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Introduction: Smartphone use has increased substantially in higher education and is widely used by university students for both academic and non-academic activities. Prolonged smartphone use combined with poor posture may increase mechanical load on cervical structures and lead to neck pain. This study aimed to examine the relationship between smartphone use and neck pain intensity among students at IKES Suaka Insan. Methods: A quantitative cross-sectional study was conducted involving 55 undergraduate nursing and physiotherapy students selected using cluster sampling. Smartphone use was assessed using a structured questionnaire, while neck pain intensity was measured using the Visual Analog Scale (VAS). Data were analyzed using Spearman’s rho correlation test. Results: The analysis showed a weak negative association between smartphone use and neck pain intensity (r = -0.16), with a p-value of 0.20 (>0.05), indicating no statistically significant relationship. Conclusion: There was no significant association between smartphone use and neck pain intensity among students. Future studies should include ergonomic posture and duration of smartphone use as additional variables.

Introduction: Smartphone use has increased substantially in higher education and is widely used by university students for both academic and non-academic activities. Prolonged smartphone use combined with poor posture may increase mechanical load on cervical structures and lead to neck pain. This study aimed to examine the relationship between smartphone use and neck pain intensity among students at IKES Suaka Insan. Methods: A quantitative cross-sectional study was conducted involving 55 undergraduate nursing and physiotherapy students selected using cluster sampling. Smartphone use was assessed using a structured questionnaire, while neck pain intensity was measured using the Visual Analog Scale (VAS). Data were analyzed using Spearman’s rho correlation test. Results: The analysis showed a weak negative association between smartphone use and neck pain intensity (r = -0.16), with a p-value of 0.20 (>0.05), indicating no statistically significant relationship. Conclusion: There was no significant association between smartphone use and neck pain intensity among students. Future studies should include ergonomic posture and duration of smartphone use as additional variables.

Sufism as a spiritual approach has a great potential to prevent mental health problems among Generation Z students at UIN Walisongo Semarang. This is because Sufism focuses on inner balance, self-awareness, and strengthening spiritual values that can be a source of psychological resilience. This study aims to investigate how Sufism practices such as dhikr, self-reflection, and spiritual guidance can help prevent mental health problems, such as stress, anxiety, and loneliness among Generation Z students. The method used in this study is a qualitative study with a phenomenological design. Data were obtained from in-depth interviews with students, observations of religious activities on campus, and focus group discussions, then analyzed thematically. Interviews were conducted with three students: Wilda Ismatus Sarifah (Faculty of Tarbiyah and Teacher Training), Sinta Wahdatul Khusna (Faculty of Tarbiyah of Social and Political Sciences), and Umi Fathonah (Faculty of Tarbiyah and Teacher Training). The study found that regular Sufism practice guided by experienced individuals helped students feel more meaningful, more socially connected, and develop coping strategies. This was associated with reduced symptoms of stress and anxiety, as well as improved well-being. The study recommends integrating Sufism-based spiritual programs into campus counseling services and character development activities. It also recommends training spiritual mentors and fostering collaboration between student welfare units and religious institutions on campus to support the mental health of young people.

Anxiety during pregnancy is one of the most common psychological problems experienced by pregnant women, particularly during the third trimester when they face childbirth preparation as well as various physical and emotional changes. If not properly managed, anxiety may adversely affect both maternal and fetal health. This study aimed to describe the level of anxiety among third-trimester pregnant women at Mlati II Public Health Center in 2026. This research employed a descriptive quantitative design with a cross-sectional approach. The study involved 40 third-trimester pregnant women selected using a total sampling technique. Data were collected using the Hamilton Anxiety Rating Scale (HARS) questionnaire and analyzed through univariate analysis in the form of frequency and percentage distributions. The results showed that most respondents were of healthy reproductive age (20–35 years) (92.5%), primigravida (67.5%), had a secondary level of education (70%), and were unemployed (70%). The respondents' anxiety levels were categorized as no anxiety (47.5%), mild anxiety (47.5%), and moderate anxiety (5%), while no cases of severe anxiety or panic were identified. The most dominant anxiety indicators were anxious feelings, tension, respiratory symptoms, and sleep disturbances. These findings indicate that some third-trimester pregnant women still experience anxiety, highlighting the need for early detection, health education, and psychological support through antenatal care services to promote maternal mental well-being during pregnancy.

Schizophrenia is a mental disorder characterized by deviation in attitudes, thoughts and behaviors, and can cause positive and negative symptoms. One of the most frequently occurring negative symptoms is social withdrawal, which leads to the problem of Social Isolation: Withdrawal. Social isolation is a condition that causes individuals to experience a decline or even inability to interact with others and their environment. The purpose of this case study was to apply nursing care to patients with social isolation: withdrawal due to undifferentiated schizophrenia in Gatotkaca Ward of RSJD dr. Amino Gondohutomo, Central Java Province. This scientific paper was written using a descriptive method in the form of a case study through the nursing process approach. Data collection methods used were interview, observation, documentation study, and literature study. Nursing diagnoses that emerged in the patient with Social Isolation: Withdrawal were Social Isolation as the Core Problem, Low Self-Esteem as the Cause, Risk of Hallucination as the Effect, and Self-Care Deficit as a concurrent problem. Interventions were only carried out on Social Isolation and Self-Care Deficit problems, consisting of SP 1 through SP 3 for Social Isolation and SP 2 for Self-Care Deficit: Grooming. After nursing implementation for 4 days, of the 4 nursing diagnoses that emerged, only 2 nursing diagnoses were intervened, namely Social Isolation and Self-Care Deficit. SP 1 through SP 3 for Social Isolation and SP2 for Self-Care Deficit: Grooming were competently achieved. This indicates that the goals of the Implementation Strategy provided were achieved cognitively, affectively, and psychomotorically.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that may persist into adulthood and affect academic, social, and occupational functioning. In adult patients, ADHD is frequently associated with an increased risk of Substance Use Disorder (SUD), raising concerns regarding the potential for misuse and dependence related to stimulant medications used in ADHD therapy. This study aimed to evaluate the effectiveness of pharmacotherapy for adult ADHD and to review the risk of stimulant misuse and dependence based on current scientific evidence. The method employed in this study was a literature review using data obtained from national and international journals indexed in Scopus, PubMed, and Google Scholar published between 2017 and 2026. The findings indicated that stimulant medications, such as methylphenidate and amphetamine, were effective in reducing the core symptoms of ADHD by increasing dopamine and norepinephrine activity in the central nervous system. Most studies reported that the use of stimulant medications at therapeutic doses and under medical supervision was not significantly associated with an increased risk of substance misuse or dependence. The risk of misuse was more commonly observed in cases involving non-medical use and inadequate clinical monitoring. In addition to pharmacological therapy, non-pharmacological approaches such as cognitive behavioral therapy (CBT) also contributed to improving treatment outcomes and patients’ quality of life. Therefore, the use of stimulant medications in adult ADHD patients may be considered relatively safe and effective when administered rationally, individually, and under appropriate medical supervision.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that may persist into adulthood and affect academic, social, and occupational functioning. In adult patients, ADHD is frequently associated with an increased risk of Substance Use Disorder (SUD), raising concerns regarding the potential for misuse and dependence related to stimulant medications used in ADHD therapy. This study aimed to evaluate the effectiveness of pharmacotherapy for adult ADHD and to review the risk of stimulant misuse and dependence based on current scientific evidence. The method employed in this study was a literature review using data obtained from national and international journals indexed in Scopus, PubMed, and Google Scholar published between 2017 and 2026. The findings indicated that stimulant medications, such as methylphenidate and amphetamine, were effective in reducing the core symptoms of ADHD by increasing dopamine and norepinephrine activity in the central nervous system. Most studies reported that the use of stimulant medications at therapeutic doses and under medical supervision was not significantly associated with an increased risk of substance misuse or dependence. The risk of misuse was more commonly observed in cases involving non-medical use and inadequate clinical monitoring. In addition to pharmacological therapy, non-pharmacological approaches such as cognitive behavioral therapy (CBT) also contributed to improving treatment outcomes and patients’ quality of life. Therefore, the use of stimulant medications in adult ADHD patients may be considered relatively safe and effective when administered rationally, individually, and under appropriate medical supervision.

Background: Schizophrenia is a psychiatric disorder characterized by positive psychotic symptoms (such as hallucinations) and negative symptoms accompanied by cognitive decline. Auditory hallucinations represent the most common positive symptom, occurring in more than 75% of patients with schizophrenia. Objective: This study aimed to describe the comprehensive nursing care for Mr. F with a primary problem of perceptual sensory disorder: auditory hallucinations due to undifferentiated schizophrenia at Gatot Kaca Ward, RSJD dr. Amino Gondohutomo, Central Java Province. Method: This study used a descriptive method with a nursing process approach, including assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Data collection was carried out through interview, observation, and literature study. Results: Nursing problems identified were: perceptual sensory disorder (auditory hallucinations) as the core problem, social isolation (withdrawal) as the causa, risk of violent behavior as the effect, and self-care deficit as an accompanying problem. Nursing interventions were conducted using the implementation strategy (SP) 1, 2, and 3 for hallucinations and SP 1 for self-care deficit. Conclusion: After 4 days of nursing implementation, 2 out of 4 nursing diagnoses were resolved: perceptual sensory disorder (auditory hallucinations) and self-care deficit, while social isolation (withdrawal) and risk of violent behavior remained unresolved. Patients with hallucinations are expected to be able to control hallucinations using the methods that have been taught.

Background: Schizophrenia is a serious mental disorder characterized by disturbances in thought processes, emotions, and behavior. One of the positive symptoms that can occur in schizophrenic clients is the risk of violent behavior. Risk of violent behavior is one of the nursing diagnoses frequently found in the Citroanggodo Ward of RSJD dr. Amino Gondohutomo, Central Java Province. Therefore, the author conducted psychiatric nursing care for Mrs. N with the main problem of risk of violent behavior due to undifferentiated schizophrenia. Methods: The writing method used is descriptive with a case study approach. Data collection was carried out through interviews, observation, documentation studies, and literature studies. The general objective of this Scientific Paper is to provide nursing care to patients with Risk of Violent Behavior due to Undifferentiated Schizophrenia. Results: The nursing diagnoses that emerged in the patient with Risk of Violent Behavior due to Undifferentiated Schizophrenia were: Risk of Violent Behavior, Self-Concept Disorder: Low Self-Esteem, and Self-Care Deficit. Nursing interventions carried out included SP 1 through SP 4 for Risk of Violent Behavior and SP 2 for Self-Care Deficit. Conclusion: After 8 days of nursing implementation, of the 3 diagnoses raised, 1 diagnosis was partially resolved (risk of violent behavior), 1 diagnosis was resolved (self-care deficit), and 1 diagnosis was not implemented (self-concept disorder: low self-esteem).

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.

Chronic rhinosinusitis (CRS) is a long-term inflammatory condition affecting the nasal mucosa and paranasal sinuses, which significantly impacts patients’ quality of life due to persistent and recurrent symptoms. Limited epidemiological data regarding CRS are available in Central Kalimantan, particularly at RSUD dr. Doris Sylvanus in Palangka Raya, prompting this study to determine its prevalence and patient distribution characteristics. This research employed a quantitative descriptive design with a cross-sectional approach. Data were collected from medical records of patients diagnosed with CRS in 2023 and 2024. Univariate analysis was conducted, and results were presented in tables and diagrams illustrating frequency distributions by year, gender, age, and main complaints. The findings showed a total of 118 CRS patients, with 53 cases in 2023 and 65 cases in 2024. The prevalence of CRS increased from 4.91% in 2023 to 10.83% in 2024. Based on gender, males accounted for 50.8% (60 patients), while females represented 49.2% (58 patients). The age group most affected was 46–55 years (31%), indicating a predominance among individuals of productive age. Nasal congestion was the most frequent primary complaint, reported by 35% of patients. The study concludes that the prevalence of CRS at RSUD dr. Doris Sylvanus increased notably from 2023 to 2024, with a slightly higher incidence among males in the productive age group. These findings highlight the need for enhanced preventive measures and early diagnosis to manage CRS more effectively in the local population.

