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Introduction: Congestive Heart Failure (CHF) is a complex clinical syndrome caused by the inability of the heart to pump blood adequately to meet the body's metabolic demands. This condition may result in dyspnea, edema, activity intolerance, fatigue, and reduced quality of life. Comprehensive nursing care is essential to address patients' needs and improve health outcomes. Methods: This study employed a descriptive case study approach. Data were collected through interviews, observation, physical examination, and medical record review. Nursing care was provided using the nursing process, including assessment, nursing diagnosis, planning, implementation, and evaluation. Results: The assessment of Mrs. T identified four nursing diagnoses: ineffective breathing pattern, hypervolemia, activity intolerance, and knowledge deficit. Nursing interventions included semi-Fowler positioning, fluid balance monitoring, passive Range of Motion (ROM) exercises, and health education. Following two days of nursing implementation, three nursing diagnoses were resolved, namely ineffective breathing pattern, activity intolerance, and knowledge deficit. Hypervolemia was partially resolved due to persistent fluid imbalance. Discussion: The findings indicate that the application of systematic nursing care can improve several clinical problems experienced by CHF patients. However, fluid balance management remains a challenge, highlighting the importance of patient adherence to fluid restriction and continuous monitoring to prevent worsening symptoms.

Intracerebral hemorrhage (ICH) is the most common type of hemorrhhagic stroke and a leading cause of death and disability in Indonesia. The prevalence of stroke in Indonesia reached 0.83% in 2023, with ICH cases at RSUD dr. Soeselo, Tegal Regency recording 203 cases in 2024 and increasing significantly to 304 cases in 2025. This study aims to describe comprehensive nursing care for a patient with Intracerebral Hemorrhage. The method used was descriptive narrative through a nursing process approach. Nursing assessment of Ny. S (73 years old) revealed subjective data including headache, nausea and vomiting, and weakness in the left hand and foot, while objective data showed blood pressure 180/80 mmHg, MAP 113.3 mmHg, muscle strength of left extremities 2/2, and CT scan results showing a hyperdense lesion (volume 17.17 cc) with perifocal edema in the right thalamus and right corona, partially filling the ventricular system. Four nursing diagnoses were established: decreased intracranial adaptive capacity related to cerebral edema, impaired physical mobility related to decreased muscle strength, knowledge deficit related to lack of information exposure, and risk of falls. Nursing interventions included intracranial pressure management, mobilization support, health education, and fall prevention. After three days of nursing implementation, three nursing diagnoses were resolved, while impaired physical mobility was partially resolved, resulting in discharge planning recommendations including ROM exercises, gradual mobilization, and family involvement in patient care.

Background: Acute pharyngitis is an inflammation of the pharynx caused by viral or bacterial infections, frequently resulting in sore throat, fever, and dysphagia. This condition is among the most prevalent acute respiratory tract infections in children and adolescents worldwide, contributing significantly to morbidity and the burden of healthcare services. Objective: This case study aimed to describe the comprehensive nursing care provided to patient An. F with acute pharyngitis at Ward Anggrek 1, RSUD dr. Soeselo, Tegal Regency. Methods: A descriptive study design with a nursing process approach was employed. Data were collected through anamnesis, physical examination, observation, and documentation review. The nursing process encompassed assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Results: Assessment revealed chief complaints of throat pain (NRS scale 5), fever (38.8°C), erythematous tonsils, and nutritional deficit. Three nursing diagnoses were established: acute pain related to physiological injury, hyperthermia related to disease process, and knowledge deficit related to insufficient information exposure. Interventions included pain management, hyperthermia management, and health education. Following two days of nursing care, the patient’s condition significantly improved, with pain scale reduced from 5 to 3 and body temperature normalized to 37.7°C. Conclusion: Comprehensive nursing care incorporating pharmacological and non-pharmacological approaches effectively reduced pain and fever, and improved patient and family health literacy regarding acute pharyngitis.

