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31,377 Article Results

Determinants of community perception on food technology-based shallot waste management for nutritional security: a cross-sectional study

10.11591/ijphs.v15i2.27077
D. Yan El Rizal Unzilatirrizqi , Riska Arsita Harnawati
Shallot production in Indonesia, particularly in Brebes Regency, generates substantial agricultural by-product waste that poses significant environmental and public health risks due to inadequate community-level management. This cross-sectional quantitative study investigated the influence of government role, infrastructure availability, and public knowledge on perceptions of shallot by-product waste management among 180 respondents selected through proportional random sampling. Data were collected using structured Likert-scale questionnaires and analyzed through multiple linear regression, Spearman's rank correlation, and gap analysis. Gap analysis revealed critical deficiencies in public knowledge (50.6-76.1%) and infrastructure (69.2%), despite universally positive perceptions toward waste management. Multiple linear regression demonstrated that government role (β = 0.342, p < 0.001), infrastructure availability (β = 0.298, p < 0.001), and public knowledge (β = 0.152, p = 0.007) significantly predicted waste management perceptions, collectively explaining 37.8% of the variance (Adj. R² = 0.378). The government's role contributed the largest effective contribution at 18.74%. These findings carry substantial public health implications, as improved waste management can reduce disease vectors, minimize environmental contamination, and enable by-product valorization for nutritional supplementation. The study recommends strengthening government intervention, expanding waste infrastructure, and enhancing community health literacy as integrated policy strategies to optimize agricultural by-product management and safeguard community nutritional well-being in shallot production centers.
Volume: 15
Issue: 2
Page: 525-533
Publish at: 2026-06-01

Therapeutic adherence and somatic symptom perception in patients with heart failure: a scoping review

10.11591/ijphs.v15i2.27004
Tri Andayani , Kumboyono Kumboyono , Lilik Supriati
Heart failure is a chronic condition associated with high morbidity and frequent hospital readmissions, requiring effective self-management strategies. Therapeutic adherence and somatic symptom perception are essential components of self-management, enabling early symptom recognition and timely intervention. However, evidence regarding the relationship between these two factors remains limited. This scoping review aimed to map current evidence on the relationship between therapeutic adherence and somatic symptom perception in patients with heart failure and to identify influencing factors. The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Literature searches were conducted in ProQuest, ScienceDirect, Springer, and Google Scholar for studies published between 2016 and 2025. Eligible studies involved adult patients with heart failure and assessed therapeutic adherence and somatic symptom perception using validated instruments. Eight studies were included, comprising four cross-sectional studies, three randomized controlled trials, and one quasi-experimental study. Findings indicated a positive association between adherence to self-care behaviors and improved somatic symptom perception. Patients with consistent symptom monitoring demonstrated better recognition of early deterioration signs. However, a greater symptom burden was associated with lower adherence in several studies. Integrating symptom perception training, motivational strategies, and caregiver involvement may improve adherence, enhance early symptom detection, and reduce hospital readmissions.
Volume: 15
Issue: 2
Page: 417-427
Publish at: 2026-06-01

Empowerment-based ToT HIV intervention among Indonesian construction workers: a quasi-experimental study

