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Korelasi Pemeriksaan Human Epidermal Growth Factor Receptor-2 (Her-2) dengan Stadium Klinis TNM pada Pasien Kanker Payudara di Instalasi Patologi Anatomi RS dr. Saiful Anwar Periode Januari 2010-Desember 2012 Rozi, Achmad Fahrur; Bekti, Rachmad Sarwo; Roebijoso, Jack
Majalah Kesehatan FKUB Vol 3, No 3 (2016): MAJALAH KESEHATAN
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (307.487 KB)

Kanker payudara merupakan kanker yang mematikan yang sering muncul pada wanita dan menempati urutan kedua setelah kanker paru-paru. Salah satu permasalahan utama kanker payudara ialah kesulitan dalam menentukan prognosis terkait keterlibatan proses metastasis sebagai salah satu kriteria stadium klinis TNM. Telah banyak penelitian mengenai faktor prognostik terhadap kanker payudara agar modalitas terapi kanker payudara semakin baik, salah satunya tes HER-2 melalui pemeriksaan imunohistokimia (IHK). Namun pemeriksaan ini masih relatif mahal dan sulit ditemui di Indonesia. Penelitian ini bertujuan untuk mengetahui apakah ada korelasi antara ekspresi HER-2 dengan stadium klinis TNM pada pasien kanker payudara. Penelitian ini merupakan penelitian cross sectional yang dilakukan di Instalasi Patologi Anatomi RS dr. Saiful Anwar Malang. Sampel penelitian yaitu pasien kanker payudara yang melakukan pemeriksaan di Instalasi Patologi Anatomi RS dr. Saiful Anwar Malang periode Januari 2010 hingga Desember 2012 yang memenuhi kriteria inklusi dan eksklusi. Sampel tersebut adalah jaringan kanker payudara yang telah dinilai status HER-2 melalui pemeriksaan IHK dan dilakukan penentuan stadium klinisnya. Analisis korelasi antara ekspresi HER-2 dengan stadium klinis TNM diuji dengan uji Spearmanâ€™s rho. Hasil penelitian menunjukkan tidak ada hubungan yang signifikan antara status HER-2 dengan stadium klinis TNM (p = 0,871; r = -0,018; N = 89). Kesimpulan dari penelitian ini adalah tidak ada korelasi yang signifikan antara ekspresi HER-2 dengan stadium klinis TNM pada penderita kanker payudara di Instalasi Patologi Anatomi RS dr. Saiful Anwar Malang periode Januari 2010 sampai Desember 2012.Kata kunci: Ekspresi HER-2, Kanker payudara, Stadium klinis TNM.

ANALISIS PERBANDINGAN FIKSASI MENGGUNAKAN LARUTAN FORMALIN DAN LARUTAN CARNOY PADA SOMIT, NEURAL TUBE, DAN VASKULAR EMBRIO AYAM USIA 48 JAM DENGAN PEWARNAAN HEMATOXYLIN-EOSIN Nuralim, Ernst Randy; Rahayu, Indriati Dwi; Bekti, Rachmad Sarwo
Majalah Kesehatan FKUB Vol 4, No 1 (2017): MAJALAH KESEHATAN FAKULTAS KEDOKTERAN
Publisher : Faculty of Medicine Universitas Brawijaya

