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The problem with a 4-stroke gasoline engine-driven electric generator is a decrease in tool performance due to wear on important components for the stator, cooling fan, air filter, oil filter, and gasket. The purpose of component replacement planning is to obtain replacement costs, maintenance schedules in 2027, and the ratio of maintenance costs to profits. The component replacement planning method includes collecting maintenance data from previous years, applying the inspection-replace-repair-overhaul (IRRO) method, assessing component conditions, predicting component lifespan, predicting labor costs, predicting supporting equipment to be used in maintenance, predicting spare part replacement times, predicting maintenance costs in 2027, and calculating the ratio of maintenance costs to profits. The results of the replacement planning obtained maintenance costs in 2027 amounting to IDR 570,007,- with an estimated electric generator rental rate of IDR 30,000,-/hour which has the potential to be rented for 128 hours/year, a profit of IDR 3,840,000,- was obtained, and the ratio of maintenance costs to profits was 14.84% which implies that a 2.5 kW electric generator that uses gasoline-pertalite fuel of around 1.5 liters/hour at maximum power is still suitable for use in the next few years and has the potential to generate profits.

This study discusses the introduction of digital signature patterns using the Backpropagation method on Artificial Neural Network (JST) to identify a person's characteristics and potential. The increasing use of digital identities demands a verification system that is more secure, accurate, and adaptive to the variations of each individual's signature. The main problem faced in the signature recognition system is the low level of accuracy when the visual features of the signature have similarities between users, both in terms of shape, size, and stroke pressure. In addition, variations of signatures made by the same individual are also a challenge in the identification process. As a solution, this study implements Principal Component Analysis (PCA) to extract important features from the signature image before the training process using JST. PCA is used to reduce the data dimension so that the learning process becomes more efficient and optimal. A total of 80 signature images were used in this study, consisting of 60 training data and 20 test data. The results showed that the system was able to achieve an accuracy level of 92.5%. These findings prove that the combination of PCA and JST methods is effective in recognizing digital signature patterns and has the potential to be applied to digital security-based biometric identification systems.

This research examines the mentoring of nationalistic activities by students from the Al-Azhar Menganti Gresik Institute and field supervisors at MI Darunnajah Lebani Suko, Wringinanom District, Gresik Regency, in commemoration of Heroes' Day. Thru a descriptive qualitative approach, this program involves four main activities: the red and white parade, patriotic love songs, little warrior strokes (coloring and writing hero stories), and a colossal drama of patriotic fervor. These activities are creatively designed and based on direct experience to instill nationalistic values in elementary school students. The research results show a significant improvement in students in terms of courage, discipline, creativity, cooperation, and respect for national symbols such as the flag and national anthem. Collaboration between students as facilitators, teachers as pedagogical directors, and the school environment creates a conducive learning ecosystem where participatory methods are more effective than conventional approaches. This experiential learning approach not only enhances cognitive understanding of the struggles of national and local heroes but also builds emotional empathy and social skills. Positive impacts include high student enthusiasm, reduced learning boredom, and character strengthening in accordance with the Pancasila Student Profile, such as mutual cooperation and integrity. Overall, this mentoring program serves as a relevant model for non-formal character education that can be replicated in other schools to strengthen nationalism from an early age amidst the challenges of post-pandemic globalization and individualism.

Hypertension is a primary risk factor for cardiovascular diseases, including stroke, coronary artery disease, atrial fibrillation, and peripheral vascular disease. Often referred to as "The Silent Killer," its onset is frequently asymptomatic, making early detection challenging. Effective interventions, both pharmacological and non-pharmacological, are necessary to manage hypertension and reduce complications. Long-term treatment requires adherence to prescribed medications, with self-care management playing a vital role in minimizing hypertension's adverse effects. Self-efficacy, or an individual's belief in their abilities, is crucial for improving medication adherence and self-care activities. This study aimed to examine the correlation between self-efficacy and self-care management in relation to medication adherence among hypertension patients at RSUD Mandau District. A non-experimental, quantitative, analytic correlation study with a cross-sectional design was conducted, involving 38 hypertension patients. Self-efficacy was measured using the MASES-R (Medication Adherence Self-Efficacy Scale-Revision), medication adherence was assessed with the MMAS-8 (8-item Morisky Medication Adherence Scale), and self-care management was evaluated using the HBP-SCP (Hypertension Self-Care Profile). The findings revealed a significant correlation between self-efficacy and medication adherence (p=0.000, r=0.594). Additionally, self-care management was significantly correlated with medication adherence (p=0.027, r=0.360). In conclusion, self-efficacy and self-care management both significantly correlate with medication adherence in hypertension patients at RSUD Mandau District.

Hypertension substantially increases the risk of developing secondary conditions, including stroke, renal disease, coronary heart disease, and heart failure. Early management is therefore essential to prevent complications and adverse outcomes. Evidence indicates that untreated hypertension contributes to approximately 60% of stroke cases. Public knowledge regarding hypertension-related complications remains limited, and many individuals are unable to identify early signs of stroke the most common complication associated with hypertension. This study aimed to assess the knowledge of hypertensive patients regarding stroke risk and management at Santa Elisabeth Hospital Medan in 2024. A descriptive research design was employed. The sample consisted of 67 hypertensive patients attending the outpatient clinic, selected through purposive sampling. Data were presented using frequency distribution tables. The findings revealed that 52.2% of respondents demonstrated poor knowledge, 32.8% had moderate knowledge, and only 14.9% showed good knowledge regarding stroke risk and management. These results underscore the need for patients to adopt healthier lifestyles and for the hospital to strengthen educational efforts by providing more engaging and interactive learning materials for patients and their families.

The prevalence of hypertension in the elderly continues to increase and is a major cause of morbidity and mortality. Uncontrolled blood pressure can lead to serious complications such as heart disease, stroke, and kidney failure. Anxiety, which is often experienced by the elderly, also plays a role in worsening hypertension through activation of the sympathetic nervous system and increased stress hormones. This study aims to determine the relationship between anxiety levels and the incidence of hypertension in the elderly at the Kuta Alam Community Health Center in Banda Aceh City. The study used a quantitative method with a cross-sectional analytical design. The study population consisted of 145 elderly people with hypertension, with a sample of 59 people selected through a purposive sampling technique. The study was conducted from April 28 to May 8, 2025. Anxiety levels were measured using the Geriatric Anxiety Inventory (GAI) questionnaire, and blood pressure was measured using a digital sphygmomanometer. Data analysis was carried out univariately and bivariately using the Chi-square test. The results showed that the majority of respondents experienced panic anxiety (39.0%) and Grade III hypertension (44.1%). There was a significant relationship between anxiety levels and the incidence of hypertension in the elderly (ρ = 0.000; ρ < 0.05). In conclusion, anxiety influences the severity of hypertension, so psychological aspects need to be considered in elderly health services at the Kuta Alam Community Health Center.

Impaired emotion regulation and decreased quality of life are common, yet often untreated, sequelae of stroke. Conventional rehabilitation primarily targets physical and cognitive recovery, leaving affective disturbances unaddressed. This study examined the efficacy of a structured Buddhist meditation program—Mindful Resilience After Stroke (MRAS)—for improving emotion regulation and quality of life in stroke survivors. Forty-two ischemic/hemorrhagic stroke patients (3–18 months post-onset) were consecutively recruited and randomly allocated to an intervention group (n = 21) receiving an 8-week MRAS protocol (1 × 60 min/week) or a control group (n = 21) receiving standard care only. Emotion regulation was assessed with the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) and quality of life with the Stroke-Specific Quality of Life Scale (SS-QOL). Between-group changes (Δ post-pre) were analyzed using independent t-tests or Mann–Whitney U tests (α = 0.05). The intervention group showed a significantly greater reduction in emotion-regulation difficulties than controls (ΔDERS-SF −18.4 ± 5.1 vs. −3.2 ± 4.3; p < 0.001; d = 1.62). Quality-of-life gains were also larger in the intervention group (ΔSS-QOL 35.7 ± 8.9 vs. 7.1 ± 6.5; p < 0.001; d = 1.89). The most improved sub-domains were emotional acceptance, emotional awareness, and impulse control (DERS-SF), as well as energy, mood, and social participation (SS-QOL). No intervention-related adverse events were reported. MRAS is an effective and safe adjunctive intervention to enhance emotion regulation and quality of life after stroke. Embedding mindfulness practices grounded in Buddhist tradition into stroke rehabilitation offers a holistic, culturally adaptable approach for neuropsychological services in Indonesia.

