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This study investigates the decoupling phenomenon between ESG (Environmental, Social, and Governance) sustainability reporting and communal Tri Hita Karana (THK) sustainability practices in a Rural Bank in Bali. Through Ethnographic Content Analysis (ECA) of official documents from BPR Luhur Damai covering 2023–2025, this study identifies that the Sustainability Report (SR), prepared strictly according to Financial Services Authority Regulation (POJK) 51/2017, does not incorporate substantial THK practices, namely banten (ceremonial offerings) Rp131.6 million, dana punia (religious donations) Rp8.5 million, and monthly banjar (communal community unit) contributions, producing a Hindu religious expenditure to formal Social and Environmental Responsibility (SER) ratio of 10:1. Drawing on the Institutional Logics perspective, this study identifies four decoupling mechanisms: (1) cognitive, namely THK as taken-for-granted, not perceived as “sustainability”; (2) administrative, namely departmental silos between Compliance and General Affairs; (3) template, namely POJK 51/2017 provides no space for local wisdom; and (4) capacity, namely limited Human Resources (HR) and institutional capacity. These findings lead to the concept of “invisible sustainability,” that is, real sustainability contributions that are invisible to conventional reporting frameworks, and “cultural accounting gap,” that is, the absence of accounting categories for local cultural-religious contributions. The theoretical contribution is demonstrating that decoupling in Global South contexts is not merely symbolic compliance but results from structural misalignment between transnational and communal logics that renders local sustainability contributions institutionally invisible.

This study aims to know the decision-making strategies in individuals with pragmatic personality. The approach used was qualitative with a case study method. The subjects of the study consisted of three individuals who were selected using purposive sampling techniques based on pragmatic personality characteristics, i.e. oriented to results, efficiency, and practical considerations in decision making. Data were collected through semi-structured interviews and observations, then analyzed using thematic analysis. The results of the study showed that all three respondents had relatively similar decision-making patterns, namely starting with understanding the problem, followed by identification and evaluation of multiple alternatives, as well as considering the advantages and disadvantages of each option. In determining the final decision, pragmatic individuals tend to choose solutions that are realistic, simple, effective, and have the lowest risk yet provide the optimal benefit. Additionally, in the face of important decisions, respondents showed a cautious attitude by calming themselves, not rushing, as well as partially considering the opinions of others as additional evaluation material. Overall, the findings of this study suggest that pragmatic personality plays a role in forming logical, adaptive, and real outcome-oriented decision-making strategies in daily life.

Anxiety disorders are common mental health problems among adolescents, particularly high school students who face academic demands, social pressure, and emotional changes. Family support, sleep quality, and academic stress are considered factors related to students’ anxiety levels. This study aimed to examine the relationship between family support, sleep quality, academic stress, and anxiety disorders among students of SMAN 1 Sumbawa Besar. An analytical study with a cross-sectional design was conducted involving 114 students selected through stratified random sampling. Data were collected using the Perceived Social Support–Family (PSS-Fa), Pittsburgh Sleep Quality Index (PSQI), Educational Stress Scale for Adolescence (ESSA), and Depression Anxiety Stress Scale (DASS-42). Bivariate analysis was performed using the chi-square test, while multivariate analysis employed binary logistic regression. Bivariate results indicated significant associations between family support, sleep quality, academic stress, and anxiety disorders (p < 0.05). However, multivariate analysis revealed that only family support and sleep quality were significantly associated with anxiety disorders, while academic stress was not significant after controlling for other variables. These findings suggest that anxiety prevention efforts should prioritize strengthening family support and improving sleep quality, alongside academic stress management within the school environment.

