[Outcomes and care practices of extremely preterm infants at 22-25 weeks' gestation age from the Chinese Neonatal Network].

Objective: To describe the current status and trends in the outcomes and care practices of extremely preterm infants at 22-25 weeks' gestation age from the Chinese Neonatal Network (CHNN) from 2019 to 2021. Methods: This cross-sectional study used data from the CHNN cohort of very preterm infants. All 963 extremely preterm infants with gestational age between 22-25 weeks who were admitted to neonatal intensive care units (NICU) of the CHNN from 2019 to 2021 were included. Infants admitted after 24 hours of life or transferred to non-CHNN hospitals were excluded. Perinatal care practices, survival rates, incidences of major morbidities, and NICU treatments were described according to different gestational age groups and admission years. Comparison among gestational age groups was conducted using χ2 and Kruskal-Wallis tests. Trends by year were evaluated by Cochran-Armitage and Jonckheere-Terpstra tests for trend. Results: Of the 963 extremely preterm infants enrolled, 588 extremely preterm infants (61.1%) were male. The gestational age was 25.0 (24.4, 25.6) weeks, with 29 extremely preterm infants (3.0%), 88 extremely preterm infants (9.1%), 264 extremely preterm infants (27.4%), and 582 extremely preterm infants (60.4%) at 22, 23, 24, and 25 weeks of gestation age, respectively. The birth weight was 770 (680, 840) g. From 2019 to 2021, the number of extremely preterm infants increased each year (285, 312, and 366 extremely preterm infants, respectively). Antenatal steroids and magnesium sulfate were administered to 67.7% (615/908) and 51.1% (453/886) mothers of extremely preterm infants. In the delivery room, 20.8% (200/963) and 69.5% (669/963) extremely preterm infants received noninvasive positive end-expiratory pressure support and endotracheal intubation. Delayed cord clamping and cord milking were performed in 19.0% (149/784) and 30.4% (241/794) extremely preterm infants. From 2019 to 2021, there were significant increases in the usage of antenatal steroids, antenatal magnesium sulfate, and delivery room noninvasive positive-end expiratory pressure support (all P<0.05). Overall, 349 extremely preterm infants (36.2%) did not receive complete care, 392 extremely preterm infants (40.7%) received complete care and survived to discharge, and 222 extremely preterm infants (23.1%) received complete care but died in hospital. The survival rates for extremely preterm infants at 22, 23, 24 and 25 weeks of gestation age were 10.3% (3/29), 23.9% (21/88), 33.0% (87/264) and 48.3% (281/582), respectively. From 2019 to 2021, there were no statistically significant trends in complete care, survival, and mortality rates (all P>0.05). Only 11.5% (45/392) extremely preterm infants survived without major morbidities. Moderate to severe bronchopulmonary dysplasia (67.3% (264/392)) and severe retinopathy of prematurity (61.5% (241/392)) were the most common morbidities among survivors. The incidences of severe intraventricular hemorrhage or periventricular leukomalacia, necrotizing enterocolitis, and sepsis were 15.3% (60/392), 5.9% (23/392) and 19.1% (75/392), respectively. Overall, 83.7% (328/392) survivors received invasive ventilation during hospitalization, with a duration of 22 (10, 42) days. The hospital stay for survivors was 97 (86, 116) days. Conclusions: With the increasing number of extremely preterm infants at 22-25 weeks' gestation admitted to CHNN NICU, the survival rate remained low, especially the rate of survival without major morbidities. Further quality improvement initiatives are needed to facilitate the implementation of evidence-based care practices.

Qualidade de vida no trabalho dos docentes de enfermagem universitários na modernidade líquida / Quality of work life of university nursing teacher in liquid modernity / Calidad de vida laboral de profesores universitarios del área de enfermería en la modernidad líquida

Objetivo: analisar a qualidade de vida no trabalho dos docentes de enfermagem universitários, considerando a configuração do mundo líquido. Método: estudo qualitativo, descritivo, de abordagem qualitativa, realizado em duas universidades públicas. Os participantes do estudo foram 14 docentes de enfermagem pertencentes às universidades. Para a coleta de dados foi utilizado o grupo focal e os dados foram analisados à luz da técnica de análise de conteúdo. Resultados: observa-se excesso de atividades e cobrança exacerbada refletindo na sobrecarga de trabalho, bem como desmonte das universidades públicas ocasionando instabilidade no processo de trabalho e consequente condições laborais inadequadas. Considerações finais: o trabalho docente no mundo líquido guarda características diferenciadas inerentes à prática da educação, quando comparada a outros grupos de trabalhadores. Assim, configura-se a necessidade de investimento nas universidades públicas a fim de proporcionar a disponibilização de verbas para o desenvolvimento do ensino, pesquisa e extensão, no incremento da ciência e tecnologia.

Objective: to analyze the quality of life at work of university nursing professors, considering the configuration of the liquid world. Method: qualitative, descriptive study, with a qualitative approach, carried out in two public universities. Study participants were 14 nursing professors belonging to universities. For data collection, a focus group was used and the data were analyzed using the content analysis technique. Results: there is an excess of activities and exacerbated demands, reflecting on work overload, as well as the dismantling of public universities, causing instability in the work process and consequent inadequate working conditions. Final considerations: the teaching work in the liquid world has different characteristics inherent to the practice of education, when compared to other groups of workers. Thus, there is a need for investment in public universities in order to provide funds for the development of teaching, research and extension, in the increment of science and technology.

Objetivo: analizar la calidad de vida en el trabajo de profesores universitarios de enfermería, considerando la configuración del mundo líquido. Método: estudio descriptivo, con enfoque cualitativo, realizado en dos universidades públicas. 14 profesores de enfermería pertenecientes a universidades participaron en el estudio. Para la recolección de datos se utilizó un grupo focal y se analizaron los datos mediante la técnica de análisis de contenido. Resultados: hay un exceso de actividades y exigencias exageradas, lo que se refleja en la sobrecarga de trabajo, así como el desmantelamiento de las universidades públicas, lo que provoca inestabilidad en el proceso de trabajo y consecuentemente condiciones de trabajo inadecuadas. Consideraciones finales: el trabajo docente en el mundo líquido tiene características diferentes inherentes a la práctica de la educación, cuando se compara con otros grupos de trabajadores. Por lo tanto, existe la necesidad de invertir en las universidades públicas con fines de poner a disposición fondos para el desarrollo de la enseñanza, la investigación y la extensión, en el incremento de la ciencia y la tecnología.

