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OBJECTIVES: This study investigated how Brazilian young people perceive their role in promoting and supporting their peer community's mental health and well-being, and the conditions and contexts influencing their engagement. DESIGN: Co-produced qualitative study using in-depth interviews and focus groups with adolescents. The sessions were audio-recorded, transcribed and anonymised. Data were analysed using reflexive thematic analysis. SETTING: Data collection took place remotely across Brazil via audio or video calls conducted by a youth collaborator and a senior researcher. PARTICIPANTS: 46 Brazilian adolescents aged between 15 and 18 years old, recruited primarily via social media. RESULTS: Our analysis generated four overarching themes: (1) young people's sense of responsibility and motivation-many participants felt committed to promoting the mental health and well-being of their friends and community, while also critically emphasising responsibilities of and partnerships with adult stakeholders to make a meaningful difference; (2) strategies for promoting peer mental health-suggested strategies included peer-to-peer support, such as non-judgemental listening, and collective actions such as forming school groups; (3) intrapersonal barriers-key barriers to participation included a lack of necessary skills and self-efficacy; and (4) contextual barriers-young people reported feeling unheard, invalidated, and fearing judgement due to mental health stigma. CONCLUSION: These findings support an ecological view of youth participation in the promotion of mental health as dependent on intrapersonal, interpersonal and contextual factors. Realising young people's potential in advancing mental health in their communities requires fostering youth-adult partnerships, providing peer support training, and combating adultism and mental health stigma.

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Students play a key role in university social responsibility (USR), as they are the protagonists of change and the fundamental axis in the teaching-learning process. This study aims to assess the factors associated with the perception of university social responsibility among dental students from two universities in the Peruvian capital. This analytical cross-sectional study assessed 754 students from two Peruvian universities between May and July 2023. The study utilized a validated 51-item questionnaire to assess sociodemographic factors and dental students' perception of USR. A Poisson regression model with robust variance and prevalence ratio (PR) was used to assess the influence of variables such as age, sex, marital status, type of university, academic year, and awareness of taking subjects related to USR. The significance was set at p < 0.05. The perception of USR was rated as poor, fair, and good by 16%, 67%, and 17% of the participants, respectively. According to the study, dental students from public universities were 68% more likely to perceive their USR education as poor than those from private universities (APR = 1.68, 95% CI: 1.06-2.66), and those who were aware of taking MSR-related courses were 37% less likely to perceive their USR education as poor (APR = 0.63, 95% CI: 0.40-0.98). Similarly, dental students attending public universities were 2.28 times more likely to perceive poor organizational management in USR compared to their counterparts at private universities (APR = 2.28, 95% CI: 1.51-3.44). Additionally, students in their first and second academic years were 62% and 57% less likely to perceive poor organizational management in USR compared to those in their sixth year (APR = 0.38, 95% CI: 0.19-0.79 and APR = 0.43, 95% CI: 0.20-0.95; respectively). Furthermore, students from public universities were 2.31 times more likely to perceive social participation in USR poorly compared to their counterparts from private universities (APR = 2.31, 95% CI: 1.63-3.26). Lastly, it was observed that students from public universities were 2.51 times more likely to have a poor overall perception of USR compared to students from private universities (APR = 2.51, 95% CI: 1.67-3.78). Acknowledging the diverse contexts and challenges inherent in public and private institutions, it can be concluded that more than half of the dental students had a fair perception of USR. Additionally, attending a public university was found to be a risk factor for having a poor perception of USR. However, taking a course related to USR and being in the early years of the program were identified as protective factors against a poor perception of organizational training and management in USR. It is recommended that students be involved in USR activities, including the Sustainable Development Goals, from the first years of their university education, especially in public universities.

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OPS Adelante es una iniciativa a nivel de toda la Organización, basada en resultados, para innovar y modernizar sistemáticamente las prácticas de gestión a fin de aumentar la eficiencia, la transparencia y la rendición de cuentas tanto de manera interna como externa. El plan de acción 2.0 de OPS Adelante permite operacionalizar el marco de esta iniciativa, e incluye objetivos específicos relativos a fortalecer la eficiencia, la transparencia y la rendición de cuentas de la Oficina Sanitaria Panamericana (la Oficina); reforzar la visibilidad de la Organización Panamericana de la Salud (OPS), el enfoque centrado en los países y la capacidad para proporcionar cooperación técnica, mejorar el desempeño de los recursos humanos de la Oficina e impulsar la innovación para hacer avanzar a la Organización. En este informe se describen los principales componentes del plan actualizado y se presenta la lista completa de acciones y resultados previstos que han sido priorizados por la gobernanza de OPS Adelante para el período de junio del 2024 a mayo del 2025. Asimismo, se incluye el informe anual del primer año de ejecución de la iniciativa OPS Adelante.

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PAHO Forward is a results-based, Organization-wide initiative to systematically innovate and modernize management practices to increase efficiency, transparency, and accountability internally and externally. The PAHO Forward Plan of Action 2.0 operationalizes the PAHO Forward framework and includes the specific objectives of strengthening the Pan American Sanitary Bureau (PASB) efficiency, transparency, and accountability; bolster the Pan American Health Organization (PAHO) visibility, country focus, and capacity to deliver technical cooperation; enhance the PASB human resources performance and drive innovation to move the Organization forward. This report describes the main components of the updated plan, and outlines the full list of actions and expected results that have been prioritized by PAHO Forward Governance for the period June 2024 to May 2025.

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A pesquisa recorre ao método cartográfico de Rosário e Coca para refletir sobre o suicídio nos campos midiático e jornalístico. Para isso, analisa a responsabilidade midiática e a construção do suicídio pelo jornalismo no caso Jéssica Canedo, uma jovem de 22 anos que se matou após publicação de uma conversa falsa com o humorista Whindersson Nunes. O conteúdo foi amplamente divulgado por perfis em sites de redes sociais, entre elas o Choquei, no Instagram. Foram selecionadas 51 matérias jornalísticas, de nove jornais, que noticiaram o caso. Elas foram analisadas por meio de um quadro com orientações de instituições de Saúde e de empresas de mídia para a cobertura responsável do suicídio, além da análise de discurso. A pesquisa demonstrou que o jornalismo mantém uma cobertura deficiente sobre o acontecimento e que o amplo acesso às plataformas de redes sociais traz novas preocupações no que tange à responsabilidade midiática.

The research uses Rosário and Coca's cartographic method to reflect on the coverage of suicide in media and among journalists. To do so, the paper analyses media responsibility and how the press constructed the suicide of Jéssica Canedo, a 22-year-old girl who killed herself after fake conversations between herself and the humorist Whindersson Nunes were published. The content was widely disseminated on social media profiles, among them, Choquei, on Instagram. To conduct the analysis, 51 news pieces from 9 Brazilian newspapers were selected. Subsequently, they were analyzed using a framework based on guidelines from health institutions and media companies for responsible coverage of suicide, as well as through discourse analysis. The findings show poor journalistic coverage of the event and how the far-reaching potential of social media brings new concerns to the field of media responsibility.

La investigación utiliza el método cartográfico de Rosário y Coca reflexionar sobre el suicidio en los medios y el periodismo. Así, analiza la responsabilidad mediática y la construcción del suicidio por parte del periodismo en el suicidio de Jéssica Canedo, una joven de 22 años que se suicidó tras verse involucrada en una conversación falsa con el comediante Whindersson Nunes. El contenido fue ampliamente difundido en los perfiles de las plataformas de redes sociales, incluido Choquei, en Instagram. Se seleccionaron 51 artículos periodísticos, de nueve diarios, que informaron sobre el caso. Fueron analizados mediante una tabla con directrices de instituciones de Salud y medios de comunicación para la cobertura responsable del suicidio, además de análisis del discurso. La investigación demostró que el periodismo mantiene una cobertura deficiente del evento y que el amplio acceso a las plataformas de redes sociales trae preocupaciones sobre la responsabilidad de los medios.

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INTRODUCTION: Health challenges in the 21st century underscore the need for adaptable and innovative approaches in public health. Academic institutions can and should contribute much more effectively to generate and translate scientific knowledge that will result in better programmes to improve societal health. Academic accountability to local communities and society requires universities to actively engage with local communities, understanding the context, their needs, and leveraging their knowledge and local experience. The Programme Science initiative provides a framework to optimize the scale, quality and impact of public health programmes, by integrating diverse approaches during the iterative cycle of research and practice within the strategic planning, programme implementation and programme management and evaluation. We illustrate how the Programme Science framework could be a useful tool for academic institutions to accomplish accountability to local communities and society through the experience of Project HOPE in Peru. DISCUSSION: Project HOPE applied the Programme Science framework to introduce HPV self-sampling into a women's health programme in Peru. Collaboration with local authorities and community members was pivotal in all phases of the project, ensuring interventions aligned with community needs and addressing social determinants of health. The HOPE Ladies-community women trained and empowered to promote and provide the HPV kits-crafted the messages used through the study and developed strategies to reach individuals and provided support to women's journey through health centres. By engaging communities in co-creating knowledge and addressing health inequities, academic institutions can generate contextually relevant and socially just scientific knowledge. The active participation of community women in Project HOPE was instrumental in improving service utilization and addressing barriers to self-sampling. CONCLUSIONS: The Programme Science approach offers a pathway for academic institutions to enhance their accountability to communities and society at large. By embedding researchers within public health programmes and prioritizing community engagement, academic institutions can ensure that research findings directly inform policy improvements and programmatic decisions. However, achieving this requires a realignment of research agendas and recognition of the value of community engagement. Establishing Programme Science networks involving academia, government and funding entities can further reinforce academic accountability and enhance the impact of public health programmes.

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BACKGROUND: This study delves into the States' accountability for health-related Sustainable Development Goal (SDG) indicators from 2016 to 2020. An analysis of Voluntary National Reviews (VNR) is employed as an instrument to scrutinize the alignment of States' indicators with the global indicator framework, shedding light on global health governance within the context of the 2030 Agenda and States' strategic prioritization. A curation of 60 health-related indicators from 195 VNRs, produced during the aforementioned period, is organized into thematic groups. RESULTS: Our results highlight a concerning discrepancy in the reporting frequency of various health-related themes. The findings reveal a paradoxical coexistence characterized by the concurrent strengthening and diminution of the global health governance articulated in the Agenda's global health governance. This manifests in the increased utilization and consistency of health-related indicators over the study years, coupled with an emphasis on infectious diseases and child and maternal health indicators. Conversely, a discernible governance decline is evidenced by the inadequate representation of health-related indicators in VNRs, notably within the domains of universal health coverage and health system indicators. Furthermore, High-Income States exhibit diminished accountability. CONCLUSIONS: The VNRs unveil a paradox wherein burgeoning technical capacity coexists with governance deficits, a phenomenon attributable to both statistical capabilities and political preferences. The prevalent use of proxy indicators in VNRs oversimplifies the presentation of official indicators, thereby compromising the aspirational goal of pioneering statistical innovations for measuring intricate issues in the SDGs. In light of our conceptualization of the 2030 Agenda's global health as a regime complex governance, we advocate for comprehensive investigations into each health regime cluster. This approach aims to unravel disputes, discern patterns, and elucidate States' preferences concerning specific thematic areas. Functioning as an accountability mechanism for the Agenda's governance, VNRs underscore States' adaptability and short-term learning capabilities, offering valuable insights for identifying harmful goal prioritization. The discretionary nature of indicator selection by States in the VNRs, enabled by the Agenda's proposition of a contextual adaptation of the SDGs and a blind eye to the guideline's request to review all SDG indicators, highlights a critical flaw in the VNR as an accountability mechanism.

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Corporate social responsibility (CSR) is a constantly evolving concept that reflects changes in society and the expectations of stakeholders in a process that leads companies to adapt to respond to new challenges and demands. Similarly, the theory and practice of CSR have moved from regulatory compliance to a more holistic approach that requires more sophisticated models that allow for a deeper understanding. Following the fact that companies now have access to a greater amount of information related to their social and environmental performance, as well as comparative data from other organizations, which is why it is necessary to have a management tool that allows collecting, process, and generating more accurate and meaningful metrics that more effectively reflect a company's impact on society. Consequently, the present work aims to identify a system of variables and dimensions representative of the management of organizations that allows the validation of a generic model of corporate social responsibility determined through factorial and structural modeling capable of reflecting more accurate and up-to-date dimensions and metrics of model variables and dimensions. To carry out the study, a sample of 667 middle and senior managers from medium and large companies in Guayas, Ecuador, were randomly contacted in their respective business contexts by trained interviewers. The data processing was carried out in stages. First, the exploratory factorial analysis method of the items was applied to form relevant factors. Then, the dimensions' structural modeling was formulated and ratified through the pertinent goodness-of-fit indices. The results determined a system of correlated factors whose items present estimators of commonality and high and significant factorial loads, excluding variables that did not exceed the sensitization criteria applied. Finally, a model made up of 15 factors and 66 variables ratified using the comparative adjustment indices, the chi-square likelihood ratio, and the mean square error of approximation is introduced, confirming the proposed corporate social responsibility model.

