Abstract The persistent increase in cesarean deliveries as a means of completing pregnancy represents a critical public health issue worldwide. This has been highlighted by academia, international health institutions, and feminist studies. In Uruguay, 63.81% of births in the private sector and 36.19% in the public sector in 2023 were by cesarean section. Cesarean delivery on maternal request (CDMR) is one of the main causes of this increase, being considered a non-medically indicated intervention that may pose unnecessary risks to maternal-fetal health. From a principlist perspective, the ethical conflict between the principles of autonomy and non-maleficence is identified. This article explores the analysis of CDMR from a feminist bioethics perspective, proposing the notion of relational autonomy and shared decision-making as ethical frameworks to address this conflict and ensure the sexual and reproductive rights of pregnant individuals.

Resumo O aumento persistente das cesáreas como forma de concluir a gestação representa um problema crítico de saúde pública em nível global. Isso foi destacado pela academia, instituições internacionais de saúde e estudos feministas. No Uruguai, 63,81% dos nascimentos no setor privado e 36,19% no setor público em 2023 foram por cesariana. A cesárea por solicitação materna (CSM) é uma das principais causas desse aumento, sendo considerada uma intervenção sem indicação médica, que pode acarretar riscos desnecessários para a saúde materno-fetal. De uma perspectiva principialista, identifica-se o conflito ético entre os princípios de autonomia e não maleficência. Este artigo explora a análise das CSM a partir de uma perspectiva de bioética feminista, propondo a noção de autonomia relacional e a tomada de decisão compartilhada como estruturas éticas para abordar esse conflito e garantir os direitos sexuais e reprodutivos das gestantes.

Resumen El aumento persistente de las cesáreas como forma de culminar la gestación representa un problema crítico de salud pública a nivel global. Esto ha sido señalado por la academia, instituciones internacionales de salud y estudios feministas. En Uruguay, el 63,81% de los nacimientos en el sector privado y el 36,19% en el sector público en 2023 fueron por cesárea. La cesárea por petición materna (CPM) es una de las causas principales de este incremento, siendo considerada una intervención sin indicación médica, que puede acarrear riesgos innecesarios para la salud materno-fetal. Desde un enfoque principialista, se identifica el conflicto ético entre los principios de autonomía y no maleficencia. Este artículo explora el análisis de las CPM desde una perspectiva de bioética feminista, proponiendo la noción de autonomía relacional y la toma de decisiones compartidas como marcos éticos para abordar este conflicto y garantizar los derechos sexuales y reproductivos de las gestantes.

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 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 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.

RESUMEN Introducción: Las intervenciones en la salud pública cubana tienen la función de mejorar la calidad de vida de la población y brindar salud con el mejor costo posible. Este artículo pretende evaluar la efectividad de la cronoterapia a hipertensos diabéticos tipo dos, mediante un procedimiento metodológico, desde la perspectiva de un enfoque integral. Método: Se realizó una investigación analítica observacional, longitudinal y prospectiva en el Hospital Universitario Manuel Ascunce Domenech, en el período de enero 2022 a enero 2024. La muestra de estudio fue 220 pacientes mayores de 18 años de edad, diabéticos y no diabéticos con hipertensión no controlada. Se emplearon métodos empíricos, la revisión documental, encuestas, criterios de expertos, método Delphi y el método Iadov en su validación. Se aplicó el Statistical Packageforthe Social Sciences (SPSS V.24.0) para el análisis descriptivo o inferencial. Resultados: Se diseñó el procedimiento metodológico que permitió valorar la efectividad con enfoque integral de la cronoterapia a los pacientes hipertensos diabéticos tipo 2, en el proceso de monitorización ambulatoria de presión arterial. El índice de satisfacción grupal en el estudio según la técnica Iadov fue de 0,81, expresión de la aceptación y la utilidad de la propuesta. Discusión: La cronoterapia es una solución sostenible al control de hipertensos diabéticos tipo 2, la apreciación de su efectividad a partir de un enfoque integral, implica el análisis de la eficacia y eficiencia desde múltiples dimensiones como garantía de bienestar general de la población y mejor disponibilidad de los recursos destinados al sector público de la salud.

