Media Penelitian dan Pengembangan Kesehatan
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Clinical audit of medical records based on clinical pathway: case study Benign Prostatic Hyperplasia (BPH)
Background: Benign Prostatic Hyperplasia (BPH) is a common condition in adult men with a prevalence exceeding 50% by the age of ≥ 60 years. BPH causes symptoms of lower urinary tract infection, which reduces the quality of life and increases the burden of health services through visits, examinations, and medical interventions. BPH service practices still vary between health services, and medical records are still inconsistent and often deviate from clinical guidelines Objective: To examine the implementation of the BPH clinical pathway (CP) through clinical audit and explore its inhibiting factors. Methods: Qualitative research with a case study design in one regional referral service center. Data were collected through three triangulation sources: (1) observation of medical audits of 63 BPH patients' medical records, (2) in-depth interviews with 12 health workers (doctors and nurses), and (3) policy documents related to CP. Thematic analysis was carried out iteratively to identify patterns of CP non-conformity and implementation barriers. Results: Thirty-five percent of medical records did not meet CP criteria. Key obstacles included low awareness of the CP among healthcare workers, limited clinical time, and lack of integration of health information systems. Conclusion: The implementation of the BPH clinical pathway remains hindered by clinical and systemic factors. Evidence-based CP provides strategic solutions to improve service consistency and quality, but supporting policies, ongoing training, and integration of information systems are needed to optimize its application.
Copyright (c) 2026 Ida Sugiarti, Dedi Setiadi, Fadil Ahmad Junaedi, Ida Wahyuni https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of breadfruit leaf extract in mouthwash formula to inhibit the bacteria of Streptococcus mutans that causes caries
Background: Dental caries is caused by Streptococcus mutans, which forms biofilms and produces acid that damages tooth enamel. Prevention is often achieved through mouthwashes containing antibacterial agents, but commercial products may have side effects due to chemical ingredients. Artocarpus altilis (breadfruit) leaves contain bioactive compounds like flavonoids and tannins, which have potential as natural antibacterial agents. Objective: This study aimed to evaluate the antibacterial activity of Artocarpus altilis leaf extract and formulate an effective mouthwash against Streptococcus mutans. Methods: The study used a true experimental design with a pretest-posttest control group. The extract was obtained by maceration with 96% ethanol. Three mouthwash formulations were prepared with varying glycerin concentrations (15%, 20%, and 25%). Antibacterial activity was assessed using the paper disk method, and data were analyzed using Kruskal-Wallis and Mann-Whitney tests. Results: The 2-4% extract had strong antibacterial activity, with inhibition zones ranging from 20.25–23.81 mm, significantly different from the negative control (p<0.05). The mouthwash formulations were liquid, yellow-green in color, with a characteristic breadfruit and mint scent, pH ranging from 5.5 to 7.9, and viscosity of 1 cPs. The mouthwash exhibited strong antibacterial activity, with inhibition zones between 18.81±1.5 mm and 18.94±0.5 mm, showing no significant differences across formulas (p>0.05). Conclusion: The 2% Artocarpus altilis extract and 15% glycerin formula was stable and effectively inhibited Streptococcus mutans
Copyright (c) 2026 Nur Khairi, Andi Nur Aisyah, Maulita Indrisari, Sukmawati Sukmawati, Michrun Nisa https://creativecommons.org/licenses/by-sa/4.0
Dynamic capabilities, knowledge management, and lecturer performance as determinants of health workers' readiness in health services
Background: Higher education institutions play a strategic role in preparing competent healthcare professionals and ensuring the quality of health services in the community. In the era of rapid health system transformation and technological advancement, health polytechnics are required to strengthen organizational performance through effective knowledge management, lecturer competence, and motivation to support adaptive institutional capabilities. Objective: This study examined the effects of knowledge management, lecturer motivation, and lecturer competence on the institutional performance of Health Polytechnics. Methods: Using an explanatory quantitative design, data were collected from 380 lecturers at 38 institutions through stratified sampling and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: The results indicate that all independent variables significantly influence institutional performance. Organizational dynamic capabilities and lecturer performance are proven to act as significant mediators, both in parallel and serial relationships. A crucial finding indicates that the serial mediation pathway of knowledge management through dynamic capabilities and lecturer performance has the strongest influence. This confirms that the transformation of knowledge into organizational adaptive capabilities significantly determines institutional effectiveness. Conclusions: This research indicates that strengthening lecturer capacity is essential for producing graduates who are adaptive to digital transformation and modern healthcare systems. Practically, this study provides strategic guidance for human resource development in higher health education to improve public health services sustainably.
Copyright (c) 2026 Tarjuman Tarjuman, Eeng Ahman, Edi Suryadi, Askolani Askolani https://creativecommons.org/licenses/by-sa/4.0
The impact of postpartum depression symptom on breastfeeding outcomes: a literature review
Background: Postpartum depression is among the most prevalent mental health conditions during the postpartum period. Postpartum depression is regarded as detrimental to breastfeeding. Depressed mothers may experience a diminished interest and attraction towards their infants. Ultimately, the mother is incapable of adequately caring for her infant, including the inability to breastfeed directly. Objective: Consequently, we performed a literature analysis to rigorously assess the evidence regarding the correlation between postpartum depressive symptoms and breastfeeding habits. Methods: A literature review utilized the PubMed, Scopus, and Science Direct databases, referencing selected publications published between 2019 and 2024. A total of 9,146 articles were obtained from the specified databases and subsequently analyzed using the PRISMA. Results: The review of 22 selected articles revealed a strong correlation between postpartum depression symptoms and decreased breastfeeding success. Depressed mothers tend to have lower breastfeeding initiation rates. In addition, other factors influence breastfeeding success, such as the benefits of breastfeeding, societal and ecological assistance, malnutrition, insomnia, social and demographic characteristics, psychological factors, and patterns of breastfeeding. Conclusion: Postpartum depression symptoms correlate with breastfeeding success. Health practitioners should implement mental health evaluation in breastfeeding programs to identify maternal risk, which can be treated early. This enhances the rates of successful breastfeeding practices and supports the mother's and child's health.
