Journal Hygeia Public Health

Quantitative Evaluation Of Antibiotic Use In Hospitalized Patients With Acute Gastroenteritis At UNS Hospital

An Nisa Sinara Nur Aini — 2026-09-14

Antibiotics are the primary treatment for bacterial infections, but irrational use can lead to antibiotic resistance. One effort to control this problem is to conduct a quantitative evaluation of antibiotic use. This study aims to evaluate antibiotic use in patients treated at UNS Hospital in Surakarta in 2025 for acute gastroenteritis. Retrospective data were collected from patient medical records in this descriptive observational study. The sampling technique used was total sampling with inclusion criteria of inpatients aged 19–59 years diagnosed with acute gastroenteritis and receiving systemic antibiotic therapy. Quantitative data analysis was performed using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) and Drug Utilization 90% (DU 90%) methods. The results showed a total antibiotic use of 75.27 DDD/100 hospitalization days with a total hospitalization period of 891 days. The antibiotic with the highest use was ceftriaxone injection at 33.22 DDD/100 hospitalization days, followed by ciprofloxacin injection, levofloxacin injection, and metronidazole injection. Based on the DU 90% analysis, antibiotics included in the highest usage segment were ceftriaxone, ciprofloxacin, levofloxacin, metronidazole, cefixime, ampicillin, and azithromycin. The conclusion of this study indicates that broad-spectrum antibiotics still dominate therapy in hospitalized patients with acute gastroenteritis, thus requiring periodic monitoring and evaluation of antibiotic use to support rational antibiotic use.

Gingivectomy on the Maxillary Central Incisor: A Case Report

Leonardo Jaya Setiadi Tanumiharja — 2026-09-17

Exaggerated gingival display is one of the esthetic features of the periodontium, which is related to the attractiveness of a smile. APE (Altered passive eruption) margin gingiva failed to migrate apically to reach the level at or near the cementoenamel junction (CEJ), so that the gingival margin was more incisal/coronal to the crown of the tooth. In APE cases, gingivectomy is performed by cutting the gingival tissue to remove the lateral wall of the pocket so that the clinical crown length will increase and be symmetrical with the clinical crown length of the adjacent teeth. In this case report, we will discuss the treatment of gingivectomy using conventional techniques in a 22-year-old male patient with a shortened gingival appearance on teeth 11 and 21.

Characteristics Of TB-HIV Patients At Rumah Sakit Paru Jawa Barat Sidawangi 2022-2024

Dyocta Ksatria Setiawan — 2026-09-17

Background: Tuberculosis (TB) and HIV (Human Immunodeficiency Virus) coinfection is a serious health problem worldwide. HIV infection increases the risk of TB and worse condition. It is important to understand the clinical and demographic characteristics of TB-HIV patients to improve treatment and intervention strategies. This study aims to describe characteristics TB- HIVpatients at Rumah sakit Jawa Barat Sidawangi [West Java Sidawangi Hospital]. Methods: This is a descriptive observational by medical records of 49 TB-HIV patients in January 2022 to December 2024.Results: Most patients were male (81.63%) and young adults (87.76%). Almost all cases (97.96%) were new pulmonary TB. Cases most patients had a lost to follow-up treatment (44.90%). Nutritional assessment showed 36.73% of patients were underweight. Conclusion: TB-HIV patients in Rumah sakit Jawa Barat Sidawangi [West Java Sidawangi Hospital] are mostly young adult males with new pulmonary TB. The high lost to follow-up rate shows the need for better patient monitoring. Also,the significant number of patients with poor nutrition highlights the need to provide nutritional support to help improve treatment outcomes.

The Relationship Between Academic Self-Efficacy and Communication Skills Mastery among Medical Students at the Faculty of Medicine, Universitas Swadaya Gunung Jati

Citra Dewi Kusfebrianti — 2026-09-17

Communication skills are fundamental competencies for medical students in establishing therapeutic relationships and supporting effective healthcare delivery. Their mastery may be influenced by psychological factors, including academic self-efficacy. This study aimed to determine the relationship between academic self-efficacy and communication skills mastery among medical students at the Faculty of Medicine, Universitas Swadaya Gunung Jati. This quantitative analytical study employed a cross-sectional design. A total of 258 active medical students were selected using probability sampling. Data were collected using The Academic Self-Efficacy Scale (TASES) and the Interpersonal Communication Competence Scale (ICCS). The relationship between variables was analyzed using the Spearman rank correlation test. Most respondents had a high level of academic self-efficacy (65.6%), while communication skills mastery was predominantly moderate (60.2%). The Spearman rank test demonstrated a statistically significant positive relationship between academic self-efficacy and communication skills mastery (ρ = 0.442; p < 0.001), with a moderate correlation strength. Academic self-efficacy was positively and significantly associated with communication skills mastery among medical students. Strengthening academic self-efficacy through active learning, communication practice, simulation, and constructive feedback may contribute to the development of clinical communication competencies.