This study aims to describe gazebo management strategies as tourism infrastructure to increase visitor attraction at Pasir Putih Parparean II Beach, Porsea Subdistrict, Toba Regency. The beach is a unique destination in the Lake Toba area, characterized by fine white sand that is rarely found in the region. However, visitor data from the Toba Regency Tourism Office reveals a significant decline, from 35,304 visitors in January–April 2023 to only 1,550 visitors in January–August 2025. This decline is closely linked to the unplanned construction of permanent gazebos on the beach area, which has reduced the open space that constitutes the beach’s main attraction. This study employed a descriptive qualitative method. Data were collected through in-depth observation, semi-structured interviews, and documentation. The key informants consisted of three beach managers: Herbert Napitupulu, Nora Pandiangan, and Her Hutasoit, selected purposively based on their direct involvement and in-depth knowledge. Two regular tourists were also included as additional informants. Data analysis followed the Miles and Huberman model, encompassing data reduction, data presentation, and conclusion drawing. The results indicate that gazebo management strategie including facility improvements, environmental landscaping, and the provision of supporting amenities contribute significantly to enhancing visitor comfort and tourism appeal. This study recommends more systematic and planned management, spatial restructuring of gazebo placement, and the implementation of effective promotional strategies to support Pasir Putih Parparean II Beach as a sustainable tourism destination.

Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood adequately to meet the metabolic needs of the body. CHF is one of the most prevalent cardiovascular disorders globally, nationally, and locally, contributing to significant morbidity and mortality. This study aims to describe a comprehensive nursing care process applied to a patient (Mr. R) diagnosed with CHF at the Mawar 1 Ward of RSUD dr. Soeselo, Tegal Regency. This study used a descriptive case study design. Data were collected through interviews, physical examination, observation, and medical record documentation on February 9–11, 2026. Three nursing diagnoses were identified: ineffective airway clearance related to airway hypersecretion, fatigue related to physiological conditions (chronic disease), and knowledge deficit related to insufficient information exposure. Nursing interventions applied included airway management (semi-Fowler positioning, oxygen therapy, effective coughing technique), energy management (range-of-motion exercise, gradual activity), and health education about CHF. After 2×24 hours of nursing care, all three nursing diagnoses were resolved: airway clearance improved (SpO₂ increased from 91% to 95%, respiratory rate decreased from 28 to 23 times/minute), fatigue decreased, and patient knowledge about CHF improved. Systematic nursing care significantly improved the patient's condition in CHF management.

Background: Non-communicable diseases (NCDs) are a major global public health concern, with hypertension affecting an estimated 1.4 billion adults worldwide. In Indonesia, the prevalence of hypertension among individuals aged 18 years and above reached 30.8% in 2023. In Kecamatan Tonjong, Kabupaten Brebes, the number of hypertension sufferers aged 15 years and above reached 15,951 people in 2025. Objective: To implement comprehensive family nursing care for Ny. S, family of Tn. F, who experienced cardiovascular system disorders due to hypertension in Desa Karang Jati RT 01 RW 05, Kecamatan Tonjong, Kabupaten Brebes. Method: This study used a descriptive narrative method with a nursing process approach (assessment, diagnosis, intervention, implementation, and evaluation), conducted through home visits over three days from December 26–28, 2025. Data were collected through interviews, observation, physical examination, and documentation. Results: Two nursing diagnoses were identified: acute pain related to hypertension and knowledge deficit regarding hypertension. Nursing interventions included pain management, oral medication administration (captopril 25 mg), and health education. Complementary non-pharmacological therapy using cucumber juice was applied once daily for three days. Conclusion: After three days of nursing implementation, both nursing diagnoses were fully resolved. Blood pressure decreased from 165/90 mmHg to 132/77 mmHg and the pain scale reduced from 4 to 1. Discharge planning was provided including recommendations for routine blood pressure monitoring, healthy lifestyle, and consistent medication adherence.

Background: Distal radius fracture is the most common fracture of the radius bone near the wrist joint. The prevalence of fractures in Indonesia in 2024 was 3.8%, indicating that approximately 20 million people experienced fractures. Therefore, nursing care planning is required to address musculoskeletal disorders. Objective: To describe the nursing care for patients with Musculoskeletal System Disorders: Post-Op ORIF Fracture of One-Third Distal Radius Dextra. Method: This study used a descriptive narrative method by providing an overview of nursing care through a nursing process approach. Results: Nursing diagnoses that emerged in the patient included acute pain, impaired physical mobility, risk of infection, and knowledge deficit. Interventions performed included pain management, mobilization support, infection prevention, and health education. Conclusion: After two days of nursing implementation, one diagnosis was fully resolved and three diagnoses were partially resolved due to time constraints. Discharge planning was provided including deep breathing relaxation techniques, passive ROM exercises, and wound dressing changes every two days.  

The rapid growth of e-commerce among university students has provided greater convenience in conducting digital transactions. However, it has also created various challenges, including online fraud, discrepancies between advertised and delivered products, delayed shipments, and limited understanding of consumer rights and dispute resolution mechanisms. This community service program aimed to enhance legal literacy and increase students’ awareness of consumer protection in electronic transactions, particularly within the Faculty of Teacher Training and Education (FKIP) of Yapis University Papua. The program employed an educational-participatory approach through counseling sessions, interactive discussions, case simulations, and participant comprehension evaluations. The materials covered consumer rights and obligations, common violations in electronic transactions, complaint procedures on e-commerce platforms, and non-litigation dispute resolution mechanisms. The results demonstrated a significant improvement in students’ understanding of consumer protection laws, their ability to identify violations of consumer rights, and their knowledge of appropriate actions when disputes arise in online shopping transactions. Furthermore, participants showed strong engagement throughout the activities and were able to apply their knowledge effectively during case simulations. The program contributed to the development of more critical, informed, responsible, and legally aware digital consumers who are better prepared to engage safely and confidently in e-commerce activities.

This study analyzes the integration of aesthetics and ethics in cosmetology education and its implications for strengthening the professionalism of cosmetology teachers. Cosmetology is often viewed as an applied field that primarily produces visual beauty through make-up, skin care, hair care, and cosmetic services. However, professional cosmetology practice also involves moral responsibility because it deals directly with the human body, personal identity, safety, comfort, and client trust. This article uses a normative qualitative method with conceptual and philosophical approaches through library research. The analysis is organized through three dimensions of philosophy of science: ontology, epistemology, and axiology. The findings show that, ontologically, cosmetology studies beauty and the human body not merely as physical objects, but as subjects with value, dignity, and diverse meanings. Epistemologically, cosmetology knowledge is constructed through the integration of scientific theory, practical skills, professional experience, sanitation principles, occupational safety, and service standards. Axiologically, cosmetology contains ethical values that guide beauty practices so that they remain honest, safe, responsible, and respectful of human dignity. The integration of aesthetics and ethics strengthens the role of cosmetology teachers as educators, professional models, and character builders in vocational education. Therefore, cosmetology learning should not only emphasize technical competence and visual results, but also internalize ethical awareness, reflective judgment, and responsibility in every stage of professional practice.

Communication within the family, especially between parents and children, is an important foundation for the development of a child's personality, emotions, and social skills. The purpose of this writing is to identify the types of parental communication styles, analyze the factors that influence them, examine their impact on child development, and provide practical recommendations to improve the effectiveness of communication patterns within the family. The method used in writing this paper is a literature study. The discussion results show that there are three main types of parental communication styles: permissive, authoritarian, and democratic. The permissive style tends to give the child unlimited freedom, the authoritarian style emphasizes control and obedience, while the democratic style encourages openness and mutual respect. The choice of communication style is influenced by various factors such as educational background, culture, past experiences, and the socio-economic conditions of parents. Each communication style has a different impact on the emotional, social, and cognitive development of children. The democratic style is considered the most effective in optimally supporting child development. This article provides recommendations to parents to increase knowledge about dialogical-based parenting, practice assertive communication skills, give children space to express their opinions, and build a family culture that is open and mutually respectful.