10.11591/ijphs.v15i2.27117
Anisful Lailil Munawaroh , Fatma Lestari , Baiduri Widanarko
Preventing HIV/AIDS in high-risk workplaces remains a public health priority, particularly in the construction sector. However, empirical evidence on structured, sustainable, and empowerment-based Training-of-Trainers (ToT) interventions for HIV prevention in Indonesian construction workplaces remains limited. This study evaluated a ToT-based intervention designed to build internal peer-facilitator capacity among construction workers and to strengthen workplace HIV prevention through a feasible, scalable, and participatory model. MA quasi-experimental single-group pre-test-post-test study was conducted among 30 construction workers attending a two-day facilitator training. HIV/AIDS knowledge was assessed before and immediately after training using a structured questionnaire. Paired-sample t-tests, Wilcoxon signed-rank test, Cohen’s dz, and thematic content analysis were applied. Results: Mean knowledge scores increased significantly from 60.00 (SD = 12.66) to 91.33 (SD = 7.65), with a mean difference of 31.33 (95% CI: 26.76-35.90; p < 0.001). These findings suggest that peer-facilitator training may be a promising workplace health promotion strategy to strengthen HIV prevention capacity in construction settings, although further controlled studies are needed. Qualitative findings highlighted increased confidence, perceived relevance, and stronger peer networking. The ToT-based intervention was associated with substantial short-term gains in HIV/AIDS knowledge among construction workers and may help strengthen internal workplace prevention capacity. Further controlled studies with longer follow-up are needed to confirm its effectiveness and sustainability.
Volume: 15
Issue: 2
Page: 484-493
Publish at: 2026-06-01

Association between educational level and diabetes knowledge among older adults with type 2 diabetes in Bandung City: a cross-sectional study

10.11591/ijphs.v15i2.26915
Citra Windani Mambang Sari , Hartiah Haroen , Neti Juniarti , Lisda Amalia , Jerico Franciscus Pardosi
Diabetes mellitus (DM) is a major non-communicable disease among older adults and a growing public health problem in Indonesia. Older people often have limited health literacy, which may affect their knowledge and self-management of DM. This study aimed to analyze the relationship between education level and knowledge about DM among the elderly in Bandung City, West Java. A descriptive cross-sectional study was conducted on 150 elderlies with type 2 DM using purposive sampling at primary health care facilities with high DM cases. Data were collected through structured interviews using a demographic questionnaire and a 15-item multiple-choice questionnaire on DM knowledge that had been tested for validity and reliability previously, adapted from an Indonesian diabetes self-management instrument. Knowledge scores were categorized into good and poor. Data were analyzed using the Chi-square test. Most respondents had an elementary or high-school education. The majority of the elderly with higher education levels had good knowledge about DM, while those with lower education levels tended to have poorer knowledge. There was a statistically significant association between education level and elderly knowledge about DM (p<0.001). Education level is significantly associated with DM knowledge among the elderly in Bandung. These findings highlight the need for a tailored continuity of care diabetes program, especially for the elderly with lower educational attainment, in order to improve self-management and glycemic control.
Volume: 15
Issue: 2
Page: 370-377
Publish at: 2026-06-01

Hybrid convolutional neural network–transformer models for liver tumor segmentation: a comprehensive review

10.11591/ijece.v16i3.pp1382-1398
Ibrahim Mohamed Attiya , Mostafa Thabet , Mostafa R. Kaseb
Liver cancer is a major cause of cancer deaths worldwide, and early and accurate segmentation of liver tumors is a critical step in cancer diagnosis and treatment. However, existing image segmentation techniques have difficulty handling the variability of liver tumors on different image modalities. The emergence of deep learning (DL) and the development of convolutional neural networks (CNNs) have revolutionized image segmentation techniques. However, CNNs have limitations in handling long-range dependencies, which is a critical requirement for tumor segmentation. To overcome these limitations, researchers have proposed hybrid deep learning architectures, which combine CNNs and attention mechanisms or transformers, to integrate local and global information for image segmentation. In this paper, we provide a comprehensive and analytical review of over 50 state-of-the-art deep learning architectures for liver and tumor segmentation. In addition, we provide an extensive evaluation of 38 hybrid and advanced architectures for liver tumor segmentation and a comprehensive discussion of hybrid CNN-transformer architectures. We propose a novel multi-dimensional taxonomy and evaluate the state-of-the-art architectures on various dimensions, including architectural innovation, segmentation accuracy, computational efficiency, and clinical applicability using benchmark datasets such as LiTS and 3DIRCADb. In our critical evaluation of the state-of-the-art architectures, we identify some of the limitations and challenges of existing research and propose a unified evaluation framework and future research directions on self-supervised learning, explainable artificial intelligence (XAI), federated learning, and lightweight architectures.
Volume: 16
Issue: 3
Page: 1382-1398
Publish at: 2026-06-01

