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The objective of the study was to determine if there is a significant correlation between academic motivation and student learning. For this reason, research on academic motivation was carried out to improve the teaching and learning of university students. The study carried out is applied, being the level of descriptive-correlational research. The research was cross-sectional; since the CEAP48 Scale survey was applied only once; but only the EMAP-01 Learning Motivation Subscale was used, which consists of 24 statements and notes. The sample is a simple random of 46 students enrolled in the 2022-1 semester. It was shown that the application of academic motivation and learning occupies 71.7% (33) at the highest level in the performance motivation dimension. Therefore, motivation improves in learning; however, it is necessary for teachers to apply this didactic resource in their classes, since it is demonstrated in the results. It was determined that more than 50% of the respondents are above 3.96 in the mean, that is, they have a favorable attitude. On average, the subjects are located in superficial motivation. Likewise, 0.631 scale units deviate from the average. Therefore, the use of this resource benefits the student. Finally, it is concluded that there is an adequate significant relationship between the variables, due to a moderate correlation, that is, it is favorable.

La Caducidad administrativa es una figura existente en el Derecho Administrativo Sancionador que busca resguardar el equilibrio entre el deber de impulsar el procedimiento de la autoridad y del derecho de los administrados, cuando se encuentren sometidos a algún procedimiento gravoso, a contar con un plazo razonable para la determinación de infracciones y sanciones.Sin embargo, pese a que esta institución fuera introducida en la normativa peruana en el año 2016, con reglas claras para su aplicación, el INDECOPI, a través de diferentes pronunciamientos emitidos por sus diferentes órganos de resolución, ha realizado disímiles interpretaciones, incluso, contradictorias, de la manera en la que esta figura debe aplicarse (o no aplicarse). Así, el autor realiza un análisis de los criterios emitidos por esta entidad para posteriormente emitir su valoración final sobre los elementos necesarios para aplicar la caducidad.Abstract: the administrative Expiration is an existing figure in the Administrative Sanctions Procedure that seeks to safeguard the balance between the duty to promote the procedure of the Authority and the rights of the administrated ones, when they are subject to some burdensome procedure, have to have a reasonable period for the determination of the infractions and penalties.However, despite the fact that this institution was introduced in the Peruvian regulations in 2016 with clear rules for its application, INDECOPI through different pronouncements issued by its different resolution bodies, has made different interpretations, even contradictory, in the manner of how this figure should be applied (or not applied). In this way the author performs an analysis of the criteria issued by this entity to subsequently issue its final assessment about the necessary elements to apply this institution.

Major oil spills can cause significant impacts on marine-coastal zones, particularly on areas with a high oil spill risk, which combine a high oil spill hazard-high likelihood of oil stranding at high concentrations, and a high environmental sensitivity-high concentration of highly sensitive ecological and socioeconomic resources. In this context, a straightforward multicriteria methodology is proposed to determine the second factor of the oil spill risk, namely the strategic environmental sensitivity (SES), in 68 sectors covering the entire Peruvian marine-coastal zone. The methodology comprised the weighted integration of physical, biological, and socioeconomic sensitivity indicators based on their relevance in surface marine oil spills and the Peruvian ecological and socioeconomic context. As a result, relative SES levels from very low to very high were assigned to the sectors. To demonstrate the SES applicability, an oil spill risk assessment at a screening level was performed in a selected sector with current oil production activities. The oil beaching likelihood of worst-case discharge scenarios modelled for January 2021 was used to determine an overall screening oil spill hazard level in the selected sector, while a matrix relating the SES and hazard determined the screening oil spill risk. The results can be used as a decision-support tool to enhance the oil spill contingency planning in Peru or be used in other relevant processes such as the integrated coastal zone management, the marine spatial planning, or the contingency planning of other liquid contaminants. In addition, the proposed methodologies can be adapted to different local and international contexts and scales.