A balanced diet is a daily dietary pattern that contains nutrients in types and amounts appropriate to the body's needs. Knowledge of balanced nutrition and healthy eating habits is an important factor in preventing nutritional problems among adolescents. A lack of understanding regarding appropriate food choices can lead to unhealthy eating behaviors. Therefore, nutrition education is needed to improve students’ knowledge and awareness of the importance of implementing a balanced diet in daily life. This counseling activity aimed to increase students’ knowledge regarding balanced dietary patterns. The activity was conducted on June 4, 2025, at State Junior High School 5 Kendari and involved 30 seventh-grade students as respondents. The counseling methods included lectures using PowerPoint media, an ice-breaking session in the form of the WHO six-step handwashing simulation, question-and-answer sessions, and interactive quizzes. Evaluation was carried out using pre-tests and post-tests to measure students’ knowledge levels before and after the counseling activity. The results showed an increase in the mean knowledge score from 68.40 in the pre-test to 89.67 in the post-test. The paired t-test analysis showed a Sig. (2-tailed) value of 0.000 (p < 0.05), indicating a significant difference between pre-test and post-test results. In addition, students gave positive responses to the counseling activity, stating that the material was interesting, easy to understand, and enjoyable. These findings indicate that balanced diet counseling was effective in improving students’ knowledge regarding the implementation of healthy eating habits in daily life.

Adolescents are a nutritionally vulnerable group at risk of double burden of malnutrition. Riskesdas 2023 data showed that the prevalence of undernutrition in adolescents aged 13–15 years in North Sumatra reached 16.8%, while overweight and obesity reached 18.3%. The habit of consuming unhealthy snacks at school is one of the main preventable risk factors through structured nutrition education. Objective: This community service program aimed to increase knowledge of balanced nutrition and healthy snack selection behavior among Grade VIII students of SMP Negeri 19 Medan. Methods: Activities were carried out through interactive lectures, demonstrations, educational games, and workshops with 64 students. Evaluation used pre-test and post-test analysis with Wilcoxon Signed Rank Test. Results: There was a significant increase in nutritional knowledge in both classes (p=0.001) and healthy snack selection behavior (p=0.000). Conclusion: The Healthy Teen School program effectively improved adolescent nutrition knowledge and behavior.

Amidst rising global pressure regarding sustainability and cross-border trade, customs agencies are no longer viewed merely as gatekeepers but as strategic actors in global environmental governance through the Green Customs Initiative (GCI). This research aims to uncover the evolutionary patterns of GCI research within the context of adaptive policy, map its intellectual structure, and identify future thematic directions. The methodology employs a bibliometric analysis of documents sourced from the Web of Science database, utilizing VOSviewer software to perform co-authorship, bibliographic coupling, and co-word analysis.The results demonstrate that the dominance of scientific actors in this field is determined more by the strength of collaboration networks than by the mere volume of publications. The findings identify that the primary intellectual foundations of GCI research rest upon the critical relationship between environmental regulation, international trade, market responses, and eco-innovation. Furthermore, country-level analysis highlights the central roles of China, the United States, and the United Kingdom in shaping the knowledge structure of this domain. Overall, these findings underscore that the GCI has evolved into a multidisciplinary field that requires an adaptive policy framework to respond to the dynamics of ecological risks and global trade demands through institutional flexibility and cross-actor collaboration. By integrating environmental protection into border management and risk assessment, this study provides a strategic reference for customs authorities to move toward a more responsive and knowledge-based green customs administration.