Copyright (c) 2026 Shafi’ah Shafi’ah, Rahma Sasmita Indrani, Aghniyya Shabira, Qorinah Estiningtyas Sakilah Adnani, Hadi Susiarno, Victor Abiola Adepoju https://creativecommons.org/licenses/by-sa/4.0
Validity and reliability test of the knowledge level questionnaire of cancer patients undergoing radiotherapy
Background: Radiotherapy is one of the main modalities in cancer treatment. The success of this therapy is strongly influenced by the knowledge of patients about the disease and radiotherapy. The researcher developed a questionnaire to measure the level of knowledge among cancer patients undergoing radiotherapy. Objective: This study aimed to assess the validity and reliability of a knowledge-level questionnaire for cancer patients receiving radiotherapy at Dr. M. Djamil General Hospital, Padang. Methods: This research employed a quantitative approach with a cross-sectional design. A total of 30 cancer patients undergoing radiotherapy were included as respondents using a consecutive sampling technique. The questionnaire instrument was developed by the researcher and consisted of 25 items covering five domains of knowledge: cancer, radiotherapy, side effects, self-care, and nutrition. Results: Validity testing was conducted using Pearson’s correlation analysis, while reliability was assessed using Cronbach’s Alpha. Out of the 25 items, 19 were statistically valid (p<0.05), with correlation coefficients (r) ranging from moderate to strong (0.470–0.745). The Cronbach’s Alpha value for the valid items was 0.904, indicating excellent reliability. Conclusion: The developed questionnaire was proven to be both valid and reliable for measuring the knowledge level of cancer patients undergoing radiotherapy. This instrument has the potential to be used in clinical practice and research to support more targeted educational interventions.
Copyright (c) 2026 Fathiya Juwita Hanum, Rizanda Machmud, Soehartati Gondhowiardjo, Daan Khambri, Wirsma Arif Harahap, Aisyah Elliyanti, Firdawati Firdawati, Rima Semiarty https://creativecommons.org/licenses/by-sa/4.0
Influence of family and child demographic characteristics on the incidence of stunting
Background: Stunting cases in Surakarta ranked fourth lowest in Central Java. However, the stunting target in Surakarta is zero. Objective: This study aimed to analyze the influence of maternal and child demographic factors on the incidence of stunting at the Gilingan Surakarta Community Health Center. Methods: This research method used analytical observations with a case-control research design. The research subjects were obtained using a simple random sampling method consisting of 38 stunted toddlers and 38 non-stunted toddlers aged 24-59 months at Gilingan Surakarta Community Health Center. Data collection was done by distributing questionnaires to respondents. The statistical test used for bivariate analysis is the chi-square, and multivariate analysis uses multiple logistic regression. Results: Bivariate analysis showed that maternal occupation (p=0.047) and family income (p=0.002) influenced the incidence of stunting. Multivariate analysis then found that maternal occupation and family income were associated with the incidence of stunting (p=0.005). Conclusion: The conclusion in this study was that mothers' occupation and family income significantly influence the incidence of stunting. Therefore, there is a need for assistance in the form of additional food for toddlers from underprivileged families to meet their nutritional needs so that stunting can be prevented.
Anak Agung Alit Kirti Estuti Narendra Putri
Copyright (c) 2026 Balgis Balgis, Anak Agung Alit Kirti Estuti Narendra Putri, Widana Primaningtyas, Khansa Firyallely Paramesti https://creativecommons.org/licenses/by-sa/4.0
The role of posyandu cadres in child growth monitoring for early detection of stunting
Background: Stunting remains a major public health challenge with long-term consequences for the quality of human resources in Indonesia. Stunting prevention requires early detection through routine child growth monitoring conducted at Integrated Health Service Posts (Posyandu). Objective: This study aimed to analyze the relationship between knowledge and motivation and the role of Posyandu cadres in child growth monitoring as an early detection strategy for stunting in the service area of Graha Indah Public Health Center, North Balikpapan. Methods: A descriptive analytical study with a cross-sectional design was conducted. A total of 79 active Posyandu cadres were purposively selected as the study sample. Data were collected using structured questionnaires that had been tested for validity and reliability and were analyzed using Spearman’s rank correlation test. Results: The results showed that Posyandu cadres generally had good levels of knowledge and motivation and performed their roles optimally. A strong and statistically significant relationship was found between motivation and the role of cadres (p=0,001), whereas knowledge was not significantly associated with cadre roles (p=0,650). Conclusion: These findings indicate that motivation is a key factor in optimizing the role of Posyandu cadres in child growth monitoring. This study recommends strengthening cadre motivation through continuous training, intensive supervision, and performance-based incentive systems to enhance the effectiveness of early stunting detection at the community level.
Copyright (c) 2026 Eli Rahmawati, Ernani Setyawati, Nuurwahidah Nuurwahidah, Damai Noviasari, Ni Nyoman Murti, Endah Wijayanti, Sekar Handayani, Ita Kusumayanti https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of the Edinburgh Postnatal Depression Scale (EPDS) as an early screening tool for detecting depression and anxiety in postpartum women
Background: Depression and anxiety in postpartum women have a significant impact on the health of the mother, infant, and family. Early detection is essential to prevent long-term psychological complications. Objective: This study aimed to evaluate whether completing the Edinburgh Postnatal Depression Scale (EPDS), followed by a 20-minute brief education session delivered by midwives, could reduce EPDS scores among postpartum women within two weeks after the intervention. Methods: A quasi-experimental non-randomized controlled pre–post design was conducted at Pondok Bambu 1 Primary Health Center (intervention) and Pondok Gede District Hospital (control) using purposive sampling. A total of 52 postpartum women participated, with 26 assigned to the intervention group and 26 to the control group. The intervention consisted of EPDS screening followed by a brief education session on perinatal mental health, while the control group received routine care only. Results: Results showed that the mean EPDS score in the intervention group decreased from 13.23 ± 2.50 to 6.96 ± 2.18 (Δ = 6.27; 95% CI [−6.89; −5.65]; p < 0.001; d = 2.07), whereas the control group showed no significant change. The post-intervention Mann–Whitney test indicated a significant difference between groups (p = 0.021). Conclusion: These findings highlight that EPDS screening followed by brief education by healthcare providers is effective in reducing psychological distress in postpartum women. Integration of this program into postnatal care services is highly recommended to improve maternal and infant mental health outcomes.
