Given the extreme importance of improving the accountability of Private Social Solidarity Institutions (IPSS), both for reasons of legal compliance (hard law) and for reasons of improving legitimacy and notoriety among their stakeholders (soft law), this paper aims to present a framework designed under a more comprehensive research project, for the assessment of IPSS accountability and, consequently, its improvement. This study also present results of the indicators conceived, identifying the main trends of the framework dimensions and sub-dimensions from a pilot test for the years 2018, 2019 and 2020 in Portugal. Given the results, we believe that the framework designed answers the research question: How to promote accountability (social, financial and economic) in the social economy sector, in particular: the case of the IPSS?, however, as this is an exploratory article, it incorporates the limitation that this is a pilot test with only 7 entities.

To examine the association of clinical, treatment, and dose parameters with late urinary toxicity after low-dose-rate brachytherapy (LDR-BT) for prostate cancer, we retrospectively studied patients with prostate cancer who underwent LDR-BT from January 2007 through December 2016. Urinary toxicity was assessed using the International Prostate Symptom Score (IPSS) and Overactive Bladder (OAB) Symptom Score (OABSS). Severe and moderate lower urinary tract symptoms (LUTS) were defined as IPSS ≥ 20 and ≥ 8, respectively; OAB was defined as a nocturnal frequency of ≥ 2 and a total OABSS of ≥ 3. In total, 203 patients (median age, 66 years) were included, with a mean follow-up of 8.4 years after treatment. The IPSS and OABSS worsened after 3 months of treatment; these scores improved to pretreatment levels after 18–36 months in most patients. Patients with a higher baseline IPSS and OABSS had a lower frequency of moderate and severe LUTS and OAB at 24 and 60 months, respectively. LUTS and OAB at 24 and 60 months were not correlated with the dosimetric factors of LDR-BT. Although the rate of long-term urinary toxicities assessed using IPSS and OABSS was low, the baseline scores were related to long-term function. Refining patient selection may further reduce long-term urinary toxicity.