The use of synthetic feed additives in Peking ducks has adverse effects on their growth and productivity. Spirulina sp., a blue-green algae, has the potential to be used as a safe feed additive that can enhance the growth and productivity of ducks. This study aims to analyze the effects of Spirulina (Spirulina sp.) powder as a feed additive on the histomorphometry of the duodenum in Peking ducks (Anas platyrhynchos), focusing on the duodenal lumen diameter, villus height, villus width, mucosal tunic thickness, submucosal tunic thickness, and muscular tunic thickness. This study used a Completely Randomized Design (CRD) with 35 ducks divided into 5 treatments and 5 repetitions. The treatments included a control group and the addition of spirulina powder in feed at concentrations of 2.5%, 5%, 7.5%, and 10%. The data were analyzed by ANOVA with a significance level of 5%, followed by Duncan's test. The results of data analysis showed that spirulina powder had a significant effect (P<0.05) on villus height and duodenal mucosa tunica thickness. The conclusion of this study is that spirulina powder has the potential to be used as a feed additive to improve digestive performance in male Peking ducks, as evidenced by the increase in villus height and thick tunica mucosa in the small intestine. The novelty of this study lies in the utilization of spirulina powder as a feed additive to increase the size of the duodenal tissue structure in Peking ducks. The results of this study are expected to be a new reference on the potential of spirulina as a feed additive to improve poultry feed quality and digestive performance, especially in peking ducks.

Acute Coronary Syndrome (ACS) is a medical emergency that is still a major cause of global morbidity and mortality. The success of ACS treatment and prevention of recurrence is highly dependent on self-care. However, many ACS patients have difficulty performing self-care due to low self-efficacy. This study aims to explain the relationship between self-efficacy and self-care in ACS patients. This study used a correlation analytic design with a cross-sectional approach. The study population was 62 outpatients at the Heart Clinic, with a sample of 41 people selected using purposive sampling. Self-efficacy was measured using the Cardiac Self-Efficacy Scale (CSE scale) and self-care using the Self-Care of Coronary Heart Disease Inventory (SC-CHDI). The study was conducted in April-May 2025. Data were analyzed using the Pearson product moment correlation test. The results showed a p value of 0.004 (p <?), which means there is a relationship between self-efficacy and self-care in ACS patients. The direction of the relationship is positive, meaning that the higher the self-efficacy, the better the self-care, and vice versa with the closeness of the relationship in the weak category (r 0.437). Self-efficacy is positively related to better self-care behavior in ACS patients. Therefore, nurses can integrate self-care improvement care through comprehensive self-efficacy education.

ST Elevation Myocardial Infarction (STEMI) is an emergency condition caused by rupture of atheroma plaque in the coronary arteries which blocks blood flow to the heart. If this condition is not treated immediately it can result in disability and death. The family has an important role in determining the treatment needed by the patient in the Intensive Care Unit. However, families are vulnerable to experiencing anxiety which will slow down the process of decision making and patient care, so the role of nurses is very important in overcoming family anxiety. One of them is the intervention of providing educational therapy. The aim of this research is to provide nursing care to Paisen families with STEMI to overcome anxiety. The type and research design used is a descriptive method with a case study approach. The subjects of this case study are families who have met the inclusion criteria, namely the patient's wife with anxiety problems, can read and write, and is willing to be a respondent. The participant collection technique used purposive sampling. The research instrument used the HARS (Hamilton Anxiety Raiting Scale) questionnaire. The research was carried out in 2 days. The research results show that educational therapy intervention can reduce the patient's family's anxiety from severe to mild anxiety. For this reason, nurses are expected to be able to provide social support both informationally and emotionally so that there is no anxiety in the family.

Introduction: Needle procedures are common actions that are often encountered in emergencies. Emergency Departement (ED) with high workloads sometimes needle procedures are performed by force, thus causing uncontrolled pain, long-term negative psychological disorder, impairing physical evaluation and clinical outcome. The purpose of this review is to identify nursing intervention to reduce pediatric pain in needle procedures in ED. Methods: The literature search used the PubMed database with the keywords: nursing intervention, pain, needle procedures or injection and emergency department. Article criteria: 1) full text, 2) published in the 2016-2020 period, 3) employing Randomized Controlled Trial (RCT) research design, and 4) respondents aged 3-13 years old. Analysis of the quality of articles using the Critical Appraisal Skills Programme (CASP) and Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Result: 171 articles identified. Based on criteria and quality assessment of articles as many as 6 articles reviewed with focus intervention: virtual reality, parental presence, buzzy aplication, ditto aplication, humanoid robot and listening music. Conclusion: Nurses can use these interventions in the nursing care to reduce pediatric pain during needle procedures in ED.