ABSTRACT Introduction: Interventions in Cuban public health have the function of improving the quality of life of the population and providing health at the best possible cost. This article aims to evaluate the effectiveness of chronotherapy for type two diabetic hypertensive patients, through a methodological procedure, from the perspective of a comprehensive approach. Method: An observational, longitudinal and prospective analytical research was carried out at the Manuel Ascunce Domenech University Hospital, in the period from January 2022 to January 2024. The study sample was 220 patients over 18 years of age, diabetic and non-diabetic with uncontrolled hypertension. Empirical methods, documentary review, surveys, expert criteria, Delphi method and the Iadov method were used in their validation. The Statistical Package for the Social Sciences (SPSS V.24.0) was applied for descriptive or inferential analysis. Results: The methodological procedure was designed to assess the effectiveness of chronotherapy with a comprehensive approach in type 2 diabetic hypertensive patients during the ambulatory blood pressure monitoring process. The group satisfaction index in the study according to the Iadov technique was 0.81, an expression of the acceptance and usefulness of the proposal. Discussion: Chronconapy is a sustainable solution to the control of type 2 diabetic hypertensive patients. The assessment of its effectiveness from a comprehensive approach implies the analysis of the efficacy and efficiency from multiple dimensions as a guarantee of general well-being of the population and better availability of resources destined to the public health sector.

Resumo A reestruturação produtiva das metrópoles ocidentais, nas últimas décadas do século XX, exigiu dos governos nacionais e locais o debate e a elaboração de novos instrumentos urbanísticos voltados à reconversão física e funcional dos espaços então ocupados pela atividade industrial. Este artigo examina os casos do projeto urbano de King’s Cross, em Londres, e da Operação Urbana Água Branca, em São Paulo, ambos pautados na parceria entre poder público e iniciativa privada, especialmente por meio da negociação de ativos urbanos. Constatamos que no caso internacional, embora se observem elementos de exclusão, o processo projetual mirou soluções integradas de requalificação socioambiental. No caso paulistano, o processo de implementação foi caracterizado pela prevalência da modelagem regulatória do espaço em detrimento do projeto urbano. ocidentais XX industrial Kings King s Cross Londres Branca Paulo privada urbanos internacional exclusão socioambiental paulistano

Abstract The production restructuring of Western metropolises in the last decades of the 20th century required national and local governments to debate and develop new urban planning instruments aimed at the physical and functional reconversion of spaces previously occupied by industrial activities. This article examines the cases of the King's Cross urban project in London and the Água Branca Urban Operation in São Paulo, both based on partnerships between the public sector and private initiative, particularly through the negotiation of urban assets. We found that in the international case, although elements of exclusion were observed, the design process aimed at integrated solutions for socio-environmental requalification. In the São Paulo case, the implementation process was characterized by the regulatory modeling of the space to the detriment of urban design. th activities Kings King s initiative assets case observed socioenvironmental socio environmental requalification

Universities face the challenges of substantial reforms such as new managerialism, corporatism, neoliberalism, McDonaldisation, entrepreneurialism, massification, decolonisation, and many other approaches, philosophies, and practices that influence the original idea of the university. In competitive environments, new managerialism in the public sector can be a means of achieving more efficient, flexible, and adaptable management, thus, the permeation and manifestation of new managerialism in public higher education engender business practices and private-sector ideas. Furthermore, these transformations include globalisation and internationalisation, mass participation and vocational credentialing; business-like administration and internal product and performance regimes; quasi-market competition between institutions; and the part marketisation of teaching and research and services. These managerialist ideas, embedded in a neo-liberal conception of globalisation, have specific implications for higher education in the sense that they have the potential to limit contribution to future public administration research and graduate products to serve as public servants. Compounding the situation is academic capitalism, academic entrepreneurs, entrepreneurial academics and the commodification and commoditisation of a public good (education). Furthermore, even research universities seem to be giving way to entrepreneurial universities and are associated with the emergence of corporate universities. The university's entrepreneurial behaviour is seen in professors' perspectives on the university's role in knowledge dissemination -innovation agents being entrepreneurial academics and academic entrepreneurs - the former resembles innovative university members, while the latter resembles a typical start-up entrepreneur. This "Stalinist plan or new managerialism or new functionalism" and entrepreneurialism represents a healthy capitalist enterprise and propel thinking about whether or not universities pursue epistemologies, ontological scholarship, research and curriculum to improve public administration. This conceptual paper identifies complexities in propelling universities to a higher fitness landscape in producing public administration research and graduates. This is because a public university now fends for itself as it influences distinctive segments of the economy and militates against origins of public administration.

In marketing, perception is reality. This scholarly discourse investigates the inherent bias manifested in the perceived disparity between qualifications conferred by private higher education institutions and public universities within the South African context. It is argued that Private Higher Education Institutions (PHEIs) are integral to the education system. Government funding for students who elect to study at a PHEI would be a strategic investment in the nation's future. The article begins with a summation of the higher education (HE) landscape in South Africa, highlighting the target student enrolment numbers set by the National Development Plan 2030 and the need for additional investment in the sector in its entirety. The article raises the question of what makes a qualification from one institution more valuable than a qualification from another registered within the same quality assurance and accreditation framework where students can articulate from private to public Institutions and vice versa. Furthermore, the article explores the constraints experienced by students eligible for financial assistance but excluded from eligibility by the National Student Financial Aid Scheme (NSFAS) when electing to study at a PHEI. The article emphasises the significance of addressing these biases and advocates for promoting the equitable treatment of PHEIs and public universities within the domestic HE landscape. The article highlights the need to improve access to HE and foster social justice in the South African HE system.

RESUMO O objetivo deste trabalho é descrever e analisar a composição do Movimento da Reforma Sanitária Brasileira (MRSB) no período 2013-2022, partindo do pressuposto de que a composição original pode ter se modificado em função das mudanças no cenário sociopolítico e da capacidade de mobilização dos militantes junto a diversos sujeitos políticos na conjuntura mais recente. Parte de um estudo mais amplo, a metodologia deste artigo utiliza a análise de documentos e notícias veiculados nos sites do Centro Brasileiro de Estudos de Saúde (Cebes) e da Associação Brasileira de Saúde Coletiva (Abrasco), e entrevistas realizadas com informantes-chave. Os resultados indicam a permanência do protagonismo político de sujeitos políticos coletivos historicamente vinculados ao MRSB, como o Cebes e a Abrasco, em torno dos quais se agregaram entidades que atuam no espaço setorial da saúde. Com a criação da Frente pela Vida (FpV), em 2020, verificou-se a ampliação do movimento, pela agregação de organizações e entidades que atuam no espaço societal. Conclui-se que o MRSB se mantém vivo e atuante, destacando-se que a atuação da FpV pode sinalizar a retomada da ‘via sociocomunitária’ na defesa da democracia, da Reforma Sanitária Brasileira e do Sistema Único de Saúde.

ABSTRACT The objective of this paper is to describe and analyze the composition of the Brazilian Health Care Reform Movement (MRSB) in the period 2013-2022, assuming that the original composition of the movement may have changed due to changes in the sociopolitical scenario and the ability of activists to mobilize with various political actors in the most recent context. Part of a broader study, the methodology of this article uses the analysis of documents and news published on the websites of Brazilian Center for Health Studies (CEBES) and the Brazilian Association of Public Health (ABRASCO), and interviews conducted with key informants. The results indicate the continued political protagonism of collective political actors historically linked to the MRSB, such as CEBES and ABRASCO, around which entities operating in the health sector have gathered. With the creation of the Frente pela Vida (FpV) in 2020, the movement expanded through the aggregation of organizations and entities that operate in the societal space. It is concluded that the MRSB remains alive and active, highlighting that the actions of the FpV may signal the resumption of the ‘socio-community path’ in the defense of democracy, Brazilian Health Reform and the Unified Health System.