Copyright (c) 2026 Rahayu Khairiah, Rizky Yanti; Nurul Hikmah; Heny Surahman https://creativecommons.org/licenses/by-sa/4.0
Detection of the Murine Double Minute2 (MDM2) gen in formalin-fixed tissue samples using PCR
Background: Tissue preservation is a crucial procedure in pathological studies to maintain cellular and structural integrity, commonly performed through formalin fixation. However, formalin fixation may cause DNA degradation, posing challenges for molecular analysis. Detection of cancer biomarker genes, such as Murine Double Minute 2 (MDM2), can be performed using Polymerase Chain Reaction (PCR), a technique for amplifying specific DNA fragments. Objective: This study aimed to determine the presence of the MDM2 gene in formalin-preserved tissues stored for different periods using PCR. Methods: A descriptive qualitative design with random sampling was employed. The study was conducted at the Anatomical Pathology and Molecular Biology Laboratories of Sekolah Tinggi Ilmu Kesehatan Nasional. Samples included 10 hair and nail tissues as controls, and formalin-fixed tissues stored for 2 days, 1 month, 2 months, and 8 years. DNA isolation was performed using the Geneaid gSYNC™ DNA Extraction Kit. DNA quality was assessed by 1.5% agarose gel electrophoresis, while concentration and purity were measured using a UV-Vis spectrophotometer. DNA concentrations ranged from 320–420 ng/µL, with purity ratios between 0.8 and 1.125. Results: The results showed that the MDM2 gene (178 bp amplicon) was detectable in tissues stored for up to 2 months but was not detected in tissues stored for 8 years. Conclusion: These findings indicate that storage duration affects the success of gene detection in formalin-fixed tissues.
Copyright (c) 2026 Hanifah Velda Sanita, Fitria Diniah Janah Sayekti https://creativecommons.org/licenses/by-sa/4.0
Inpatient therapy profile for coronary heart disease patients at Universitas Indonesia Hospital
Background: Coronary heart disease (CHD) was the second-highest cause of death in Indonesia. West Java is one of the provinces with a high prevalence of heart disease in Indonesia. Objective: This study aimed to determine the inpatient therapy profile for CHD patients at Universitas Indonesia Hospital (RSUI). Methods: This study was a descriptive study using data from medical records of inpatients with CHD who were registered as BPJS Kesehatan participants at RSUI from January to September 2024. Results: The results showed that 84 patients met the inclusion and exclusion criteria from a total study population of 208 patients, with the majority of patients being male (59,5%), aged <60 years (56,0%), and having a primary complaint of chest pain (79,8%). Based on laboratory characteristics, most patients had normal troponin T levels (86,9%), normal blood creatinine levels (54,8%), and random blood glucose levels <200 mg/dL (77,4%). The length of hospitalization was ≤5 days (82,1%) with improved clinical outcomes (97,6%). Most patients had ≥3 comorbidities (53,6%), with the most common comorbidities being HHD (38,1%), hypertension (35,7%), and CHF (33,3%). In addition, most patients received ≥5 drugs (97,6%), with the commonly used therapeutic profiles being platelet aggregation inhibitors (79,8%), HMG CoA reductase inhibitors (78,6%), organic nitrates (67,9%), selective beta-blocking agents (56,0%), and ACE inhibitors (45,2%). Conclusion: The predominant therapeutic profile of CHD inpatients at RSUI included platelet aggregation inhibitors, HMG CoA reductase inhibitors, organic nitrates, selective beta-blocking agents, and ACE inhibitors.
Copyright (c) 2026 Khoirun Nisak, Retnosari Andrajati, Atika Wahyu Puspitasari https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of front-of-pack nutrition labels on consumer behavior: implications for food labelling policy in Indonesia
Background: Non-communicable diseases (NCDs) such as obesity, diabetes, and hypertension have become significant global health challenges. One of the main factors contributing to this problem is the high consumption of packaged foods and beverages with excessive sugar, fat, and sodium content. Nutrition information labels have been identified as an effective strategy to raise awareness and encourage healthier consumption behavior change. Objective: This study aimed to evaluate the effectiveness of various nutrition information labeling systems, including Front-of-Pack Labeling (FOPL) such as Nutri-Score, Nutri-Grade, Health Star Rating, and warning-based labels, in improving consumer awareness, understanding, and consumption behavior. Methods: A scoping review was conducted using thirteen journals selected based on PRISMA guidelines, focusing on awareness, understanding, and changes in consumption behavior. Results: Intuitive visual labels increased consumer awareness by 75% and reduced sugar consumption by 1.51 grams per serving. Warning-based labels reduced purchases of unhealthy products by 17%. Conclusions: Effective nutrition labeling should adopt clear visual formats and be supported by public education. Further policy recommendations include integrating labeling with education campaigns and additional regulations, such as sugar taxes, to strengthen the long-term impact on healthier consumption patterns.
Copyright (c) 2026 Maulia Dewi Kurnia Putri, Zahroh Shaluhiyah, Ratih Indraswari https://creativecommons.org/licenses/by-sa/4.0
Age and employment status as dominant factors in medication adherence among hypertensive patients
Background: Hypertension is a common chronic condition that requires consistent medication adherence to prevent complications. Despite various control programs, adherence remains influenced by sociodemographic factors. Objective: This study aimed to examine the association between sociodemographic characteristics, national health insurance enrollment (JKN), smoking habits, and medication adherence among hypertensive patients. Methods: This cross-sectional study was conducted at the Mengwi Public Health Center, Badung Regency, Bali Province. The study population included 611 adult hypertensive patients, and 239 respondents were selected using random sampling. The dependent variable was medication adherence, while the independent variables were age, gender, marital status, education, employment status, household position, JKN membership, and smoking habits. Data were analyzed using the Chi-square test to assess associations. Results: The results showed that among 239 participants, 82.8% adhered to their medication. Age was significantly associated with adherence (p = 0.008), and regression analysis (p = 0.901; OR = 1.001; 95% CI: 0.980–1.023) indicated a small effect but a pattern where older and middle-aged patients were more compliant than younger adults. Employment status was also significantly related to adherence (p = 0.039), with regression results (p = 0.039; OR = 3.125; 95% CI: 1.061–9.206), showing a positive association. Other variables, including gender, marital status, education, household position, JKN membership, and smoking habits, were not significantly associated. Conclusion: Age and employment status significantly influenced medication adherence among hypertensive patients. These findings emphasize the importance of age- and occupation-based interventions, such as adherence education for younger patients and time management strategies for employed individuals.
Copyright (c) 2026 Moh Fairuz Abadi, Didik Prasetya, Putu Teguh Surya Pratama https://creativecommons.org/licenses/by-sa/4.0
Development of an iron diagnostic method using Malaka fruit based on digital imaging
Background: Iron (Fe) is a geochemically active element that needs to be monitored because excessive levels in water can reduce water quality and pose health risks. WHO sets a safe limit of Fe in drinking water at 0.3 mg/L. This condition demands an accurate, simple, and applicable Fe detection method without complex instruments. Objective: This study developed a digital imaging-based Fe(III) detection method using a natural reagent, malacca fruit extract, which is rich in gallic acid and forms a blue Fe-gallic acid complex. Methods: The study design included laboratory experiments involving gallic acid extraction, optimization of the Fe(III): extract ratio, optimization of measurement time, and evaluation of linearity, precision, accuracy, LoD, LoQ, and t-test against the UV-Vis spectrophotometry method. Results: The results showed an optimum Fe(III): extract ratio of 1:2, with reaction stability up to the 5th minute. A linear relationship was obtained in the range of 0.1–2 ppm (R² = 0.9969), with an LoD of 0.1377 ppm and a LoQ of 0.4589 ppm. The %RSD values ​​of 2.34–3.82% indicate good precision, while the accuracy ranges from 92.76–111.2%. A t-test confirmed that the digital imaging results were not significantly different from those of UV-Vis spectrophotometry. Conclusion: Overall, this method offers a portable, economical, and environmentally friendly analytical approach for Fe(III) detection and provides a basis for the development of digital application-based diagnostic systems using natural reagents.
