Projeto de vida em planos individuais de atendimento no contexto socioeducativo / Life project in individual plansof attendancein the socio-educational context / Proyecto de vida en planes individuales de asistenciaen el contexto socioeducativo

Este artigo tem como objetivo apresentar como o projeto de vida de adolescentes que cumprem medida socioeducativa de Liberdade Assistida (LA) é abordado no instrumento institucional Plano Individual de Atendimento ­ PIA. Para tanto, foi feita a análise documental de 26 PIAs produzidos em um Creas da zona sul do Rio de Janeiro, bem como entrevista com a psicóloga à frente do Serviço de Acompanhamento a adolescentes em cumprimento de medida socioeducativa da referida instituição. Ao final, percebeu-se que o PIA não é usado como base instrumental para o trabalho articulado a um projeto de vida dos adolescentes, mas é reduzido a um contrato firmado com eles no início do cumprimento da medida com registro de expectativas de futuro. Isso aponta para a necessidade de o PIA avançar de um campo de registro de expectativas de futuro para um de trabalho com o projeto de vida dos adolescentes. (AU)

This article aims to present how the life project of adolescents serving socio-educational measure of assisted freedom is addressed in the institutional instrument Individual Plan of Attendance ­IPA. To this end, a documentary analysis of 26 IPAs produced in a Specialized Reference Center for Social Assistance in Rio de Janeiro, Brazil, was carried out, as well as an interview with the psychologist, who is one of the techniques of the referred institution. In the end, it was noticed that the IPA is not used as an instrumental basis for the work articulated to a life project, but is reduced to a contract signed with them at the beginning of the fulfillment of the measure with a record of future expectations. This points to the need for the IPA to move from a field of recording expectations of the future to one of working with the adolescents' life project. (AU)

Este artículo tiene como objetivo presentar cómo el proyecto de vida de los adolescentes que cumplen con una medida socioeducativa de libertad asistida se aborda en el instrumento institucional Plan Individual de Asistencia­PIA. Para ello, se realizó un análisis documental de 26 PIAs producidos en un Centro de referencia especializado en asistencia social en Río de Janeiro, Brasil, así como una entrevista con el psicólogo, quien es uno de los técnicos de la institución. Al final, se advirtió que el PIA no se utiliza como base instrumental del trabajo articulado al proyecto de vida, sino que se reduce a un contrato firmado con ellos al inicio del cumplimiento de la medida con un registro de expectativas futuras. Esto apunta a la necesidad de que el PIA pase de un campo de registro de expectativas de futuro a uno de trabajo con el proyecto de vida. (AU)

La oferta de médicos especialistas en Uruguay, 2020. El caso de la nefrología / Medical specialists supply in Uruguay in 2020. A study that focuses on nephrologists / Oferta de médicos especialistas no Uruguai, 2020. O caso da nefrologia

Resumen: Objetivo: estimar la oferta de nefrólogos en Uruguay en 2020. Método: Se plantea analizar las fuentes de información de acceso público como insumo para estimar la oferta de especialistas médicos en Uruguay, su completitud, fiabilidad y limitaciones. Resultados: en 2020, se identifican 178 médicos con desempeño profesional activo en el área de la nefrología en Uruguay. Es una especialidad con una pirámide feminizada (más del 70% son mujeres), y con más de la mitad de los médicos con edades por encima de los 49 años. Si se restringe el universo a los de 65 años o menos, el país cuenta con una oferta de 173 especialistas. Más allá de las limitaciones, es la mejor aproximación a la cantidad y estructura demográfica de la profesión en el país. Conclusiones: el estudio aporta una estimación sobre la oferta de recursos humanos en nefrología. El poder realizar este tipo de trabajo es un avance sustantivo para el Uruguay. La información y los sistemas de información se conciben como un insumo fundamental para el proceso de toma de decisión y gestión en salud. En tal sentido cobra relevancia la optimización del uso de los datos y la información disponible en cada momento, así como la identificación de los datos necesarios y no disponibles, de manera de promover su incorporación en próximas innovaciones de los sistemas de registros sistemáticos de datos.

Abstract: Objective: to estimate nephrologists´ supply in Uruguay in 2020. Method: an analysis of information sources of public access was performed to estimate medical specialists supply in Uruguay, as well as its completeness, reliability and limitations. Results: in 2020, 178 physicians were identified as active nephrology professionals in Uruguay. This area of specialization may be represented as a feminized pyramid, 70% of nephrologists are women and over 50% of them are over 49 years old. If you further restrict these specialists' universe to those who are 65 years old or younger, we find there are 173 medical specialists in Uruguay. Beyond limitations in the method, this is the most accurate survey in terms of the number of nephrologists in the country and the demographic structure of this medical specialization. Conclusions: the study provides an estimation on the human resources supply in nephrology. The ability to conduct this kind of study constitutes a significant progress in Uruguay. Information and information systems are seen as a key input to manage health issues and make decisions in the field of healthcare. As a matter of fact, optimization in the use of data and information available at any time, as well as identifying required data that are not available in order to promote its collection in future innovations of data recording systems is highly relevant.