Penelitian embriologi memiliki peran penting dalam dunia kesehatan, oleh karena itu diperlukan pengetahuan berbagai faktor pendukung salah satunya adalah larutan fiksatif. Meskipun telah diketahui bahwa larutan Carnoy memberikan efek pengerutan hingga dapat menghancurkan sitoplasma, banyak penelitian yang menggunakan larutan Carnoy sebagai pilihan utama untuk larutan fiksatif pada penelitian embrio ayam. Penelitian ini bertujuan untuk menguji kualitas gambaran embrio yang difiksasi menggunakan larutan Carnoy dan membandingkannya dengan kualitas gambaranÂ embrio yang difiksasi menggunakan larutan formalin. Telur ayam yang digunakan diperoleh dari peternakan ayam Randu Agung Singosari. Telur ayam diinkubasi selama 48 jam, lalu satu kelompok difiksasi menggunakan larutan Carnoy dan kelompok yang lain difiksasi menggunakan larutan formalin. Hasil fiksasi kemudian dibuat preparat dan diwarnai dengan pewarnaan hematoxylin-eosin (HE), untuk selanjutnya dilakukan evaluasi terhadap somit, vaskuler, dan neural tube. Hasil penelitian dianalisis menggunakan paired T test menunjukkan bahwa larutan Carnoy memberikan hasil yang signifikan berbeda (p < 0,05) dengan larutan formalin pada evaluasi somit dan vaskuler embrio ayam usia 48 jam, namun memberikan hasil yang signifikan tidak berbeda (p > 0,05) penggunaan larutan Carnoy dengan larutan formalin pada evaluasi neural tube embrio ayam usia 48 jam. Kesimpulan dari penelitian ini adalah fiksasi dengan larutan formalin menunjukkan hasil yang berbeda dengan fiksasi menggunakan larutan Carnoy pada evaluasi somit dan vaskuler, namun tidak berbeda pada evaluasi neural tube embrio ayam usia 48 jam.Â Kata kunci: embrio, hematoxylin-eosin, larutan Carnoy, larutan formalin, somit, neural tube,Â vaskular.

TEACHERS’ PERCEPTION OF PROFESSIONALISM IN COMPETENCY-BASED MEDICAL EDUCATION: ARE THERE ANY DIFFERENCES? Rachmad Sarwo Bekti; Carissa Putri Irnanda; Setyawati Soeharto
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 7, No 1 (2018): MARET
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Background: Medical professionalism learning for medical students in Faculty of Medicine of Universitas Brawijaya (FMUB) requires some clear indicators or values because of the Competency-based Curriculum (KBK). Those values can be arranged by looking for the local wisdom which is a group of visions or values from the lecturers’ perceptions toward professionalism. This research was aimed to reveal the specific components of professionalism in FKUB perceived by faculty. Method: This research was designed as a qualitative research by using semi-structured interviews of targeted subjects to gather the data constructs. The questions in interviews were designated to dig out the informer’s perception in interpreting medical professionalism, based on their experiences, current visions, and hopes. Standardized qualitative analysis were applied to reveal the main themes of the responses. Results: Themes which came up as the components of professionalism from 15 lecturers’s perceptions were categorized as follow: attitude, clinical competence, and knowledge. Those main components were mentioned in National and International Standards related to professionalism, but not all the sub-components were mentioned. Spirituality and medical attire which became the sub-component of attitude were considered as specific construct of professionalism perceived by FKUB lecturers. Conclusion: The concept of professionalism rooted on spirituality and expressed into proper attire in this research was expected to become a local wisdom of medical professionalism in Indonesia. It is advised that the results of this study can help the medical program administrator to develop instruments that nurture the professionalism development of students. Further research might be conducted by using different university context or by taking samples from larger faculty perspective with different specialization.

Pencegahan Stunting dan Disbiosis Mikrobiota Saluran Cerna Melalui Partisipasi Aktif Siswa, Orang Tua dan Guru Sekolah Dasar di Kabupaten Malang Mulyastuti, Yuanita; Rahayu, Siwipeni Irmawanti; Tulle, Andrew William; Ruliatna, Etty Fitria; Sutjipto, Yossy Imelda; Nuriyana, Fatatie; Rohman, Ibrahim Abdur; Dzulfikar, Afuza Ahnaf; Ilhami, Mukhammad Nurvi Farhan; Bekti, Rachmad Sarwo
Jurnal Abdimas Kartika Wijayakusuma Vol 6 No 1 (2025): Jurnal Abdimas Kartika Wijayakusuma
Publisher : LPPM Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26874/jakw.v6i1.656

