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Health and wellness interventions addressing risk factors for early mortality among individuals with serious mental illness have demonstrated success and can be further augmented with digital technology. These programs may be suitable for delivery in psychosocial rehabilitation clubhouses, especially given many services have transitioned to digital platforms during the pandemic. This qualitative study aimed to: (a) explore clubhouse members’ experiences engaging with the virtual clubhouse platform, and their preferences for accessing digital wellness and health promotion content; and, (b) gauge members’ interest in an online peer-driven lifestyle intervention and their suggestions for program design. This study was guided by a community-based participatory action research framework. Ten focus groups were conducted with clubhouse members. Focus groups were coded and analyzed thematically by trained clubhouse members and the research team. Thirty-three members participated in the focus groups. Participants expressed the importance of having technical support from staff; that one-on-one support and consistent communication are important to keep them engaged in health and wellness programming; and described mixed views about use of the virtual platform, but generally were open to engaging in lifestyle intervention programming virtually. Participants who joined the clubhouse during the pandemic expressed feeling overwhelmed by in-person gatherings, and were especially interested in opportunities for remote participation. This study can inform health and wellness programming for delivery on the virtual clubhouse platform for members. The taxonomy of codes, created to generate a framework with recommendations, will inform the design of a virtual health and wellness intervention.

Background Recording and reporting health data in facilities is the backbone of routine health information systems which provide data collected by health facility workers during service provision. Data is firstly collected in a register, to record patient health data and care process, and tallied into nationally designed reporting forms. While there is anecdotal evidence of large numbers of registers and reporting forms for primary health care (PHC) facilities, there are few systematic studies to document this potential burden on health workers. This multi-country study aimed to document the numbers of registers and reporting forms use at the PHC level and to estimate the time it requires for health workers to meet data demands. Methods In Cambodia, Ghana, Mozambique, Nigeria and Tanzania, a desk review was conducted to document registers and reporting forms mandated at the PHC level. In each country, visits to 16 randomly selected public PHC facilities followed to assess the time spent on paper-based recording and reporting. Information was collected through self-reports of estimated time use by health workers, and observation of 1360 provider-patient interactions. Data was primarily collected in outpatient care (OPD), antenatal care (ANC), immunization (EPI), family planning (FP), HIV and Tuberculosis (TB) services. Result Cross-countries, the average number of registers was 34 (ranging between 16 and 48). Of those, 77% were verified in use and each register line had at least 20 cells to be completed per patient. The mean time spent on recording was about one-third the total consultation time for OPD, FP, ANC and EPI services combined. Cross-countries, the average number of monthly reporting forms was 35 (ranging between 19 and 52) of which 78% were verified in use. The estimated time to complete monthly reporting forms was 9 h (ranging between 4 to 15 h) per month per health worker. Conclusions PHC facilities are mandated to use many registers and reporting forms pausing a considerable burden to health workers. Service delivery systems are expected to vary, however an imperative need remains to invest in international standards of facility-based registers and reporting forms, to ensure regular, comparable, quality-driven facility data collection and use.

Next-generation sequencing approaches have fundamentally changed the types of questions that can be asked about gene function and regulation. With the goal of approaching truly genome-wide quantifications of all the interaction partners and downstream effects of particular genes, these quantitative assays have allowed for an unprecedented level of detail in exploring biological interactions. However, many challenges remain in our ability to accurately describe and quantify the interactions that take place in those hard to reach and extremely repetitive regions of our genome comprised mostly of transposable elements (TEs). Tools dedicated to TE-derived sequences have lagged behind, making the inclusion of these sequences in genome-wide analyses difficult. Recent improvements, both computational and experimental, allow for the better inclusion of TE sequences in genomic assays and a renewed appreciation for the importance of TE biology. This review will discuss the recent improvements that have been made in the computational analysis of TE-derived sequences as well as the areas where such analysis still proves difficult. This article is part of a discussion meeting issue ‘Crossroads between transposons and gene regulation’.