Hypertension is one of the most common diseases experienced by the community and poses a high risk of causing serious complications. Persistently elevated blood pressure can damage vital organs and increase the risk of cardiovascular diseases such as heart attacks, strokes and kidney failure. The purpose of this study is to determine the implementation of foot reflexology massage to reduce blood pressure in patients with hypertension. This research employed a case study approach involving two hypertensive patients at TK II Putri Hijau Hospital Medan. The Nursing care process included assessment, nursing diagnosis, planning, implementation, and evaluation. The results showed a decrease in both systolic and diatolic blod pressure after the foot reflexology intervention. The first patient experienced a reduction in blood pressure from 145/90 mmHg to 130/82 mmHg, while the second patient’s blood pressure from 144/89 mmHg to 128/82 mmHg. The study cocludes that the implementation of foot reflexology massage is proven to be efeective in lowering blood pressure in hypertensive patients. This therapy is recommended as a complementary intervention in nursing practice to assist in controlling hypertension.

Background: Hemorrhagic stroke is a critical condition caused by the rupture of cerebral blood vessels, which leads to intracranial bleeding, increased intracranial pressure (ICP), and decreased adaptive capacity of the brain. One of its main impacts is a significant disturbance of consciousness. Nurses have applied non-pharmacological approaches, such as bimodal sensory stimulation, as innovative interventions to stimulate neurological function and indirectly stabilize intracranial pressure. Objective: This study analyzed the implementation of bimodal sensory stimulation in improving intracranial adaptive capacity in patients with hemorrhagic stroke. Methods: This case study involved a patient with a hemorrhagic stroke and impaired consciousness in an intensive care unit. The intervention was conducted for three consecutive days by providing auditory stimuli (voices of family members and nurses) and gustatory stimuli (lemon) five times daily. Measurements included the Glasgow Coma Scale (GCS) and neurological response observations. Results: After receiving bimodal sensory stimulation therapy, the patient showed improved consciousness, as indicated by a consistent increase in GCS scores from 9 to 11 over the three days. The patient's responses to auditory and gustatory stimuli also improved, including mild motor movements, pupil reflexes, and simple interactions such as blinking or opening the eyes in response to sounds. Conclusion: Bimodal sensory stimulation effectively facilitated the recovery of consciousness and enhanced intracranial adaptive capacity in patients with hemorrhagic stroke. Nurses can integrate this intervention into evidence-based nursing practice in intensive care units with active family involvement.

Ischemic stroke occurs when a thrombus, embolus, or vascular stenosis disrupts blood supply to the brain, causing vessel rupture and blood leakage into the surrounding neuronal space. A common clinical symptom of stroke is hemiparesis, or muscle weakness on one side of the body. Non-pharmacological management, such as range of motion exercises using mirror therapy, can support rehabilitation. Mirror therapy is a form of motor rehabilitation that engages the patient's motor imagery. The mirror provides visual stimulation to the brain, particularly the cerebral motor nerves on both the affected and unaffected sides, to assist movement in limbs experiencing hemiparesis. This study used a case study method, implementing nursing care and evidence-based nursing practice. Over six consecutive days of intervention, mirror therapy led to increased muscle strength. Prior to the therapy, muscle strength was recorded at. After the therapy, muscle strength improved to. These results suggest that mirror therapy can serve as an effective rehabilitation strategy to address impaired physical mobility in patients with ischemic stroke.

