Proceedings of International Conference on Health Science, Practice, and Education

COMMUNITY BASED APPROACH DEVELOPMENT FOR AVIAN INFLUENZA PREVENTION IN SEMARANG CITY

2026-07-10T21:43:55+07:00

Avian influenza (AI) remains a persistent public health concern in Indonesia due to its zoonotic potential and recurrent outbreaks among poultry and humans. Household-scale poultry farmers are particularly vulnerable, necessitating effective community-based prevention strategies. This study aimed to develop and evaluate a community-based intervention model for avian influenza prevention. A Research and Development (R&D) approach was applied through five stages: preliminary exploration, model design, expert validation, pilot testing, and effectiveness evaluation. Ninety household poultry farmers in Gunungpati District, Semarang City, Central Java, participated in the study. Data were collected using questionnaires, interviews, observations, and expert assessments. Paired test results showed a significant increase in knowledge, attitudes, practices, self-efficacy, and health commitment in the intervention group (p < 0.05), while no significant changes were observed in the control group. These findings suggest that community-based interventions are particularly effective in promoting practical behavioral change rather than immediately altering attitudes or long-term commitment. In conclusion, the proposed community-based model demonstrates potential as an effective strategy for avian influenza prevention among small-scale poultry farmers. Further adaptation and multisectoral collaboration are recommended to enhance community resilience against zoonotic threats.

Cost-Effectiveness Analysis of Telemedicine Implementation in the Management of Non-Communicable Diseases in Hospitals

2026-07-10T21:48:00+07:00

Non-communicable diseases (NCDs) remain the leading cause of morbidity and mortality, necessitating continuous and efficient care delivery. Telemedicine has emerged as an innovative approach to enhance healthcare accessibility, efficiency, and patient adherence. This study analyzes the costeffectiveness of telemedicine implementation in managing chronic diseases within hospital settings using a mixed-method design with a sequential explanatory approach. Quantitative data were obtained through Cost-Effectiveness Analysis (CEA) of inpatient records for NCD patients over one semester, while qualitative insights were derived from in-depth interviews with hospital managers, Hospital Management Information System (HMIS) teams, and Electronic Medical Record (EMR) administrators. Findings indicate that telemedicine could potentially reduce 19 hospitalizations, with an incremental cost of IDR 134.1 million and an average Incremental Cost-Effectiveness Ratio (ICER) of IDR 7.1 million per avoided admission. The highest cost-effectiveness was observed in ischemic heart disease cases (ICER IDR 6.8 million), offering additional benefits such as time efficiency, shorter queues, and lower transportation costs. Nonetheless, barriers were identified in financing policies, human resource preparedness, and network infrastructure. In conclusion, telemedicine demonstrates relative cost-effectiveness in NCD management, particularly for ischemic heart disease and type 2 diabetes mellitus, highlighting the need for strengthened policies, infrastructure, and workforce capacity to support sustainable implementation.

Effectiveness and Implementation of PROLANIS for Hypertension in Indonesia: A Systematic Review with RE-AIM Synthesis

2026-07-10T21:52:08+07:00

Hypertension remains a major disease burden in Indonesia; the national chronic disease management program (PROLANIS) in primary care is positioned as a key strategy. Heterogeneous field performance highlights the need for a systematic review of clinical effectiveness and implementation quality. This study aims to synthesize evidence on PROLANIS effects on blood pressure control and to map implementation factors moderating results in first-level health facilities. Systematic literature review following PRISMA 2020. Data sources were Scopus and PubMed (2014–2025). Records identified: 770; after de-duplication/retraction removal, 711 remained for screening; 85 passed title screening; 11 full-text articles were included. Dual-reviewer extraction; appraisal with JBI/CASP/MMAT; effectiveness synthesized with SWiM; implementation factors mapped using RE-AIM. Results. Evidence suggested a favorable direction of effect on blood pressure control and adherence, especially when structured pharmacist counseling, regular monitoring, and physical activity were implemented consistently. Cohort/quasi-experimental studies supported reductions in SBP/DBP and improved adherence; HRQoL tended to improve but was not always statistically significant. RE-AIM mapping indicated that reach/retention, inter-professional adoption, medicine/equipment availability, and documentation fidelity influenced between-facility variation. In conclusion, PROLANIS can improve hypertension outcomes when core components are well executed and documented. Policies linking minimum process indicators (counseling, monitoring, retention) to performance-based incentives may enhance implementation consistency and sustainability.

A Bibliometric Analysis of Global Research Trends on Adolescent Obesity Interventions (2005-2025)

2026-07-10T21:53:38+07:00

The global rise in adolescent obesity presents a pressing public health concern, with long-term implications including metabolic disorders and psychosocial challenges. Despite the growing urgency for practical and evidencebased interventions, existing literature remains fragmented and lacks systematic synthesis. This study aims to provide a comprehensive bibliometric overview of research trends, thematic dynamics, and emerging hotspots in adolescent obesity interventions over the past two decades (2005-2025). Data were retrieved from the Scopus database and analyzed using Microsoft Excel, VOSviewer, and Harzing’s Publish or Perish. A total of 661 publications met the inclusion criteria. The findings reveal a significant increase in research productivity, peaking between 2012 and 2019. The United States emerged as the most prolific contributor, with the highest volume of international collaborations. Eaton et al. were the most cited authors in 2012, while Kelishadi, R. was the most productive, contributing 14 publications. Keyword evolution analysis indicates a shift in focus: between 2015 and 2020, dominant themes included sugar-sweetened beverages, fruit and vegetable intake, and unhealthy diets, particularly in high-income countries. From 2020 to 2025, attention shifted toward social media, sedentary behavior, sex-based factors, and healthy lifestyle promotion. These findings underscore the evolving landscape of adolescent obesity research and the need for targeted, context-sensitive interventions.

Predictive Model of the Impact of Digital Health Infrastructure on Health Equity in Developing Regions

2026-07-10T21:55:44+07:00

Health equity in developing regions is constrained by limited access and unequal distribution. Digital health infrastructure offers a strategic opportunity to reduce these disparitas. This study aimed to develop and test a predictive model examining the impact of digital health infrastructure on health equity mediated by service accessibility and service qualty. A quantitative study involving 300 healthcare stakeholdersfrom twelve developing regions in Indonesia was conducted. Data collected by validated questionnaires were analyzed using multiple linear regression. Results showed digital health infrastructure significantly predicts improved service accessibility and quality, which in turn significantly predict higher health equity. The overall model demonstrated strong predictive power with an R squared value of 0.59, indicating that fifty-nine percent of the variance in health equity was explained by the predictor variables. These findings confirm that digital health infrastructure enhances health equity primarily through improvements in accessibility and service quality. This study contributes theoretically by offering a regression-based predictive model and practically by providing guidance for policymakers and healthcare managers to align technological investments with strategies for equitable service distribution.

Perceived Usefulness and Ease of Use on Behavioral Intention to Use Electronic Signatures at a Dental Hospital

2026-07-10T22:00:40+07:00

The adoption of electronic signatures (e-signatures) is a key component of digital transformation in healthcare services, aiming to improve administrative efficiency and data security. This study investigates the impact of Perceived Usefulness (PU) and Perceived Ease of Use (PEOU) on the Behavioral Intention to Use (BIU) e-signatures at the Dental Hospital of Universitas Muhammadiyah Semarang, using the Technology Acceptance Model (TAM). A cross-sectional quantitative method was applied, involving 30 staff selected through purposive sampling. Data were collected via questionnaires and analyzed using multiple linear regression. Results showed that both PU and PEOU significantly influenced BIU (p<0.001), with a combined explanatory power of 62.7%. PU (β=0.617) was the most dominant factor, indicating that perceived practical benefits are the main driver of adoption. PEOU (β=0.310) also had a significant effect, highlighting the importance of system simplicity and usability. The study concludes that successful implementation of e-signatures depends largely on user perception. Emphasizing the functional advantages of the system and providing a user-friendly interface with adequate support and training are essential steps. These findings serve as a reference for broader digital technology adoption in healthcare, reinforcing that user acceptance is critical to the success of digital transformation initiatives.

Path Analysis of Technology Integration and Social Systems on the Quality of Primary Healthcare Services

2026-07-10T22:35:07+07:00

The transformation of primary healthcare services in the digital era requires not only the adoption of technology but also the strength of social systems capable of integrating and sustaining innovation. This study aims to analyze how technology integration and social systems jointly influence the quality of primary healthcare services and to examine the mediating role of social systems in enhancing the effectiveness of technology adoption. This study applied a quantitative approach using Structural Equation Modeling (SEM). A total of 250 respondents, consisting of healthcare professionals and administrative staff from 15 urban community health centers, participated in the survey. Standardized questionnaires were employed to measure the constructs of technology integration, social systems, and primary healthcare service quality. Data were analyzed using AMOS to examine both direct and indirect pathways among variables. The path analysis results indicated that technology integration significantly influenced service quality (p < 0.001). Social systems also had a direct and significant effect on service quality (p < 0.01). Moreover, technology integration exerted a significant effect on social systems (p < 0.001), creating an indirect mediating effect on service quality (β = 0.19). The model demonstrated excellent fit indices (χ²/df = 1.89; CFI = 0.95; TLI = 0.94; RMSEA = 0.046). These findings indicate that improving primary healthcare quality depends not only on digital technology adoption but also on the mediating role of social systems in maximizing its impact. This study contributes an empirical SEM-based model that enriches theoretical understanding and provides practical guidance for healthcare managers to balance technological investments with organizational culture and human resource development for sustainable quality improvement.

Systematic Literature Review: Benefits of Fe Tablets for Adolescents

2026-07-10T22:36:09+07:00

Iron tablets act as iron supplements. Iron is a mineral needed to form red blood cells. Iron deficiency can lead to anemia. Anemia is a disease caused by a lack of hemoglobin (Hb), which occurs when red blood cells are insufficient to supply oxygen to tissues. This systematic review aims to systematically examine the benefits of iron tablets for adolescents. The research method used was a systematic literature review sourced from PubMed and Scopus databases spanning 2014-2024. Six articles analyzed revealed that iron tablets are beneficial for adolescents in increasing blood hemoglobin levels and preventing anemia.

Integrating Technology, Social Systems, and Equity for Reducing Health Disparities: a Bibliometric Review (2014-2024)

2026-07-10T22:44:01+07:00

Health disparities persist due to systemic factors that negatively affect disadvantaged groups worldwide. Digital health technologies hold potential for addressing these issues but integrating them with social systems requires a deeper understanding of how they can promote equity. This study examines the current state of knowledge on technology, social determinants, and health equity through a bibliometric analysis of published research in PubMed (2014-2024). Methods: we are using R packages from the Bibliometrix suite software, we analysed 1384 papers to identify key trends, clusters, and conceptual connections. Results of the study show three main themes emerged: digital health equity, technology-driven interventions for marginalized populations, and integrating social determinants of health (SDOH) into health information systems (HIS). Although some solutions showed promise, they often failed to address the underlying social factors that contribute to health disparities. Conclusion: Transforming health systems requires a shift towards socio-technical approaches that prioritize equity from the outset. Future research should involve stakeholders from diverse backgrounds and focus on evaluating the impact of interventions on reducing health inequalities.

The Effectiveness of Community-Based Family Planning Village Policies in Addressing Population Issues in Indonesia

2026-07-10T22:42:28+07:00

Demographic issues such as high birth rates, early marriage, and low public awareness of family planning programs remain significant challenges in developing countries, including Indonesia. The Family Planning Village program is regulated by national laws and policies as part of a broader strategy to address population and reproductive health challenges. Although the program has been widely implemented nationwide, empirical evidence on its effectiveness and implementation dynamics at the local level remains limited. This study provides novel insights by evaluating the effectiveness of the Family Planning Village program in Sumedang Regency and identifying supporting and inhibiting factors in rural areas. A descriptive qualitative approach was employed through structured interviews, field observations, and document reviews. Data were analyzed using George C. Edward III's policy implementation framework, which encompasses communication, resources, disposition, and bureaucratic structure. The results indicated that the policy was relatively effective in increasing contraceptive use, strengthening community participation, and promoting cross-sectoral collaboration. However, key obstacles included limited funding, inadequate cadre training, and suboptimal inter-agency coordination. These findings contribute to the growing evidence that community-based approaches can be effective strategies for addressing demographic challenges in rural Indonesia.

ECOLOGICAL AND HEALTH RISKS OF MERCURY EXPOSURE (A Systematic Literature Review)

2026-07-10T22:45:23+07:00

Mercury, also known as quicksilver, is a liquid metal that is silver in color, odorless, shiny, a good electrical conductor, with a freezing point in the range of -38.9°C and a boiling point in the range of 357°C. Mercury is a heavy metal that is highly toxic and easily mixes with enzymes in the human body, resulting in the loss of enzyme ability as a catalyst for important bodily functions. Mercury has the unique ability to combine with other elements to form organic and inorganic compounds. Exposure to increased levels of organic and inorganic mercury can damage the brain, kidneys, and developing fetus. Furthermore, higher levels of mercury exposure over a shorter period can cause damage to the lungs, increased heart rate, vomiting, diarrhea, nausea, and skin rashes. Metals are always found in both fresh and saltwater, although in small amounts. Some types of metals, whether light or heavy, are present in small quantities in water under normal conditions. Heavy metals in water are rarely in atomic form but are bound to other compounds, forming molecules. The objective of this literature study is to analyze the ecological and health risks of mercury exposure in order to obtain recommendations related to control and use efforts. The literature review used a comprehensive strategy in searching for journals both nationally and internationally. This literature review was written based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search strategy utilized electronic databases such as ScienceDirect, ResearchGate, Google Scholar, SemanticScholar, and Springerlink. The keywords used were "Hg pollution" for the search in international journals, and "Risk Exposure of Hg" and "environmental health" for the search in general. The search results were then filtered based on full text availability and publication date from 2016 to 2022, resulting in 1005 articles that were considered relevant. These articles will be further screened based on inclusion criteria for the systematic literature review.

Determinants of Community Participation in the National Health Insurance Scheme: Evidence from RTSU Public Health Service in Pandan, Sintang Regency of West Kalimantan

2026-07-10T23:13:43+07:00

The social health insurance system is a principle of solidarity between workers and employers, and there is a guarantee of access to health services for the entire population. The coverage of participants is high, but the level of participant activity in paying contributions still needs to be increased, with a minimum target of 75% active participants. The aim of this study is to explain the factors related to BPJS Health participation in the RTIU Pandan Health Center Work Area, Sintang Regency, West Kalimantan. Quantitative research method with a cross-sectional approach using chi-square test analysis with a 95% confidence level and a 5% error rate, so the number of samples required is around 100 respondents. The results of the study showed that paying BPJS health (p value = 0.001 and OR = 9.257), family members of BPJS health participants (p value = 0.001 and OR = 10.147), BPJS health information (p value = 0.001 and OR = 9.091), Service Users (p value = 0.001 and OR = 9.091), Health Services (p value = 0.008 and OR = 5.179) with BPJS Health participation. The most dominant variable related to BPJS Health participation is family members of BPJS Health participants (OR = 6.046) followed by the variable of paying BPJS Health (OR = 4.665) and users of health services (OR = 4.050). In conclusion, there is a relationship between paying BPJS health, family members of BPJS health participants, BPJS health information, service users, health services and BPJS health participation.

