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Bendung Ranggah merupakan bendung yang terletak di DAS Sungai Ngeluk, Desa Materaman, Kecamatan Gembong, Kabupaten Pati, Provinsi Jawa Tengah yang mengairi daerah irigasi seluas 1,163,20 Ha. Bendung Ranggah  memiliki kerusakan pada komponen struktural yang dapat menurunkan kinerja. Oleh karena itu, penelitian ini bertujuan untuk mengevaluasi kinerja Bendung Ranggah berdasarkan kondisi fisik komponen utama bendung. Metode penelitian menggunakan pendekatan kuantitatif melalui observasi lapangan, pengumpulan data primer dan sekunder, serta analisis pembobotan Analytic Hierarchy Process (AHP) guna menentukan tingkat kepentingan per komponen terhadap kinerja bendung secara keseluruhan. Hasil penelitian menunjukkan bobot komponen pada mercu sebesar 56,81%, bangunan pengambilan 24,10%, bangunan penguras 13,33%, dan sayap 5,76%. Berdasarkan analisis kondisi, Bendung Ranggah mengalami kerusakan sebesar 26,56% dan masuk dalam tingkat kerusakan sedang. Secara keseluruhan bendung masih berfungsi, namun memerlukan rehabilitasi struktural secara terencana dan berkelanjutan agar kinerja bendung mampu mendukung sistem irigasi secara optimal.

Pulmonary tuberculosis is an infectious disease that remains a public health problem, especially in developing countries such as Indonesia. The transmission of this disease can be prevented through appropriate behavior, which is influenced by the level of individual knowledge. This study aims to determine the relationship between knowledge level and preventive behavior of pulmonary tuberculosis transmission among patients at a public health center. This study used a quantitative method with a cross-sectional design. The sample consisted of 20 respondents selected using total sampling technique. The research instrument was a questionnaire measuring knowledge and behavior. Data were analyzed using the Chi-Square test. The results showed that most respondents had a good level of knowledge (50.0%) and good preventive behavior (60.0%). The Chi-Square test showed a p-value of 0.000 (p < 0.05), indicating a significant relationship between knowledge level and preventive behavior of pulmonary tuberculosis transmission. In conclusion, there is a significant relationship between knowledge level and preventive behavior, indicating that improving knowledge is essential in preventing tuberculosis transmission.

Pulmonary tuberculosis is an infectious disease that remains a public health problem, especially in developing countries such as Indonesia. The transmission of this disease can be prevented through appropriate behavior, which is influenced by the level of individual knowledge. This study aims to determine the relationship between knowledge level and preventive behavior of pulmonary tuberculosis transmission among patients at a public health center. This study used a quantitative method with a cross-sectional design. The sample consisted of 20 respondents selected using total sampling technique. The research instrument was a questionnaire measuring knowledge and behavior. Data were analyzed using the Chi-Square test. The results showed that most respondents had a good level of knowledge (50.0%) and good preventive behavior (60.0%). The Chi-Square test showed a p-value of 0.000 (p < 0.05), indicating a significant relationship between knowledge level and preventive behavior of pulmonary tuberculosis transmission. In conclusion, there is a significant relationship between knowledge level and preventive behavior, indicating that improving knowledge is essential in preventing tuberculosis transmission.

This study uses a one group pretest posttest design model. posttest on the correlation between vocabulary mastery, reading habits, while pretest with conventional learning, then both groups were measured with the same measuring instrument. To test whether the two data (variables) are the same or different, a t-test was conducted. The t-test obtained a t count of 2.082 with α = 0.05 and t table = 1.725. The testing criteria in the one-tailed test are Ho is rejected and H1 is accepted if t count > t table. The hypothesis can be accepted because t count > t table, namely 2.082 > 1.725. The results of student learning completeness show a significant percentage, namely the pretest gets 10 (50%) students who have not completed and 10 (50%) students who have completed after being carried out on the correlation between vocabulary mastery, reading habits get completeness posttest learning results 18 (88.89%) students who have completed and 2 (11.11%) students who have not completed. It was concluded that through the correlation between vocabulary mastery, students' reading habits can achieve learning completeness because it is one indicator of the effectiveness of this research. The conclusion is that the correlation between vocabulary mastery, reading habits is effective in achieving English reading comprehension for fifth grade students of Gunungsari 01 Pati State Elementary School. Based on the results of this study, the suggestion obtained is that the correlation between vocabulary mastery and reading habits be used as an alternative for teachers to teach English in class.

