Stunting and its association with education and cognitive outcomes in adulthood: A longitudinal study in Indonesia.

BACKGROUND: Stunting is associated with adverse outcomes in adulthood. This article specifically aims to analyse the relationship between childhood stunting and education as well as cognitive outcomes for adults in Indonesia. METHODS: Pooled data from wave one (1) and two (2) of the Indonesia Family Life Survey (IFLS) in 1993 and 1997 identified a sub-sample of 4,379 children aged 0-5 by their height-for-age (HAZ) to be compared for their differences in educational outcomes and cognitive abilities in 2014. HAZ was used to proxy relative height to determine stunting status based on 2006 WHO child's growth standards. Education and cognitive abilities outcomes include years of schooling, age of school entry, grade repetition, and scores for cognitive and math tests. The study employs estimation models of pooled regressions and instrumental variable (IV) to address problems of endogeneity and bias from omitted variables. RESULTS: Stunting and relatively small stature had significant associations with cognitive development, and they worked as intermediaries to cognitive developmental barriers as manifested in reduced educational outcomes. A lack of one SD in HAZ was associated with 0.6 years shortened length of the school, 3% higher chances of dropouts from secondary school, and 0.10-0.23 SD lowered cognitive and numerical scores. Similarly, stunting is associated with decrease cognitive test scores by 0.56-0.8 SD compared to non-stunting, two years less schooling, and 0.4 years of delayed entry to school. As for cognitive abilities, stunting is associated with lower cognitive and numerical abilities by 0.38-0.82 z-scores. CONCLUSION: Growth retardation during childhood in Indonesia was associated with lower cognitive abilities, particularly during school age, and this correlation faded as individuals grew up. Subsequently, growth retardation is significantly linked to lower educational outcomes. Impaired growth has implications for reduced lifetime earnings potential mediated by diminished cognitive capacity and lower educational attainment. The finding suggests that development in Indonesia during recent decades has not provided an adequate environment to enable children to achieve their potential educational outcomes.

Smartphone-Enabled Quantification of Potassium in Blood Plasma.

This work describes a new method for determining K+ concentration, [K+], in blood plasma using a smartphone with a custom-built optical attachment. The method is based on turbidity measurement of blood plasma solutions in the presence of sodium tetraphenylborate, a known potassium precipitating reagent. The images obtained by a smartphone camera are analyzed by a custom image-processing algorithm which enables the transformation of the image data from RGB to HSV color space and calculation of a mean value of the light-intensity component (V). Analysis of images of blood plasma containing different amounts of K+ reveal a correlation between V and [K+]. The accuracy of the method was confirmed by comparing the results with the results obtained using commercial ion-selective electrode device (ISE) and atomic absorption spectroscopy (AAS). The accuracy of the method was within ± 0.18 mM and precision ± 0.27 mM in the [K+] range of 1.5-7.5 mM when using treated blood plasma calibration. Spike tests on a fresh blood plasma show good correlation of the data obtained by the smartphone method with ISE and AAS. The advantage of the method is low cost and integration with a smartphone which offers possibility to measure [K+] on demand and in remote areas where access to hospitals is limited.

Sources identification of the atmospheric aerosol at urban and suburban sites in Indonesia by positive matrix factorization.

Samples of fine and coarse fractions of airborne particulate matter were collected in Indonesia (west central Java) at an urban site in Bandung and in suburban Lembang from January 2002 to December 2004. The samples were collected using a Gent stacked filter sampler in two size fractions of <2.5 microm (fine) and 2.5 to 10 microm (coarse). The samples were analyzed for elemental concentrations by instrumental neutron activation analysis (INAA) and proton-induced X-ray emission (PIXE). Black carbon was determined using an EEL Smoke Stain Reflectometer. The data sets were then analyzed using positive matrix factorization to identify the possible sources of fine and coarse atmospheric aerosols in both areas. The best solutions were found to be seven factors and five factors for elemental compositions of fine and coarse particulate matter in the urban area of Bandung and six factors and five factors for elemental compositions of fine and coarse particulate matter in the suburban area of Lembang, respectively. The sources are soil dust, motor vehicles, biomass burning, sea salt, and road dust. The PMF results showed that more than 50% of the PM2.5-10 mass at both sites comes from soil dust and road dust. The biomass burning factor contributes about 40% of the PM2.5 mass in case of suburban Lembang and about 20% in urban Bandung.

Panel 2.15: civil-military cooperation in humanitarian health action.

This is a summary of the presentations and discussion of Panel 2.15, Civil-Military Cooperation in Humanitarian Health Action of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to civil-military collaboration in humanitarian health actions as pertain to the responses to the damage created by the Tsunami. It is presented in the following sections: (1) how effective civil-military cooperation can help health responses, including: (a) needs assessment; (b) coordination; (c) filling gaps; and (d) capacity building; (2) what was done well, and what could have been done better; and (3) conclusions and recommendations. Conclusions and recommendations included: (1) the best coordination mechanisms for civil-military cooperation; and (2) suggested additions and improvements.