Fatmawati Hospital

This study examines the role of Taman Pendidikan Al-Qur’an (TPQ) in developing children’s spiritual values at Masjid Al Ikhlas, Jalan Semangka 3, Panorama Subdistrict, Singgaran Pati District, Bengkulu City. A qualitative descriptive approach was employed to explore spiritual development practices implemented through nonformal Islamic education. Data were collected through observations, interviews with teachers and administrators, and documentation of learning activities. The findings reveal that TPQ contributes significantly to children’s spiritual formation through Qur’anic learning, worship habituation, moral guidance, and exemplary behavior demonstrated by educators. Learning activities emphasize value internalization, religious discipline, and character development rather than cognitive mastery alone. Support from the mosque environment, parental involvement, and community participation strengthens the effectiveness of spiritual education. The study concludes that TPQ functions as an essential nonformal educational institution in fostering children’s spiritual awareness, moral conduct, and consistent religious practice.

BACKGROUNDMetabolic dysfunction-associated fatty liver disease (MAFLD) may progress to cirrhosis and lead to serious complications. Lipid accumulation, hepatocellular ballooning, and sinusoidal endothelial dysfunction increase intrahepatic vascular resistance, resulting in early clinically significant portal hypertension (CSPH). Although hepatic venous pressure gradient (HVPG) remains the gold standard, decompensated cirrhosis may yield deceptively low values. Transient elastography and platelet count provide supportive diagnostic evidence, yet obesity can overestimate disease severity. This report highlights the diagnostic challenge of CSPH, especially MAFLD in geriatric patients.CASE SUMMARYA 78-year-old woman with class I obesity, type 2 diabetes mellitus, and dyslipidemia presented with hematemesis and melena for a three-day period. A prior computed tomography scan revealed moderate diffuse hepatic steatosis, splenic vein dilatation, and splenomegaly. On admission, she presented with pallor, epigastric tenderness, splenomegaly, and mild ascites. Laboratory findings showed anemia, thrombocytopenia, hypoalbuminemia, and hyperglycemia. Abdominal ultrasound confirmed chronic liver disease with splenomegaly. Esophagogastroduodenoscopy demonstrated grade II-III esophageal varices and portal hypertensive gastropathy. Noninvasive fibrosis assessments (non-alcoholic fatty liver disease fibrosis score, aspartate transaminase-to-platelet ratio index, fibrosis-4 index, and FibroScan: E = 28 kPa, controlled attenuation parameter = 191 dB/m) indicated advanced hepatic fibrosis. HVPG measurement was not performed, however due to the Baveno VII criteria (transient elastography ≥ 25 kPa and platelet count < 150 × 109/L), confirmed the diagnosis of CSPH. The patient received endoscopic variceal ligation, a nonselective beta-blocker, a proton pump inhibitor, insulin, a sodium-glucose cotransporter 2 inhibitor, and lifestyle modification, resulting in clinical improvement.CONCLUSIONEarly and precise evaluation of CSPH in geriatric MAFLD requires an integrated clinical assessment to optimize diagnosis, management, and improve outcomes.

The development of Islamic finance in Indonesia shown significant growth as alternative financial system based Islamic principles. Data from Bank Syariah Indonesia (BSI) shows the number of Hajj savings accounts reached 5.5 million accounts as of November 2024 and increased to 6.33 million in July 2025. This growth reflects the high level of public enthusiasm in preparing for Hajj funds early on through Islamic financial institutions. In various regions of South Sumatra, BSI has become one of the institutions widely used by the public to open Hajj savings accounts due to its service network and ease of access. The village of Pagar Banyu has great potential for increasing the use of Sharia-based Hajj savings, particularly through the dissemination of information about BSI products. Through appropriate outreach activities, the public can understand wadiah contracts, the benefits of hajj savings, and the process of opening an account and registering for a hajj quota. In this context, Bank Syariah Indonesia (BSI) plays an important role as it is one of the largest Islamic banks. The target audience for this outreach activity is the general public in Pagar Banyu Village, Pagaralam City, South Sumatra Province. This study aims to improve Islamic financial literacy among people Pagar Banyu Village, particularly regarding Hajj savings at BSI, by providing practical understanding of how to open a Hajj savings account, requirements, procedures, and benefits, and encouraging community to start planning for pilgrimage by saving gradually and building awareness of importance of managing finances in accordance with Islamic principles.