Background:Tuberculosis remains a serious public health challenge in Indonesia, including in Pekalongan City, which sees an annual increase in cases. The still high number of TB cases and deaths each year indicates that the program being implemented is not yet fully effective, therefore requiring active community involvement, increased capacity of health workers, and closer cross-sector integration. Aims: This activity aims to provide comprehensive community nursing care through a promotive and preventive approach, with an emphasis on identifying risky behaviors, knowledge deficits, and non-adherence to TB treatment. Method: The methods used included community assessment, establishing a community nursing diagnosis, planning education-based interventions, implementing outreach and simulation activities, and evaluating outcomes. Results: The results of the activity indicated that most people have limited knowledge about TB prevention, and that risky behaviors and non-adherence to therapy persist. Interventions, including group outreach, interactive discussions, and education on the importance of medication adherence, demonstrated increased knowledge and healthier behavior changes. Conclution: The conclusion of this activity emphasized the importance of the active role of community nurses in reducing TB transmission rates through educational approaches, active surveillance, and cross-sector collaboration. Recommendations focused on strengthening ongoing education and the involvement of families and community health workers in early detection and monitoring of TB patient therapy.

Patient satisfaction is a key indicator of health service quality in the National Health Insurance era. Outpatient services for BPJS members still face problems regarding waiting time, communication, and facilities. This study aimed to analyze factors affecting BPJS patient satisfaction with outpatient service quality at Malahayati Islamic Hospital Medan in 2026. A cross-sectional analytic design was applied to 150 respondents selected through consecutive sampling. Data were collected using a validated questionnaire (r>0.361; α=0.876) and analyzed by Chi-square and multiple logistic regression. Results showed that waiting time (p<0.001), staff competence (p<0.001), staff attitude (p<0.001), drug availability (p=0.032), facility comfort (p<0.001), administrative ease (p=0.003), and information clarity (p=0.008) were significantly associated with satisfaction. Multivariate analysis revealed waiting time as the most dominant factor (OR=5.42; 95% CI: 2.31–12.71), followed by staff competence (OR=4.18), facility comfort (OR=2.87), and staff attitude (OR=2.42), with Nagelkerke R²=0.512. Hospital management should optimize service flow and adopt digital queuing systems to enhance patient satisfaction.

The development of Artificial Intelligence (AI) has driven significant transformation in hospital management, particularly in operational efficiency, service quality, and patient safety. This study aims to analyze the implementation of AI in hospital management based on recent scientific evidence from 2020 to 2026. The method used was a systematic review guided by the PRISMA 2020 framework. Literature was retrieved from PubMed, ScienceDirect, SpringerLink, Google Scholar, and ProQuest. From 360 identified articles, a stepwise selection process was conducted, resulting in 15 articles that met the inclusion criteria. The findings indicate that AI contributes to improved operational efficiency through patient flow optimization, operating room management, workforce scheduling, and electronic medical record management. AI also enhances service quality through predictive data analytics and supports patient safety through risk detection and early warning systems. In conclusion, AI has strong strategic potential to support modern hospital management. However, its implementation still faces several challenges, including human resource readiness, data security, algorithmic bias, system interoperability, and investment requirements. Therefore, AI implementation should be carried out in a planned, ethical manner and evaluated from a health economics perspective.

This study aims to analyze the religious and spiritual symbols represented in the film Titip Surat untuk Tuhan through Roland Barthes’ semiotic approach, focusing on the three levels of meaning: denotation, connotation, and myth. The research employs a qualitative descriptive method using semiotic analysis based on document studies of selected scenes, dialogues, and visual elements portraying religious values, prayer, sacrifice, patience, hope, gratitude, and trust in God. The findings reveal that symbols such as the mosque, mukena, sarong, prayer mat, the Qur’an, prayer activities, the post office as a medium for sending letters to God, and the calligraphy of “Allah” and “Prophet Muhammad” on the walls function not only as literal signs but also convey profound religious and spiritual connotations. These symbols further develop into myths that reinforce religious norms and cultural beliefs accepted as natural within society. The film successfully constructs a subtle yet powerful representation of faith by portraying a Muslim family that upholds devotion, moral values, patience, compassion, and an enduring relationship with God. Overall, the film demonstrates how religious symbols effectively communicate spiritual messages while strengthening viewers’ understanding of Islamic values through visual and narrative storytelling.

