Abstract: Introduction: Advanced activities of daily living (A-ADLs) are an important indicator of adult functional status and active aging. However, few studies have investigated the influence of two personality attributes (openness to experience and resilience) on A ADLs, and there is no data in the Argentine context. The relationship between A-ADLs and openness and resilience were analyzed, and secondarily the relationship between openness and resilience was examined. Methods: 151 Argentineans (M age = 66) were evaluated with the Scale of Expansive Activities of Daily Life, the IPIP-NEO Personality Inventory and the Brief Resilient Coping Scale. Partial correlations and regression were carried out, controlling for age and education. Results: there were significant (moderate) correlations between all the variables of interest: openness, resilience and A-ADLs. The measures of resilience, openness and education explain 21 % of the variation in the A-ADLs score. Resilience was the variable that most influenced A-ADLs. Conclusion: a personality with more resilience and openness is associated with greater achievement of A-ADLs in Argentines ≥ 50 years old. It is suggested that the Argentine state implement public policies that promote recreational activity and social integration in older and middle age.

Resumo: Introdução: as atividades da vida diária avançadas (AVD-A) são um importante indicador do estado funcional adulto e do envelhecimento ativo. No entanto, poucos estudos investigaram a influência de dois atributos de personalidade (abertura a novas experiências e resiliência) sobre o AVD-A e não há dados no contexto argentino. Foi analisada a relação entre AVD-A, abertura e resiliência, e secundariamente foi examinada a relação entre abertura e resiliência. Materiais e métodos: foram avaliados 151 argentinos (M idade = 66 anos) com a Escala de Atividades Expansivas da Vida Diária, o Inventário de Personalidade IPIP-NEO e a Escala Breve de Enfrentamento Resiliente. Foram realizadas correlações parciais e regressão, controlando por idade e educação. Resultados: Foram encontradas correlações significativas (moderadas) entre todas as variáveis de interesse: abertura, resiliência e AVD A. As medidas de resiliência, abertura e escolaridade explicam 21 % da variância da pontuação do AVD-A. A resiliência foi a variável que mais influenciou o AVD-A. Conclusão: uma personalidade com maior resiliência e abertura está associada a maior realização de AVD-A em argentinos ≥ 50 anos. Sugere-se que o Estado argentino implemente políticas públicas que promovam a atividade recreativa e a integração social na meia-idade e terceira idade.

Resumen: Introducción: las actividades de la vida diaria avanzadas (AVD-A) son un importante indicador del estado funcional adulto y del envejecimiento activo. Sin embargo, pocos estudios investigaron la influencia de dos atributos de personalidad (apertura a nuevas experiencias y resiliencia) sobre las AVD-A y hasta donde se tiene conocimiento no hay datos en contexto argentino. Se analizó la relación de AVD-A con apertura y resiliencia, y secundariamente se examinó la relación entre apertura y resiliencia. Materiales y métodos: fueron evaluados 151 argentinos (M edad = 66) con la Escala de Actividades Expansivas de la Vida Diaria, el Inventario de Personalidad IPIP-NEO y la Escala Breve de Afrontamiento Resiliente. Se efectuaron correlaciones parciales y regresión, controlando por edad y educación. Resultados: se hallaron correlaciones significativas (moderadas) entre todas las variables de interés: apertura, resiliencia y AVD-A. Las medidas de resiliencia, apertura y educación explicaron el 21 % de la varianza del score de AVD-A. La resiliencia fue la variable que más influyó sobre las AVD-A. Conclusión: una personalidad con más resiliencia y apertura está asociada a mayor realización de AVD A en argentinos ≥ 50 años. Se sugiere al Estado argentino implementar políticas públicas que promuevan la actividad recreativa e integración social en mediana y tercera edad.

Este artigo analisou a gestão federal da Política Nacional de Atenção Integral Saúde do Homem (PNAISH) sob uma perspectiva histórico-crítica. Foi realizada análise documental do processo de implementação da política entre 2009 e 2024 contido no arquivo da Coordenação de Atenção à Saúde do Homem (COSAH). A análise de conteúdo resultou nas seguintes categorias temáticas: organização e gestão da COSAH; processo de revisão da PNAISH; e desafios e frentes estratégicas para a implementação da PNAISH. Foram encontradas fragilidades na institucionalização da coordenação, além de uma revisão da política, em 2021, marcada pelo discurso neoconservador, que excluiu as menções a gênero e direitos sexuais e reprodutivos. Esses princípios epistemológicos da PNAISH foram retomados em 2023 com ações de qualificação da Atenção Primária para abordagem das repercussões do machismo e do patriarcado sobre a saúde de homens, mulheres e crianças.

Este artículo analizó la gestión federal de la Política Nacional de Atención Integral Salud del Hombre (PNAISH), bajo una perspectiva histórico-crítica. Se realizó un análisis documental del proceso de implementación de la política entre 2009 y 2024, contenida en el archivo de la Coordinación de Atención a la Salud del Hombre (COSAH). El análisis de contenido resultó en las siguientes categorías temáticas: organización y gestión de la COSAH; proceso de revisión de la PNAISH; y desafíos y frentes estratégicos para la implementación de la PNAISH. Se encontraron fragilidades en la institucionalización de la coordinación, además de una revisión de la política, en 2021, marcada por el discurso neoconservador que excluyó las menciones a género y derechos sexuales y reproductivos. Esos principios epistemológicos de la PNAISH se retomaron en 2023 a partir de acciones de calificación de la atención primaria para el abordaje de las repercusiones del machismo y del patriarcado sobre la salud de hombres, mujeres y niños.

This study analyzed federal government management of the National Policy for Comprehensive Men's Health Care (PNAISH) from a critical historical perspective. We analyzed documents addressing the policy implementation process between 2009 and 2024 contained in the archives of the National Office for the Coordination of Men’s Healthcare (COSAH). The content analysis resulted in the following thematic categories: COSAH organization and management; the PNAISH review process; and challenges and key strategic areas for implementing the PNAISH. We found weaknesses in the institutionalization of coordination, in addition to a policy review in 2021 marked by neoconservative discourse excluding gender and sexual and reproductive rights. These epistemological principles of the PNAISH were revisited in 2023, stemming from actions to improve the quality of primary care addressing the effects of machismo and patriarchy on men’s, women’s and children’s health.

Abstract Mapping is relevant for creating socio-territorial diagnostics as it allows an approach to public policies from the definitions, objectives, resources, and approaches they entail. This article contains and develops a mapping proposal as a theoretical-methodological tool that aims to contribute to the design, monitoring, and evaluation of social policies in four intermediate cities in the province of Córdoba, Argentina. The proposal is structured into five components: 1) policy selection; 2) description of dimensions; 3) data analysis; 4) systematization; and 5) scheme development. The authors consider mapping a strategy that can be included in instances of dialogue and negotiation and offer a dynamic image of state interventions regarding decision-making in the cities of Villa María, Villa Nueva, San Francisco, and Bell Ville in the province of Córdoba.

Resumen Los mapeos son relevantes para la creación de diagnósticos socio-territoriales ya que permiten un acercamiento a las políticas públicas desde las definiciones, objetivos, recursos y abordajes que suscitan. Este artículo contiene y desarrolla una propuesta de mapeo como herramienta teórico-metodológico que espera contribuir al diseño, seguimiento y evaluación de las políticas sociales en cuatro ciudades intermedias de la provincia de Córdoba, en Argentina. La propuesta se estructura en cinco componentes: 1) selección de políticas; 2) descripción de dimensiones; 3) análisis de datos; 4) sistematización; y 5) elaboración de esquema. Las autoras consideran que el mapeo es una estrategia que puede incluirse en las instancias de diálogo y negociación y ofrecer una imagen dinámica de las intervenciones estatales respecto a la toma de decisiones en las ciudades de Villa María, Villa Nueva, San Francisco y Bell Ville en la provincia de Córdoba.

Abstract To describe the current situation of some elements of the food systems in Colombia, a narrative literature review was conducted from the years 2003 to 2023 It was found that agricultural production predominates in this country based on monocultures with intensive use of pesticides and fertilizers, extensive livestock farming on large estates, and the area occupied by small producers is small. The contribution of the agricultural sector to the gross domestic product is low and it depends on food imports for the internal supply. More than half of the population has difficulties accessing food, which may explain the prevalence of malnutrition and non-communicable diseases. Healthy and sustainable agricultural production policies and measures aimed at improving food environments are required to improve people's health and maintain biodiversity.

