2 research outputs found
"Ouça sempre o outro lado": a pluralidade de fontes na perspectiva dos manuais de redação
No presente trabalho analisamos como os manuais de redação dos jornais brasileiros Folha de S. Paulo, O Estado de S. Paulo, O Globo, Zero Hora e Estado de Minas abordam o acionamento de fontes jornalísticas e a ideia de pluralidade de versões como forma de garantir isenção e objetividade às narrativas jornalísticas. Considerando a noção de serviço público exigida do jornalismo e o dever de dar conta de todas as perspectivas do fato noticiado, o objetivo é compreender como esse tipo de material normativo orienta os profissionais sobre o tema. Observamos que as orientações trazidas pelos manuais não refletem a complexidade da questão, reduzindo a discussão sobre a necessária pluralidade de fontes e versões a casos controversos e à máxima “ouvir o outro lado”, contribuindo para a perpetuação de rituais estratégicos (TUCHMAN, 2016) não necessariamente eficazes.In the present paper, we have analyzed how the editorial guidelines of the Brazilian newspapers Folha de S. Paulo, O Estado de S. Paulo, O Globo, Zero Hora, and Estado de Minas approach the activation of journalistic sources and the idea of plurality of versions as a way of guaranteeing neutrality and objectivity to journalistic narratives. Considering the notion of public service required by the journalism and the obligation of accessing all the perspectives of the reported fact, the objective is to comprehend how this type of normative material leads the professionals about the topic. We have observed that the guidance brought by the editorial guidelines do not reflect the issue’s complexity, reducing the discussion about the necessary plurality of sources and versions to controversial cases and also to the ideal “listen to the other side”, contributing to the perpetuation of strategic rituals that are not necessarily effective
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