Independent Nursing Practice (INP) is a form of healthcare service that provides direct care to the community, including Homecare services. Public interest in these services is influenced by various factors; however, the dominant factors affecting interest in the Tambah Rejo area have not been clearly identified. This study aimed to identify and analyze factors associated with interest in Homecare services at independent nursing practices and to determine the most influential factor. This study employed a quantitative approach using an analytical survey design with a cross-sectional method. A total of 153 respondents were selected through purposive sampling. Data were collected using questionnaires and analyzed using the Chi-square test and multiple logistic regression. The results showed significant relationships between economic factors (p = 0.023; OR = 2.187), distance (p = 0.003; OR = 0.361), comfort (p < 0.001; OR = 49.67), service quality (p = 0.009; OR = 0.404), family support (p < 0.001; OR = 52.62), patient satisfaction (p < 0.001; OR = 0.212), and interest in Homecare services. Multiple logistic regression analysis revealed that comfort was the most dominant factor influencing interest in Homecare services (p < 0.001; OR = 0.124). Comfort was identified as the strongest determinant affecting community interest in Homecare services at independent nursing practices. Therefore, improving comfort in service delivery should be a primary priority in the development of independent nursing practices.

Communication is a crucial element in the learning process, particularly in the education of students with special needs who possess diverse characteristics, abilities, and communication requirements. These differences require teachers to implement adaptive communication strategies to ensure that learning messages are effectively conveyed and understood by students. This study aims to analyze the communication at SLB YPAC Medan. The subjects of this study specifically focused on third-grade students with intellectual disabilities (tunagrahita) and slow learners. The. The study adopted a qualitative approach using a case study method. Data were collected through observation, in-depth interviews, and documentation, and analyzed using the Miles and Huberman model, which includes data reduction, data display, and conclusion drawing. The findings reveal that teachers apply communication strategies through a combination of verbal and nonverbal communication. Verbal communication involves the use of simple language, repetition of learning materials, and step-by-step instructions tailored to students’ abilities. Meanwhile, nonverbal communication is expressed through facial expressions, body movements, eye contact, and the use of visual learning media to clarify instructional messages. In addition, interpersonal approaches emphasizing patience, attention, empathy, and emotional closeness were found to enhance the effectiveness of teacher–student interactions. Supporting factors include adequate school facilities, psychological services, and therapy programs, while inhibiting factors involve differences in students’ characteristics and limitations in their communication abilities. This study concludes that adaptive communication strategies that accommodate individual student needs play a significant role in creating an effective, comfortable, and supportive learning environment for students with special needs.

Independent Nursing Practice (INP) is a form of healthcare service that provides direct care to the community, including Homecare services. Public interest in these services is influenced by various factors; however, the dominant factors affecting interest in the Tambah Rejo area have not been clearly identified. This study aimed to identify and analyze factors associated with interest in Homecare services at independent nursing practices and to determine the most influential factor. This study employed a quantitative approach using an analytical survey design with a cross-sectional method. A total of 153 respondents were selected through purposive sampling. Data were collected using questionnaires and analyzed using the Chi-square test and multiple logistic regression. The results showed significant relationships between economic factors (p = 0.023; OR = 2.187), distance (p = 0.003; OR = 0.361), comfort (p < 0.001; OR = 49.67), service quality (p = 0.009; OR = 0.404), family support (p < 0.001; OR = 52.62), patient satisfaction (p < 0.001; OR = 0.212), and interest in Homecare services. Multiple logistic regression analysis revealed that comfort was the most dominant factor influencing interest in Homecare services (p < 0.001; OR = 0.124). Comfort was identified as the strongest determinant affecting community interest in Homecare services at independent nursing practices. Therefore, improving comfort in service delivery should be a primary priority in the development of independent nursing practices.