The Relationship between Spiritual Intervention and Physical Exercise on Quality of Life of Cancer Survivors: A Bibliometric Analysis

2026-07-10T23:15:39+07:00

Quality of life in cancer survivors is a primary concern in holistic health interventions. Recent research suggests that an integrative approach—combining spiritual interventions and physical activity—has the potential to significantly impact the physical, psychological, and spiritual well-being of cancer survivors. However, there is still a gap in the exploration of local culture-based interventions, such as qosidah therapy and dhikr, in the global scientific literature. This study aims to map global trends, key themes, and research gaps in the field of spiritual and physical interventions on the quality of life of cancer survivors using a bibliometric approach, to support the development of more contextual and integrative therapy models. This study uses a quantitative descriptive design with a bibliometric approach. Data were obtained from 650 scientific publications indexed in the Scopus database during the period 2015–2024, using a combination of keywords such as spiritual intervention, mind-body therapy, physical activity, cancer survivors, and quality of life. Data analysis was performed using VOSviewer v1.6.20 software, to visualize the collaboration network of authors, institutions, countries, and keyword co-occurrence maps. The results show a sharply increasing publication trend, peaking in 2024. Research is dominated by institutions from the United States such as Harvard Medical School and the NIH. The main themes that emerged included controlled trials, mind-body therapy, complementary medicine, and psychology. Popular interventions studied include yoga, tai chi, and mindfulness. However, local culture-based approaches such as qosidah, dhikr, or religious music have not received much attention in international literature. This analysis reveals that spiritual and physical activity interventions for cancer survivors tend to emphasize Westernbased medical and psychological approaches. There is a need to develop more contextual and culturally based integrative research, especially in developing countries. The results of this study provide an important basis for the development of an Integrative Model of Qosidah Therapy and Physical Activity that is spiritually, psychosocially, and culturally relevant to improve the quality of life of cancer survivors in Indonesia and regions with similar characteristics.

Determinants of Integrated Primary Healthcare (ILP) Cadres’ Performance Based on Individual, Psychological, and Organizational Dimensions

2026-07-10T23:17:33+07:00

The Posyandu framework has transitioned into Posyandu ILP in alignment with the Health Transformation agenda initiated by the Ministry of Health. Integrated Primary Healthcare (ILP) aims to coordinate primary health services to meet life cycle-based needs. Semarang City faces several health issues, including stunting (872 cases), maternal mortality (16 cases), and pulmonary tuberculosis (5,039 cases). Addressing these challenges requires active involvement of health cadres and Posyandu through their roles in implementing Posyandu ILP. This study aimed to identify determinants of Posyandu ILP cadre performance in Semarang City based on individual, psychological, and organizational dimensions. A cross-sectional study was conducted with 165 Posyandu ILP cadres in Semarang City between March to April 2025. Sociodemographic data, the abilities and skills, the perception, the attitude, the motivation, the resources, the organizational support, the leadership, the rewards, and the workload were collected by questionnaire and were analyzed using Chi-square to assess their correlation with cadre performance. Chi-square analysis showed significant associations between cadre performance and skills and abilities (0.001), perception (0.003), attitude (0,001), motivation (0.001), resources (0.004), leadership (0.005), rewards (0.019), and workload (0.034). However, age (1.000), years of service (0.583), and organizational support (0.062) showed no significant relationship with cadre performance.This study highlights skills and abilities, perception, attitude, motivation, resources, leadership, rewards, and workload as determinants of Posyandu ILP cadre performance. This study provides valuable insights into the performance of Posyandu ILP cadres and the contributing factors, thereby supporting stakeholders in identifying appropriate interventions to ensure the optimal implementation of Posyandu ILP.

THE EFFECT OF SUJOK THERAPY ON REDUCING DYSMENORRHEA IN ADOLESCENT FEMALES AT SAHABATQU ISLAMIC BOARDING SCHOOL

2026-07-10T23:33:33+07:00

Adolescence is a transitional phase marked by puberty, menstruation, and lower abdominal pain, or dysmenorrhea. Pharmacological treatment generally involves analgesics, but long-term use can cause side effects. Therefore, nonpharmacological therapies are gaining popularity, including Sujok therapy. Sujok therapy is a complementary method originating in South Korea that stimulates specific points on the hands and feet to reduce pain. This study aims to determine the effect of sujok therapy on reducing menstrual pain in adolescent girls at the Sahabatqu Islamic Boarding School. This study was pre-experimental study with a one-group pre-test and post-test design was conducted at the Sahabatqu Islamic Boarding School on August 3–15, 2025. A total of 73 respondents were selected through consecutive sampling. Pain was measured using the Numeric Rating Scale (NRS) and analyzed using the Wilcoxon Signed-Rank test. Results: After 15 minutes of intervention, pain intensity decreased significantly. The Wilcoxon Signed-Rank test showed a z value of -7.64 with p = 0.000 (p < 0.005), indicating a significant difference between pain scores before and after therapy. In conclusion, there is an effect of sujok therapy on reducing the scale of dysmenorrhea in female adolescents at the sahabatqu Islamic boarding school.

EFFECTIVENESS OF OROMOTORIC STIMULATION IN IMPROVING CHILDREN'S EATING ABILITY AND NUTRITIONAL STATUS: A SYSTEMATIC LITERATURE REVIEW

2026-07-10T23:21:01+07:00

This systematic literature review examines the effectiveness of oral motor stimulation in improving feeding skills and nutritional status among infants and young children. Seven eligible studies published between 2014 and 2024 were analyzed, including randomized controlled trials and cohort studies with a total sample exceeding 6,000 participants. Results consistently demonstrated that structured oral motor interventions, such as the Premature Infant Oral Motor Intervention (PIOMI) and Oral Motor Facilitation Technique (OMFT), significantly enhanced oral motor coordination, feeding readiness, and chewing–swallowing efficiency (p<0.001). The interventions reduced transition time to full oral feeding by an average of 2.6 days and improved Neonatal Oral Motor Assessment Scale (NOMAS) scores. Long-term effects were observed in improved anthropometric indices, including weight-for-age and height-for-age Z-scores (+0.21–0.32 SD; p<0.05). Integrating oral motor stimulation with responsive feeding and nutritional education further strengthened cognitive and language outcomes in early childhood. The overall probability of intervention success ranged from 85–95%, with large effect sizes (Cohen’s d≈2.8). These findings confirm that oral motor stimulation is a physiologically grounded, safe, and scalable approach that should be incorporated into stunting prevention and pediatric feeding management programs to achieve sustainable improvements in child growth and development.

In Silico Anaysis of Gene Sequence Variation and Molecular Characterization Segregation and Condensation Protein B (ScpB) Streptococcus agalactiae

2026-07-10T23:31:48+07:00

Streptococcus agalactiae is a causes sepsis in mothers and neonates. Cases of infection in the United States are estimated at 8000 cases of GBS infection early – onset occurs annually in cases per 1000 live births. Approximately 4-6% of infected babies die and 25-50% survive will experience sequelae such as mental retardation, blindness and deafness. Gold standard for diagnosing sepsis is the culture method, but this method has limitations in the examination, including requiring a long time, the culture results which are declared negative after being confirmed by the PCR method get positive results. The result of culture examination was not infected and when the baby was born get suffered from sepsis. The ScpB gene plays a role in immunogenic factors. Therefore, this study aims to molecularly characterizing variants in the ScpB gene of Streptococcus agalactiae back bacteria. Genetic variations in a population will influence traits and responses. This research aims to analyze genetic variations in the ScpB sequence Streptococcus agalactiae NCBI with PopSet 2572585596 using BsmAI restriction enzyme with RFLP method in silico. The results showed that there were genetic variations in the ScpB gene sequence and three allelic variations contained in 10 sequences. ScpB is also responsible for the response to antibiotics. Some antibiotics are resistance, even the antibiotic recommended by. FDA omandacycyline, is also caused by. the biofilm which product from ScpB. In conclusion, there are 3 allelic variations result from in silico RFLP, these variations will certainly have varying effect including immune responses, biofilm production and resistance to antibiotics.