Clean and healthy living habits (PHBS) is the essence and human right to maintain the continuity of life. Clean and healthy living habits is a set of behaviors that are practiced on the basis of awareness as a result of learning, which makes a person, family, group or community able to help themselves (independently) in the health sector and play an active role in realizing public health. The impacts of families who do not practice PHBS are numerous, this problem comes from unhealthy behavior and environments. Clean and Healthy Living Behavior in Cemparam Lama Village, Bener Meriah Regency, based on the results of observations made by the Mesidah District Health Center, Bener Meriah Regency, in 2022 is 1.8%. The aim of this research is to see the description of clean and healthy living behavior in the household structure in Cemparam Lama Village, Mesidah District, Bener Meriah Regency. This type of research is purely descriptive which aims to see the description of clean and healthy living habits in the family structure in Cemparam Lama Village, Bener Meriah Regency. Results of this research were good knowledge of respondents with a percentage of 93.9%, positive attitudes of respondents with a percentage of 95.6%, and good actions of respondents with a percentage of 94. 7%. Conclusion of this research is that the majority of families in Cemparam Lama Village, Mesidah District, Bener Meriah Regency have a good description of characteristics, knowledge, attitudes and actions regarding Clean and Healthy Living Habits.  

This study aims to examine the development of teachers’ multicultural competence at SMA Ta'miriyah Surabaya. The study employed a qualitative approach using a case study design. Data were collected through interviews, observations, and documentation involving the principal and teachers as research informants. Data analysis applied the interactive model of Miles, Huberman, and Saldana, which consisted of data condensation, data display, and conclusion drawing. The findings revealed that the development of teachers’ multicultural competence at SMA Ta'miriyah was carried out through three main pathways. First, training programs that implicitly integrated multicultural values into general educational programs, such as the teacher mobilization program. Second, organizational development grounded in Islamic values as the foundation for fostering tolerance and respect for diversity, implemented through curriculum integration, school regulations, teacher role modeling, and collaboration among teachers. Third, career development, which remained primarily focused on academic aspects and had not explicitly incorporated indicators of multicultural competence. Teachers’ multicultural competence at SMA Ta'miriyah was reflected in three main dimensions. In terms of knowledge, teachers acquired understanding through teaching experience, formal education, and training. In terms of attitudes, teachers demonstrated tolerant and inclusive behavior when interacting with students from diverse cultural and ethnic backgrounds. In terms of skills, teachers were able to manage classroom diversity harmoniously through adaptive and responsive pedagogical approaches that accommodated students’ differences.

In Islam, prayer (salat) is a fundamental obligation that must be performed under all circumstances, including during illness. Muslim patients have high spiritual needs, in which religious practices serve as a source of strength in coping with disease. Although Islam provides concessions (rukhsah) in performing prayer for the sick, limitations in patients’ understanding of how to perform prayer according to their health conditions are still found. This lack of knowledge may affect the proper practice of prayer during hospitalization. Therefore, this study aims to identify patient characteristics related to the practice of prayer, to examine the level of knowledge of the five daily prayers in relation to their practice among patients, and to analyze patients’ overall level of knowledge regarding prayer. This study employed a quantitative method with a cross-sectional design. The results show that patient characteristics, particularly productive age and higher educational level, contribute to their ability to perform prayer during hospitalization. A significant relationship was found between the level of knowledge of prayer and its practice, where better understanding was associated with more optimal religious practice. Overall, most patients had a high level of knowledge of prayer, although a small proportion still had low knowledge, indicating the need for spiritual education. It can be concluded that the level of knowledge of prayer is associated with the quality of prayer practice among Muslim patients at RSUD Haji Makassar. Strengthening spiritual education is needed to support the fulfillment of patients’ religious needs during hospitalization.

