Care in family coping with adolescent drug users

Objetivo: Conocer los significados y afrontamiento familiar de adolescentes que consumen drogas en rehabilitación. Método: Investigación cualitativa de diseño fenomenológico, buscó conocer las historias de vida de las familias de los adolescentes que consumen drogas en un centro de rehabilitación de la ciudad de Chihuahua. Se utilizó la observación participante, diario de campo y entrevista en profundidad, se realizó análisis de contenido en tres momentos: descubrimiento, codificación y construcción de unidades de significado. Resultados: El consumo de sustancias adictivas en los adolescentes provoca cambios y sentimientos en la dinámica familiar, generando impotencia, enojo y al mismo tiempo estrés y miedo. Desde la perspectiva del afrontamiento que vive la familia del adolescente que consume drogas, se encuentran cuatro categorías: comunicación familiar deficiente, a nosotros como familia quien nos cuida, intuición de madre un despertar a la realidad y por último derrota como familia. Conclusión: Se encontró desintegración en la familia como unidad, carente de comunicación y con sentimientos complejos de dolor y sufrimiento ante una realidad de vida, un despertar difícil como padres, pero con la esperanza de que cada día es la oportunidad para salir adelante. No es sencillo estructurar una forma de cuidado, fue necesario llegar a las fibras más sensibles del ser humano para poder comprender los procesos en los que se encuentra inmerso, estableciendo un diálogo íntimo e intencionado con él, que lo envuelve en un torbellino de dolor y sufrimiento.Objective: Knowing the meanings and family coping of drug using adolescents in rehabilitation. Methodology: Qualitative research with a phenomenological research design, attempting to know the life histories of families of drug using adolescents in a rehabilitation center in the city of Chihuahua. Participant observation, field journal, and in-depth interviews were used, and content analysis of three moments was conducted: discovery, coding, and construction of units of meaning. Results: Adolescent use of addictive substances causes changes and feelings in the family dynamics, generating impotence, anger, and at the same time stress and fear. From the perspective of family coping with drug using adolescents, there are four categories: deficient family communication, who cares for the family, mother’s intuition: awakening to reality and finally, family defeat. Conclusion: Disintegration of the family as a unit was found, lacking communication and with complex feelings of pain and suffering before a reality of life, a difficult awakening as parents, but hoping each day to be an opportunity to get ahead. It is not easy to structure a form of care, it was necessary to touch the most sensitive strings of human beings by establishing an intimate and well-intentioned dialogue with them to understand the processes they go through and which get them into a whirlwind of pain and suffering

Accounting Ethics, Financial Reporting Focused on Financial Frauds: A Bibliometric Analysis

Purpose:  The aim of this research is to carry out a bibliometric analysis of accounting ethics and its relationship with financial reports and financial fraud   Theoretical framework:  Accounting ethics refers to the set of principles and values that govern the professional conduct of accountants in their daily work activity. Likewise, frauds on financial statements have generated accounting scandals and they include unethical behavior by public accountants. Understanding and analyzing the relationship between accounting ethics, reports, financial fraud and their evolution over time is essential for improving the curriculum of the accounting student.   Design/Methodology/Approach: Data from the SCOPUS database was collected from 1986 to 2022. Descriptive and inferential statistical methods were used to carry out a bibliometric analysis wich included, articles, reviews and conference reviews. In order to analyse research trends, no type of documents were excluded. The citation and bibliographic information, as well as the abstract and keywords of the obtained results were exported to a CSV file. Furthremore, the bibliometric analysis was performed using R studio software through the biblioshiny platform.   Findings: The findings revealed that the field of accounting ethics in relation to financial reporting or financial fraud is not well established in the scientific literature, but has potential for growth in the near future. The results reported that since the year 2000 this area has had an exponential growth led by the countries of the US, Australia and Spain that contributed documents in this area compared to other countries. The new developments in the field of accounting ethics have not been sufficiently studied and understood in a logical and concise manner. This study used a conceptual framework to organize and analyze the various streams and research topics in the field. These themes and subthemes have suggested research recommendations and crucial research areas.   Research, Practical & Social implications:  The authors recommend more research in the field of accounting ethics with other accounting areas and thus identify areas that need further exploration. The current study can help researchers and recruiters analyze the upcoming trends in accounting ethics by helping decision-makers in accountant education.   Originality/Value: The research turns out to be an original investigation that contributes to the bibliometric representation in the field of accounting ethics.

