Factors Related to the Quality of Life in Children with Transfusion-Dependent Thalassemia.

Objective: Increased survival rate of patients with Transfusion-dependent Thalassemia (TDT) should be in line with their good quality of life (QoL). The study aimed to analyze the relationship between sociodemographic factors and clinical characteristics with the QoL of children with TDT. Methods: A cross-sectional study was conducted at Hasan Sadikin General Hospital from December 2022 to February 2023. A total of 158 eligible subjects aged 5-18 years with TDT were included in the analysis. QoL assessment was performed using child self-report and parent-proxy report questionnaires, along with physical examination findings. Bivariate and multivariate analyses were conducted to analyze the data. Results: A total of 158 subjects who met the research criteria were included in the analysis. Of 58.9% of children with TDT had a low adherence rate to iron chelating therapy (ICT). School function had the lowest score in QoL based on child-self report and parent proxy. Gender (p<0,05) and adherence to ICT (p<0,05) were significantly associated with lower quality of life. Conclusion: Female and adherence to ICT were predictors of children with TDT's QoL.

Efficacy and Safety Profile of Tuberculin Protein Purified Derivative Injection As Immunotherapy For the Treatment of Cutaneous and Anogenital Warts: A Review Article.

Introduction: Various treatments available today for anogenital and cutaneous warts have limitations, including time-consuming, challenging to perform, and the risk of scarring. A new treatment using tuberculin purified protein derivative (PPD) has been developed, which is expected to generate cellular immunity against HPV. Objective: To assess the evidence for the efficacy and safety of PPD treatment for cutaneous and anogenital warts. Materials and methods: A literature search was performed with the keyword-based search on digital libraries, including the National Library of Medicine, Cochrane Controlled Register of Trial, and Google Scholar, using the following terms: anogenital warts, condyloma acuminata, cutaneous warts, human papillomavirus, immunotherapy, and tuberculin purified protein derivative. Original studies on treating cutaneous or anogenital warts with PPD were included. The results were 47 clinical trials and 4 case reports. Most of the research was done in countries with common Mycobacterium tuberculosis infection. The treatment showed good efficacy. Comparative studies showed that the treatment has similar efficacy with other immunotherapies. No significant side effects were reported, with evidence of the safety use on the pregnant population. Conclusion: Based on good efficacy and safety, PPD can be considered an alternative therapy, especially in countries where tuberculosis is frequent.

Development of an internet-based intervention to improve health professionals' counseling skills around adolescent weight management in Indonesia.

BACKGROUND: Obesity is a growing public health and clinical concern, worldwide. In many countries, including Indonesia, health professionals lack the capacity to promote behavior change around obesity prevention and management, especially with adolescents for whom a wider set of communication skills are required. This study describes the theoretical basis, approach to development of content, use and satisfaction of an internet-based educational intervention designed to improve the quality of health professional weight management counseling with adolescents in Indonesia. METHODS: This study is part of an exploratory sequential mixed methods design which was undertaken from 2020 to 2022. Following a needs analysis, an internet-based training resource was developed, informed by constructive alignment theory and active learning principles. Using both synchronous and asynchronous approaches over a four-week pilot study, a weekly interactive session was held online, using multifaceted training materials housed on a website (https://ramahremaja.id). The training resource was then tested in a two-arm study involving health professionals from 17 of 34 provinces across Indonesia. RESULTS: Sixty-four primary health professionals were recruited for the two-arm study. The completion rate for reviewing all materials and assignments on the website was 72% and the online meeting participation rate was 78%. Participants were highly positive about the clarity of the training material and the appropriateness of the delivery methods. The main challenges related to poor internet literacy and interrupted internet connectivity. CONCLUSION: Designed to support weight management in adolescents, this internet-based training program shows potential for enhancing Indonesian health professional behavior-change counseling skills.

Immunogenicity and safety of Quadrivalent Influenza HA vaccine compared with Trivalent Influenza HA vaccine and evaluation of Quadrivalent Influenza HA vaccine batch-to-batch consistency in Indonesian children and adults.