This article explores how existing health inequities in the Guatemalan health system facilitate the emergence of its medical tourism industry. We report on our thematic analysis of 50 key informant interviews conducted with 4 groups of stakeholders in the local medical tourism sector. Participants frequently discussed the interplay between the country’s longstanding health inequities and the promotion of medical tourism, characterized by 4 thematic viewpoints: the private health sector is already flourishing; the highly fragmented health system already faces multiple challenges; the underfunded public health sector has a weak regulatory capacity; and the commodification of health care has already advanced. Medical tourism and health inequities shape each other in low- and middle-income countries. In addition to the potential for medical tourism to exacerbate health inequities, previously existing health inequities create opportunities for the industry’s growth. Although regulation of the medical tourism industry is necessary, it needs to be implemented both at the domestic and supranational levels for it to be effective in preventing greater health inequities, and it needs to address the political and economic drivers that make health systems generate health disparities.

This chapter explores the relationship between well-being and equity, and makes the case for well-being approaches as a powerful pathway to advance equity. In a world without equity, well-being is impossible. Inequities in income, health, education, environmental conditions, access to opportunity, and other factors hinder individual, community, and civic well-being. Pursuing a well-being approach centered on equity—from what gets measured and how, to the way stories are told and the voices that tell them, to what gets prioritized and acted upon and by whom—can reduce these inequities. And in the symbiotic relationship between well-being and equity, as well-being improves, so does equity; likewise, as equity improves, so does well-being. The chapter addresses three intersecting components of well-being and equity: economic equity, human rights, and social cohesion. Through these lenses, it looks at implications and opportunities for social and policy change and illuminates work that remains to be done.

Background Citizen-led accountability initiatives are a critical strategy for redressing the causes of health inequalities and promoting better health system governance. A growing body of evidence points to the need for putting power relations at the forefront of understanding and operationalizing citizen-led accountability, rather than technical tools and best practices. In this study, we apply a network lens to the question of how initiatives build collective power to redress health system failures affecting marginalized communities in three municipalities in Guatemala. Methods Network mapping and interpretive discussions were used to examine relational qualities of citizen-led initiatives’ networks and explore the resources they offer for mobilizing action and influencing health accountability. Participants in the municipal-level initiatives responded to a social network analysis questionnaire focused on their ties of communication and collaboration with other initiative participants and their interactions with authorities regarding health system problems. Discussions with participants about the maps generated enriched our view of what the ties represented and their history of collective action and also provided space for planning action to strengthen their networks. Results Our findings indicate that network qualities like cohesiveness and centralization reflected the initiative participants’ agency in adapting to their sociopolitical context, and participants’ social positions were a key resource in providing connection to a broad base of support for mobilizing collective action to document health service deficiencies and advocate for solutions. Their legitimacy as “representatives of the people” enabled them to engage with authorities from a bolstered position of power, and their iterative interactions with authorities further contributed to develop their advocacy capabilities and resulted in accountability gains. Conclusions Our study provided evidence to counter the tendency to underestimate the assets and capabilities that marginalized citizens have for building power, and affirmed the idea that best-fit, with-the-grain approaches are well-suited for highly unequal settings characterized by weak governance. Efforts to support and understand change processes in citizen-led initiatives should include focus on adaptive network building to enable contextually-embedded approaches that leverage the collective power of the users of health services and grassroots leaders on the frontlines of accountability.

This article examines youth-led anti-corruption protests in Guatemala in 2015, which contributed to the resignation of the president and vice-president. It outlines three key factors that were part of the initial success of the #RenunciaYa social media campaign, and the subsequent struggle towards political and structural reforms. First, it can be regarded as part of a much longer history of rights-led civic engagement and protest. Second, while social media proved indispensable for mobilising civic action, it was insufficient to reach beyond urban-based youth activists. Third, the removal of the president and vice-president was possible not only because of public pressure generated by anti-corruption youth activists, but also because of the longer-term work of two Attorney Generals and the International Commission Against Impunity in highlighting the fight against corruption within the national political agenda. Finally, the article argues that civic participation after conflict requires at least one generation to spring.