RESUMEN Alinear los objetivos de aprendizaje con las necesidades del mercado laboral representa un desafío considerable para las universidades en la actualidad. A pesar de que las organizaciones demandan profesionales con competencias variadas y flexibles, a menudo las universidades subestiman la relevancia de las competencias transversales. Por tanto, este artículo tiene como objetivo identificar la percepción de los recién graduados sobre la importancia de las competencias transversales adquiridas y desarrolladas en su formación universitaria, así como la manera en que estas se aplican en el entorno laboral. En el marco de este estudio exploratorio, se distribuyó un cuestionario a los recién graduados que actualmente están empleados en 14 instituciones educativas de la Zona Sur de Manabí y en 3 instituciones de educación básica pública de Jipijapa. Esta metodología permitió analizar el desarrollo y la aplicabilidad de las competencias transversales en las organizaciones del sector educativo y su impacto en la práctica pedagógica. Los resultados se discuten en el contexto más amplio de cómo las universidades se están adaptando a los intensos desafíos socioeconómicos que caracterizan el presente, así como la integración de los recién graduados en el mercado laboral. Se concluye que la flexibilidad curricular y el desarrollo de competencias transversales son esenciales para mejorar la empleabilidad de los egresados y su capacidad para enfrentar las exigencias del mundo laboral contemporáneo.

ABSTRACT Aligning learning objectives with the needs of the labour market represents a considerable challenge for universities today. Although organisations demand professionals with varied and flexible skills, universities often underestimate the relevance of transversal skills. Therefore, this article aims to identify the perception of recent graduates on the importance of transversal skills acquired and developed in their university education, as well as the way in which these are applied in the work environment. Within the framework of this exploratory study, a questionnaire was distributed to recent graduates who are currently employed in 14 educational institutions in the Southern Zone of Manabí and in 3 public basic education institutions in Jipijapa. This methodology allowed us to analyse the development and applicability of transversal skills in organisations in the educational sector and their impact on pedagogical practice. The results are discussed in the broader context of how universities are adapting to the intense socio-economic challenges that characterise the present, as well as the integration of recent graduates into the labour market. It is concluded that curricular flexibility and the development of transversal competences are essential to improve the employability of graduates and their ability to face the demands of the contemporary labor market.

BACKGROUND. Infective endocarditis (IE) poses significant diagnostic and therapeutic challenges, especially in cases of blood culture-negative infective endocarditis (BCNIE). Among patients undergoing surgery for IE, valve tissue may be evaluated for additional microbiological information by performing a broad-range 16S rDNA polymerase chain reaction (PCR) test, tissue culture and tissue histopathology. In patients with BCNIE, these diagnostic tests may identify the causative agents, guide further clinical management and improve local IE-related epidemiological data. The clinical utility of additional analysis of explanted tissue in a local South African (SA) setting has yet to be described. OBJECTIVES. To assess the clinical utility of performing PCR, culture and histopathology on the tissue of surgically explanted valves in BCNIE patients in an SA public sector hospital. We assess their diagnostic yield and treatment impact in a cohort of BCNIE patients treated with empirical antibiotic regimens. METHODS. We analysed data from the Groote Schuur Hospital (GSH) Infective Endocarditis Registry, a prospective observational study of adult patients with infective endocarditis. Participants for this analysis were selected based on clinical and pathological criteria for IE and negative blood cultures. All participants were treated between January 2017 and March 2021. RESULTS. During the study period, we identified 165 IE cases, 57 (34.5%) of which were blood-culture negative. BCNIE patients had a mean (standard deviation) age of 40.2 (13.4) years, and 41 (71.9%) were male. Twenty-seven of the 57 BCNIE patients underwent cardiac surgery and had tissue analysis performed. Tissue PCR identified an aetiological agent in 17/27 (63%) cases, with Bartonella spp. (12/27, 44%) being the most common organism. Tissue culture was positive in 3/27 (11%) cases, but the organisms identified were thought to reflect sample contamination. Tissue histopathology was performed in 22/27 (81.5%) cases and provided macroscopic confirmation of IE, but did not identify any specific organisms in any of the specimens. Only a small subset of the overall BCNIE cohort (11/57 (19.3%)) had serum serology for Bartonella spp. and Coxiella spp. performed, and 5/11 (45.5%) were positive for Bartonella spp. There was a 100% concordance rate between positive serum serology and tissue PCR. Tissue PCR impacted the antimicrobial regimen in 20/27 (74%) cases. Tissue culture and tissue histopathology did not influence antibiotic regimens in any patients. CONCLUSION. In this single-centre study, perioperative serum serological testing was underutilised in BCNIE. Tissue PCR was valuable in determining the aetiology of BCNIE, and influenced management. Tissue culture and histopathology had a poor yield and added little value in identifying the microbiological cause of BCNIE. Finally, the most common BCNIE causative organism identified by additional non-culture testing in our setting is Bartonella spp.