One of the newest strategies developed by the Global Influenza Strategy has been to broaden the composition of the current influenza vaccine formulations from trivalent products to quadrivalent products. This study aimed to assess the immunogenicity and safety of Quadrivalent Influenza HA vaccine (QIV) compared with Trivalent Influenza HA vaccine (TIV) and to evaluate three consecutive batches of QIV equivalence in Indonesian children and adults. This was an experimental, randomized, double blind, four arm parallel group bridging study involving unprimed healthy children and adults aged 9-40 years. A total of 540 subjects were enrolled in this study and randomized into four arm groups. Each subject received one dose of TIV or QIV with three different batch codes. Serology tests were performed at baseline and 28 days after vaccination. Hemagglutination inhibition (HI) antibody titers were analyzed for Geometric Mean Titer (GMT), seroprotection, and seroconversion rates. Solicited, unsolicited, and serious adverse events were observed up to 28 days after vaccination. A total of 537 subjects completed the study per protocol and were analyzed for immunogenicity criteria. All randomized subjects were analyzed for safety criteria. The percentage of the subjects with anti-HI titer ≥1:40 28 days after QIV vaccination was 99.5% for A/H1N1; 99.5% for A/H3N2; 93.1% for B/Texas, and 99.0% for B/Phuket. The seroprotection, GMT, and seroconversion rates of QIV were not significantly different from those of TIV for the common vaccine strains (p > 0.01) and were significantly different from those of TIV for the added B/Phuket strains (p < 0.01). Most solicited injection-site and systemic reactions with either vaccine were mild to moderate and resolved within a few days. Antibody response to QIV were equivalence among vaccine batches and comparable between age groups for each of the 4 strains. QIV was immunogenic and well-tolerated and had immunogenicity and safety profiles compared with TIV for all common strains. The immunogenicity of the three batches of QIV was equivalent for the four strains. Trial registration. Clinical Trial registration: NCT03336593.

Correlation Between Adolescent Mental Health and Sleep Quality: A Study in Indonesian Rural Areas During the COVID-19 Pandemic.

Objective: The study aims to analyze the correlation between sleep quality and adolescent mental health in rural areas during the Coronavirus Disease 2019 (COVID-19) pandemic. Material and Methods: A cross-sectional study was conducted in Bandung rural area in February 2023. The subjects were adolescents aged 12-15 years who attended high school in Sagaracipta Village. To assess mental health, the Strength and Difficulties Questionnaire (SDQ) was used. Meanwhile, sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The questionnaires were distributed and then filled in directly by the participants under close supervision. The relationship between mental problems and sleep quality was analyzed with the Spearman Rank correlation. The confidence range employed was 95%, while p< 0.05 was considered statistically significant. Results: The results showed that at two junior high schools in Sagaracipta Village, 70.6% of the 109 subjects had poor sleep quality. Among the subjects, a significant number exhibited abnormal scores on various subscales. Specifically, 24 subjects (22%) showed abnormalities in the emotional subscales, 18 (16.5%) in conduct, 5 (4.6%) in hyperactivity, 15 (13.8%) in problems with peers, 26 (23.9%) in total difficulty, but there were no abnormal subjects on the pro-social sunscale. Based on the Rank Spearman correlation test, there was a statistically significant correlation between sleep quality and the emotional, behavioral, hyperactivity, and overall difficulties subscales, with coefficients of 0.247; 0.258; 0.22; and 0.310 as well as p-values of 0.010; 0.007; 0.021; and 0.001 respectively. Conclusion: During the COVID-19 pandemic, there was a correlation between mental health and sleep quality among adolescents in rural area.

Intelligence, motoric and psychological outcomes in children from different ART treatments: a systematic review and meta-analysis.