An automatic content classification technique is an essential tool in multimedia applications. Present research for audio-based classifiers look at short- and long-term analysis of signals, using both temporal and spectral features as well as using auditory models. In this paper, we present a hierarchical scheme that maps familiar single-type streaming content sources (e.g., either music, movie, or voice) to processes in a JavaScript Object Notation (JSON) configuration file. For streaming sources containing mixed-type of content (e.g., movies and music) we employ a machine learning (ML) model to classify between the movie, music, and voice-based on metadata. Towards this end, statistical models of the various metadata are created since a large metadata dataset is not available. Subsequently, synthetic metadata are generated from these statistical models, and the synthetic metadata is input to the ML classifier as feature vectors. We demonstrate high discriminating capabilities (accuracy ≈ 90%), with very low latency (viz., ≈ on an average 7 ms), using real metadata from real-world content such as from YouTubeTM, Blu-rayTM, and user-generated content (UGC). The combined hierarchical system (comprising JSON file and ML-model) reliably identifies the content type with an accuracy greater than 90%.

The objective was to explore the frequency and forms of use of medicinal plants in a group of pregnant women from the “Vina Alta” health center, La Molina. 21 pregnant women participated voluntarily, they were administered a survey validated by experts, which inquired about the use of medicinal plants. It was shown that 86% of pregnant women used medicinal plants, 67% did not consult their doctor about their use, the main form of use was by oral intake through infusion, and the most consumed plants were chamomile, parsley, eucalyptus, boldo, aloe, mint, and rue. Teratogenic effect, uterine stimulant, abortifacient, among others, of some medicinal plants used are reported. It is necessary to know the real load of plant use in Peruvian pregnant women, and to make a safety classification of medicinal plants, to promote the rational use of traditional medicine and contribute to public health. Keywords: Medicinal plants, pregnant women, consumption, risk, teratogenic, abortion

Strengthening citizen-led accountability initiatives is a critical rights-based strategy for improving health services for indigenous and other marginalized populations. As these initiatives have gained prominence in health and other sectors, there is great interest in how they operate and what makes them effective. Scholarly focus is shifting from measuring the efficacy of their tools and tactics to deepening understanding of the context-sensitive pathways through which change occurs. This paper examines how citizen-led initiatives’ actions to strengthen grassroots networks, monitor health services and engage with authorities interact with local sociopolitical conditions and contribute to accountability achievements for indigenous populations in rural Guatemala. We used qualitative comparative analysis to first systematize and score structured qualitative monitoring data gathered in 29 municipal-level initiatives, and then analyze patterns in the presence of different forms of citizen action, contextual conditions and accountability outcomes across cases. Our study identifies pathways of collective action through which citizen-led initiatives bolster their power to engage and negotiate with authorities and bring about solutions to some of the health system deficiencies that they face. While constructive engagement is widely advocated as the most effective approach to interaction with authorities, our study indicates that success depends on wider processes of community mobilization. To overcome the power asymmetries that marginalized groups face when engaging with authorities, iterative processes of network building and participatory monitoring as well as persistence in their demands are critical. These processes further provide an enabling environment for moving beyond the local and projecting indigenous voices to engage with authorities at higher governance levels. Initiatives also applied adversarial legal action as an alternative engagement strategy that contributed to bolster citizen power. Our findings indicate the potential of collective power generated by the actions of citizen-led initiatives to enable marginalized populations to hold authorities accountable for health system failures. publishedVersion

Power is a critical concept to understand and transform health policy and systems. Power manifests implicitly or explicitly at multiple levels-local, national and global-and is present at each actor interface, therefore shaping all actions, processes and outcomes. Analysing and engaging with power has important potential for improving our understanding of the underlying causes of inequity, and our ability to promote transparency, accountability and fairness. However, the study and analysis of the role of power in health policy and systems, particularly in the context of low- and middle-income countries, has been lacking. In order to facilitate greater engagement with the concept of power among researchers and practitioners in the health systems and policy realm, we share a broad overview of the concept of power, and list 10 excellent resources on power in health policy and systems in low- and middle-income countries, covering exemplary frameworks, commentaries and empirical work. We undertook a two-stage process to identify these resources. First, we conducted a collaborative exercise involving crowdsourcing and participatory validation, resulting in 24 proposed articles. Second, we conducted a structured literature review in four phases, resulting in 38 articles reviewed. We present the 10 selected resources in the following categories to bring out key facets of the literature on power and health policy and systems-(1) Resources that provide an overarching conceptual exploration into how power shapes health policy and systems, and how to investigate it; and (2) examples of strong empirical work on power and health policy and systems research representing various levels of analyses, geographic regions and conceptual understandings of power. We conclude with a brief discussion of key gaps in the literature, and suggestions for additional methodological approaches to study power.