Resumen Se realizó una revisión narrativa de literatura de los años 2003 a 2023, para describir la situación actual de algunos elementos de los sistemas alimentarios en Colombia. Se encontró que en este país predomina la producción agrícola basada en monocultivos con uso intensivo de plaguicidas y fertilizantes químicos y la ganadería extensiva en latifundios, el área ocupada por pequeños productores es reducida. El aporte del sector agropecuario al producto interno bruto es bajo y se depende de importaciones de alimentos para el abastecimiento. Más de la mitad de la población tiene dificultades para acceder a los alimentos, lo que puede explicar la prevalencia de malnutrición y enfermedades no transmisibles en la población. Se requieren políticas de producción agropecuaria saludable y sustentable, y medidas dirigidas a mejorar los entornos alimentarios para mejorar la salud de las personas y mantener la biodiversidad.

Abstract Using the multilevel and multi-stakeholder governance approach, this article investigates the effective promotion of sustainable development in the Northeast of Uruguay in the departments of Tacuarembó, Rivera and Cerro Largo. This development is approached from the perspective of integrated water resources management (IWRM) and waste management (WRM), through a case study that includes participant observation and interviews with key actors within the territory. Although the three departments share a territorial and human development backlog, what really differentiates them are the weaknesses and tensions to generate agreements and resolutions, as well as the different levels of multi-stakeholder articulation with regulations, plans, public policies and the respective instances. The conclusions warn that these internal dynamics affect the response capacity and decision making of the three departments with a view to IWRM and WRM.

Resumen Empleando el enfoque de la gobernanza multinivel y multiactoral, este artículo indaga por la efectiva promoción del desarrollo sostenible en el Noreste de Uruguay, específicamente en los departamentos de Tacuarembó, Rivera y Cerro Largo. Este desarrollo se aborda desde la gestión integrada de recursos hídricos (GIRH) y de residuos (GIR), mediante un estudio de caso que incluye observación participante y entrevistas a actores clave. Aunque los tres departamentos comparten un rezago territorial y de desarrollo humano, lo que realmente los diferencia son las debilidades y tensiones para generar acuerdos y resoluciones, así como los diferentes niveles de articulación multiactoral con la normativa, los planes, las políticas públicas y las instancias respectivas. Las conclusiones advierten que estas dinámicas internas afectan la capacidad de respuesta y la toma de decisiones de los tres departamentos en relación con la GIRH y la GIR.

Abstract The initial teacher training for basic education gained prominence on the Brazilian public agenda in the 2000s, leading to a series of public policies. One of these policies involved reserving 20 % of the seats in the newly created Federal Institutes for initial teacher training, in what were called undergraduate teaching courses. At the time, there was a growing shortage of teachers, both in quantitative terms (reflected in the lack of teachers) and qualitative terms (with many professionals in the classroom who did not have specific graduation in the subject they were teaching). This study specifically focuses on the Federal Institutes, with the aim of analyzing their impact on improving the educational indicator "teacher training adequacy," an instrument used by the Ministry of Education to monitor the progress of public policies designed to address issues related to teaching in basic education. Using a quantitative and descriptive correlational approach, the study uses three statistical databases from the Ministry of Education to explore the relationship between the availability of seats in teaching courses and the teacher training adequacy indicator. In the end, it confirms the hypothesis that the Federal Institutes contributed to raising the mentioned indicator: on average, the 336 Brazilian cities that have Federal Institutes showed a 5.2 % higher performance in teacher training adequacy when compared to cities without the presence of the institution.

Resumen La formación inicial de docentes para la enseñanza de la educación básica ganó protagonismo en la agenda pública brasileña en la década del 2000, generando una serie de políticas públicas. Una de estas políticas implicó reservar el 20 % de las plazas en los recién creados Institutos Federales para la formación inicial de docentes, en las llamadas carreras de licenciatura. En su momento se diagnosticó el agravamiento de la escasez de docentes, tanto en términos cuantitativos (traducidos en falta de docentes) como cualitativos (con muchos profesionales en las aulas que no contaban con una titulación específica en el componente curricular que impartían). Este estudio depende precisamente de los Institutos Federales y tiene como objetivo analizar su impacto en la mejora del indicador educativo “adecuación de la formación docente”, instrumento utilizado por el Ministerio de Educación en el seguimiento de los avances en las políticas públicas destinadas a enfrentar los problemas que orbitan alrededor de enseñanza en la educación básica. Con un enfoque cuantitativo y de carácter descriptivo y correlacional, el estudio utiliza tres bases de datos estadísticas del Ministerio de Educación para explorar la relación entre la oferta de plazas en carreras de licenciatura y el indicador de adecuación de la formación docente. Al final, se confirma la hipótesis de que los Institutos Federales colaboraron para elevar el indicador antes mencionado: en promedio, las 336 ciudades brasileñas que tienen Institutos Federales que ofrecen cursos de licenciaturas presentaron un desempeño 5,2 % mayor en la adecuación de la formación docente en comparación con las ciudades sin la presencia de la institución.

Abstract Based on the scenario of a low degree of national coordination in the educational policy of the Brazilian federation, the article aims to identify and discuss the challenges, mechanisms and contexts that motivated, in 2016, the decision by the government of Espírito Santo to adopt and institutionalize the Pact for Learning (PAES) inspired by the collaborative regime program of the state of Ceará. To achieve the proposed objective, this case study was based on exploratory research with qualitative bibliographic and documentary studies, linked to the concept of public policy diffusion. The results showed that the adoption of the program was consolidated through cooperation and learning mechanisms and that the policy adopted had, in its conception, a certain structural rigidity that disregarded local contexts and factors. The discussions emphasized the central role played by the National Council of Education Secretaries and third sector institutions in fostering a network of horizontal interaction that encouraged the spread of ideas and successful public policy models. It was concluded that the adoption of the program was an isolated government decision and that social protagonism was not taken into account in the policy formulation and construction stages. Finally, it was inferred that the lack of a National Education System compromises articulation and cooperation between education systems.

Resumen Partiendo del escenario de un bajo grado de coordinación nacional en la política educativa de la federación brasileña, el artículo tiene como objetivo identificar y discutir los desafíos, mecanismos y contextos que motivaron, en 2016, la decisión del gobierno de Espírito Santo de adoptar e institucionalizar el Pacto por el Aprendizaje (PAES) inspirado en el programa esquema de colaboración en el estado de Ceará. Para lograr el objetivo propuesto, este estudio de caso se basó en una investigación exploratoria con estudios bibliográficos y documentales cualitativos, vinculados al concepto de difusión de políticas públicas. Los resultados mostraron que la adopción del programa se consolidó a través de mecanismos de cooperación y aprendizaje y que la política adoptada tuvo, en su concepción, cierta rigidez estructural que desconocía los contextos y factores locales. Las discusiones enfatizaron el papel central desempeñado por el Consejo Nacional de Secretarios de Educación y las instituciones del tercer sector en el fomento de una red de interacción horizontal que estimuló la propagación de ideas y modelos exitosos de políticas públicas. Se concluyó que la adopción del programa fue una decisión gubernamental aislada y que el protagonismo social no fue considerado en las etapas de formulación y construcción de políticas y, finalmente, se infirió que la falta de un Sistema Educativo Nacional compromete la articulación y cooperación entre la educación. sistemas.

Abstract Introduction: Research on the governmental approach to drug trafficking in the province of Buenos Aires establishes that most governments have dismissed this problem and dealt with it superficially. However, little is known about the performance of the provincial government headed by María Eugenia Vidal (2015-2019) in this area. Objective: In this framework, the work aims to contribute to the knowledge about the discourses and governmental practices regarding drug trafficking during Vidal's administration. Methodology: For this purpose, a qualitative methodology based on the application of a case study and a theoretical approach based mainly on the notion of public policies to control drug trafficking is proposed. Conclusions: The article highlights the discursive overreaction and the profound lack of knowledge that prevails in the provincial sphere in terms of drug trafficking control and the deficiencies exhibited by the institutional actions and policies promoted by the government of Buenos Aires during the period in question.

Resumen Introducción: las investigaciones sobre el abordaje gubernamental del narcotráfico en la provincia de Buenos Aires establecen que la mayoría de los gobiernos desestimaron esta problemática y la afrontaron de manera superficial. Sin embargo, poco se conoce respecto del desempeño del gobierno provincial encabezado por María Eugenia Vidal (2015-2019) en esa materia. Objetivo: en este marco, el trabajo tiene por objeto aportar al conocimiento sobre los discursos y las prácticas gubernamentales en torno al narcotráfico durante la gestión de Vidal. Metodología: se propone una metodología cualitativa basada en la aplicación de un estudio de caso y un enfoque teórico asentado, principalmente, en la noción de políticas públicas de control del narcotráfico. Conclusiones: el artículo evidencia la sobreactuación discursiva y el profundo desconocimiento que predomina en el ámbito provincial en materia de control del narcotráfico, y las deficiencias que exhibieron las acciones institucionales y políticas impulsadas por el gobierno bonaerense durante el periodo señalado.

