Physical activity and associated factors among Indonesian pregnant women: a mixed-method study

Exercise is recommended for pregnant women, but many are sedentary. Studies on barriers to physical activity and exercise among pregnant women in West Java Province, Indonesia, are scarce. This study aims to identify and explore the underlying factors associated with physical activity during pregnancy in West Java, Indonesia. This study was conducted using a mixed-methods strategy that integrates quantitative and qualitative data. The study surveyed pregnant women in West Java, Indonesia, from January to March 2023. The study involved 18-year-olds, married women, and fluent Bahasa participants. It used a questionnaire to assess physical pregnancy activity intention, and analyzed data using descriptive, correlation withp<0.025 included in linear regression analysis. While in a qualitative study used semi-structure interview. A study of 200 pregnant women found that age negatively correlated with total metabolic equivalent of task (MET), while gestational age, education level, body mass index (BMI), and pregnancy complications positively impacted it. Pregnancy symptoms, limited time, and low social support were identified as themes impacting adhering to physical activity recommendations. The study reveals that factors such as age, gestational age, education level, BMI, and pregnancy complications significantly influence total MET in pregnant women, suggesting the need for personalized interventions

Tacrolimus outcomes in adult kidney transplants: a decade review

Tacrolimus remains a principal immunosuppressive agent in kidney transplantation, yet its reported efficacy and safety vary due to differences in study design, treatment regimens, and patient characteristics. Objectives: To summarize recent evidence on the clinical performance of tacrolimus in adult kidney transplant recipients and identify factors contributing to variability in outcomes. A narrative review was conducted using PubMed as the primary database because of its comprehensive indexing of clinical and pharmacological studies relevant to transplant immunosuppression. Additional databases were screened to ensure completeness. Studies published between 2015 and 2025 were searched using predefined keywords. Of 91 open-access articles identified, 19 met the inclusion criteria and were analyzed. Results: Reported clinical outcomes demonstrated wide variability across studies. Acute rejection ranged from 0-18.8%, while biopsy-proven acute rejection varied substantially (0-85%). Graft loss occurred in 0-15% of recipients and mortality in 0-8%. Major adverse events were also heterogeneous, including cytomegalovirus (CMV) infection (0-16.9%), new-onset diabetes after transplantation (NODAT) (0-22.8%), and tremor (3-28.6%). Variability in findings was largely influenced by differences in study methodology, concomitant immunosuppressive protocols, monitoring practices, population characteristics, and limited ethnic diversity, as most participants were Caucasian. Tacrolimus maintains a strong efficacy-safety profile in adult kidney transplantation. Future studies with more diverse populations, standardized therapeutic drug monitoring, and longer follow-up durations are required to enhance generalizability and support individualized immunosuppressive management

Association between anemia, mental health, and nutritional status among junior high school students: a cross-sectional study in Pontianak

Iron deficiency can affect emotional regulation and contribute to symptoms of anxiety, stress, and depression. Poor dietary habits combined with mental health problems may further increase the risk of anemia. This study examined the association between anemia, mental health, and nutritional status among junior high school students in Pontianak. A cross-sectional design was used from May to December 2024 involving 277 students. Data were collected using body mass index (BMI) measurements, hemoglobin screening, and the DASS-Y questionnaire, and were analyzed with Spearman’s Rho. Most respondents were female (63.9%), and 90.96% had experienced menstruation. A total of 103 students were underweight, with an average mid–upper arm circumference of 21.48 cm, indicating chronic nutritional risk. Eighty-one students (29.2%) had anemia, predominantly females. Most students had good mental health (below the 50th percentile). No significant associations were found between anemia and mental health (p = 0.623) or between anemia and nutritional status (p = 0.664). Despite the lack of significant relationships, ongoing nutrition education, regular iron supplementation, counseling support, and routine monitoring of students’ nutritional and mental health remain important to maintain and improve overall wellbeing

Antibiotic susceptibility profile of uropathogens in pregnant women with asymptomatic bacteriuria in tertiary care hospital: a cross-sectional study

Urinary tract infections (UTIs) are common during pregnancy due to physiological and anatomical changes that predispose women to infections. One such condition, asymptomatic bacteriuria (ASB), if left undiagnosed and untreated, can lead to serious maternal complications such as pyelonephritis, postpartum UTI, and hypertensive disorders, as well as neonatal complications including preterm birth, low birth weight, and intrauterine growth restriction. This study aimed to determine the prevalence of ASB, identify the major uropathogens, and analyze their antibiotic susceptibility patterns in pregnant women, to guide effective antenatal care and treatment. This cross-sectional study was conducted on 100 midstream urine samples, which were cultured using standard microbiological techniques. The bacterial isolates obtained were identified, and their antibiotic susceptibility was determined following standard guidelines. Out of 100 samples, 14 (14%) were positive for significant bacteriuria. The most common isolates were Staphylococcus aureus (42.8%), followed by Escherichia coli (28.6%) and Klebsiella species (28.6%). ASB was most prevalent in women aged 21-30 years (64.3%), during the first trimester (64.2%), and among multigravida women (57.2%). The isolated organisms showed good susceptibility to Ceftazidime/Clavulanic acid, Ciprofloxacin, Vancomycin, Amikacin, Piperacillin–Tazobactam, Imipenem, Teicoplanin, and Linezolid. Early detection and treatment can significantly reduce adverse outcomes, making bacteriuria screening an essential part of routine antenatal care

Emotional experiences of Indonesian health science students with self-harm: a phenomenological study

Health students often face academic pressure and interpersonal conflicts that can affect their emotional regulation, thereby increasing the risk of self-harm behavior. This study aimed to explore the emotional experiences of health students who have engaged in self-harm through a phenomenological approach. A total of 8 participants (aged 18-25 years) who had engaged in self-harm and came from various health study programs participated in in-depth interviews lasting 45-70 minutes. The results of the study reveal three main themes: i) psychosocial stress as a trigger for negative emotions, ii) the role of social support in the recovery process, and iii) coping mechanisms and the need for professional intervention. These findings reveal emotional dynamics that have not been widely explored in the context of health students in Indonesia, particularly how self-harm is perceived as a strategy to control excessive emotional intensity. This study makes a new contribution by highlighting the need for interventions based on emotional regulation and increased social support that are appropriate to the subjective experiences of health students. Interventions based on empathy and psychological approaches that are more sensitive to the cultural context of the campus are the main recommendations

Workplace spirituality and nurses’ well-being: integrative review (2015-2025)

Occupational well-being and workforce sustainability in post-pandemic healthcare systems are at risk due to increasing emotional, ethical, and workload-related stressors that nurses encounter. Workplace spirituality has also been suggested as a protective factor, but empirical research remains fragmented and insufficiently synthesized. This integrative review aimed to synthesize the recent evidence on the role of workplace spirituality in the occupational well-being of nurses. A systematic search of Scopus, MEDLINE, and Cochrane databases identified English-language quantitative studies published between 2015 and 2025. Nineteen studies met the inclusion criteria and were synthesized using Whittemore and Knafl integrative review framework, with reporting relying on PRISMA 2020. There were five themes that included i) spirituality and burnout reduction, ii) organizational commitment and retention, iii) work engagement and job satisfaction, iv) spiritual congruence and interpersonal care, and v) spiritual leadership and well-being. Most findings demonstrated moderate-to-strong associations between workplace spirituality and decreased burnout, increased engagement, and greater organizational commitment. Nevertheless, these advantages were conditional and mitigated in the conditions of overwork, insufficiency of staffing, moral tension, and insufficient organizational support. This review offers a quantitative integrative synthesis of the first nursing-specific evidence to be published after the pandemic and shows that workplace spirituality serves as a complementary resource, rather than a standalone, to occupational well-being. The findings highlight important implications of nursing policy regarding introducing spirituality-based leadership development, ethical governance, and workforce support as part of the broader structural reforms

Post-COVID-19 syndrome in children: a scoping review

Post-COVID-19 syndrome (PCS) and multisystem inflammatory syndrome in children (MIS-C) have emerged as significant pediatric health challenges, yet the true prevalence and long-term effects remain unclear. Children typically experience milder acute infections than adults, but a subset develop persistent physical, neurological, and psychological symptoms that impair quality of life. To synthesize current evidence on the long-term symptoms, risk factors, and outcomes of PCS and MIS-C in children and adolescents from 2021-2025. Following the PRISMA-ScR framework, 30 studies involving children aged 0-19 years were systematically reviewed across major databases. Thematic analysis identified clinical patterns, risk determinants, and mechanistic explanations. The construal level theory (CLT) was used to interpret behavioral and psychological adaptations influencing recovery. While most pediatric cases resolved fully, 15-30% of MIS-C survivors exhibited prolonged neuropsychological symptoms, fatigue, cognitive impairment, and mood disturbances lasting beyond12 weeks. Risk factors included adolescent age, severe acute illness, and preexisting conditions. Major gaps include inconsistent definitions, limited longitudinal follow-up, and the absence of standardized rehabilitation or psychosocial care protocols. Post-COVID-19 sequelae in children warrant structured follow-up programs integrating neurocognitive assessment, mental health support, and standardized care pathways to reduce long-term disability and guide policy formulation. Post-COVID-19 syndrome, MIS-C, pediatrics, long COVID, scoping review

Strengthening intensive care training in response to COVID-19: lessons for medical education

Frequent updates to clinical guidelines during the COVID-19 pandemic have posed significant challenges for audit processes, quality improvement, and the preparedness of healthcare professionals, particularly in intensive care settings. This study aimed to explore the impact of COVID-19-related demands on medical education and training from the perspective of healthcare teams working in intensive care units (ICUs) in Indonesia during the first wave of the pandemic. A qualitative design was employed using semi-structured interviews and focus group discussions with medical personnel directly involved in the care of COVID-19 patients at national referral hospitals. Purposive sampling was applied to recruit participants, including general practitioners, interns, residents, anesthesiologists, and ICU consultants. A total of 66 participants were included across eight focus group discussions, each consisting of eight to nine participants. Data collection continued until thematic saturation was achieved. Transcripts were analyzed using content analysis to identify key themes and subthemes. The analysis revealed five major themes: i) the need for continuous upgrading of knowledge and competencies, ii) the importance of innovative education and training approaches, iii) the role of professional organizations, iv) challenges encountered during training implementation, and v) time constraints. These findings highlight the urgent need for adaptive, continuous, and technology-supported training strategies to strengthen intensive care workforce preparedness during public health emergencies

Calgary family intervention model enhances dietary compliance and knowledge in T2DM patient

The urgency was in developing a more holistic and sustainable approach to supporting type 2 diabetes mellitus (T2DM) patients. This study evaluated the effectiveness of the Calgary Family Intervention Model (CFIM) in improving dietary adherence and knowledge in patients with T2DM. This study used a quantitative method with a quasi-experimental design, involving 280 patients with type 2 diabetes mellitus at the Bolo Community Health Center from January to October 2025. The sample was divided into two groups: intervention (CFIM education) and control (booklet). Data were collected using a valid and reliable questionnaire to measure knowledge and dietary adherence. Data analysis was performed using the Wilcoxon and Mann-Whitney tests. The analysis showed significant results, with the mean knowledge score in the intervention group increasing from 4.84±1.235 to 8.98±2.851 (p < 0.05), while in the control group, it increased from 4.64±1.120 to 7.06±1.219. For dietary adherence, the intervention group showed an increase from 27.00±6.518 to 61.38±7.171 (p = 0.000), compared to the control group, which increased from 27.28±5.592 to 49.44±10.194(p < 0.05). The implications of these results have the potential to strengthen the family-based health intervention model and improve the overall well-being of T2DM patients. This study contributes significantly to family nursing practice by demonstrating the efficacy of the CFIM in enhancing dietary adherence and knowledge among patients with T2DM

Factors affecting health-promoting services provision of the sub-district health promoting hospital transferred to mahasarakham provincial administration

Hospital services have been transferred to provincial government oversight, making it important to assess the impact of this policy on service quality and efficiency. This study examined factors influencing service delivery at sub-district health-promoting hospitals transferred to the Mahasarakham Provincial Administration in Mahasarakham Province, Thailand. The research was conducted from March 2022 to September 2023 using a mixed-methods approach, including descriptive content analysis for qualitative data. The examined factors were categorized into accessibility, processes, productivity, and outcomes. Data were collected from 500 health workers and 300 patients using questionnaires consisting of six sections with a Likert scale to evaluate perceptions of service quality. Paired t-tests were applied to compare service unit performance before and after the transfer, while one-way ANOVA was used to assess differences among service units. Binary logistic regression identified key factors influencing service quality. The findings revealed a significant relationship between healthcare workers’ attitudes and skills and overall service quality. Units with less than 50% transfer showed minimal improvement, indicating that the extent of transfer strongly influences service outcomes. Despite these differences, the main goal of health promotion remained consistent across units. Effective policy decisions, appropriate management, and stakeholder engagement are essential to improve health outcomes. These findings provide insights for policymakers and administrators to refine health service transfer policies and highlight the need for further research on long-term impacts on service quality and patient outcomes