Copyright (c) 2026 Zuri Rismiarti, Mamat Rahmat, Asep Iin Nur Indra, Nurul Hakimah, Rani Nurmayanti, Nur Fadilah https://creativecommons.org/licenses/by-sa/4.0
The role of serum ferritin as a biomarker of iron and inflammation in anemia: a systematic literature review
Background: Anemia remains a major global health concern, particularly in low- and middle-income countries where distinguishing Iron Deficiency Anemia (IDA) from Anemia of Inflamation (AI) remains diagnostically challenging. Hemoglobin alone cannot differentiate these conditions, necessitating more specific biomarkers. Serum ferritin, the primary iron-storage protein, reflects body iron reserves but is also elevated during inflammation through interleukin-6-mediated hepcidin induction. Objective: This review examines the dual role of ferritin as an iron biomarker and an inflammatory marker. Methods: A literature search was conducted in PubMed, ScienceDirect, SpringerLink, and the Cochrane Library with a ten-year publication limit. Of the 89 articles identified, only eight studies met the inclusion criteria and directly evaluated the relationship between ferritin, iron status, and inflammatory processes. Results: Ferritin remains a key indicator of iron reserves, but its interpretation needs to take into account the inflammatory status. Conclusion: The combination of ferritin with inflammatory biomarkers such as C-Reactive Protein (CRP)and Alpha-1-acid glycoprotein (AGP) improves the diagnostic accuracy for anemia related to both iron deficiency and inflammation.
Copyright (c) 2026 Rafi Andyah Arum Kedaton, Nabila Sinta Devi, Kusworini Kusworini, Diadjeng Setya Wardani https://creativecommons.org/licenses/by-sa/4.0
Factors influencing maternal-fetal attachment in adolescent pregnant women: scoping review
Background: During pregnancy, one important aspect that needs to be considered is the formation of maternal-fetal attachment (MFA), which is the emotional bond that forms between a mother and her fetus during pregnancy. Maternal-fetal attachment begins to develop before the baby is born, even while it is still in the womb. Objective: This study analyses scientific evidence related to factors that influence maternal-fetal attachment in adolescent pregnant women. Methods: This review used the PRISMA-ScR diagram. Literature searches were conducted using three databases and one search engine, namely PubMed, ScienceDirect, Wiley Online Library, and Google Scholar. This review began in February 2025. Articles were assessed using the Critical Appraisal Skills Programme (CASP) checklist for cohort, cross-sectional, and qualitative studies, with inclusion criteria being original research articles, articles published between 2020-2025, in English, open access and available in full text, with a research focus on MFA in adolescent pregnancy, while exclusion criteria were paid articles and articles with only abstracts. From the 211 articles selected, 7 relevant articles were obtained, 6 quantitative articles and 1 qualitative article. Results: the factors that influence maternal-fetal attachment in adolescent pregnant women are health practices during pregnancy, the mother's psychological condition, emotional and social support, sociodemographic and marital factors, pregnancy characteristics, and family and cultural background. Conclusion: Maternal-fetal attachment in adolescent pregnancy is influenced by psychological, social, and contextual factors. Strengthening psychosocial support and promoting healthy behaviors are essential to improve attachment and maternal well-being.
Copyright (c) 2026 Astika Astika, Endang Koni Suryaningsih, Anjarwati Anjarwati https://creativecommons.org/licenses/by-sa/4.0
Increasing haemoglobin level of pregnant women: potential of corn cookies and purple sweet potato cookies
Background: Iron deficiency anemia is common in pregnant women and can cause premature birth, low birth weight, and labor complications. Corn and purple sweet potatoes are foods rich in iron, folic acid, and antioxidants. Objective: The study aimed to determine the effect of consuming corn cookies and purple sweet potato cookies on increasing hemoglobin levels in pregnant women. Methods: The method used was a quasi-experimental design with a pre-post test only with a control group. After the initial hemoglobin examination (pre-test) in the three groups, an intervention was given: corn cookies and purple sweet potato cookies for 14 days in the intervention group, and a repeat Hb examination in the 3 groups (Post-Test). The study sample was 30 respondents and was analyzed using Kruskal-Wallis. Results: The results showed a statistically significant difference in average hemoglobin (Hb) value after treatment between the three study groups, namely the purple sweet potato cookies group (19.40), the corn cookies group (16.30), and the control group (10.80). The results of the calculation of the nutritional value of corn cookies per serving (100 gr), obtained energy results of 171.2 Kcal, Protein 3.66 g, Fat 11.94 g, carbohydrates 14.26 g, and Iron (Fe) of 1.32 mg while the nutritional value of purple sweet potato cookies per serving (100 gr), shows energy of 180.1 Kcal, protein 3.18 g, fat 12.22 g, carbohydrates 16.14 g, and Iron (Fe) of 1.58 mg. Conclusion: Purple sweet potato cookies and corn cookies have the potential to increase hemoglobin levels in pregnant women.
Copyright (c) 2026 Wa Ode Nurul Mutia, Hilda Sulistia Alam, Dahniar Dahlan https://creativecommons.org/licenses/by-sa/4.0
The effect of systemic chemotherapy on hematological profiles in lung cancer patients
Background: Cancer is a disease characterized by uncontrolled cell growth in one or both lungs originating from epithelial cells. In Indonesia, lung cancer ranks fourth among all cancer types and is the second leading cause of death after cardiovascular diseases. Management of lung cancer involves various therapeutic modalities, including surgery, radiotherapy, chemotherapy, and combination therapy. Certain chemotherapeutic agents, such as cisplatin and carboplatin, are known to have a narrow therapeutic index and high toxicity, so inappropriate regimen selection or dosing may result in serious adverse effects or even death. All chemotherapy agents carry the potential for toxicity, including both hematological and non-hematological effects, with hematological toxicities commonly manifesting as anemia, leukopenia, and thrombocytopenia of varying severity. Objective: This study aimed to determine the hematologic profile in patients after chemotherapy. Methods: This study was a descriptive research with a cross-sectional design using a total sampling technique. During the August-December 2023 period, 36 lung cancer patients met the inclusion criteria at Arifin Achmad Hospital, namely lung cancer patients with adenocarcinoma or squamous cell carcinoma who underwent advanced chemotherapy with a cycle of 21 days in the August-December 2023 period. Results: Of the 36 patients, 29 (80.56%) were male. The highest age of patients undergoing chemotherapy was ≥ 40 years (94.44%). Changes in the hematological profile after chemotherapy occurred in 14 patients (38.89%), with the most common hematological profile being anemia. Conclusion: The use of chemotherapy regimens can cause changes in the hematologic profile, including anemia, leukopenia, and thrombocytopenia.