Android mobile 3D augmented reality engineering devices design using marker-based technique

10.11591/ijict.v15i2.pp683-698
Mohamad Azim Ibrahim , Murizah Kassim , Jasni Mohammad Zain , Suhaili Beeran Kutty , Marina Mohd Yusoff , Barokah Isdaryanti , Farid Ahmadi , Nor Syazwani Mohd Pakhrudin
Engineering teaching and learning utilizing using augmented reality (AR) technologies is crucial with new technology adaptation. This study has developed an Android mobile based augmented reality of engineering device (ARED) with description using marker-based technique. Unity 3D, Vuforia, and Blender Animation were used to design 3D models of engineering devices on AR platforms. ARED is used to scan a marker and display an AR 3D model of engineering devices with its information. Ten engineering devices models were created using Blender Animation Tools and exported to Unity 3D which are Ups Power, Infrared Thermometer, Cisco Router, Multi meter, Poe Switch, Clamp Meter, Power Supply, Arduino Uno, Raspberry Pi and Oscilloscope. ARED mobile app is successfully tested which presents users can interact with the 3D model using touch input to enhance their learning experience. Result presents user’s evaluation analysis at 86.2% of ARED’s effectiveness and impact for future education. The technical analysis shows that ARED can handle the optimum distance range between 35 to 100 cm, operation angle is best between 45 and 135 degrees and occlusion average maximum of 55%. The significance of the research is to improve the quality and process of engineering education by using AR and promotes the learning society’s transition to digital learning with mixed reality in engineering, which creates a borderless learning environment.
Volume: 15
Issue: 2
Page: 683-698
Publish at: 2026-06-01

User-centred socio-technical requirements for telehomecare in hospital-based homecare services in Indonesia: a qualitative study

10.11591/ijphs.v15i2.26989
Iman Permana , Moch Zihad Islami , Winny Setyonugroho , Ika Puspita Sari , Janatarum Sri Handono , Sentagi Sesotya Utami
The increasing number of homebound and bedridden patients in Indonesia illustrates the importance of effective hospital-based telehomecare. While telehomecare can improve access and continuity of care, its implementation depends on alignment with user needs. This study aimed to identify user-centered socio-technical requirements for telehomecare in hospital-based homecare services in Indonesia. A qualitative descriptive study was conducted using in-depth interviews and a focus group discussion with 12 purposively selected stakeholders. A telemonitoring device was used as a contextual probe. Data were analyzed using inductive thematic analysis with stakeholder triangulation. Three main areas of needs were identified: i) functional needs, which include constant monitoring, settings for specific diseases, early warning alerts, organized communication, and access to long-term data; ii) technical needs, like ease of use for older people, access through mobile devices, support for location tracking, easy-to-read dashboards, and compatibility with hospital information systems; and iii) data security, privacy, and making sure everyone can use the system, which involves dealing with. These findings help shape the design and growth of fair telehomecare systems in health settings with limited resources and provide real-world evidence from a low- and middle-income country.
Volume: 15
Issue: 2
Page: 501-510
Publish at: 2026-06-01

Association of body mass index and age as risk factors for post-anesthetic shivering in mastectomy patients under general anesthesia in East Java, Indonesia

