Abstract The accelerated degradation of rigid highway pavements under Over-Dimension Overload (ODOL) freight traffic necessitates advanced mechanistic evaluation beyond traditional static Winkler design codes. This study develops a rigorously validated 2D explicit Finite Difference Method (FDM) to simulate the dynamic non-local response of a concrete slab subjected to moving 8-axle heavy vehicle loads. The pavement-subgrade interaction is formulated using a two-parameter Pasternak foundation to account for soil shear continuity, evaluated under conservative Free Edge boundary conditions. Spatial contour and time-history numerical outputs reveal that closely spaced multi-axle configurations (e.g., quad-trailers) induce severe dynamic superposition. This continuous loading prevents the slab's elastic rebound, creating a sustained tensile strain basin that significantly accelerates fatigue potential compared to isolated axles. Furthermore, a comprehensive parametric sweep coupling vehicle velocity and foundation stiffness demonstrates that subgrade shear ( $${{\varvec{G}}}_{{\varvec{p}}}$$ ) acts as a critical mechanistic mitigation driver. A competent Pasternak foundation reduces peak static deflections by approximately 35% compared to the Winkler baseline and induces a critical "resonance shift." While Dynamic Amplification Factors (DAF) can reach 1.55 near 60 km/h on weak subgrades, increasing shear stiffness shifts this destructive resonance velocity well beyond standard highway operational limits (> 140 km/h). Ultimately, this computational framework proves that mitigating structural vulnerability requires prioritizing adequate axle-spacing and foundation shear stiffness alongside traditional gross vehicle weight limits.
Background: Diabetes Mellitus is a metabolic disease with an increase in blood sugar levels above normal, which can cause complications if not properly managed. One of the complications that can arise is diabetic ulcers, which require nursing interventions after debridement or post-amputation. Methods: This study employed a mixed-methods approach, combining both quantitative data and a case study design. Following STROBE guidelines, the quantitative component included 19 individuals diagnosed with diabetes mellitus. Using purposive sampling, 7 participants were selected based on the inclusion criteria of having diabetic ulcers and being hospitalised for at least 3 days, and 5 nurses who cared for the patients. Data were collected using structured observation sheets and nursing care records. For the qualitative component, guided by COREQ criteria, in-depth interviews were conducted using semi-structured interview guides to explore patients' experiences and perceptions. Data analysis for the qualitative data used grounded theory methodology, while descriptive statistics were applied to the quantitative data. NVivo software was used for qualitative coding, while SPSS was employed for descriptive analysis. Results: Orem's theory can be used in self-care efforts by carrying out wholly compensatory system nursing interventions, such as wound care, monitoring infections, and carrying out antibiotic treatment, while partially compensatory systems can be carried out by patients independently, such as insulin treatment at home, physical activity, and not smoking, while supportive educative systems by providing foot care education by assessing foot health status. Orem's theory can be used in self-care efforts by performing wholly compensatory system nursing interventions with education, and patients can perform self-care with partially compensatory systems, such as physical activity, not smoking, and insulin use. Conclusion: Self-care nursing interventions for diabetic ulcers include partially compensatory and totally compensatory systems.
This article examines how public administration shapes policy-making. Scholarship typically treats Classical Management, Neo-Classical Management, and New Public Administration (NPA) as successive stages, while policy studies often analyse decision-making, participation, and implementation separately. Consequently, literature lacks an integrated account of how shifting administrative logics structure policy-making and contribute to persistent governance challenges. Drawing on a systematic literature review guided by PRISMA, the study analyses 23 peer-reviewed, Scopus-indexed articles. Rather than aggregating empirical effects, it uses thematic coding to examine policy-making dynamics across paradigms, from Classical Management to NPA. Findings show each paradigm embodies a distinct logic: hierarchical technocratic control in the classical model; behaviourally informed but administratively managed decision-making in the neo-classical model; and collaborative, reflexive governance in the NPA model. Paradigms coexist rather than replace one another. In the Global South, although NPA principles support SDG 16.6 and 16.7, implementation is constrained by neo-classical reforms and residual classical bureaucracies, limiting participatory engagement envisaged by SDG 16.8. Effective governance reform requires aligning institutional capacity with participatory processes rather than adopting a new paradigm.
This study examines the comparative associations of Augmented Reality (AR)–based environmental education and local wisdom–based environmental education with pro-environmental behavior among Indonesian youth. Grounded in the Theory of Planned Behavior, the study focuses on environmental attitudes as a key mediating mechanism. Data were collected from 282 high school students in Jakarta and Banten, Indonesia, using a structured survey and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) and Multi-Group Analysis (MGA). The results indicate that local wisdom–based environmental education is positively associated with both environmental attitudes and pro-environmental behavior, whereas AR-based environmental education is positively associated with environmental attitudes but is not directly associated with pro-environmental behavior. Instead, the association between AR-based environmental education and pro-environmental behavior is fully mediated by environmental attitudes. The structural model explains a substantial proportion of variance in environmental attitudes (R2 = 0.913) and pro-environmental behavior (R2 = 0.950). MGA results reveal that subgroup differences emerge primarily in the associations between educational interventions and environmental attitudes. Specifically, AR-based environmental education shows stronger associations with environmental attitudes among students in Banten and female students, whereas local wisdom–based environmental education exhibits stronger associations among students in Jakarta, male students, and older students. In contrast, the association between environmental attitudes and pro-environmental behavior remains stable across regions, genders, and age groups. These findings suggest that immersive technologies alone may be insufficient to translate learning into behavioral outcomes without alignment with culturally grounded values. As a cross-sectional, non-experimental study, this research contributes to the environmental education literature by integrating cultural and technological dimensions within a TPB-informed framework. Practically, the findings highlight the importance of positioning local wisdom as a foundational element of environmental value formation, with AR serving as a complementary tool to enhance engagement and understanding rather than a stand-alone behavioral intervention.
Background: Timely tuberculosis diagnosis is essential for reducing transmission, preventable morbidity, and inequitable losses across the care cascade. In Indonesia, primary health centres are central to screening and diagnostic coordination, but delays may still occur after individuals with presumptive tuberculosis enter formal care. Objective: To quantify post-registration diagnostic delay among people with presumptive tuberculosis in Indonesian primary care and identify demographic, clinical, and referral-pathway factors associated with delayed results, tuberculosis diagnosis, and treatment initiation. Methods: We conducted a facility-based, register-based observational study using national presumptive tuberculosis register data from a primary health centre in Tasikmalaya City, West Java, Indonesia, covering 1 January to 31 December 2025. Diagnostic delay was defined as the interval from presumptive tuberculosis registration to the first recorded diagnostic result. Negative binomial regression estimated adjusted incidence rate ratios for delay, and logistic regression estimated adjusted odds ratios for prolonged delay, final diagnosis, and treatment initiation. Findings: Among 503 presumptive tuberculosis episodes, 486 had complete delay data. Median diagnostic delay was 4 days (interquartile range, 1-11 days). Delays longer than 14 and 30 days occurred in 94 episodes (19.3%) and 37 episodes (7.6%), respectively. Longer delay was associated with age 65 years or older (adjusted incidence rate ratio, 1.46; 95% CI, 1.12-1.90), extrapulmonary disease (1.58; 95% CI, 1.21-2.07), and referral from another health facility (1.35; 95% CI, 1.01-1.82). Overall, 176 presumptive episodes (35.0%) resulted in a tuberculosis diagnosis; 158 diagnosed patients (89.8%) had documented treatment initiation. Conclusions: Although most diagnostic results were recorded rapidly after registration, delays were concentrated among older adults, people with extrapulmonary disease, and referred patients. Strengthening register-based tracking, referral feedback, and escalation pathways for extrapulmonary tuberculosis may improve equitable continuity across primary care tuberculosis services.
