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Background: Audio-visual diary to collect data on daily routines of study participants is relatively new in health systems research. The concept uses participatory research techniques to elicit participants' views, priorities and empower them to take action.\ud \ud Methods: We discuss a collaborative qualitative study conducted by university researchers, rural communities and health managers (Southwest Ethiopia). We used Videovoice to understand the role of community health volunteers as mediators of accessible and responsive Primary Health Care in Ethiopia. Footage is obtained from 30 Health Development Army leaders in 3 diverse districts, over 3–4 months. Following community engagement and training, participants received an encrypted phone with recording capability. They are supported by researchers through regular contacts, to establish trust, support, and reduce social desirability. A co-production workshop with participants and researchers to interpret the findings will be held.\ud \ud Results: Employing Videovoice diaries demonstrates that collaborations involving academic researchers, community members and volunteers (as lay researchers) and managers have considerable benefits as well as challenges. Videovoice shifts power to the participants: they determine what to capture, what is important and how to convey their views and activities. Data is enriched by participant-generated insights into the reasons behind their decisions. Intensive engagement, effective communication and trust are essential in understanding constraints and preferences of their role, and interpreting findings. A multi-disciplinary research team will enhance the analytical process.\ud \ud Discussion: Videovoice can be a useful tool in enabling lay researchers to describe their daily life, better understand their needs, and identify mechanisms for change. The approach can strengthen the immediacy of the research, capturing perceptions within context. Co-production will involve a significant shift in power and emergence of new directions.

The cerebrovascular bed is very sensitive to CO2 changes, particularly the areas responsible for generation and control of respiratory rhythm. We have used BOLD functional magnetic resonance imaging (fMRI) and externally induced CO2 challenges that stimulate respiration, to identify respiratory areas in-vivo in humans and to quantify the dynamic effects of CO2 on the BOLD fMRI signal (dynamic CO2 reactivity). We sought to identify regional differences in dynamic reactivity within the brainstem and other respiratory related areas (thalamus) by using linear impulse response (IR) and nonlinear Volterra models, as well as experimental measurements obtained during spontaneous breathing and larger externally induced step CO2 changes (end-tidal forcing). The results revealed areas in the brainstem and thalamus that responded strongly to the external CO 2 stimuli, which correspond to respiratory nuclei identified in recent rodent studies, as well as pronounced regional differences in CO 2 reactivity.

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model.

Spinal cord stimulation (SCS) is considered as an option for the management of complex regional pain syndrome (CRPS). Hyperalgesia, an increased pain response to a mechanical or thermal stimulus at normal or increased threshold is a common feature of CRPS. Animal studies have demonstrated that SCS significantly reduces mechanical hyperalgesia. These studies suggest that SCS mechanisms may involve reduction of glial activation at spinal cord level and/or activation of μ-opioid and δ-opioid receptors. However, in humans it has been observed that SCS had no effect on experimental pain thresholds and did not produce decreased sensitivity for pressure, warmth, and cold induced pain in CRPS patients. The majority of currently available studies on the effectiveness of SCS, including those using quantitative sensory testing (QST) rely on patient reported outcomes such as visual analogue or numerical rating scales. The current case report investigates the effectiveness of SCS based on electroencephalogram (EEG) analysis of contact heat evoked potentials following experimental induction of thermal stimuli.

Cet article étudie la manière dont les femmes ou les couples gèrent les grossesses non prévues dans les capitales du Maroc et du Sénégal (Rabat et Dakar), deux pays soumis à des règles strictes en matière de sexualité des célibataires. Nous analysons les logiques sociales et individuelles qui prévalent à l'annonce d'une grossesse inattendue et la manière dont se prennent les décisions qui vont aboutir à la poursuite de cette grossesse ou à son interruption. Nous nous basons sur des données qualitatives tirées d'un programme financé par l'Union Européenne entre 2005 et 2009, sur l'usage de la contraception d'urgence dans les villes africaines. Nos résultats montrent qu'en dépit de programmes de planification familiale plus performants dans leur pays, les femmes de Rabat vivent leur entrée en sexualité dans des conditions difficiles. Si à Dakar la chasteté avant le mariage est prônée, le non-respect de cette règle entraîne des sanctions beaucoup moins sévères qu'au Maroc. Le choix de l'avortement en cas de grossesse non prévue évolue avec le cycle de vie des individus et selon le stade de la relation. Une pratique envisageable à un moment donné, ne l'est plus forcément à d'autres moments de la relation. Enfin, dans les deux villes, nos données révèlent une forte implication des familles dans la gestion de la formation des couples et de leur fécondité. Cette tendance apparaît cependant plus exacerbée au Maroc où les familles se mobilisent parfois âprement pour obliger ou interdire un avortement.

This paper examines how women or couples manage unplanned pregnancies in the capital cities of Morocco and Senegal (Rabat and Dakar), both subject to strict rules in terms of sexuality among single people. We analyze the social and individual logics prevailing when an unexpected pregnancy is announced and how decisions are made as to whether to continue or terminate the pregnancy. We analyse qualitative data from a program funded by the European Union between 2005 and 2009 on the use of emergency contraception in African cities. Our results show that despite the existence of effective family planning programs in Rabat, circumstances of sexual debut among women are difficult. In Dakar, although chastity before marriage is promoted, non-compliance with this rule is not as severely condemned than in Morocco. Choosing abortion when faced with unplanned pregnancy depends on people's life cycle and on the stage of their relationship. One practice contemplated at a given time in the relationship may no longer be feasible at another time. Finally, in both cities, our data highlight the strong involvement of families in managing couple relationships and their fertility. This influence seems further exacerbated in Morocco where families sometimes fiercely require or forbid abortion.

Supply chain thinking is more important today than ever before. The impact of supply chain on company performance is increasingly prominent, not only in terms of cost, but also in terms of value creation - this is shown to be especially true in recessionary times, where supply chain thinking has gained prominence in many businesses in response to the economic pressures and concern for good cash management. Research has shown that poor management of the supply chain can significantly impact on an organisation's shareholder value and that for businesses to succeed, supply chain strategy should, therefore, be coming under far greater scrutiny in the boardroom and needs to be better understood. For these reasons, Cranfield embarked on this piece of research with the support of Solving Efeso.

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