Subjective Norms and Perceived Behavioral Control as Predictors of Pregnant Women's Intention to Undergo HIV Testing

2026-07-10T23:19:14+07:00

HIV testing among pregnant women is an important preventive measure in preventing mother-to-child transmission of HIV. This study aims to analyze the relationship between subjective norms and perceived behavioral control (PBC) with the intention of pregnant women to undergo HIV testing at the Kesugihan 2 Community Health Center (Puskesmas) in Cilacap Regency in 2024. This research employed a quantitative design with a cross-sectional approach. The sample for this study consisted of 49 pregnant women. Data were collected through a questionnaire and analyzed using the chi-square test. The results showed that the majority of respondents were aged 20–35 years (93.9%), had a junior high school education (57.1%), and were in their third trimester of pregnancy (42.9%). A total of 83.7% of respondents had positive subjective norms, and 75.5% had a high level of PBC. A significant relationship was found between subjective norms and the intention to undergo HIV testing, as well as between PBC and intention. Pregnant women with positive subjective norms and high PBC levels were found to have a greater intention to undergo HIV testing. In conclusion, subjective norms and PBC are significant factors influencing the intention of pregnant women to undergo HIV testing. Interventions focused on education, strengthening social support, and improving access to health services are needed to reinforce women's intention to undergo HIV testing as a protective measure for themselves and their unborn children.

National Strategy for Managing Burnout in Healthcare Workers through the Implementation of the TCL Model as a Hospital Team Management System

2026-07-10T23:41:06+07:00

Burnout among healthcare workers is a growing issue that directly affects service quality, patient safety, and the well-being of medical staff. Contributing factors include high workloads, lack of team support, and poor work environments. Despite various training programs like TeamSTEPPS, CRM, and Lean Healthcare, these approaches remain isolated and ineffective without integration. To address this, a national strategy integrating these models through the Team-Centered Leadership (TCL) approach is recommended. TCL focuses on team communication, resource management, and work efficiency to create a collaborative and supportive work environment. A study at Bhakti Asih General Hospital revealed that high mental and physical workloads significantly contribute to burnout, leading to decreased nurse performance. Key policy recommendations include establishing a TCL-based framework for hospitals, mandatory training for hospital leaders, and developing an integrated system for monitoring burnout and team welfare. By implementing this integrated management approach, hospitals can improve communication, reduce workload pressure, and promote a healthy work-life balance, ultimately enhancing both worker well-being and patient safety. Implementing TCL could transform Indonesia’s healthcare system into a more resilient and sustainable model.

Trends and Research Gaps in Healthcare Compliance Law for Improving Hospital Service Quality: A Bibliometric Analysis (2010–2025) with Implications for Indonesia

2026-07-10T23:42:00+07:00

In order to guarantee patient safety, legal risk reduction, and service quality, the application of Healthcare Compliance Law (HCL) has emerged as a crucial paradigm in hospital governance worldwide. There is still a dearth of thorough literature mapping on the development and unmet research needs in this area, especially in the Indonesian setting. This study aims to map the global trends, major issue clusters, and research gaps in the field of HCL and its link to hospital service quality between 2010 and 2025. It also analyzes the significance of these findings for Indonesian research and policy development. This study's methodology is a thorough bibliometric examination. A predefined search string consisting of 473 articles was used to retrieve data from the Scopus and Publish or Perish (PoP) databases. It was then subjected to conceptual, intellectual, and social mapping analysis as well as performance analysis utilizing Vosviewer and Biblioshiny software (R-package). According to the study's findings, there has been a sharp rise in publications, particularly in the past seven years. This suggests that regulatory complexity, health technology advancements, and post-pandemic accountability demands have prompted researchers to concentrate on important topics like risk governance, compliance ethics, digital-based compliance system integration, and health data compliance (data privacy).

Iodized Salt Intake by Pregnant Woman Can Affect Stunting in Toddlers: a Case Control Study

2026-07-10T23:50:19+07:00

Iodized intake was important to pregnant women, because lack of iodine can lead to a spectrum of growth, developmental, and functional morbidities across the entire life cycle. This study aimed to determine the relationship between intake iodized salt with the prevalence of stunting among toddlers. This research employed case control study for toddlers in Rahayu Community Health Center area, Margaasih District. The sample consisted of 118 respondents divided into 59 cases and controls. All data were obtained through interviews, and testing iodized salt intake using iodine test kit. Results showed maternal anthropometry at risk was 33.1%, average parity was at second parity. Most education level was in low group. Age pregnancy at risk was 32.2%. As many as 30.5% respondents did not consume iodized salt for their daily intake. There was a significant relationship between maternal characteristics (p:0.019), maternal parity (p:0.023), maternal education level (p: 0.025), and maternal age during pregnancy (p:0.030) and consume of iodized salt (p: 0.009;) with stunting prevalence in toddlers. It can be concluded that it is needed to promote health information about iodized salt and the best way to storage, use and the amount consumed every day in the family.

Overview of Elderly Knowledge About Thanatophobia

2026-07-11T00:01:52+07:00

The elderly are a vulnerable group who experience various physical, psychological, and social changes as they age. One common psychological issue among the elderly is fear of death (thanatophobia), which can negatively affect mental health and quality of life. Knowledge about thanatophobia is important to help the elderly become more prepared for the aging process. This study aims to describe the level of knowledge among the elderly regarding thanatophobia in the working area of Gunungsari Public Health Center, West Lombok. This research used a quantitative descriptive design with a survey approach. A total of 97 elderly participants were selected using purposive sampling. Data were collected using a questionnaire modified from the Death Anxiety Scale. Data analysis was conducted descriptively using frequency and percentage distribution. The findings showed that the majority of respondents (54%) had low knowledge about thanatophobia, 15% had moderate knowledge, and only 31% had a good level of knowledge. Most respondents were female, aged 60–74 years, unemployed, and had a low level of education. Most elderly individuals in the Gunungsari Public Health Center area have a low level of knowledge about thanatophobia. Educational interventions and holistic mental health counseling involving families and healthcare professionals are needed to improve the elderly’s understanding of death anxiety, supporting them in facing old age with greater peace and better quality of life.

Sexual And Reproductive Health Services In Disaster And Humanitarian Crisis Situations: A Global Systematic Review

2026-07-11T00:03:55+07:00

Natural disasters, conflicts, and humanitarian crises have profound impacts on sexual and reproductive health (SRH), particularly among women and adolescents who face heightened vulnerabilities in accessing essential services and safeguarding reproductive rights. This study aimed to systematically review crosscountry evidence on challenges, strategies, and best practices in delivering SRH services during emergencies. A systematic literature review (SLR) was conducted using PubMed, Scopus, Web of Science, and Google Scholar with the keywords “sexual and reproductive health (SRH)”, “adolescents”, “women”, “disaster”, and “humanitarian crisis”. From 1,276 identified records, 842 remained after duplicate removal. Screening and eligibility assessment yielded 20 studies for final synthesis, comprising qualitative, quantitative, mixed-method, observational, and descriptive designs from Asia, Africa, the Pacific, and the Americas. Narrative synthesis was employed to identify overarching themes. Women and adolescents were disproportionately vulnerable during emergencies, encountering barriers such as limited health infrastructure, socio-cultural stigma, economic hardship, and weak policy coordination. Effective strategies included capacity building for health workers, community participation, gender-sensitive interventions, and integration of SRH with psychosocial and livelihood recovery efforts. Addressing SRH needs in crises requires comprehensive, gender-responsive, rights-based, and evidencedriven strategies. Strengthening global health policies and building resilient systems are crucial for equitable SRH service delivery.

Spatial Analysis of Landslides in Kulon Progo Regency, Yogyakarta as a Basis for Disaster Mitigation

2026-07-11T00:05:28+07:00

Kulon Progo Regency, Yogyakarta, is a region with a high risk of landslides due to hilly topography and intense rainfall. This disaster routinely threatens life and infrastructure, so spatial analysis is needed as a basis for mitigation. This study aims to map the level of landslide vulnerability and identify the dominant factors that influence it in Kulon Progo Regency. The method used is spatial analysis with a tiered quantitative approach (scoring and weighting) using a Geographic Information System (GIS). The parameters analyzed include slope gradient, rainfall, soil type, geology, and land use overlaid with landslide point distribution data. The results of the study produced a landslide vulnerability zoning map divided into three classes: low, medium, and high. Areas with a high level of vulnerability are concentrated in the western part from the north to the south with dominant factors being steep slopes (>40%) and high rainfall intensity on dryland agricultural land. In conclusion, this zoning map is an important and strategic instrument for local governments to prepare disaster risk-based spatial plans, determine evacuation routes, and develop early warning systems for the community.

Mobile Applications for Labor Pain Management: Scoping Review of Design, Features, and Clinical Impact

2026-07-11T00:08:08+07:00

Labor pain influences birth experience and analgesic needs; mobile applications may strengthen education and coping, including yoga-based modules (breathing, relaxation, movement/positioning), yet evidence remains scattered. This study aims to map app designs, core features—particularly yoga components— behavior-change techniques, and clinical impact of mobile applications for labor pain management. Methods: Scoping review guided by JBI and PRISMA-ScR with searches in PubMed/MEDLINE, Scopus, CINAHL, Cochrane Library, and Embase (2015–2025). Inclusion: RCTs, quasi-experiments, pre–post, and feasibility/usability studies involving pregnant or intrapartum women that evaluate apps targeting pain reduction or coping; studies featuring yoga (e.g., pranayama, guided relaxation, safe asana/positioning) will be identified as a subgroup. Data items include design approach, features (breathing coach, relaxation audio, contraction timer, guidance on positioning/heat, yoga modules), behavior-change techniques, and outcomes (VAS/NRS pain, anxiety, analgesic use, labor duration, satisfaction). This abstract presents a protocol; findings will map design patterns and a minimum viable feature set (including yoga) and synthesize effects on clinical outcomes, with implementation issues in low-resource settings. The review is expected to inform a practical design brief and implementation considerations for a safe, acceptable, and potentially effective app-based complementary model to reduce labor pain.

Strategy for Integration of Non-Pharmacological Interventions for Hypertension Care in Indonesia

2026-07-11T00:09:53+07:00

Hypertension is a major health problem in Indonesia, affecting tens of millions of adults and posing the greatest risk factor for cardiovascular diseases such as stroke and heart failure. Currently, hypertension management largely focuses on pharmacological therapy, while non-pharmacological approaches such as light physical activity, hypertension exercises, and relaxation have not been systematically implemented in primary care. Study shows that integrating nonpharmacological therapies such as accupressure and mindfulness-based therapies into community health centers (Puskesmas) has the potential to improve patient compliance, reduce blood pressure, and strengthen holistic and sustainable approaches. Therefore, a multilevel intervention is needed that includes the development of national guidelines, training for health workers and cadres, revitalization of Posyandu Lansia as community intervention centers, and research and health communication based on local culture to encourage the adoption of integrative services at the primary level.

Optimizing Non-Communicable Disease Health Promotion Through Medical Informatics Systems in Primary Healthcare Centers

2026-07-11T00:15:27+07:00

Non-communicable disease prevalence is experiencing exponential increases requiring paradigmatic transformation in primary healthcare delivery through medical informatics systems utilization. This study aims to analyze optimization of NCDs health promotion through medical informatics systems implementation in primary healthcare settings using qualitative analysis approach. The study employed multiple case study design analyzing three specific cases: SATUSEHAT NCDs screening module implementation in 300 primary healthcare centers, Integrated Primary Services program digitalization, and PASS Mantap innovation program at Nan Balimo Primary Healthcare Center. Data analysis utilized thematic analysis with Technology Acceptance Model and Implementation Science frameworks. Medical informatics systems implementation demonstrated significant improvements in clinical documentation standardization, care continuity, and patient engagement. Success factors included organizational readiness, infrastructure adequacy, and community acceptance. Primary challenges encompassed digital divide, change resistance, and financing sustainability. In conculusion, NCDs health promotion optimization requires holistic approaches integrating technological innovation with organizational transformation and community engagement to achieve sustainable digital health ecosystems.

The Effectiveness of a Family-Based and SocioCultural Health Promotion Model on Behavioral Changes in Stunting Prevention in North Gorontalo

2026-07-11T00:17:08+07:00

Stunting remains a major public health problem in Indonesia, particularly among children under five years old. This study aimed to evaluate the effectiveness of family-based health promotion programs in improving mothers’ knowledge, attitudes, and practices toward stunting prevention in five Primary Health Centers (Puskesmas) located in North Gorontalo Regency, namely Kwandang, Molingkapoto, Anggrek, Ilangata, and Monano. This quasi-experimental study employed a pre-test and post-test design without a control group. A total of 365 respondents, who were mothers of children under five and pregnant women, were selected using inclusion and exclusion criteria. Data were collected using structured questionnaires covering three domains: knowledge, attitude, and practice, each with dichotomous responses (Yes/No). The results showed an overall improvement in the post-test compared to the pre-test in four health centers (Kwandang, Anggrek, Ilangata, and Monano), indicating enhanced maternal capacity in stunting prevention. However, in Molingkapoto, post-test scores declined compared to the pre-test, suggesting contextual challenges in health promotion delivery. In conclusion, family-based health promotion proved effective in strengthening mothers’ capacity to prevent stunting, though its success varies by local context. Tailored interventions considering cultural, social, and economic factors are needed to maximize the program’s impact and sustainability.

Mapping Global Research on Packaged Food Labeling Policy: A Bibliometric Study

2026-07-11T00:18:47+07:00

Food labeling policies are an important strategy in combating noncommunicable diseases. Front-of-pack labeling (FOPL) policies have been adopted by various countries with different approaches, both mandatory and voluntary, which aim to effectively convey the health risks associated with excessive consumption of sugar, salt, and fat. However, the effectiveness of these policies is highly dependent on the social and cultural context, nutrition literacy levels, and regulatory capacity in each country. This study aims to map and analyze global trends in scientific literature on packaged food labeling policies over the past decade (2015–2024). Bibliometric methods were applied to 1,843 documents from Scopus, analyzed using VOSviewer. The results show a significant increase in publication volume, with the United States, Australia, and the United Kingdom dominating. Thematic analysis revealed five main clusters: consumer behavior, health policy, sustainability, research methodology, and global health. This research is multidisciplinary but still concentrated in developed countries. Inclusive global collaboration and a contextual approach are needed to improve the implementation of labeling policies in low and middle income countries.

Identifying Effective Health Promotion Strategies to Increase Exclusive Breastfeeding Coverage: Systematic Literature Review

2026-07-11T00:20:06+07:00

Exclusive breastfeeding during the first six months of a baby's life is an important strategy in improving maternal and child health. However, exclusive breastfeeding coverage is still low in various countries, including Indonesia. This study aims to identify effective health promotion strategies in increasing exclusive breastfeeding coverage through the Systematic Literature Review method. Literature searches were conducted through the Scopus database with specific keywords related to breastfeeding promotion, self-efficacy, counseling, and social support. Of the 119 articles identified, 42 met the inclusion criteria and were analyzed thematically. The results showed that the most effective interventions were multifaceted interventions that combined education based on behavioral theory (especially Theory of Planned Behavior), husband and family support, prenatal and postnatal breastfeeding counseling, health worker training, and the use of digital technology. These interventions consistently improve maternal self-efficacy, breastfeeding intention, and exclusive breastfeeding practices. This study concludes that effective breastfeeding health promotion requires an integrated, sustainable, and contextual approach. These findings make an important contribution to the development of exclusive primary and community-based breastfeeding promotion programs, particularly in developing countries such as Indonesia

The Impact of Fatigue on Academic Performance and Well Being in Undergraduate Medical Students: a Systematic Literature Review

2026-07-11T00:21:59+07:00

Medical education imposes exceptional cognitive, emotional, and physical demands that make medical students particularly vulnerable to fatigue and its detrimental consequences on learning and well-being. These factors contribute to fatigue, which may negatively affect both academic performance and psychological well-being. This systematic review aims to synthesize current evidence on the effects of fatigue on academic outcomes and well-being among medical students and to propose OHS-based recommendations to enhance student health and learning performance. A comprehensive literature search was conducted across four databases: PubMed, Scopus, EuropePMC, and OpenAlex. A total of 293 records were identified, with 149 screened after duplicate and irrelevant records were removed. Full-text assessment was performed on 121 articles, resulting in 34 studies. The PRISMA 2020 guidelines were followed to ensure methodological rigor. The review found consistent evidence that fatigue particularly mental and emotional exhaustion was associated with decreased academic performance, impaired concentration, and increased risk of burnout, anxiety, and depression. Several studies highlighted the lack of institutional support and coping strategies among students. Fatigue significantly affects both academic outcomes and psychological well-being in undergraduate medical students. A holistic, evidence-based strategy that connects educational innovation with psychological well-being is needed to address medical students' fatigue.