<h2>Abstract</h2><h3>Background</h3> Assessment of malnutrition is important in cancer patients, especially in gastrointestinal cancer in Indonesia. The Scored Patient-Generated Subjective Global Assessment (PG-SGA), an instrument that allows interdisciplinary assessment of malnutrition and its risk factors, has yet to be available in the Indonesian version. <h3>Object</h3> To produce a valid and reliable PG-SGA questionnaire in Indonesian while maintaining the English version's form, purpose, and meaning. <h3>Methods</h3> The PG-SGA questionnaire was translated, culturally and linguistically adapted, following the International Society for Pharmacoeconomics (ISPOR) principles. Each question item in the questionnaire will be assessed based on content validity, comprehensibility, and difficulty, operationalized by calculating item and scale indices. A scaled score of 0.80–0.90 is considered acceptable, while a score of more than 0.90 is considered excellent. <h3>Results</h3> The content validity of the entire PG-SGA questionnaire obtained an S-CVI of 0.92. The content validity score of the PG-SGA questionnaire on professional participants was S-CVI 0.91. The comprehensibility score of professional and general public participants was S–CI 0.89. The score for the difficulty of question items on the PG-SGA questionnaire with professional and general public participants obtained the results of S-DI 0.86 and 0.88. <h3>Conclusion</h3> The translation and cultural adaptation of the PG-SGA questionnaire according to the ISPOR principles of successfully maintaining the format, purpose, and meaning of the Indonesian version of the PG-SGA questionnaire. The PG-SGA questionnaire's Indonesian version is now comprehensible and relevant for patients, the general public, and professionals. However, there are components of the professional questions that are considered difficult, so additional descriptions or brief explanations and training are needed, especially for physical examinations.

Reading is an essential skill in learning English as a Foreign Language (EFL) because it plays a significant role in developing students’ academic abilities and knowledge. One of the rapid reading techniques introduced at the Madrasah Aliyah level is skimming, which is used to obtain the general idea and main points of a text without reading it in detail. However, based on preliminary observations at MA Muhammadiyah Bengkulu, many students still experience difficulties in applying skimming techniques effectively. Therefore, this study aims to analyze students’ difficulties in reading English texts using skimming techniques and to identify the factors causing these difficulties. This research employed a descriptive qualitative approach. The participants were 15 tenth-grade students of MA Muhammadiyah Bengkulu selected through purposive sampling. Data were collected through classroom observations, semi-structured interviews, and documentation. The data were analyzed using Miles and Huberman’s interactive model, which includes data reduction, data display, and conclusion drawing. The findings reveal that students faced several difficulties in applying skimming techniques, such as identifying the main idea, understanding vocabulary, locating word references, making inferences, and finding detailed information in the text. The main factors contributing to these difficulties were limited vocabulary mastery, students’ lack of understanding of skimming strategies, and insufficient practice in reading English texts. Based on these findings, it can be concluded that students’ skimming ability still needs improvement through more structured reading instruction, appropriate strategy application, and continuous practice in order to help students comprehend English texts more effectively and efficiently.

Background: Learning motivation is a crucial factor influencing students’ academic success, particularly in Islamic Religious Education, which is often perceived as monotonous. Low learning motivation among seventh-grade students at SMP Negeri 32 Satu Atap Kaur highlights the need for innovative instructional strategies to create an engaging learning environment. Objective: This study aims to examine the effect of icebreaking activities on improving students’ learning motivation in Islamic Religious Education subjects. Method: The research employed Classroom Action Research (CAR) across two cycles. Data were collected using learning motivation questionnaires and classroom observations. Result: The average student motivation score in the pre-cycle stage was 60.5, with classical completeness reaching only 30%. After implementing icebreaking activities in Cycle I, the average score increased to 68.7, with classical completeness improving to 60%. In Cycle II, the use of more varied, interactive icebreaking activities further increased the average motivation score to 80.2, with classical completeness reaching 90%. These findings demonstrate that icebreaking activities are effective in enhancing students’ learning motivation, fostering a positive classroom atmosphere, and encouraging active participation. Conclusion: Regular integration of icebreaking activities can significantly improve student motivation in Islamic Religious Education. Contribution: This study provides practical insights for teachers on implementing innovative, student-centered learning strategies.