BACKGROUND: Subtle abnormalities in children's intelligence, motor skills, and psychology from various assisted reproductive treatments (ARTs) might be underdiagnosed. Understanding the prognosis of intelligence, motor skills, and psychology in children from ART would provide parents with reasonable expectations and enable them to plan relevant support to achieve the optimum potential in ART children. METHODS: We searched PubMed, EMBASE, Ovid, Google Scholar, and Scopus databases until April 13, 2021, to identify relevant studies. Thirty-four studies met the inclusion and exclusion criteria. The meta-analysis employed a standardized mean difference model. The outcome of this study is to compare intelligence quotient (IQ), motoric ability, and behavioral problems between all ARTs, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) to naturally conceived (NC) children. Subdomains of intelligence based on the Cattell, Horn, and Carroll Model (CHC Model) of cognitive architecture, including fluid reasoning, short-term and working memory, processing speed, visual-spatial ability, long-term memory retrieval, and crystalized intelligence (knowledge), were evaluated and summarized in details. Motor skill was stratified into two domains: gross motoric and fine motoric. Behavioral problem was categorized as externalizing and internalizing behavior. RESULTS: Meta-analysis showed that verbal intelligence score in IVF toddlers is significantly lower than NC toddlers (p = 0.02); conversely, ICSI toddlers scored significantly higher verbal intelligence score compared to NC toddlers (p = 0.005). Toddlers born after ART had significantly lower non-verbal intelligence score (p = 0.047). IVF toddlers scored significantly lower fine motor score (p = 0.01) compared to naturally conceived toddlers. Based on parent's CBCL, NC toddlers had higher total (p = 0.01) and externalizing behavior (p = 0.001) scores  compared to ART toddlers. Evaluation of full scale IQ and all domains of intelligence in preschool and primary school children revealed that no significant differences exist between ART and NC children. Based on preschool and primary school parents' CBCL, IVF children had significantly lower externalizing behavior score compared to NC children (p = 0.04). Meta-analyses of studies on young adolescents revealed that ART young adolescents scored higher academically than their NC counterparts, including on mathematics (p < 0.00001) and reading or language (p < 0.00001). CONCLUSIONS: Despite differences in certain aspects, this finding suggests that ART is unlikely to cause negative impacts on children's neurodevelopment.

Epigenetic Regulation Interplays with Endometriosis Pathogenesis in Low-Birth-Weight Patients via the Progesterone Receptor B-VEGF-DNMT1 Axis.

BACKGROUND: Low birth weight (LBW) is a risk factor associated with endometriosis. Our study aimed to analyze the risk of endometriosis in women with a LBW history and the relationships of progesterone receptor B (PR-B) gene promoter methylation, DNA methyltransferase-1 (DNMT1) expression, PR-B expression, and vascular endothelial growth factors (VEGF) with endometriosis. METHODS: This study was conducted in two stages, a retrospective case-control design and a cross-sectional design, with 52 cases of endometriosis and 30 controls, which were further subdivided into LBW and non-LBW groups, at Hasan Sadikin General Hospital and its hospital networks from October 2017 to August 2021. Menstrual blood was taken from subjects and analyzed using pyrosequencing techniques to assess DNA methylation, while q-RT PCR was used to assess gene expression. RESULTS: There were significant differences in PR-B methylation, DNMT1 expression, PR-B expression, and VEGF expression (p < 0.001) between the case and control groups. There was a significant negative correlation between PR-B methylation and PR-B expression (r = -0.558; p = 0.047). Based on a multiple logistic analysis, the most dominant factor affecting endometriosis incidence is PR-B (OR 10.40, 95% CI 3.24-33.4, R2 = 45.8). We found that patients with a low birth weight history had a 1.41-times-higher risk of developing endometriosis (95% CI 0.57-3.49, p = 0.113), although the relationship was not statistically significant. CONCLUSION: Endometriosis is associated with PR-B gene promoter hypermethylation, decreased PR-B expression, and increased DNMT1 and VEGF expression. The methylation of PR-B is the most dominant factor affecting endometriosis incidence.

Comparison of Immunogenicity and Safety of Diphtheria-Tetanus-Pertussis-Hepatitis B-Haemophilus influenza B (Bio Farma) with Pentabio® Vaccine Primed with Recombinant Hepatitis B at Birth (Using Different Source of Hepatitis B) in Indonesian Infants.