Influência do contexto político-institucional na tomada de decisões de docentes de enfermagem sobre a aposentadoria / Influence of the political-institutional context on nursing professors' decision-making about retirement / Influencia del contexto político-institucional en la toma de decisiones de los profesores de enfermería sobre la jubilación

Objetivo: compreender as percepções de docentes de enfermagem aposentados de uma universidade pública sobre a influência do contexto político-institucional na tomada de decisão pela aposentadoria. Método: pesquisa qualitativa, realizada com 13 docentes de enfermagem aposentados de uma universidade pública do estado do Rio de Janeiro, Brasil. Dados coletados entre março e abril de 2022, mediante entrevista semiestruturada, submetida à análise lexical apoiada pelo software Iramuteq. Resultados: os léxicos "reforma da previdência", "medo", "salário" e "greve" apontaram para um contexto de incerteza vivenciado pelos docentes, o qual influenciou na decisão pela aposentadoria. Considerações finais: a decisão pela aposentadoria é complexa, pois é marcada não somente pelas questões pessoais, como também pela relação que o docente estabelece com o trabalho e a instituição, bem como pela percepção que tem sobre o contexto social, econômico e político. Nesse cenário, os docentes de enfermagem aposentam-se com pesar e precocemente, em função dos riscos associados à perda de direitos(AU)

Objective: to understand the perception of retired nursing professors at a public university about the influence of the political-institutional context on decision-making for retirement. Method: qualitative research, carried out with 13 retired nursing professors from a public university in the state of Rio de Janeiro. Data were collected through semi-structured interviews submitted to lexical analysis supported by the Iramuteq software. Results: the lexicons pension reform, fear, salary and strike pointed to a context of uncertainty experienced by teachers which influenced the decision to retire. Final considerations: the decision to retire is complex, as it is marked not only by personal issues, but by the relationship that the professor establishes with work and the institution, as well as the perception he has of the social, economic and political context. In this scenario, nursing professors retire with regret and early due to the risks associated with the loss of rights(AU)

Objetivo: comprender la percepción de profesores de enfermería jubilados de una universidad pública sobre la influencia del contexto político-institucional en la toma de decisiones respecto a la jubilación. Método: investigación cualitativa, realizada con 13 enfermeros docentes de enfermería, jubilados de una universidad pública del estado de Río de Janeiro, Brasil. Los datos se recopilaron entre marzo y abril de 2022, a través de entrevistas semiestructuradas sometidas al análisis léxico con el apoyo del software Iramuteq. Resultados: los léxicos reforma previsional, miedo, salario y huelga señalaron un contexto de incertidumbre experimentado por los docentes, lo que influyó en su decisión de jubilarse. Conclusión: la decisión de jubilarse es compleja, ya que está marcada no solo por cuestiones personales, sino también por la relación que el profesor establece con el trabajo y la institución, así como por su percepción del contexto social, económico y político. En este escenario, los docentes de enfermería se jubilan con pesar y a una edad temprana debido a los riesgos asociados con la pérdida de derechos(AU)

[Immune checkpoint inhibitor-induced eosinophilic fasciitis: a case report and literature review].

A 58-year-old male patient with angioimmunoblastic T-cell lymphoma developed a rash and skin tightness on the face, limbs, and trunk together with joint stiffness and dysfunction after 6 months of treatment with the programmed cell death protein-1 inhibitor camrelizumab. Laboratory tests revealed progressive eosinophilia over 6 months, with the eosinophil count increasing from 0.07×109/L to 3.3×109/L. Magnetic resonance imaging showed thickened skin of both forearms, while T2-weighted imaging showed markedly increased signal intensity within the myofascia. Skin biopsy of the right forearm showed thickened and fibrosed fascia and infiltration of inflammatory cells, including lymphocytes, plasma cells, and eosinophils. The patient was diagnosed with immune checkpoint inhibitor (ICI)-induced eosinophilic fasciitis (EF). After beginning treatment with methylprednisolone (40 mg daily), methotrexate (10 mg/week), and baricitinib (4 mg daily), his symptoms of skin tightness and joint dysfunction significantly improved within 1 month, and his peripheral blood eosinophil count decreased to 0.17×109/L. ICI-induced EF is a rare immune-related adverse reaction. To date, only 20 cases have been reported in published foreign literature, and their clinical characteristics are summarized here. The time from ICI treatment to EF was 12 (8,15) months, and the main clinical manifestations included skin involvement (n=19), joint dysfunction (n=11), myalgia/muscle weakness (n=9), and peripheral eosinophilia (n=16). After treatment, the clinical symptoms of EF improved in 17 patients, and eosinophil counts returned to normal after 3 (1,8) months. EF is a dysfunctional adverse response to ICI therapy. Tumor patients undergoing immunotherapy should be monitored for symptoms of EF. Early treatment is essential for preventing complications.

Direitos dos docentes de enfermagem na contemporaneidade: análise a partir de grupo focal / Rights of nursing teachers in the contemporany: analysis from focal group / Derechos de los profesores de enfermería en la contemporánea: análisis desde un grupo focal

Objetivo: verificar a percepção dos docentes universitários de enfermagem acerca dos seus direitos laborais e discutir tais direitos na contemporaneidade. Método: pesquisa descritiva e exploratória de abordagem qualitativa realizada em universidades públicas situadas no município do Rio de janeiro. Os participantes do estudo foram 14 docentes de enfermagem lotados em duas universidades públicas. Para a coleta de dados foi utilizado o grupo focal e os dados foram analisados à luz da técnica de análise de conteúdo. Resultados: emergiram três categorias: os direitos do docente de enfermagem nas universidades públicas no contexto neoliberal; educação como direito de todos para o desenvolvimento do Brasil; e direitos laborais sob a ótica dos docentes de enfermagem: respeito ao contrato de trabalho. Conclusão: destaca-se a necessidade de respeito aos direitos humanos, para a promoção da qualidade de vida no contexto do trabalho do docente

Objective: to verify the perception of university nursing professors about their labor rights and to discuss these rights in contemporary times. Method: descriptive and exploratory research with a qualitative approach carried out in public universities located in the city of Rio de Janeiro. Study participants were 14 nursing professors working at two public universities. For data collection, the focus group was used and the data were analyzed in the light of the content analysis technique. Results: three categories emerged: the rights of nursing professors in public universities in the neoliberal context; education as a right for all for the development of Brazil; and labor rights from the perspective of nursing professors: respect for the employment contract. Conclusion: the need to respect human rights is highlighted, in order to promote quality of life in the context of the teacher's work