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BACKGROUND: We present the first results of the Accreditation System of Medical Schools (Sistema de Acreditação de Escolas Médicas - SAEME) in Brazil. METHODS: We evaluated the results of the accreditation of medical schools from 2015 to 2023. The self-evaluation form of the SAEME is specific for medical education programs and has eighty domains, which results in final decisions that are sufficient or insufficient for each domain. We evaluated the results of the first seventy-six medical schools evaluated by the SAEME. RESULTS: Fifty-five medical schools (72.4%) were accredited, and 21 (27.6%) were not. Seventy-two (94.7%) medical schools were considered sufficient in social accountability, 93.4% in integration with the family health program, 75.0% in faculty development programs and 78.9% in environmental sustainability. There was an emphasis on SAEME in student well-being, with seventeen domains in this area, and 71.7% of these domains were sufficient. The areas with the lowest levels of sufficiency were interprofessional education, mentoring programs, student assessment and weekly distribution of educational activities. CONCLUSION: Medical schools in Brazil are strongly committed to social accountability, integration with the national health system, environmental sustainability and student well-being programs. SAEME is moving from episodic evaluations of medical schools to continuous quality improvement policies.

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Como organismo especializado en salud pública en las Américas, la Organización Panamericana de la Salud (OPS) está en el centro de la lucha contra las enfermedades, de la respuesta a emergencias y desastres, y del fortalecimiento de los sistemas regionales de salud. Para destacar sus esfuerzos y amplificar sus resultados, la OPS adoptó en toda la organización un marco de Gestión Basada en Resultados (GBR) en 2010. Dados estos avances hacia una GBR más integral en la gestión del portafolio de la OPS, la Organización condujo un análisis de los logros alcanzados hasta la fecha. Este informe es el primero de este tipo: una evaluación externa exhaustiva del marco de la GBR de la OPS. Se realizó para examinar la implementación de la GBR, incluido su funcionamiento, el valor añadido a la labor de la OPS y los detalles sobre las mejoras que se podrían introducir. La evaluación abarcó los cuatro componentes del marco de la GBR: Planificación estratégica y operativa; Implementación, monitoreo y evaluación de desempeño; Evaluación independiente y aprendizaje; y Rendición de cuentas; y consideró el período de enero de 2008 a diciembre de 2022 en todos los niveles de la OPS (entidades regionales, subregionales y las oficinas de país).

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Las prioridades estratégicas que definió la Organización Mundial de la Salud para su labor en la década 2020-2030 son el sustrato de este trabajo. El mismo grupo interdisciplinario de profesionales de la salud que reflexionó en la primera entrega sobre las prioridades relacionadas con lograr poblaciones más sanas, continúa con otras prioridades orientadas a lograr una cobertura sanitaria universal y un mejor manejo de las emergencias sanitarias. En las conclusiones de la segunda entrega se destaca la importancia de desarrollar cada una de las prioridades involucrando a la sociedad civil, la familia y los medios de comunicación. La manera de hacerlo será haciendo girar todas las iniciativas de ejecución alrededor de estrategias educativas adecuadamente planteadas en todos los niveles, sin que se admitan injerencias ni presiones, para recuperar así la confianza necesaria para conseguir las soluciones que son buenas para el ser humano, el ecosistema y las futuras generaciones.

The strategic priorities defined by the World Health Organization for its work in the 2020-2030 decade are the basis of this work. The same interdisciplinary group of health professionals that reflected in the first installment on the priorities related to achieving healthier populations, continues with those other priorities grouped in achieving universal health coverage and better management of health emergencies. In the conclusions of the second installment, the importance of tackling each of the priorities is highlighted, associating civil society, the family and the media with this work. The way to do it will be by revolving all the implementation initiatives around educational strategies at all levels, properly planned, without admitting interference or pressure, to thus recover the necessary confidence to achieve solutions that are good for the human being, the ecosystem and future generations.

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As a specialized agency for global health in the Americas, the Pan American Health Organization (PAHO) is at the center of efforts to combat diseases, respond to emergencies and disasters, and strengthen regional health systems. To underscore efforts and amplify regional results in these areas, PAHO adopted an Organization-wide Results-Based Management (RBM) Framework in 2010. Given these strides towards a more comprehensive RBM of PAHO’s portfolio of work, the Organization conducted an assessment of its efforts to determine its achievements thus far. This publication complements the original report, which is the first of its kind – a comprehensive external evaluation of the RBM Framework for PAHO. It was commissioned to examine the implementation of RBM including its functioning, value added to the work of PAHO, and details around any improvements that could be made. The evaluation covered all four components of the RBM framework: Strategic and Operational Planning; Implementation, Performance Monitoring, and Assessment; Independent Evaluation and Learning; and Accountability; and considered the period from January 2008 to December 2022 within all levels of PAHO entities (regional, subregional, and country offices).

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As a specialized agency for global health in the Americas, the Pan American Health Organization (PAHO) is at the center of efforts to combat diseases, respond to emergencies and disasters, and strengthen regional health systems. To underscore efforts and amplify regional results in these areas, PAHO adopted an Organization-wide Results-Based Management (RBM) Framework in 2010. Given these strides towards a more comprehensive RBM of PAHO’s portfolio of work, the Organization conducted an assessment of its efforts to determine its achievements thus far. This report is the first of its kind – a comprehensive external evaluation of the RBM Framework for PAHO. It was commissioned to examine the implementation of RBM including its functioning, value added to the work of PAHO, and details around any improvements that could be made. The evaluation covered all four components of the RBM framework: Strategic and Operational Planning; Implementation, Performance Monitoring, and Assessment; Independent Evaluation and Learning; and Accountability; and considered the period from January 2008 to December 2022 within all levels of PAHO entities (regional, subregional, and country offices).

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Esta pesquisa teve como objetivo investigar as perspectivas dos psicólogos dos Centros de Referência da Assistência Social (CRAS) que compõem a equipe de Proteção e Atenção Integral à Família (PAIF) a respeito do seu trabalho no Acompanhamento Familiar oferecido para famílias com membros com transtornos mentais. Oito psicólogos que atuavam nos CRAS de um município no interior de Minas Gerais participaram do estudo. O instrumento utilizado foi um roteiro de entrevista semiestruturada, com a subsequente análise de conteúdo temática. As categorias temáticas foram analisadas à luz da literatura específica da área. De maneira geral, os resultados indicaram que os psicólogos se sentem despreparados para o exercício de sua função no CRAS, uma vez que a formação específica e continuada em Psicologia não ofereceu subsídios adequados para o conhecimento da atuação no campo da Assistência Social. A natureza (psico)terapêutica do trabalho é discutida, assim como a necessidade de formações continuadas para a atuação. Ressalta-se a necessidade de mais pesquisas que abordem a formação em Psicologia e suas relações com a Assistência Social, bem como os impactos desse despreparo na prática dos profissionais, de maneira a fomentar maior satisfação pessoal/profissional e, consequentemente, aprimorar a assistência oferecida à comunidade.(AU)

This study aims to investigate the views of psychologists who worked at Social Assistance Reference Centers (CRAS) associated with the Comprehensive Family Care Program (PAIF) on their work with the aforementioned program. Overall, eight psychologists who worked at CRAS units in small municipalities in Minas Gerais for at least one year participated in this research. The instrument used was a semi-structured interview script, and the data were analyzed under the content analysis (thematic) method. Thematic categories were analyzed based on the specific literature. Results indicate that the psychologists generally felt unprepared to work at CRAS since their degree in Psychology provided inadequate knowledge to deal with Social Assistance issues. This study discusses the (psycho)therapeutic nature of their practice and the need for ongoing training for their proper performance. This study highlights the need for further research that addresses the links between education in Psychology and Social Assistance and the impacts of said unpreparedness on the performance of those professionals. Such research might provide more professional/personal satisfaction and, in turn, improve the quality of the offered service.(AU)

Este estudio tuvo la intención de conocer las perspectivas de los psicólogos de los Centros de Referencia de Asistencia Social (CRAS) que forman parte de los equipos del Protección y Atención Integral a la Familia (PAIF) acerca del seguimiento de familias con miembros portadores de trastornos mentales. Ocho psicólogos que actuaban en los CRAS de un municipio del interior del estado de Minas Gerais (Brasil) participaron en el estudio. El instrumento utilizado fue un guion de entrevistas semiestructuradas; y, para análisis de datos, se utilizó el análisis de contenido temático. Las categorías temáticas se analizaron a la luz de la literatura específica del campo. De modo general, los resultados indicaron que los psicólogos no se sienten preparados para desempeñar la función en el CRAS, puesto que la formación en Psicología no ofreció conocimientos adecuados para actuar en el campo de la asistencia social. Se discuten la naturaleza (psico)terapéutica del trabajo y la necesidad de formación continua para esta actuación. Se destaca la necesidad de más investigaciones que tratan de la formación en Psicología y sus relaciones con la asistencia social, y los impactos de esta falta de preparo en la práctica de los profesionales, de modo a promover una satisfacción personal/profesional y, consecuentemente, optimizar la asistencia ofrecida a la comunidad.(AU)

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Existe una responsabilidad ética en el desarrollo del conocimiento científico. La investigación biomédica representa un beneficio para la humanidad resultando ser el pilar sobre el que se asientan los avances diagnósticos y terapéuticos. Además del respeto a los estándares exigidos, existe la trascendente responsabilidad de formarse. Se considera a la educación y al control adecuado como los garantes de una investigación respetuosa de las buenas prácticas. Planteamos la enseñanza de la integridad científica desde una etapa temprana en las carreras de grado para incorporar la importancia de la credibilidad, siendo este el acervo más valioso que tiene el investigador y la institución en la cual estos desarrollan su labor. Una educación sólida en bioética es la mejor manera de adoptar una conducta íntegra, y por ende responsable, al realizar proyectos de investigación. La formación ética debe ser una construcción constante resultando necesario plantear estrategias multidimensionales para evitar prácticas inadecuadas. (AU)

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A sobrevivência ao câncer de mama é um problema de saúde pública que demanda serviços especializados com foco na reabilitação psicossocial. Entre as necessidades identificadas nesse contexto está o incentivo à adoção de estratégias de promoção de autocuidados pelas mulheres. Uma das estratégias adotadas consiste no grupo de apoio psicológico, que auxilia as pacientes a enfrentar a longa jornada do tratamento. Assim, o objetivo deste estudo é compreender os significados produzidos por mulheres com câncer de mama sobre sua participação em um grupo de apoio. Trata-se de um estudo qualitativo, descritivo e exploratório realizado com dez mulheres com câncer de mama usuárias de um serviço de reabilitação para mastectomizadas. Como referencial metodológico foi utilizada a Teoria Fundamentada nos Dados. A coleta de dados foi realizada por meio de entrevista aberta em profundidade e os conteúdos foram transcritos e codificados. A análise indutiva e o método de comparação constante foram aplicados nos processos de codificação aberta, axial e seletiva, que permitiram identificar três categorias nucleares: percepção das atividades realizadas no grupo, identificação de benefícios e barreiras do convívio no grupo e transformações decorrentes da participação. As participantes significaram sua presença no grupo como fonte de acolhimento, apoio, desenvolvimento de recursos pessoais e amizades, contribuindo para promover sua qualidade de sobrevida. Além dos potenciais benefícios, também foram identificadas barreiras que podem dificultar a adesão e continuidade da participação no grupo, o que sugere a necessidade de incorporar no cuidado um olhar para as dimensões subjetivas da saúde da mulher.(AU)

Surviving breast cancer is a public health problem and depends on services focused on psychosocial rehabilitation. Healthcare providers must encourage women to adopt strategies to promote their self-care. The psychological support group is a resource that helps women to face the long journey of treatment. This study aimed to understand the meanings women with breast cancer produced about their participation in a support group. This exploratory cross-sectional study was carried out with 10 women with breast cancer who use a rehabilitation service for mastectomized patients. Grounded Theory was used as a methodological reference. An open in-depth interview was applied for data collection. The contents were transcribed and coded. Inductive analysis and the constant comparison method were applied in the open, axial, and selective coding processes, which enabled the identification of three core categories: perception of the activities carried out in the group, identification of benefits and barriers of living in the group, and transformations resulting from participation. Participants denote their involvement with the group as a source of shelter, support, development of personal resources and friendships that helps promoting quality of life. Besides these potential benefits, participants also evinced barriers that can hinder adherence and continuity of participation in the group, suggesting the importance of incorporating a look at the subjective dimensions of women's health into care.(AU)

Sobrevivir al cáncer de mama es un problema de salud pública que depende de los servicios centrados en la rehabilitación psicosocial. Entre las necesidades identificadas en esta materia se encuentra el uso de estrategias para promover el autocuidado. Uno de los recursos que ayuda a afrontar el largo camino del tratamiento es el grupo de apoyo psicológico. El objetivo de este estudio es conocer los significados que producen las mujeres con cáncer de mama sobre su participación en un grupo de apoyo. Se trata de un estudio cualitativo, descriptivo y exploratorio, realizado con diez mujeres con cáncer de mama usuarias de un servicio de rehabilitación para mastectomizadas. Como referencia metodológica se utilizó la teoría fundamentada en los datos. Se aplicó una entrevista abierta en profundidad para la recogida de datos, cuyos contenidos fueron transcritos y codificados. El análisis inductivo y el método de comparación constante se aplicaron en los procesos de codificación abierta, axial y selectiva, lo que permitió identificar tres categorías centrales: percepción de las actividades realizadas en el grupo, identificación de los beneficios y las barreras de vivir en el grupo y transformaciones resultantes de la participación. Las mujeres denotan su participación en el grupo como una fuente de acogida, apoyo, desarrollo de recursos personales y amistades, que ayuda a promover la calidad de vida. Además de los beneficios potenciales, también se identificaron barreras que pueden dificultar la adherencia y continuidad de la participación en el grupo, lo que sugiere la necesidad de incorporar en la atención una mirada centrada en las dimensiones subjetivas de la salud de las mujeres.(AU)

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Abstract This article analyzes the relationship between accountability and equity in public services in the context of open government plans in unequal countries and cities. It presents a conceptual discussion interweaving collaborative and inclusive governance, accountability, equity, and open government, supporting the analysis of the 5th Brazilian Open Government National Plan, the 4th Colombian Open State National Plan, and the current Municipal Open Government Action Plans of São Paulo and Bogotá. The research question addressed is: How do open government plans recognize power asymmetries and inequities among population groups when accessing public services? The study also identifies trends in connecting accountability and equity in public services, showing examples from Bogotá and São Paulo, highlighting the inclusion of equity goals in Colombian and Brazilian development plans. This qualitative and exploratory research introduces a conceptual discussion bridging academic and technical literature, conducting a documentary analysis of the empirical realities in two countries and two cities. The results show that equity in public services is usually approached broadly and is more visible in municipal than national open government plans. The operationalization and measurement of equity in public services are challenging. Improvements in this direction could make equity efforts more accountable, accountability processes more equitable, governance more inclusive, and power less concentrated.

Resumen El artículo busca analizar la relación entre accountability y equidad en los servicios públicos, en el contexto de planes de gobierno abierto en países y ciudades con altas desigualdades socioeconómicas. Presenta una discusión conceptual que articula gobernanza colaborativa e inclusiva, accountability, equidad y gobierno abierto, para el análisis del V Plan Nacional de Gobierno Abierto de Brasil, el IV Plan Nacional de Estado Abierto de Colombia y los actuales planes de acción municipales de gobierno abierto de São Paulo y Bogotá. La pregunta de investigación es ¿Cómo los planes de gobierno abierto reconocen las asimetrías de poder y las iniquidades entre grupos poblacionales en el acceso a los servicios públicos? El estudio también identifica tendencias en la conexión entre accountability y equidad en los servicios públicos y muestra ejemplos de Bogotá y São Paulo, además de la presencia de metas de equidad en los planes de desarrollo de Brasil y Colombia. Se trata de una investigación cualitativa y exploratoria, que propone una discusión teórico-conceptual, articulando literatura académica y técnica y análisis documental sobre la realidad empírica en dos países y dos ciudades. Los resultados muestran que la equidad en los servicios públicos es abordada de manera general y es más visible en los planes municipales que en los planes nacionales de gobierno abierto. La operacionalización y medición de la equidad en los servicios públicos es todavía un desafío. Las mejoras en estos aspectos podrían hacer que los esfuerzos en materia de equidad sean más accountable, los procesos de accountability más equitativos, la gobernanza más inclusiva y el poder menos concentrado.

Resumo O trabalho analisa a relação entre accountability e equidade nos serviços públicos, no contexto de planos de governo aberto em países e cidades com elevadas desigualdades socioeconômicas. A partir de uma discussão conceitual que articula governança colaborativa e inclusiva, accountability, equidade e governo aberto, analisamos o 5º Plano Nacional de Governo Aberto do Brasil e o 4º Plano Nacional de Estado Aberto da Colômbia, bem como os atuais Planos de Ação de Governo Aberto de São Paulo e Bogotá. A pergunta que orienta a investigação é como os planos de governo aberto reconhecem as assimetrias de poder e as iniquidades entre grupos populacionais no acesso aos serviços públicos? Ainda, identificamos tendências de conexão entre accountability e equidade nos serviços públicos, mostrando exemplos de Bogotá e São Paulo, além da presença de metas de equidade em planos de desenvolvimento de Brasil e Colômbia. Trata-se de uma pesquisa de caráter qualitativo e exploratório, que propõe uma articulação e discussão teórico-conceitual, articulando literatura acadêmica e técnica e análise documental sobre a realidade empírica em dois países e duas cidades. Os resultados mostram que a equidade é abordada de forma geral e é mais visível nos planos municipais do que nos planos nacionais de governo aberto. A operacionalização e mensuração da equidade em serviços públicos são desafiadoras. Melhorias nesses aspectos podem ajudar a tornar os esforços de equidade mais accountable, os processos de accountability mais equitativos, a governança mais inclusiva e o poder menos concentrado.

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INTRODUCTION: Coproduction of mental health research and interventions involving researchers and young people is increasingly common. However, this model raises challenges, related, for instance, to communication, power and control. This paper narrates-from a collective first-person perspective-the lived experience of coproduction of a digital intervention by institutional researchers and young citizen researchers in Brazil. METHOD: This study employed a collaborative autoethnographic methodology, utilising autobiographical data such as meeting recordings, individual notes and collective guided reflections on the coproduction process. Our analysis focused on challenges and solutions that arose during the process. RESULTS: Throughout the project, we created formal and informal mechanisms for accountability, transparency and fair inclusion of multiple voices. We engaged in mutual capacity-building, invested in building interpersonal knowledge, and implemented practices to reduce overload and promote equitable participation. Through ongoing reflection and readjustment in response to challenges, we progressively embraced more democratic and egalitarian values. The collective care invested in the process fostered synergy, trust, and intergroup friendship. CONCLUSION: Our experience points to the value of creating a space for multiple research identities: the citizen young person and the institutional researcher, both of whom critically reflect on their roles in the research process. Our focus on coproduced care calls into question participation metaphors that represent the process via a single axis-young people-who linearly progress from minimal participation to full autonomy. Instead, our analysis highlights the importance of a social and caring bond that supports the radical co-production of innovative health solutions in contexts of vulnerability.

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OPS Adelante se centra en la modernización, innovación y simplificación de las políticas, los procesos y los sistemas para fortalecer la gestión interna, los controles y la toma de decisiones. Fomenta una cultura de eficiencia, transparencia y rendición de cuentas a fin de aumentar la eficacia de la Organización Panamericana de la Salud (OPS) en todos los niveles. Gracias a la racionalización de los procesos, la utilización de la tecnología, los análisis avanzados de datos y la comunicación abierta, la Oficina Sanitaria Panamericana (la Oficina) estará mejor equipada para abordar los desafíos cambiantes en materia de salud pública a los que tienen que hacer frente los Estados Miembros. Por medio de procesos de gestión innovadores, OPS Adelante puede ayudar a colocar a la salud en el centro de la recuperación económica de la Región de las Américas y en las políticas para abordar la pobreza, las inequidades y las desigualdades que se han profundizado en los últimos años. La Oficina debe cultivar una fuerza laboral comprometida, empoderada y diversa, equipada con las habilidades y competencias necesarias para desempeñarse en un entorno de salud pública cada vez más complejo. Las prácticas y procesos de gestión eficaces e innovadores en materia de recursos humanos son esenciales para lograr la misión de la OPS. Los sistemas de tecnología de la información y de las comunicaciones ayudarán a la Oficina a aprovechar las tecnologías, los sistemas de gestión de datos y las plataformas de intercambio de información para simplificar los procesos, facilitar la adopción de decisiones y medidas basadas en la evidencia, y mejorar el desempeño general de la Organización. Durante una crisis, la Organización debe evaluar rápidamente la situación, y determinar el nivel de apoyo y los recursos adicionales que se necesitan. Los recursos deben asignarse estratégicamente para proporcionar el apoyo necesario, y abordar las necesidades particulares de los países a fin de responder de manera eficaz durante toda la crisis. OPS Adelante fortalecerá la capacidad de la Oficina para proporcionar cooperación técnica a fin de promover el impacto y la sostenibilidad en el ámbito de la salud pública para los países y los pueblos a los que servimos.

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PAHO Forward focuses on modernizing, innovating, and streamlining policies, processes, and systems to strengthen internal management, controls, and decision-making. It fosters a culture of efficiency, transparency, and accountability to enhance the effectiveness of the Pan American Health Organization (PAHO) across all levels. Through streamlined processes, technology utilization, advanced data analyses, and open communication, the Pan American Sanitary Bureau (PASB) will become better equipped to address the evolving public health challenges of Member States. Through innovative management processes, PAHO Forward can contribute to placing health at the heart of the Region’s economic recovery and in policies to address the poverty, inequities, and inequalities that have deepened in recent years. PASB must cultivate an engaged, empowered, and diverse workforce equipped with the necessary skills and competencies within an increasingly complex public health landscape. Effective and innovative human resources management practices and processes are integral to achieving PAHO’s mission. Information technology and communication systems will help PASB leverage technologies, data management systems, and information-sharing platforms to streamline processes, facilitate evidence-based decisions and actions, and improve overall organizational performance. During a crisis, the Organization must quickly assess the situation and determine the required level of support and additional resources needed. Resources must be strategically allocated to provide the required support and address the unique needs of countries, ensuring an effective response throughout the duration of the crisis. PAHO Forward will strengthen PASB’s capacity to deliver technical cooperation to drive public health impact and sustainability for the countries and peoples that PAHO serves.