Stunting merupakan masalah kesehatan dengan efek jangka panjang berupa risiko penurunan produktivitas pembangunan nasional. Dampak stunting dapat dicegah dengan perbaikan literasi anak, guru dan orang tua saat anak usia sekolah dasar. Disbiosis saluran cerna sebagai salah satu faktor yang berperan pada kejadian stunting dapat dicegah dengan pola makan seimbang serta pola hidup bersih dan sehat. Desain program pengabdian masyarakat ini bersifat partisipatoris dengan melibatkan guru, siswa, dan orang tua terkait literasi tentang stunting. Program dilakukan dalam beberapa tahap meliputi penyusunan agenda bersama, penyuluhan edukasi, pemilihan duta siswa sehat, serta diskusi penyusunan rencana pengembangan program dengan guru. Dari pengabdian masyarakat yang dilakukan, didapatkan perubahan literasi kognitif siswa terhadap perilaku sehat yang berhubungan dengan stunting seperti pola makan seimbang dan pola hidup bersih dan sehat. Sementara diskusi dengan guru memunculkan upaya kerjasama penguatan program UKS (Usaha Kesehatan Sekolah) dengan pola UES (University to Elementary School) sebagai bentuk tindak lanjut untuk melembagakan upaya peningkatan kesehatan siswa secara konstruktif. Penelitian lebih lanjut perlu dilakukan sebagai evaluasi jangka panjang dari pengabdian, terutama pada dampak lanjut dari duta siswa dan penguatan UKS melalui skema UES.

Beyond Tumor Grade: Investigating the Heterogeneity of PD-L1 Expression in Soft Tissue Sarcomas and the Need for Subtype-Specific Analysis Hamka Muhammad Nasir Laitupa; Eviana Norahmawati; RA Rose Khasana Dewi; Rachmad Sarwo Bekti; Diah Prabawati Retnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1350

Background: Soft tissue sarcomas (STS) represent a diverse group of malignant mesenchymal neoplasms with considerable histological variety and differing degrees of malignancy. Programmed Death-Ligand 1 (PD-L1) expression is a crucial immunotherapy target in various cancers, but its role and expression patterns in STS, particularly within the Indonesian population, remain inadequately defined. This study aimed to investigate the differences in PD-L1 expression between low-grade and high-grade STS and to determine the correlation between PD-L1 expression and histological grading in an Indonesian cohort. Methods: This analytical observational study utilized a cross-sectional design, incorporating 29 archival paraffin-embedded tissue blocks from STS patients diagnosed at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. PD-L1 expression was assessed immunohistochemically using the monoclonal antibody clone 22c3, and scoring was performed using the Combined Positive Score (CPS). Statistical analyses, including the Mann-Whitney U test and Spearman correlation, were employed to evaluate differences and correlations. Results: The majority of STS cases (89.7%) exhibited negative PD-L1 expression. The mean PD-L1 CPS was 0.1429 in low-grade STS and 0.233 in high-grade STS. No statistically significant difference in PD-L1 expression was observed between the low-grade and high-grade groups (p=0.620). Furthermore, Spearman correlation analysis revealed no significant association between PD-L1 expression (numeric CPS and categorical positivity) and histological grade (r=0.094, p=0.629 for CPS; r=0.102, p=0.600 for interpretation). Conclusion: This study found no significant difference in PD-L1 expression between low-grade and high-grade soft tissue sarcomas, nor a significant correlation with histological grade in the investigated Indonesian patient cohort. These findings suggest that PD-L1 expression, when assessed independently, may not be a reliable prognostic biomarker based solely on tumor grading in STS. Further research with larger sample sizes, encompassing diverse histological subtypes and incorporating additional immune biomarkers, is warranted.