Introduction: Vitamin D has been proposed as a potential adjunctive therapy in melanoma based on its biological effects on tumor cells and immune modulation. However, the clinical benefit of vitamin D supplementation in reducing melanoma recurrence or progression remains uncertain. Objective: To systematically evaluate the impact of vitamin D supplementation on recurrence-free survival in patients with melanoma. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Eligible studies included randomized controlled trials and cohort studies comparing vitamin D supplementation to placebo or no supplementation in melanoma patients and reporting recurrence-free, disease-free, or progression-free survival. Data were synthesized using a random-effects model, and hazard ratios (HRs) were pooled. Results: Three studies (n=739) were included, encompassing both adjuvant and advanced melanoma settings. The pooled analysis demonstrated no statistically significant association between vitamin D supplementation and improved recurrence-free survival (HR 0.83, 95% CI: 0.52–1.32; p = 0.43). Moderate heterogeneity was observed. Only one study, involving patients treated with anti–PD-1 immunotherapy, showed a significant benefit, whereas randomized trials in the adjuvant setting did not. Discussion: Although preclinical and observational data support a potential role for vitamin D in melanoma, clinical trial evidence does not demonstrate a significant effect on recurrence-free survival. Heterogeneity in study populations, supplementation regimens, and timing may influence outcomes. Conclusion: Vitamin D supplementation cannot currently be recommended solely to prevent recurrence or progression in melanoma, but remains important for general health. Further research, particularly in the context of immunotherapy, is warranted.

Background: The Emergency Department of Hospital X Jakarta faces challenges in developing nurses' critical thinking skills, influenced by time constraints and high workloads. One potential strategy to support nurses' continuous professional development is through structured journal reading activities. However, this activity has not been optimally implemented due to the lack of systematic and documented implementation guidelines. Purpose: To optimize the implementation of journal reading in the emergency department using Kotter's 8-Step Change Model. Method: A case study approach with management function analysis covering the stages of planning, organizing, directing, implementing, and Fish Bone analysis. The framework uses Kotter's 8-step change model approach. The activity was carried out at the Emergency Room of Hospital X Jakarta on June 19–28, 2025. Results: There was an increase in knowledge scores on 80% of the items after the socialization, although challenges still occurred in selecting appropriate articles. The socialization was conducted in a hybrid manner with the participation of 44 nurses and generated positive responses to the existence of Standard Operating Procedures (SOPs). Monitoring of nurses showed an increase in understanding and ability to conduct journal reading according to the guidelines. Conclusion: Implementation of the SOP socialization for journal reading has been proven to improve the quality of journal-based learning. Suggestion: Further mentoring and integration of SOPs into cross-unit nursing professional development programs are needed. Keywords: Emergency Department; Journal Reading; Kotter's 8-Step Change Model Approach. Pendahuluan: Instalasi Gawat Darurat Rumah Sakit X Jakarta menghadapi tantangan dalam mengembangkan keterampilan berpikir kritis perawat, dipengaruhi oleh keterbatasan waktu dan tingginya beban kerja. Salah satu strategi yang potensial untuk mendukung pengembangan profesional berkelanjutan perawat adalah melalui kegiatan journal reading yang terstruktur. Namun, kegiatan ini belum terlaksana secara optimal karena belum adanya acuan pelaksanaan yang sistematis dan terdokumentasi. Tujuan: Untuk mengoptimalisasi pelaksanaan journal reading di instalasi gawat darurat melalui pendekatan kotter’s 8-step change model. Metode: Pendekatan studi kasus dengan analisa fungsi manajemen yang meliputi tahapan perencanaan, pengorganisasian, pengarahan, pelaksanaan, serta analisa Fish Bone. Kerangka kerja menggunakan pendekatan kotter’s 8-step change model. Kegiatan dilaksanakan di Instalasi Gawat Darurat Rumah Sakit X Jakarta pada tanggal 19–28 Juni 2025. Hasil: Terdapat peningkatan skor pengetahuan pada 80% butir soal setelah sosialisasi, meskipun masih ditemukan kendala pada pemilihan artikel yang tepat. Sosialisasi dilakukan secara hybrid dengan partisipasi 44 perawat, dan menghasilkan tanggapan positif terhadap keberadaan Standar Prosedur Operasional (SPO). Monitoring terhadap perawat pelaksana menunjukkan peningkatan pemahaman dan kemampuan dalam melakukan journal reading sesuai panduan. Simpulan: Implementasi sosialisasi SPO journal reading terbukti meningkatkan kualitas pembelajaran berbasis jurnal. Suggestion: Diperlukan pendampingan lanjutan serta integrasi SPO dalam program pengembangan profesional keperawatan lintas unit. Kata Kunci: Instalasi Gawat Darurat; Journal Reading; Pendekatan Kotter’s 8-Step Change Model.