Non-communicable diseases (NCDs) are a major challenge in today's health development. One category of these diseases is hypertension, which is classified as a chronic disease with a relatively high mortality rate. Hypertension serves as a major predictor for various chronic diseases and is a common disease found in the community (Putri et al., 2025). If not managed properly, hypertension can lead to more serious complications such as stroke, coronary heart disease, diabetes, kidney failure, and blindness. Stroke (51%) and coronary heart disease (45%) are the leading causes of death related to hypertension (Pokhrel, 2024). The increasing prevalence of hypertension along with changes in lifestyle and unhealthy eating patterns adds to the global health burden. Therefore, effective management of hypertension is essential to prevent further complications. Appropriate hypertension management and regular monitoring can reduce the risk of related diseases, improve quality of life, and reduce mortality caused by complications of heart disease and stroke. Preventive and promotive efforts through health education are key to reducing the prevalence of hypertension in the community.

Background: Stroke is a medical condition characterized by a disruption in blood flow to the brain, most commonly resulting in ischemic stroke, which accounts for 70%–85% of all stroke cases. Prolonged immobility in stroke patients increases the risk of pressure ulcers. Effective prevention strategies Include regular repositioning and meticulous skin care. Effleurage massage, when combined with Virgin Coconut Oil (VCO), enhances blood circulation and skin hydration, thereby potentially reducing the risk of impaired skin integrity. Objective: To analyze the management of a non-hemorrhagic stroke patient Through the application of Effleurage Massage therapy using Virgin Coconut Oil (VCO) to reduce the risk of skin integrity impairment. Methods: This case study involved a non-hemorrhagic stroke patient who was observed during hospital visits over a three-day period. Effleurage massage using VCO was applied twice daily—once in the morning and once at night. Skin integrity was assessed before and after the intervention using the Braden Scale Results: A decrease in the risk of skin integrity impairment was observed following the intervention, as evidenced by improved Braden Scale scores. Conclusion: Effleurage Massage using Virgin Coconut Oil may serve as an effective complementary therapy to reduce the risk of skin integrity Impairment in non-hemorrhagic stroke patients.

Hypertension is one of the main health problems in the elderly that can reduce the quality of life and increase the risk of complications such as stroke and kidney failure. Hypertension treatment is not only through pharmacological therapy, but also non-pharmacological interventions such as hypertension exercise which has been proven effective in lowering blood pressure. This study aims to implement and evaluate the effect of hypertension exercise on reducing blood pressure in the elderly in the work area of ​​the Kampung Baru Health Center UPT. The method used is a case study of a 71-year-old elderly with blood pressure of 160/100 mmHg. The exercise intervention was carried out for seven consecutive days with blood pressure measurements taken before and after the intervention. The results showed a decrease in blood pressure and complaints of headaches, as well as an increase in patient knowledge about hypertension. Hypertension exercise has been proven to be an effective independent nursing intervention to lower blood pressure and improve the quality of life of the elderly.

Stroke is a major neurological disease that occurs in adults and the elderly, based on the high number of emergencies and the main cause of disability and death. The most common disorder in stroke is weakness or deficits in the musculoskeletal system such as parese or plegia. These conditions will cause various disorders in patients such as decreased muscle tone and strength, muscle weakness which if not treated immediately will lead to contractures, which ultimately cause impaired mobilization. Impaired fulfillment of daily activities and disability. Nursing actions to overcome physical mobility disorders are muscle strengthening exercises, especially in the upper extremities by holding a rubber ball. Purpose:  Help solve the problem of physical mobility disorders to increase muscle strength in stroke patients with rubber ball grasping exercises. Methods: By collecting data from interviews and observations using case studies and subjects in stroke patients with nursing problems. Results:  After performing the exercise of grasping a rubber ball for 2 times in 7 days there is an increase in muscle strength with a muscle strength value of 1/5 to 3/5. Conclusion: The action of grasping rubber ball exercises can increase muscle strength to overcome physical mobility disorders in stroke patients

Hypertension is defined as a systolic blood pressure greater than 120 mmHg and a diastolic blood pressure greater than 80 mmHg, measured twice within 5 minutes during rest. If left untreated, hypertension can lead to kidney and heart damage and increase the risk of stroke. This study aims to assess the community's knowledge regarding the use of antihypertensive medication, specifically the calcium channel blocker (amlodipine), in RT 006 RW 03 Kelurahan Johar Baru, Central Jakarta. The study involved 50 participants aged 17-64 years with a history of hypertension. A descriptive quantitative method was used, with data collected through questionnaires and analyzed using SPSS. The results show that 83% of the participants had good knowledge about hypertension, 76% had good knowledge about the dosage of amlodipine, 76% had good knowledge about the correct administration of amlodipine, and 50% had sufficient knowledge about the side effects of the drug. The average knowledge level based on the indicators was 71%, which is categorized as adequate.

Background: Ischemic stroke is an acquired brain injury caused by blockage of blood vessels or inadequate blood supply resulting in infarction or hemorrhage in the brain parenchyma. Stroke is ranked as the second leading cause of death in the world and is the largest contributor to disability, resulting in a significant economic burden. The problem that often arises in ischemic stroke patients is the presence of a problem in the limbs so that the individual's ability to move cannot be free and limited which is commonly referred to as the problem of physical mobility disorders. Ischemic stroke is part of cardiovascular disease which is classified as a catastrophic disease because it has a wide economic and social impact. Ischemic stroke can cause permanent disability which can certainly affect the productivity of the sufferer. Purpose: Knowing the results of the application of Range Of Motion (ROM) exercises on the patient's muscle strength. Methods: Using case studies and subjects by collecting data from interviews and observations on Ischemic Stroke patients with nursing problems of Physical Mobility Disorders. Results: after carrying out Range Of Motion (ROM) therapy nursing actions on a routine schedule twice a day morning and evening for 6 days with 15-20 minutes, it was found that there was an increase in muscle to 4 5 4 5. Conclusion: there is an increase in muscle strength in Ischemic Stroke patients after Range Of Motion (ROM) therapy.

Hipertensi merupakan salah satu kondisi medis yang dapat menyebabkan berbagai komplikasi serius, seperti penyakit jantung koroner, stroke, dan gagal ginjal . Manajemen perawatan diri (self-care management) menjadi faktor penting dalam mengontrol tekanan darah pada penderita hipertensi . Self-care management mencakup regulasi diri, kepatuhan terhadap pengobatan, pemantauan tekanan darah, serta interaksi dengan tenaga medis . Penelitian ini menggunakan pendekatan kuantitatif dengan desain deskriptif korelasional dan metode cross-sectional . Sampel penelitian berjumlah 159 pasien hipertensi yang berobat di RS Islam Sultan Agung Semarang. Dari analisis univariat, mayoritas responden berada dalam rentang usia 45-59 tahun, berpendidikan terakhir SD, bekerja sebagai wiraswasta, serta memiliki tekanan darah tinggi selama rata-rata 3 tahun. Hasil analisis bivariat menunjukkan terdapat hubungan signifikan antara self-care management dan tekanan darah sistolik (p = 0,035) serta tekanan darah diastolik (p = 0,041) . Kesimpulannya terdapat hubungan antara self-care management dengan tekanan darah pada pasien hipertensi . Dengan meningkatkan self-care management, pasien dapat mengelola tekanan darah secara lebih efektif.

Hypertension is one of the most common non-communicable diseases, with a high incidence rate that has become a major global health concern. It is often referred to as a “silent killer” because many patients are unaware of their condition until serious complications arise. In Indonesia, the prevalence of hypertension is relatively high, yet many sufferers remain undiagnosed or do not receive proper medical treatment. Several risk factors contribute to hypertension, including age, heredity, high-salt diet, obesity, lack of physical activity, and unhealthy lifestyles such as smoking and alcohol consumption. Without proper management, hypertension may lead to severe complications such as stroke, heart failure, and chronic kidney disease. Management of hypertension generally involves pharmacological therapy, such as the administration of antihypertensive drugs, as well as non-pharmacological interventions through lifestyle modifications. Nurses play a crucial role in patient education, monitoring, and preventing complications through comprehensive nursing care. The purpose of this study is to describe the nursing care provided to Mr. R, who experienced a cardiovascular system disorder, namely hypertension, in the Dahlia Ward of RSUD dr. Soeselo, Tegal Regency. The research method used was descriptive with a case study approach, allowing for a systematic and clear presentation of the patient’s condition. The case findings showed that the patient’s main complaint was a headache radiating to the nape of the neck. Based on nursing assessment, two nursing diagnoses were identified: acute pain and lack of knowledge regarding the disease and its management. Interventions were determined using national standards such as SDKI, SLKI, and SIKI, which are expected to reduce symptoms and improve the patient’s understanding of hypertension.

Hypertension or high blood pressure is a medical condition that can cause serious complications, such as stroke and heart disease. The causes of hypertension are very diverse, ranging from unhealthy diet, lack of physical activity, stress, to genetic factors. The phenomenon that occurs at the UPTD Menteng Palangka Raya Health Center, namely that there are still many families who have not carried out their role as the right family members and have not been able to overcome family health problems, for example, such as compliance with taking hypertension medication in family members who suffer from hypertension. The purpose of this study is to determine the relationship between family roles and medication adherence in family members with hypertension. This type of research is correlational using a cross-sectional  approach using a spearman rank statistical test. The sampling technique used in consecutive sampling at the Menteng Palangka Raya Health Center. Sampling in this study is based on the inclusion criteria set. Data collection in this study used questionnaires on family roles and medication adherence that had gone through validity and reliability tests with Cronbach's alpa for family role 0.89 and Cronbach's alpa for medication adherence 0.92. Based on statistical tests using  Spearman's rank , a correlation coefficient value of 0.812 with a significance value of <0.001 was obtained. It can be concluded that there is a significant relationship between the role of the family and medication compliance at the Menteng Palangka Raya Health Center. The relationship between family roles and medication adherence in family members with hypertension at the Menteng Palangka Raya Health Center.”

Hypertension is one of the global public health issues with serious implications as it may lead to severe complications such as stroke, coronary heart disease, and kidney failure. Elderly individuals are among the most vulnerable groups, with the highest prevalence found in the age group of 65–74 years (57.6%) and those over 75 years (63.8%). Non-pharmacological treatment for hypertension includes regular and consistent elderly gymnastics. This study aims to examine the effect of elderly gymnastics on blood pressure among elderly individuals with hypertension at the Rumoh Sejahtera Geunaseh Sayang Nursing Home, Ulee Kareng, Banda Aceh. The study applied a quasi-experimental design with a deductive approach. The population consisted of 55 elderly individuals, and 17 were selected as the sample using total sampling technique. The elderly gymnastics intervention was conducted three times a week, from April 17th to 22nd, 2025. Blood pressure was measured before and after the intervention using a pre-test and post-test observation sheet. Data analysis was performed using the Wilcoxon test, suitable for non-parametric data. Results showed that on the first day, there was no significant difference in systolic and diastolic blood pressure (p = 0.091). On the second day, systolic blood pressure showed a significant decrease (p = 0.003), while diastolic pressure remained non-significant (p = 0.161). On the third session, a significant reduction occurred in both systolic (p = 0.000) and diastolic (p = 0.001) blood pressure. Conclusion: Elderly gymnastics has an effect on reducing blood pressure in elderly individuals with hypertension. This intervention may serve as an effective and applicable non-pharmacological therapy in daily life.