Humanization Of Healthcare Services From The Patient's Perspective At Cipeundeuy Community Health Center, West Bandung Regency, West Java Province

Galoh Sutrisno — 2026-09-18

Anggraini, S., dkk. (2025). Peran petugas administrasi dalam membentuk persepsi humanisasi pelayanan rumah sakit. https://ejournal.unimman.ac.id/index.php/jka/article/view/957

Astuti, R., dkk. (2025). Kepuasan pasien di fasilitas pelayanan kesehatan primer berdasarkan perspektif pasien. https://jurnal.htp.ac.id/index.php/keskom/article/view/2104

Manurung, T., & Simarmata, R. (2025). Digitalisasi layanan kesehatan dan tantangan humanisasi pelayanan pasien. https://ejournal.appihi.or.id/index.php/Presidensial/article/view/811

Masmumah, A., Suminar, E., & Sari, D. J. E. (2024). Hubungan komunikasi efektif perawat dengan kepuasan pasien di Rumah Sakit Muhammadiyah Gresik. Jurnal Keperawatan, 22(1), 12–20. https://doi.org/10.35874/jkp.v22i1.1216

Miolda, P. R., Aldia Pratama, E. P., & Pramudyawardani, F. D. (2022). Patient‑centered care in improving the quality of health services: A systematic review. SEHAT: Jurnal Kesehatan Terpadu, 2(2), 16528.

Qisthijahraa, N., dkk. (2025). Transformasi digital dan implikasinya terhadap humanisasi pelayanan kesehatan. https://ejournal.yasin-alsys.org/arzusin/article/view/8326

Saputra, A., & Yustanti, D. (2026). Humanisasi pelayanan kesehatan dalam telemedicine: Perspektif perlindungan hak pasien. https://ejournal.appihi.or.id/index.php/Desentralisasi/article/view/1526

Talahatu, O., Paliyama, D. G., Manuhutu, F., & Wakano, G. J. (2023). Pelaksanaan konsep patient centered care berdasarkan perspektif pasien dan perawat. Journal of Telenursing (JOTING), 5(2). https://doi.org/10.31539/joting.v5i2.8087

Tinggogoy, M., Rusca Putra, K., & Kapti, R. E. (2024). Factors influencing the implementation of patient‑centered care in health services: A scoping review. Jurnal Riset Kesehatan Poltekkes Depkes Bandung, 17(2), 2944

Green Tea Consumption and Adjunctive Green Tea Products for Periodontal Disease Prevention and Management: A Narrative Review

Leonardo Jaya Setiadi Tanumiharja — 2026-09-18

Intoduction: Periodontal disease is common among older adults and may contribute to tooth loss, oral discomfort, and compromised quality of life. This PubMed-based narrative review summarises evidence on green tea (Camellia sinensis) consumption and adjunctive green tea products for the prevention or management of periodontal disease, with emphasis on relevance to Indonesian older adults. Method: PubMed was searched up to 28 June 2026 using combinations of green tea, Camellia sinensis, catechin, epigallocatechin gallate, EGCG, matcha, periodontitis, periodontal disease, gingivitis, plaque, and scaling and root planing. PubMed-indexed clinical trials and systematic reviews relevant to periodontal outcomes were prioritised. Indonesian epidemiological and quality-of-life studies were included only when indexed in PubMed. Result and Discussion: No PubMed-indexed clinical trial was found that specifically evaluated green tea for periodontal disease in Indonesian older adults. Evidence from adult periodontal populations suggests that green tea catechins or EGCG, delivered as gels, strips, dentifrices, mouthwashes, ultrasonic scaler irrigants, or oral intake, may reduce gingival inflammation, bleeding, microbial burden, oxidative stress, inflammatory biomarkers, and, in some studies, probing depth or clinical attachment loss. Conclusion: Green tea may be a low-cost adjunct to plaque control and professional periodontal therapy, but it should not replace scaling and root planing, oral hygiene instruction, maintenance care, or management of systemic risk factors. Current evidence is heterogeneous and generally limited; therefore, recommendations for Indonesian older adults should be conservative and framed as supportive rather than curative.

Levels Of Pain, Stiffness, And Physical Function In Patients Who Underwent Total Knee Replacement (TKR) Surgery Based On WOMAC Scores At Waled Regional General Hospital (RSUD Waled)

Permata Hasna Hamidah — 2026-09-18

Intoduction: Osteoarthritis is a degenerative joint disease that can cause pain, stiffness, and limited physical function. In advanced stages of knee osteoarthritis, total knee replacement (TKR) is an effective procedure to reduce pain and improve joint function. However, post-operative complications may still occur in some patients. This Studi to determine the level of complaints of pain, stiffness, and physical function in patients who have undergone Total Knee Replacement (TKR) surgery at Waled Regional Hospital, based on measurement results using the WOMAC questionnaire. Method: This study was a descriptive cross-sectional study. The sample consisted of 62 patients who underwent unilateral TKR at Waled Regional Hospital between 2021-2025 and were selected using a total sampling technique. Data were obtained through medical records and the WOMAC questionnaire, then analyzed univariately. Result and Discussion: Most respondents were aged >65 years (54.8%), female (71.0%), and housewives (46.8%). Based on WOMAC, most experienced mild pain (80.6%), moderate stiffness (61.3%), mild physical dysfunction (72.6%), and had a total WOMAC score in the mild category (96.8%). Conclusion: Post-TKR surgery patients at Waled Regional Hospital generally have mild levels of post-operative complaints based on the WOMAC score, although joint stiffness is still in the moderate category in most respondents.