Satisfying the needs of the national immunization program requires maintaining diphtheria-tetanus-pertussis (DTP)-hepatitis B (HB)-Haemophilus influenza B (Hib) production. Therefore, new hepatitis B sources are needed. This study aimed to evaluate the immunogenicity of the DTP-HB-Hib vaccine (Bio Farma) that used a different source of hepatitis B. A prospective randomized, double-blind, bridging study was conducted. Subjects were divided into two groups with different batch numbers. Healthy infants 6-11 weeks of age at enrollment were immunized with three doses of the DTP-HB-Hib vaccine after a birth dose of hepatitis B vaccine. Blood samples were obtained prior to vaccination and 28 days after the third dose. Adverse events were recorded until 28 days after each dose. Of the 220 subjects, 205 (93.2%) completed the study protocol. The proportion of infants with anti-diphtheria and anti-tetanus titers ≥ 0.01 IU/mL was 100%, with anti-HBsAg titers ≥ 10 mIU/mL was 100%, and with Polyribosylribitol Phosphate-Tetanus Conjugate (PRP-TT) titers > 0.15 µg/mL was 96.1%. The pertussis response rate was 84.9%. No serious adverse events related to the study vaccine occurred. The three-dose DTP-HB-Hib vaccine (Bio Farma) is immunogenic, well tolerated, and suitable to replace licensed-equivalent vaccines.

Correlation between anthropometric measurements of height and arm span in Indonesian children aged 7-12 years: a cross-sectional study.

BACKGROUND: Height is an anthropometric measurement that serves as the most constant indicator of growth. In certain circumstances, arm span can be used as an alternative to height measurements. This study aims to analyze the correlation between anthropometric measurements of height and arm span in children aged 7-12 years. METHODS: A cross-sectional study was carried out from September to December 2019 in six elementary schools in Bandung. Children aged 7-12 years were recruited with a multistage cluster random sampling method. Children with scoliosis, contractures, and stunting were excluded from the study. Height and arm span were measured by two pediatricians. RESULTS: A total of 1,114 children, comprising 596 boys and 518 girls, fulfilled the inclusion criteria. The ratio of height to arm span was 0.98-1.01. The regression equation used to predict height through measurement of arm span in male subjects was Height = 21.8623 + 0.7634 x Arm span (cm) + 0.0791 x age (month); R2 = 94%; standard error of estimate (SEE): 2.66 and that in female subjects was Height = 21.2395 + 0.7779 x Arm span (cm) + 0.0701 x age (month); R2 = 95.4%; SEE: 2.39. The predicted height and the average actual height were not significantly different. There is a strong correlation between height and arm span in children aged 7-12 years. CONCLUSIONS: Arm span can be used to predict the actual height of children aged 7-12 years and as an alternative measurement for growth.

The barriers of home environments for obesity prevention in Indonesian adolescents.

BACKGROUND: Obesity and its related cardiovascular-metabolic diseases are growing public health concerns. Despite global attention to obesity, its prevalence is steeply increasing in developing countries, especially in children and adolescents. Eating behaviours and physical activity are modifiable risk factors for obesity that can variably be shaped by families. Eating behaviours and physical activity are especially important during adolescence, given its significance as a foundational period for developing healthy lifestyles. This qualitative study aimed to explore barriers and opportunities around creating healthy lifestyles among adolescents in Indonesia, focussing on family environments from diverse socio-demographic backgrounds. METHOD: In-depth interviews using a semi-structured guide were undertaken with consecutively recruited 10-18-year-old adolescents with overweight or obesity, and their parents, from three different sites: urban (Jakarta, the capital city of Indonesia), peri-urban (West Java Province) and rural (Banten Province). Thematic analysis was used to identify patterns of meaning. RESULTS: Nineteen dyads were interviewed. Thematic analysis revealed four themes: limited knowledge of healthy lifestyles; healthy lifestyles not a concern of daily life; limited parenting skills, including inequity around gender roles; and aspects of availability and accessibility. These interconnected barriers influenced lifestyle practices at home within the context of daily preferences and decisions around food and activities. Gender role inequity and healthy food accessibility were more prominent in rural families than in those from urban or peri-urban settings. CONCLUSIONS: Healthy lifestyles in adolescence may be supported by strategies to enhance parenting skills, build individual motivation, and support the development of more enabling environments.

