Working with Youth as Stakeholders in Mental Health System Transformation: An Institutional Ethnography of a Service Organization in ACCESS Open Minds

As national system- and research-agendas invest heavily in the improvement of youth mental health services delivery, the discursive and policy impetus for the inclusion of youth as advisors has increased. However, we know little about the work of youth engagement (YE) in the everyday realities of a care-delivery organization. Does the engagement of youth advisors ultimately inform care? This dissertation addresses the knowledge concerns of YE with a detailed account of the experiences of youth advisors, service providers, and an organization in the process of services reform. I used institutional ethnography to (1) reveal the day-to-day work of engaging young people as advisors to a mental health services delivery site; (2) examine the linkages and tensions between the discourse of YE and its realities in practice; and, (3) understand the processes by which youths’ knowledge is articulated and admitted to organizational decision-making. Fieldwork consisted of meeting observations and interviews with service providers and youth advisors, and a discourse analysis of YE practice texts to understand how their discursive framings coordinate local work. Detailing engagement work made visible how service providers negotiate between a ruling discourse of engagement and the realities of mental health services delivery. They adapt to and resist problematic elements in the ideology of engagement, including its individualizing rhetoric and the omission of structural and social considerations. At the same time, they employ a youth-centred orientation made concrete by the youth advisors, using it to alter established organizational processes that have excluded youth as knowers from the institution of healthcare. Findings from this study were analyzed in light of recent work on epistemic injustice. This proved to be a useful lens, making more precise whether and how YE makes a difference to youth, the organization and the culture of mental healthcare. My findings underscore the necessity of framing YE as the labour of epistemic inclusion of youth in the design of formal systems of care. In telling this story of YE work at one service site, I suggest a new pathway for the operation and evaluation of engagement, as underpinning appropriate care and, ultimately, health equity

Promising points for intervention in re-imagining partnered research in health services comment on “Experience of health leadership in partnering with university-based researchers in Canada – A call to ‘re-imagine’ research”

In this commentary, we respond to Bowen and colleagues’ empirical study of research partnerships between Canadian health organizations and university-based investigators. We draw on our experiences of university and health-services partnerships to elaborate on some of the misalignments between researchers and health services leaders identified by Bowen et al. We take up Bowen and colleagues’ call to re-imagine research by proposing three promising points of intervention in research partnerships. These are: (1) orient towards research relationships rather than project-based partnerships; (2) recognize shared and diverging expectations and objectives; and (3) foster a more nuanced understanding of mutual gains

Our roles are not at ease: The work of engaging a youth advisory council in a mental health services delivery organization

Objectives: There is growing policy impetus for including youth voices in health services research and health system reform. This article examines the perspectives of professionals in a mental healthcare organization charged with engaging young people as advisors in service transformation. Methods: An institutional ethnography of a youth mental health services organization in Ontario, Canada, was conducted. Fieldwork consisted of twelve months of observation of meetings, interviews with youth advisors and adult service providers, with subsequent text analysis of engagement training and policy materials. The present article reports data from six adult professionals and related field observations. Results: Service providers’ efforts to engage youth were observed in three areas: a) supporting youth\u27s development as advisors, b) retaining and deepening youth participation while waiting for organizational change and c) embedding relationships between youth and adults at various levels within the system of care. This work denotes existing tensions between the values and ideals of youth engagement and the everyday demands of services delivery. Conclusion: In this setting, a fundamental dimension of this work consisted of negotiating tensions between the policy enthusiasm for engagement and its realization in a health services context. In describing these contextual challenges, we outline implications for consideration by other youth mental health services. Engagement efforts that are authentic and sustained require resources and flexibility, and leadership commitment to instil service users’ perspectives throughout multiple levels within the organization

Promising Points for Intervention in Re-Imagining Partnered Research in Health Services; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada – A Call to ‘Re-imagine’ Research”

In this commentary, we respond to Bowen and colleagues’ empirical study of research partnerships between Canadian health organizations and university-based investigators. We draw on our experiences of university and health-services partnerships to elaborate on some of the misalignments between researchers and health services leaders identified by Bowen et al. We take up Bowen and colleagues’ call to re-imagine research by proposing three promising points of intervention in research partnerships. These are: (1) orient towards research relationships rather than project-based partnerships; (2) recognize shared and diverging expectations and objectives; and (3) foster a more nuanced understanding of mutual gains

Informing ‘good’ global health research partnerships: A scoping review of guiding principles

Background: Several sets of principles have been proposed to guide global health research partnerships and mitigate inequities inadvertently caused by them. The existence of multiple sets of principles poses a challenge for those seeking to critically engage with and develop their practice. Which of these is best to use, and why? To what extent, if any, is there agreement across proposed principles? Objective: The objectives of this review were to: (1) identify and consolidate existing documents and principles to guide global health research partnerships; (2) identify areas of overlapping consensus, if any, regarding which principles are fundamental in these partnerships; (3) identify any lack of consensus in the literature on core principles to support these partnerships. Methods: A scoping review was conducted to gather documents outlining ‘principles’ of good global health research partnerships. A broad search of academic databases to gather peerreviewed literature was conducted, complemented by a hand-search of key global health funding institutions for grey literature guidelines. Results: Our search yielded nine sets of principles designed to guide and support global health research partnerships. No single principle recurred across all documents reviewed. Most frequently cited were concerns with mutual benefits between partners (n = 6) and equity (n = 4). Despite a lack of consistency in the inclusion and definition of principles, all sources highlighted principles that identified attention to fairness, equity, or justice as an integral part of good global health research partnerships. Conclusions: Lack of consensus regarding how principles are defined suggests a need for further discussion on what global health researchers mean by ‘core’ principles. Research partnerships should seek to interpret the practical meanings and requirements of these principles through international consultation. Finally, a need exists for tools to assist with implementation of these principles to ensure their application in research practice

What do we mean by critical and ethical global engagement? Questions from a research partnership between universities in Canada and Rwanda

Language – the words we use – can play a key role in enabling or limiting transformation of inequalities in the field of global health. At the same time, given the interdisciplinary, intersectoral, and international nature of much global health work, intended meanings, commitments, and underlying values for words used cannot be taken for granted. This commentary sets out to clarify, and in this manner render available for further discussion and debate, the phrase ‘critical and ethical global engagement’ (CEGE). It derives from discussions between scholars and partners in research, education, and healthcare practice based at one Canadian and two Rwanda institutions. Initially, our aim was to conceptualise the term ‘critical and ethical global engagement’ in order to guide our own practices. As the complexity of the values, commitments, and considerations underlying our use of this phrase emerged, however, we realised these discussions merited being captured and shared, to facilitate further exploration and exchange on this phrase

Carotenoides en agroalimentación y salud

Los carotenoides son compuestos especiales; si bien es común referirse a ellos como pigmentos, lo cierto es que son compuestos de gran versatilidad e importancia en la naturaleza. Más específicamente, son de gran interés en agroalimentación y salud. Así, por ejemplo, son pigmentos naturales y por lo tanto tienen un importante papel en la elección de alimentos por parte de los consumidores. Asimismo, algunos de ellos son precursores de la vitamina A. Sin embargo, que cada vez exista más interés en los carotenoides en este contexto se debe en gran parte a muchos estudios de distinta naturaleza que indican que pueden proporcionar beneficios para la salud. Su interés en alimentación funcional es por lo tanto indudable. En este libro se refleja la experiencia en carotenoides de un gran número de profesionales de la región iberoamericana. En conjunto, se ofrece una visión general de la investigación sobre estos compuestos en agroalimentación y salud. Los autores son miembros de la red ibercarot (http://carotenoides.us.es), que tiene entre sus objetivos conformar una red estable y funcional de profesionales que aúnen esfuerzos en pos de identificar nuevas fuentes de carotenoides de interés nutricional, mejorar su producción y aumentar el valor de los productos que los contengan. Me gustaría agradecer a todas y cada una de las personas que han contribuido de una u otra forma a que este libro sea una realidad. Todos esperamos que sea de ayuda para personas interesadas en los temas desarrollados. Gracias especialmente al Programa Iberoamericano de Ciencia y Tecnología para el Desarrollo (Cyted, http:// www.cyted.org/) que, con su apoyo económico a la red ibercarot, ha hecho posible que varias decenas de equipos interaccionen en torno a temas de interés común para contribuir al desarrollo a distintos niveles de la región iberoamericana.RED TEMÁTICA IBERCAROT (referencia 112RT445) http://carotenoides.us.es PROGRAMA IBEROAMERICANO DE CIENCIA Y TECNOLOGIA PARA EL DESARROLLO – CYTEDPeer reviewe

La investigación universitaria y sus contribuciones en Mesoamérica

La Universidad Autónoma de Chiapas a través de su Proyecto Académico 2014-2018, reafirma su compromiso con el desarrollo de nuestra región, al establecer líneas de desarrollo de nuestra región, al establecer líneas de desarrollo institucional, donde la vinculación de la investigación ocupa un lugar preponderante; en este sentido, a partir de 2015, junto con la comunidad académica internacional, se unió a la Agenda 2030 para el Desarrollo sostenible de la ONU y priorizó los 17 Objetivos de Desarrollo Sostenible (ODS) y sus 169 metas, con la finalidad de dar soluciona los grandes desafíos sociales, económicos y medioambientales que enfrenta la sociedad. Este libro es la recopilación de trabajos realizados por académicos de diversas Instituciones de Educación Superior y Centros de Investigación, de manera multidisciplinaria, interinstitucional e internacional, los cuales han permitido compartir intereses en diversas líneas de generación y aplicación del conocimiento

La investigación universitaria y sus contribuciones en Mesoamérica

La Universidad Autónoma de Chiapas a través de su Proyecto Académico 2014-2018, reafirma su compromiso con el desarrollo de nuestra región, al establecer líneas de desarrollo de nuestra región, al establecer líneas de desarrollo institucional, donde la vinculación de la investigación ocupa un lugar preponderante; en este sentido, a partir de 2015, junto con la comunidad académica internacional, se unió a la Agenda 2030 para el Desarrollo sostenible de la ONU y priorizó los 17 Objetivos de Desarrollo Sostenible (ODS) y sus 169 metas, con la finalidad de dar soluciona los grandes desafíos sociales, económicos y medioambientales que enfrenta la sociedad. Este libro es la recopilación de trabajos realizados por académicos de diversas Instituciones de Educación Superior y Centros de Investigación, de manera multidisciplinaria, interinstitucional e internacional, los cuales han permitido compartir intereses en diversas líneas de generación y aplicación del conocimiento