Beyond Co-Expression: Unraveling the Complex Relationship Between PD-L1 and Tumor-Infiltrating Lymphocytes in Basal Cell Carcinoma Subtypes Fitria Mayasari; Kenty Wantri Anita; Diah Prabawati Retnani; Rachmad Sarwo Bekti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1354

Background: Basal cell carcinoma (BCC) is the most prevalent non-melanoma skin cancer, characterized by high recurrence rates. Immunotherapy, particularly targeting the Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1) axis, offers a promising therapeutic avenue. The interplay between PD-L1 expression on tumor and immune cells and the nature of Tumor-Infiltrating Lymphocytes (TILs) is crucial for immune response, yet their relationship in BCC, especially across diverse histological subtypes, remains incompletely understood. This study aimed to investigate the correlation between PD-L1 expression and TILs density in various BCC subtypes, seeking to elucidate the complexities of their interaction within the tumor microenvironment. Methods: This analytical observational study utilized a cross-sectional design, analyzing 20 archived paraffin-embedded BCC tissue samples from Dr. Saiful Anwar Regional General Hospital Malang. PD-L1 expression was assessed by immunohistochemistry using the 22c3 clone and evaluated via the Combined Positive Score (CPS). TILs were semi-quantitatively assessed as percentage infiltration and categorized into low, moderate, and high grades. Histological subtypes of BCC were documented. Spearman correlation was used to analyze the relationship between PD-L1 expression and TILs. Results: Of the 20 BCC cases, 55% exhibited PD-L1 positivity (CPS ≥ 1). TILs infiltration was predominantly moderate (70%), with 25% high and 5% low. The cohort included nodular (40%), infiltrating (35%), and basosquamous (25%) as the main subtypes, with specific variants also analyzed. Basosquamous BCC consistently showed positive PD-L1 expression (100% of its cases positive), while nodular and infiltrating subtypes displayed varied PD-L1 expression. TILs distribution also varied across subtypes, with nodular BCC exhibiting the full range from low to high TILs. Overall, no significant correlation was observed between PD-L1 expression and TILs density (Spearman's r = -0.077, p = 0.747). Conclusion: This study confirms PD-L1 expression and TILs presence in BCC but reveals no direct linear correlation between them across the cohort, even when considering broad subtypes. Basosquamous BCC consistently expressed PD-L1. The lack of overall correlation suggests a complex, potentially subtype-specific interplay within the BCC tumor microenvironment, warranting further investigation into functional TILs subsets and other immune modulators.

Beyond Tumor Grade: Investigating the Heterogeneity of PD-L1 Expression in Soft Tissue Sarcomas and the Need for Subtype-Specific Analysis Hamka Muhammad Nasir Laitupa; Eviana Norahmawati; RA Rose Khasana Dewi; Rachmad Sarwo Bekti; Diah Prabawati Retnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1350

Background: Soft tissue sarcomas (STS) represent a diverse group of malignant mesenchymal neoplasms with considerable histological variety and differing degrees of malignancy. Programmed Death-Ligand 1 (PD-L1) expression is a crucial immunotherapy target in various cancers, but its role and expression patterns in STS, particularly within the Indonesian population, remain inadequately defined. This study aimed to investigate the differences in PD-L1 expression between low-grade and high-grade STS and to determine the correlation between PD-L1 expression and histological grading in an Indonesian cohort. Methods: This analytical observational study utilized a cross-sectional design, incorporating 29 archival paraffin-embedded tissue blocks from STS patients diagnosed at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. PD-L1 expression was assessed immunohistochemically using the monoclonal antibody clone 22c3, and scoring was performed using the Combined Positive Score (CPS). Statistical analyses, including the Mann-Whitney U test and Spearman correlation, were employed to evaluate differences and correlations. Results: The majority of STS cases (89.7%) exhibited negative PD-L1 expression. The mean PD-L1 CPS was 0.1429 in low-grade STS and 0.233 in high-grade STS. No statistically significant difference in PD-L1 expression was observed between the low-grade and high-grade groups (p=0.620). Furthermore, Spearman correlation analysis revealed no significant association between PD-L1 expression (numeric CPS and categorical positivity) and histological grade (r=0.094, p=0.629 for CPS; r=0.102, p=0.600 for interpretation). Conclusion: This study found no significant difference in PD-L1 expression between low-grade and high-grade soft tissue sarcomas, nor a significant correlation with histological grade in the investigated Indonesian patient cohort. These findings suggest that PD-L1 expression, when assessed independently, may not be a reliable prognostic biomarker based solely on tumor grading in STS. Further research with larger sample sizes, encompassing diverse histological subtypes and incorporating additional immune biomarkers, is warranted.

