Effect of a smartphone intervention on self-managed medication abortion experiences among safe-abortion hotline clients in Indonesia: A randomized controlled trial.

OBJECTIVE: To investigate the impact of a smartphone application (app) providing information and support for medication abortion (MA) on the primary outcomes of 'feelings of support' and 'preparedness' among clients of Samsara, a safe-abortion hotline in Indonesia. METHODS: In a parallel-arm, non-clinical, randomized controlled trial, women (ages ≥15) who contacted Samsara between February 2017- July 2018 seeking information on MA for pregnancies ≤13 weeks gestation were randomized to receive either an app with abortion information, or standard of care (high-quality comprehensive and empathic counseling on pregnancy options). Participants completed a questionnaire 24 days after enrollment; Fisher exact tests and risk differences were used to assess differences in self-reported feelings of preparedness and support throughout the process of self-managed MA. RESULTS: No differences in feelings of support or preparedness were detected between participants in the app arm versus the standard of care arm. CONCLUSION: This study represents the first-ever randomized control trial (and prospective study) among those who contacted a safe-abortion hotline for information about and support for self-managed abortion. Levels of preparedness, confidence, and feelings of support were all extremely high among both control and intervention arms-indicative of the high-quality, evidence-based information, comprehensive, and supportive abortion counseling that safe-abortion hotline clients receive.

Social stigma, adherence to medication and motivation for healing: A cross-sectional study of leprosy patients at Jember Public Health Center, Indonesia.

OBJECTIVES: Social stigma surrounding leprosy patients (LPs) in the community is still related to the adherence of these patients to medication and to their internal motivation for healing. Unfortunately, the leprosy case programme has not been optimally established in public health centres (PHCs). The aim of this study was to assess the social stigma towards adherence to medication and motivation for healing among LPs in PHCs in Indonesia. METHODS: A cross-sectional study was conducted from March to May 2017 at PHCs in Jember, Indonesia. Data were collected using a self-administered questionnaire, and secondary data related to medical treatment was assessed from PHCs' medical records. The data were analysed using a t-test and a Chi-square test, while linear regression was used to evaluate factors that could influence LPs' adherence to medication and their motivation for healing. RESULTS: Among the 35 LPs in this study, 25.7% and 74.3%, respectively, had paucibacillary and multibacillary types of leprosy. The type of leprosy was associated with the length of time patients were infected with the disease, their adherence to medication and their motivation for healing. The factors that influenced adherence to medication and motivation for healing were the time period that the LP remained infected and the type of leprosy. CONCLUSIONS: Infection period and type of leprosy were associated with adherence to medication and motivation for healing in the community. Efforts should be made to find active cases of leprosy at PHCs. Activities at PHCs should include self-care groups to improve LP adherence to medication and their motivation for healing in the community.

Reduction of meningitis and impact on under-5 pneumonia after introducing the Hib vaccine in the Kingdom of Tonga.

AIMS: To document the impact of Hib vaccine on Haemophilus influenzae (Hi) invasive disease, meningitis and inpatient pneumonia in children under 5 in the Kingdom of Tonga. METHODS: Cases of meningitis and pneumonia were sourced from the paediatric discharge book from 1 January 2000 to 2 November 2007 and from computerised discharge records from Vaoila Hospital on the island of Tongatapu where approximately 70% of the total population resides. Laboratory-confirmed cases were sourced from the microbiology laboratory register over the same period. RESULTS: Prior to the introduction of Hib vaccine in 2005, there were, on average, 5.6 cases of invasive Hi disease per year. In the 22 months after Hib vaccine introduction, there was only one case of invasive Hi disease. This corresponds to a fall in the annual incidence of invasive Hib disease from 54.3 to 5.1/100,000 children under 5 years of age. The annual incidence of inpatient pneumonia has fallen by 28.3% from 1007.6 to 722.8/100,000 children under 5 in the 22 months after introducing the vaccine. CONCLUSION: Hib vaccine has reduced invasive Hi disease and Hi meningitis in Tonga. The reduction in inpatient pneumonia is more likely a reflection of annual fluctuations in viral pneumonia than of a reduction in Hib pneumonia, but ongoing surveillance is recommended.

Isolation of the first ferromagnetically coupled Mn(III/IV) complex.

Binuclear manganese complexes Mn2(III/IV)(dtsalpn)2DCBI, 1, Mn2(III/III)(dtsalpn)2HDCBI, 2, containing the ligand dicarboxyimidazole (DCBI) have been prepared in order to address the issue of imidazole bridged and ferromagnetically coupled Mn sites in high oxidation states of the OEC in Photosystem II (PS II). Temperature dependent magnetic susceptibility studies of 1 indicates that the interaction between the two Mn(III)/Mn(IV) ions is ferromagnetic (J = +1.4 cm(-1)). Variable temperature EPR spectra of 1 shows that a g = 2 multiline is as an excited state signal corresponding to S = 1/2.

Preparation and characterization of vanadyl complexes with bidentate maltol-type ligands; in vivo comparisons of anti-diabetic therapeutic potential.

A series of 2-alkyl-3-hydroxy-4-pyrone oxovanadium(IV) compounds has been synthesized, characterized, and tested for bioactivity as potential insulin-enhancing agents. The vanadyl complexes, bis(maltolato)oxovanadium(IV), BMOV, bis(ethylmaltolato)oxovanadium(IV), BEOV, and bis(isopropylmaltolato)oxovanadium(IV), BIOV, were compared against vanadyl sulfate for glucose-lowering ability, when administered i.p. to STZ-diabetic rats, at a one-time dose of 0.1 mmol kg(-1)body weight. Blood levels of vanadium were determined at regular intervals, to 72 h, following i.p. injection. All complexes tested exceeded vanadyl sulfate in glucose-lowering ability; this effect was not correlated, however, with blood vanadium levels. Analysis of the pharmacokinetics of the disappearance of [ethyl-1-(14)C]BEOV after an oral gavage dose (50 mg kg(-1), 0.144 mmol kg(-1), in a 10 mL kg(-1) volume of 1% CMC solution) indicated clearly that metal ion-ligand dissociation took place relatively soon after oral ingestion of the complex. Half-lives of fast phase uptake and slow phase disappearance for (14)C and V were calculated from a two-compartment model for whole blood, plasma, liver, kidney, bone, small intestine, and lung, ranging from 17 min ( t(1/2)alpha for (14)C, liver) to 30 days ( t(1/2)beta for V, bone). Curves of disappearance of plasma and whole blood (14)C and V diverged dramatically within the first hour after administration of the vanadium complex.