Burnout among nurses is a serious problem that can reduce the quality of nursing services and the well being of nurses. Work motivation and self efficacy are psychological factors that play an important role in reducing burnout. The aim is to minimize the occurrence of burnout among nurses in their performance.The purpose of this study is to determine the significance of the relationship between work motivation and self efficacy with the level of burnout among nurses. This research is quantitative in nature with a cross-sectional approach. Data collection was conducted using questionnaires administered to 98 respondents from the total population. The instruments used included a work motivation questionnaire (ERG), a general self-efficacy scale (GSES), and a Maslach Burnout Inventory (MBI). The data collected was processed using Spearman's test and ordinal logistic regression. Results researchers found that respondents who reported high work motivation numbered 89 respondents with a percentage of (90.8%), self-efficacy among nurses also showed a high category in 90 respondents with a percentage of (91.8%), and the majority of burnout levels were in the low category range of 65 respondents with a percentage of (66.4). Statistical tests showed a relationship between work motivation and burnout levels with a p-value of 0.000 (a = -0.358), and showed that there was a relationship between self-efficacy and burnout levels with a p-value of 0.013 (a = -0.250). Furthermore, multivariate statistics found that work motivation was the dominant factor influencing burnout with a p-value of 0.012 (E = -2.030). Conclusion there is a significant relationship between work motivation and self-efficacy with the level of burnout among nurses. Nurses with high work motivation and self-efficacy tend to have lower levels of burnout. Work motivation is a dominant factor in influencing burnout.

The dimensions of healthcare service quality are a concept for measuring service quality. This study aims to determine the effect of the dimensions of healthcare service quality on the satisfaction of inpatients at Cut Nyak Dhien General Hospital in Langsa City. This study uses a quantitative design of the Survey Analytic type with a cross-sectional approach. The population consisted of 121 inpatients with a sample size of 55 respondents using purposive sampling technique. Analysis used multiple logistic regression test (α=0.05). The research results show that there is an influence between Responsiveness p<0.042 with an EXP (B) value of 11.361, Assurance p<0.008 with an EXP (B) value of 20.163, Empathy p<0.018 with an EXP (B) value of 13.547, Reliability p<0.033 with an EXP (B) value of 6.896 on inpatient patient satisfaction (p<0.05), while the Tangible variable shows no influence with p<0.088 and an EXP (B) value of 4.967. Among these variables, the one that significantly affects inpatient patient satisfaction is the Assurance variable with p<0.008 and an EXP (B) value of 20.163. It is recommended to continuously improve the quality of service comprehensively in every dimension of service quality, strengthen the competence and professionalism of healthcare personnel, enhance the speed and accuracy of service, and build good communication to improve the quality of inpatient services and maintain patient trust in the hospital.  

The digital era demands a fundamental transformation in the role of early childhood educators, shifting from passive technology consumers to active architects of digital literacy. However, the dominance of technocentric views often acts as a substantial psychological and pedagogical barrier for teachers in regional areas. This collaborative community service project aims to reconstruct the paradigm of 50 kindergarten teachers in Bulukumba Regency by integrating "unplugged coding" logic and deep learning into play-based learning. Utilizing a Product-Based Intensive Training method with a "Logic over Laptop" strategy, the program focused on deconstructing technology-related stigmas and reconstructing teachers' ability to transform abstract concepts into safe, concrete media for children. Data analysis revealed a significant shift in teacher paradigms; while the majority were initially in the "less successful" category, 100% of participants reached positive categories (successful and very successful) post-intervention. Statistically, the program's effectiveness was evidenced by a dramatic increase in mean scores from 18.04 to 31.24 (p < 0.05) and an N-Gain score of 0.778, classified as highly effective. Furthermore, the partner satisfaction index reached 4.82 (very satisfied), confirming that the tri-campus collaboration model (STAI Al-Gazali, UNM, and Unismuh) is highly relevant to the implementation of the Merdeka Belajar curriculum. This project concludes that strengthening digital literacy through non-digital algorithmic reasoning effectively dismantles technical barriers for teachers while ensuring the safety of child development in the digital age.

This study comprehensively analyzes the impact of sectarian conflict on mental health in Kirkuk through an ethnoreligious meta-analysis of 42 studies with a total of N=15,427 participants published between 2003 and 2023. The quantitative synthesis indicates a PTSD prevalence of 47.3% (95% CI: 44.2–50.4) among victims of sectarian conflict, with an uneven distribution across groups, where the Turkmen minority records the highest prevalence at 56.8%, exceeding Arab Sunni at 43.2% and Kurdish at 41.5%. Logistic regression analysis demonstrates that direct exposure to sectarian violence increases the risk of major depression by 3.4 times (OR=3.42, p<.001), anxiety by 2.8 times (OR=2.83, p<.001), and psychosomatic disorders by 2.5 times (OR=2.54, p<.001). Further meta-regression identifies duration of conflict exposure (β=.426, p<.001) and intensity of sectarian violence (β=.389, p<.001) as significant predictors of symptom severity. In contrast to the findings of Cummings et al. (2013) and Eltally (2019), which emphasize the general impact of conflict, this study reveals specific intergenerational trauma patterns within distinct ethnoreligious communities, with the highest transmission observed among families of sectarian massacre victims (d=0.82), while simultaneously highlighting variations in communal resilience across groups as a differential determinant of post-conflict psychosocial dynamics.

Hospital nutrition services are an integral component of improving the quality of patient health. This descriptive observational study aims to evaluate the achievement of Minimum Service Standards (MSS) for nutrition at RSUD Dr. H. Slamet Martodirdjo Pamekasan, specifically focusing on the accuracy of diet types, timeliness of food distribution, and patient food waste. Data were collected over a single menu cycle (10 days) from November 24 to December 4, 2025, involving 44 patients per day. Research instruments included observation sheets and the Comstock visual method, with data analyzed based on the Decree of the Minister of Health (Kepmenkes) No. 129 of 2008. The results indicated that the timeliness of food distribution reached 96% and the accuracy of diet types reached 100%, both of which met the MSS requirements (≥ 90% and 100%, respectively). However, the average patient food waste was 25%, which does not yet meet the maximum standard of ≤ 20%. In conclusion, while logistical aspects have fulfilled the established standards, the hospital needs to conduct further evaluations regarding food flavor factors and patients' clinical conditions to reduce food waste in accordance with the applicable standards.

As HIV transitions into a manageable chronic condition, optimizing lifestyle behaviors is key to achieving long-term health outcomes. This study aims to explore lifestyle behaviors in people with HIV (ODHIV) who participate in peer support groups as well as identify socioeconomic and clinical predictors of healthy lifestyle engagement. The research design was a cross-cutting analysis involving 250 ODHIV registered in a community support group. Lifestyle behavior was measured using  a modified Health-Promoting Lifestyle Profile II (HPLP-II) instrument. Multivariate logistic regression analysis was used to determine independent predictors, with Nagelkerke R² and Hosmer–Lemeshow tests  to assess model suitability. The results showed that 56.2% of respondents had a healthy lifestyle. Factors of higher education (OR = 2.77; p = 0.006), older age (OR = 2.32; p = 0.015), employment status (OR = 2.00; p = 0.029), and longer duration of ART therapy (OR = 1.17 per year; p = 0.003) were significant predictors. The model explains 32% of lifestyle variations, with ART compliance and substance control as the strongest behavioral domains. These findings confirm the role of peer support groups as a behavioural reinforcement environment, but socioeconomic disparities remain influential. The integration of theory-based lifestyle interventions into community-based HIV services is necessary to optimize chronic disease outcomes.

This study examines the transformation of family structures among Syrian refugees in Gaziantep, Turkey, using a meta-synthesis of 47 studies published between 2015 and 2024. The research focuses on changes in relational, economic, and normative aspects due to prolonged displacement. The findings reveal significant shifts in family dynamics, with 73.8% of families redefining traditional gender roles and 64.2% of women becoming the primary breadwinners. The divorce rate increased by 42.6%, with 38.7% of cases linked to economic pressures. Logistic regression shows a strong correlation (r = 0.78, p < 0.001) between displacement duration and family structure transformation. The study supports Heger, Boyle, and Ali’s (2010) argument about the fluidity of gender roles in forced migration but challenges Buscher’s (2011) view on the persistence of patriarchal structures. Additionally, 82.3% of families adopted more egalitarian parenting, and children's participation in education rose to 67.4%, reducing the gender gap to 8.2%. The study also identifies adaptive strategies, such as the use of communal support systems by 58.6% of families and the integration of local cultural values by 45.2%, offering insights into resilience and adaptive capacity in prolonged crises.

The third trimester of pregnancy is a challenging period since pregnant women experience various physical and psychological changes that can affect their readiness for childbirth. High anxiety levels and the presence of pregnancy complications are known to reduce maternal preparedness for labor. This study aims to determine the relationship between anxiety levels and pregnancy complications with the readiness of third trimester pregnant women in facing childbirth in the working area of Benteng Community Health Center, Selayar Islands Regency. This research used a quantitative approach with a correlational design and a cross-sectional method. The population consisted of all third trimester pregnant women, with a total sample of 86 respondents selected using purposive sampling. The research instruments included an anxiety questionnaire using the Hamilton Anxiety Rating Scale (HARS), a pregnancy complication checklist, and a childbirth readiness questionnaire. Data were analyzed using the Chi-Square test and multiple logistic regression at a significance level of α = 0.05. The results of the study showed no significant relationship between anxiety and readiness for childbirth (p < 0.550) or between pregnancy complications and readiness for childbirth (p < 0.690). Therefore, it can be concluded that anxiety and pregnancy complications are not significantly related to the readiness of pregnant women in the third trimester for childbirth. This indicates that maternal readiness is influenced by factors other than the variables studied, such as knowledge, family support, and previous childbirth experiences.

Stunting remains a major public health problem in Indonesia, particularly in Aceh Province. Family smoking behavior and adherence to exclusive breastfeeding are considered important determinants of child nutritional status. This study aimed to analyze the relationship between family smoking behavior and exclusive breastfeeding adherence with stunting among toddlers in Tuha Village, Trienggadeng District, Pidie Jaya Regency. This study used a quantitative cross-sectional design with a sample of 46 toddlers selected using simple random sampling. Data were collected through structured questionnaires and analyzed using univariate and bivariate analysis with logistic regression tests. The results showed that family smoking behavior was significantly associated with stunting (p = 0.002; OR = 0.12; 95% CI: 0.03–0.47). Meanwhile, exclusive breastfeeding adherence was not significantly associated with stunting (p = 0.940; OR = 0.94; 95% CI: 0.17–5.09). These findings indicate that exposure to cigarette smoke in the household is an important risk factor affecting child nutritional status. Strengthening family-based interventions, especially smoke-free home initiatives, is essential to reduce stunting prevalence.

In the era of information and globalization, critical thinking skills have become an essential competence for children, including students in Islamic boarding schools. These skills include the ability to ask questions, seek and evaluate evidence, compare alternatives, and solve problems logically. Islamic boarding schools inherently provide a disciplined environment grounded in religious values that supports the development of critical thinking. However, observations at Raudlatul Hanan Islamic Boarding School reveal several challenges, such as low social sensitivity, limited constructive conflict resolution, and the absence of consistent critical thinking habits. These conditions have the potential to hinder students’ adaptability and problem-solving abilities in the future. To address these issues, a program entitled “Optimizing Children’s Critical Thinking Character through the Internalization of Socio-Environmental Sensitivity Values” was implemented using a Participatory Action Research (PAR) approach. This approach actively involved students, ustadz/ustadzah, and Islamic boarding school administrators from problem identification through planning, implementation, and reflection. The activities included character education seminars, critical discussions, group competitions, and interviews aimed at fostering social sensitivity, reducing exclusive attitudes, and strengthening critical thinking skills from an early age. The results indicate high and enthusiastic student participation throughout all activities, leading both students and administrators to hope that the program will be implemented sustainably on an annual basis.