Rheumatoid arthritis (RA) is a daily disease seen in rheumatology clinics. It predominantly involves the appendicular skeleton. The axial skeleton is mostly spared except for the cervical spine where instability can occur and can be carefully assessed with cervical spine radiographs in flexion and extension. Radiographs may show erosion at the C1-C2 level with destruction of the transverse ligament that can result in atlantoaxial subluxation. Diagnosis is based on clinical, laboratory, and radiographic findings. Conventional radiography has been the mainstay for diagnosis of joint damage and subsequent follow-up. Radiography can provide only indirect information on synovial inflammation, however, and the technique is insensitive to early bone damage. Hand radiographs are frequently ordered as the first imaging modality in the assessment of patients presenting with peripheral arthritis. They can provide invaluable information about the bones, joints, mineralization, soft tissues and the distribution of abnormalities. Given the wide spectrum of rheumatic diseases, it might be challenging to make the diagnosis solely based on the clinical findings and imaging plays an important role in narrowing the differential diagnosis. Having the knowledge of the common radiographic manifestations of inflammatory arthritis is of paramount importance for clinicians and radiologists to diagnose the underlying disease in early stages of disease in order to start treatment. The purpose of the article is to review the key radiographic findings of common rheumatic diseases in the hands.

The role of citizenship education is fundamental in internalizing the values of nationalism and ethics within a society. This research is motivated by the increasing challenges of globalization and moral degradation that threaten the national identity of the younger generation. The primary objective of this study is to analyze the strategic role of citizenship education in shaping and strengthening national character within the Indonesian context. The research employs a qualitative descriptive method, utilizing literature reviews and thematic analysis of educational policies and social phenomena. The findings indicate that citizenship education serves as a vital instrument not only for transferring political knowledge but also for fostering civic disposition, including integrity, tolerance, and social responsibility. Furthermore, the integration of local wisdom within the curriculum significantly enhances the effectiveness of character building. The implications of this study suggest that a revitalized citizenship education curriculum, which adapts to digital era challenges, is essential for maintaining social cohesion. Stakeholders in the education sector must prioritize interactive and participatory pedagogical approaches to ensure that national character values are not merely memorized but practiced in daily life, thereby ensuring the long-term sustainability of the nation's democratic values.

This study analyzes netizen sentiment concerning the 17+8 public aspirations circulating the digital platform X spanning the period from August 18 through October 31, 2025. 1,837 comments obtained through scraping method. Classification Research stages include data preprocessing, sentiment weighting based on lexicon, and feature extraction using TF-IDF. Data 80% used for learning purposes and the remaining 20% utilized for validation. The findings reveal that the majority of comments, amounting to 81.14%, contained negative sentiment, while the remaining 18.86% were positive. The outcomes demonstrate that community reactions toward the 17+8 People's Demands were dominated by unsupportive views. From a theoretical standpoint this scholarly work offers to enriching knowledge concerning public opinion classification on political issues through a computational approach, while also serving as a reference for future research focused on improving the accuracy of sentiment analysis related to political dynamics and the behavior of state institutions.

Indonesia’s multicultural diversity poses serious challenges in maintaining social harmony, marked by increasing cases of intolerance driven by differences in ethnicity, religion, and culture. Education, particularly civics (PPKn), plays a strategic role in instilling tolerance values from an early age. This study aims to analyze the strategies used by elementary school teachers in cultivating tolerance attitudes through PPKn  learning, identify the implementation of tolerance values in classroom activities and student social interactions, and reveal the challenges faced by teachers along with effective and contextual learning strategies. This study employed a qualitative descriptive approach based on library research, collecting data from accredited scientific journals published between 2021 and 2025, sourced from databases including google scholar, DOAJ, and sinta- indexed journals. Data were analyzed using descriptive qualitative analysis through stages of data reduction, data presentation, and conclusion drawing, with source triangulation appliet to ensure validity. The findings reveal that affective teachers employ a holistic approach encompassing cognitive, affective, and psychomotor domains, consistent with Bloom’s revised taxonomy. Teachers serve not only as knowledge transmitters but also as moral role models, as supported by Bandura’s Social Learning Theory. Implementation is carried out through three channels: intracurricular, co-curricular, and extracurricular activities. Key challenges include dominance of cognitive approaches, limited understanding of multicultural education, and negative influencesof social media. This study implies the urgent need for continuous professional training for PPKn teachers, differentiated and inclusive learning design, and active collaboration between schools and families to strengthen the internalization of tolerance values in elementary school students.