Sensibilidad ética, conocimientos y su relación con el consumo del alcohol en estudiantes universitarios

Introduction: care is an element influenced by multiple factors, among them, the axiological approach and ethical sensitivity, acting as a determinant in the quality of care provided to the patient. On the other hand, health problems related to alcohol consumption are becoming more and more frequent, giving way to the creation of moral dilemmas, in which the question arises whether an individual who affects his human responses by choice deserves the same level of care as those without control over his disease. Objective: to determine the relationship between ethical sensitivity, knowledge and alcohol consumption in university students. Methods: quantitative, descriptive, correlational, prospective and cross-sectional study, applying the Ethical Sensitivity, NEADA and AUDIT instruments to a group of nursing students belonging to a public university and selected by stratified probabilistic sampling. Results and discussion: ethical sensitivity scored at medium levels (52.3%), knowledge about alcohol was medium (81.7%) and consumption was characterized as risky (58.0%). Conclusions: The aim is for students to promote ethical and healthy behaviors through participation in social groups and workshops on didactic techniques that address addiction issues.Introducción: el cuidado es un elemento influenciado por múltiples factores, entre ellos, el enfoque axiológico y sensibilidad ética, fungiendo como un determinante en la calidad de la atención que se brinda al paciente. Por otro lado, los problemas de salud relacionados con el consumo de alcohol son cada vez más más frecuentes, dando paso a la creación de dilemas morales, en ellos plantea si un individuo que afecta sus respuestas humas por elección propia merece el mismo nivel de atención que aquellos sin control sobre su enfermedad. Objetivo: determinar la relación que existe en sensibilidad ética, conocimientos y consumo de alcohol en estudiantes universitarios. Material y métodos: estudio cuantitativo, descriptivo, correlacional, prospectivo y transversal, aplicando los instrumentos Sensibilidad ética, NEADA y AUDIT a un grupo de estudiantes de Enfermería pertenecientes a Universidad pública y seleccionados mediante un muestreo probabilístico estratificado. Resultados y discusión: la sensibilidad ética puntuó en niveles medios (52.3%), el conocimiento sobre el alcohol en medio (81.7%) y el consumo se caracterizó como riesgoso (58.0%). Conclusiones: se busca que el estudiante en promueva conductas éticas y saludables mediante la participación en grupos sociales y talleres sobre técnicas didácticas que aborden de temas de adicciones

Academic stress in nursing undergraduates, a longitudinal cross-sectional study in covid-19 times

Introducción: el confinamiento vivido por el SARS-Cov2 ha modificado la forman en que el mundo funcionaba, sin embargo, el mayor impacto ha sido recibido en tres sectores, el sanitario, económico y educativo, siendo este último el punto de partida para la realización de la presente investigación. Objetivo: comparar la media de estrés académico en un grupo de alumnos de la licenciatura en enfermería en dos períodos durante la pandemia por Covid-19. Materiales y métodos: estudio cuantitativo, descriptivo, comparativo y longitudinal, aplicando el Inventario SISCO-24, con un muestreo no probabilístico consecutivo. Resultados y discusión: 75.0% de la población pertenece al sexo femenino, 38.8% estudia y trabajan simultáneamente, la edad promedio es de 19.72± DE 1.43, los dominios que resultaron más afectados son los síntomas físicos y psicológicos (ME: 14.63± DE 4.38; ME: 15.99± DE 4.44) y a través de la prueba t de Student para muestras relacionadas se identificó que no existen diferencias significativas entre las medias de estrés académico (t= 0.13; Sig. Bilateral: .990). Conclusión: los métodos de educación virtuales manifiestan una incompatibilidad con el proceso enseñanza-aprendizaje, señalando que el aumento de factores estresores académicos es persistente y mantiene niveles peligrosamente elevados que amenazan a la salud mentalIntroduction: the confinement experienced by SARS-Cov2 has modified the way in which the world functioned; however, the greatest impact has been received in three sectors, health, economic and educational, the latter being the starting point for this research. Objective: to compare the mean academic stress in a group of nursing students in two periods during the Covid-19 pandemic. Materials and methods: quantitative, descriptive, comparative, and longitudinal study, applying the SISCO-24 Inventory, with non-probabilistic consecutive sampling. Results and discussion: 75.0% of the population was female, 38.8% studied and worked simultaneously, the mean age was 19.72 SD 1.43, the most affected domains were physical and psychological symptoms (ME: 14.63 SD 4.38; ME: 15.99 SD 4.44) and through the student’s t-test for related samples it was identified that there were no significant differences between the means of academic stress (t= 0.13; Bilateral Sig.: .990). Conclusion: virtual education methods manifest an incompatibility with the teaching-learning process, indicating that the increase of academic stressors is persistent and maintains dangerously high levels that threaten mental healt

Precision restoration: a necessary approach to foster forest recovery in the 21st century

We thank S. Tabik, E. Guirado, and Garnata Drone SL for fruitful debates about the application of remote sensing and artificial intelligence in restoration. E. McKeown looked over the English version of the manuscript. Original drawings were made by J. D. Guerrero. This work was supported by projects RESISTE (P18-RT-1927) from the Consejeria de Economia, Conocimiento, y Universidad from the Junta de Andalucia, and AVA201601.19 (NUTERA-DE I), DETECTOR (A-RNM-256-UGR18), and AVA2019.004 (NUTERA-DE II), cofinanced (80%) by the FEDER Program. F.M.-R. acknowledges the support of the Agreement 4580 between OTRI-UGR and the city council of La Zubia. We thank an anonymous reviewer for helpful comments that improved the manuscript.Forest restoration is currently a primary objective in environmental management policies at a global scale, to the extent that impressive initiatives and commitments have been launched to plant billions of trees. However, resources are limited and the success of any restoration effort should be maximized. Thus, restoration programs should seek to guarantee that what is planted today will become an adult tree in the future, a simple fact that, however, usually receives little attention. Here, we advocate for the need to focus restoration efforts on an individual plant level to increase establishment success while reducing negative side effects by using an approach that we term “precision forest restoration” (PFR). The objective of PFR will be to ensure that planted seedlings or sowed seeds will become adult trees with the appropriate landscape configuration to create functional and self-regulating forest ecosystems while reducing the negative impacts of traditional massive reforestation actions. PFR can take advantage of ecological knowledge together with technologies and methodologies from the landscape scale to the individual- plant scale, and from the more traditional, low-tech approaches to the latest high-tech ones. PFR may be more expensive at the level of individual plants, but will be more cost-effective in the long term if it allows for the creation of resilient forests able to providemultiple ecosystemservices. PFR was not feasible a few years ago due to the high cost and low precision of the available technologies, but it is currently an alternative that might reformulate a wide spectrum of ecosystem restoration activities.Junta de Andalucia P18-RT-1927European Commission AVA201601.19 A-RNM-256-UGR18 AVA2019.004OTRI-UGR 4580city council of La Zubia 458

Global urban environmental change drives adaptation in white clover.

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING: Bill & Melinda Gates Foundation

Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019

Summary: Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group