Walter Flores and Jeannie Samuel argue that grassroots organisations are essential to ensure improvements in the health of marginalised populations

The 400 million indigenous people worldwide represent a wealth of linguistic and cultural diversity, as well as traditional knowledge and sustainable practices that are invaluable resources for human development. However, indigenous people remain on the margins of society in high, middle and low-income countries, and they bear a disproportionate burden of poverty, disease, and mortality compared to the general population. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators in relation to the 15-year push to meet the Millennium Development Goals. As we enter the Sustainable Development Goals (SDGs) era, there is growing consensus that efforts to achieve Universal Health Coverage (UHC) and promote sustainable development should be guided by the moral imperative to improve equity. To achieve this, we need to move beyond the reductionist tendency to frame indigenous health as a problem of poor health indicators to be solved through targeted service delivery tactics and move towards holistic, integrated approaches that address the causes of inequalities both inside and outside the health sector. To meet the challenge of engaging with the conditions underlying inequalities and promoting transformational change, equity-oriented research and practice in the field of indigenous health requires: engaging power, context-adapted strategies to improve service delivery, and mobilizing networks of collective action. The application of systems thinking approaches offers a pathway for the evolution of equity-oriented research and practice in collaborative, politically informed and mutually enhancing efforts to understand and transform the systems that generate and reproduce inequities in indigenous health. These approaches hold the potential to strengthen practice through the development of more nuanced, context-sensitive strategies for redressing power imbalances, reshaping the service delivery environment and fostering the dynamics of collective action for political reform. publishedVersion

Background : Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector. Objective : To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications. Design : In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development. Results : Four common drivers of medical tourism development were identified: 1) unused capacity in existing private hospitals, 2) international portability of health insurance, vis-a-vis international hospital accreditation, 3) internationally trained physicians as both marketable assets and industry entrepreneurs, and 4) promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1) the high expense of market entry, 2) poor sector-wide planning, and 3) structural socio-economic issues such as insecurity or relatively high business costs and financial risks. Conclusion : There are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public investment promotion agencies and the private health sector seeking economic benefits with limited consideration and planning for the health equity concerns medical tourism raises. Keywords: medical tourism; health services research; qualitative methods; Central America; Caribbean (Published: 21 November 2016) Citation: Glob Health Action 2016, 9 : 32760 - http://dx.doi.org/10.3402/gha.v9.32760

Background: Health inequalities disproportionally affect indigenous people in Guatemala. Previous studies have noted that the disadvantageous situation of indigenous people is the result of complex and structural elements such as social exclusion, racism and discrimination. These elements need to be addressed in order to tackle the social determinants of health. This research was part of a larger participatory collaboration between Centro de Estudios para la Equidad y Gobernanza en los Servicios de Salud (CEGSS) and community based organizations aiming to implement social accountability in rural indigenous municipalities of Guatemala. Discrimination while seeking health care services in public facilities was ranked among the top three problems by communities and that should be addressed in the social accountability intervention. This study aimed to understand and categorize the episodes of discrimination as reported by indigenous communities.Methods: A participatory approach was used, involving CEGSS’s researchers and field staff and community leaders. One focus group in one rural village of 13 different municipalities was implemented. Focus groups were aimed at identifying instances of mistreatment in health care services and documenting the account of those who were affected or who witnessed them. All of the 132 obtained episodes were transcribed and scrutinized using a thematic analysis.Results: Episodes described by participants ranged from indifference to violence (psychological, symbolic, and physical), including coercion, mockery, deception and racism. Different expressions of discrimination and mistreatment associated to poverty, language barriers, gender, ethnicity and social class were narrated by participants.Conclusions: Addressing mistreatment in public health settings will involve tackling the prevalent forms of discrimination, including racism. This will likely require profound, complex and sustained interventions at the programmatic and policy levels beyond the strict realm of public health services. Future studies should assess the magnitude of the occurrence of episodes of maltreatment and racism within indigenous areas and also explore the providers’ perceptions about the problem.