Abstract Over the last four decades, Ecuador has experienced a series of social, economic, and political conflicts that have significantly affected the well-being of its population due to governmental decisions, natural disasters, and structural problems such as unemployment, poverty, and transnational crime. This research analyzes social conflicts in the public sector and the involvement of mediation in the branches of government. The approach applied was descriptive and qualitative to identify trends and emerging conflicts, as well as prospective research to understand the history of conflicts and the evolution of mediation. Finally, statistics on mediation in the public sector were analyzed to assess its effectiveness and scope. The results highlight the need to implement mediation as a state policy to effectively address conflicts and promote social cohesion. Although mediation has been used in the judicial sphere, its application in other branches of government and in society, in general, is limited. However, there is an increase in the use of mediation in the public sector, suggesting a growing recognition of its effectiveness in conflict resolution, promoting a culture of peace and peaceful coexistence.

Resumen Durante las últimas cuatro décadas, Ecuador ha experimentado una serie de conflictos sociales, económicos y políticos que han afectado significativamente el bienestar de su población, debido a decisiones gubernamentales, desastres naturales y problemas estructurales como el desempleo, la pobreza y la delincuencia transnacional. Esta investigación analizó los conflictos sociales en el ámbito público y la participación de la mediación en los poderes del Estado. El enfoque aplicado fue el descriptivo y cualitativo para identificar tendencias y conflictos emergentes, así como el estudio prospectivo para entender la historia de los conflictos y la evolución de la mediación. Finalmente, se analizaron estadísticas de mediación en el sector público para evaluar su efectividad y alcance. Los resultados evidenciaron la necesidad de implementar la mediación como una política estatal para abordar los conflictos de manera efectiva y promover la cohesión social. Aunque la mediación se ha utilizado en el ámbito judicial, su aplicación en otros poderes del Estado y en la sociedad en general es limitada. Sin embargo, se observa un aumento en el uso de la mediación en el sector público, lo que sugiere un reconocimiento creciente de su eficacia en la resolución de conflictos como cultura de paz y la convivencia pacífica.

Abstract In Colombia, public policies aimed at the youth population were structured under the framework of social, economic, and cultural rights established by the national constitution of 1991, which allowed for broadening perspectives regarding the role of this age group and its life cycle. In this article, I focus on public policies aimed at youth in Colombia between 1992 and 2022, especially in relation to youth employment, which constitutes the case study. The analysis seeks to contrast theoretical patterns regarding the role of young people with the role assigned to them in public policy, examining national development plans, documents from the National Council for Economic and Social Policy (CONPES, in Spanish), and employment programs, to demonstrate changes and advances towards the recognition of their rights. It is concluded that the governmental structure implemented for the development of these policies, as well as their respective programs, have limited the continuity and progression of youth rights, as a vision prevails in which youth is understood as a transitional stage and family and individual resources determine to a great extent the effective enjoyment of rights.

Resumen En Colombia, las políticas públicas orientadas a la población joven se estructuraron bajo el marco de los derechos sociales, económicos y culturales establecido por la Constitución Política aprobada en el año 1991, lo que permitió ampliar la perspectiva sobre el rol de este grupo etario y de su ciclo de vida. En el presente artículo me enfoco en las políticas públicas dirigidas a la juventud en Colombia entre 1992 y 2022, ahondando especialmente en lo relacionado al empleo juvenil, el cual constituye el caso de estudio. El análisis busca contrastar los patrones teóricos sobre el papel de los y las jóvenes con el rol que se les asigna en la política pública, examinando los planes de desarrollo nacional, los documentos publicados por el Consejo Nacional de Política Económica y Social (CONPES) y los programas de empleo, con el fin de evidenciar los cambios y la evolución hacia el reconocimiento de sus derechos. Se concluye que la estructura gubernamental implementada para el desarrollo de estas políticas, al igual que sus respectivos programas, han limitado la continuidad y la progresión de los derechos juveniles, pues prevale una visión donde se entiende a la juventud como una etapa de transición en la que los recursos familiares e individuales determinan en gran medida el goce efectivo de sus derechos.

Abstract This study analyzes spatial patterns in the entrepreneurial intention of university students in Latin America. Studies on the entrepreneurial phenomenon have paid little attention to possible spatial associations, which might explain the dissimilar results reported by prior work. The analysis uses a sample of 70,337 university students drawn from the GUESSS survey. The results of the exploratory spatial model reveal significant spatial patterns in Costa Rica and Panama with a high entrepreneurial intention (hot spots). This study can serve as a basis for developing public policies to promote entrepreneurship and, when appropriate, propose articulated and coordinated strategic initiatives between countries located in the identified clusters (hot/cold spots).

Resumen El objetivo de este trabajo es de analizar los patrones espaciales de la intención emprendedora de los estudiantes universitarios en el continente americano. Los estudios sobre el fenómeno emprendedor han omitido la posible asociación espacial, lo cual podría explicar la inconsistencia de los resultados y conclusiones de investigaciones anteriores. Los datos se han obtenido de la Encuesta GUESSS y contienen una muestra inicial de 70,337 participantes. El Análisis Exploratorio de Datos Espaciales demuestra patrones espaciales en Costa Rica y Panamá con una alta intención emprendedora (hot spots). Este estudio puede servir de base para el desarrollo de políticas públicas que promuevan y apoyen el emprendimiento; y, cuando sea pertinente, proponer iniciativas estratégicas articuladas y coordinadas entre países basadas en la ubicación se estos en los clústers identificados (hot/ cold spots).

A gravidez na adolescência é um desafio de saúde pública no Brasil, com uma taxa de fecundidade de 43,6 nascimentos por mil meninas de 15 a 19 anos em 2022. Este estudo investigou as desigualdades nas taxas de fecundidade adolescente (TFA) nos municípios brasileiros, utilizando dados do Sistema de Informações sobre Nascidos Vivos (SINASC) e do Censo Demográfico de 2022. A análise considerou nascimentos entre 2020 e 2022, excluindo municípios com menos de 50 nascimentos nos três anos. As TFAs municipais foram comparadas com a taxa média de países classificados por nível de renda (alta, média-alta, média-baixa e baixa renda) e descritas conforme o Índice Brasileiro de Privação e o tamanho populacional. As desigualdades dentro de cada região geográfica foram avaliadas usando a diferença absoluta média em relação à média regional e a amplitude. Foram observadas grandes disparidades nas TFAs entre as regiões, com o Norte e Nordeste apresentando as maiores taxas, e o Sul e Sudeste, as menores. O Centro-Oeste teve valores intermediários. As desigualdades entre os municípios foram evidenciadas por gráficos e índices, com uma pequena parcela de municípios da região Norte mostrando TFA excepcionalmente alta. Foi identificada uma forte associação entre vulnerabilidade social e gravidez precoce, com municípios em situações de maior privação apresentando taxas de fecundidade marcadamente mais altas. Os resultados destacam a necessidade de políticas públicas que abordem os determinantes contextuais subjacentes para reduzir as taxas de fecundidade entre adolescentes no Brasil. Versão em Português: https://doi.org/10.1590/SciELOPreprints.11537

Adolescent childbearing is a major public health challenge in Brazil, with a fertility rate of 43.6 births per thousand girls aged 15-19 years in 2022. This study investigated inequalities in adolescent fertility rates (AFR) across Brazilian municipalities, utilizing data from the National Live Births Information System (SINASC) and the 2022 Demographic Census. Analyses included births between 2020 and 2022, excluding municipalities with fewer than 50 births in the 3 years. Municipal AFRs were compared with the average rate in countries classified by income level (high, upper-middle, lower-middle, and low income) and described according to the Brazilian Deprivation Index and population size. Inequalities within each geographic region were assessed using the mean absolute difference to the regional mean and range. Substantial disparities in AFR across regions were found, with the North and Northeast exhibiting the highest estimates, while the South and Southeast showed comparatively lower rates. The Midwest presented intermediate values. We found vast inequalities between municipalities, revealed by graphs and summary measures. A small proportion of municipalities, concentrated in the North region, experience exceptionally high AFR. A strong association between social vulnerability and early childbearing was also identified. Municipalities with higher levels of deprivation had markedly higher AFR, underscoring the influence of broader socio-economic factors on adolescent fertility. The results emphasize the need for targeted interventions and policies that address these underlying contextual determinants to reduce fertility rates among girls in Brazil effectively. Versão em Português: https://doi.org/10.1590/SciELOPreprints.11537