SOCIO-CULTURAL INFLUENCES ON PREGNANT WOMEN'S FIRST CONTACT WITH HEALTH WORKERS IN THE WORKING AREA OF THE WAWAROPE PUBLIC HEALTH CENTER KONAWE KEPULAUAN REGENCY

2026-07-11T00:41:57+07:00

The Wawarope District, Konawe Islands Regency, remains a region deeply rooted in local cultural values and traditions. Community adherence to Islamic customs and practices is still strong, shaping socio-cultural influences on daily life. A preliminary study revealed that socio-cultural factors, particularly knowledge and habits, affect maternal health-seeking behavior. Many pregnant women continue to place strong trust in traditional birth attendants (paraji) as long as the fetus is perceived to be healthy, thereby discouraging them from seeking early prenatal care. The objective of this study was to examine the socio-cultural influence on the first contact between pregnant women and health workers at the Wawarope Community Health Center (Puskesmas), Konawe Islands Regency, in 2025. This quantitative study employed a cross-sectional design with 30 respondents, selected through purposive sampling, and data were collected using questionnaires. The chisquare test showed a p-value of 0.000 < α = 0.05, leading to the rejection of Ho and acceptance of Ha. This indicates a significant influence of socio-cultural factors on the first contact of pregnant women with health workers in the Wawarope Community Health Center working area, Konawe Islands Regency, in 2025. In conclusion, the stronger the belief in traditions and myths that hinder visits to health workers, the greater the likelihood that pregnant women will delay their first antenatal check-up

Fostering Sexual Health Literacy Through Children's Digital Storytelling: A Participatory Action Research for S.A.F.E (Self-Awareness and Friendship Education)

2026-07-11T00:43:07+07:00

This Participatory Action Research (PAR) aimsto addresssocio- cultural barriers and stigma in childhood sexuality education by developing a S.A.F.E. (SelfAwareness and Friendship Education) model. The study seeks to improve sexual health literacy by engaging children as active creators through digital storytelling. The study involved 31 fourth-grade students from diverse multicultural family backgrounds, from whom 15 student cadres were selected to lead the creation process. They were given special training to create their own stories about selfprotection. The core methodology involved collecting rich qualitative "student voice" following the provision of stimulating materials such as songs, stories, and films. In- depth analysis of these portfolios was used to design the Interactive Virtual Digital Storytelling (IVDS) prototype. Findings show a significant impact on student comprehension, with an average comprehensive success rate of 96.8% regarding self-protection concepts. This result is validated by the use of strong studentgenerated metaphors, such as "Secret Door" for body autonomy and "Rescue Captain" for reporting mechanisms. The study affirms that a child-centred and culturally responsive approach can dismantle taboos, contributing to measurable, evidence-based abuse prevention strategies

Research Trends in Physical Activity to Improve Quality of Life in Type 2 Diabetes Mellitus Patients with Knee Osteoarthritis: Bibliometric Analysis

2026-07-11T00:45:15+07:00

There are 529 million people living with Diabetes Mellitus worldwide with a global Diabetes Prevalence of 6.1%. In 2050, it is estimated that more than 1.31 billion people are projected to suffer from DM which results in loss of insulin receptor sensitivity, reduced chondrocyte survival and differentiation capacity, thus accelerating the development of knee Osteoarthritis (OA). The combination of chronic pain, limited mobility, and high disease burden leads to a decline in quality of life. The purpose of this study is to analyze the quality of life of people with Type 2 Diabetes Mellitus with knee Osteoarthritis. The selection process focused on articles that have been cited and have been published between 2020 and 2025. Researchers analyzed the articles to determine research progress in the field of quality of life of people with Diabetes Mellitus with knee Osteoarthritis in the last five years. Furthermore, it emphasizes important discoveries in the field of interventions to improve the quality of life of people with DM with knee OA. Furthermore, researchers provide a comprehensive analysis of factors related to the quality of life of people with type 2 DM with knee OA by measuring publications and identifying journals that publish related articles. This study also reveals journals and authors that obtain the highest citations. Future research needs to increase physical activity and strength and muscle training to reduce disease severity and improve the quality of life of DM patients with OA.

Oral Administration of a Hypercholesterol Feed Formula to Develop a Dyslipidemia Animal Model in Male Rats (Rattus norvegicus)

2026-07-11T00:49:42+07:00

Dyslipidemia is a metabolic disorder characterized by elevated cholesterol levels, which can be induced through high-fat and high-cholesterol diets. Establishing an animal model of dyslipidemia is essential for studying its pathophysiology and for evaluating potential therapeutic agents. This study aimed to develop a dyslipidemia model in male white rats (Rattus norvegicus) through oral administration of a hypercholesterol feed formula. A true experimental design with a pretest–posttest control group was used, involving healthy male rats aged 2–3 months with an average weight of 150–200 g. The experimental group received a high-fat feed consisting of lard, duck egg yolk, and propylthiouracil administered orally for 14 days, while the control group received a standard diet. Total cholesterol levels and body weight were measured on day 1 and day 14. Statistical analysis using paired t-test showed a significant increase in body weight and total cholesterol levels in the dyslipidemia group (p < 0.001), whereas the control group only demonstrated slight, non-significant increases. These findings indicate that oral administration of hypercholesterol feed successfully induces dyslipidemia in rats. This model can be applied as a valid experimental platform for further research on dyslipidemia mechanisms and the evaluation of anti-hyperlipidemic agents.

Optimization of ARC In Sagittal T2 FSE Thoracolumbar MRI: Impact On Image Quality And Diagnostic Information In Clinical HNP

2026-07-11T00:51:03+07:00

MRI has a sensitivity and specificity of 96%–97%. The Autocalibrating Reconstruction for Cartesian Imaging (ARC) technique is an acceleration method that reduces acquisition time. Although ARC2 is commonly applied in clinical practice, other ARC variations are available. This study aimed to evaluate differences in signal-to-noise ratio (SNR) and diagnostic clarity among ARC settings and to determine the optimal configuration for thoracolumbar MRI. An experimental study was conducted on ten patients scanned using ARC 1, 1.5, and 2. SNR was measured using ROI, and diagnostic evaluation of intervertebral discs, vertebral bodies, cerebrospinal fluid, and spinal cord was independently assessed by radiologists. Data were analyzed using ANOVA, Friedman, and Wilcoxon tests with a significance level of α = 0.05. Results showed significant SNR differences across ARC settings (p < 0.001). Post hoc analysis indicated differences between ARC1 and ARC1.5 (p = 0.041) and between ARC1.5 and ARC2 (p = 0.002), but not between ARC1 and ARC2 (p = 0.861). Diagnostic clarity also different significantly (p < 0.001), with ARC1 providing the highest clarity (mean rank = 2.39). Wilcoxon confirmed significant differences between ARC1 and ARC1.5 (p < 0.001) and between ARC1.5 and ARC2 (p < 0.001), but not between ARC1 and ARC2 (p = 0.083). ARC1 offers the best balance of image quality and diagnostic clarity for thoracolumbar sagittal T2-weighted FSE MRI

Bridging the Knowledge Gap: A Bibliometric Study of Digital Tools to Improve Parental Healths Literacy in Child Grow Monitoring