Copyright (c) 2026 Amarudin Amarudin, Sri Melati Munir https://creativecommons.org/licenses/by-sa/4.0
Provision of complementary therapy of five-finger hypnosis and provision of education on anxiety in pregnant women
Background: Anxiety during pregnancy is common and may negatively affect both mother and fetus. Non-pharmacological approaches, such as relaxation and hypnosis, are increasingly recommended to minimize risks. Objective: This study aimed to assess the effect of five-finger hypnosis combined with health education on anxiety among pregnant women. Methods: A quantitative quasi-experimental study with a one-group pre- and post-test design was conducted at Community Health Center I, West Denpasar, from June to September 2024. Thirty pregnant women were recruited using purposive sampling. Anxiety was measured using the Indonesian version of the State Anxiety Inventory (S-AI). After baseline assessment, participants received education about pregnancy-related anxiety and danger signs, along with audio-visual videos demonstrating five-finger hypnosis. They were instructed to practice four times per week for one month with support from family members. Results: Results showed the proportion of mothers with moderate anxiety decreased, while most participants reported mild anxiety after the intervention (73.3%). In conclusion five-finger hypnosis had an impact on the anxiety levels of pregnant women, as indicated by a p-value of 0.001. Conclusion: The study concluded that anxiety disorders during pregnancy can be prevented or reduced by offering five-finger hypnosis and effective education as non-pharmacological treatments.
Copyright (c) 2026 Ni Wayan Sukma Adnyani, Ni Made Rai Widiastuti, Ni Ketut Ayu Sugiartini, Ni Nyoman Ayuk Widiani, Ni Made Ari Febriyanti https://creativecommons.org/licenses/by-sa/4.0
Ergonomic working positions with musculoskeletal disorders and work fatigue in lifting workers at a furniture company
Background: Furniture workers who lift and carry heavy loads face various ergonomic risks that impact their work performance and health. Field observations indicate that manual material handling is carried out conventionally with heavy and large loads without the use of assistive devices. This results in workers working in non-ergonomic positions. In addition, the high frequency of repetitive movements and the lack of education on correct lifting techniques increase the risk of fatigue and musculoskeletal disorders. Objective: This study aims to analyze the differences in work fatigue and musculoskeletal disorders in the ergonomic work positions of furniture workers. Methods: The study subjects were 60 male workers. Work fatigue was measured using a reaction time meter with millimeter (mm) units and a questionnaire. This study used an experimental design with a randomized controlled trial method. Data collection on musculoskeletal disorders used the Nordic Body Map (NBM) questionnaire. Results: Comparison of pre-employment and post-employment scores in the treatment group showed that the average value decreased from 719.63 mm before work to 235.07 mm after work. The average musculoskeletal disorders in the control group increased before and after work from 30.30 to 33.30 (p=0.001). These results indicate that ergonomic work position interventions can reduce fatigue and musculoskeletal disorders in lifters. Conclusion: Therefore, companies need to implement comprehensive work ergonomic standards including manual handling technique training for all workers, provision of lifting aids such as trolleys or hand trucks, and worker health monitoring as a preventive measure against work fatigue and musculoskeletal disorders.
Copyright (c) 2026 Sunarsieh Sunarsieh, Paulina Paulina, Indah Nurdiana Setya Rahmawati https://creativecommons.org/licenses/by-sa/4.0
Microbial safety and stability of avocado–turmeric oil-based herbal milk as a basis for food safety education in public health promotion
Background: Herbal milk formulated with avocado oil and turmeric is a functional beverage with potential health benefits, but its microbiological safety requires evaluation to determine appropriate storage conditions. Objective: This study aimed to analyze the effects of storage temperature and duration on total bacterial count (Total Plate Count/TPC) as well as the presence of Escherichia coli, coliforms, Staphylococcus aureus, and Enterobacteriaceae. Methods: A laboratory experimental design using a factorial Completely Randomized Design (CRD) was applied, involving two factors: storage temperature (4°C, 25°C, and 40°C) and storage duration (0, 3, and 7 days). Results: The results showed that storage at 4°C effectively affected microbial growth, indicated by a decrease in TPC from 5.51 log CFU/mL to 2.57 log CFU/mL on day 7. In contrast, storage at room temperature (25°C) and elevated temperature (40°C) led to increased microbial activity during the first three days. Conclusion: Overall, storage at 4°C is recommended as the safest condition, with a maximum storage duration of seven days to maintain the microbiological safety and stability of the avocado–turmeric herbal milk.
Copyright (c) 2026 Sri Winarni, Annasari Mustafa, Atik Kurniawati https://creativecommons.org/licenses/by-sa/4.0
The antifungal potential of rice straw (Oryza sativa) extract against the growth of pathogenic fungi
Background: Opportunistic fungal infections such as Candida albicans and Aspergillus fumigatus are increasing, particularly among immunocompromised patients. The use of synthetic antifungal agents is often limited by side effects, resistance, and high costs, thus alternatives from natural sources are needed. Rice straw (Oryza sativa L.), an agricultural by-product rich in bioactive compounds, has been reported to possess antibacterial activity; however, its potential as an antifungal agent has not been extensively investigated. Objective: This study aimed to evaluate the antifungal potential of rice straw (Oryza sativa L.) extract against the growth of two pathogenic fungi, Candida albicans and Aspergillus fumigatus. Methods: The research was conducted experimentally in a laboratory with a quantitative approach. Extraction of rice straw was carried out using maceration with 96% ethanol, followed by fractionation with n-hexane, ethyl acetate, and n-butanol solvents based on polarity differences. Antifungal activity was tested using the well diffusion method, with inhibition zone measurements as an indicator of effectiveness. Results: The results showed that ethyl acetate and n-butanol fractions exhibited significant antifungal activity against Candida albicans and Aspergillus fumigatus, as evidenced by the largest inhibition zones at a concentration of 7%. The ethyl acetate fraction demonstrated an average inhibition zone of 18.25 mm against Candida albicans and 12.83 mm against Aspergillus fumigatus. Conversely, the n-hexane fraction did not show antifungal activity. Statistical analysis using one-way ANOVA revealed significant differences among concentrations and fraction types. Conclusion: This study concludes that rice straw extract, particularly the ethyl acetate fraction, possesses potential as a natural antifungal agent effective against pathogenic fungi, and may be further developed for traditional plant-based therapy.