Fundamental Aspects of the Development of a Model of an Integrated Health Care System for the Prevention of Iron Deficiency Anemia among Adolescent Girls: A Qualitative Study.

Iron deficiency anemia (IDA) in adolescent girls is a problem that has not been resolved. This study aimed to explore the critical aspects of an integrated health care system model for preventing IDA in adolescent girls in a rural area of Indonesia. This qualitative research employed a grounded theory approach in order to build a substantive theory. This study used in-depth interviews with adolescents, parents, teachers, health workers, and persons in charge of adolescent programs at the health office, education office, and ministry of religion. Purposive sampling was performed until data saturation was achieved. Codes, categories, and themes were generated through thematic data analysis to develop a substantive theory. Data analysis was performed using MAXQDA 2022 software. A total of 41 people participated in this study. This investigation generated twenty-two categories and seven themes. These themes relate to policymaker commitments, stakeholder governance, quality, adolescents' lifestyles, adolescents' self-factors, adolescents' access to health services, and social support. The themes identified become fundamental aspects of the integrated health care system model for preventing IDA in adolescent girls. The model of the integrated health care system consists of several essential points, which include awareness and efforts from policymakers and adolescent girls, supported by parents, teachers, and the community.

Correlation between Cord Blood Vitamin D Levels and Problem-Solving Neurodevelopment in Early Childhood: A Cohort Study in Rural Indonesia.

Vitamin D influence on brain development and subsequent postnatal neurodevelopment remains controversial. We explored the correlation between cord blood vitamin D levels and longitudinal neurodevelopment in early childhood. A cohort study was conducted on term infants with no congenital abnormalities, born from pregnant women from a cohort study. Cord blood samples were collected to measure vitamin D. Neurodevelopment was examined three times in infants aged 6, 12 and 24 months using the Ages and Stages Questionnaire-3, which comprises 30 questions of five developmental domains: gross motor, fine motor, communication, problem-solving and social-personal. Statistical analysis was conducted with Spearman's rank correlation and multiple linear regression. Of the 141 babies born from previous cohort studies, only 116 participants were included. The mean level of cord blood vitamin D was 16.2 ng/mL. The percentage participants with vitamin D deficiency and insufficiency were 12.9 and 65.5, respectively. Cord blood vitamin D and the problem-solving domain for infant aged 12 and 24 months were correlated (r = 0.217 and 0.414, respectively). Multiple linear regression showed a decreased problem-solving domain score of 0.641 associated with decreased vitamin D levels. In conclusion, cord blood vitamin D levels correlated with infant neurodevelopmental status.

The Effect of Mobile Health (m-Health) Education Based on WANTER Application on Knowledge, Attitude, and Practice (KAP) Regarding Anemia among Female Students in a Rural Area of Indonesia.

Female students, as adolescent girls, are more at risk of anemia because of high nutritional requirements. Health education through mobile applications influences the knowledge, attitude, and practice (KAP) of anemia in adolescent girls. Based on our previous study, several adolescents experienced anemia. This study aims to analyze the effect of health education through mobile applications, namely the WANTER application, on increasing KAP. This study was quasi-experimental with a pretest−posttest design; the sample was divided into an intervention (WANTER application) and a control group (booklet). The study was conducted in a rural area of Indonesia. There were 162 adolescent girls included in the intervention group and as many as 115 adolescent girls in the control group. Our study showed that adolescents' knowledge and attitude increased significantly in three months after the intervention of WANTER and booklets toward preventing anemia with p < 0.001; however, there was no significant difference in KAP between the control and intervention groups. In addition, there was no improvement in practice, either in the control or intervention groups. Knowledge, attitudes, and practices to prevent anemia need to be continuously improved. Health education through appropriate media for adolescents is very important to make interventions more effective.

Correlation of Maternal Prenatal Vitamin D Level with Postnatal Infant Growth in Length and Head Circumference: A Cohort Study on Vitamin D Status and Its Impact During Pregnancy and Childhood in Indonesia.