Designing A Board Game For Early Detection Of Attention Deficit Hyperactivity Disorder (ADHD) Symptoms Among Kindergarten Students At Eka Dharma Surabaya

Rr Andyna Putri Felisha — 2026-09-18

ADHD in early childhood should be recognized early because it may affect attention, behavioral control, social interaction, and learning readiness. Method: This observational cross-sectional study was conducted at Eka Dharma Kindergarten Surabaya in January-February 2025 involving 30 students with parental consent. Children completed a cut-and-paste board game, their behavior was observed using a companion table modified from GPPH, and teachers completed the SNAP-IV. Data were analyzed descriptively and tested using Chi-square/Fisher Exact Test. Result and Discussion: Board game results were mostly moderate (70.0%), followed by high (26.7%) and low (3.3%). Board game results were significantly associated with inattention (p=0.033) and hyperactive/impulsive symptoms (p=0.033), but not with oppositional/defiant symptoms (p=0.117). Conclusion: The Board Game Companion (GPPH) may serve as an initial ADHD screening medium for inattention and hyperactive/impulsive domains, but further validation is required.

The Relationship Between Occupational Safety and Health (OSH) Knowledge and Operator Performance at the Sorting Station of the PTPN IV Pabatu Palm Oil Mill

Shofa Aprilia Zahara — 2026-09-18

Operators’ ability to complete each stage of their tasks to maintain the quality of fresh fruit bunches (FFB) has a significant impact on the success of the sorting process at palm oil mills. The level of knowledge regarding Occupational Safety and Health (OSH) is one factor believed to influence this ability. It is estimated that operators can work more efficiently while reducing the risk of workplace accidents by implementing safe work procedures and having a deep understanding of potential hazards in the workplace. The objective of this study is to determine the relationship between operator performance at the Pabatu Unit Sorting Station, PTPN IV, and their OSH expertise. This study employs a cross-sectional design and a quantitative approach. The study population consisted of all 61 sorting station operators, and a sample of 30 respondents was selected at random. A valid and reliable questionnaire was used to collect research data. Descriptive statistics were used in the data analysis process to describe the characteristics of the research variables. The relationship between variables was then tested using the Pearson Product-Moment correlation test at a 5% significance level. Based on the data, the average work performance score was 42.63 ± 7.642, while the average OSH knowledge score was 46.23 ± 6.087. The statistical test results showed a positive and significant relationship between operators’ work performance and OSH knowledge.is associated with better work performance among sorting station operators. Therefore, the company is encouraged to strengthen the implementation of OSH programs through continuous education, training, supervision, and competency development to enhance operators' performance.

The Relationship Between the Implementation of Occupational Safety and Health (OSH) and Employee Performance at PT Pertamina Patra Niaga’s Meulaboh Fuel Terminal

Lyra Thania — 2026-09-18

The implementation of Occupational Safety and Health (OHS) is crucial for creating a safe workplace and improving worker performance, particularly in high-risk sectors such as fuel distribution. However, observations at PT Pertamina Patra Niaga Fuel Terminal Meulaboh continue to show irregularities in the use of personal protective equipment (PPE) and compliance with occupational safety protocols, which can impact worker performance. The purpose of this study is to examine the relationship between employee performance at PT Pertamina Patra Niaga Fuel Terminal Meulaboh and the use of Occupational Safety and Health (OHS). This study employed a cross-sectional design and quantitative methodology. A complete sampling strategy was employed to select 52 respondents for the study sample. A questionnaire was used to collect data, and the Chi-Square test was used for univariate and bivariate analysis at a 95% significance level (α = 0.05). The Chi-Square test yielded a χ² score of 13.019 with a p-value <0.001, indicating a strong correlation between OHS implementation and employee performance. It is concluded that by creating a safer and more comfortable work environment, effective implementation of K3 is related to improved employee performance.

Trends In The Prevalence Of Stunting Among Toddlers Based On The 2022–2025 Community-Based Electronic Nutrition Recording And Reporting System In The Service Area Of The Samadua Community Health Center, South Aceh Regency

Resi Aprilyandari — 2026-09-18

The e-PPGBM application can display graphs showing changes in case prevalence, but with some limitations depending on the version of the application used and the user’s access rights. However, for research trend analysis, the e-PPGBM graphs are insufficient because they have several limitations, such as not calculating the Annual Percent Change or Average Annual Percent Change, not providing statistical trend tests such as Joinpoint Regression, and being intended more for program monitoring than for epidemiological analysis. This study aims to analyze trends in the prevalence of stunting among toddlers based on e-PPGBM data from 2022–2025 in the service area of the Samadua Community Health Center (Puskesmas) in South Aceh Regency. The study employs a quantitative approach with an ecological study design based on secondary e-PPGBM data from 2022–2025. The sample was determined using total sampling. Trend analysis was conducted using the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). The prevalence of stunting decreased from 26.55% in 2022 to 16.23% in 2023 and 7.85% in 2024, then increased to 9.71% in 2025. The total AAPC value of -22.28% indicates a downward trend in the average prevalence of stunting, although some villages still experienced an upward trend. The conclusion of this study is that the prevalence of stunting in the service area of the Samadua Community Health Center tended to decline during the study period. APC and AAPC analyses based on e-PPGBM data provide a comprehensive picture of trends, thereby supporting the identification of priority areas and the development of evidence-based policies to accelerate the reduction of stunting.

