District to examine the impact IEC on mothers' attitudes and knowledge on the provision of full basic immunizations for newborns. Maternal and child health books (KIA) and a questionnaire approach were used in this qualitative study. The purpose of this study is to ascertain how IEC affects mothers' knowledge and attitudes on giving their babies the recommended basic vaccinations at the Jikohay Health Center in the West Obi District. There were 60 individuals in the population and 40 responders in the sample. Purposive sampling was used for the sample process. The Wilcoxon test was utilized for data analysis. According to the study's findings, 20 respondents had good attitudes, 20 had sufficient attitudes, and 29 had good knowledge, 10 had sufficient knowledge, and 1 had insufficient knowledge after receiving counseling on parental attitudes and knowledge in providing full basic immunizations to infants. At the Jikohay Health Center in the West Obi District, the results of the statistical test with a p-value of 0.000 indicated that IEC had an impact on mothers' attitudes and knowledge toward giving their infants all of the recommended basic vaccinations.

Umbilical cord care is an important part of newborn care because the umbilical cord that has not fallen off has the potential to become an entry point for germs if not cared for hygienically. In the community, traditional umbilical cord care practices are still widely practiced and often do not comply with medical standards. This study aims to determine the effect of umbilical cord care education on cleanliness and duration of umbilical cord detachment in newborns in the Bongo 2 Community Health Center, Boalemo Regency. This study used a pre-experimental design with a one-group pretest-posttest approach. The study sample consisted of 24 newborns selected using a total sampling technique. The intervention in the form of umbilical cord care education was given to the parents of the babies, then measurements were taken of umbilical cord cleanliness and duration of umbilical cord detachment before and after education. Data analysis was performed using a paired t-test or Wilcoxon signed-rank test with a significance level of p < 0.05. The results showed an increase in umbilical cord cleanliness after education, with a p value = 0.001. In addition, the average duration of umbilical cord detachment decreased significantly after education, with a p value = 0.000. This study concludes that umbilical cord care education has a significant effect on improving hygiene and optimizing the duration of umbilical cord removal in newborns.