Copyright (c) 2026 Ahmad Purnawarman Faisal, Masniah Masniah https://creativecommons.org/licenses/by-sa/4.0
Psychological effects of People Affected by Leprosy (PAL) and social reintegration strategies
Background: Leprosy is a chronic infectious disease that has an impact not only on the physical but also psychosocial aspects of its survivors. Even though they have been declared medically cured, people affected by leprosy still face stigma and discrimination that hinder social reintegration. This is reflected in the high number of leprosy cases in Indramayu Regency, which reached 3,777 cases in. Objective: This study aimed to analyze the psychological effects experienced by People Affected by Leprosy (PAL) and its relationship with the social reintegration process in Indramayu Regency. Methods: The research used a quantitative design with a descriptive-analytical survey approach. The sample was determined through purposive sampling technique with a total of 208 PAL respondents who had been declared medically cured and had post-treatment social interaction experience. Data collection was carried out using online and offline questionnaires with the assistance of field cadres and health workers. Data analysis includes descriptive statistics, Chi-Square tests, and Spearman correlation. Results: The results showed that the majority of respondents experienced significant psychological impacts, including shame (90.9%), low self-esteem (95.4%), loss of zest for life (77.3%), fear of social rejection (68.2%), and experiences of discrimination (72.8%). Bivariate analysis showed that shyness, low self-esteem, fear of rejection, and experiences of discrimination were significantly associated with social reintegration (p<0.05), while family support and community acceptance were positively associated with the reintegration process. Conclusion: This research confirms that PAL social reintegration requires community-based multidimensional interventions, strengthening family support, and sustainable public education to reduce stigma and discrimination.
Copyright (c) 2026 Priyanto Priyanto, Nengsih Yulianigsih https://creativecommons.org/licenses/by-sa/4.0
Optimizing the use of partographs by midwives in early detection of labor complications: analysis of influencing factors
Background: The use of partographs in obstetric care is an important topic, especially in low- and middle-income countries, including Indonesia, which face high maternal and neonatal mortality rates. Objective: This study aimed to explore and analyze factors influencing midwives' use of the partograph for early detection of labor complications. Methods: This study employed a non-experimental quantitative approach with a cross-sectional design to analyze factors influencing partograph use by midwives. The study population was 135 midwives in Hulu Sungai Utara Regency, with a sample of 101 midwives determined using a simple random sampling technique. The dependent variable was partograph utilization, while the independent variables included midwives' knowledge, attitudes, motivation, perception of supervision, training, length of service, age, and education level. Data were collected through a structured questionnaire and observation sheet. Data analysis used the chi-square test and multiple logistic regression to identify relationships between variables influencing partograph utilization. Results: The education was significantly associated with partograph utilization (p=0.001; OR 6.0), with midwives with higher education being more likely to use it. Conversely, length of service ≥5 years was associated with decreased partograph utilization (p=0.000; OR 0.05). In addition, motivation (p=0.002; OR 1.6) and supervision (p=0.032; OR 1.7) also positively influenced partograph use. The logistic regression model showed that higher education increased the probability of partograph use (Exp(B)=11.172), while longer work experience decreased the probability (Exp(B)=0.028). Conclusion: Higher education significantly increased partograph use, while work experience above 5 years decreased its use. Motivation and supervision also positively contributed to optimal partograph use.
Copyright (c) 2026 Erni Yuliastuti, Fathurrahman Fathurrahman, Rafidah Rafidah, Syahrianti Syahrianti, Sultina Sarita, Dina Rosana https://creativecommons.org/licenses/by-sa/4.0
Social support and coping strategies as predictors of marital interaction in couples experiencing unintended pregnancy
Background: Unintended pregnancy (UP) is a reproductive health problem that can undermine psychological well-being, social functioning, and family dynamics, particularly marital interaction. Objective: This study aimed to analyze the extent to which social support and coping strategies predict the quality of marital interaction among couples experiencing UP. Methods: A cross-sectional design was employed involving 200 couples from Bekasi City and Bekasi Regency, Indonesia, selected using purposive sampling. Data were collected through structured interviews using standardized questionnaires and analyzed with Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: The results showed that most couples reported low levels of social support and marital interaction, while coping strategies were generally at a moderate level. Social support had a significant positive effect on both coping strategies (p < 0.01) and marital interaction (p < 0.01), and coping strategies also had a significant positive effect on marital interaction (p < 0.05). Conclusion: These findings highlight the importance of strengthening social support networks and enhancing adaptive coping skills to improve marital quality and foster family resilience in the context of unintended pregnancy.
Copyright (c) 2026 Nia Reviani, Ujang Sumarwan, Tin Herawati, Lilik Noor Yuliati https://creativecommons.org/licenses/by-sa/4.0
The effects of heat treatment files and taper lock depth on the torsional fatigue resistance of rotary NiTi instruments
Background: A file fracture is a significant complication in endodontic treatment, particularly when it obstructs access to the apical root canal. The primary cause is torsional fatigue, occurring when applied force exceeds the elastic limit of NiTi alloys. Heat-treated rotary files have been developed to improve torsional resistance. Objective: To compare the time to fracture due to torsional fatigue between gold and blue heat-treated rotary files under taper lock conditions. Methods: A total of 48 heat-treated rotary files (#25.04) were embedded in bulk-fill composite resin blocks to simulate taper lock. Samples were randomly divided into eight groups (n=6): E-Flex Gold (3 mm, 5 mm), EndoArt Smart Gold (3 mm, 5 mm), E-Flex Blue (3 mm, 5 mm), and EndoArt Smart Blue (3 mm, 5 mm). Torsional fatigue time was recorded from the start of rotation using an endomotor until fracture occurred. Results: One-way ANOVA revealed a statistically significant difference in torsional fatigue time among groups (p<0.05). Conclusion: Blue heat-treated rotary files showed longer fracture times and may be safer in high taper lock conditions, although results are limited by the in vitro resin model.