Correlation Analysis Between Hazard Identification, Risk Assessment, Risk Control, And Safety Culture And The Prevention Of Workplace Accidents In The Fruit Receiving Area Of The Pabatu Palm Oil Mill Unit

Ade Rita Suryani Siregar — 2026-09-18

One of the work places at a palm oil mill that presents possible risks because of operational activities and employee interactions with the workplace is the Fruit Receiving Area. Risk management and the avoidance of workplace accidents depend heavily on the application of Hazard Identification, Risk Assessment, and Risk Control (HIRARC) and a safety culture. In order to reduce workplace accidents in the Fruit Receiving Area of the Pabatu Palm Oil Mill, this study is to examine the relationship between hazard identification, risk assessment, risk control, and safety culture. The study employs a cross-sectional design and a quantitative methodology. Purposive sampling was used to pick a sample of 30 respondents from the 61 workers that made up the study population. Data were collected using a questionnaire and analyzed univariately using the median (minimum–maximum), as well as bivariately using the Spearman rank test with a 95% significance level (α=0.05). The results showed a median score of 24.00 (12–25) for hazard identification, 18.50 (11–20) for risk assessment, 19.00 (11–20) for risk control, 18.50 (12–20) for safety culture, and workplace accident prevention at 23.50 (18–25). The Spearman’s rank correlation test revealed significant relationships between hazard identification (r = 0.422; p = 0.020), risk assessment (r = 0.417; p = 0.022), risk control (r = 0.522; p=0.003), and safety culture (r=0.551; p=0.002) with workplace accident prevention. Safety culture had the strongest correlation compared to the other variables. Consistent implementation of the HIRARC framework, supported by the strengthening of safety culture, ongoing occupational safety and health (OSH) training, and monitoring of worker compliance, is necessary to enhance workplace accident prevention efforts

Validation Of An Analytical Method For The Determination Of Retinoic Acid In Facial Whitening Creams Marketed In Bengkulu City Using UV–Visible Spectrophotometry

Malarisa Lala — 2026-09-18

ntroduction: Retinoic acid is a prescription-only vitamin A derivative prohibited as a cosmetic ingredient under Indonesian FDA Regulation No. 17 of 2022, yet it may still be present in unregistered facial lightening creams. This study aimed to validate a UV-Vis spectrophotometric method and determine the presence and level of retinoic acid in facial whitening creams marketed in Bengkulu City. Method: Five products were purposively collected from Panorama Market and Minggu Market. Preliminary identification used antimony(III) chloride (SbCl3) color reaction and thin-layer chromatography (TLC), while quantitative determination used UV-Vis spectrophotometry. Validation covered linearity, precision, accuracy, limit of detection (LOD), and limit of quantitation (LOQ). Result and Discussion: Samples C and D were positive by color reaction and TLC, showing an Rf of 0.89 compared with 0.86 for the reference standard, whereas samples A, B, and E were negative. The maximum wavelength was 341 nm. R² values from three linearity replications were 0.99832, 0.99137, and 0.99592; precision was 3.14% RSD; recovery ranged from 97.39% to 103.53%; LOD and LOQ were 0.1546 and 0.4686 ppm, respectively. Mean retinoic acid levels in samples C and D were 0.00072% and 0.0020%. Conclusion: Retinoic acid was detected in part of the tested products. The method showed acceptable precision and accuracy, although sample concentration estimates require cautious interpretation because the regression-derived concentrations were below the LOQ.

Analysis Of The Occupational Safety Culture Among Press-An (Kempa) Station Operators At The Pabatu Palm Oil Mill, Tebing Tinggi Subdistrict, Serdang Bedagai Regency