Management Sciences for Health, Washington DC, USA, member of the Steering Committee for the Second Global Symposium on Health Systems Research (Beijing 2012) and chair of the working group tasked with creating the international society for health systems research (Health Systems Global), Assistant Director-General – Innovation, Information, Evidence and Research, World Health Organization, Switzerland, and member of the Executive Committee for the second Global Symposium on Health Systems Research, Professor, Copenhagen HIV Programme, Copenhagen University, Denmark, and Head of the Interim Secretariat for Health Systems Global

This letter was published in The Lancet [© 2017 Lancet Publishing Group] and the definitive version is available at : http://doi.org/10.1016/S0140-6736(17)31445-9 The Journal's website is at: https://www.sciencedirect.com/science/article/pii/S0140673617314459?via%3Dihub

No mercado existem dois tipos de marcas, as sem emocao e as marcas emocionais. A diferenca entre elas esta na forma como cada uma se comunica com as pessoas. A primeira cria uma identidade empresarial “imposta” enquanto a segunda cria um relacionamento unico com o seu cliente, envolto em misterio, sensualidade e intimidade. Este relacionamento deve ser construido desde a concepcao da marca, no seu DNA. O DNA de uma marca e, assim como nos seres vivos, o que diferenciara uma marca de outra, formado por diversas caracteristicas proprias que ao se ligarem, formam um conceito unico e diferencial, de onde serao construidas todas as estrategias e posicionamento da mesma. Este tem como objetivo estudar o Brand DNA Process, processo que serve para validar uma marca dentro de um processo co-criativo entre designers e empresas, dentro de dois casos praticos de aplicacao do processo, mostrando os resultados obtidos e comentando os mesmos.

La gobernanza se refiere a procesos de toma de decisión en los cuales confluyen relaciones de poder e intereses particulares de actores e instituciones. Situaciones de consenso y conflicto son inherentes a dichos procesos. En adición, la toma de decisión sucede dentro de un marco de principios éticos, motivaciones e incentivos que pueden ser explícitos o implícitos. Los sistemas de salud, en la mayoría de países de América Latina y el Caribe, definen los principios de equidad, solidaridad, participación social y derecho a la salud como rectores. Por lo tanto, estos principios deben presidir los procesos de gobernanza. Sin embargo, este no es siempre el caso y es allí donde reside la importancia de investigar la gobernanza en los sistemas de salud. Avanzar en la investigación de la gobernanza tiene implicaciones conceptuales y metodológicas. A nivel conceptual, es de relevancia clarificar e integrar los enfoques normativos y analíticos puesto que ambos son necesarios para un abordaje que busque indagar y comprender la complejidad de los fenómenos sociales. En lo metodológico, es necesario expandir la gama de variables, fuentes de información e indicadores para estudiar la toma de decisiones relacionadas a lograr una mayor equidad, ejercicios de ciudadanía en salud y eficiencia en las políticas públicas.

Appropriate deployment or posting and transfer (P&T) of health workers – placing the right people in the right positions at the right time – lies at the heart of fostering communities’ faith in government health services and cementing the role of the health system as a core social institution. The authors of this paper have been involved in an ongoing transnational dialogue about P&T practices and determinants. This dialogue seeks to call attention to the importance of P&T as a health system function; to urge donors and policy-makers working in health systems, HRH and public administration governance to consider how to address issues around P&T; and to suggest avenues and approaches to research. P&T is a vexed and unresolved issue in many low- and middle-income countries that requires, above all, political commitment to improving public sector services and to new thinking and research. It holds promise as a focal point for inter-disciplinary collaboration in research and implementation that can inform other areas in HRH and health systems strengthening. Innovative social science and management theorizing, and iterative, locally driven interventions that focus on establishing transparent professional norms and building the credibility of government administration, including the health services, are likely the way forward.

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão, Programa de Pós-Graduação em Design e Expressão Gráfica, Florianópolis, 2014. Vivemos em uma sociedade onde as pessoas passaram a exercer um papel mais ativo de agir no meio em que estão inseridas. Isto faz com que as organizações precisem se adaptar para sobreviver em meio a esta mudança e a conquistar os seus consumidores através de uma ligação emocional, criando assim uma história cheia de experiências que ficarão marcadas em suas lembranças. Para auxiliar nestas mudanças, surge o design com seus processos e ferramentas, gerando assim a diferenciação almejada por estas organizações no intuito de destacarem-se perante seus concorrentes. Esta diferenciação faz com que o design adquira uma certa importância dentro das empresas, pelo fato de este estar contribuindo na construção da imagem organizacional destas, apresentando para a sociedade os valores e responsabilidades das organizações. Tais valores e outros conceitos como a visão, missão e cultura da organização fazem parte da essência da sua marca, identificados através do seu ?DNA?, que é construído dentro de um processo cocriativo, envolvendo a empresa e seus stakeholders compartilhando as experiências que ambos possuem a respeito da marca. Neste cenário de transformação das organizações, vem surgindo novas metodologias, preocupadas com a construção da marca de forma que estas evidenciem os valores da mesma garantindo seu valor autêntico perante a sociedade. Garantir a autenticidade da marca corresponde aos estudos da área de branding, que defendem a costrução de um DNA corporativo como uma forma de aplicação inovadora de seus conceitos e valores, auxiliando as empresas a terem uma melhor compreensão dos seus funcionamentos e dos elementos que as cercam, para que as mesmas possam se diferenciar no mercado onde se encontram inseridas. Neste sentido, metodologias cocriativas como o Brand DNA Process são vistas como um elemento motivador, que oferece uma experiência gratificante e marcante aos participantes do processo, reforçando a identificação entre seus colaboradores e a marca da organização. Para fortalecer a aplicação de métodos como o do Brand,DNA,Process, vem se desenvolvendo estudos com base na "gamificação" e no pensamento visual, com o intuito de utilizar-se destas técnicas na intenção de fortalecer o elemento cocriativo destes métodos, enriquecendo o processo com os conhecimentos de cada um e trazendo um resultado mais assertivo ao final de todo o projeto. Estudar as ferramentas do processo e agrupar todo o seu material em um kit metodológico acaba por se transformar em um processo gamificado com uma aplicação de forma mais amigável, e cria, ao longo do projeto, uma conexão emocional por parte de seus participantes. A presente pesquisa tem como objetivo desenvolver, para a metodologia do Brand, DNA, Process, um conjunto de ferramentas (toolkit) que abarque toda a teoria científica e facilite a sua aplicação. Abstract : We live in a society where people began exerting a more active role on acting within the environment they live in. That fact is responsible for making the organizations try and adapt to survive in the midst of such change, and to conquer new consumers through an emotional connection, creating thus, a history full of experiences that will be marked in their memories. To help with these changes, the Design arises, with its processes and tools, creating the sought differentiation that these organizations have been looking for, with the aim of being highlited in compariHson with its competitors. This differentiation makes the Design to acquire a certain importance for the companies, because of the fact that it contributes to the construction of their organizational image, presenting to the Society the companies's values and responsibilities. Such values and other concepts, such as vision, mission and organizational culture, are part of the brand's essence, identified through its "DNA", which is built within a cocreative process, involving the company and its stakeholders,, by sharing the experiences that both of them have in relation to the brand. Within this scenery of organizational transformation, it has been arising new methodologies worried with the brands' construction in a way that these are able to show the brand's value, thus assuring its auHthentic value to society. That assures that the brand's authenticity is linked to the studies in the area of branding, which advocates the conHstruction of a corporate DNA as a means of innovative application of its concepts and values, helping the companies to achieve a better understanding about their own functioning and of the elements on their surHroundings, so that these same companies can achieve their own market differentiation in the place where they are inserted. In this sense, coHcreative methodologies as the Brand DNA Process are seen as a motivaHtional element which offers a marking and gratifying experience for the participants in the process, reinforcing the the identification between the organization's brand and its collaborators. To strenghten the application of methods such as the Brand DNA Process, it has been developed studies based on the "gamification" and on visual thought, with the aim of utilizing such techniques with the purpose of strenghten the cocreative elements of such methods, thus enriching the process with the participants' knowledge and bringing on a more assertive result by the end of the whole project. To study the process tools and to assemble all its material in a methodological kit turns out to be transformed in a gamified process applied in a friendlier way, and creates, throughout the process, an emotional connection for its participants. The current research has the objective of developing, for the Brand DNA Process, a set of tools (toolkit) which encompasses all the scientific theory and facilitates its application.