Copyright (c) 2026 Viola Shelvannia Haryanto, Rosita Stefani, Eddy, Bernard Ongkie Iskandar https://creativecommons.org/licenses/by-sa/4.0
The influence of the use of the SiANEH application on mothers’ independence in monitoring the growth and development of toddlers
Background: Stunting is a significant health issue in Indonesia, affecting children's physical and cognitive development, as well as their future quality of life. One key strategy for preventing stunting is ensuring optimal monitoring of toddlers' growth and development. Objective: This study examined the impact of the Android application "SiANEH" on monitoring growth, development, and stimulation, aiming to improve mothers' independent practices in stunting prevention efforts in Kutalimbaru Village, Deliserdang Regency. Methods: A quasi-experimental design with a quantitative analytical approach was used, specifically a one-group pretest-posttest design. The research was conducted in Kutalimbaru Village, with a sample of 30 mothers of toddlers selected via purposive sampling. The study measured mothers' independent practices in monitoring growth and stimulating toddlers, utilizing the "SiANEH" app, which provides information on child development and reminders for stimulation. Data were collected through observation and completion of observation sheets. The research instruments were validated for content and reliability before application, and ethical approval was obtained from the Health Research Ethics Committee of Poltekkes Kemenkes Medan. Results: The results revealed a positive and significant effect of the "SiANEH" app on child growth monitoring (r=0.532, p= 0.002), child stimulation (r=0.790, p= 0.000), and maternal independence in monitoring and stimulation (r=0.534, p= 0.002). Pretest scores for growth monitoring (1.57) and stimulation (1.60) increased significantly in the posttest (3.40 and 3.70, respectively), as did maternal independence (from 1.80 to 3.60). Conclusion: These findings indicate that the "SiANEH" application enhances mothers' involvement in independently monitoring and stimulating child development, contributing to stunting prevention.
Copyright (c) 2026 Nilda Yulita Siregar, Arihta Br. Sembiring, Eva Mahayani Nasution, Herni Kurnia, Siti Julianita Siregar Siregar https://creativecommons.org/licenses/by-sa/4.0
Forced Vital Capacity (FVC) and heat stress with work fatigue in field workers at PT X
Background: The rapid development of industry demands improvements in both the quality and quantity of production, which often burdens workers. Field workers, particularly at PT X, are exposed to various environmental factors that may affect pulmonary function, while heat stress significantly contributes to work fatigue. Objective: This study aimed to evaluate the relationship between forced vital capacity and heat stress with work fatigue among field workers at PT X. Methods: An analytical observational design with a cross-sectional method was employed, involving 32 field workers as research subjects. Forced vital capacity was measured using a Chestgraph Spirometer, heat stress was measured using a QuestTemp Heat Stress Monitor, and work fatigue was measured using a Reaction Timer. Data analysis was conducted using the chi-square test to determine the relationship between forced vital pulmonary capacity and heat stress with work fatigue. Results: The results showed a significant relationship between forced vital pulmonary capacity and work fatigue (p = 0.011), as well as between heat stress and work fatigue (p = 0.014). Conclusion: These findings were important as they provide an overview of workers’ physiological conditions that can influence occupational safety and productivity. It is recommended that companies routinely evaluate working conditions and workers’ health, and provide early training and heat stress management to prevent work fatigue and improve workers’ well-being.
Copyright (c) 2026 Reni Wijayanti, Sumardiyono, Maria Paskanita Widjanarti, Bachtiar Chahyadhi, Farhana Syahrotun Nisa Suratna, Rachmawati Prihatina Fauzi, Yeremia Rante Ada https://creativecommons.org/licenses/by-sa/4.0
Validity and reliability test of an Electric Knee Height Measuring Device (EKHMD) predicting body height and nutritional status
Background: Direct height measurement is often difficult in immobilized patients. Knee height measurement becomes an alternative, thus encouraging the development of an electronic knee height measuring device (EKHMD). Objective: The aim of this study was to determine the validity and reliability of the EKHMD in estimating knee height, height, and nutritional status. Methods: This study used a quantitative approach with 30 healthy adults (15 men, 15 women) through purposive sampling. Anthropometric measurements used the EKHMD and a microtoise as standards. Validity was assessed using Pearson or Spearman correlation tests, agreement or accuracy using Bland–Altman plot analysis, and reliability using Cronbach-Alpha. Results: The results of the validity test showed that knee height measurements (r = 0.929), estimated height (r = 0.863 (sitting), r = 0.869 (lying down), and nutritional status (r = 0.952 (sitting), r = 0.970 (lying down) with significance for all variables (p = 0.00) which means that EKHMD correlated strongly with microtoise measurements (p < 0.05). Accuracy analysis using Bland–Altman measurements was in the range of Upper LoA and Lower LoA knee height (2.13 – (-1.43 cm)), estimated height (7.89 – (-9.05) cm (sitting) 0.049 (-0.029) cm (lying down)), and nutritional status (2.35 – (-2.01) (sitting), 0.06 – (-0.023) (lying down)) and Cronbach’s Alpha showed high reliability (p > 0.60), knee height (p=0.61), estimated height ((p=0.936 (Sitting), p=0.928 (Lying)), and nutritional status (p=0.983 (Sitting), p=0.984 (Lying)). Conclusion: Thus, EKHMD can be considered as a tool to measure estimated height and nutritional status but still needs to be developed further.
Copyright (c) 2026 Alfian Abdul Rajab, Fista Utami https://creativecommons.org/licenses/by-sa/4.0
Eco enzyme mixture of sludge sediment treatment reduces BOD, COD, TSS, and detergent content in greywater
Background: Household activities generate greywater containing pollutants such as BOD, COD, TSS, and detergents, contributing to environmental pollution. Eco enzyme offers a biological alternative to degrade organic waste. Objective: This study aimed to evaluate the effectiveness of the eco enzyme combined with sludge sediment in reducing greywater pollutants. Methods: A true experimental study with a pretest–posttest control group design was conducted using four greywater reactors. Eco enzyme doses of 10 ml, 30 ml, and 50 ml per 1000 ml of wastewater were tested, along with a control. The eco enzyme was mixed with 1.5 liters of sludge sediment. The detention time was three days. Sampling was performed once per treatment using purposive sampling. Parameters analyzed included BOD, COD, TSS, and detergents based on SNI standards. Data were analyzed using one-way ANOVA. Results: The treatment showed no significant effect on BOD reduction (p=0.48), but significantly reduced COD (p=0.01) and TSS (p=0.0001). Detergent reduction was moderate, with the 50 ml dose being the most effective, although not statistically significant (p=0.07). Conclusion: Eco enzyme combined with sludge sediment has potential as a simple biological treatment to reduce COD, TSS, and detergents in greywater. However, additional processes such as aeration are needed to effectively reduce BOD. This research can be the basis for the development of advanced research that can apply eco enzymes to waste, with a longer time and more varied dosage use.
Copyright (c) 2026 Pratiwi Hermiyanti, Fitri Rokhmalia, Putri Arida Ipmawati, Rizki Amalia https://creativecommons.org/licenses/by-sa/4.0
Lifestyle and environmental stress as determinants of hypertension development in rural Indonesia: a multinomial logistic regression analysis
Background: Global evidence indicates that lifestyle behaviors and environmental stress contribute to blood pressure regulation; however, studies examining their combined effects on hypertension severity, particularly in rural Indonesian populations, remain limited. Objective: This study addresses this gap by applying multinomial logistic regression to predict hypertension stages and examine interactions between lifestyle and environmental stress. Methods: A cross-sectional study was conducted among 373 adults with hypertension aged ≥45 years in three rural villages in Kuningan Regency, Indonesia, selected through purposive sampling. Lifestyle behaviors and environmental stress were assessed using validated questionnaires with acceptable internal consistency (Cronbach’s α> 0.70). Blood pressure was classified into Stage 1, Stage 2, and Stage 3 hypertension. Multinomial logistic regression analyses adjusted for age, sex, body mass index, and hypertension duration were performed to estimate main and interaction effects. Results: The model demonstrated strong predictive validity (χ²= 174.10; p< 0.001). A healthy lifestyle was significantly associated with higher odds of Stage 1 (OR= 30.04) and Stage 2 hypertension (OR= 11.45) compared with Stage 3. Mild to moderate environmental stress also showed a protective association with hypertension severity (p< 0.01). A significant lifestyle–stress interaction (p< 0.05) indicated that a healthy lifestyle attenuated the adverse effects of severe stress, maintaining a high predicted probability of milder hypertension (0.67). Conclusion: These findings provide empirical evidence from rural Indonesia that lifestyle behaviors and environmental stress function as independent and interactive predictors of hypertension severity, supporting adaptive and health promotion frameworks and community-based interventions aligned with Sustainable Development Goal 3.
Copyright (c) 2026 Lia Mulyati, Linda Rosalia, Yana Hendriana https://creativecommons.org/licenses/by-sa/4.0
Correlation between coping mechanisms and the burden experienced by caregivers of cancer patients
Background: Caregivers of breast cancer patients are at risk of experiencing a high caregiver burden due to prolonged physical, emotional, and social demands. Coping responses play an important role in determining how caregivers manage these challenges. Objective: The study aimed to analyze the relationship and caregiver burden in caring for breast cancer patients. Methods: This study employed a quantitative cross-sectional design involving 200 caregivers of breast cancer patients. Inclusion criteria were age ≥18 years, good health status, active involvement in caregiving, and the ability to read Indonesian. Data were collected from August to December 2024 using a demographic questionnaire, the Coping Orientation to Problems Experienced (COPE), and the Indonesian version of the Zarit Burden Interview (ZBI). Data were analyzed using the chi-square test. Most caregivers with maladaptive coping experienced a high caregiver burden (79.8%), while only 20.2% of caregivers with adaptive coping reported a high burden. Results: Statistical analysis showed a significant association between coping responses and caregiver burden (p = 0.001). Conclusion: Caregivers who used maladaptive coping strategies had a significantly higher likelihood of experiencing a high caregiver burden compared with those who used adaptive coping strategies. Coping responses are significantly associated with caregiver burden among caregivers of breast cancer patients. Strengthening adaptive coping strategies through caregiver-focused interventions is essential to reducing caregiver burden and supporting optimal patient care.
Copyright (c) 2026 Mey Lona Verawaty Zendrato, Astika Irmawaty Sigalingging, Ni Putu Ika Novita Gunawan https://creativecommons.org/licenses/by-sa/4.0
Association of medication adherence with clinical outcomes and quality of life in type 2 diabetes mellitus patients: a cross-sectional study
Background: Type 2 diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels. Patient adherence to medication is a critical factor in effective management, as it can reduce morbidity and mortality while improving health-related quality of life (HRQoL). Digital interventions, such as smartphone-based medication reminder applications, represent a promising strategy to enhance adherence. Objective: This study aimed to examine the relationship between medication adherence and clinical outcomes, specifically fasting blood glucose levels and HRQoL, among patients with type 2 diabetes in primary health care settings. Methods: A cross-sectional pre–post test design was employed involving 96 respondents, divided equally into control and intervention groups, selected through convenience sampling. Primary data were collected using the MARS-10 adherence questionnaire and the DQOL Brief Clinical Inventory, while secondary data were obtained from pre– and post–fasting blood glucose measurements. Results: Results showed no significant relationship between medication adherence and fasting blood glucose levels (p > 0.05), nor between adherence and HRQoL (p > 0.05), even with the implementation of the Drug Reminder App intervention. Conclusion: These findings highlight the need for additional interventions or further innovations in digital adherence support to improve clinical and quality-of-life outcomes in type 2 diabetes management.
Copyright (c) 2026 Selly Septi Fandinata, Deddy Aryanda Putra; Eziah Ika Lubada; Silfiana Nisa Permata Sari, Chinthia Devientasari, Iin Ernawati, Mercyska Suryandari, Dini Berliana https://creativecommons.org/licenses/by-sa/4.0
Analysis of the differences in the quality of briquettes made from durian peel and young coconut shells as an alternative energy source
Background: Durian peel and young coconut shells are abundant organic waste in Bengkulu City. Up to 80% of coastal waste consists of coconut shells, while durian peel waste can reach 1.5–2 tons/day during harvest season. Poor management contributes to environmental pollution. Converting this waste into biochar briquettes offers a sustainable solution. Objective: To compare the quality of briquettes from durian peel and young coconut shells based on moisture, ash, fixed carbon, volatile matter, and calorific value. Methods: A quasi-experimental (posttest-only) design was used. Briquettes were produced from durian peel and coconut shell charcoal with 5% tapioca binder (300 g per treatment). Results: Coconut shell briquettes showed better quality, with moisture 3.33%, ash 6.33%, fixed carbon 85.96%, volatile matter 4.38%, and calorific value 5922 cal/g. Durian peel briquettes had moisture 2.38%, ash 11.37%, fixed carbon 81.49%, volatile matter 4.77%, and calorific value 5398 cal/g. Coconut shell briquettes met SNI 1/6235/2000 standards, and all parameters differed significantly (p < 0.05). Conclusion: Coconut shell briquettes are more efficient as a solid fuel, while durian peel briquettes remain potential when combined with other biomass. This study supports the use of organic waste as a renewable energy source and contributes to sustainable environmental management in Indonesia.
Copyright (c) 2026 Andriana Marwanto, Mualim Mualim, Rosalia Rina Bathari https://creativecommons.org/licenses/by-sa/4.0