This community service program is entitled Improving Microcontroller Competence of Students of SMK Negeri 3 Pematangsiantar through Arduino Training Based on Industrial Practice and is implemented as a follow-up to the school's official request to invite university practitioners as guest teachers in order to strengthen industry-based vocational learning. The activity was carried out on November 27, 2025 at the Computer Laboratory of SMK Negeri 3 Pematangsiantar involving 50 grade XI students, and guided by Andi Setiadi Manalu, S.Kom., M.Ti as the main instructor of Arduino material which focuses on the introduction of microcontrollers, basic programming, sensor integration, and simple automation project design. The purpose of this activity is to improve students' technical competence in the field of embedded systems while fostering work readiness through real-world practice-based learning experiences. The implementation method uses an experiential learning and project-based learning approach, which combines brief conceptual explanations with direct practice, technical discussions, and problem-based project assignment completion. The evaluation results show an increase in students' understanding of microcontroller functions, programming logic structures, and the ability to connect hardware and software in one work system. In addition, students demonstrated increased motivation, confidence, and interest in industrial technology, as reflected in their active participation during the practicum and their successful independent completion of functional prototypes. Overall, this activity proved effective in strengthening the technical competencies of vocational high school students and supporting the implementation of the link and match policy between vocational education and the needs of the industrial world, while also emphasizing the strategic role of higher education institutions in supporting the improvement of human resource quality at the vocational high school level.

Aceh Tamiang Regency is an area with a high risk of annual flooding. This emergency condition often triggers a surge in environment-related diseases such as skin diseases, respiratory infections, and diarrhea. The success of managing health crises heavily depends on pharmaceutical logistics management, especially the availability of essential medicines and ease of access for refugees at evacuation points. This study aims to analyze the extent of medicine availability at community health centers and health posts, as well as to evaluate the barriers to medicine accessibility for flood victims in Aceh Tamiang Regency. This study uses a qualitative/quantitative descriptive method (choose one) with a case study approach. Primary data were collected through in-depth interviews with pharmaceutical logistics officers and surveys of flood survivors. Secondary data were obtained from the drug stock reports of the Aceh Tamiang District Health Office. Analysis was conducted on variables such as drug types, stock amounts (Buffer Stock), and distribution channels during the emergency response period. The results of the study indicate that the availability of drugs in the initial disaster phase tends to be (state the prediction, e.g., sufficient/limited). However, accessibility is often hindered by damaged road infrastructure and uneven distribution to remote posts. There is an urgent need to strengthen the logistics early warning system so that the types of medicines available match the disease patterns that emerge after floods. Although medicine stocks are generally available in central pharmacy warehouses, geographical constraints and distribution coordination are the main factors hindering accessibility. It is recommended that local governments map out alternative distribution routes and provide disaster-specific buffer stock of medicines at the sub-district level.

Senior high school students represent a strategic age group transitioning into adulthood and are expected to become future leaders of the nation. In the context of achieving Indonesia’s Vision 2045, threats to national resilience are no longer dominated by military aggression, but rather by non-military challenges in the form of cognitive warfare. One prominent manifestation of this threat is the massive exposure of students to low-value digital content, commonly referred to as brain rot, on social media platforms. Such content has the potential to reduce attention span, critical thinking ability, and national awareness among adolescents. Consequently, senior high school students have become a vulnerable group in the spread of misinformation, disinformation, and ideologies that contradict Pancasila values. This community service activity aims to provide training and strengthen national defense character (bela negara) among senior high school students in Jakarta through an educational and participatory approach. The methods employed include the delivery of conceptual materials on national defense awareness and digital literacy, as well as national defense debate simulations designed to enhance students’ critical, argumentative, and ethical thinking skills. The results indicate an improvement in participants’ understanding of national defense values and their ability to express logical and responsible arguments. This activity is expected to contribute to the development of a resilient, critical, and nationally-minded young generation capable of facing contemporary challenges in the digital era.