10.11591/ijphs.v15i2.26908
Reko Priyonggo , Muhammad Rodli , Suryanto Suryanto , Annes Rindy Permana , Widigdo Rekso Negoro , Sindu Sintara
Intraoperative hypothermia and post-anesthetic shivering (PAS) remain frequent complications in oncologic surgery under general anesthesia, yet evidence integrating intraoperative temperature changes with PAS severity in mastectomy patients is limited. This study aimed to evaluate intraoperative temperature profiles, determine the incidence and severity of PAS, and analyze the association between age, body mass index (BMI), and PAS among radical mastectomy patients. A cross-sectional observational study was conducted involving 36 women undergoing radical mastectomy with endotracheal general anesthesia. Core temperature was measured at 30 and 60 minutes intraoperatively, and PAS was assessed using the bedside shivering assessment scale (BSAS) upon admission to the recovery room. Moderate intraoperative hypothermia was observed in 72.2% of patients at 60 minutes, while PAS occurred in 30.6% of cases. Significant associations were identified between PAS and BMI (p = 0.001), as well as age (p = 0.026). Moderate-to-severe shivering (BSAS scores 2-3) was more frequently observed among underweight and elderly patients. This study provides novel evidence by linking intraoperative hypothermia patterns with PAS severity using BSAS in mastectomy patients. Clinically, the findings support structured perioperative temperature monitoring and the implementation of risk-based warming protocols, particularly for patients with low BMI and advanced age.
Volume: 15
Issue: 2
Page: 511-517
Publish at: 2026-06-01

Effectiveness of HIPO Android-based application in improving hypertension self-management literacy among obese patients

10.11591/ijphs.v15i2.27015
Ros Endah Happy Patriyani , Sunarsih Rahayu
Hypertension in obese patients requires comprehensive management through enhanced health literacy. Android-based applications represent a promising innovation for improving hypertension control literacy. To analyze the effectiveness of the Android-based hypertension and obesity information system (HIPO) application in improving hypertension control literacy among obese patients. This quasi-experimental study employed a one-group pretest-posttest design without a control group, conducted at Sibela Community Health Center, Surakarta, from June to December 2025. Seventy-six respondents were selected through purposive sampling, meeting criteria of primary hypertension (≥ 140/90 mmHg) and BMI ≥ 25 kg/m². The intervention involved four weeks of HIPO application use. Data were analyzed using the Wilcoxon Signed Rank Test. Respondents were predominantly female (67.11%), aged 46-55 years (31.58%), with a genetic predisposition to hypertension (57.89%). Systolic blood pressure significantly decreased from 159.53 ± 14.19 to 144.48 ± 11.44 mmHg (p < 0.001), and diastolic from 95.20 ± 6.55 to 88.50 ± 4.58 mmHg (p < 0.001). Good knowledge increased from 35.53% to 55.26%, and good hypertension control increased from 35.53% to 61.84%. The HIPO application significantly improved blood pressure, knowledge, and hypertension control. However, the absence of a control group limits causal inference. This application may serve as a supplementary educational tool in primary healthcare chronic disease management programs.
Volume: 15
Issue: 2
Page: 408-416
Publish at: 2026-06-01

Ensemble windows intrusion detection system using XGBoost and deep learning

10.11591/ijict.v15i2.pp565-577
Pranitha Kedambady Shiva , Pushparaj D. Shetty
Intrusion detection systems (IDS) are critical for preserving the Windows environment from an ever-changing collection of cyber threats. Current IDS uses deep learning (DL), which are heavy models if used for detection, while others use machine learning (ML) techniques, which require external feature extraction. To resolve this challenge, this paper introduces XGBNN, a new ensemble model that combines the benefits of ML and DL to identify and mitigate attacks against Windows machines effectively. The various ML methods are trained on the publicly available dataset to classify eight types of attacks in a Windows environment. Additionally, deep neural networks (DNNs) are proposed by optimizing the layers and hyperparameters to achieve the best accuracy. Then, the DNN model and XGBoost model are integrated to detect intrusions by utilizing the feature extraction ability of DNN and providing the intermediate features extracted from the last second layer of the DNN to the XGB for classification. The Ensemble model XGBNN optimizes features and offers better decisions. The proposed model achieves an exceptional accuracy of 100%, as demonstrated by the empirical results, and outperforms the benchmark models with an improvement of 0.004%. The purpose of this study is to highlight the effectiveness of hybrid architectures in intrusion detection. These architectures offer a more robust, scalable, and effective method to improve the security of the Windows system against more sophisticated attacks.
Volume: 15
Issue: 2
Page: 565-577
Publish at: 2026-06-01

