Capitalización de la agenda setting por parte del Tercer Sector. El caso de las ONG ante las inundaciones de Buenos Aires, agosto 2015

The main objective of the present research was to observe how the main graphic news media in Argentina (Clarín, La Nación and Página 12) treated the third sector during the floods that occurred in August, 2015, in the province of Buenos Aires. The results indicate that, although the press gave a relevant place to the event, including numerous flood news reports, the presence of civil society organizations on the media agenda was limited. This would account for a weak capitalization of the media agenda by the third sector, because their organizations did not become relevant even when they had direct participation in such event. Moreover, it was discursively observed that alliances with other stakeholders (soccer clubs or personalities) were necessary to obtain greater projection in the diffusion of undertaken actions, an alliance that in many cases resulted in a greater media presence of the other actors compared to that of the third sector. Different Civil Society Organizations (CSOs) were interviewed and it could be established that the low capitalization of the media agenda would be associated with a lack of proactivity or initiative in the generation and management of press releases, whereas third sector entities respond to the demand for information by of the media. Along with the mentioned general conclusion, it should be added that this treatment was mediated by editorial and political aspects. Thus, it was observed that Página 12 practically did not allude to the CSOs, emphasizing instead the tasks of governmental entities. On the other hand, the newspapers Clarín and La Nación made reference to the Third Sector over the activities of official dependencies. This certain polarity in the presence of CSOs in the media, as opposed to state action, accounts not only for an agenda set by the media, but also for the assimilation of the Third Sector to a culture of assistance. This is corroborated in the discursive analysis where organizations appear, above all, as entities that gather materials and donations for the victims. In the case of floods, in a very secondary way, environmental entities appear claiming in favor of new legislations.La investigación realizada tuvo como objetivo principal observar cómo los principales medios periodísticos gráficos de Argentina (Clarín, La Nación y Página 12) trataron al Tercer Sector durante las inundaciones ocurridas en agosto del año 2015, en la provincia de Buenos Aires. Los resultados indican que si bien la prensa dio un lugar relevante al hecho, incluyendo numerosas noticias sobre las inundaciones, la presencia en la agenda mediática de las organizaciones de la sociedad civil fue reducida. Esto daría cuenta de una escasa capitalización de la agenda de los medios por parte del Tercer Sector, porque sus organizaciones no cobraron relevancia aún ante un suceso en el cual tuvieron participación directa. Aún más, se observó discursivamente que fue necesaria la alianza con otros actores (clubes de fútbol o personalidades) para obtener mayor proyección en la difusión de acciones emprendidas, alianza que en muchos casos redundó en una mayor presencia mediática de los otros actores por sobre el Tercer Sector. Se entrevistó a distintas Organizaciones de la Sociedad Civil (OSC) y se pudo establecer que la baja capitalización de la agenda de los medios se asociaría a la falta de proactividad o iniciativa en la generación y gestión de notas de prensa, en tanto las entidades del Tercer Sector responden a la demanda de información de los medios. Junto con la conclusión general mencionada, cabe agregar que este tratamiento estuvo mediado por aspectos político editoriales. Así, se observó que el diario Página 12 prácticamente no aludió a las OSC, y destacó en cambio las tareas de entidades gubernamentales. En cambio, los diarios Clarín y La Nación hicieron presentes al Tercer Sector por sobre las actividades de dependencias oficiales. Esta cierta polaridad en la presencia de las OSC, como opuesta a la acción estatal, da cuenta no solo de una decisión de agenda por parte de los medios, sino también de la asimilación del Tercer Sector al asistencialismo. Esto queda corroborado en el análisis discursivo donde las organizaciones aparecen, ante todo, como entidades que juntan donaciones y materiales para los damnificados. En el caso de las inundaciones, de manera muy secundaria, aparecen entidades ambientalistas como entes de reclamo en favor de nuevas legislaciones

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used