BackgroundMost maternal and child deaths are preventable or treatable with proven, cost-effective interventions for infectious diseases and maternal and neonatal complications. In 2015 sub-Saharan Africa accounted for up to 66% of global maternal deaths and half of the under-five deaths. Access to essential medicines and commodities and trained healthcare workers to provide life-saving maternal, newborn and post-natal care are central to further reductions in maternal and child mortality.MethodsAvailable data for 24 priority medicines for women and children were extracted from WHO service availability and readiness assessments conducted between 2012 and 2015 for eight countries in sub-Saharan Africa. The mean availability of medicines in facilities stating they provide services for women or children and differences by facility type, ownership and location are reported.ResultsThe mean availability of 12 priority essential medicines for women ranged from 22% to 40% (median 33%; IQR 12%) and 12 priority medicines for children ranged from 28% to 57% (median 50%; IQR 14%). Few facilities (ConclusionsThe survey results show unacceptably low availability of priority medicines for women and children in the eight countries. Governments should ensure the availability of medicines for mothers and children if they are to achieve the health sustainable development goals.

To describe the Service Availability and Readiness Assessment (SARA) and the results of its implementation in six countries across three continents.The SARA is a comprehensive approach for assessing and monitoring health service availability and the readiness of facilities to deliver health-care interventions, with a standardized set of indicators that cover all main programmes. Standardized data-collection instruments are used to gather information on a defined set of selected tracer items from public and private health facilities through a facility sample survey or census. Results from assessments in six countries are shown.The results highlight important gaps in service delivery that are obstacles to universal access to health services. Considerable variation was found within and across countries in the distribution of health facility infrastructure and workforce and in the types of services offered. Weaknesses in laboratory diagnostic capacities and gaps in essential medicines and commodities were common across all countries.The SARA fills an important information gap in monitoring health system performance and universal health coverage by providing objective and regular information on all major health programmes that feeds into country planning cycles.Décrire l'Évaluation de la Disponibilité et de l'État de Préparation des Services, ainsi que les résultats de sa mise en œuvre dans six pays, sur trois continents.L'évaluation de la Disponibilité et de l'État de Préparation des Services est une approche globale permettant d'évaluer et de surveiller la disponibilité des services de santé et l'état de préparation des installations pour assurer des interventions médicales, avec un ensemble normalisé d'indicateurs qui couvre tous les programmes principaux. Des instruments normalisés de collecte de données sont utilisés pour recueillir des informations concernant une série définie d'éléments traceurs sélectionnés dans des installations publiques et privées par le biais d’une enquête ou d'un recensement auprès d'un échantillon de participants. Les résultats des évaluations dans six pays sont présentés.Les résultats soulignent les importantes lacunes en termes de prestations des services qui constituent des obstacles à l'accès universel aux services de santé. Des variations considérables ont été constatées au sein de et entre les pays en termes de la distribution des infrastructures des établissements de santé, des effectifs et des services offerts. Les défaillances en termes de capacités diagnostiques dans les laboratoires et les insuffisances au niveau des médicaments et des produits essentiels sont communes dans tous les pays.L'évaluation de la Disponibilité et de l'État de Préparation des Services comble un manque important d'informations dans le domaine de la surveillance de la performance des systèmes de santé et de la couverture sanitaire universelle en fournissant des données objectives et régulières sur tous les principaux programmes de santé qui alimentent les cycles de planification des pays.Describir la evaluación de la disponibilidad y preparación de los servicios (SARA), así como los resultados de su aplicación en seis países de tres continentes.La evaluación de la disponibilidad y preparación de los servicios es un enfoque integral que tiene como objeto evaluar y realizar un control de la disponibilidad de servicios de salud y la preparación de las instalaciones para realizar intervenciones de atención sanitaria, y que incluye un conjunto estandarizado de indicadores que abarcan todos los programas principales. Se emplean instrumentos estandarizados de recolección de datos para recopilar información sobre un conjunto definido de indicadores seleccionados a través de un censo o encuesta muestral sobre las instalaciones de los servicios de salud públicos y privados. Se muestran los resultados de las evaluaciones en seis países.Los resultados ponen en relieve deficiencias importantes en la prestación de servicios que obstaculizan el acceso universal a los servicios de salud. Tanto en cada país como entre los países se observa una variación relevante en la distribución de la infraestructura de las instalaciones de salud y del personal sanitario, así como en los tipos de servicios que se ofrecen. En todos los países se observó una falta de fiabilidad en la capacidad de diagnóstico de laboratorio y una insuficiencia de medicamentos esenciales y de productos básicos.La evaluación de la disponibilidad y preparación de los servicios colma una carencia importante de información para el control del desempeño del sistema de salud y la cobertura universal de salud, y proporciona información objetiva y periódica sobre los programas de salud principales que se incorpora a los ciclos de planificación de los países.وصف تقييم توفر الخدمات والتأهب (SARA) ونتائج تنفيذه في ستة بلدان عبر ثلاث قارات.تقييم توفر الخدمات والتأهب عبارة عن نهج شامل لتقييم ورصد توفر الخدمات الصحية وتأهب المرافق لإيتاء تدخلات الرعاية الصحية، باستخدام مجموعة موحدة من المؤشرات التي تغطي جميع البرامج الرئيسية. وتستخدم أدوات جمع البيانات الموحدة لجمع المعلومات حول مجموعة محددة من عناصر اقتفاء الأثر المختارة من مرافق الصحة العامة والخاصة من خلال التعداد أو المسح الخاص بعينات المرافق. ويتم عرض نتائج التقييمات في ستة بلدان.تبرز النتائج ثغرات مهمة في إيتاء الخدمات تمثل عقبات أمام الإتاحة الشاملة للخدمات الصحية. وتم التوصل إلى وجود تفاوت كبير داخل البلدان وبينها في توزيع البنية التحتية والقوى العاملة في المرافق الصحية وفي أنواع الخدمات المقدمة. وكان الضعف في القدرات التشخيصية المخبرية والثغرات في الأدوية والسلع الأساسية شائعاً بين جميع البلدان.يسد تقييم توفر الخدمات والتأهب ثغرة معلوماتية مهمة في رصد أداء النظام الصحي والتغطية الصحية الشاملة عن طريق تقديم معلومات موضوعية ومنتظمة عن جميع البرامج الصحية الكبرى التي تؤثر على دورات التخطيط القطرية.描述服务可及性和准备情况评估(SARA)及其在三大洲六个国家中的实施效果。SARA有一套覆盖所有主要计划的标准化指标集合,是评估和监控卫生服务可及性和设施准备情况的综合方案,以便于提供医疗卫生干预。使用标准化数据采集工具,通过设施抽样调查或普查,从公共和私人设施收集已确定的一组所选示踪项目方面的信息。显示六个国家的评估结果。结果凸显了服务交付的重要缺口,这些缺口正是普及医疗服务的障碍。在卫生基础设施和劳动力的分配以及所提供的服务类型方面,在各个国家内部和各个国家之间存在相当大的差异。实验室诊断能力薄弱、基本药品和商品的缺口是所有国家共有的情况。SARA提供了所有关于主要健康计划的客观和定期的信息注入到国家计划周期中,填补了健康卫生系统绩效和全民医保的重要信息缺口。Описать Оценку услуг и готовности (SARA), а также результаты ее проведения в шести странах на трех континентах.SARA — это всеобъемлющий подход к оценке и мониторингу доступности медико-санитарных услуг и готовности объектов здравоохранения к оказанию мер медико-санитарной помощи с использованием набора стандартизированных показателей, охватывающих все основные программы. Стандартизированные инструменты сбора данных используются для сбора информации об определенном наборе избранных показателей государственных и частных медицинских учреждений в рамках выборочного обследования или статистического исследования объекта. Здесь приводятся результаты оценок, проведенных в шести странах.Результаты свидетельствуют о существенных недостатках в предоставлении услуг, которые являются препятствием для обеспечения всеобщего доступа к медико-санитарным услугам. Существенные различия были обнаружены как внутри стран, так и между ними в части распределения инфраструктуры и персонала медицинских объектов и по типам предлагаемых услуг. Общие недостатки всех стран — нехватка лабораторно-диагностических возможностей и основных лекарственных средств и товаров.SARA восполняет важный пробел в мониторинге эффективности работы системы здравоохранения и всеобщего охвата медико-санитарной помощью, предоставляя объективную и регулярную информацию о всех крупных программах в области здравоохранения для учета в циклах планирования в странах.