Medical students need to take the Competence test as Doctor Profession Program (UKMPPD) to be passed and earned their medical profession. Exams are one of the most common stressors experienced by medical students and the body will respond to these stressors in the form of feelings of depression or anxiety. Anxiety and depression itself can affect student performance during exam preparation. The purpose of this study was to determine the relationship between anxiety and depression on the preparation of the Professional Doctoral Program Competency Test (UKMPPD) for students of the Faculty of Medicine, University of Pattimura. The method used is quantitative analysis with cross sectional research design and total sampling technique. The sample is all the student population of the Faculty of Medicine, University of Pattimura who meet the inclusion and exclusion criteria, totaling 90 respondents. The results showed that the majority of respondents experienced mild anxiety symptoms, which is 37% during the CBT exam and 34% during the OSCE exam. The majority of respondents also did not experience depression, which is 68% during the CBT and 70% during the OSCE and the majority had an optimal level of preparation for UKMPPD, which is 63% during the CBT and 64% during the OSCE. Data analysis using the chi square test showed a significant relationship between anxiety symptom and the level of preparation for UKMPPD both CBT (p=0.030) and OSCE (p=0.012). There was no significant relationship between depression symptom and the level of preparation for UKMPPD for both CBT (p=0.123) and OSCE (p=0.07). It can be concluded that there is a significant relationship between anxiety and preparation for UKMPPD, but there is no significant relationship between depression and preparation for UKMPPD.

Abstract: Detecting chili leaf diseases remains challenging due to the non-uniform manifestation of symptoms, local discoloration, small lesion regions, and visual similarity between disease patterns and natural leaf background variations. Although YOLO-based detectors provide favorable computational efficiency, lightweight variants often struggle to distinguish subtle lesion characteristics, while conventional attention mechanisms such as CBAM primarily rely on global feature aggregation and may overlook regional activation variability. To address these limitations, this study proposes a YOLOv9s-based detection framework integrated with a Region-Dispersion Channel Spatial Attention (RDCSA) module. The proposed module incorporates regional dispersion statistics, namely mean, standard deviation, and range, as channel descriptors to capture inter-region feature variability before applying spatial attention refinement. Experiments were conducted on the COLD dataset containing 532 original images from five chili leaf condition categories using a split-before-augmentation protocol to ensure objective evaluation. RDCSA was integrated at the P5 feature level and evaluated through attention placement analysis, component-wise ablation, sensitivity analysis, stability assessment, and comparison with modern attention mechanisms. The proposed YOLOv9s + RDCSA model achieved an mAP@50 of 0.894, mAP@50–95 of 0.773, precision of 0.858, recall of 0.861, and an F1-score of 0.859 with only a marginal increase in model parameters. The results suggest that regional dispersion-based attention improves feature discrimination while preserving computational efficiency, particularly for disease symptoms characterized by heterogeneous spatial patterns. Nevertheless, performance remains influenced by visually ambiguous symptom categories, indicating that further validation across multiple datasets and field conditions is required. Overall, the proposed RDCSA module enhances detection capability without substantially increasing computational overhead, making it a promising attention mechanism for lightweight plant disease detection systems.