The implementation of Electronic Medical Records (EMR) has become an essential part of digital transformation in the healthcare sector, aiming to improve the quality, effectiveness, efficiency, and continuity of healthcare services. In Indonesia, the implementation of EMR is supported by the Regulation of the Minister of Health Number 24 of 2022, which mandates healthcare facilities to adopt electronic medical records. However, the implementation process is often challenged by various technical and non-technical factors that may affect its success. This study aims to analyze the success factors and barriers to EMR implementation in hospitals through a literature review approach. The research method used was a literature review by examining and analyzing 11 scientific articles obtained from Google Scholar and other relevant scientific sources. The findings indicate that the success of EMR implementation is influenced by three main aspects, namely human, organizational, and technological factors. Supporting factors include management commitment, user readiness, continuous training, availability of information technology infrastructure, system quality, and organizational support. Meanwhile, common barriers include limited digital literacy among healthcare workers, insufficient information technology personnel, unstable internet connectivity, system errors, inadequate facilities and infrastructure, budget limitations, and the absence of specific standard operating procedures. Furthermore, EMR implementation provides significant benefits, such as improving service efficiency, facilitating access to patient information, enhancing documentation quality, supporting communication among healthcare professionals, and increasing patient safety. Therefore, successful EMR implementation requires synergy between human resources, organizational readiness, and technological infrastructure to achieve optimal healthcare service delivery.

Background: The application of ethical principles is an essential foundation in nursing practice, as nurses frequently encounter complex clinical situations that require a careful balance between professional demands, patient safety, and patient rights. Objective: This study aims to explore nurses' experiences in applying ethical principles within clinical nursing practice. Methods: This study utilized a qualitative design with a phenomenological approach. Participants were selected via purposive sampling based on their work experience in direct patient care. Data were collected through in-depth interviews and analyzed using thematic analysis. Results: The findings revealed four main themes: 1) patient autonomy and decision-making in care; 2) the interaction of beneficence, safety, and religious values in care; 3) justice and patient prioritization in care; and 4) effective communication and patient confidentiality. Conclusion: The application of ethical principles is influenced by knowledge, clinical reasoning, moral sensitivity, and teamwork. Continuous reinforcement of ethical education and organizational support are highly required to enhance the quality of nursing care services.

Diabetes Mellitus (DM) is a metabolic disease with an increasing prevalence and a risk of causing macrovascular complications such as stroke. This study aimed to describe the characteristics of Diabetes Mellitus patients with stroke complications based on CT-scan results at RSKD Dadi Makassar in 2024–2025. This was a descriptive observational study with a retrospective design using medical record data. Samples were taken using a total sampling technique, comprising 60 patients, and analyzed univariately using the Statistical Product and Service Solutions (SPSS) version 26. The results showed that the majority of respondents were in the late elderly group (>56 years) at 66.7%, female (51.7%), and from the Makassar ethnic group (63.3%). Most respondents experienced hyperglycemia in random blood glucose (66.7%) and had uncontrolled fasting blood glucose (68.3%) and HbA1c (76.7%) levels. CT-scan results were dominated by non-specific cerebral infarction (68.3%), with ischemic stroke as the most common type (93.3%), a length of stay of 5–10 days (53.3%), and right-sided hemiparesis as the most common clinical manifestation (45.0%). It was concluded that DM patients with stroke complications were generally elderly, female, had poor glycemic control, and were dominated by ischemic stroke with non-specific cerebral infarction. Abstrak. Diabetes Melitus (DM) merupakan penyakit metabolik dengan prevalensi yang terus meningkat dan berisiko menimbulkan komplikasi makrovaskular berupa stroke. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik pasien Diabetes Melitus yang mengalami komplikasi stroke berdasarkan hasil CT-scan di RSKD Dadi Makassar tahun 2024–2025. Penelitian ini merupakan penelitian observasional deskriptif dengan desain retrospektif menggunakan data rekam medis. Sampel diambil dengan teknik total sampling sebanyak 60 pasien dan dianalisis secara univariat menggunakan Statistical Product and Service Solutions (SPSS) versi 26. Hasil penelitian menunjukkan mayoritas responden berusia lansia akhir (>56 tahun) sebanyak 66,7%, berjenis kelamin perempuan (51,7%), dan berasal dari Suku Makassar (63,3%). Sebagian besar responden mengalami hiperglikemia pada GDS (66,7%) serta memiliki kadar GDP (68,3%) dan HbA1c (76,7%) yang tidak terkontrol. Hasil CT-scan didominasi oleh infark serebri tidak spesifik (68,3%) dengan jenis stroke terbanyak berupa stroke iskemik (93,3%), lama rawat inap terbanyak 5–10 hari (53,3%), dan manifestasi klinis tersering berupa hemiparese dextra (45,0%). Disimpulkan bahwa pasien DM dengan komplikasi stroke umumnya berusia lanjut, berjenis kelamin perempuan, memiliki kontrol glikemik yang buruk, dan didominasi oleh stroke iskemik dengan gambaran infark serebri tidak spesifik.