BACKGROUND: In South Africa, graduate rehabilitation therapists undertake a compulsory community service (CS) year in public healthcare facilities, often entering this role without sufficient competency to work independently. They rely on supervision and support, which may come from senior therapists of different disciplines. This study, conducted in KwaZulu-Natal (KZN) province, explores the experiences of rehabilitation therapists regarding cross-disciplinary supervision and support during their CS year. METHODS: A qualitative, descriptive, and exploratory design was employed. Virtual semi-structured interviews were conducted with seven purposively sampled participants from five KZN districts. Data were audio recorded, transcribed verbatim, and analysed thematically. RESULTS: The findings revealed four themes and ten sub-themes, highlighting the challenges and benefits of cross-disciplinary supervision, dissatisfaction with existing support structures, and recommendations for improvement. The CS therapists, as junior staff, often lacked the experience and authority to deliver optimal patient care within resource-constrained settings. CONCLUSION: While discipline-specific supervision remains the preferred approach, cross-disciplinary supervision contributed positively to professional development, broadening therapists' understanding of other rehabilitation disciplines. However, the limited availability of accessible, discipline-specific supervisors remains a significant concern. Given their frequent isolation and minimal experience, CS therapists require consistent, discipline-specific support to meet service demands. CONTRIBUTION: This study emphasises need to address the experiences of CS therapists, who face high patient loads and limited support, in public health sector planning. Incorporating their insights can enhance their ability to deliver essential services, ensuring better outcomes for the populations served by the public health system.

Abstract This research aimed to estimate the direct costs and analyze the epidemiological aspects of ambulatory care-sensitive conditions (ACSC) in children under one year of age, São Paulo municipality, 2011-2022. Total and average costs were calculated according to ACSC diagnosis groups by components (early neonatal, late neonatal, and post-neonatal). The trend in ACSC rates was analyzed using Prais-Winsten generalized linear regression. 98,679 hospitalizations were identified. There was an annual increase of 10.2% in the ACSC rate of early neonates and in the other components the trend was stationary. The cost for the period was estimated at R$ 130.5 million in <1 year, a reduction of 8.6%. The highest absolute values were related to the most frequent causes, such as lung diseases with 43.7% of the cost in <1 year, 52.5% in late neonates, and 48.8% in post-neonates. In early neonates, 83.5% of the cost was attributed to prenatal-related diseases, especially congenital syphilis. It is concluded that it was possible to identify the costs and characteristics of hospitalizations, showing an increase in ACSC rates and the conditions that require greater attention from primary health care services to reduce hospitalizations and hospital costs in the public sector.

Resumo O objetivo desta pesquisa foi estimar os custos diretos e analisar os aspectos epidemiológicos das Internações por Condições Sensíveis à Atenção Primária (ICSAP) em menores de um ano, município de São Paulo, 2011-2022. Os custos total e médio foram calculados segundo grupos de diagnóstico de ICSAP por componentes (neonatal precoce, tardio e pós-neonatal). Analisou-se a tendência das taxas de ICSAP por meio da regressão linear generalizada de Prais-Winsten. Foram identificadas 98.679 internações. Houve aumento anual de 10,2% na taxa de ICSAP dos neonatos precoces e nos demais componentes a tendência foi estacionária. O custo do período foi estimado em R$ 130,5 milhões em <1 ano, com redução de 8,6%. Os maiores valores absolutos estiveram relacionados às causas mais frequentes, como às Doenças pulmonares com 43,7% do custo em <1 ano, 52,5% nos neonatos tardios e 48,8% nos pós-neonatos. Nos neonatos precoces, 83,5% do custo foi atribuído às Doenças relacionadas ao pré-natal, especialmente à sífilis congênita. Conclui-se que foi possível identificar os custos e características das internações, evidenciando aumento das taxas de ICSAP e as condições que requerem maior atenção dos serviços de saúde primária para reduzir internações e gastos hospitalares no setor público.

Resumen Este artículo tuvo como objetivo estimar los costos directos y analizar los aspectos epidemiológicos de las Hospitalizaciones por Condiciones Sensibles a la Atención Primaria (HCSAP) en niños menores de un año, en São Paulo, Brasil, de 2011 a 2022. Se calcularon los costos totales y promedios según grupos de diagnóstico de HCSAP por componentes (neonatal temprano, tardío y posneonatal). The trend in ACSC rates was analyzed using Prais-Winsten generalized linear regression. Se identificaron 98.679 hospitalizaciones. Hubo un aumento anual del 10,2% en la tasa de HCSAP de recién nacidos tempranos y en los demás componentes la tendencia fue estacionaria. El costo del período se estimó en R$ 130,5 millones en <1 año, una reducción del 8,6%. Los valores absolutos más altos estuvieron relacionados con las causas más frecuentes, como las enfermedades pulmonares con el 43,7% del coste en <1 año, el 52,5% en neonatos tardíos y el 48,8% en posneonatos. El 83,5% del costo se atribuyó a enfermedades relacionadas con la atención prenatal, especialmente la sífilis congénita en los recién nacidos prematuros. Se concluye que fue posible identificar los costos y características de las hospitalizaciones, mostrando un aumento en las tasas de HCSAP y las condiciones que requieren mayor atención por parte de los servicios primarios de salud para reducir las hospitalizaciones y los gastos hospitalarios en el sector público.

Abstract The aim of this study was to assess the oral condition of individuals diagnosed with COVID-19 and its impact on their quality of life. The cross-sectional study participants were patients with or without a diagnosis of COVID-19, on room air, and conscious, admitted to the ICUs and wards of Public Hospital Units in São Luís, Maranhão, Brazil. The data collected included: demographic information, length of stay, comorbidities, and type of diet, obtained from medical records; Oral Health-Related Quality of Life (OHRQoL) [Oral Health Impact Profile (OHIP-14)]questions patients were asked; oral health (measured by the Bedside Oral Exam Scale); oral hygiene status (assessed by the Oral Hygiene Index - Simplified and lingual: degree of lingual coating); and salivary flow. The prevalence of COVID-19 was associated with gender (p = 0.038), with a higher incidence observed in male patients (61.9%). Moreover, there was a correlation between the hospitalization sector (p = 0.037) and the frequency of ICU admissions (53.7%). The prevalence of comorbidities was comparable between the two groups. Relative to oral health, 53% of individuals with confirmed COVID-19 had moderate oral health, while 9% exhibited poor oral health. The prevalence of hyposalivation was higher in the group with a confirmed diagnosis of COVID-19. The quality of life of individuals with confirmed COVID-19 was most significantly impacted by moderate to severe oral health concerns. The most significant alteration in oral health was a reduction in salivary flow, negatively impacting the quality of life of individuals hospitalized for COVID-19 complications.

What motivates voters to support candidates with backgrounds in public security for Brazil’s National Congress, the so-called Law & Order (L&O) politicians? The 2018 elections witnessed a surge in parliamentarians from police and military backgrounds and the election of a president closely aligned with this agenda. We explore whether this trend correlates with municipal-level violence indicators and the presence of municipal capacity in the security sector, employing various regression models that account for socioeconomic, demographic, political, and geographic factors. Our findings from the additive model reveal a negative association between the level of violence and votes for L&O candidates. This suggests a potential disconnection between fear, victimization, and support for repressive policies, while also indicating that local capacity in the security sector tend to enhance L&O candidates’ performance. However, our model incorporating the interaction between both variables uncovers that violence exacerbates the negative impact on L&O voting when the city has capacity in the security sector. This may reflect a municipal-level preference for preventive measures, particularly in more violent areas, which contrasts with the generally repressive stance of L&O candidates. Brazils Brazil s Congress socalled so called LO L O (L&O politicians 201 agenda municipallevel socioeconomic demographic political factors fear victimization policies performance However measures areas 20 2