Honey as an alternative wound healing therapy: a systematic review of clinical and preclinical evidence (2020-2024)

10.11591/ijphs.v15i2.26951
Eni Kusyati , Dwi Indah Iswanti , Sa’adah Mujahidah , Dewi Mayangsari
Wound management remains a significant global public health challenge, contributing to substantial morbidity, mortality, and healthcare costs. Honey has been increasingly investigated as a complementary wound care agent due to its antimicrobial, anti-inflammatory, and wound-healing properties. This systematic review aimed to synthesize and critically evaluate the current evidence on the use of honey as an alternative wound treatment. A systematic review was conducted following PRISMA guidelines. Six electronic databases (Scopus, Nature, ProQuest, EBSCO, SpringerLink, and ScienceDirect) were searched using predefined search terms for studies published between 2020 and 2024. Inclusion criteria encompassed human studies, mixed-methods or quantitative designs, and interventions using honey for wound care. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. From 302 initially identified articles, 16 studies met the inclusion criteria after removing duplicates and screening. The included studies comprised randomized controlled trials, prospective controlled studies, case series, and in vitro investigations. Three themes emerged: i) Honey as a wound-healing therapy, demonstrating antimicrobial, anti-inflammatory, and biofilm-inhibiting properties; ii) Benefits of medical-grade honey (MGH), including accelerated epithelialization, reduced infection rates, and shorter recovery times; and iii) Recommendations for honey as a cost-effective, accessible alternative treatment. The evidence supports honey as a promising adjunctive therapy for wound management, particularly in resource-limited settings. However, the heterogeneity in study designs, honey types, and wound categories limits definitive conclusions. Future large-scale randomized controlled trials with standardized outcomes are needed to establish clinical guidelines for honey-based wound care.
Volume: 15
Issue: 2
Page: 605-614
Publish at: 2026-06-01

Consumer preferences and marketing strategy for black pule (Alstonia spectabilis) antimalarial tablet prototypes in South Central Timor

10.11591/ijphs.v15i2.26853
Novia Maulina , Sari Dewi Setyowati , Salma Rizqika Irwanadi , Hajar Sugihantoro , Riza Ambar Sari , Ziyana Walidah , Maximus M. Taek , Burhan Ma’arif
Malaria remains endemic in eastern Indonesia, and resistance to conventional antimalarial drugs necessitates alternative treatments. Black pule (Alstonia spectabilis) is one of the plants that has been researched and claimed to be a natural ingredient that can treat malaria. Black pule prototype has been prepared for the downstream stage through commercialization. Before that, it is necessary to conduct marketing research to ensure the success of the marketing. Therefore, this study evaluates consumer preferences and formulates marketing strategies for black pule antimalarial tablets. This study involved 100 respondents selected using cluster and purposive sampling across three malaria-endemic sub-districts in South Central Timor Regency. Using a quantitative-descriptive approach, data were collected through questionnaires and analyzed with descriptive statistics. The results show that most consumer targets stated that the antimalarial tablet prototype of black pule has a good impression and characteristics. Approximately 69-77% of respondents rated the product positively across shape, color, taste, aroma, size, and overall organoleptic attributes. The results indicate that the majority of respondents gave positive evaluations and expressed a preference for the product’s shape, color, taste, aroma, size, and overall organoleptic characteristics. Findings support aggressive marketing strategies for herbal antimalarial tablets in endemic regions. Based on these findings, an aggressive S-O marketing strategy is recommended, emphasizing product promotion, participation in health-related expos, strengthened digital outreach, and concise educational initiatives to improve public acceptance of the herbal antimalarial tablet.
Volume: 15
Issue: 2
Page: 346-359
Publish at: 2026-06-01