Objetivo: verificar la percepción de los profesores universitarios de enfermería sobre sus derechos laborales y discutir esos derechos en la contemporaneidad. Método: investigación descriptiva y exploratoria con enfoque cualitativo realizada en universidades públicas ubicadas en la ciudad de Río de Janeiro. Los participantes del estudio fueron 14 profesores de enfermería que trabajaban en dos universidades públicas. Para la recolección de datos se utilizó el grupo focal y los datos fueron analizados a la luz de la técnica de análisis de contenido. Resultados: surgieron tres categorías: los derechos de los profesores de enfermería en las universidades públicas en el contexto neoliberal; la educación como derecho de todos para el desarrollo de Brasil; y derechos laborales en la perspectiva de los profesores de enfermería: respeto al contrato de trabajo. Conclusión: se destaca la necesidad de respetar los derechos humanos, con el fin de promover la calidad de vida en el contexto del trabajo docente

[Effect of adenovirus-mediated shRNA down-regulates SHP2 expression on the apoptosis of human hepatic stellate cells LX-2].

Objective: To investigate the effect of adenovirus-mediated short hairpin RNA (shRNA) downregulating SH2 domain-containing protein tyrosine phosphatase 2 (SHP2) on the apoptosis of human hepatic stellate cells LX-2 cultured in vitro. Methods: The recombinant adenovirus Ad-shRNA/SHP2 carrying shRNA targeted SHP2 and expressing green fluorescent protein (GFP), and the empty control virus Ad-GFP expressing GFP were transfected into LX-2 cells cultured in vitro. Real-time fluorescence quantitative PCR was used to detect SHP2 mRNA expression in LX-2 cells. Western blot was used to detect the protein expressions of SHP2, Bax, and Bcl-2 in LX-2 cells. TUNEL and annexin-V/propidium iodide dual-labeled flow cytometry were used to detect apoptosis in LX-2 cells. Experimental group: (1) Control group: LX-2 cells were transfected with DMEM instead of adenovirus; (2) Ad-GFP group: transfected with empty virus Ad-GFP; (3) Ad-shRNA/SHP2 group: transfected with recombinant adenovirus Ad-shRNA/SHP2. The means between multiple groups were compared using a one-way ANOVA and the LSD test was used for inter group comparisons. Results: shRNA-targeted SHP2 significantly down-regulated the expression of SHP2 protein and mRNA in LX-2 cells (P < 0.05). The TUNEL and annexin-V/propidium iodide dual-labeled flow cytometry results showed that the apoptosis rate of LX-2 cells in the Ad-shRNA/SHP2 group (12.755%±1.606%, 19.340%±2.505%) (P < 0.05) was significantly higher compared to the control group (3.077%±0.731%, 9.438%±0.804%) and the Ad-GFP group (3.250%±0.851%, 8.893%±1.982%), with no statistically significant difference between the control group and the Ad-GFP group (P > 0.05). Western blot analysis of Bax and Bcl-2 protein expression in LX-2 cells of each group revealed that the Bax protein expression was significantly higher in the Ad shRNA/SHP2 group (2.493 ± 0.203) (P < 0.05) compared to the control group and Ad-GFP group (1.989 ± 0.147, 1.999 ± 0.162), with no statistically significant difference between the control group and the Ad-GFP group (P > 0.05), while the Bcl-2 protein was significantly decreased in the Ad-shRNA/SHP2 group (1.042±0.148) compared with the control group and the Ad-GFP group (1.707±0.146, 1.521±0.142), with no statistically significant difference between the control group and the Ad-GFP group (P > 0.05). Conclusions: SHP2 expression down-regulation induces apoptosis of human hepatic stellate cells LX-2 in vitro by reducing Bcl-2/Bax.

Pejotização and implications for nursing work in Brazil: repercussions of neoliberalism / Pejotização e implicaciones para el trabajo de enfermería en Brasil: repercusiones del neoliberalismo / Pejotização e as implicações para o trabalho de enfermagem no Brasil: repercussões do neoliberalismo

ABSTRACT Objective: To analyze pejotização in the context of nursing work and the respective implications for the protection and health of these professionals. Method: Documentary study, which had news, resolutions, and recommendations issued by the Federal Nursing Council and the Regional Nursing Councils as data collection source, which underwent lexical analysis, based on data processing using the software Iramuteq. Results: Six news items were captured for analysis. The similitude analysis was built with 40 active forms and six discussion centers were generated, with the most expressive lexicons in each of these being outsourcing, economic, pejotização, deputy, Federal Nursing Council, Bill of Law. Conclusion: In the quest to increase capital based on neoliberal ideas, strategies are produced that put the workers' and users' health and safety at risk. Pejotização leads to loss of labor rights, as it deprives the worker of consolidated labor achievements, such as the 13th salary, paid vacations, sick leave and, above all, insecurities are generated in relation to the future, with few guarantees, causing negative impacts on these workers' health.

RESUMEN Objetivo: Analizar la pejotização en el contexto del trabajo de enfermería y las respectivas implicaciones para la protección y la salud de estos profesionales. Método: Estudio documental, que tuvo como fuente de recolección de datos noticias, resoluciones y recomendaciones emitidas por el Consejo Federal de Enfermería y los Consejos Regionales de Enfermería y sometidos a análisis del léxico, a partir del procesamiento de datos utilizando el software Iramuteq. Resultados: Se capturaron seis noticias para análisis. El análisis de similitud se construyó con 40 formas activas y se generaron seis núcleos de discusión, con los léxicos más expresivos en cada uno de estos siendo terceirización, económico, pejotização, diputado, Consejo Federal de Enfermería, Proyecto de Ley. Conclusión: En la búsqueda por aumentar el capital y las ideas neoliberales se producen estrategias que ponen en riesgo la salud y seguridad de los trabajadores y usuarios. Se pierden los derechos laborales, a través de la pejotização, negándose al trabajador conquistas laborales consolidadas, como el salario 13, vacaciones pagadas, bajas por enfermedad y, sobre todo, se generan inseguridades en relación al futuro, con pocas garantías, provocando impactos negativos. sobre la salud de estos trabajadores.

RESUMO Objetivo: Analisar a pejotização no contexto do trabalho de enfermagem e as respectivas implicações para proteção e saúde desses profissionais. Método: estudo documental, que teve como fonte de coleta de dados notícias, resoluções e recomendações veiculadas pelo Conselho Federal de Enfermagem e pelos Conselhos Regionais de Enfermagem e submetidas à análise lexical, a partir do processamento dos dados pelo software Iramuteq. Resultados: Captaram-se seis notícias para análise. A análise de similitude foi construída com 40 formas ativas e geraram-se seis núcleos de discussão, sendo os léxicos mais expressivos em cada um destes: terceirização, econômico, pejotização, deputado, Conselho Federal de Enfermagem, Projeto de Lei. Conclusão: Na busca por incremento do capital no ideário neoliberal, produzem-se estratégias que colocam em risco a saúde e a segurança de trabalhadores e usuários. Existe perda de direitos trabalhistas, por meio da pejotização, negando-se ao trabalhador conquistas laborais consolidadas, como 13º salário, férias remuneradas, licença por adoecimento e, sobretudo, geram-se inseguranças em relação ao futuro, com poucas garantias, ocasionando impactos negativos na saúde desses trabalhadores.

[Summary of the 17th Chinese Symposium on Burn Medicine and the 2022 Congress of Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare, and the 12th Academic Conference on Burn and Plastic Surgery in Five Provinces and One City in Southwest China].

The 17th Chinese Symposium on Burn Medicine and the 2022 Congress of Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare, and the 12th Academic Conference on Burn and Plastic Surgery in Five Provinces and One City in Southwest China was successfully held in green city Nanning, from August 25th to 27th, 2022. The conference theme was "Burn treatment and wound repair", received nearly 200 submissions, nearly 1 100 online and offline registered delegates, and nearly 300 offline attendees. The meetings were held in one main venue and three branch venues, with combination of speaking offline and live and recorded broadcast, as well as whole process synchronous live broadcasting. During the meeting, key issues about burn treatment and wound repair were discussed, with warm academic atmosphere.

[Effects of adenovirus-mediated shRNA down-regulates PTEN expression on fibril-binding proteins vinculin, filamin A and cortactin in activated hepatic stellate cells].

Objective: To investigate the effect of adenovirus-mediated shRNA down-regulating phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expression on vinculin, filamin A, and cortactin in activated hepatic stellate cells (HSCs). Methods: Activated rats hepatic stellate cell line (HSC-T6) was cultured in vitro. Recombinant adenovirus Ad-shRNA/PTEN carrying PTEN targeted RNA interference sequence [short hairpin RNA (shRNA)] and empty control virus Ad-GFP were transfected into HSCs. The PTEN mRNA and protein expression of HSCs in each group were detected by real-time fluorescence quantitative PCR and Western blot. The expressional change of vinculin, filamin A and cortactin in HSCs of each group were detected by confocal laser scanning immunofluorescence microscope. Image-pro plus 6.0 software was used for image analysis and processing. The integrated optical density (IOD) of the fluorescence protein expression was measured. The experiment was divided into three groups: control group (DMEM instead of adenovirus solution in the adenovirus transfection step), Ad-GFP group (transfected with empty virus Ad-GFP only expressing green fluorescent protein), and Ad-shRNA/PTEN group (recombinant adenovirus Ad-shRNA/PTEN carrying shRNA targeting PTEN and expressing green fluorescent protein). One-way analysis of variance was used for comparison of mean value among the three groups, and LSD-test was used for comparison between the groups. Results: shRNA targeted PTEN was successfully transfected and the expression of PTEN mRNA and protein in HSC (P < 0.05) was significantly down-regulated. HSCs vinculin was mainly expressed in the cytoplasm. HSCs vinculin fluorescence IOD in the Ad-shRNA/PTEN group (19 758.83 ± 1 520.60) was higher than control (7 737.16 ± 279.93) and Ad-GFP group (7 725.50 ± 373.03) (P < 0.05), but there was no statistically significant difference between control group and Ad-GFP group (P > 0.05). There was no statistically significant difference in the fluorescence IOD of Filamin A among the three groups (P > 0.05), but the subcellular distribution of Filamin A among the three groups were changed. Filamin A in the Ad-shrNA /PTEN HSC group was mainly distributed in the cytoplasm. Filamin A HSC was mainly located in the nucleus.The filamin A HSC in the control group and Ad-GFP group was mainly located in the nucleus. The nucleocytoplasmic ratio of Filamin A in the AD-shrNA /PTEN group (0.60 ± 0.15) was significantly lower than control group (1.20 ± 0.15) and Ad-GFP group (1.08 ± 0.23), P < 0.05. but there was no statistically significant difference in filamin A nucleocytoplasmic ratio of HSC between the control group and the Ad-GFP group (P > 0.05). Cortactin HSCs in the three groups was mainly distributed in the cytoplasm. The cortactin fluorescence IOD of HSCs in the Ad-shRNA/PTEN group was significantly higher than control group (22 959.94 ± 1 710.42) and the Ad-GFP group (22 547.11 ± 1 588.72 ) (P < 0.05), while there was no statistically significant difference in the IOD of cortactin fluorescence in HSCs between the control group and the Ad-GFP group (P > 0.05). Conclusion: The down-regulation of PTEN expression raises the expression of microfilament-binding protein vinculin and cortactin, and changes the subcellular distribution of another microfilament binding protein filamin A, that is, translocation from nucleus to the cytoplasm in activated HSC in vitro.

Protagonismo da enfermagem na vacinação contra a covid-19 versus irregularidades contestáveis: estudo descritivo-exploratório / The leading role of nursing in the vaccination against covid-19 versus questionable irregularities: a descriptive-exploratory study / Protagonismo de la enfermería en la vacunación contra el covid-19 versus irregularidades cuestionables: estudio descriptivo exploratorio

OBJETIVO: Analisar notícias que tratem de irregularidades envolvendo profissionais de enfermagem durante o processo de vacinação contra a Covid-19 e discutir condutas técnicas, éticas e legais aplicadas ou sugeridas pelos Conselhos Federal e Regionais de Enfermagem. MÉTODO: Pesquisa documental, qualitativa, descritiva-exploratória, cujas fontes foram notícias veiculadas pelos Conselhos de Enfermagem. Os dados foram processados pelo software IRAMUTEQ®, por meio da classificação hierárquica descendente que permitiu a análise lexical dos dados. RESULTADOS: 19 notícias constituíram o corpus textual, sendo identificados 117 Segmentos de Textos, dos quais 95 foram aproveitados (81,20%) e originaram dois blocos temáticos. O primeiro trata sobre o momento da vacinação e o segundo sobre os dilemas éticos deste processo. CONCLUSÃO: Evidencia-se um protagonismo da equipe de enfermagem na imunização. Surgiram a desconfiança e o patrulhamento, em função de notícias sobre atos antiéticos. Verifica-se a necessidade de proteção da imagem dos profissionais e assegurar práticas seguras à população.