Beyond Co-Expression: Unraveling the Complex Relationship Between PD-L1 and Tumor-Infiltrating Lymphocytes in Basal Cell Carcinoma Subtypes Fitria Mayasari; Kenty Wantri Anita; Diah Prabawati Retnani; Rachmad Sarwo Bekti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1354

Background: Basal cell carcinoma (BCC) is the most prevalent non-melanoma skin cancer, characterized by high recurrence rates. Immunotherapy, particularly targeting the Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1) axis, offers a promising therapeutic avenue. The interplay between PD-L1 expression on tumor and immune cells and the nature of Tumor-Infiltrating Lymphocytes (TILs) is crucial for immune response, yet their relationship in BCC, especially across diverse histological subtypes, remains incompletely understood. This study aimed to investigate the correlation between PD-L1 expression and TILs density in various BCC subtypes, seeking to elucidate the complexities of their interaction within the tumor microenvironment. Methods: This analytical observational study utilized a cross-sectional design, analyzing 20 archived paraffin-embedded BCC tissue samples from Dr. Saiful Anwar Regional General Hospital Malang. PD-L1 expression was assessed by immunohistochemistry using the 22c3 clone and evaluated via the Combined Positive Score (CPS). TILs were semi-quantitatively assessed as percentage infiltration and categorized into low, moderate, and high grades. Histological subtypes of BCC were documented. Spearman correlation was used to analyze the relationship between PD-L1 expression and TILs. Results: Of the 20 BCC cases, 55% exhibited PD-L1 positivity (CPS ≥ 1). TILs infiltration was predominantly moderate (70%), with 25% high and 5% low. The cohort included nodular (40%), infiltrating (35%), and basosquamous (25%) as the main subtypes, with specific variants also analyzed. Basosquamous BCC consistently showed positive PD-L1 expression (100% of its cases positive), while nodular and infiltrating subtypes displayed varied PD-L1 expression. TILs distribution also varied across subtypes, with nodular BCC exhibiting the full range from low to high TILs. Overall, no significant correlation was observed between PD-L1 expression and TILs density (Spearman's r = -0.077, p = 0.747). Conclusion: This study confirms PD-L1 expression and TILs presence in BCC but reveals no direct linear correlation between them across the cohort, even when considering broad subtypes. Basosquamous BCC consistently expressed PD-L1. The lack of overall correlation suggests a complex, potentially subtype-specific interplay within the BCC tumor microenvironment, warranting further investigation into functional TILs subsets and other immune modulators.

Clinico-moleculo-pathological Conference (CMPC): A Clinical Teaching Method to optimise knowledge integration and collaboration in the workplace-based specialist education Bekti, Rachmad Sarwo; Seputra, Kurnia Penta
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 14, No 2 (2025): June
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.105471

Integrating current molecular knowledge and research with real-world clinical and pathological conditions is a critical step in finding the most appropriate approach for modern and personalized patient care. A modified clinicopathological conference, called the Clinico-molecular-pathological conference (CMPC), was introduced in one out of five introductory specialist training courses at our teaching hospital. It is intended to enhance the application of basic biomedical sciences, particularly biomolecular aspects, in integrated clinical care and personalised medicine. We attempted to analyse the CMPC’s implementation and its educational impact from the perspectives of trainees through a program evaluation activity adopting the first two levels of the Kirkpatrick Pyramid. From 4 batches (2022-2024), 433 out of 447 residents (96.87% response rate) responded to our online program evaluation questionnaire. From the reaction and learning level, the CMPC has convincingly been favoured by residents as an engaged learning method for elaborating basic medical sciences, especially biomolecular topics, into a real clinical and patient care context. Despite the poor correlation of the course’s overall satisfaction to the CMPC mark and final course marks (p>0.05), there is a positive and significant correlation between CMPC mark and Course Final mark (r=0.39; p=0.00). Qualitative response to the survey triangulated the acceptance of CMPC as a promising learning method to promote integrated learning as well as multidisciplinary collaboration. The case study provides insight into how CMPC is favoured by the residents to learn difficult subjects, and is related to academic achievement. CMPC is also perceived to be a promising method to promote integration in patient care in medical specialist education. Further research is needed to optimise both the educational and quality service impact of the CMPC in the workplace-based medical specialist education.