Health workers contribute up to 80% to the success of health development. For this reason, effective employee performance management is needed according to service performance for communicable and non-communicable diseases. The aim of this research is to analyze the factors that influence the performance of nurses in health services for non-communicable diseases and infectious diseases at the UPT Puskesmas Kuala, Kuala District, Langkat Regency.The research design used was an analytical survey with a cross sectional approach. The population of this study were all 31 nurses with a sample using a total sampling technique of 31 people. The data analysis used is the binary logistic regression test.The research results show that ability has a sig-p value of 0.025, attitude sig-p 0.014, learning sig-p 0.036, motivation sig-p 0.022, leadership sig-p 0.031 and work environment sig-p 0.048, which means it has an influence on nurse performance , while age sig-p 1.000 and perception sig-p 0.496 have no influence on nurse performance. Attitude is the dominant factor with an OR value of 28.446. In conclusion, ability, attitude, learning, motivation, leadership, and work environment influence nurse performance, while age and perception have no effect. Attitude is the most dominant factor influencing nurse performance.

Background: Dietary adherence is a crucial component in the management of patients with chronic kidney disease (CKD) undergoing hemodialysis. Non-adherence may lead to metabolic imbalance, increased morbidity, and reduced quality of life.Objective: To identify factors associated with dietary non-adherence among patients with CKD undergoing hemodialysis at Imelda Hospital, Medan. Methods: A cross-sectional study was conducted among patients undergoing routine hemodialysis. Data were collected using structured questionnaires assessing knowledge, attitudes, and family support related to dietary adherence. Statistical analysis was performed using chi-square tests and logistic regression with a significance level of p < 0.05. Results: Knowledge, attitudes, and family support were significantly associated with dietary non-adherence (p < 0.05). Family support was identified as the most influential factor. Conclusion: Dietary non-adherence among hemodialysis patients is influenced by knowledge, attitudes, and family support. Strengthening patient education and family-centered nursing interventions is essential to improve dietary adherence.

This paper analyzing how reshaping the future of global trade, explore the transition from traditional online retail models toward sustainable e-commerce ecosystems. By examining the integration of circular economy principles, green logistics, and ethical supply chain manajement, the study identifies the core drivers behind this transformation

This study discusses the phenomenon of digital entrepreneurship in the era of global climate awareness, focusing on the integration of artificial intelligence (AI) ethics, sustainable technology, and green innovation. The main issues raised are the fragmentation of analysis between digital business ethics, green economic opportunities, and technological challenges such as greenwashing, high AI energy consumption, and the digital divide. The purpose of this study is to formulate an interdisciplinary framework that combines ethical, technological, and sustainability dimensions to strengthen the role of digital entrepreneurs in achieving low-carbon development. The methods used include critical literature analysis, bibliometrics of 200 publications (2018-2025) using VOSviewer, and fuzzy logic-based simulations using the UNESCO AI ethics framework (2021) and the sustainable business model of Bocken et al. (2014). The results show four main research clusters: AI for Sustainable Innovation, Ethical Digital Business, Blockchain for Green Supply Chain, and Circular Digital Economy. The application of AI ethics increases the efficiency of green business decisions by up to 20%, consumer trust by 17%, and MSME participation by 14%. The synthesis of findings confirms that AI ethics acts as a conceptual mediator that strengthens the link between technological innovation and sustainability. In conclusion, ethical digital entrepreneurship has great potential as a driving force for Indonesia's green economy, but it requires digital ethics audit policies and the adoption of low-carbon technologies to address ethical and environmental risks in the AI era.