Objective: To determine the correlation of first trimester maternal 25-(OH)-D level with postnatal infant growth in Indonesia. Materials and Methods: A cohort of 116 mother-infant pairs from Indonesia was prospectively studied. 25-(OH)-D level was measured in maternal serum at 10-14 weeks of gestation and in umbilical cord blood shortly after birth. The newborns were observed longitudinally for 24 months. Length and head circumference were measured at birth and at ages 3, 6, 12, and 24 months. Spearman correlation and multiple linear regression analyses were performed. Results: Mean 25-(OH)-D levels in the prenatal maternal serum and umbilical cord blood were 17.55 ± 7.33 ng/mL and 16.27 ± 6.14 ng/mL, respectively. Prenatal maternal 25-(OH)-D level weakly correlated with infant length (r = -0.35) and head circumference (r = -0.21) z-scores at age 3 months. Umbilical cord blood 25-(OH)-D level did not correlate with infant length or head circumference at any time point. Multiple linear regression showed an independent association between prenatal maternal 25-(OH)-D level and infant length z-score at age 3 months (p = 0.01, SE ß = 0.02, and coefficient ß = -0.06). Conclusion: First trimester maternal serum 25(OH)D level correlated with infant length and head circumference at age 3 months.

Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life.

Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.

Iron Deficiency Anemia and Associated Factors Among Adolescent Girls and Women in a Rural Area of Jatinangor, Indonesia.

Background: Iron deficiency anemia is a common problem among adolescent girls and women, with significant consequences on personal health. One of the causes of iron deficiency anemia is inadequate nutritional intake. This study explores iron-deficiency anemia and associated factors among adolescent girls and women in a rural area of Jatinangor, Indonesia. Methods: A cross-sectional study was conducted with 95 adolescent girls and 85 women between April and November 2018. Cluster random sampling was used to select the participants from seven villages in the Jatinangor district. After obtaining informed consent, we collected sociodemographic data, menstrual histories, and related data, including nutritional intake using 24-hour dietary recall. Anthropometrics were gathered to determine the body mass Index (BMI), and venous blood samples were analyzed for complete blood count and hemoglobin levels. Descriptive statistics followed by bivariate and multivariable logistic regression were used to identify anemia-associated factors. Results: The prevalence of iron deficiency anemia among the girls was 21.1% and 9.4% among women, with an average hemoglobin level in adolescents of 10.75 g/dL (± 0.79) and in adults 11.20 g/dL (± 0.61), whereas MCV was 74.49±8.22 fL in adolescents and 7.61±8.62 fL in adults. The majority of our samples were not stunted in growth and were also within a normal weight range. Multivariate logistic regression analysis showed that protein intake (OR=0.25; 95% CI 0.11-0.58) was a positively associated factor with anemia. Conclusion: The prevalence of iron-deficiency anemia in this study represents a mild public health problem in the study sample. Based on the hemoglobin level, anemia, can be classified as moderate in adolescents and mild in adults. Low levels of MCH indicate iron-deficiency anemia. Sufficient protein intake did not prevent anemia due to macronutrient and micronutrient intake.

The Study of Nutrient Intake and Adolescent Girls' Quality of Life in a Rural Area of Indonesia.

An inadequate nutrient intake correlates with malnutrition, a problem affecting many adolescents worldwide. Nutrient intake is associated with quality of life (QoL). Our study analyzed the relationship between nutrient intake and adolescents' QoL. We conducted a cross-sectional study. Through simple random sampling, 157 adolescent girls were selected. Nutrition status was assessed using anthropometric measurements. Nutrient intake was collected using the food frequency questionnaire (FFQ). WHOQOL BREF was used to explore adolescent girls' quality of life. The median of nutrient intake: energy (908.25 kcal); protein (24.16 g); carbohydrate (128.89 g); fat (21.89 g); vitamin A (77.10 mg); vitamin E (1.40 mg); vitamin B1 (0.19 mg); vitamin B2 (0.29 mg); vitamin B6 (0.45 mg); folic acid (35.13 mg); vitamin C (12.60 mg); calcium (197.46 mg); magnesium (93.72 mg); iron (2.64 mg); and zinc (2.09 mg). The adolescents' QoL scores were physical health 44 (25-81), psychological domain 56 (19-94), social relationships 56 (19-94), and environmental domain 56 (31-100). The strongest correlations were between (1) physical health with carbohydrates, vitamin C, and fat; (2) psychological domain with calcium; (3) social relationships with carbohydrates and vitamin C; and (4) environmental domain with BMI and zinc. There was a significant positive correlation between the intake of some nutrients and adolescents' QoL, despite the observation of some significant negative correlations. The findings of this study indicate that more attention should be focused on adolescents' nutrient intake in order to improve their QoL.

Association of Mental Health Problems and Socio-Demographic Factors Among Adolescents in Indonesia.

Mental health in adolescents represent a considerable public health issue in developing countries. These problems are considered a source of problem for adolescents' quality of life. The study objective was to determine the association between mental health problems and sociodemographic variables among adolescents. A cross-sectional study was conducted from October to December 2016 using a school-based survey in 4 districts and 3 cities in West Java Province, Indonesia. Stratified multistage random sampling was used to select junior and senior high school students and self-administered questionnaires were used to collect study data which included: personal data, socioeconomic status scale, and self-reported version of Strengths and Difficulties Questionnaire (SDQ) which divided into 5 subscales. About 3452 adolescents of 32 schools were included in this study, 59% female, 56% junior high school, 56% district residence, most parents' education were senior high school. The prevalence of mental health problems based on SDQ subscale as total difficulties, conduct problem, emotional symptoms, peer problems, hyperactivity-inattention, were abnormal 31.6, 38.9, 30, 29.3, 15.6, respectively. Mental health problems were more prevalent amongst adolescents in junior high school and residence in district area, with RR and 95% CI were 1.14 (1.04-1.26), and 1.18 (1.08-1.30). As conclusions mental health problems in adolescents were associated with education level and residence area.

The Association of Vitamin D and Neurodevelopmental Status Among 2 Years Old Infants.

The previous studies about association of vitamin D and neurodevelopmental status in the first 1000 days of life showed inconsistent results. This study aimed to investigate correlation between vitamin D deficiency and neurodevelopmental in 2 years old infants. A cross-sectional study was conducted in Sukabumi and Waled, West Java involving 2 years old infants born from the mothers participated in previous cohort. Total 109 infants met the criteria. Vitamin D was measured and neurodevelopmental status was assessed using ASQ-3 in each subject. Statistical analysis using Spearman's Rank correlation and multiple regression model. 50.4% infants had vitamin D deficiency (<50 nmol/L). Neurodevelopmental status showed appropriate for age. No significant association between vitamin D level and neurodevelopmental in 2 years old infants. However, there was an association between some developmental domains and vitamin D level at birth. No correlation between vitamin D and neurodevelopmental in 2 years old infants.

Height Prediction Using the Knee Height Measurement Among Indonesian Children.

BACKGROUND: Height is essential for assessing growth and nutrition in children. Assessing height with appropriate measurement is important, although in certain physically disabled and hospitalized children direct height measurement is almost not possible. In these situations, segmental measurements can be used as proxy height. Knee height (KH) has been determined as the most reliable surrogate. OBJECTIVE: This study aimed to establish a height-predicted equation using KH for use in both community and clinical practices. METHODS: This was a cross-sectional study design that collected data from 1114 healthy children (596 boys and 518 girls) aged 7 to 12 years to develop the equations for predicting height from KH. A multiple linear regression analysis was used to develop the equations. RESULTS: Two equations were established to predict height using KH: (1) for boys H = 29.895 + (0.081 × age [months] + (2.267 × KH)) and (2) for girls H = 26.297 + (0.110 × age [months] + (2.278 × KH)). The very high correlation between KH and actual height indicates a very strong agreement. CONCLUSIONS: Knee height can be used for prediction equations for height with a very good predictive power. The age variable using the month unit generates a more accurate equation.