Typhoid fever during pregnancy can lead to complications such as uteroplacental infection, miscarriage, and vertical transmission, which causes neonatal typhoid. Typhoid fever is found worldwide and is highly prevalent in developing countries, particularly in tropical regions. It is estimated that there are 11–21 million cases per year and approximately 128,000–161,000 deaths per year; the majority of cases occur in Southeast Asia, South Asia, and Sub-Saharan Africa. Salmonella typhi is a gram-negative bacterium capable of intracellular survival. Symptoms in typhoid patients vary among different groups. While pregnant women with typhoid are more likely to exhibit coughing, non-pregnant patients more frequently report nausea/vomiting compared to pregnant patients. The effects of typhoid fever on pregnancy result from prolonged high fever and poor general health, which can lead to miscarriage, preterm labor, and intrauterine fetal death, especially if the infection occurs during the first or second trimester. Morbidity and mortality rates may be higher in pregnant women. Pregnancy itself does not affect the course of the disease. Prevention of typhoid fever involves adopting a clean and healthy lifestyle, as well as receiving the typhoid vaccine. Two effective vaccines are available for typhoid fever. The live-attenuated oral vaccine (Ty21a) requires four doses, administered 48 hours apart, without concurrent use of antibiotics or antimicrobial medications. Due to reduced gastrointestinal motility in early pregnancy and frequent nausea and vomiting associated with symptomatic gastroesophageal reflux requiring acid-reducing therapy, we do not recommend the Ty21a oral vaccine for pregnant patients.

Typhoid fever is a febrile illness that commonly occurs in urban areas with poor sanitation. It is usually caused by the consumption of untreated water and contaminated food. Because the S. typhi bacterium can survive in water for days, contamination of surface water—such as wastewater, freshwater, and groundwater—serves as the primary cause of typhoid fever. The patient presented to the Emergency Department of Cut Meutia General Hospital with complaints of high fever for approximately 4 days prior to admission, which had worsened over the past 2 days. The fever fluctuated and was accompanied by chills. It worsened at night and was not influenced by weather or temperature. These symptoms were accompanied by vomiting every time the patient tried to eat, nausea, abdominal pain, headache, and weakness. The patient reported vomiting the contents of their meal every time they ate, leading to a loss of appetite. These symptoms began when the patient first developed a fever. The patient also experienced abdominal pain. Spontaneous bleeding was denied. On physical examination, the patient appeared weak but was alert and oriented. On neck examination, palpable enlargement of the thyroid glands was found on the right and left sides of the neck, measuring 2x2 cm, mobile, and soft. On abdominal examination, increased bowel sounds were noted. Vital signs were normal except for the patient’s febrile temperature. Laboratory tests revealed a Tubex blood test result of scale 4 and a positive dengue IgG serology result.

Hyperemesis gravidarum is excessive nausea and vomiting in pregnant women to the point of interfering with daily activities. Hyperemesis gravidarum affects the mother's physiological condition. Continuous nausea and vomiting can cause carbohydrate and fat reserves to be used up for hormonal needs, resulting in activity intolerance, and imperfect fat oxidation, resulting in ketosis. This case study aims to explain Nursing Care for Patient Mrs. B with Hyperemesis Gravidarum Case in Providing Ginger Water Decoction to Reduce Nausea and Vomiting in Pregnant Women in Arafah Room 3 RSUDZA Banda Aceh. This design is a case study with a nursing process approach, the results of the case study found three nursing diagnoses, namely nausea related to pregnancy, the risk of nutritional deficits related to psychological factors (reluctance to eat) and anxiety related to lack of exposure to information. The nursing actions given are providing non-pharmacological therapy: ginger decoction, encouraging patients to eat little but often and providing information about physiological symptoms in pregnant women in the first trimester, including nausea and vomiting. The results of the evaluation after 5 visits for the nursing diagnosis of Nausea related to pregnancy were obtained at the fifth visit. The subjective data evaluation of the client said that nausea was still felt occasionally, the client said that vomiting was no longer present, the client said that appetite had started to improve

