Epidemia midiática: produção de sentidos e configuração social da febre amarela na cobertura jornalística, 2007-2008

O objetivo deste artigo, situado no campo da comunicação em saúde, é analisar os sentidos atribuídos discursivamente à febre amarela silvestre durante a cobertura jornalística da epizootia da doença, ocorrida no Brasil no verão 2007-2008. Utilizando o referencial teórico das práticas discursivas e da produção de sentidos no cotidiano e as hipóteses de agendamento (agenda-setting) e enquadramento (framing) da notícia, foram analisadas todas as matérias sobre febre amarela veiculadas pelo jornal Folha de S. Paulo, no período de 21 de dezembro de 2007 a 29 de fevereiro de 2008, e todos os documentos oficiais sobre a epizootia emitidos pela autoridade brasileira de saúde pública entre 3 de janeiro e 28 de fevereiro de 2008. Os achados indicam que as estratégias discursivas da cobertura jornalística relativizaram o discurso da autoridade de saúde pública; priorizaram a divulgação do número de casos; enfatizaram a vacinação como o limite entre a vida e a morte, omitindo riscos do uso indiscriminado do imunobiológico; e propagaram a iminência de uma epidemia de febre amarela de grandes proporções. Essas estratégias deram novos sentidos à doença, deslocando o evento de sua forma silvestre, espacialmente restrita e de gravidade limitada, para a urbana, de caráter epidêmico e potencialmente mais grave. Secundariamente, o estudo permitiu identificar os impactos desse discurso midiático sobre o sistema nacional de imunização e os riscos a que a população foi exposta em função dos sentidos produzidos: em 2008, foram registrados 8 casos de reação grave à vacina, dos quais 6 foram a óbito.

Tiller population density and tillering dynamics in marandu palisade grass subjected to strategies of rotational stocking management and nitrogen fertilization

The objective of this experiment was to evaluate tiller population density and the dynamics of the tillering process in marandu palisade grass subjected to strategies of rotational stocking management and nitrogen fertilization. Treatments corresponded to combinations between two targets of pre-grazing conditions (sward surface height of 25 and 35 cm) and two rates of nitrogen application (50 and 200 kg ha-1 year-1), and were allocated to experimental units according to a 2 x 2 factorial arrangement in a randomised complete block design, with four replications. The following response variables were studied: initial (TPDi), intermediate (TPDm) and final (TPDf) tiller population density as well as the rates of tiller appearance (TAR) and death (TDR) and the tiller population stability index (SI). TPDi was similar to all treatments, with differences in tiller population density becoming more pronounced as the experiment progressed, resulting in larger TPDf on swards managed at 25 cm pre-grazing height. Tiller death was larger on swards managed at 35 cm, with differences in tiller appearance being recorded only from February 2010 onwards. Stability of tiller population was higher on swards managed at 25 cm pre-grazing height. Overall, there was no effect of nitrogen on the studied variables, and the most adequate grazing strategy corresponded to the pre-grazing height of 25 cm, regardless of the nitrogen application rate used.

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Objective: The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue. Methods: The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue. Results: Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death. Conclusions: The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial.