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Background: Thel postpartum periodl is al recovery phase involving lphysical and psychologicall changes, during which mothersl often experience fatigue due to increased cortisol levels. Excessive fatigue can interfere with the breastfeeding process and reduce motivation for exclusive breastfeeding. Lavender aromatherapyl is al non-pharmacologicall therapy containing linalool with sedative effects to provide relaxation and reduce fatigue levels. lObjective: This studyl aimed tol determine thel effect ofl lavender aromatherapy onl reducing fatigue in postpartuml mothers atl Puskesmas Ibu, West Halmahera Regency. Methods: Thisl study was al Pre-Experimentall study withl a Onel Group lPretest-Posttest lDesign. The studyl population consisted of lall postpartum mothersl at Puskesmas Ibu, with a total sampling technique of 30 respondents. The research instrument used anl observation lsheet, and ldata analysis wasl performed usingl the Paired Sample T-Testl (α = 0.05). Results: The majorityl of lrespondents' characteristics were inl the agel range of 20-35 yearsl (76.7%), had Senior High School education (60%), were unemployed/housewives (70%), and were primiparous (60%). The resultsl of thel Paired Samplel T-Testl showed al mean fatigue score before the intervention of 27.33, which decreased to 11.50 after the intervention (mean difference 15.833) with a lp-value = l0.000. lConclusion: There isl al significant effectl ofl lavender aromatherapyl administration on reducing fatigue lin postpartum lmothers at Puskesmas Ibu, Halbar Regency. Lavender aromatherapy is effective as a complementary therapy to aid postpartum maternal recovery.

This study evaluates the effectiveness of the Free Nutritious Meal Program (MBG) in improving students' cognitive abilities based on nutritional status in Brangsong Village, Indonesia. The research used a mixed-methods approach, combining quantitative and qualitative designs. Quantitative data were collected from 30 student beneficiaries via questionnaires and analyzed using descriptive statistics and Pearson correlation coefficients. Qualitative data were gathered through in-depth interviews with managers of the Nutrition Fulfillment Service Unit (SPPG), school authorities, students, and parents, and analyzed thematically. The results show a positive and significant relationship between nutritional status and academic achievement, but no significant relationship with students' cognitive ability. Nutrient intake, however, was positively and significantly associated with both cognitive ability and academic achievement. The strongest relationship was observed between cognitive ability and academic achievement. These findings suggest that the MBG program effectively supports academic achievement by improving nutrient intake and cognitive ability. However, its impact on students’ nutritional status has not been uniformly distributed.

Background: Diabetes Mellitus (DM) is a disease that cannot be completely cured or cannot even be completely cured. The vile shard plant is empirically used by the community to treat diabetes (DM). This study aims to conduct phytochemical screening and test the activity of 96% ethanol extract of kejibeling leaves (Strobilanthes crispus (L.) Bl.) as a herbal antidiabetic in male white mice (Mus musculus) with alloxan induction. Method: This research is an experimental laboratory research with a true experimental posttest control design using a completely randomized design (CRD) with 5 treatments and 5 replications. Treatment P1 (without treatment) as normal control (N), P2 as positive control (+), P3 as negative control (-), P4 kejibeling leaf extract 250 mg/kg BW, P5 kejibeling leaf extract 500 mg/kg BW. Result:The results of phytochemical screening showed the presence of alkaloids, flavonoids, tannins, saponins, terpenoids and steroids. SPSS results show that the data is normally distributed (p>0.05) and homogeneous (p>0.05). The results of the ANOVA on the treatment of giving keji beling leaf extract 250 mg/Kg BW showed a sig. 0.393 (p>0.05) and treatment of 500 mg/Kg BW obtained a sig value. 0.517 (p>0.05). Conclusion:The conclusion from the research results shows that administering doses of 250 mg/kg BW and 500 mg/kg BW of keji beling leaf extract can reduce blood sugar levels in mice. It is hoped that the results of this research will be useful for the community as an antidiabetic therapy using kejibeling leaves (Strobilanthes crispus (L.) Bl.).

Exclusive breastfeeding (EBF) is essential for infant growth and immunity during the first six months of life. Despite its benefits, many primiparous mothers face challenges in maintaining EBF due to lack of experience, stress, and insufficient support. Husband support has been identified as a crucial social factor that can influence a mother’s confidence and success in breastfeeding. This study aimed to examine the relationship between husband support and the success of exclusive breastfeeding among primiparous mothers in the Kalibaru Public Health Center area. A cross-sectional correlational design was employed, with 90 primiparous mothers selected through purposive sampling. Data were collected using structured questionnaires measuring husband support, including emotional, informational, and instrumental dimensions, and exclusive breastfeeding practice, following the World Health Organization (WHO) definition. Descriptive statistics summarized participants’ demographic characteristics and levels of support, while inferential analysis using the Chi-square test and Pearson correlation determined the association between husband support and EBF success. The results indicated that higher levels of husband support were significantly associated with successful exclusive breastfeeding among primiparous mothers (p < 0.05). Among the types of support, emotional and informational support were particularly influential in enhancing maternal confidence and overcoming breastfeeding challenges. These findings suggest that encouraging husband involvement through prenatal education, counseling, and family-based interventions can improve EBF rates. In conclusion, husband support plays a vital role in the successful practice of exclusive breastfeeding among first-time mothers. Health programs should actively involve fathers to provide emotional, informational, and practical support, thereby promoting optimal breastfeeding outcomes and infant health in the community.

The PESIAR Program (Petakan, Sisir, Advokasi, dan Registrasi Map, Screen, Advocate, and Register) is an operational instrument of BPJS Kesehatan designed to accelerate the achievement of Universal Health Coverage (UHC) by increasing National Health Insurance (JKN) membership at the local level. However, the effectiveness of this program’s implementation is strongly determined by the institutional capacity and configuration that support it. This article aims to reposition institutional determination not only as a factor influencing program effectiveness, but as a model of administrative governance in achieving UHC. The study uses a mixed methods approach with a sequential explanatory design. Quantitative data were obtained through a survey of PESIAR Agents in Semarang City, while qualitative data were collected through open-ended questionnaires and interviews. The results show a strong, positive relationship between institutional determination and the effectiveness of the PESIAR Program. Qualitative findings further clarify that issues of program effectiveness largely originate from institutional capacity, the quality of cross-sector coordination, and the role of PESIAR Agents as field implementers. This study concludes that institutional determination deserves to be positioned as an administrative governance model for the PESIAR Program in promoting the achievement of UHC at the local level.

Dysmenorrhea or menstrual pain, is a common health issue among adolescent girls, often disrupting daily activities and quality of life. Effective management of dysmenorrhea is strongly influenced by the level of knowledge and attitudes of adolescent girls toward this condition. This literature review aims to analyze the relationship between knowledge and attitudes regarding the management of menstrual pain among adolescent girls. Various studies indicate that while adequate knowledge about dysmenorrhea is important, the correlation between knowledge and attitude is not always significant. Some research finds that good knowledge does not necessarily translate into a positive attitude towards pain management, as other factors such as stress, anxiety, and reluctance to take action also play a role. However, there are studies that show a positive relationship between increased knowledge and better attitudes toward dysmenorrhea management,  although the strength of this association is very weak. Most adolescents tend to choose non-pharmacological management, such as rest and warm compresses, but many still ignore menstrual pain due to a lack of knowledge and information. Therefore, educational interventions and counseling in schools are essential to improve knowledge and foster positive attitudes in managing dysmenorrhea among adolescent girls. These efforts are expected to help adolescent girls manage menstrual pain more effectively and enhance their quality of life.

Abstract: One of the most common harmful bacteria, particularly in hospitals, is Pseudomonasaeruginosa, which is also the most frequent cause of wound infections. Because it leads to antibioticresistance and persistent infections, one of the most significant virulence factors it produces isbiofilm. The goal of the current study is to prevent P. aeruginosa isolates from wound patients fromforming biofilms by using plantaricin, which is a peptide with broad-spectrum antibiotic generated byLactobacillus plantarum. In order to produce plantaricin, so that Lactobacillus plantarum isolates from rawbuffalo milk were screened. The plantaricin was then purified using ammonium salts and a gelfiltration column, with a final 40% recovery. The isolates of P. aeruginosa with more production tobiofilm from wound infections were tested for the inhibitory impact of pure plantaricin. The resultsshowed that the plantaricin reduced the development of biofilms in a dose-dependent manner, with alarger percentage of biofilm inhibition reaching 46–68% at 150 µg/ml.

Malaria remains a major public health challenge in eastern Indonesia, particularly in the remote highland areas Papua, where access to health services is very limited. In early 2008, a suspected malaria outbreak with several deaths was reported in Agisiga District, a remote highland area in Papua. This study aimed to investigate the epidemiological characteristics, diagnostic results, and mortality patterns of the malaria outbreak as a basis for formulating future control strategies. The outbreak investigation was conducted using a cross-sectional design in Agisiga District from January to March 2008. Capillary blood samples were examined using Rapid Diagnostic Tests (RDTs) and thin blood smear microscopy. Malaria-related deaths were traced through verbal autopsy methods and interviews with families and community leaders. Descriptive analysis was performed to describe the demographic, clinical, and parasitological characteristics the cases. A total of 92 suspected malaria cases were identified, with the highest proportion coming from Tomosiga Village (52.2%), followed by Bigasiga Village (40.2%) and Agisiga Village (7.6%). Women accounted for 58.7% of all cases, and the most affected age group was 15–35 years (34.8%). Microscopic examination confirmed malaria infection in 55.0% of samples examined, with Plasmodium vivax predominating (45.0%), while the RDT positivity rate was much lower. The malaria outbreak in Agisiga District was characterized by high mortality, delayed diagnosis, and significant gaps in diagnostic capacity, particularly in remote villages. Strengthening the surveillance system, increasing diagnostic capacity, and improving access to timely treatment are crucial steps prevent similar outbreaks and reduce malaria mortality in the Papuan highlands.

Herpes zoster is a skin infection caused by the reactivation of the varicella-zoster virus, characterized by unilateral skin lesions corresponding to dermatome distribution and complaints of pain or itching. This disease is more common in adults and the elderly, especially in individuals with reduced immunity due to stress or work overload. A case was reported of a 40-year-old woman who worked as a nurse and came to a primary health care facility complaining of itching and red spots on her right breast area that had spread to the surrounding area two weeks before the examination and had worsened in the last few days. Physical examination revealed unilateral red skin lesions in a dermatomal pattern without crossing the midline of the body, consistent with the early phase of herpes zoster. Management was comprehensive, including medication, patient education about the disease and skin care, prevention of complications, and family support. A holistic approach is necessary to improve the success of therapy and the patient's quality of life.

Asthma is a chronic inflammatory disease of the airways characterized by reversible bronchoconstriction, mucus hypersecretion, and bronchial hyperresponsiveness. This condition causes shortness of breath, coughing, wheezing, and increased respiratory rate which impacts increased respiratory muscle work. One of the non-pharmacological interventions that can be applied in nursing practice is diaphragmatic breathing relaxation to help improve breathing patterns and increase respiratory muscle relaxation. Objective: To analyze the application of diaphragmatic breathing relaxation in improving respiratory muscle relaxation in asthma patients in the inpatient ward. Method: The study used a case study design with an Evidence Based Practice (EBP) approach. The research subjects were three asthma patients who experienced increased respiratory frequency. The intervention was carried out for three days in the form of structured diaphragmatic breathing exercises. Data were collected through nursing assessment, observation of respiratory frequency before and after the intervention, and evaluation of patient responses. Results: Before the intervention, all respondents experienced tachypnea with the use of accessory respiratory muscles. After three days of diaphragmatic breathing relaxation, the respiratory rates of all three respondents returned to normal (12–20 breaths/minute), respiratory muscle tension decreased, and the patients appeared more relaxed. Conclusion: Diaphragmatic breathing relaxation is effective in increasing respiratory muscle relaxation and stabilizing respiratory rate in asthmatic patients. This intervention can be used as part of non-pharmacological nursing care for patients with respiratory system disorders.

Developmental Dysplasia of the Hip (DDH) in children often results in joint stiffness, muscle weakness, limited range of motion, and gait impairment following surgical management and immobilization. Early physiotherapy intervention is essential to restore hip function and walking ability. This study aimed to evaluate the effectiveness of active exercise on functional walking in outpatient children aged 3–5 years after DDH surgery. A case study design was conducted on three female patients who completed a five-week rehabilitation program consisting of ten active exercise sessions, including hip strengthening, mobility training, and balance exercises, combined with a home program. Outcome measures included hip range of motion, Manual Muscle Testing, and Modified McKay and Harris Hip Score assessed at baseline, mid-intervention, and post-intervention. The results showed improvements in hip range of motion, particularly in flexion, extension, abduction, adduction, and external rotation, while internal rotation improved but did not reach normal values. Muscle strength increased from grade 1–2 to grade 3 in most hip muscle groups. Functional walking scores improved from poor to good and excellent, with patients achieving independent, symmetrical gait without pain. These findings indicate that active exercise is an effective rehabilitation approach to reduce impairments and enhance functional walking in children after DDH surgery. The study highlights the importance of structured physiotherapy and caregiver involvement to optimize recovery and participation in daily activities.

This study aims to analyze the discretion of family planning counselors in implementing contraceptive policies and the influence of acceptors' socio-demographic characteristics in Demak Regency. Using a mixed-methods approach with a sequential explanatory design, the study included 89 respondents for quantitative analysis and five key informants for in-depth interviews. The results showed a strong positive correlation between counselor discretion and acceptor socio-demographic characteristics (r = 0.646; p < 0.001), which explained 41.7% of the variance in discretionary practices. Counselors adapted communication strategies based on the age, education, geographic location, and culture of acceptors. Policy implementation faced obstacles in the counselor-community ratio (1:23) and the dominance of short-term contraceptive choices due to socio-cultural influences. Theoretical implications enrich the literature on street-level bureaucracy, while practical implications recommend strengthening counselors' capacity, increasing the ideal ratio, and implementing IEC strategies tailored to local culture. Limitations include a single geographic focus and a cross-sectional design. Future research is suggested to use longitudinal designs and multi-regional comparative studies to explore the dynamics of discretion in different socio-cultural contexts.

This meta-analytic study aims to comprehensively examine the relationship between mental health, learning capacity among health education students, and competencies in nosocomial disease risk management through cross-contextual empirical synthesis. An analysis of 47 studies involving 12,847 participants from 15 countries demonstrates a strong, statistically significant association between students' mental health and competencies in nosocomial infection prevention, as reflected by a correlation coefficient of r=0.68 (p<0.001) and a 95% confidence interval of 0.61-0.74. Students with high mental health scores (M=78.4; SD=8.2) exhibited substantially superior understanding of infection prevention protocols, namely 43% higher than the control group (M=54.7; SD=12.1; t(846)=18.42; p<0.001; d=2.31). Structural equation modeling confirmed learning capacity as a significant partial mediator (β=0.52; p<0.001), with an indirect effect reaching 35.4% and a 95% CI range of 28.6-42.1%. Mindfulness-based psychoeducational interventions were shown to enhance nosocomial risk identification abilities by 38.7% (F(2,564)=42.18; p<0.001; η²=0.41) while reducing clinical anxiety by 31.2% (t(382)=9.84; p<0.001). These findings extend the frameworks proposed by Song (2024) and Schutte et al. (2025), which primarily emphasize cognitive aspects, by demonstrating that the integration of psychological dimensions yields a multidimensional predictive model explaining 64.3% of the variance in risk management competence (R²=0.643; F(5,841)=304.76; p<0.001), surpassing conventional models that account for only 38-45% of the variance.

Wounds can be defined as the loss and damage of anatomical cells or skin function. Wound healing consists of coagulation, inflammation, proliferation, and remodeling stages. This study aims to determine the effectiveness of the leaf fraction of the thick (Glochidion superbum) on wound healing in male white mice (Mus musculus). This study is experimental. This study used 24 male mice that were given a 10 mm long cut wound. Fractionation was carried out using the liquid-liquid extraction method. Fractionation used 3 different types of solvents, namely methanol, ethyl acetate, and n-hexane. The results showed that the ethyl acetate fraction had a faster wound healing effectiveness than the other groups. The ethyl acetate fraction contains a phenolic compound, namely methyl gallate. Methyl gallate has an important role in wound healing. Methyl gallate has the potential to be an antibacterial, antioxidant, and anti-inflammatory. The results of the Bonferroni post-hoc statistical analysis confirmed the effectiveness of the ethyl acetate fraction in faster wound healing. The thick leaf fraction was effective in healing incisions in male white mice. The ethyl acetate fraction was more effective in accelerating incision healing.

This study aims to analyze the relationship between public policy paradoxes, healthcare service quality, access to and continuity of postnatal care, and maternal mortality in Pekalongan Regency. A mixed-methods approach with a sequential explanatory design was employed, involving 30 respondents for quantitative analysis using Spearman correlation tests and 5 key informants for in-depth interviews. The results indicate that policy paradoxes are strongly correlated with service quality and with access and continuity of care. Service quality also shows a robust correlation with access and continuity. All variables are significantly associated with maternal mortality, with access and continuity of care demonstrating the strongest correlation. Qualitative findings reveal implementation gaps in Ministry of Health Regulation No. 21 of 2021, where postnatal visits are often conducted only 2–3 times instead of the mandated four visits, with 10 out of 13 maternal deaths occurring during the postnatal period. The persistence of maternal mortality is attributed to inconsistent implementation of standard operating procedures, high workload, and socio-cultural factors. The study highlights the need to strengthen supervision, enhance human resource capacity, and promote cross-sectoral collaboration to optimize postnatal care services.

Patient-Centered Care (PCC) is a healthcare approach that places the patient at the center of every interaction and clinical decision-making. However, a preliminary study at Tarumajaya Hospital showed that 58% of healthcare workers had not yet optimally implemented the PCC approach. This study aimed to analyze the influence of self-efficacy and social support on the implementation of Patient-Centered Care, with safety culture as a mediating variable, at Tarumajaya Hospital. The research method used was quantitative analytic with a cross-sectional design. The study sample used a saturated sampling technique of 132 healthcare workers, consisting of doctors, nurses, and medical support staff. Data analysis used Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results showed that self-efficacy and social support had a positive and significant effect on safety culture and PCC implementation. Safety culture also had a positive and significant effect on PCC implementation. Furthermore, safety culture was shown to mediate the influence of self-efficacy and social support on PCC implementation. The coefficient of determination value indicates that the model has strong ability to explain variations in PCC.

Tuberculosis (TB) remains a significant health issue in Indonesia, with the number of cases not showing a decline. Pediatric pulmonary tuberculosis is one of the leading causes of morbidity and mortality. In 2018, the number of TB cases in Aceh reached 41,595, with Aceh Utara having the highest number at 4,819 cases, followed by Bireuen with 3,636 cases, while Sabang recorded the lowest at 272 cases. The primary risk factor for pulmonary tuberculosis in children is a history of contact with adult TB patients, as children's immune systems are still weak, allowing the bacteria to enter their bodies easily. This study aims to examine the history of TB contact in children at the Pediatric Clinic of Cut Meutia General Hospital. The research used a descriptive observational design, with 105 respondents, and data was collected from medical records. The results showed that the majority of respondents were toddlers (47.6%), most were male (54.3%), and 58.1% had good nutritional status. A significant percentage of respondents (77.1%) had a history of contact with TB patients, and 83.8% did not receive BCG vaccination. These findings highlight that contact with TB patients is a key factor in the transmission to children.

Allergic contact dermatitis (ACD) is an inflammatory skin process caused by specific allergens. ACD is classified as Type IV hypersensitivity, which is sensitive to allergens. A 57-year-old woman presented to the Dermatology and Venereology Clinic at Malahayati General Hospital in Bireun with complaints of red patches on her right and left legs and on her right and left elbows for approximately two months. According to the patient, the red patches initially appeared as circular patches with white scales the size of a coin on the elbows, accompanied by itching, which then spread. The itching worsened when the patient sweated, causing her to scratch, which enlarged the lesions and caused red wounds. The skin on the lesions tended to be dry with active edges and a calmer center. The itching improved after bathing. The patient is a housewife. The patient also said that she sweats frequently. According to the patient, the itching is not affected by the food she consumes every day. The patient was given steroid pharmacotherapy, namely 1% hydrocortisone cream, 0.1% mometasone furoate cream, and 10 mg cetirizine tablets once daily.

The problem that occurs in stroke patients is damage to the autonomic nervous system that regulates intestinal peristalsis, causing a decrease in the defecation reflex and leading to constipation. If constipation is not treated properly, it will affect the quality of life of stroke patients. Constipation can be treated pharmacologically and non-pharmacologically. One non-pharmacological treatment is abdominal massage. Abdominal massage can stimulate the parasympathetic nervous system, which can increase digestive system motility, reduce tension in the abdominal muscles, and have a relaxing effect on the sphincter. The design used in the preparation of the final scientific paper for the nursing study was a one-group pretest-posttest case study with abdominal massage intervention on three respondents who had experienced constipation for ≥ 72 hours. Abdominal massage was given once a day for 10-15 minutes for three consecutive days. The constipation scores using the Constipation Assessment Scale (CAS) were as follows: respondent 1, Mrs. L, from 13 to 6; Mrs. W, from 12 to 11; and Mrs. W, from 15 to 11. There was a decrease in the CAS score before and after the abdominal massage was administered, but it was not yet able to significantly alleviate constipation in stroke patients. The application of this EBP is expected to provide additional information on the administration of abdominal massage to stroke patients experiencing constipation for ≥72 hours.

Smoking is the activity of smoking smoke from the burning of tobacco in cigarettes, one end of the cigarette is burned and the smoke can be smoked through the mouth on the other end. If the amount or form of hemoglobin is abnormal, red blood cells cannot function properly in transporting oxygen and carbon dioxide. This can trigger various health problems, including anemia. From the results of this study, we can see that the average value or mean value of hemoglobin levels is 12.5 g/dL, the median value is 12.9 g/dL, the minimum value is 11.9 g/dL, and the maximum value is 16.2 g/dL. The results showed that most of the respondents had hemoglobin levels within normal limits. In detail, hemoglobin levels in the normal category were 23 respondents, low category was 1 respondent, and high category was 1 respondent. This shows that the majority of active smokers in Market VI of North Binjai Village still have normal hemoglobin levels, although smoking has the potential to affect oxygen transport capacity in the long term and increase the risk of health problems if it continues continuously.