OBJECTIVE: To analyze news items that deal with irregularities involving Nursing professionals during the vaccination process against COVID-19 and to discuss technical, ethical and legal courses of action applied or suggested by the Federal and Regional Nursing Councils. METHOD: A documentary, qualitative and descriptive-exploratory research study, whose sources were news items published by the Nursing Councils. The data were processed in the IRAMUTEQ® software through descending hierar-chical classification, which allowed performing the lexical data analysis. RESULTS: A total of 19 news items constituted the textual corpus, with identification of 117 Text Segments, of which 95 were used (81.20%) and created two thematic blocks. The first deals with the vaccination moment and the second is on the ethical dilemmas of this process. CONCLUSION: The leading role of the Nursing team in immunization is evidenced. Mistrust and patrolling emerged, due to news items about unethical actions. There is a need to protect the professionals' image and ensure safe practices for the population

OBJETIVO: Analizar noticias que aborden irregularidades que involucran a profesionales de enfermería durante el proceso de vacunación contra el Covid-19 y discutir conductas técnicas, éticas y legales aplicadas o sugeridas por el Consejo Federal y los Consejos Regionales de Enfermería. MÉTODO: Investigación documental, cualitativa, descriptiva, exploratoria, cuyas fuentes fueron noticias publicadas por los Consejos de Enfermería. Los datos fueron procesados por el software IRAMUTEQ®, mediante la clasificación jerárquica descendente que permitió el análisis léxico de los datos. RESULTADOS: El corpus textual estuvo compuesto por 19 noticias, se identificaron 117 Segmentos de Texto, de los cuales se utilizaron 95 (81,20%) y originaron dos bloques temáticos. El primero se refiere al momento de la vacunación y el segundo a los dilemas éticos de este proceso. CONCLUSIÓN: El equipo de enfermería tiene un papel protagónico en la inmunización. Surgió la desconfianza y el control, debido a noticias sobre actos poco éticos. Es necesario proteger la imagen de los profesionales y garantizar prácticas seguras para la población.

CT texture analysis-based nomogram for the preoperative prediction of visceral pleural invasion in cT1N0M0 lung adenocarcinoma: an external validation cohort study.

AIM: To develop a nomogram based on computed tomography (CT) texture analysis for the preoperative prediction of visceral pleural invasion in patients with cT1N0M0 lung adenocarcinoma. MATERIALS AND METHODS: A dataset of chest CT containing lung nodules was collected from two institutions, and all surgically resected nodules were classified pathologically based on the presence of visceral pleural invasion. Each nodule on the CT image was segmented automatically by artificial-intelligence software and its CT texture features were extracted. The dataset was divided into training and external validation cohorts according to the institution, and a nomogram for predicting visceral pleural invasion was developed and validated. RESULTS: Of a total of 313 patients enrolled from two independent institutions, 63 were diagnosed with visceral pleural invasion. Three-dimensional (3D) CT long diameter, skewness, and sphericity, and chronic obstructive pulmonary disease were identified as independent predictors for visceral pleural invasion by multivariable logistic regression. The nomogram based on multivariable logistic regression showed great discriminative ability, as indicated by a C-index of 0.890 (95% confidence interval [CI]: 0.867-0.914) and 0.864 (95% CI: 0.817-0.911) for the training and external validation cohorts, respectively. Additionally, calibration of the nomogram revealed good predictive ability, as indicated by the Brier score (0.108 and 0.100 for the training and external validation cohorts, respectively). CONCLUSIONS: A nomogram was developed that could compute the probability of visceral pleural invasion in patients with cT1N0M0 lung adenocarcinoma with good calibration and discrimination. The nomogram has potential as a reliable tool for clinical evaluation and decision-making.

Sequential Changes of Total Adenine Nucleotide and Adenylic-Acid Energy Charge in Muscles of Rats after Death.

ABSTRACT: Objective To determine the purine adenylate [adenosine triphosphate （ATP）, adenosine diphosphate （ADP）, adenosine monophosphate （AMP）] content in the muscles of both hind limbs of rats at different postmortem interval （PMI）, calculate the changes in the total adenine nucleotide （TAN） content and the adenylic-acid energy charge （AEC）, and explore their relationship with PMI. Methods Healthy rats were sacrificed by cervical dislocation and kept at 20 ℃. The muscles of their hind limbs were extracted at 0, 24, 48, 72, 96, 120, 144, and 168 h after death. Reversed-phase high performance liquid chromatography was used to determine the content of purine adenylates, the TAN and AEC of the muscles of the both hind limbs were calculated, and the related regression equations of their relationship with PMI were established. Results Within 168 h of death of rats, the trend of ATP change was different from ADP, and the content of AMP continuously increased. The TAN value gradually increased with the extension of PMI, and the AEC showed a downward trend within 168 h after death. Among them, the patterns of AEC changes with PMI were obvious, the correlation coefficient was high （ R2=0.903）, and the curve fitting relationship was good; the fitting relationship between ATP, ADP, AMP, TAN and PMI was poor （ R2=0.198-0.754）. Conclusion The postmortem change patterns of AEC provide new research ideas for PMI estimation in the forensic field.

[Four-dimensional cone-beam CT reconstruction based on motion-compensated robust principal component analysis].

OBJECTIVE: To propose a motion compensation reconstruction method based on robust principal component analysis (RPCA) to reduce the influence of streak artifacts on accurate estimation of interphase motion deformation fields. OBJECTIVE: We propose a RPCA motion compensation reconstruction algorithm to improve the estimation of motion deformation fields based on the traditional MC-FDK algorithm. RPCA was used to decompose the cone-beam computed tomography (CBCT) images into low-rank and sparse components, and the motion deformation fields between different phase images were then estimated using Horn and Schunck optical flow method from the low-rank images to reduce the influence of striping artifacts on the accuracy of estimation of interphase motion deformation fields. The performance of the algorithm was evaluated using simulation data and real data. The simulation phantom data was obtained by back-projection of 4D-CT images acquired from Philips 16-slice spiral CT using MATLAB software programming according to the scanning geometry of Varian Edge accelerator. The real patient data were obtained using the Elekta Synergy system of CBCT scanning system with half-fan mode CB projection data from lung cancer patients. OBJECTIVE: Compared with images reconstructed using the traditional MC-FDK algorithm, the reconstructed image using the proposed method had clearer tissue boundaries with reduced motion artifact was reduced. The results of phantom data reconstruction showed that compared with the MC- FDK algorithm, the proposed algorithms resulted in improvements of PSNR by 25.4% and SSIM by 7.6%; compared with the FDK algorithm, PSNR was improved by 37.9% and SSIM by 17.6%. OBJECTIVE: The proposed algorithm can achieve accurate estimation of inter-phase motion deformation fields and improve the quality of the reconstructed CBCT images.