Oxytocin massage and clary sage aromatherapy on lactation and uterine recovery

10.11591/ijphs.v15i2.26928
Rahmadini Faricha Hakim , Dyan Permata Rachim , Hindun Mila Hudzaifah , Ulfa Farrah Lisa , Dina Taufia , Fathiya Ilma Shabrina
The postpartum period is a critical phase in maternal health, during which inadequate lactation and delayed uterine involution may contribute to an increased risk of complications. This study aimed to determine the effectiveness of combined oxytocin massage and clary sage aromatherapy on lactation and uterine involution in women during the postpartum period. A quasi experimental study was conducted among 30 participants (15 controls; 15 intervention). In the control group, mean breast milk volume increased from 32.00 ± 14.74 mL to 105.33 ± 18.07 mL (Δ = 73.33 ± 17.29; p < 0.001). In the intervention group, it increased from 37.00 ± 24.04 mL to 98.33 ± 40.39 mL (Δ = 61.33 ± 36.62; p<0.001), with no significant intergroup difference (p = 0.265). However, uterine involution differed significantly between groups (Mann-Whitney U = 43.000, Z = -2.932, p = 0.003). The combined intervention may serve as a complementary strategy to enhance uterine recovery, although its effect on breast milk production was not statistically superior to standard care.
Volume: 15
Issue: 2
Page: 428-436
Publish at: 2026-06-01

Tomato leaf disease classification using DenseNet-121 with data augmentation and fine-tuning

10.11591/ijai.v15.i3.pp2521-2532
Sufajar Butsianto , Anggi Muhammad Rifa’i
In recent years, accurate classification of agricultural images has become increasingly important to support precision farming and crop disease monitoring. However, achieving reliable performance remains challenging due to visual similarity between disease classes and dataset variability. This study presents an applied evaluation of DenseNet-121 combined with data augmentation and fine-tuning for multi-class tomato leaf disease classification. Experiments were conducted using a publicly available tomato leaf image dataset consisting of 5,000 images across 10 classes. All images were resized to 64×64 pixels and split into 80% training and 20% testing sets using a stratified strategy. Data augmentation was applied exclusively to the training data to improve generalization. The experimental results show a progressive performance improvement across training stages, achieving a final classification accuracy of 98.44% with a loss of 4.72% after fine-tuning. Per-class evaluation indicates strong performance across most disease categories, with minor confusion observed among visually similar classes. While the results demonstrate the effectiveness of the proposed training strategy under controlled experimental conditions, further validation using real-field images is required. Overall, this study shows the potential of DenseNet-121 with transfer learning to support tomato leaf disease classification in precision agriculture applications.
Volume: 15
Issue: 3
Page: 2521-2532
Publish at: 2026-06-01

Effectiveness of Afigel therapy in reducing urinary incontinence among premenopausal women: a quasi-experimental study in rural Indonesia

10.11591/ijphs.v15i2.26945
Siti Fatonah , Sulastri Sulastri
Urinary incontinence (UI) affects millions globally, predominantly women, significantly impacting quality of life. This study evaluated Afigel as a novel intervention for reducing UI symptoms. A quasi-experimental pre-posttest design was employed with 93 premenopausal women randomly assigned to intervention (n = 31) and control (n = 62) groups. Data collection utilized personal data sheets, Afigel therapy standard operating procedures, observation sheets, and the questionnaire for urinary incontinence diagnosis (QUID). Dependent and independent t-tests analyzed the data. Among participants, 43% experienced stress incontinence, 47% experienced urge incontinence, and 10% mixed incontinence. Severity was mild (41%), moderate (45%), and severe (14%). The intervention group demonstrated a significant reduction in incontinence scores from 6.30 to 1.53 (p = 0.000), while the control group showed minimal change from 6.30 to 6.18 (p = 0.21). Afigel demonstrates potential as an effective UI management therapy. These findings suggest Afigel could substantially improve quality of life by reducing UI-related social embarrassment, activity limitations, and psychological distress. For primary health care settings, Afigel offers a potentially accessible, non-invasive treatment option that community health nurses and primary care providers could implement, reducing referral burdens on specialist services while addressing this prevalent yet often underreported condition.
Volume: 15
Issue: 2
Page: 458-465
Publish at: 2026-06-01
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