Wix y desarrollo de la escritura digital académica en estudiantes universitarios de primer año

El objetivo de esta experiencia de aprendizaje digital fue replantear los cursos de Comprensión y Producción de Lenguaje 1 y Comprensión y Producción de Lenguaje 2 sobre la base de la inclusión de la herramienta WIX (herramienta en línea gratuita que permite la creación de páginas web personalizables). Para ello, se trazaron dos hipótesis de trabajo. La construcción de un espacio virtual denominado boletín y bitácora respectivamente aumentaría la motivación de los estudiantes y la publicación de contenido en línea complejizaría su escritura digital académica. Siguiendo los principios del enfoque de investigación basado en el diseño (Educational Design Research, EDR por sus siglas en inglés), esta experiencia está atravesando por ciclos iterativos de análisis y evaluación con el fin de fortalecer un diseño que atienda a las necesidades heterogéneas de los estudiantes. En este artículo, se presentan el desarrollo de esta experiencia digital durante los ciclos 2018-2 y 2019-1

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Aymara Arutha Chiqapa Qillqañataki Panka = Manual de escritura aimara 1

Este texto permite a docentes de EIB conocer más su lengua originaria, contar con orientaciones para el uso del alfabeto oficial y normas de escritura consensuadas, y avanzar en la construcción de estilos escritos que se vayan estandarizando por acción de los hablantes de esta lengua originaria. Todo esto es necesario para desarrollar la propuesta pedagógica de EIB y promover competencias comunicativas en la lengua originaria como lengua materna de los niños y niñas. Este material es el resultado de un trabajo conjunto entre lingüistas, docentes, representantes de organizaciones indígenas, especialistas de EIB y sabio(a)s quienes hablan y/o escriben competentemente en dicha lengua. El texto se pone a a disposición de los maestros y maestras de las instituciones educativas donde asisten estudiantes del pueblo aimara para que consulten diversos aspectos respecto a la escritura en esta lengua. Un docente que maneja en forma oral y escrita la lengua originaria de sus estudiantes y desarrolla competencias comunicativas en ella, contribuirá a lograr los cambios necesarios para llevar a cabo el modelo de servicio EIB en sus diferentes formas de atención y, por lo tanto, al desarrollo de aprendizajes pertinentes en los estudiantes de los pueblos originarios

Aymara Arutha Chiqapa Qillqañataki Panka = Manual de escritura aimara 1

Este texto permite a docentes de EIB conocer más su lengua originaria, contar con orientaciones para el uso del alfabeto oficial y normas de escritura consensuadas, y avanzar en la construcción de estilos escritos que se vayan estandarizando por acción de los hablantes de esta lengua originaria. Todo esto es necesario para desarrollar la propuesta pedagógica de EIB y promover competencias comunicativas en la lengua originaria como lengua materna de los niños y niñas. Este material es el resultado de un trabajo conjunto entre lingüistas, docentes, representantes de organizaciones indígenas, especialistas de EIB y sabio(a)s quienes hablan y/o escriben competentemente en dicha lengua. El texto se pone a a disposición de los maestros y maestras de las instituciones educativas donde asisten estudiantes del pueblo aimara para que consulten diversos aspectos respecto a la escritura en esta lengua. Un docente que maneja en forma oral y escrita la lengua originaria de sus estudiantes y desarrolla competencias comunicativas en ella, contribuirá a lograr los cambios necesarios para llevar a cabo el modelo de servicio EIB en sus diferentes formas de atención y, por lo tanto, al desarrollo de aprendizajes pertinentes en los estudiantes de los pueblos originarios

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe