The public you want, the public you get: Exploring the relationship between the public and science in the debate on xenotransplantation.

The debate that followed the first-in-human cardiac transplantation of a genetically modified pig organ emerged as a discussion of social justice when the patient's criminal record was revealed. This article aims to make sense of this debate by understanding the role of the 'public' today, particularly in relation to the governance of biotechnology. The relationship between the public and science is increasingly mediated through citizen participation. However, the public debate that unfolded on matters of social justice can be seen as an unmediated public discourse, which carries the risk of producing unpredictable outcomes. The content of the debate gains significance due to the functional differentiation of society. The medical subsystem does not consider the patient's history in terms of their involvement in the legal sphere, that is, their criminal record. Nevertheless, normative judgements are transferred across functional systems, allowing for the influence of public opinion and the potential for public scorn.

Participación ciudadana, imprescindible en procesos comunitarios: experiencia en la realización del diagnóstico de salud de Santpedor / Citizen participation, essential in community processes: experience in the Santpedor health diagnosis

Introducción. En este artículo se quiere plasmar la grata experiencia de hacer un diagnóstico de salud en la población de Santpedor. El diagnóstico se llevó a cabo con acción participativa desde el primer momento y durante todo el proceso. Se hizo con un grupo motor, donde solo dos de las 15 personas que lo representan eran agentes sanitarios. Estos agentes legitimaron el proceso comunitario, coordinaron el grupo motor y lo guiaron. Sin embargo, eran una pieza más del puzle comunitario, siendo los otros 13 agentes comunitarios no sanitarios los auténticos protagonistas al posibilitar llegar a la población y completar el puzle comunitario. Objetivo. Realizar el diagnóstico de salud de Santpedor con acción participativa. Métodos. Se utilizó una metodología mixta secuencial y explicativa, con una parte cuantitativa (descriptivo transversal) y una parte cualitativa (acción participativa). En este artículo se explica la metodología que se utilizó para hacer el diagnóstico de salud de Santpedor y se describen las estrategias participativas para llegar a la población y favorecer la pertinencia en el proceso comunitario, así como las técnicas empleadas para la detección de las necesidades y su priorización. Las técnicas cualitativas utilizadas para la detección de los activos fueron el mapping party y la marcha de activos. Las técnicas empleadas para identificar las necesidades fueron la encuesta y las entrevistas grupales (grupos focales, grupo nominal y entrevistas individuales). Resultados. Se identificaron 604 activos de Santpedor. En el análisis cuantitativo se observó que Santpedor presentaba un gran relevo generacional y un tejido económico diversificado. En el análisis cualitativo, se logró una gran cantidad de información con la que, una vez analizada y trabajada con todo el grupo motor, se confeccionó un listado con 17 necesidades que había que cubrir para mejorar la salud de la población. ... (AU)

Introduction. In this paper we seek to capture the pleasant experience in making a health diagnosis in the Santpedor population. The diagnosis was made with participation from the very first moment and during the entire process. It was made with a driving group where only two of the 15 people representing it were health agents. These agents legitimized the community process, coordinated the driving group and guided it. However, they were just one more piece of the community puzzle, the other 13 non-health community agents being the real protagonists to reach the population and complete the community puzzle. Aim. To make a health diagnosis in Santpedor with the population taking part. Methods. A mixed explanatory sequential methodology was used. Comprised of a quantitative part (cross-sectional descriptive) and a qualitative part (participation). This paper explains the methodology used to made this. It reports the participation used to reach the population and favour relevance in the community process; as well as the techniques used to detect needs and their prioritization. The qualitative techniques used to detect assets were: mapping party, asset march. The techniques used to detect needs were by means of a survey ("bustiada") and group interviews (focus groups, nominal group and individual interviews). Results. A total of 604 Santpedor assets were identified. In the quantitative analysis, it was observed that Santpedor had a major generational change and a diversified economic fabric. In the qualitative analysis, a large amount of information was obtained which, once analyzed and worked on with the entire driving group, led to a list of 17 needs to improve the health of the population. These needs were prioritized by means of a simple vote, where a large citizen participation was attained with 754 votes from the citizens. The first need detected was "housing needs", followed by "public transportation needs", and "work needs". ... (AU)

Participación ciudadana en Colombia. Revisión documental

El objetivo es analizar la eficacia de los procesos de participación ciudadana en Colombia. Como metodología se optó por la investigación cualitativa, bajo el enfoque hermenéutico y como estrategia la revisión documental por medio de la cual se recuperaron diferentes documentos científicos que giraban alrededor de los temas de interés para aclarar las preguntas de investigación. Entre los resultados se encontró que, a pesar de que la Constitución Política de 1991 definió los parámetros para la participación, aún existe mucha apatía y desconocimiento sobre ellos y, finalmente, se concluyó que, entre los factores que impiden las buenas prácticas en el ejercicio de participación ciudadana, están las brechas digitales, el abstencionismo electoral, el desconocimiento de la población y la apatía de los gobernantes de integrar a la población en las decisiones del país.

This article aims to analyze the effectiveness of citizen participation processes in Colombia. As a methodology, qualitative research was chosen, under the hermeneutical approach, and as a strategy, the documentary review where different scientific documents that revolved around the topics of interest were recovered to clarify the research questions. Among the results, it was found that even though the Political Constitution of 1991 defined the parameters for participation, there is still a lot of apathy and ignorance about them. It was finally concluded that among the factors that prevent good practices in the exercise of citizen participation are the digital gaps, electoral abstentionism, ignorance of the population, and the apathy of the rulers to integrate the people in the country's decisions.

O objetivo é analisar a eficácia dos processos de participação cidadã na Colômbia. Como metodologia, optou-se pela pesquisa qualitativa, sob a abordagem hermenêutica e, como estratégia, a revisão documental onde foram recuperados diferentes documentos científicos que giravam em torno dos temas de interesse para esclarecer as questões de pesquisa. Entre os resultados, verificou-se que, apesar da Constituição Política de 1991 ter definido os parâmetros para a participação, ainda há muita apatia e desconhecimento sobre eles e, por fim, concluiu-se que dentre os fatores que impedem as boas práticas no exercício de participação cidadã, são as lacunas digitais, o abstencionismo eleitoral, o desconhecimento da população e a apatia dos governantes em integrar a população nas decisões do país.

Participation through the lens of care: Situated accountabilities in the codesign of a digital health platform for HIV care.

Participation of citizens and service users is increasingly commonplace in research, policy and technology development. Alongside this development, social scientists have become increasingly incorporated into large-scale research and innovation projects to facilitate participatory spaces. This requires reflection on the mechanisms, outcomes and, ultimately, the accountabilities of participation. In this paper, we propose the lens of care framework for approaching such reflections. We illustrate its value by using it to account for our role in establishing participatory spaces as part of a European Horizon 2020-funded research and innovation project, entitled EmERGE. We describe the codesign processes we developed and implemented with the aim of enabling heterogeneous voices, distinct experiences and multiple ideas to be articulated to inform the development and implementation of a digital platform for HIV care. We show how the lens of care framework enables us to trouble participation along prior theoretical distinctions between patients/citizens roles, invited/uninvited spaces and inclusive/scientistic voices and provides novel lines of inquiry to capture the relational and emergent processes of participation in digital health innovation. In the EmERGE project, spaces of participation were co-created within and by the community, whose members skilfully arranged the material, social and temporal set-up. Within these spaces we were able to articulate voices, deliberate knowledge and study the potentialities of technology so that initial technological inscriptions of empowerment through information-push were challenged and were, eventually, replaced by more interactive forms of clinician-patient engagement in digital HIV care. Through the lens of care, this paper aims to provide a reflective tool for researchers and practitioners who are involved in the design, implementation, and evaluation of participatory projects.

Relevance of a citizen participation technology platform to strengthen sub-Saharan health systems / Pertinence d'une plateforme technologique de participation citoyenne pour consolider les systèmes de santé subsahariens

Introduction: A citizen participation intervention using a toll-free number combined with an interactive voice server to collect citizens' opinions on their health systems was conducted in Burkina Faso, Benin, and the Democratic Republic of Congo between 2020 and 2021. Purpose of research: This paper aims to assess the effectiveness, sustainability, and transferability of this m-participation intervention to the health systems strengthening. Results: The analysis shows the relevance of the telephone to include citizens in the governance of sub-Saharan health systems. Conclusion: Information and communication technologies are an important support in the quest for better health democracy in sub-Saharan Africa.

Introduction: Une intervention de participation citoyenne par téléphone, via un numéro vert combiné à un serveur vocal interactif pour recueillir les opinions des citoyens sur leurs systèmes de santé a été déployée au Burkina Faso, au Bénin et en République démocratique du Congo entre 2020 et 2021. But de l'étude: Cet article évalue l'efficacité, la viabilité et la transférabilité de cette intervention participative pour consolider les systèmes de santé. Résultats: L'analyse montre une pertinence du téléphone pour impliquer les citoyens dans la gouvernance des systèmes de santé subsahariens. Conclusion: Les technologies de l'information et de la communication sont un soutien important dans la quête d'une meilleure démocratie sanitaire en Afrique subsaharienne.

Public involvement in the Swedish health system: citizen dialogues with unclear outcomes.

BACKGROUND: In systems with representative democracy, there is a growing consensus that citizens should have the possibility to participate in decisions that affect them, extending beyond just voting in national or local/regional elections. However, significant uncertainty remains regarding the role of public involvement in decision-making, not least in healthcare. In this article, we focus on citizen dialogues (CDs) in a health system that is politically governed and decentralised. The aim of the study was to evaluate the functioning of citizen dialogues in the Swedish health system in terms of representation, process, content, and outcomes. METHODS: This study was conducted using a qualitative case design focusing on CDs at the regional level in Sweden. The regional level is politically elected and responsible for funding and provision of healthcare. The data consist of public documents describing and evaluating the CDs and interviews, which were analysed drawing on a modified version of the Abelson et al. analytical framework for evaluating public involvement in healthcare. RESULTS: Some CDs were an attempt to counteract political inequality by inviting groups that are less represented, while others aimed to increase legitimacy by reducing the distance between policymakers and citizens. The results from the CDs-which were often held in the beginning of a potential policy process-were often stated to be used as input in decision-making, but how was not made clear. Generally, the CDs formed an opportunity for members of the public to express preferences (on a broad topic) rather than developing preferences, with a risk of suggestions being too unspecific to be useful in decision-making. The more disinterested public perspective, in comparison with patients, reinforced the risk of triviality. A need for better follow-up on the impact of the CDs on actual decision-making was mentioned as a necessary step for progress. CONCLUSIONS: It is unclear how input from CDs is used in policymaking in the politically governed regions responsible for healthcare in Sweden. The analysis points to policy input from CDs being too general and a lack of documentation of how it is used. We need to know more about how much weight input from CDs carry in relation to other types of information that politicians use, and in relation to other types of patient and public involvement.

Transformative Social and Emotional Learning (T-SEL): The Experiences of Teenagers Participating in Volunteer Club Activities in the Community.

Beginning with social inequities in terms of access to quality, inclusive education for children from disadvantaged backgrounds, especially rural teenagers who leave school early, the Holtis Association, with the support of the UNICEF Representative in Romania, developed a number of interventions intended to facilitate the transition from lower to higher secondary education of students from vulnerable and disadvantaged groups. One of the interventions was the establishment of teenagers' clubs for volunteer activities, leadership development, and participation in the community to encourage social and emotional learning. (1) Background: This study aims to investigate the extent to which participation in the Holtis club projects contributed to the development of transformative social and emotional learning (T-SEL), as observed from the perspective of the Collaborative for Academic, Social and Emotional Learning (CASEL) competencies among adolescents. (2) Methods: The study was qualitative and used focus groups for data collection. Out of the 65 active clubs, 18 were selected, and their representatives participated in the focus groups. (3) Results: Participating in the club activities, which were organized in the school, with the aim of organizing activities outside the school space stimulated and developed T-SEL competencies among adolescents. (4) Conclusions: The data, which were collected through the voices of teenagers, underlined the personal transformation from the perspective of the CASEL model competencies of SEL, and the study privileged their perspectives.

Determinant factors hinder urban structure plan implementation: The case of Nekemte Town, Ethiopia.

Urban structure plan is widely used plan in the process of urbanization and rapid urban spatial expansion. However, rapidly growing urban centers of Ethiopia are facing challenges to implement their structure plan within the time horizon. Thus, this study aims to investigate the determinant factors that hinder structure plan implementation in Nekemte town. Questionnaire survey, interview, observation and land use survey were used to collect data. Descriptive data analysis and regression model were used to analyze the data. The main findings of the study show that all identified factors: lack of active participation, lack commitment, political instability and lack of sufficient budget significantly contribute for the failure of structure plan implementation at P-value of 0.05. The regression analysis further indicated that, lack of community participation; - 0.0499 coefficients is the most determining factors and followed by customary land tenure and lack of awareness -0.0489 and -0.0468 coefficients respectively. Hence, future structure plan implementation endeavors of Nekemte city must be underpinned by inculcating community participation and awareness of structure plan that is required to implement the plan to the expected level. Furthermore, use of modern technology like GIS and appropriate man power are also equally recommended to enhance structure plan implementation of Nekemte city.

Health impact assessment of local policies: methodology and tools.

The aim of this work was to design some tools and a procedure for performing the Health Impact Assessment of municipal policies. A working group made up of municipal and public health specialists from the Valencian Community (Spain) was set up. After reviewing the tools used in other contexts, the Fem Salut? questionnaire for the simplified Health Impact Assessment of regional policies was adapted for use at the local level. A pilot study was carried out in six municipalities and local initiatives promoted by different sectors were analysed. Two workshops were held per municipality (with specialists and with citizens) and participatory techniques were used to identify the possible impacts on the social determinants of health, the population groups more particularly affected and the proposals for improvement. The feasibility of the methodology and the difficulties involved in carrying it out were discussed. A procedure was defined for the Health Impact Assessment of local initiatives in six steps: Describe (the municipality and the project), Extract (screening phase), Co-produce (participatory workshops), Integrate (the scientific evidence with the qualitative information obtained), Disseminate (to politicians, specialists and community) and Evaluate (direct and indirect results) (DECIDE). A guide was developed to facilitate its application at the local level along with two complementary tools (a questionnaire and worksheets). The technical group rated the process as simple and flexible, as well as being easy to adapt to the characteristics of the municipality and project. In addition to the cross-sectoral approach, the incorporation of citizen participation in the process is an important added value.

Factors Contributing to Citizens' Participation in COVID-19 Prevention and Control in China: An Integrated Model Based on Theory of Planned Behavior, Norm Activation Model, and Political Opportunity Structure Theory.

Chinese citizens' participation in COVID-19 prevention and control has made great contributions to the successful fight against the pandemic. The factors that have impacted citizens' participation have rarely been reported based on both social-psychological and political environmental theories. This paper presented a study to explore the determinants of Chinese citizens' participation in COVID-19 prevention and control based on a combined model of the theory of planned behavior, the norm activation model, and political opportunity structure theory. A dataset involving 463 respondents from Harbin in northeast China was acquired and analyzed. The results showed that the comprehensive model explained 62.9% of the total variance in citizens' participation behavior. The openness to public participation not only significantly directly influenced citizens' participation but also indirectly affected participation behaviors through attitude and perceived behavioral control, both of which were important mediators and had the greatest overall impacts. The awareness of consequences and subjective norms were crucial antecedents to the activation of other influencing factors. Personal norms indirectly affected participation behavior through the mediation of attitude. The empirical results showed the comprehensiveness, effectiveness, and high explanatory power of the postulated model. The study also provides both new theoretical perspectives for explaining public participation and useful practical implications for future policy development in promoting citizens' participation in public health emergency management.

Análisis del sistema de salud chileno y su estructura en la participación social / Analysis of the Chilean health system and its structure in social participation

RESUMEN El desarrollo político-económico que ha tenido Chile durante las últimas décadas ha permitido la evolución de su institucionalidad sanitaria, donde se ha mejorado la cobertura, gestión e infraestructura hospitalaria. La organización de la política sanitaria es altamente centralizada y estructurada desde el Estado, ello ha permitido implementar con rapidez diversos programas. La participación, por otro lado, se mantiene dentro de los espacios que la institucionalidad permite, sin embargo, existe una permanente presión de grupos no gubernamentales que piden una gobernanza diferente. Se desea, por lo tanto, pasar de una reactividad participativa en materias sanitarias a una proactividad permanente, aunque ello requiere de una permanente conversación entre el Estado y la ciudadanía. En el artículo se analiza el sistema sanitario chileno y cómo se relaciona con la participación ciudadana subsecuente, evidenciando los elementos, que bajo la realidad social actual, necesitan de un cambio para satisfacer adecuadamente a la población.

ABSTRACT The political-economic development that Chile has had in recent decades has allowed the evolution of its health institutions, where hospital coverage, management, and infrastructure have been improved. The health policy organization is highly centralized and structured by the State, and this has allowed the rapid implementation of several programs. On the other hand, participation is maintained within the spaces allowed by institutionality. However, there is permanent pressure from non-governmental groups asking for different governance. Therefore, moving from a participatory reactivity in health matters to permanent proactivity is desired, although this requires a constant dialogue between the State and citizens. This paper analyzes the Chilean health system and how it relates to subsequent citizen participation, highlighting the elements that, under the current social reality, require a change to satisfy the population adequately.

Participação pública em saúde e Covid-19 em Portugal / Public participation in health and COVID-19 in Portugal

RESUMO Nas últimas décadas, o tema da participação pública em processos de decisão tem estado presente nas agendas políticas, com mais ou menos centralidade, em vários contextos democráticos do mundo. No campo da saúde, a participação pública apresenta-se como estratégia política com potencialidades para garantir maior corresponsabilização entre os atores envolvidos e para incrementar a transparência dos serviços, sendo enfatizada como boa prática que deve ser implementada em prol da qualidade das decisões, mas também de decisões que sejam orientadas para os reais problemas das populações. A pandemia da Covid-19 trouxe pressões adicionais aos sistemas de saúde, constituindo-se como contexto propício à análise da participação cidadã nos processos de decisão que enquadram problemas de saúde na sua relação com a pandemia. Este ensaio apresenta uma análise exploratória sobre a evolução das práticas de participação cidadã nas políticas de saúde em Portugal, destacando alguns dos seus desafios atuais e futuros. Procura-se, assim, compreender como a pandemia teve ressonância na forma como a participação em saúde vinha decorrendo no País, aferindo se, em um período global de crise com características singulares, a pandemia, enquanto problema coletivo, distendeu ou contraiu essas práticas participativas.

ABSTRACT In the last decades, public participation in decision-making processes has been an ongoing theme, assuming more or less centrality, within the political agendas in several democratic contexts around the world. In the health domain, public participation has been considered a political strategy with the potential of ensuring greater co-responsibility among the actors involved, as well as to increase health services' transparency, thus being emphasized as one of the best practices that should be implemented towards the quality of decisions, especially those oriented to the real health problems of the populations. The COVID-19 pandemic brought additional pressures to health systems, constituting itself as a conducive context to the analysis of citizen participation in health decision-making processes. This essay presents an exploratory analysis on the evolution of citizen participation practices in health policies in Portugal, highlighting some of its current and future challenges. The present analysis aims to understand how the pandemic resonated in the way in which participation in the health domain had been carried out in the country, assessing whether, in a singular global period of crisis, the pandemic as a collective problem expanded or contracted these participatory practices.

Participatory Systems Mapping for Municipal Prioritization and Planning.

Rapidly growing cities face new and compounding health challenges, leading governments and donors to seek innovative ways to support healthier, more resilient urban growth. One such approach is the systems mapping process developed by Engaging Inquiry (EI) for the USAID-funded Building Healthy Cities project (BHC) in four cities in Asia. This paper provides details on the theory and methods of the process. While systems mapping is not new, the approach detailed in this paper has been uniquely adapted to the purpose of municipal planning. Strategic stakeholder engagement, including participatory workshops with a diverse group of stakeholders, is at the core of this approach and led to deeper insights, greater buy-in, and shared understanding of the city's unique opportunities and challenges. This innovative mapping process is a powerful tool for defining municipal priorities within growing cities across the globe, where the situation is rapidly evolving. It can be used to provide evidence-based information on where to invest to gain the biggest impact on specific goals. This paper is part of a collection in this issue providing a detailed accounting of BHC's systems mapping approach across four project cities.

Prioridades de atención en zonas rurales en escenarios posconflicto: un análisis de minería de texto / Attention priorities in rural areas in post-conflict scenarios: a text mining analysis

RESUMEN Las herramientas automatizadas de análisis de texto resumen grandes volúmenes de información y permiten generar, de forma eficiente, conocimiento a partir de datos desestructurados, como las opiniones. El objetivo de este trabajo fue identificar prioridades en comunidades afectadas por el conflicto armado, utilizando ejercicios participativos de 13 municipios de Antioquia, Colombia. Se analizaron 15.534 opiniones, de 9.765 personas; tras una limpieza de texto, se describió el uso, la asociación, la diferenciación y la importancia de los términos, según los enfoques temáticos y tipos de opinión expresados, utilizando minería de texto en R. Se encontró que las prioridades giraban en torno a la disponibilidad de infraestructuras, dotación e insumos, ya que eran las problemáticas más mencionadas por las comunidades y correspondía con la realidad territorial; por otra parte, las oportunidades estaban representadas, principalmente, por los recursos naturales y humanos. El análisis de minería de texto del ejercicio participativo permitió identificar las prioridades de las comunidades, a nivel socioeconómico, de forma satisfactoria; sin embargo, la preparación de la información requiere mucho trabajo y los resultados se deben revisar cuidadosamente, para asegurar su coherencia. Que la información pueda ser analizada por agentes externos a la colección de datos, representa otra ventaja de esta herramienta.

ABSTRACT Automated text analysis tools summarize large volumes of information and allow efficient generation of insights from unstructured data such as opinions. The objective of this work was to identify priorities in communities affected by the armed conflict using participatory exercises in 13 municipalities of Antioquia, Colombia. 15,534 opinions from 9,765 people were analyzed. After a text cleaning, the use, association, differentiation and importance of the terms were described according to the thematic approaches and types of opinion expressed using text mining in R. It was found that the priorities revolved around the availability of infrastructures, endowment and inputs, since they were the most mentioned problems by the communities, and that this corresponded to the territorial reality. On the other hand, the opportunities were mainly represented by natural and human resources. The text mining analysis of the participatory exercise allowed to identify the priorities of the communities at the socio-economic level in a satisfactory way. However, the preparation of the information is labor intensive and the results must be carefully reviewed to ensure consistency. Another advantage of this tool is that the information can be analyzed by external agents to the data collection.

La participación ciudadana en las actividades mineras en Colombia / Citizen Participation in Mining Activities in Colombia

Resumen Por medio del presente artículo de investigación se pretende analizar desarrollo jurídico y democrático que ha representado, en los últimos años, para Colombia un mecanismo de participación ciudadana, como lo es la consulta popular, en las actividades mineras a través de las cuales se permite la exploración y explotación de los recursos naturales yacentes en el subsuelo. La investigación se desarrolló a partir del Método Cualitativo, aplicándose los métodos tradicionales de interpretación, que permitieron el análisis a los pronunciamientos realizados por la Corte Constitucional.

Abstract The purpose of this research article is to analyze the legal and democratic development that has represented, in recent years, for Colombia a mechanism of citizen participation, such as the popular consultation, in mining activities through which the exploration and exploitation of natural resources lying in the subsoil is allowed. The research was developed based on the Qualitative Method, by applying the traditional methods of interpretation, which allowed the analysis of the pronouncements made by the Constitutional Court.

Participación ciudadana en la política pública de deporte en Medellín / Citizen Participation in the Public Policy of Sport in Medellin

Resumen ¿Cuál es la incidencia de la participación ciudadana en la formulación de políticas públicas locales? Este artículo de reflexión responde, exploratoriamente, esta pregunta desde el caso de la política pública del deporte, la recreación y la actividad física en Medellín. Teniendo en cuenta el mismo método, instrumentos e información recolectada durante el proceso original de reformulación, se contrasta esta información con la incorporada en los documentos oficiales que recogen la actualización de la política pública. Aunque se invoca la metodología de co-creación, se mantienen los mismos canales y limitaciones a la participación ciudadana; entonces, se participa, pero no se co-crea.

Abstract What is the incidence of citizen participation in the formulation of local public policies? This reflective article answers, in an exploratory way, this question from the case of the public policy of sport, recreation, and physical activity in Medellin. By taking into account the same method, instruments, and information collected during the original reformulation process, this information is contrasted with that incorporated in the official documents that reflect the updating of the public policy. Although the methodology of co-creation is invoked, the same channels and limitations to citizen participation are maintained. Thus, there is participation, but there is no co-creation.

Medium-Sized Cities Facing the Demographic Challenge in Spain's Low-Density Regions through Citizen Participation Projects.

The roles of medium-sized cities in processes of demographic challenge have taken many different paths. New forms of urban sprawl, deconcentrating processes, and the emergence of the diffuse city have marked a change in the relations that Spanish medium-sized cities have traditionally had with their most directly influenced territories. In line with the theoretical framework of the European next generation urban regeneration programme, the main aim of this paper is to propose a methodology to develop a project that fosters resilience strategies and the revitalization of local environments. This will also benefit the institutions that are involved in promoting it. The innovative methodology employed has been denominated the "We Propose!" project and has received several national acknowledgments. This is a strategically designed civic participation urban renewal project and has been subject to geographical analysis through field trips and in situ research. A case study into urban renewal strategies was carried out in Ciudad Real, which is a medium-sized city in Spain's third largest region. It includes an evaluation of both the design and implementation of what could be considered a successful case of urban renewal carried out in the city. This urban development initiative was undertaken by the public administration, but it was designed and proposed by local citizens.

Public participation in health and Covid-19 in Portugal / Participação pública em saúde e Covid-19 em Portugal

In the last decades, public participation in decision-making processes has been and ongoing theme, assuming more or less centrality, within the political agendas in several democratic contexts around the world. In the health domain, public participation has been considered a political strategy with the potential of ensuring greater co-responsibility among the actors involved, as well as to increase health services' transparency. In this way, it has been emphasized as a best practice that should be implemented towards the quality of decisions, especially those oriented to the real health problems of the populations. The COVID-19 pandemic brought additional pressures to health systems, which constitutes itself as a conducive context to the analysis of citizen participation in health decision-making processes. This essay presents an exploratory analysis on the evolution of citizen's participation practices in health policies in Portugal, highlighting some of its current and future challenges. The present analysis aims to understand how the pandemic had resonance in the way in which participation in the health domain had been carried out in the country, assessing whether, in a singular global period of crisis, the pandemic as a collective problem expanded or contracted these participatory practices. 

Nas últimas décadas, o tema da participação pública em processos de decisão tem estado presente nas agendas políticas, com mais ou menos centralidade, em vários contextos democráticos do mundo. No campo da saúde, a participação pública apresenta-se como estratégia política com potencialidades para garantir maior corresponsabilização entre os atores envolvidos e para incrementar a transparência dos serviços, sendo enfatizada como boa prática que deve ser implementada em prol da qualidade das decisões, mas também de decisões que sejam orientadas para os reais problemas das populações. A pandemia COVID-19 trouxe pressões adicionais aos sistemas de saúde, constituindo-se como contexto propício à análise da participação cidadã nos processos de decisão que enquadram problemas de saúde na sua relação com a pandemia.  Este ensaio apresenta uma análise exploratória sobre a evolução das práticas de participação cidadã nas políticas de saúde em Portugal, destacando alguns dos seus desafios atuais e futuros. Procura-se, assim, compreender como a pandemia teve ressonância na forma como a participação em saúde vinha decorrendo no país, aferindo se, num período global de crise com características singulares, a pandemia enquanto problema coletivo distendeu ou contraiu estas práticas participativas.

Analysis of the chilean health system and its structure in social participation / Análisis del sistema de salud chileno y su estructura en la participación social

The political-economic development that Chile has had in recent decades has allowed the evolution of its health institutions, where hospital coverage, management and infrastructure have been improved. The organization of health policy is highly centralized and structured from the State, this has allowed the rapid implementation of various programs. Participation, on the other hand, is maintained within the spaces that the institutionality allows, however, there is permanent pressure from non-governmental groups that ask for a different governance. Therefore, it is desired to move from a participatory reactivity in health matters to a permanent proactivity, although this requires a permanent conversation between the State and the citizenry. The article analyzes the Chilean health system and how it relates to subsequent citizen participation, highlighting the elements that, under the current social reality, need a change to adequately satisfy the population.

El desarrollo político-económico que ha tenido Chile durante las últimas décadas ha permitido la evolución de su institucionalidad sanitaria, donde se ha mejorado la cobertura, gestión e infraestructura hospitalaria. La organización de la política sanitaria es altamente centralizada y estructurada desde el Estado, ello ha permitido implementar con rapidez diversos programas. La participación, por otro lado, se mantiene dentro de los espacios que la institucionalidad permite, sin embargo, existe una permanente presión de grupos no gubernamentales que piden una gobernanza diferente. Se desea, por lo tanto, pasar de una reactividad participativa en materias sanitarias a una proactividad permanente, aunque ello requiere de una permanente conversación entre el Estado y la ciudadanía. En el artículo se analiza el sistema sanitario chileno y cómo se relaciona con la participación ciudadana subsecuente, evidenciando los elementos, que bajo la realidad social actual, necesitan de un cambio para satisfacer adecuadamente a la población.