A quasi-experimental text messaging trial to improve adolescent sexual and reproductive health and smoking knowledge in Indonesia

Background To evaluate the feasibility and acceptability of a text message intervention to improve young people's knowledge of sexual reproductive health (SRH) and harms related to smoking in Indonesia. METHODS: A quasi-experimental short message service (SMS) trial of young people aged 16-24 years receiving twice weekly SMS over a 10-week intervention period. Pre- and post-online demographic and risk behaviour surveys were used to assess changes in knowledge. Among respondents who completed both surveys, we assessed changes in knowledge before and after SMS intervention using paired McNemar's test and differences in mean knowledge score using a paired t-test. RESULTS: In total, 555 eligible young people were enrolled into the SMS intervention; 235 (42%) completed a follow-up survey, of which 198 (84%) were matched to a baseline survey. Median age of participants was 19 years and the majority were female (63%). The mean knowledge score significantly increased between baseline and follow-up surveys for SRH questions [2.7, (95% CI 2.47, 2.94) vs 3.4 (95% CI 2.99, 3.81) (P = <0.01)] and smoking-related questions [3.8 (95% CI 3.66, 3.99) vs 4.1 (95% CI 3.99, 4.28) (P = 0.03)]. A majority of participants reported that the SMS intervention increased their knowledge (95%) and were a useful reminder (95%). CONCLUSIONS: An SMS intervention was feasible, acceptable and improved adolescents' SRH knowledge and smoking knowledge in a low- to middle-income setting. SMS interventions targeting young people need to be scaled up, with the potential to explore additional topics around healthy lifestyle, nutrition and physical activity

The rapid expansion of Indonesia’s marine protected area requires improvement in management effectiveness

Indonesia’s marine ecosystems are among the most diverse in the world, supporting extensive critical habitats with strong connections to coastal communities. To keep pace with increasing pressures on the environment, conservation efforts need to be strengthened and expanded. The Government of Indonesia has committed to protecting marine ecosystems through establishing 32.5 million ha of marine protected areas (MPAs), with 20 million ha effectively managed, by 2030. Therefore, collating data on the status and progress of marine conservation efforts nationally is important to show the extent to which this target is being reached. Here we provide an overview of the status and trends of spatial coverage and management effectiveness of MPAs in Indonesia. As of 2020, Indonesia had made good progress in reaching its target – with 23.9 million ha MPA established and some —albeit slow— increases in MPA management effectiveness. Moving forward, we recommend that marine protection efforts in Indonesia need to balance MPAs expansion with improvement in effectiveness. Improvement of management effectiveness will require significant efforts, including improving institutional coordination, ensuring adequate human and financial resources, and strengthened monitoring, evaluation, and learning to inform adaptive management. Future MPA expansion should focus on addressing specific gaps in the existing network, such as increasing coastal habitat representation, and connectivity, or increasing recognition of a diversity of governance approaches (e.g., by communities or private entities). Progress over recent decades, however, suggests Indonesia is making progress on its marine protection goals and is well placed to meet potential future targets

The inclusion of fisheries and tourism in marine protected areas to support conservation in Indonesia

With the rapid growth of Indonesia’s marine protected area (MPAs) estate in Indonesia, reaching 23.9 million hectares by January 2020, attention needs to be focused on strengthening the effectiveness of MPA management. Consolidating and expanding protection of Indonesia’s marine resources is critical with increasing pressure from a fast-expanding population, illegal, unreported, and unregulated fishing, pollution, coastal development, unsustainable tourism and climate change. Biodiversity conservation must therefore concurrently consider multiple economic sectors such as fisheries and tourism, and their synergies with MPA management. This paper aims to outline the current landscape of fisheries and marine tourism pertaining to area-based conservation in Indonesia, to inform and support improved integration into effective MPA management. Four areas to focus efforts were identified: diversification of governance types of community-based management, improved coordination between fisheries and MPAs during planning and management implementation, the development and support of pathways for sustainable tourism, and planning for future conditions. Sustainable development for fisheries and tourism must be incorporated into all aspects of MPA management, whilst recognising that current management systems are insufficient to ensure long-term sustainability for natural resources and local communities, and strategies need to increase resilience of social-ecological systems in anticipation of future conditions

Older Human B Cells and Antibodies

B cells have a number of different roles in the immune response. Their excellent antigen presentation potential can contribute to the activation of other cells of the immune system, and evidence is emerging that specialized subsets of these cells, that may be increased with age, can influence the cell-mediated immune system in antitumor responses. They can also regulate immune responses, to avoid autoreactivity and excessive inflammation. Deficiencies in regulatory B cells may be beneficial in cancer but will only exacerbate the inflammatory environment that is a hallmark of aging. The B cell role as antibody producers is particularly important, since antibodies perform numerous different functions in different environments. Although studying tissue responses in humans is not as easy as in mice, we do know that certain classes of antibodies are more suited to protecting the mucosal tissues (IgA) or responding to T-independent bacterial polysaccharide antigens (IgG2) so we can make some inference with respect to tissue-specific immunity from a study of peripheral blood. We can also make inferences about changes in B cell development with age by looking at the repertoire of different B cell populations to see how age affects the selection events that would normally occur to avoid autoreactivity, or increase specificity, to antigen