"Preserve" ou "deixe ruir"?: processos de patrimonialização da ponte Hercílio Luz (Florianópolis-SC)

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas, Programa de Pós-Graduação em História, Florianópolis, 2016Nesta pesquisa foram analisados os processos (cultural, político e administrativo) de patrimonialização da ponte Hercílio Luz. Ela é uma estrutura metálica de tecnologia pênsil com barras de olhal, construída no início do século XX, que está situada entre a porção insular e a porção continental da cidade de Florianópolis, capital do estado de Santa Catarina, na região Sul do Brasil. O estudo procurou observar a "biografia cultural" da ponte e demonstrar que seu valor patrimonial e monumental foi construído culturalmente na região, através de discursos que destacavam a memória política local, através da referência ao governador Hercílio Luz e de ideais de desenvolvimento urbano. Ela foi criada como monumento republicano, como ícone de modernidade e legado de Hercílio Luz. Seus tombamentos (municipal, estadual e federal) que aconteceram entre as décadas de 1980 e 1990, tornaram-se uma questão política de ampla abrangência, servindo como instrumento para a promoção política, turística e de valores regionais de determinados grupos. Mas a interdição do tráfego sobre sua estrutura e a obrigatoriedade de restauração que indicaram sua obsolescência técnica e física fizeram da ponte um caso limite do patrimônio cultural, transparecendo as ambivalências entre o simbólico e a função utilitária. Esta dissertação está embasada em documentos relativos aos tombamentos, legislações municipais, estaduais e federais, jornais estaduais, entrevistas orais e pesquisas acadêmicas elaboradas principalmente na área de História.Abstract: In this research, it was possible to analyze processes (cultural, political and administrative) of patrimonialization of the Hercílio Luz Bridge. The bridge is a metal structure of suspension technology with eyelet bars built in the early twentieth century. It is located between the island and mainland portion of the city of Florianópolis, the state capital of Santa Catarina, in Southern Brazil. The study tries to show the "cultural biography" of the bridge and demonstrate that its patrimonial and significant value was culturally constructed in the region through speeches that highlighted the local political memory, by referencing the governor Hercílio Luz and urban development ideals. It was created as a Republican monument, a modernity icon and legacy of Hercílio Luz. It became a municipal, state and federal heritage between the 1980s and 1990s. It appeared as a political issue of broad scope, serving as a tool for political promotion, tourism and local values for some groups. However, the traffic interdiction on its structure and requirement of restoration that indicated its technical and physical obsolescence turn the bridge into a patrimony limit case, transpiring the ambivalences between symbolic and utilitarian function. The study is grounded on documents about historic landmarks, municipal, state and federal laws, state newspapers, oral interviews and academic research elaborated, mainly, in the area of History

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status