Judicialização da saúde: reserva do possível e mínimo existencial / Judicialización de la salud: reserva de lo posible y mínimo existencial / Judicialization of health: contingency reserve and basic human dignity

RESUMO Objetivo analisar casos de judicialização da saúde, descrever seu desfecho e discutir as repercussões das decisões judiciais para o atendimento em saúde e o Sistema Único de Saúde Método estudo de caso, realizado em maio e julho de 2020, nos sítios do Tribunal de Justiça do Rio de Janeiro - Brasil, Tribunal Regional Federal da Segunda Região e Superior Tribunal de Justiça. A análise baseou-se na teoria da reserva do possível e mínimo existencial Resultados identificaram-se quatro casos sobre judicialização na saúde, os quais caracterizaram-se como mecanismo de garantia de direitos laboral, evidenciando a necessidade de mais eficiência nas políticas públicas para melhorar o acesso à saúde Considerações finais o dilema entre a vida humana e a economia apareceu nas decisões judiciais, e a judicialização apresentou-se como mecanismo de garantia de direitos. Contribuiu-se com a discussão sobre demandas judiciais na saúde e a baixa capacidade de atendimento às pessoas com necessidades complexas.

RESUMEN Objetivo analizar casos de judicialización de la salud, describir sus resultados y debatir las repercusiones de las decisiones judiciales para la atención de la salud y para el Sistema Único de Salud Método estudio de caso, realizado entre mayo y julio de 2020 en los sitios web del Tribunal de Justicia de Río de Janeiro - Brasil, del Tribunal Regional Federal de la Segunda Región y de la Suprema Corte de Justicia. El análisis se basó en la teoría de la Reserva de lo posible y mínimo existencial Resultados se identificaron cuatro casos sobre judicialización de la salud, que se caracterizaron como un mecanismo de garantía de derechos laborales, evidenciando así la necesidad de mayor eficiencia en las políticas públicas para mejorar el acceso a la salud Consideraciones finales el dilema entre la vida humana y la economía se hizo presente en las decisiones judiciales, y la judicialización se presentó como un mecanismo de garantía de derechos. El aporte del estudio fue el debate sobre demandas judiciales en salud y la escasa capacidad para atender a las personas con necesidades complejas

ABSTRACT Objective to analyze cases of judicialization of health, describe their outcome and discuss the repercussions of the legal decisions for health care and the Unified Health System Method a case study, carried out from May to July 2020, in the websites of the Court of Justice of Rio de Janeiro - Brazil, Regional Federal Court of the Second Region and Superior Court of Justice. The analysis was based on the theory of contingency reserve and basic human dignity Results four cases about judicialization in health were identified, which were characterized as a mechanism for guaranteeing labor rights, evidencing the need for more efficiency in the public policies to improve access to health Final considerations the dilemma between human life and economy emerged in the legal decisions, and judicialization presented itself as a mechanism for guaranteeing rights. It contributed to the discussion about lawsuits in health and about the low ability to serve people with complex needs

Brazilian labor reform and implications for nursing work: a case study / Reforma laboral brasileña e implicaciones para el trabajo de enfermería: un estudio de caso / Reforma trabalhista brasileira e implicações para o trabalho de enfermagem: estudo de caso

Abstract Objective: to analyze the Brazilian labor reform repercussions and its implications for nursing work. Method: this is an exploratory-descriptive case study. Data were collected on the website of four Regional Labor Courts (in Brazil), taking into account the cases judged in first and second instance, involving nurses and aspects of labor rights that were linked to labor reform. Results: two cases were captured that dealt with: 1) lack of prior inspection for unhealthy work; 2) expansion of nurses' working hours without overtime pay. These two situations were based on the labor reform, which confirms the process of loss of rights for nurses. Conclusion: implementing the new labor rules brought harm and had negative repercussions for nursing work, as it resulted in professionals' loss of rights. In this treadmill, it is believed that the dissatisfaction of these workers will increase and may result in professional evasion.

RESUMEN Objetivo: analizar las repercusiones de la reforma laboral brasileña y sus implicaciones para el trabajo de enfermería. Método: se trata de un estudio de caso exploratorio-descriptivo. Los datos fueron recolectados en el sitio web de cuatro Tribunales Laborales Regionales (en Brasil), tomando en cuenta los casos juzgados en primera y segunda instancia, involucrando enfermeras y aspectos de derechos laborales vinculados a la reforma laboral. Resultados: se capturaron dos casos que abordaron: 1) falta de inspección previa por trabajo insalubre; 2) ampliación de la jornada laboral de las enfermeras sin pago de horas extraordinarias. Estas dos situaciones se basaron en la reforma laboral, que confirma el proceso de pérdida de derechos de las enfermeras. Conclusión: la implementación de las nuevas normas laborales trajo perjuicios y repercusiones negativas para el trabajo de enfermería, ya que resultó en la pérdida de derechos de los profesionales. En esta cinta, se cree que la insatisfacción de estos trabajadores aumentará y puede resultar en la evasión profesional.

RESUMO Objetivo: analisar as repercussões da reforma trabalhista brasileira e suas implicações para o trabalho de enfermagem. Método: trata-se de um estudo de caso exploratório-descritivo. Os dados foram coletados no site de quatro Tribunais Regionais do Trabalho (do Brasil), levando-se em consideração os casos julgados em primeira e segunda instância, envolvendo enfermeiros e aspectos de direitos laborais que se vinculavam à reforma trabalhista. Resultados: foram captados dois casos que versavam sobre: 1) ausência de inspeção prévia para o trabalho insalubre; 2) ampliação da jornada de trabalho do enfermeiro sem pagamento de horas extras. Essas duas situações se fundamentaram na reforma trabalhista, que chancela o processo de perda de direitos dos enfermeiros. Conclusão: a implementação das novas regras trabalhistas trouxe prejuízo e repercutiu negativamente para o trabalho de enfermagem, pois se concluiu pela perda de direitos dos profissionais. Nessa esteira, acredita-se que a insatisfação desses trabalhadores aumentará e poderá resultar em evasão profissional.

Nursing work in the COVID-19 pandemic and repercussions for workers' mental health / Trabajo de enfermería en la pandemia de COVID-19 y repercusiones para la salud mental de los trabajadores / Trabalho de enfermagem na pandemia da covid-19 e repercussões para a saúde mental dos trabalhadores

ABSTRACT Objective: To reflect about the work context of nursing professionals in the COVID-19 pandemic and the repercussions for these professionals' mental health. Method: This is a theoretical reflective study with two thematic axes: i) Pandemic by COVID-19: epidemiological condition, manifestations, and preventive measures; ii) Precariousness of work in times of pandemic and impacts on the worker's mental health. Results: The COVID-19 pandemic made explicit the reflects of precariousness in the health sector. For example, the psychological suffering of nursing workers was evidenced due to the scarcity of personal protective equipment, the weakness in the description of the protocols and the flows for the effective control of infections, the long working hours, the inadequate professional training for crisis scenario and uncertainty in relation to therapeutic measures. Conclusion: The present article brings to light the aggravation of a scenario that raises the potential for negative impact on the mental health of nursing workers.

RESUMEN Objetivo: Reflexionar sobre el contexto de trabajo de los profesionales de enfermería en la pandemia de COVID-19 y las repercusiones para la salud mental de estos profesionales. Método: Se trata de un estudio teórico reflexivo con dos ejes temáticos: i) Pandemia de COVID-19: cuadro epidemiológico, manifestaciones y medidas preventivas; ii) Trabajo precario en tiempos de pandemia e impactos en la salud mental del trabajador. Resultados: La pandemia de COVID-19 explicitó los reflejos de precariedad en el sector de la salud, por ejemplo, el sufrimiento psicológico de los trabajadores de enfermería debido a la escasez de equipos de protección individual, la fragilidad en la descripción de los protocolos y los flujos al hospital. control efectivo de infecciones, horas de trabajo prolongadas, capacitación profesional inadecuada para el escenario de crisis e incertidumbres en relación con las medidas terapéuticas. Conclusión: El presente artículo saca a la luz el agravamiento de un escenario que aumenta el potencial de impacto negativo en la salud mental de los trabajadores de enfermería.

RESUMO Objetivo: Refletir sobre o contexto de trabalho dos profissionais de enfermagem na pandemia da Covid-19 e as repercussões para saúde mental desses profissionais. Método: Trata-se de um estudo teórico reflexivo com dois eixos temáticos: i) Pandemia pela Covid-19: quadro epidemiológico, manifestações e medidas preventivas; ii) Precarização laboral em tempos de pandemia e impactos na saúde mental do trabalhador. Resultados: A pandemia da Covid-19 explicitou os reflexos da precarização no setor saúde. Por exemplo, evidenciou-se o sofrimento psíquico dos trabalhadores de enfermagem decorrente da escassez de equipamento de proteção individual, da fragilidade na descrição dos protocolos e dos fluxos para o controle efetivo de infecções, das prolongadas horas de trabalho, da formação profissional inadequada para o cenário de crise e das incertezas em relações as medidas terapêuticas. Conclusão: O presente artigo traz à tona a agudização de um cenário que eleva o potencial de impacto negativo na saúde mental dos trabalhadores de enfermagem.

Contradicting perceptions of nursing teachers on the neoliberal context of labor / Percepciones contradictorias de docentes de enfermería acerca del contexto neoliberal de trabajo / Percepções contraditórias de docentes de enfermagem sobre o contexto neoliberal do trabalho

ABSTRACT Objectives: To identify and analyze the perceptions of nursing teachers on the new configurations of the job world and the repercussions for their labor activities. Methods: Qualitative, descriptive, exploratory research, carried out at two federal nursing colleges in Rio de Janeiro. Data collection occurred with 27 nursing teachers, between May and June 2016, through semi-structured interviews. The data were treated using the thematic content analysis technique. Results: The results showed contradictions in the teachers' perceptions about the job world, which has been guided by neoliberal precepts. Such contradictions are characterized by manifestations in favor of incorporating these precepts, highlighting their negative effects on nursing teaching work. Final considerations: There are incongruities in the way of perceiving the current configuration of the job world, proposing more and profound reflections on such a work scenario.

RESUMEN Objetivos: Identificar y analizar las percepciones de docentes de Enfermería acerca de las nuevas configuraciones del mundo laboral y las repercusiones para sus actividades laborales. Métodos: Investigación cualitativa, descriptiva, exploratoria, realizada en dos facultades de Enfermería federales, en Rio de Janeiro. La recogida de datos ocurrió con 27 docentes de Enfermería, entre mayo y junio de 2016, por medio de entrevista semiestructurada. Los datos tratados por técnica de análisis temático de contenido. Resultados: Apuntaron contradicciones en las percepciones de los docentes acerca del mundo laboral, lo cual ha se pautado por preceptos neoliberales. Tales contradicciones se caracterizan por manifestaciones a favor de incorporación de eses preceptos, evidenciando sus efectos negativos acerca del trabajo docente de Enfermería. Consideraciones finales: Hay disonancias en la manera de percibir la actual configuración del mundo laboral, proponiéndose más y profundas reflexiones acerca de tal escenario laboral.

RESUMO Objetivos: Identificar e analisar as percepções de docentes de Enfermagem acerca das novas configurações do mundo do trabalho e as repercussões para suas atividades laborais. Métodos: Pesquisa qualitativa, descritiva, exploratória, realizada em duas faculdades de enfermagem federais, no Rio de Janeiro. A coleta de dados ocorreu com 27 docentes de Enfermagem, entre maio e junho de 2016, por meio de entrevista semiestruturada. Os dados foram tratados pela técnica de análise temática de conteúdo. Resultados: Os resultados apontaram contradições nas percepções dos docentes sobre o mundo do trabalho, o qual tem se pautado por preceitos neoliberais. Tais contradições se caracterizam por manifestações a favor da incorporação desses preceitos, evidenciando seus efeitos negativos sobre o trabalho docente de Enfermagem. Considerações finais: Há dissonâncias na maneira de perceber a atual configuração do mundo do trabalho, propondo-se mais e profundas reflexões sobre tal cenário laboral.