A kind of courtship is going on between proponents of universal health coverage (UHC) and proponents of global health security (GHS). In our opinion, efforts to make progress on the path to UHC and efforts to improve GHS can be synergistic, but are not self-evidently so. Making this partnership work will require careful thinking and planning. Several comments on ‘lessons from Ebola’ highlight the potential of UHC as a way to improve GHS.1 Simon Rushton, Louis Lillywhite and Bhimsen Devkota argue that the “[p]romotion of health security therefore entails ensuring that effective health systems exist before a crisis, are sustained during and after conflict and disaster, and are at all times accessible to the population.”1 Rob Yates, Ranu Dhillon and Ravi Rannan-Eliya remind us that several epidemics of global concern ‘occurred in settings without universal health coverage where health systems were unable to perform effective public health functions’.1 In a reaction to these ‘lessons from Ebola’, and a preview to the G7 summit in Ise-Shima of May 2016, Gavin Yamey argued that a way to make the case for UHC more compelling ‘could be to link UHC to the worldwide concern about pandemics in the wake of the Ebola crisis’,2 and he encouraged Japan—a longstanding proponent of UHC and GHS—to ‘rouse the G7 nations into action on universal health coverage’.2 Japan indeed promoted UHC and GHS, as an ‘inseparable couple’,3 and the ‘G7 Ise-Shima Vision for Global Health’ outcome document highlights both.4 ### Not a new attempt to create an alliance The present courtship is not new. The 2007 World Health Report, on ‘A safer future: global public health security in the 21st century’,5 highlighted the importance of strong health systems to enhance GHS. Without using the expression UHC, this report tried to tie efforts to make progress towards UHC into …

This editorial was published in the Bulletin of the World Health Organization [© 2013 Bulletin of the World Health Organization] and the definite version is available at: http://www.who.int/bulletin/volumes/91/1/12-115808/en/

Background The objective of this study was to implement a rapid assessment of the performance of four malaria control strategies (indoor spraying, insecticide-treated bed nets, timely diagnosis, and artemisinin-based combination therapy) using adequacy criteria. The assessment was carried out in five countries of the Amazon subregion (Bolivia, Colombia, Ecuador, Guyana, and Peru). Methods A list of criteria in three areas was created for each of the four strategies: preliminary research that supports the design and adaptation of the control strategies, coverage of the control strategies and quality of the implementation of the strategies. The criteria were selected by the research team and based on the technical guidelines established by the World Health Organization. Each criterion included in the four lists was graded relative to whether evidence exists that the criterion is satisfied (value 1), not satisfied (value 0) or partially satisfied (value 0.5). The values obtained were added and reported according to a scale of three implementation categories: adequate, intermediate and deficient. Results Implementation of residual indoor spraying and timely diagnosis was adequate in one country and intermediate or deficient in the rest. Insecticide-treated bed nets ranged between deficient and intermediate in all the countries, while implementation of artemisinin-based combination therapy (ACT) was adequate in three countries and intermediate in the other two countries evaluated. Conclusions Although ACT is the strategy with the better implementation in all countries, major gaps exist in implementation of the other three malaria control strategies in terms of technical criteria, coverage and quality desiredThe countries must implement action plans to close the gaps in the various criteria and thereby improve the performance of the interventions. The assessment tools developed, based on adequacy criteria, are considered useful for a rapid assessment by malaria control authorities in the different countries.