Adolescent childbearing is a major public health challenge in Brazil, with a fertility rate of 43.6 births per thousand girls aged 15-19 years in 2022. This study investigated inequalities in adolescent fertility rates (AFR) across Brazilian municipalities, utilizing data from the National Live Births Information System (SINASC) and the 2022 Demographic Census. Analyses included births between 2020 and 2022, excluding municipalities with fewer than 50 births in the 3 years. Municipal AFRs were compared with the average rate in countries classified by income level (high, upper-middle, lower-middle, and low income) and described according to the Brazilian Deprivation Index and population size. Inequalities within each geographic region were assessed using the mean absolute difference to the regional mean and range. Substantial disparities in AFR across regions were found, with the North and Northeast exhibiting the highest estimates, while the South and Southeast showed comparatively lower rates. The Midwest presented intermediate values. We found vast inequalities between municipalities, revealed by graphs and summary measures. A small proportion of municipalities, concentrated in the North region, experience exceptionally high AFR. A strong association between social vulnerability and early childbearing was also identified. Municipalities with higher levels of deprivation had markedly higher AFR, underscoring the influence of broader socio-economic factors on adolescent fertility. The results emphasize the need for targeted interventions and policies that address these underlying contextual determinants to reduce fertility rates among girls in Brazil effectively. English version: https://doi.org/10.1590/SciELOPreprints.11534

A gravidez na adolescência é um desafio de saúde pública no Brasil, com uma taxa de fecundidade de 43,6 nascimentos por mil meninas de 15 a 19 anos em 2022. Este estudo investigou as desigualdades nas taxas de fecundidade adolescente (TFA) nos municípios brasileiros, utilizando dados do Sistema de Informações sobre Nascidos Vivos (SINASC) e do Censo Demográfico de 2022. A análise considerou nascimentos entre 2020 e 2022, excluindo municípios com menos de 50 nascimentos nos três anos. As TFAs municipais foram comparadas com a taxa média de países classificados por nível de renda (alta, média-alta, média-baixa e baixa renda) e descritas conforme o Índice Brasileiro de Privação e o tamanho populacional. As desigualdades dentro de cada região geográfica foram avaliadas usando a diferença absoluta média em relação à média regional e a amplitude. Foram observadas grandes disparidades nas TFAs entre as regiões, com o Norte e Nordeste apresentando as maiores taxas, e o Sul e Sudeste, as menores. O Centro-Oeste teve valores intermediários. As desigualdades entre os municípios foram evidenciadas por gráficos e índices, com uma pequena parcela de municípios da região Norte mostrando TFA excepcionalmente alta. Foi identificada uma forte associação entre vulnerabilidade social e gravidez precoce, com municípios em situações de maior privação apresentando taxas de fecundidade marcadamente mais altas. Os resultados destacam a necessidade de políticas públicas que abordem os determinantes contextuais subjacentes para reduzir as taxas de fecundidade entre adolescentes no Brasil. English version: https://doi.org/10.1590/SciELOPreprints.11534

The interactions between the state and civil society in the production of public policies are the subject of intense theoretical debate in the literature. The relationship between institutionalization processes and the fundamental characteristics of policy sectors remains insufficiently understood, particularly regarding the factors that enhance or limit civil society's influence when engaged in these processes. We argue that even in successful cases of institutionalization, some policy sectors are marked by sectoral hermeticism — a concept developed based on contributions from historical institutionalism and public policy literature to illuminate a specific configuration of the constitutive characteristics of policy production and the actors endowed with institutional resources to drive this process. The article proposes two analytical models: the first defines the constitutive dimensions of sectoral hermeticism and the conditions that favor its continuity or transformation; the second examines the possibilities for change in policy sectors characterized by such hermeticism. This model explores three possible pathways for institutionalization trajectories driven by civil society actors, either within the constraints of hermeticism or by reforming it. In the former case, the paths of adjusted institutionalization and demarcated institutionalization are possible; in the latter, the path of reformative institutionalization is only viable when preceded by a sweeping sectoral reform capable of reshaping the sector's status quo.

As interações entre Estado e sociedade civil na produção de políticas públicas são objeto de intenso debate teórico na literatura. A relação entre processos de institucionalização e características fundamentais dos setores de políticas públicas ainda é insuficientemente compreendida quanto aos fatores que ampliam ou limitam a incidência da sociedade civil quando engajada nesses processos. Argumentamos que, mesmo em casos bem-sucedidos de institucionalização, alguns setores de políticas são marcados por hermetismo setorial, conceito desenvolvido com base em contribuições do neoinstitucionalismo histórico e da literatura de políticas públicas para iluminar um tipo de configuração das características constitutivas da produção da política e dos atores investidos de recursos institucionais para conduzir essa produção. O artigo propõe dois modelos analíticos: o primeiro delimita as dimensões constitutivas do hermetismo setorial e das condições que favorecem sua continuidade ou transformação; o segundo examina as possibilidades de mudança nos setores de políticas marcados por tal hermetismo. Neste modelo examinam-se três caminhos possíveis para trajetórias de institucionalização impulsionadas por atores da sociedade civil, quer dentro das restrições derivadas do hermetismo ou quer reformando-o. No primeiro caso, os caminhos da institucionalização ajustada e da institucionalização demarcada são possíveis, no segundo, o caminho da institucionalização reformadora apenas é viável quando precedido por uma reforma setorial abrangente, capaz de reconfigurar o status quo do setor.

ABSTRACT: Maxillofacial trauma is one of the fields of surgical activity in our specialty and constitutes a relevant problem in highly complex hospitals, the presence of our specialists being essential within an interdisciplinary team for the resolution of this type of pathology. An adequate management and early treatment is essential from the moment the patient is admitted, without leaving aside the sequelae and the subsequent rehabilitation work for the work and daily reinsertion of the patients. The purpose of this work is to present the experience of the Maxillofacial Surgery team of the Rancagua Hospital in the surgical resolution of 320 maxillofacial fractures with a retrospective review of 5 years. A study was carried out with analysis of the surgical protocols of patients operated on for maxillofacial trauma, in the central pavilion, under general anesthesia, in a period of 5 years. The variables analyzed were diagnosis, age, sex, compromised facial third, type of fracture, approaches used, and type of rigid internal fixation. 368 surgical procedures were performed. The average age of the operated patients was 36 years, with a predominance of the male sex (80.4 %), the middle third was the most affected (49.1 %) followed by fractures of the lower third of the face (35.5 %). It is necessary to develop epidemiological investigations of these pathologies in order to obtain demographic conclusions and contribute to unifying diagnostic and treatment criteria, thus establishing efficient prevention and treatment policies in relation to each service and as a whole at the public health level.

RESUMEN: El trauma maxilofacial es uno de los campos de actividad quirúrgica en nuestra especialidad y constituye un problema relevante en hospitales de alta complejidad, siendo esencial la presencia de nuestros especialistas dentro de un equipo interdisciplinario para la resolución de este tipo de patología. Un manejo adecuado y un tratamiento temprano son esenciales desde el momento en que el paciente es admitido, sin dejar de lado las secuelas y el posterior trabajo de rehabilitación para la reinserción laboral y diaria de los pacientes. El propósito de este trabajo es presentar la experiencia del equipo de Cirugía Maxilofacial del Hospital Dr. Franco Ravera Zunino en la resolución quirúrgica de 320 fracturas maxilofaciales con una revisión retrospectiva de 5 años. Se realizó un estudio con análisis de los protocolos quirúrgicos de pacientes operados por trauma maxilofacial, en pabellón central, bajo anestesia general, en un período de 5 años. Las variables analizadas fueron diagnóstico, edad, sexo, tercio facial comprometido, tipo de fractura, enfoques utilizados y tipo de fijación interna rígida. Se realizaron 368 procedimientos quirúrgicos. La edad promedio de los pacientes operados fue de 36 años, con predominio del sexo masculino (80,4 %), el tercio medio fue el más afectado (49,1 %) seguido de las fracturas del tercio inferior de la cara (35,5 %). Es necesario desarrollar investigaciones epidemiológicas de estas patologías para obtener conclusiones demográficas y contribuir a la unificación de criterios diagnósticos y de tratamiento, estableciendo así políticas eficientes de prevención y tratamiento en relación a cada servicio y en conjunto a nivel de salud pública.