2026-07-11T00:56:44+07:00

Parental health literacy plays a critical role in monitoring child growth and preventing nutritional problems such as stunting, wasting, and overweight. Low literacy often delays detection of growth disturbances and reduces the utilization of preventive health services. Digital technologies, including mHealth, interactive platforms, and IoT devices, offer new opportunities to address these gaps. This study aims to analyze scientific publications on digital tools for improving parental health literacy in child growth monitoring through a bibliometric approach. A quantitative descriptive design was applied using Scopus data from 2015–2024. Keywords included early childhood, nutritional status, digital health, and literacy. The analysis covered publication trends, core journals, productive authors, institutional and country affiliations, subject areas, funding sponsors, and keyword networks visualized with VOSviewer. A total of 1,151 publications were identified, peaking in 2023 (188, 16.28%). Nutrients ranked as the leading journal (60 articles), Dibley MJ as the most productive author (15), and the University of Sydney as the top institution (46). The United States contributed the most documents (378). Medicine was the dominant subject area (43.2%), with NIH as the main funder (94). Keyword mapping revealed strong links between health literacy, mHealth, parental involvement, and child growth monitoring. Research on digital tools for parental health literacy shows a growing trend, with significant contributions from international journals and scholars. Future studies should examine effectiveness, sustainability, and long-term impacts.

Development Of A Stunting Risk Prediction Model Using Binary Logistic Regression In The Working Area Of Public Health Center Marawola, Sigi Biromaru Regency

2026-07-11T00:58:47+07:00

Stunting remains a major health problem in Indonesia, with a national prevalence of 19.8% (SSGI, 2024) and Central Sulawesi Province reaching 26.1%. Sigi Regency has the second-highest prevalence of stunting, reaching 33.0% (SSGI, 2024). This condition affects long-term child growth and development. To identify risk factors, an appropriate prediction model is needed, one of which is binary logistic regression, which is able to map the relationship between various determinants and the incidence of stunting. This study aimed to predict early risk factors for stunting using binary logistic regression in the working area of Public Health Center Marawola, Sigi Biromaru Regency. The method used was a quantitative study with a cross-sectional design. The sample consisted of 40 mothers with toddlers. Data analysis was performed using the Binary Logistic Regression Test. The results of the study showed that the determinants proven to be significant and could be used as early prediction indicators for stunting risk were cigarette smoke exposure (smoking behavior of the toddler’s parents) (p = 0.010; Exp(B) = 24.8) and family income (p = 0.012; Exp(B) = 0.024). Meanwhile, maternal height was not a risk factor for stunting (p = 0.329; Exp(B) = 1.9). Thus, stunting prevention efforts should focus on controlling exposure to cigarette smoke in the household environment and improving household economic welfare through community empowerment programs.

Assessing Indonesia’s First Hydrogen Refuelling Station in Jakarta: Emissions Reduction, Safety, and Policy Implications for Transport Decarbonization

2026-07-11T01:01:47+07:00

Indonesia’s first hydrogen refuelling station (HRS) in Senayan, Jakarta, was commissioned in 2024 as a pilot for transport decarbonization. This study evaluates its environmental performance and safety using a well-to-wheel greenhouse gas (GHG) framework aligned with ISO 14064, and a safety programme integrating HAZOP and Quantitative Risk Assessment (QRA) supported by computational fluid dynamics (CFD). The analysis draws on station design and techno-economic parameters to estimate carbon abatement and energy performance, and benchmarks safety against ISO 19880-1 and NFPA 2. Results indicate the HRS can avoid ~114 tCO₂e per year when supplied with green hydrogen, with a stationlevel electricity-to-hydrogen efficiency of ~75%, and an individual risk level below 1×10⁻⁶ yr⁻¹ at public boundaries—consistent with widely accepted tolerability criteria. These findings, discussed against international experiences in Japan and Europe, demonstrate that hydrogen infrastructure in Indonesia can deliver measurable CO₂ reductions within conservative safety margins, provided the hydrogen supply remains low-carbon and design/operation adhere to international codes. Scientifically, this paper contributes the first integrated techno-economic and environmental-safety assessment of an Indonesian HRS, offering a replicable framework for project-level GHG accounting and risk-informed design. Policy recommendations emphasize standard adoption (ISO 19880-1, NFPA 2), performance-based safety verification, green hydrogen supply assurance, and targeted fleet deployment to accelerate credible pathways toward Indonesia’s 2060 net-zero goal.

Impact of Occupants’ Behaviour on Environmental Health of Urban Wetland Settlements in Banjarmasin

2026-07-11T01:03:03+07:00

Located on wetland area, Banjarmasin residential area is mainly resided on swamp area and riverbank. Rapid growth of residential area development resulted in the decreasing area of wetland. This condition leads to the declining quality of the environment. Another factor that contributes to the environmental deteroriation is inhabitants’ behaviour. Subsequently, environmental deteroriation produce negative impact on environmental health of the residential settlements. The objective of this study is to define the impact of the occupants’ behaviour and habit ed in this study to describe the relationship between behaviour/habit and environmental health. Field observation is used to collect primary dain using river resources on environmental health of the settlements on Alalak riverbank. Descriptive method is used. This study shows that there is a major impact of bad behaviour/habit in using resources on the river ecology, such as declining water quality. Initially, this leads to decreasing quality of environmental health of the settlement.

The Role of Ethical Leadership Based Spiritually in Patient Safety Culture: A Systematic Literature Review

2026-07-11T01:05:22+07:00

Systematic Literature Review of Preeclampsia Prevention Models: Implications for Developing an Integrated Model in Indonesia

2026-07-11T01:21:37+07:00

Preeclampsia is a leading cause of maternal morbidity and mortality worldwide, including in Indonesia. Preventive strategies such as calcium supplementation, community-based interventions, and self-monitoring of blood pressure have been widely studied. However, these approaches remain fragmented and lack integration into a comprehensive management model. This study aimed to analyze existing preeclampsia prevention management models reported in international guidelines and trials and to synthesize the evidence as a basis for developing an integrated prevention model for Indonesia. A Systematic Literature Review was conducted following PRISMA guidelines. Searches in PubMed, Scopus, ScienceDirect, and Google Scholar identified 1,236 records. After screening, 12 studies were included, comprising international guidelines, Cochrane reviews on calcium. The review identified three major categories of prevention models: (1) risk screening and prediction with biomarkers; (2) education and empowerment, including self-monitoring; and (3) integrated guideline-based care emphasizing high-quality antenatal services and preventive supplementation. Evidence indicates greater effectiveness when these strategies are applied holistically. Current preeclampsia prevention models show effectiveness when integrated into a holistic management framework that combines risk screening, maternal and family education, and primary health services aligned with international guidelines. This systematic review provides an evidence-based foundation for developing an integrated preeclampsia prevention management model.

Caregiver factors and relapse in schizophrenia patients

2026-07-11T01:23:18+07:00

Relapse in schizophrenia is widely recognized as the reappearance or worsening of psychotic symptoms. Prevention of relapse is a major challenge for patients and their families, and mental health professionals, and is one of the main goals in the management of schizophrenia. Due to the fact that families of schizophrenic patients are their primary caregivers, their involvement is critical in managing and preventing recurrence of symptoms (continuum of care). To identify caregivers and relapse in schizophrenic patients. The articles were obtained from the ScienceDirect, Pubmed, and Ovid databases. When dealing with patients, family care for schizophrenics is demonstrated via the use of parenting techniques and family expressed emotion. It is possible to gauge the patient's family's feelings for him or her by how they express themselves. Relapse was more common among schizophrenic patients who lived in families where expressed emotion was strong, compared to those who lived in families where expressed emotion was low. Factors that influence the relapse in patients with schizophrenia are the family's emotional expression. good socioeconomic factors, extended family support, community and psychoeducation play an important role in building the emotional stability of caregivers or caregivers of people with schizophrenia.