Allergic rhinitis (AR) is an inflammatory process of the nasal mucosa initiated by a hypersensitivity reaction and caused by exposure to allergens mediated by immunoglobulin E (IgE), with several characteristic symptoms including: nasal congestion, a runny nose or watery nasal discharge (rhinorrhea), nasal itching, sneezing, and  postnasal drip (PND). According to the World Health Organization’s Allergic Rhinitis and its Impact on Asthma (WHO-ARIA) guidelines, based on the duration of symptoms, allergic rhinitis is classified into two categories: intermittent allergic rhinitis (symptoms lasting less than 4 days per week or for less than 4 weeks) and persistent allergic rhinitis (symptoms lasting more than 4 days per week and for more than 4 weeks). The prevalence of allergic rhinitis based on a doctor’s diagnosis is approximately 15%; however, it is estimated to reach 30% when considering patients with nasal symptoms. Appropriate management of allergic rhinitis, in addition to alleviating symptoms, is also expected to improve the quality of life of patients whose lives have been disrupted by the condition, as the higher the severity and frequency of allergic rhinitis symptoms, the greater the impact on reduced quality of life.

Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations and has a significant impact on patients’ psychosocial functioning. This condition can reduce medication adherence, thereby increasing the risk of relapse. In this context, the role of caregivers is crucial in supporting treatment success. This study aims to describe psychiatric nursing care for patients with auditory hallucinations in improving medication adherence through caregiver involvement. The method used is a case study with a nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. Interventions focus on hallucination management, psychoeducation, and caregiver involvement in care. The results show an increase in patients’ and families’ knowledge regarding the illness and its treatment, improved medication adherence, and enhanced patient ability to control responses to auditory hallucinations. Caregiver involvement has been shown to assist in supervision and providing support to patients. Therefore, comprehensive psychiatric nursing care through hallucination management, psychoeducation, and caregiver involvement is effective in improving medication adherence and controlling symptoms in patients with auditory hallucinations.

According to the WHO and the Ministry of Health, hypertension is defined as blood pressure ≥ 140/90 mmHg, consistent with the ESC/ESH guidelines. Hypertension is one of the leading causes of premature death worldwide. Symptoms experienced by patients with hypertension include headaches, sweating, palpitations, snoring, daytime sleepiness, muscle weakness, cramps, and cardiac arrhythmia. Clinical manifestations of hypertensive urgency include elevated blood pressure, severe headache, anxiety, and shortness of breath. Mrs. M, a 68-year-old woman, came to the Samudera Community Health Center complaining of a headache that had worsened approximately 3 days ago. The headache is felt at the back of the head, feeling heavy, and sometimes radiates throughout the entire head. The patient also describes the headache as throbbing. The headache was exacerbated when the patient could not sleep, consumed salty foods, and did not take her medication regularly.  The headache subsides slightly when the patient takes medication and sleeps with their head elevated.  The patient reported that the symptoms were also accompanied by nausea, dizziness, palpitations, and an inability to sleep at night. The patient has been diagnosed with hypertension for approximately 5 years. On physical examination, the patient’s blood pressure was 190/100 mmHg. The patient was advised to adopt a healthy diet by reducing salt intake. The patient was also prescribed the following medications: Captopril 25 mg twice daily, Amlodipine 5 mg once daily, Paracetamol 500 mg three times daily, and Domperidone 10 mg twice daily, to be taken as needed.

Breast tumors are classified into two types, namely benign and malignant tumors, the latter commonly referred to as breast cancer. Breast cancer is one of the major health problems affecting women worldwide, including in Indonesia. According to WHO data in 2022, there were 2.3 million breast cancer cases with 685,000 deaths globally, while in Indonesia, 396,914 cases and 234,511 deaths were reported. The high incidence rate is exacerbated by low public awareness in recognizing early symptoms and performing early detection, resulting in 60–70% of cases being diagnosed at an advanced stage, supported by findings that 65.6% of female students still have a low level of knowledge. Female students were selected as research subjects because they are in a vulnerable reproductive age group and have an important role in increasing awareness of early detection, yet they still have limited knowledge. Based on this, this study aims to design a web-based early detection system for breast tumor risk using the Forward Chaining method, which functions as a tool to identify early symptoms, assess risk levels, and provide information on prevention and initial management. This study employed the method with the Expert System Development Life Cycle (ESDLC) model, consisting of the stages of assessment, knowledge acquisition, design, testing, and documentation, along with the Forward Chaining inference method.