Configurações do mundo do trabalho e o processo saúde-doença dos trabalhadores docentes de enfermagem / Working world's configurations and the health-disease process of nursing teachers / Configuraciones del mundo laboral y el proceso de salud-enfermedad de los trabajadores docentes de enfermería

Objetivo: analisar as repercussões do trabalho docente na saúde nos professores de enfermagem. Método: estudo qualitativo e descritivo realizado com 27 docentes de duas universidades públicas federais do Rio de Janeiro. A coleta de dados ocorreu por meio de entrevista semiestruturada e a técnica utilizada para o tratamento dos dados foi a análise temática de conteúdo. Resultados: devido às novas configurações do trabalho docente, que pressiona por alta demanda laboral e, por sua vez, oferece inadequadas condições de trabalho, esta atividade favorece ao adoecimento desses profissionais, que em contrapartida, relegam a segundo plano o cuidado com a própria saúde. Conclusão: compromissos exigidos no dia a dia e a falta de qualidade no trabalho tornam a vida do docente cada vez mais afastada do seu autocuidado e com elevado potencial para o adoecimento.

Objective: to analyze the repercussions of teaching work on the health of nursing professors. Method: qualitative and descriptive study with 27 teachers from two federal public universities in Rio de Janeiro. The data collection took place through a semi-structured interview and the technique used for the data treatment was the thematic content analysis. Results: due to the new configurations of the teaching work, which presses for high labor demand and, in turn, offers inadequate working conditions, this profession favors the teaching sickness, which, on the other hand, relegate health care to the background. Conclusion: commitments required on a daily basis and lack of quality in the work make the life of the teacher increasingly removed from their self-care and with high potential for illness. Descriptors: Faculty; occupational health; education, nursing; working conditions.

Objetivo: analizar las repercusiones del trabajo docente en la salud de los profesores de enfermería. Método: estudio cualitativo y descriptivo realizado con 27 maestros de dos universidades públicas federales de Río de Janeiro. La recolección de datos ocurrió por medio de entrevista semiestructurada y la técnica utilizada para el tratamiento de los datos fue el análisis temático de contenido. Resultados: debido a las nuevas configuraciones del trabajo docente, que presiona por alta demanda laboral y, a su vez, ofrece inadecuadas condiciones de trabajo, esta profesión favorece al enfermo docente, que en contrapartida, relegan a segundo plano el cuidado con la propia salud. Conclusión: compromisos exigidos en el día a día y la falta de calidad en el trabajo hacen la vida del docente cada vez más alejada de su autocuidado y con elevado potencial para la enfermedad.

De cuidador a paciente: na pandemia da Covid-19, quem defende e cuida da enfermagem brasileira? / De cuidador a paciente: en la pandemia de Covid-19, ¿quién defiende y cuida la enfermera brasileña? / From caregiver to patient: in the Covid-19 pandemic, who defends and cares for Brazilian nursing?

Objetivo: Refletir sobre a saúde do trabalhador de enfermagem diante da crise da pandemia pela Covid-19. Método: Artigo de reflexão cujo tema envolve a pandemia pela Covid-19 e a saúde do trabalhador de enfermagem. Desenvolveu-se a partir de duas seções teóricas: i) pandemia, aspectos epidemiológicos e recomendações para proteção do trabalhador de enfermagem; ii) saúde do trabalhador da enfermagem no contexto da Covid-19. Resultados. Os riscos à saúde do trabalhador de enfermagem, que já eram reocupantes antes da pandemia, tornaram-se alarmantes no atual contexto, especialmente por conta da incapacidade de um sistema de saúde há muito precarizado. Tal fato gera dilemas éticos, sofrimento físico e psíquico aos trabalhadores de enfermagem, além de adoecimentos e mortes. Conclusão e implicações para a prática. Logo, é preciso planejar e operacionalizar recursos materiais e humanos em quantidade e qualidade adequadas, considerando a premência do tempo, para dar suporte aos serviços de saúde e aos trabalhadores de enfermagem. Destaca-se o papel dos órgãos de classe, a necessidade da mobilização do coletivo profissional e o esforço de instâncias governamentais e sociais, como forma de mudar a situação apontada

Objective: Reflect on the health of nursing workers in the face of the pandemic crisis by Covid-19. Method: Reflection article whose theme involves the pandemic by Covid-19 and the health of nursing workers. It was developed from two theoretical sections: i) pandemic, epidemiological aspects and recommendations for the protection of nursing workers; ii) health of nursing workers in the context of Covid-19. Results. The risks to the health of nursing workers, which were already worrisome before the pandemic, have become alarming in the current context, especially due to the incapacity of a precarious health system existing for a long time. Conclusions and implications for practice. This fact generates ethical dilemmas, physical and psychic suffering for nursing workers, as well as illnesses and deaths. Therefore, it is necessary to plan and operationalize material and human resources in adequate quantity and quality, considering the last time, to support health services and nursing workers. We highlight the role of class organs, the need to mobilize the professional collective and the effort of governmental and social bodies, as a way to change the situation pointed out

Objetivo. Reflexionar sobre la salud de los trabajadores de enfermería ante la crisis de la pandemia por Parte de Covid-19. Método. Artículo de reflexión cuyo tema implica la pandemia de Covid-19 y la salud de los trabajadores de enfermería. Se desarrolló a partir de dos secciones teóricas: i) pandemia, spectos epidemiológicos y recomendaciones para la protección de los trabajadores de enfermería; ii) la salud de los trabajadores de enfermería en el contexto de Covid-19. Resultados. Los riesgos para la salud de los trabajadores de enfermería, que ya eran preocupantes antes de la pandemia, se han vuelto alarmantes en el contexto actual, especialmente debido a la incapacidad de un sistema de salud hace ya tempo precarizado. Este hecho genera dilemas éticos, sufrimiento físico y psíquico para los trabajadores de enfermería, así como enfermedades y muertes. Conclusiones e implicaciones para la práctica. Por lo tanto, es necesario planificar y poner en práctica los recursos materiales y humanos en cantidad y calidad decuadas, teniendo en cuenta la urgencia del tiempo, para apoyar a los servicios de salud y a los trabajadores de enfermería. Destacamos el papel de los órganos de clase, la necesidad de movilizar al colectivo profesional y el esfuerzo de los organismos gubernamentales y sociales, como una forma de cambiar la situación señalada