Reproductive Health Surveillance Policy: Innovative Pre-marital Screening Model for Early Detection of Female Infertility Risks in Indonesia

2026-07-11T01:24:51+07:00

Female infertility in Indonesia remains a serious reproductive health challenge, with a prevalence of 10–15% among couples of reproductive ages. The low rate of early detection of ovulation and hormonal disorders means that many new cases are only identified after two years of marriage without pregnancy. A study by Kusuma et al. (2025) shows that 34.6% of married women experience infertility, while 36–40% of the population does not consider it a medical problem. The lack of fertility literacy and the absence of a surveillance system to monitor the risk of infertility exacerbate this condition. The proposed policy is the development of an Integrated Risk-Based Premarital Screening Model, which combines physical assessment, anthropometry, lifestyle assessment, and hormonal biomarker testing (AMH, LH, FSH), as well as evidencebased fertility counseling. This model is integrated into the national surveillance system through cross-sector collaboration between the Ministry of Health, the Ministry of Religious Affairs, and the National Population and Family Planning Agency (BKKBN). This policy directly contributes to the achievement of SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality) through a preventive, educational, and genderequitable approach to women's reproductive health in Indonesia.

Determinants of Second-Dose HPV Vaccine Uptake among Elementary School Students in the Catchment Area of Genuk Health Center Semarang

2026-07-11T01:25:45+07:00

Cervical cancer is one of the leading causes of mortality among women, primarily caused by persistent infection of oncogenic Human Papillomavirus (HPV). The Indonesian government has included HPV vaccination in the national immunization program through the School-Based Immunization Month (BIAS), yet the coverage of the second dose remains below the national target in several areas, including Puskesmas Genuk Semarang. This study aimed to analyze the determinants of HPV second-dose vaccine acceptance among elementary school students. A quantitative analytic study with a cross-sectional design was conducted in August 2025, involving 106 parents or guardians of 6th-grade female students selected using proportional random sampling. Data were collected using a structured questionnaire and analyzed with the Chi-Square test. The results showed that education level, knowledge, trust, attitude, school support, health workers’ support, and perceived need for the vaccine were significantly associated with vaccine acceptance (p < 0.05), while age, gender, and access to information were not. The majority of respondents (84.9%) accepted the HPV second-dose vaccination. It can be concluded that cognitive and social support factors play a crucial role in determining HPV vaccine completion. Strengthening health education, improving communication strategies, and enhancing collaboration between schools and health workers are essential to increase vaccine coverage and support cervical cancer elimination efforts.

Implementation of Family Centered Care (FCC) to Improve Maternal and Infant Health: Systematic Literature Review

2026-07-11T01:27:05+07:00

The global MMR in 2023 is 197 per 100,000 live births. The causes include hemorrhage, infection, pre-eclampsia and eclampsia, complications during childbirth, and abortion. The Family-Centered Care (FCC) model is a collaboration between medical professionals, patients, and families to address the emotional, social, and developmental needs of the patient. This study aims to determine the impact of FCC on maternal and infant health. A systematic literature search based on PRISMA in the Scopus, PubMed, and ScienceDirect databases yielded 13,301 articles (Scopus 270, PubMed 5,071, ScienceDirect 7,960). Screening of publications from the past 5 years (2020 – 2025) resulted in 3,895 articles, abstract identification (n=11), and full-text review. Based on eligibility criteria, 11 articles were deemed suitable for analysis. The implementation of FCC is beneficial for improving the quality of life of infants, motor development, and neurological behavior in very premature babies, the role of parenting and parents' sense of competence, family care without causing harm, effectively reducing the length of care for premature babies, and increasing parental satisfaction. In conclusion, the implementation of FCC has a positive impact on improving the health status of mothers and infants. It is hoped that healthcare workers will apply FCC in every care service.

The effect of family empowerment on increasing knowledge and behavior to prevent pulmonary TB transmission in children in Semarang

2026-07-11T01:33:59+07:00

Tuberculosis is a chronic infectious disease which is a major health problem globally, including in Indonesia. To increase knowledge and behavior to prevent transmission of pulmonary TB in children, this can be done through family empowerment. Empowering families through education can increase awareness and encourage preventive behavior changes, thus making the prevention practices of pulmonary TB in children more optimal and reducing the incidence and transmission of the disease. Intensive education can enhance knowledge about the causes, modes of transmission, symptoms, and preventive measures for pulmonary TB in children, which in turn can improve family support in treatment and prevention of transmission. Therefore, family empowerment becomes an effective strategy in improving the quality of life for children with pulmonary tuberculosis and supports a more optimal recovery. The aim of this research is to determine the effect of family empowerment on increasing knowledge and behavior in preventing transmission of pulmonary TB in children. This research used a quasy experimental quasy experiment with a non-randomized control group pre-posttest design. Data collection techniques include interviews using questionnaires, observation and measurement. Data were analyzed using the Wilcoxon Sign Rank Test, MannWhitney test, and Spearman Rho. The sample was 31 families who had children with pulmonary TB or pulmonary TB sufferers, divided into treatment and control groups. The results of this research show that before being given health education, the majority of knowledge of the 31 respondents was in the sufficient category, 16 people (51.7%) with the pre-test results of the attitudes and behavior of the majority in the positive characteristics category, 16 people (51.6%). After being given health education, there was an increase with good knowledge reaching 21 people (67.7%), attitudes and behavior increasing by 18 people (58.0%). The conclusion of this research is that there is an influence of health education on the level of knowledge, attitudes and behavior of families regarding preventing transmission of TB in children, namely with a significance value of p=0.000.

Effectiveness of RAVS Mode Autosuggestion in Controlling Blood Pressure in Hypertensive Patients: A Limited Pilot Study on Urban Elderly in Tangerang City

2026-07-11T01:35:29+07:00

Hypertension is one of the most common chronic diseases among urban seniors, which can increase the risk of cardiovascular disease and death. The autosuggestion of RAVS mode is effective in reducing stress and anxiety, but its effectiveness in controlling blood pressure in urban seniors with hypertension has not been widely studied. This study aims to determine the efficacy of RAVS mode autosuggestion in controlling blood pressure in urban elderly with hypertension. Methods: This limited pilot study involved 15 urban elderly Posbindu participants aged > 55 with hypertension who received the RAVS autosuggestion intervention for 4 weeks or 1 month. Blood pressure was measured simultaneously, as a baseline before being measured first and after the intervention at weeks 1, 2nd, 3rd, and 4. The trial was carried out 3 times a week for 30 minutes per activity session. The study showed that RAVS autosuggestion was relatively effective in controlling blood pressure in urban elderly with hypertension, with a reasonably stable and significant decrease in systolic and diastolic blood pressure. A substantial decrease in blood pressure was seen in the second and third weeks, and an improvement in the fourth week. Relative RAVS autosuggestion may be one of the therapeutic alternatives to control blood pressure in urban elderly with hypertension. This study shows that RAVS autosuggestion can be an easy, cheap, effective, and non-invasive method of blood pressure control in urban seniors with hypertension.

The Effectiveness of the EDHIV Game Intervention on HIV/AIDS Knowledge and Risk Behavior Among Adolescents

2026-07-11T01:37:13+07:00

The high global and national prevalence of HIV/AIDS, particularly among the 15–24 age group, underscores the urgent need for innovative and engaging preventive education. This study aimed to analyze the effect of a new educational intervention, the EDHIV Game, on improving HIV/AIDS knowledge and reducing risk behavior among adolescents. A quasi-experimental design using a pre-test and post-test with a control group was conducted involving 156 adolescents (78 in the intervention group and 78 in the control group), primarily aged 14–16 years. The intervention group received the EDHIV Game, while the control group received standard health education. Data were collected using validated questionnaires for knowledge and self-reported risk behavior. The results showed a significant increase in knowledge scores and a significant reduction in risk behavior scores in the intervention group compared to the control group (p<0.001). The EDHIV Game is statistically effective as a media-based intervention to promote comprehensive HIV/AIDS literacy. Future implementation is recommended in school-based and community-based health promotion programs targeting youth.