Nur Fatimah — 2026-09-18

In the palm oil industry, occupational safety culture plays a critical role in preventing workplace accidents, particularly in the press station, which is recognized as one of the highest-risk operational areas. Preliminary observations at Pabatu Palm Oil Mill revealed several safety concerns, including inconsistent use of personal protective equipment (PPE) by operators, slippery floors caused by oil spills, and production demands that may affect workers' compliance with occupational safety procedures. This study aimed to examine the influence of safety leadership, occupational health and safety (OHS) training and competency, safety communication, workplace facilities and environment, and production pressure on the occupational safety culture of press station operators. This study employed a quantitative approach with an explanatory cross-sectional design. The study population consisted of 61 operators working at the press station, of whom 30 were selected as research participants using a purposive sampling technique. Primary data were collected through a structured questionnaire based on a five-point Likert scale and analyzed using multiple linear regression. The findings indicated that occupational safety culture was positively influenced by safety leadership (B = 0.267), OHS training and competency (B = 0.231), safety communication (B = 0.208), workplace facilities and environment (B = 0.318), and production pressure (B = 0.176). Collectively, these five independent variables explained 81.7% of the variance in occupational safety culture (R² = 0.817), while the remaining 18.3% was attributable to other factors not examined in this study. Among the variables investigated, workplace facilities and environment emerged as the most influential factor. Therefore, strengthening occupational safety culture requires an integrated approach through effective safety leadership, continuous OHS training, effective safety communication, the provision of safe workplace facilities and environments, and production target management that consistently prioritizes occupational safety.

The Association Between Employee Characteristics and Attitudes Toward the Implementation of the Smoke-Free Area Policy at General Ahmad Yani Regional Public Hospital, Metro City, Indonesia

Hepi Desi Elitasari — 2026-09-18

The implementation of a Smoke-Free Area (SFA) policy in hospitals aims to protect patients, visitors, and employees from exposure to tobacco smoke. Although the SFA policy has been disseminated uniformly to all employees, attitudes toward its implementation may vary among individuals. These differences are presumed to be influenced by employee characteristics. This study aimed to analyze the association between employee characteristics and attitudes toward the implementation of the Smoke-Free Area policy, including the cognitive, affective, and conative domains, and to identify the most dominant characteristic associated with attitudes toward SFA implementation among employees of General Ahmad Yani Regional Public Hospital, Metro City, Indonesia, in 2026.

Methods: This quantitative study employed a cross-sectional design involving 298 employees selected using an accidental sampling technique. Data were collected using a valid and reliable questionnaire and analyzed using univariate analysis, bivariate analysis with the Chi-square test, and multivariate analysis using logistic regression.

Results and Discussion: A total of 52.0% of respondents had a positive attitude toward the implementation of the SFA policy. Bivariate analysis showed that sex (p<0.001) and educational level (p=0.011) were significantly associated with attitudes toward SFA implementation, whereas employment category, age, and length of employment were not (p>0.05). Domain analysis revealed that sex and educational level were significantly associated with the cognitive, affective, and conative domains. Logistic regression identified sex as the most dominant factor associated with attitudes toward SFA implementation (OR=2.761; 95% CI=1.640–4.650; p<0.001).

Conclusion: Sex and educational level were significantly associated with attitudes toward the implementation of the Smoke-Free Area policy, with sex being the most dominant factor. These findings may serve as a basis for developing more effective SFA education and capacity-building strategies tailored to employee characteristics.

The Relationship Between Lighting Intensity And Eye Fatigue Complaints With Visual Acuity Disorders In Bamboo Weaving Workers In Payaman Village Lamongan

Alya Nabilah — 2026-09-18

Bamboo weaving is a job that requires high visual accuracy, thus requiring adequate lighting conditions to support workers' eye health. Lighting that does not meet standards and visual activities carried out continuously for long periods can cause eye fatigue and potentially lead to impaired visual acuity. Based on a preliminary study in Payaman Village, Lamongan, most bamboo weaving workers use household lamps as a source of lighting while working and many complain of eye disorders. This study aims to analyze the relationship between lighting intensity and complaints of eye fatigue with impaired visual acuity in bamboo weaving workers in Payaman Village, Lamongan. Method: This study used an observational analytical design with a cross-sectional approach. The study population was 97 bamboo weaving workers and a sample of 78 respondents was obtained using the Slovin formula with a simple random sampling technique. Lighting intensity was measured using a lux meter, complaints of eye fatigue were measured using a questionnaire, while visual acuity was measured using a Snellen Chart. Data analysis was performed using the Chi-Square test with a significance level of 5%. Result and Discussion: The results of the study showed that there was a relationship between lighting intensity and visual acuity disorders (p-value = 0.006; OR = 3.710; 95% CI = 1.430–9.629) and there was a relationship between complaints of eye fatigue and visual acuity disorders (p-value = 0.003; OR = 4.125; 95% CI = 1.575–10.803). Conclusion: It was concluded that lighting intensity that did not meet standards and complaints of eye fatigue were associated with an increased risk of visual acuity disorders in bamboo weaving workers.