Diabetes Mellitus (DM) is a chronic metabolic disease characterized by persistently high blood sugar levels, which can lead to complications such as diabetic foot issues. A crucial aspect for healthcare professionals providing care to DM patients is assessing the patient's level of adherence and understanding regarding self-care and disease management. Data from the 2023 SKI (Indonesian Health Survey) indicates there were 118,184 cases of Diabetes Mellitus in Central Java. Foot care education delivered via remote services assists patients in performing proper foot care to prevent complications associated with the condition. This study aimed to determine the effectiveness of an animated video based on the Theory of Planned Behavior in improving the knowledge and adherence of patients with diabetic ulcers. A quasi-experimental design was employed, utilizing a one-group pre-test and post-test approach with a control group. Incidental sampling was used to select 60 respondents. The Mann-Whitney test yielded a p-value of < 0.05 (0.017), demonstrating that the animated video based on the Theory of Planned Behavior was effective in enhancing both adherence and knowledge among patients with diabetic ulcers. The findings suggest that this animated video, leveraging audiovisual media, can be implemented in educational settings to help prevent foot complications in patients with diabetes.

Stroke is a neurological disorder caused by impaired blood flow to the brain, resulting in brain tissue damage and various functional impairments. One of the common problems experienced by stroke patients is sleep disturbance, which may be influenced by neurological deficits, limited physical mobility, pain, and post-stroke anxiety. Persistent sleep disturbances can delay the recovery process and reduce patients’ quality of life. The long-term use of sleeping medications may lead to adverse effects; therefore, safe and easily applicable complementary therapies are needed. This study aimed to determine the effectiveness of peppermint oil aromatherapy in improving sleep quality among stroke patients in the working area of Barebbo Community Health Center, Bone Regency. The method used was the implementation of complementary therapy through the administration of peppermint oil aromatherapy to stroke patients experiencing sleep disturbances. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. The assessment results showed that before the intervention, patients experienced poor sleep quality, characterized by difficulty initiating sleep, frequent nighttime awakenings, insufficient sleep duration, and daytime fatigue. After receiving peppermint oil aromatherapy, patients demonstrated increased comfort, reduced anxiety, improved ability to initiate sleep, and better overall sleep quality compared to their condition before the intervention. Therefore, peppermint oil aromatherapy was found to be effective in improving sleep quality among stroke patients and can be used as a complementary non-pharmacological intervention in nursing care.

Esophageal atresia with tracheoesophageal fistula is a congenital anomaly requiring early diagnosis and prompt surgical correction. Gross type D esophageal atresia, characterized by both proximal and distal tracheoesophageal fistulas, is an exceedingly rare variant that poses significant diagnostic and operative challenges. We report a case of a full-term female neonate with a birth weight of 3,200 grams who presented with hypersalivation since the first day of life, accompanied by coughing and choking during feeding. Orogastric tube insertion failed, with the tube arrested at approximately 15 cm. The patient was referred with a diagnosis of neonatal pneumonia and suspected esophageal atresia with tracheoesophageal fistula. Physical examination revealed tachypnea, chest wall retraction, and respiratory distress requiring ventilatory support. Babygram demonstrated the orogastric tube tip arrested at the proximal esophageal pouch with distal gastrointestinal air. Contrast esophagography confirmed proximal esophageal atresia at the upper thoracic level with suspected proximal fistula. Associated findings included bilateral pneumonia, right upper lobe atelectasis, and vertebral anomalies suggestive of VACTERL association. Intraoperative findings confirmed Gross type D esophageal atresia with proximal and distal tracheoesophageal fistulas. Both fistulas were excised, followed by primary esophageal anastomosis and transanastomotic nasogastric tube placement. Gross type D esophageal atresia is a rare congenital anomaly that should be considered in neonates presenting with hypersalivation, failed orogastric tube insertion, and respiratory distress. Anatomical subtype confirmation relies on intraoperative findings. Early surgical repair can be performed successfully; however, associated anomalies necessitate careful long-term follow-up.