By involving citizens and health workers in producing evidence and learning, participatory action research has potential to organize community evidence, stimulate action, and challenge the marginalization that undermines achievement of universal health coverage. This paper summarizes and analyzes results of two sessions on this research model convened by the authors at the First Global Symposium on Health Systems Research in Montreux Switzerland, November 16-19, 2010. In so doing, it reviews case studies and experiences discussed, particularly their contribution to universal health coverage in different settings. The paper also reflects on challenges faced by participatory action research, and outlines recommendations from the two sessions, including creation of a learning network for participatory action research.

Objetivos En la mayoría de países de América Latina, la descentralización y otras políticas públicas han creado espacios públicos de participación donde representantes comunitarios, en conjunto con autoridades municipales y otros funcionarios públicos, definen y deciden planes de inversión social, incluyendo servicios de salud e infraestructura. En Guatemala, este espacio público lo constituye el sistema de Consejos de Desarrollo. Métodos Este estudio analiza la gobernanza de dicho sistema en una muestra de seis municipios rurales. Se utilizó un diseño descriptivo aplicando técnicas cualitativas y cuantitativas a partir de tres categorías centrales: los actores estratégicos, las reglas del juego y los niveles de asimetría de poder entre los actores. Resultados Los hallazgos revelan inconsistencias entre los actores que deben participar según el marco legal y los actores que lo hacen en la práctica. También identificó intereses divergentes para participar que afectan la posibilidad de alcanzar consenso durante la toma de decisiones. El análisis de las reglas del juego identificó mecanismos formales y no formales que favorecen la capacidad de influencia de unos actores sobre otros. Finalmente, el análisis de los niveles de asimetría de poder identificó que los representantes comunitarios cuentan con menores recursos de poder que los representantes institucionales (gobierno local y otras organizaciones gubernamentales). Los comunitarios también confrontan diferentes barreras para la participación y perciben una menor capacidad de influencia. Conclusiones Las barreras y menores recursos de poder, inciden en que los comunitarios tengan limitadas posibilidades para influir el proceso de toma de decisión en los Consejos de Desarrollo.

Governance refers to decision-making processes in which power relationships and actors and institutions' particular interests converge. Situations of consensus and conflict are inherent to such processes. Furthermore, decision-making happens within a framework of ethical principles, motivations and incentives which could be explicit or implicit. Health systems in most Latin-American and Caribbean countries take the principles of equity, solidarity, social participation and the right to health as their guiding principles; such principles must thus rule governance processes. However, this is not always the case and this is where the importance of investigating governance in health systems lies. Making advances in investigating governance involves conceptual and methodological implications. Clarifying and integrating normative and analytical approaches is relevant at conceptual level as both are necessary for an approach seeking to investigate and understand social phenomena's complexity. In relation to methodological level, there is a need to expand the range of variables, sources of information and indicators for studying decision-making aimed to greater equity, health citizenship and public policy efficiency.

Decentralisation and other public policies have created public spaces for participation in most Latin-American countries where community representatives, together with municipal authorities and other public functionaries, decide on social investment plans, including health services and infrastructure. The municipal development council system constitutes such public space in Guatemala.This study analysed such system's governance in a sample of 6 rural municipalities. A descriptive design was used, applying qualitative and quantitative techniques to study three central categories: the strategic actors, the rules of the game and power asymmetry levels amongst actors.The findings revealed inconsistencies amongst the actors who had to participate according to the legal framework and those actors who actually did so in practice. Divergent interests were also identified for participating which affected the possibility of reaching consensus during decision-making. Analysing the rules of the game led to identifying formal and non-formal mechanisms favouring some actors' ability to influence decisions. Analysing power asymmetry levels led to identifying that community representatives had fewer power resources than institutional representatives (local government and other government organisations). Community representatives also face different barriers blocking their participation and perceive a lesser capacity to influence decision-making.Existing barriers and fewer power resources experienced by community representatives reduce their abilities to influence decision-making in municipal development councils.