Evaluasi Program Sanitasi Total Berbasis Masyarakat (STBM) Di Wilayah Kerja Puskesmas Way Halim II Kota Bandar Lampung Tahun 2022-2024

Deddy Maulana Hasyim — 2026-09-18

Community-Based Total Sanitation (CBTS) aims to reduce the prevalence of environmental illnesses by encouraging people to modify their sanitation habits. Bandar Lampung City has a reasonably high rate of access to better sanitation, but it is still difficult to meet the five pillars of CBTS and make behaviour change last. Using input, process, and output metrics, this research sought to assess the CBTS Program's efficacy at the Bandar Lampung City workplace of Way Halim II Primary Health Center. An evaluation strategy based on qualitative data was used. Using purposive sampling, fifteen informants were chosen: the health center director, environmental health officers, community health volunteers, village authorities, and community representatives. Miles and Huberman's interactive model was used to analyse data gathered via in-depth interviews, field observations, and document reading. Despite minimal dedicated CBTS financing, the results showed that the input component had sufficient human resources and significant program commitment. The process component revealed that there was constant engagement of community and local leaders in triggering, mentoring, health education, and monitoring activities; however, the intensity of the mentoring was not up to par. The output component showed improvements in sanitation behaviour, such as using soap to wash hands and ending open defecation; nonetheless, progress toward all five CBTS goals was unequal, notably in the areas of solid waste and wastewater management. In conclusion, there have been beneficial outcomes from implementing CBTS. However, to guarantee sustainability, there has to be more financing, mentorship, and cooperation across sectors.

Implementation of the Antimicrobial Resistance Control Program (PPRA) in Improving the Rational Use of Antibiotics in Indonesian Hospitals: A Literature Review

Delvi Fadillah Rahmad Gusman — 2026-09-18

Intoduction: The cat breeder every day began by feeding, bathing, cutting the nails and cleaning the Antimicrobial resistance is a major public health concern closely associated with irrational antibiotic use in healthcare facilities, particularly hospitals. The Antimicrobial Resistance Control Program (PPRA) is one of the strategies implemented in Indonesian hospitals to promote the rational use of antibiotics and control the development of antimicrobial resistance. This literature review aimed to analyze the implementation of PPRA and its contribution to improving the rational use of antibiotics in Indonesian hospitals. A literature search was conducted for scientific articles published between 2018 and 2026 that discussed PPRA implementation, antibiotic use, rational antibiotic therapy, and antibiotic utilization evaluation in Indonesian hospitals. A total of 17 articles that met the inclusion criteria were included in the literature synthesis. The findings indicate that PPRA implementation in various hospitals involves antibiotic utilization surveillance, qualitative and quantitative evaluations, antibiotic use audits, restrictions or pre-authorization of selected antibiotics, and multidisciplinary involvement in antimicrobial stewardship. Evaluations using the Gyssens and ATC/DDD methods demonstrated that irrational antibiotic use remains present in several healthcare settings; however, various antimicrobial stewardship interventions showed potential to improve the appropriateness of antibiotic selection and utilization. The effectiveness of PPRA implementation is influenced by multidisciplinary collaboration, adherence to therapeutic guidelines, availability of antibiotic utilization data, and consistency in program implementation. Therefore, PPRA plays an important role in improving the rational use of antibiotics and supporting efforts to control antimicrobial resistance in Indonesian hospitals.

The Relationship Between Maternal Knowledge Level and the Growth and Development of Infants Aged 6–12 Months at Gondokusuman I Public Health Center, Yogyakarta City

Ayu Anggraini Mutmainun — 2026-09-18

Intoduction: Infancy at 6–12 months is a critical period of rapid growth and development. Maternal knowledge regarding nutrition, childcare, stimulation, and developmental monitoring contributes to optimal outcomes. This study aimed to analyze the relationship between maternal knowledge level and growth and development of infants aged 6–12 months at Gondokusuman I Public Health Center, Yogyakarta City. Method: This analytical observational study used a cross-sectional design and involved 53 mother–infant pairs selected through total sampling. Maternal knowledge was assessed using a questionnaire with a reported reliability coefficient of α=0.725, while infant growth and development were assessed using the study measurements and instruments. Data were analyzed using the Chi-Square test at α=0.05. Result and Discussion: Most mothers had good knowledge (41.5%). Normal infant growth accounted for 56.6%, while age-appropriate development accounted for 41.5%. Maternal knowledge was significantly associated with infant growth (p=0.01) and development (p=0.01). Better knowledge was linked to more appropriate childcare, nutritional provision, developmental stimulation, and routine monitoring. Conclusion: Maternal knowledge is associated with growth and development among infants aged 6–12 months. Strengthening maternal education and routine monitoring at primary health-care level is recommended to support optimal infant growth and development.

Analysis Of The Relationship Between Occupational And Environmental Factors And The Level Of Work Fatigue Among Ship Crew

Trihariyanto Trihariyanto — 2026-09-18

Introduction: Work fatigue among ship crew members may be influenced by work-related and environmental factors, potentially reducing productivity, safety, and workers' health. This study aimed to analyze the relationship between work-related and environmental factors and work fatigue among ship crew members in Sarawak, Malaysia. Method: The study employed a quantitative method with a cross-sectional design and involved 20 respondents selected using a non-probability sampling technique. Data were collected through an online questionnaire using Google Forms and measurements of environmental conditions, including noise intensity, temperature, and lighting. Data were analyzed using univariate and bivariate analyses with Spearman's rho correlation test at a 95% confidence level (α = 0.05). Results and Discussion: The results showed a significant, strong, and positive relationship between work and environmental factors and the level of work fatigue (p = 0.000; r = 0.723). Higher workloads and poorer environmental conditions were associated with higher levels of fatigue among ship crew members. Conclusion: Workload control, improvements in the work environment, and stress management are needed to reduce fatigue and improve the occupational safety, health, and productivity of ship crew members.

The Relationship Between Socioeconomic Characteristics, Social Assistance Receipt, And Dietary Diversity With Household Food Security

Annisa Nanda Salsabila — 2026-09-18

Introduction: Global food security is currently facing increasingly complex challenges, including in Indonesia. This study aimed to analyze the relationship between socioeconomic characteristics, social assistance receipt, and household dietary diversity with household food security among communities in Sungai Bakau Besar Laut Village, Mempawah Regency. Method: This study employed a quantitative cross-sectional design. A multi-stage sampling technique, consisting of purposive sampling and simple random sampling, was used to select 117 respondents. Data were collected through face-to-face interviews using structured questionnaires. Data were analyzed using the Chi-square test with SPSS software.Result and Discussion: The results showed significant associations between the occupation of the household head (p-value = 0.024), household income (p-value = 0.030), household food expenditure share (p-value = 0.040), social assistance receipt (p-value = 0.030), and household dietary diversity (p-value = 0.002) with household food security. Meanwhile, the educational level of the household head (p-value = 0.586) and household size (p-value = 0.336) were not significantly associated. Conclusion: In conclusion, the occupation of the household head, household income, household food expenditure share, social assistance receipt, and household dietary diversity play important roles in household food security. In contrast, the educational level of the household head and household size were not significantly associated with household food security.

Analysis Of Drug Interactions And Their Severity In The Therapy Of Patients With Chronic Obstructive Pulmonary Disease (Copd): A Literature Review

Fitria Salsabela — 2026-09-18

Intoduction: Patients with Chronic Obstructive Pulmonary Disease (COPD) are vulnerable to multimorbidity and polypharmacy because bronchodilator regimens are frequently combined with therapies for comorbid conditions, increasing the risk of pharmacokinetic and pharmacodynamic drug-drug interactions (DDIs). This review aimed to identify the specific patterns, causal mechanisms, and severity of DDIs in COPD regimens and to formulate clinical mitigation strategies. Method: This narrative literature review adopted PRISMA 2020 principles and extracted 11 primary and secondary studies from PubMed/MEDLINE, ScienceDirect, SpringerLink, Wiley Online Library, and Google Scholar, focusing on publications from 2021–2026 while retaining fundamental references that remained relevant. Result and Discussion: The cumulative prevalence of DDIs reached 72.2% and increased to 96% during hospitalization for acute exacerbations. DDIs were predominantly pharmacodynamic, particularly additive QT-interval prolongation and INR modulation, with pharmacokinetic interactions involving cytochrome P450 pathways. Severity was dominated by moderate (52.8%) and major (25.1%) interactions. Conclusion: DDI risk in COPD is complex and supports the need for medication reconciliation, structured pharmacist-led medication review, and targeted clinical monitoring during transitions of care to reduce preventable drug-related harm.

Analisis Penerapan Rme Pada Layanan Rawat Inap Menggunakan Metode Tam Di Rs Panti Waluya Malang

Catharina Novita Clara — 2026-09-18

Intoduction: RME is a subsystem of the health care facility information system that is connected to other information subsystems in health care facilities. At Panti Waluya Hospital, Malang, there are several problems, namely some health workers who have not received training related to RME, downtime occurs (planned downtime and unplanned downtime), and SOPs for the use of RME in inpatient units have been created but have not been formalized. This study aims to analyze the implementation of RME in inpatient health services at Panti Waluya Hospital, Malang using the TAM method. The study used a quantitative cross-sectional design. The study used a quantitative research type with a descriptive and analytical approach. The research respondents were medical record officers, doctors, nurses, and midwives in the inpatient department with a total sample of 148 people. Data were collected through a 31-item questionnaire covering four TAM constructs and then analyzed using SEM-PLS (SMART PLS). The results of the study based on the structural model analysis, the Perceived Usefulness variable has a positive and significant effect on Behavioral Intention to Use (coefficient 0.438; t 6.753; p 0.000). The Perceived Ease of Use variable has a negative but significant effect on Perceived Usefulness (coefficient -0.255; t 2.963; p 0.003) and on Behavioral Intention to Use (coefficient -0.236; t 4.107; p 0.000). Furthermore, Behavioral Intention to Use has a positive and significant effect on Actual System Use (coefficient 0.436; t 6.913; p 0.000). In conclusion, the implementation of EMR in the inpatient unit has generally been running well, but the aspect of ease of use still needs to be improved. This study is expected to provide input for Panti Waluya Hospital Malang in providing a concise and easily accessible EMR usage guide.

