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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.

Improving service quality is a primary priority in hospital management. Service quality can be improved by reducing the percentage of non-value added activities through the Lean Hospital approach. This study aims to identify activities and analyze the root causes of critical waste in the drug distribution and utilization processes at the Outpatient Pharmacy Installation of Karanganyar Regency Hospital. This study is a non-experimental research with a qualitative descriptive design. Critical waste was obtained through the distribution of a waste weighting questionnaire assessed by all personnel involved in the drug distribution and utilization processes. The results show that the Value Stream Mapping calculation for the drug distribution process obtained a lead time of 147.41 minutes and a VAR value of 36%, while in the drug utilization process, compounded prescription service obtained a lead time of 128.53 minutes and a VAR of 24%, and non-compounded prescription service obtained a lead time of 75.8 minutes and a VAR of 26%. The critical waste questionnaire calculation using the Borda method in the drug distribution process showed overproduction 60%, inventory 53.33%, and waiting 43.33%, while in the drug utilization process, waiting 43.75%, overproduction 42.85%, and defect 39.70%. The 5S method, a Lean method, was used to eliminate waste in the service process at the Outpatient Pharmacy Installation of Karanganyar Regency Hospital.

The incidence of degenerative diseases, which are part of Non-Communicable Diseases (NCDs), remains a major cause of death worldwide and in many regions of Indonesia. Meanwhile, efforts to prevent degenerative diseases affecting the adolescent age group are still rare, such as the establishment of a Youth Posyandu, including in Sungai Duren Village. There is no health post that provides youth care services in Sungai Duren Village, while there are many teenagers living there (students under 21 years old) with various lifestyles that are at risk of degenerative diseases. This study aims to analyze the increase in adolescent knowledge about CERDIK between before and after the establishment of the Youth Posyandu in order to prevent degenerative diseases early. This study is a quasi-experimental study involving 30 adolescents by measuring the dependent variable of knowledge. The research instrument used is a questionnaire. Computerized data processing and analysis were conducted through descriptive statistical analysis and T-test analysis. The results showed a significant difference in respondents' knowledge of CERDIK before and after the establishment of the Youth Posyandu in Sungai Duren Village (p=0.000). This study indicates that structured health education can improve adolescents' understanding of CERDIK and can be used as an effective promotive and preventive strategy.

The study was conducted at Middle Technical University (College of Health & Medical Techniques, Baghdad) from 29Th October 2024 to 15Th January 2025, enrolling 148 students aged 20–24 years (47.3%), 25–29 years (41.9%), 30–39 years (9.5%), and over 40 years (1.4%), Participants completed a structured questionnaire to assess attitudes toward drug abuse. Regarding protective attitudes, 66.2% agreed that educational programs aid prevention, 68.9% viewed better education as protective, 58.8% cited close family ties, and 72.2% recommended avoiding friends who use drugs, Departmental analysis showed the highest proportion of ―good knowledge in Anesthesia Techniques (95.3%) and the lowest in Physical Therapy Techniques (80.2%) While overall awareness of drug abuse is high among health and medical students, misconceptions regarding its symptoms and effects persist. Targeted educational interventions—especially within departments showing lower knowledge—and reinforcement of accurate prevention and treatment strategies are recommended to strengthen students’ competencies in addressing drug abuse.

Significant changes occurring today are characterized by technological disruption, demographic shifts, globalization, and economic instability. The combination of these factors creates complex challenges for human resources (HR) in adapting and enhancing their capabilities. The purpose of this study was to examine the relationship between organizational commitment and perceptions of transformational leadership style with Organizational Citizenship Behavior of teachers in Surabaya. The research subjects were 397 teachers in Surabaya, East Java. The sampling technique used was purposive sampling. Data was collected through scale filling using Google Forms. The measurement instruments in this study were the Organizational Citizenship Behavior Scale, the Organizational Commitment Scale, and the Transformational Leadership Style Perception Scale. The data analysis used multiple linear regression analysis. The results showed that there was a significant positive relationship between organizational commitment and perceptions of transformational leadership style with Organizational Citizenship Behavior. The higher the organizational commitment and perceptions of transformational leadership style, the higher the Organizational Citizenship Behavior among teachers. There was a significant relationship between organizational commitment and Organizational Citizenship Behavior, and there was also a significant positive relationship between perceptions of transformational leadership style and Organizational Citizenship Behavior. The higher the perceptions of transformational leadership style, the higher the Organizational Citizenship Behavior among teachers.

Smoking behavior among adolescents is a serious and growing public health problem. Data from the 2023 Indonesian Health Survey (SKI) shows that 7.4% of adolescents aged 10–18 years smoke. This literature review aims to determine the determinants of smoking behavior among adolescents based on the Health Belief Model (HBM) theory, with a focus on components such as perceived vulnerability, perceived seriousness, perceived benefits, perceived barriers, cues to action, and self-efficacy. Using a literature review approach, this study identified and analyzed several academic references such as journals, books, encyclopedias, and others that discuss topics related to the determinants that influence smoking behavior among adolescents based on the Health Belief Model (HBM). The analysis conducted indicates that there is a relationship between perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues to action, and smoking behavior among adolescents. The conclusion of this study shows that in 9 studies that applied the Health Belief Model (HBM) theory in examining smoking behavior in adolescents, all major components of HBM were proven to have a significant relationship with this behavior. This study provides an important theoretical basis for the development of effective and sustainable health promotion programs in controlling smoking behavior among adolescents.

Background: Sleep disorders in adolescents are a significant health problem, with a global prevalence reaching 57.8% and particularly high rates in several cities in Indonesia. Poor sleep quality negatively impacts physical health, such as the risk of cardiovascular disease and anemia, as well as mental and cognitive health. Sleep behavior is influenced by a dynamic interaction between personal and environmental factors, as explained in Social Cognitive Theory (SCT). Research Objective: To identify the determinants of sleep deprivation in adolescents, specifically individual and environmental factors, based on a Social Cognitive Theory (SCT) perspective through a literature review from 2019 to 2025. Method: This study utilized a literature review. To obtain research data, the authors searched for scientific articles through Google Scholar, PubMed, and ScienceDirect databases, then analyzed 10 articles that met the inclusion criteria, published between 2020 and 2025. Results: Factors significantly associated with adolescent sleep quality were identified, with individual factors being the most dominant determinant (found in 7 studies), including academic stress and smartphone addiction. Furthermore, a positive association was found with environmental factors (found in 4 studies), such as bright lighting, noise, and uncomfortable room temperature. Conclusion: Within the framework of Social Cognitive Theory, adolescent sleep quality is the result of a reciprocal interaction between personal factors (perceived stress and self-control over gadgets), the physical environment, and sleep behavior. Individual factors such as stress and nighttime gadget use reduce self-efficacy for regular sleep, which is exacerbated by an unfavorable environment.

Suicide among adolescents is a serious mental health problem; however, not all adolescents with suicidal ideation progress to suicide attempts. Understanding the psychological factors that influence the transition from intention to actual behavior is essential for effective prevention efforts. This study aims to examine the role of the Theory of Planned Behavior (TPB) in understanding the transition from suicidal intention to suicide attempt behavior, as well as protective behaviors such as mental health help-seeking among adolescents. This study employs a literature review method with a quantitative correlational approach based on the TPB framework, using secondary data from scientific articles published between 2021 and 2025 and obtained through Google Scholar and PubMed. The findings indicate that suicidal ideation is the strongest predictor of suicidal intention but does not always lead to suicide attempts. TPB constructs, particularly perceived behavioral control (PBC), play a crucial role in determining whether intention develops into risky behavior or is redirected toward protective behaviors. In addition, positive attitudes toward mental health services and supportive social norms were found to strengthen adolescents’ intentions to seek help. In conclusion, TPB is a relevant theoretical framework for explaining both risk pathways and prevention pathways of adolescent suicide and has the potential to serve as a foundation for developing more effective prevention interventions.

BPJS Health has incurred losses exceeding 200 billion rupiah over a two-year period due to the payment of contributions that were discontinued by participants who had utilized maternity services. Data show that 64.7% of mothers registered as BPJS Health participants only one month prior to childbirth, after which 43% either withdrew their membership or failed to continue paying contributions following delivery. The highest proportion of this behavior was observed among independent participants or non-wage recipients (PBPU). In Jambi Province, the highest level of contribution non-compliance occurs in Jambi City. In 2023, there were 77,489 participants with contribution arrears, resulting in financial losses amounting to 60.1 billion rupiah. Contribution non-compliance is influenced by various factors. This study aims to analyze the factors contributing to non-compliance among independent participants in paying BPJS Health contributions after utilizing childbirth services in Jambi City. The findings revealed that 33.3% of independent participants were non-compliant in paying BPJS Health contributions after using maternity services. Significant associations were found between contribution non-compliance and the number of family members (p = 0.001), level of knowledge (p = 0.000), illness perception (p = 0.001), clinical assessment (p = 0.000), and willingness to pay (WTP). Based on these findings, it is recommended that BPJS Health consider implementing a waiting period policy for participants intending to utilize maternity services. In addition, the Jambi City Government should strengthen promotive efforts to educate the public and raise awareness of the importance of health insurance in safeguarding household financial security.

Syphilis is one of the reproductive health problems that remains a challenge in Indonesia, with a trend of increasing cases, while the level of adolescent knowledge about this disease is still low. Educational efforts are needed to improve adolescent understanding, one of which is through video media which is considered more interesting because it combines visual and audio elements. This study aims to evaluate the effectiveness of video as an educational medium in improving adolescent knowledge about syphilis at SMKS Al Hikmah 2 Sirampog, Brebes Regency. This type of research is a pre-experimental study with a one group pretest-posttest design. The study sample consisted of 47 students selected using a purposive sampling technique. The research instrument was a syphilis knowledge questionnaire administered before and after the educational video intervention. Data analysis used the Wilcoxon Signed Rank Test and N-Gain calculation. The study showed that Results Before the intervention, the level of knowledge of respondents was in the good category for 24 students (51.1%), sufficient for 11 students (25.5%), and poor for 12 students (23.4%). After being given the educational video intervention, there was a significant increase with all respondents (100%) being in the good category. The Wilcoxon Signed Rank Test showed a significant difference between pretest and posttest scores (p-value = 0.000). N-Gain analysis categorized the increase in knowledge as high. The study concluded that video media has proven effective as an educational tool in increasing adolescent knowledge about syphilis, making it a viable alternative learning medium in reproductive health programs.

This study aims to analyze hematocrit values ​​using a micro method with capillary blood samples in pregnant women with anemia at the Sidodadi Kisaran Barat Community Health Center. This study is a descriptive study with a cross-sectional approach involving 15 pregnant women as respondents. Data collection was carried out through hematocrit laboratory examinations and data collection of respondent characteristics. The results showed that 60% of respondents had hematocrit levels below normal values, while 40% of respondents had hematocrit levels within normal limits. Low hematocrit levels in pregnant women are influenced by several factors, including age, education level, employment status, and level of knowledge about anemia during pregnancy. This condition has the potential to increase the risk of pregnancy complications if not optimally managed. Therefore, it is recommended that health workers continue to increase educational efforts regarding anemia prevention, the importance of regular pregnancy check-ups, and encourage pregnant women to maintain a balanced nutritional consumption pattern and adequate iron intake to support maternal and fetal health.

Antenatal Care (ANC) is a health service provided to pregnant women during pregnancy by healthcare professionals in accordance with established standards, one of which is the implementation of the 10T ANC service components. The quality of ANC services plays an important role in determining pregnant women’s satisfaction, which in turn affects their compliance with antenatal visits and the effectiveness of pregnancy monitoring. Maternal satisfaction is an essential indicator for assessing the quality of healthcare services at primary healthcare facilities. This study aimed to examine the relationship between 10T Antenatal Care services and pregnant women’s satisfaction at Biru-Biru Public Health Center in 2025. This research employed a quantitative method with an analytical design using a cross-sectional approach. The sample was selected through purposive sampling, involving 48 third-trimester pregnant women. Data were collected using questionnaires that assessed the implementation of 10T ANC services and the level of maternal satisfaction. The collected data were analyzed statistically to determine the relationship between the variables. The findings of this study are expected to provide insights into the importance of optimal implementation of 10T ANC standards. Therefore, healthcare providers, particularly midwives, are encouraged to continuously improve the quality of ANC services to enhance pregnant women’s satisfaction and support efforts to improve maternal and child health outcomes.

Stress among early adolescent girls in junior high school is an increasing health concern due to academic demands, social pressure, digital exposure, and menstrual related discomforts. Complementary interventions such as deep-breathing techniques offer a simple method that can be implemented in school settings to rapidly reduce stress. This study aimed to examine the effect of deep-breathing techniques on menstrual related stress among ninth-grade female students at SMPN 2 Rambutan, Banyuasin Regency.  A pre-experimental one-group pretest–posttest design was used. The sample consisted of 60 students selected from the ninth-grade population. Stress levels were measured using the Perceived Stress Scale (PSS-10) focusing on stress during menstruation before and after a single deep-breathing session. Data were analyzed using the Wilcoxon test. The results showed a significant reduction in stress scores after the intervention (p < 0.001). The proportion of students in the high-stress category decreased from 20% to 6.7%, while those in the low-stress category increased from 10% to 30%. The mean stress score decreased from 21.35 ± 4.82 to 15.42 ± 4.11. This study concludes that deep-breathing techniques are effective in reducing menstrual-related stress in female students within a single session and can be recommended as a complementary strategy that is easy to implement in schools for adolescent menstrual stress management.

Weight gain can be a concern for some women, with some considering a body conforming to specific beauty standards as an ideal or desired goal. The use of progesterone hormone injections, which affect the appetite control center in the hypothalamus, can increase appetite and potentially lead to weight gain. This research employs a descriptive-analytical method with a quantitative approach conducted at the Independent Midwife Practice in the working area of the Kragilan Serang Community Health Center, Banten, using secondary data from medical records. Data collection involved 96 respondents divided into 48 samples of 1-month injectable contraceptive (KB Suntik) users and 48 samples of 3-month injectable contraceptive users. The total research sample size is 96 respondents, with the majority falling in the 20–40 age group and the remainder aged >40 years. The results indicate that among the 48 respondents using the 1-month injectable contraceptive, the average weight gain is 0. 938 kg, while for the 3-month injectable contraceptive, the average weight gain is 4. 251 kg.

Primary Healthcare Facilities (Fasilitas Kesehatan Tingkat Pertama, FKTP) represent the first level of contact in the healthcare system and play a central role in infection prevention and control. Despite mandatory Infection Prevention and Control (IPC) training in Indonesia, evidence regarding its effectiveness in improving cognitive abilities among primary healthcare workers remains limited. This study aimed to evaluate the effectiveness of IPC training in enhancing the cognitive abilities of healthcare workers in FKTP. A quasi-experimental study with a one-group pretest–posttest design was conducted involving 91 healthcare workers who participated in IPC training across three cohorts in 2024. The training was delivered online through a Learning Management System and consisted of structured learning modules accompanied by a pre-test and a final quiz. Cognitive improvement was assessed using paired samples t-tests, while the magnitude of training impact was evaluated using Cohen’s dz effect size. The results showed statistically significant improvements in cognitive scores across all cohorts (p < 0.001), with mean score increases ranging from 16.10 to 23.35 points. Effect size analysis revealed large to very large effects, with an overall Cohen’s dz of 1.19, indicating substantial and practically meaningful cognitive gains. In conclusion, IPC training was effective in improving cognitive competence among FKTP healthcare workers. These results reinforce the value of well-structured training programs as an essential component of efforts to strengthen infection prevention capacity in primary healthcare settings.

The JKN Mobile application is an electronic-based service innovation introduced by BPJS Health to facilitate JKN participants in accessing healthcare services and managing their membership information. This study aims to explore the experiences and perspectives of outpatient patients regarding the effectiveness of the JKN Mobile online registration system at Baubau City Regional General Hospital. A qualitative phenomenological approach was employed, with informants selected through purposive sampling. Data were collected to capture the meanings of patients’ experiences in using the application. The findings show that most patients are satisfied with the practicality, speed, and flexibility of the online registration system. However, technical problems, particularly unstable internet connectivity, remain a major challenge. Furthermore, the online registration system has contributed to improved service efficiency and patient satisfaction. These findings indicate the importance of continuous evaluation and improvement of the JKN Mobile online registration system to enhance service quality and health information system development at Baubau City Regional General Hospital.

Introduction: Dental and oral health problems in school-age children are still a major public health concern. The Little Doctor Program is a school-based health promotion approach that involves the active role of students as agents of change. This study aims to analyze the effectiveness of Small Doctors in promoting dental health in elementary schools. Methods: This study used a quasi-experimental design with a one group pretest–posttest approach. The subjects of the study were elementary school students who participated in dental health promotion activities by Small Doctors. Interventions include counseling, demonstrations of proper brushing of teeth, and the use of educational media. Data were collected using a questionnaire of dental health knowledge, attitudes, and behaviors before and after the intervention. Data analysis was carried out using the paired t-test or Wilcoxon test with a significance level of p < 0.05. Results: There was a significant improvement in students' dental health knowledge, attitudes, and behaviors after the intervention (p < 0.05). Conclusion: The Small Doctor Program is effective as a strategy for promoting dental health in elementary schools and has the potential to support promotional and preventive efforts for children's dental health.

Advancements in modern technology have reshaped people’s lifestyles, including how individuals carry out their daily activities. These changes have influenced individuals to make less realistic decisions in an effort to align themselves with their desired lifestyle. This study aims to examine whether college students with certain lifestyle tendencies are more likely to engage in impulsive buying when shopping online. The study involved 392 college students residing in Surabaya, East Java, selected through a random sampling technique. Data were collected using a Google Form–based questionnaire containing measurement instruments developed by the researcher: (1) the Impulsive Buying Scale (15 items; α = 0.858) and (2) the Lifestyle Scale (22 items; α = 0.898). Multiple linear regression was used to analyze the data.The findings reveal a significant positive relationship between lifestyle and impulsive buying. The strongeran individual’s consumerist lifestyle tendency, the more likely they are to make impulsive purchases.  

Physical fitness is a fundamental determinant of athletic performance and is strongly influenced by dietary intake and lifestyle behaviors. Adequate protein consumption is essential for muscle development and energy metabolism, whereas smoking has detrimental effects on lung function and aerobic capacity. This study aimed to explore the relationship between protein intake and smoking habits with physical fitness, measured by maximal oxygen uptake, among athletes of Persela Football Academy under-eighteen. A quantitative approach with a cross-sectional design was applied, involving adolescent male athletes. Protein intake was assessed using a semi-quantitative food frequency questionnaire, smoking habits were obtained through structured interviews, and maximal oxygen uptake was measured using the multistage fitness test. Findings revealed that the average daily protein intake of athletes was relatively high, while the mean maximal oxygen uptake score fell within the good category. Correlation analysis demonstrated a significant association between protein intake and aerobic fitness, as well as between smoking habits and aerobic fitness. The results indicate that lower protein intake and higher smoking frequency are linked to reduced physical fitness capacity. This study highlights the importance of nutritional interventions and healthy lifestyle promotion as integral components in the development of youth athletes to optimize performance and prevent decline in fitness.

Low Birth Weight (LBW) remains a critical global health issue that significantly contributes to neonatal morbidity and mortality, particularly in developing countries such as Indonesia. The main challenge in addressing LBW lies in its complex and multifactorial risk profile, which involves biological, social, environmental, and healthcare-related determinants. This study aims to analyze and synthesize the risk factors associated with LBW based on recent scientific literature. A literature review method was applied by searching articles from Portal Garuda, DOAJ, PubMed, and Google Scholar published between 2020 and 2025 using relevant keywords. The findings indicate that maternal age, interpregnancy interval, nutritional status, anemia, preeclampsia, infections, socioeconomic conditions, environmental exposure, and the quality of antenatal care are significant determinants of LBW. The synthesis of evidence confirms that LBW is influenced by the interaction of multiple individual and healthcare system factors rather than a single cause. In conclusion, this study highlights the urgent need to strengthen antenatal care services, improve maternal nutritional status, control maternal diseases during pregnancy, and implement community-based promotive and preventive strategies as key efforts to reduce the incidence of LBW.