Hubungan Literasi Orang Tua Tentang Perkembangan Bahasa Anak Dengan Pemberian Stimulasi Bahasa Pada Anak Usia Pra Sekolah Cut Nashwa Bhilbina; Rachmad Sarwo Bekti; Ningrum Paramita Sari
Journal of Issues in Midwifery Vol. 9 No. 2 (2025): Volume 9 No 2 Tahun 2025
Publisher : Journal of Issues in Midwifery

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.JOIM.2025.009.02.1

ABSTRAK Masa prasekolah merupakan periode krusial dalam perkembangan anak, khususnya perkembangan bahasa yang menjadi fondasi utama bagi aspek kognitif dan sosial. Tingginya prevalensi gangguan bahasa, termasuk di Kota Malang yang mencapai 62% pada tahun 2023, menunjukkan pentingnya keterlibatan orang tua dalam pemberian stimulasi bahasa. Tujuan dari studi ini yaitu untuk menganalisis hubungan antara literasi orang tua tentang perkembangan bahasa anak dengan pemberian stimulasi bahasa pada anak usia prasekolah. Penelitian ini menggunakan desain observasional analitik dengan pendekatan cross-sectional, melibatkan 41 orang tua di TK Brawijaya Smart School (BSS) Malang. Analisis data dilakukan melalui uji chi-square serta korelasi Spearman. Analis menunjukkan bahwa mayoritas responden memiliki tingkat literasi tinggi (68,3%) dan memberikan stimulasi bahasa yang baik (87,8%). Hasil analisis korelasional non-parametrik menunjukkan hubungan yang kuat dan signifikan antara literasi orang tua dan pemberian stimulasi bahasa (p = 0,000; r = 0,685). Selain itu, variabel usia, pendidikan, pendapatan, bahasa sehari-hari, dan akses informasi kesehatan juga berkorelasi signifikan terhadap literasi dan stimulasi. Temuan penelitian ini mengindikasikan bahwa literasi orang tua merupakan faktor penting dalam mendukung perkembangan bahasa anak, dan menyoroti perlunya intervensi kolaboratif antara bidan, sekolah, dan orang tua. Kata Kunci: Literasi orang tua, stimulasi bahasa, perkembangan bahasa anak, anak usia prasekolah, kolaborasi bidan-sekolah-orang tua. ABSTRACT The preschool period is a crucial period in child development, especially language development which is the main foundation for cognitive and social aspects. The high prevalence of language disorders, including in Malang City which reached 62% by 2023, shows the importance of parental involvement in providing language stimulation. This study aims to analyze the relationship between parents' literacy about children's language development and the provision of language stimulation in preschool-age children. The study used an analytic observational design with a cross-sectional approach, involving 41 parents at Brawijaya Smart School (BSS) Kindergarten in Malang. The analysis showed that the majority of respondents had a high literacy level (68.3%) and provided good language stimulation (87.8%). The results of non-parametric correlational analysis showed a strong and significant relationship between parental literacy and language stimulation (p = 0.000; r = 0.685). In addition, the variables of age, education, income, daily language, and access to health information were also significantly correlated to literacy and stimulation. The findings of this study indicate that parental literacy is an important factor in supporting children's language development, and highlight the need for collaborative interventions between midwives, schools and parents. Keywords: Parental literacy, language stimulation, child language development, preschool children, midwife-school-parent collaboration.

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