Comparison of 96% Ethanol and 10% Formal Alcohol as Fixatives on the Staining Quality of Papanicolaou-Stained Pleural Effusion Smears

Dina Mayasari — 2026-09-18

Background: Adequate fixation is an essential pre-analytical step in pleural effusion cytology because it preserves cellular morphology and supports optimal Papanicolaou staining. Although 96% ethanol is commonly used as a wet fixative, 10% formal alcohol may provide an alternative when conventional alcohol fixation is less practical. However, comparative information regarding the staining quality of pleural effusion smears fixed with these two solutions remains limited.Objective: This study aimed to compare the staining quality of Papanicolaou-stained pleural effusion smears fixed with 96% ethanol and 10% formal alcohol.Methods: A descriptive comparative laboratory study was conducted using 20 pleural effusion specimens. The specimens were divided into two fixation groups: 96% ethanol (n=10) and 10% formal alcohol (n=10). Cytological smears were prepared from pleural effusion sediments, fixed according to the assigned fixation group, and stained using the conventional Papanicolaou method. Staining quality was evaluated microscopically based on three parameters: nuclear–cytoplasmic contrast, background cleanliness, and staining uniformity. Data were analyzed descriptively using frequencies and percentages.Results: All specimens in both fixation groups demonstrated good overall staining quality (100%). Nuclear–cytoplasmic contrast and staining uniformity were classified as good in all specimens in both groups (100%). Differences were observed in background cleanliness. Good background cleanliness was observed in 7 of 10 smears (70%) fixed with 96% ethanol and 5 of 10 smears (50%) fixed with 10% formal alcohol.Conclusion: Both 96% ethanol and 10% formal alcohol produced good overall staining quality in Papanicolaou-stained pleural effusion smears. The two fixatives showed comparable nuclear–cytoplasmic contrast and staining uniformity, whereas 96% ethanol produced a higher proportion of smears with good background cleanliness. Thus, 96% ethanol remains the preferred fixative when optimal background cleanliness is required, while 10% formal alcohol may be considered as an alternative for routine cytological preparation.

The Relationship Between Family Support and the Incidence of Depression Among Pregnant Women at the Independent Midwifery Practice of BDN. Febra Ayudiah, SST, Bengkulu City

Mepi Sulastri — 2026-09-29

Pregnancy is a physiological process that causes various changes in women, including physical, hormonal, psychological, and social changes. These changes may affect the mother’s emotional condition and increase the risk of mental health disorders, one of which is depression during pregnancy. Family support is one of the psychosocial factors that plays an important role in helping mothers cope with changes during pregnancy. This study aimed to determine the relationship between family support and the incidence of depression among pregnant women at the Independent Midwifery Practice of Bdn. Febra Ayudiah, SST, Bengkulu City. This study used an observational analytic research design with a cross-sectional approach. The study was conducted at the Independent Midwifery Practice of Bdn. Febra Ayudiah, SST, Bengkulu City, in July 2026. The study sample consisted of 30 pregnant women. Data were collected using questionnaires assessing family support and the incidence of depression. Data were analyzed using univariate and bivariate analyses with the Chi-Square test. Primary data were obtained through questionnaires completed by the respondents, while secondary data were obtained from relevant literature and supporting research documents. The results showed that most pregnant women received good family support, consisting of 13 respondents (43.3%), followed by adequate family support among 10 respondents (33.3%), and poor family support among 7 respondents (23.4%). Regarding the incidence of depression, 15 respondents (50%) did not experience depression, 9 respondents (30%) experienced mild depression, and 6 respondents (20%) experienced moderate-to-severe depression. The Chi-Square test yielded a p-value of 0.010 (p < 0.05), indicating a significant relationship between family support and the incidence of depression among pregnant women. There was a significant relationship between family support and the incidence of depression among pregnant women. Adequate family support can help maintain the psychological well-being of mothers during pregnancy.

The Association Between a History of Hypertension and the Incidence of Hypertension in Pregnancy in the Working Area of Sawah Lebar Community Health Center, Bengkulu City

Kintan Anissa — 2026-09-30

Hypertension in pregnancy is a complication that can increase the risk of maternal and fetal morbidity and mortality. A history of pre-existing hypertension is a risk factor that requires attention during pregnancy monitoring. This study aimed to determine the relationship between a history of hypertension and the occurrence of hypertension in pregnancy. This study employed a quantitative method with an observational analytic design and a cross-sectional approach. The sample consisted of 40 pregnant women selected using purposive sampling. Data were collected through interviews and observation sheets regarding hypertension history and blood pressure measurements. Data analysis was conducted using univariate and bivariate methods, specifically the Chi-Square test with a significance level of α=0.05. Of the 40 respondents, 10 (25.0%) had a history of hypertension, while 30 (75.0%) did not. Fourteen respondents (35.0%) developed hypertension during pregnancy, and 26 (65.0%) did not. Among the 10 respondents with a history of hypertension, 8 (80.0%) developed hypertension during pregnancy. Meanwhile, among the 30 respondents without a history of hypertension, 6 (20.0%) developed hypertension during pregnancy. The Chi-Square test result showed a p-value of 0.001 (p<0.05). There is a significant relationship between a history of hypertension and the occurrence of hypertension in pregnancy. A history of hypertension is a factor associated with the occurrence of hypertension in pregnancy, though it is not the sole influencing factor.