Stigma toward people with mental disorders affects not only individuals living with mental illness but also the psychological well-being of family members who serve as their primary caregivers. Families often experience social rejection, discrimination, and negative stereotypes, which increase emotional and psychological burdens while reducing the quality of care they provide. This study aimed to explore the impact of stigma on the psychological well-being of families caring for people with mental disorders in Pamekasan Regency. A qualitative study using a phenomenological approach was conducted involving 11 participants selected through purposive sampling. Data were collected through in-depth interviews and analyzed using thematic analysis to identify participants' lived experiences. The findings revealed one overarching theme, namely the negative impact of stigma, which consisted of three categories: effects on family members, family relationships, and patients. Stigma generated feelings of sadness, anxiety, psychological distress, sleep disturbances, social withdrawal, family conflicts, and changes in family interactions with patients. These experiences negatively influenced caregivers’ emotional well-being and their ability to provide optimal support for family members with mental disorders. The study concludes that stigma has a substantial adverse impact on the psychological well-being of family caregivers and the quality of care provided to people with mental disorders. Therefore, comprehensive interventions focusing on stigma reduction, community education, and strengthening psychosocial support systems are essential to improve family resilience and promote better mental health outcomes.

Introduction: The Beyond Use Date (BUD) is the expiration date for a drug product after its primary packaging has been opened, mixed, or prepared. The BUD differs from the expiration date printed on the manufacturer's packaging and is not always listed on the drug, so many people still don't fully understand this concept.Objective: To evaluate the level of knowledge of Prolanis patients regarding the Beyond Use Date (BUD) at the Purwokerto Utara I Community Health Center before and after being given counseling. Methods: A quantitative descriptive method with a cross-sectional design was used on 20 Prolanis patient respondents. Primary data collection consisted of questionnaires administered before (pretest) and after (posttest) the lecture-based counseling using flyers. Data analysis was performed using univariate analysis. Results: The level of knowledge of Prolanis patients regarding Beyond Use Date before counseling showed that the majority were in the poor category with 16 respondents (80.0%) and the sufficient category with 4 respondents (20.0%). After being given counseling, there was an increase in the good category with 6 respondents (30.0%), but the majority were still in the poor category with 14 respondents (70.0%).Conclusion: The level of knowledge of Prolanis patients regarding Beyond Use Date (BUD) at Purwokerto Utara I Health Center before counseling was mostly in the poor category, and after counseling there was an increase although most were still in the poor category.

Background: Chronic Kidney Disease (CKD) patients undergoing long-term hemodialysis often experience anxiety due to therapy dependency, changes in health conditions, and uncertainty regarding the disease. Unresolved anxiety can reduce quality of life, comfort, and patient adherence to treatment. Therefore, non-pharmacological interventions are needed that are safe, easy to implement, and aligned with the patient's spiritual values. Mantram Tri Sandya has the potential to provide relaxation and psychological calm, thus helping to reduce anxiety. However, scientific evidence regarding the effectiveness of this therapy in hemodialysis patients is still limited, making this research crucial.  Purpose: The aim of this research is to determine the effect of the Tri Sandya mantra on reducing anxiety levels in CKD patients who are undergoing hemodialysis at the Buleleng Regency Regional Hospital. Methods: Pre-Experimental One Group Pre-Test & Post-Test research design with the Wilcoxon Signed Rank Test conducted at the Buleleng Regency Regional General Hospital. Data were collected using the HARS (Hamilton Anxiety Rating Scale) questionnaire sheet with Purposive Sampling technique with a sample size of 88 people. Results: The results obtained from this study were that there was a decrease in anxiety levels when given Mantra Tri Sandya therapy to CKD patients who were undergoing hemodialysis with a P value <0.001 (p<0.05). Conclusion: There is a significant effect of administering the Tri Sandy mantra on reducing anxiety levels in CKD patients who are undergoing hemodialysis at the Buleleng Regency Regional Hospital.