Stronger governance and leadership is needed to implement and maintain integrated reporting systems, say Theresa Diaz and colleagues

Purpose: We determined the prevalence of requests for postmortem sperm procurement and the degree to which procurement is performed by those working in the field of infertility.Materials and Methods: Structured telephone interviews were conducted with personnel at 273 assisted reproductive facilities in the United States and Canada. The number of facilities reporting requests and the number of facilities reporting that they performed the procedure were determined.Results: The prevalence of requests for postmortem sperm procurement was much greater than initially anticipated. A total of 82 requests was reported at 40 facilities in 22 different states between 1980 and 1995. More than half of the reported requests (43) were made between 1994 and 1995. Of the 82 requests 25 were honored at 14 facilities in 11 different states. No requests or procedures were reported from Canada.Conclusions: Medical advances in postmortem sperm procurement, cryopreservation and in vitro fertilization permit retrieval o...

(1990). Ending the Cold War in Southern Africa. Third World Quarterly: Vol. 12, No. 3-4, pp. 81-96.

International audience; In November 2013, tens of thousands of protesters marched twice in cities of western Brittany, wearing a red cap with reference to a large peasant revolt led in Brittany in 1675 and bloodily repressed by the troops of Louis XIV. Beyond their immediate demands, the issues of demonstrations in 2013 were multiple: governance crisis in France, economic crisis, social crisis... However, these events were judged harshly by many French politicians and journalists, who described them as a disparate movement, practicing class alliance and Poujadism (a French populist movement of the 1950s against taxes, industrialization and urbanization), who wrongfully assumed the legacy of the Red Caps of 1675. Our hypothesis is that these harsh judgments are part of a struggle for symbolic domination. To verify this, we conducted two types of searches: a comparison of the revolt of 1675 and of 2013 events; and a comparison of the remarks made by the elites in 2013 and of traditional social representations of the Breton people in France. It shows, first, that, mutatis mutandis, 1675 and 2013 have many similarities, and, secondly, that many of the arguments of the elites are part of the extension of (sometimes centuries-old) stereotypes on the Bretons. This means that the use of the symbolic red cap by protesters is not usurped and, above all, that, beyond a legitimate reserve, the hostility to this popular movement is part of a conservative approach.; En novembre 2013, des dizaines de milliers de manifestants ont défilé à deux reprises dans des villes de Bretagne occidentale, coiffés d’un bonnet rouge en référence à une grande révolte de paysans bretons menée en 1675 et réprimée dans le sang par les troupes de Louis XIV. Par-delà leurs revendications immédiates, les enjeux des manifestations de 2013 étaient multiples : crise de la gouvernance à la française, crise économique, crise sociale… Or, ces manifestations furent jugées sévèrement par beaucoup d’observateurs du monde politique et médiatique français, qui y virent un mouvement hétéroclite, relevant de l’alliance de classe et du poujadisme (un mouvement populiste français antifiscal, anti-industrialisation et anti-urbanisation des années 1950), indigne, donc, de l’héritage des Bonnets rouges de 1675. Notre hypothèse est que ces jugements sévères relèvent d’une lutte de domination symbolique. Pour le vérifier, nous avons procédé à deux types de recherches : une comparaison de la révolte de 1675 et des manifestations de 2013 ; et une comparaison des propos des élites de 2013 et des représentations sociales traditionnelles de la population bretonne. Il en ressort, d’une part, que, mutatis mutandis, 1675 et 2013 présentent de nombreuses analogies, et, d’autre part, que beaucoup des arguments des élites s’inscrivent dans le prolongement de stéréotypes (parfois pluriséculaires) relatifs aux Bretons. Cela signifie que le recours à la symbolique du bonnet rouge par les manifestants n’est pas usurpé et surtout que (par-delà une légitime réserve) l’hostilité à ce mouvement populaire s’inscrit dans une démarche conservatrice.