Resumo: Objetivo: estimar a oferta de nefrologistas no Uruguai no ano de 2020. Método: propor a análise das futuras informações de acesso público como entrada para estimar a oferta de especialistas médicos no Uruguai, sua completitude, fiabilidade e limitações. Resultados: em 2020, foram identificados 178 médicos com desempenho profissional ativo na área da Nefrologia no Uruguai. É uma especialidade com uma pirâmide feminizada - mais de 70% são mulheres, e mais da metade dos médicos com mais de 49 anos. Se este universo for restringido a profissionais com 65 anos ou menos, o país conta com uma oferta de 173 especialistas. Mesmo considerando as limitações, esta é a melhor aproximação à quantidade e estrutura demográfica da profissão no país. Conclusões: o estudo aporta uma estimativa sobre a oferta de recursos humanos em nefrologia. A possibilidade de realizar este tipo de análise é um avanço importante para o Uruguai. A informação e os sistemas de informação são concebidos como um insumo fundamental para o processo de tomada de decisões e o processo de gestão em saúde. Sendo assim, a otimização do uso de dados e informações disponíveis em cada momento, bem como a identificação dos dados necessários e não disponíveis, para promover sua incorporação nas próximas inovações dos sistemas de registros sistemáticos de dados.

Historical language records reveal a surge of cognitive distortions in recent decades.

Individuals with depression are prone to maladaptive patterns of thinking, known as cognitive distortions, whereby they think about themselves, the world, and the future in overly negative and inaccurate ways. These distortions are associated with marked changes in an individual's mood, behavior, and language. We hypothesize that societies can undergo similar changes in their collective psychology that are reflected in historical records of language use. Here, we investigate the prevalence of textual markers of cognitive distortions in over 14 million books for the past 125 y and observe a surge of their prevalence since the 1980s, to levels exceeding those of the Great Depression and both World Wars. This pattern does not seem to be driven by changes in word meaning, publishing and writing standards, or the Google Books sample. Our results suggest a recent societal shift toward language associated with cognitive distortions and internalizing disorders.

Análisis de la confección de los certificados de asistencia de primera intención del lesionado. Matanzas 2015 / Analysis of the preparation of the first intention assistance certificates of the injured party. Matanzas 2015

Resumen Dentro de las actuaciones medicolegales de mayor trascendencia en el delito de lesiones se encuentra la asistencia de primera intención del lesionado con la correspondiente certificación médica inicial. La confección en Cuba del certificado de asistencia de primera intención de un lesionado dista mucho de ser la adecuada, comprobado por diversos trabajos de autores nacionales y extranjeros. La presente investigación tiene como objetivo el análisis de la confección de los certificados de este tipo, realizados en el municipio de Matanzas, Cuba, en el año 2015 para lo cual se utilizaron variables como la descripción anatómica de las lesiones y el pronóstico medicolegal. Para el análisis de los resultados se utilizaron métodos estadísticos como valores porcentuales y tablas de frecuencia. Los resultados obtenidos arrojaron como conclusiones que el desconocimiento de la clasificación de las lesiones según el código penal, las dificultades en la descripción anatómica y en el pronóstico médico legal de las lesiones constituyen las principales deficiencias detectadas.

Abstract Among the most important medical legal actions in the crime of injuries is the first intention assistance of the injured party with the corresponding initial medical certification. The preparation in Cuba of the certificate of first intention assistance of an injured person is far from being adequate, proven by various works by national and foreign authors. The objective of this research is to analyze the preparation of certificates of this type, carried out in the municipality of Matanzas, Cuba, in 2015, for which variables such as the anatomical description of the injuries and the medical-legal prognosis were used. . For the analysis of the results, statistical methods such as percentage values and frequency tables were used. The results obtained yielded as conclusions that the ignorance of the classification of injuries according to the penal code, the difficulties in the anatomical description and in the legal medical prognosis of the injuries constitute the main deficiencies detected.

Preserving quantifiable ethnographic records of disappearing human lifeways.

The human evolutionary sciences place high value on quantitative data from traditional small-scale societies that are rapidly modernizing. These data often stem from the sustained ethnographic work of anthropologists who are today nearing the end of their careers. Yet many quantitative ethnographic data are preserved only in summary formats that do not reflect the rich and variable ethnographic reality often described in unpublished field notes, nor the deep knowledge of their collectors. In raw disaggregated formats, such data have tremendous scientific value when used in conjunction with modern statistical techniques and as part of comparative analyses. Through a personal example of longitudinal research with Batek hunter-gatherers that involved collaboration across generations of researchers, we argue that quantifiable ethnographic records, just like material artifacts, deserve high-priority preservation efforts. We discuss the benefits, challenges, and possible avenues forward for digitizing, preserving, and archiving ethnographic data before it is too late.

Firearm-Related Deaths in Multnomah County, Oregon, 2010-2016: Linking Medical Examiner Data to State Vital Records Data.

OBJECTIVES: Violence due to firearms is a substantial public health problem. Death data from medical examiner and vital records were linked to evaluate the use of medical examiner data to augment routine surveillance and determine any differences in sex, age, manner of death, or race and ethnicity between the 2 data systems. MATERIALS AND METHODS: Medical examiner data were searched for keywords of interest, and vital records data were obtained and linked for deaths occurring in Multnomah County, Oregon, from January 1, 2010, through December 31, 2016. Both data sets were compared for the number and proportion of firearm-related deaths by sex, age, manner of death, and race/ethnicity. Sensitivity and positive predictive values were calculated for variables that had discordant results. RESULTS: A total of 568 firearm-related deaths were identified in the medical examiner data. After matching with manual review, the 2 data systems had 100% case agreement. A reverse match showed that most cases not found in medical examiner data were due to transfer of case jurisdiction. The 2 systems matched nearly perfectly in sex, age, and manner of death but differed in characterization of race and ethnicity. Sensitivity was 62% for Hispanic ethnicity but 93% for white and black race. PRACTICE IMPLICATIONS: Using medical examiner data was a useful way to augment routine surveillance of firearm-related deaths in our jurisdiction in close to real time. However, caution is needed when analyzing data by subgroups because of discordant classifications of race between the data systems.

Blurred lines: racial misclassification in death certificates in Brazil.

OBJECTIVES: To analyze the agreement between self-reported race and race reported on death certificates for older (≥ 60 years) residents of São Paulo, Brazil (from 2000 to 2016) and to estimate weights to correct mortality data by race. METHODS: We used data from the Health, Well-Being and Aging Study (SABE) and from Brazil's Mortality Information System. Misclassification was identified by comparing individual self-reported race with the corresponding race on the death certificate (n = 1012). Racial agreement was analyzed by performing sensitivity and Cohen's Kappa tests. Multinomial logistic regressions were adjusted to identify characteristics associated with misclassification. Correction weights were applied to race-specific mortality rates. RESULTS: Total racial misclassification was 17.3% (13.1% corresponded to whitening, and 4.2% to blackening). Racial misclassification was higher for self-reported pardos/mixed (63.5%), followed by blacks (42.6%). Official vital statistics suggest highest elderly mortality rates for whites, but after applying correction weights, black individuals had the highest rate (45.85/1000 population), followed by pardos/mixed (42.30/1000 population) and whites (37.91/1000 population). CONCLUSIONS: Official Brazilian data on race-specific mortality rates may be severely misclassified, resulting in biased estimates of racial inequalities.

[Suggestion for recommendations for the wise use of social media in French internal medicine - take control of online reputation]. / Utilisation avisée des réseaux sociaux pour la gestion de la e-réputation des médecins internistes français ­ proposition de recommandations.

Social networks (or SoMe) expanded exponentially over the last ten years, including healthcare. SoMe have changed the doctor's daily life and the relationship with patients. Poor management of SoMe can impact on "e-reputation". On the other hand, the proper use of SoMe allows the opening up of new functionalities in both clinical and research settings. Several scientific societies have made recommendations for the proper handling of SoMe in order to protect the personal information and privacy of physicians. Professionals are advised to differentiate between a professional account and a personal account. Confidentiality settings and certain "codes" for managing publications must be followed. Physicians must be aware that their publications are indelible and can damage their "e-reputation". The proper handling of SoMe will allow internists to organize their bibliographic monitoring, increase the altmetric of their articles, facilitate communication between researchers and modify the relationship with their patients.

Violation of children's and adolescents' rights ­ the profile of a southern state in Brazil

The rights of children and adolescents are provided by law and it is the duty of the State, family and society to care for them. Health and education professionals are responsible for reporting suspected or confirmed cases of rights violation. This study aimed to investigate the prevalence and qualification of violation of children's and adolescents' rights in the State of Paraná between 2009 and 2014. A descriptive and observational quantitative study was carried out based on the records of the Child Protective Services in Paraná, accessed through the Information System for Childhood and Adolescence (SIPIA). A total of 129.123 violations of rights were found. Among those cases, the right to familiar and communitarian companionship stands out with the greatest number of violations, followed by the right to education, culture, sports and leisure. Mothers were found to be the main aggressors, followed by fathers, and sexual violence/abuse was the most prevalent type of violence. In conclusion, there was a significant amount of violation of children's and adolescents' rights in the State of Paraná during the period covered by this research, and it has increased over the years. Besides, we found out that there is a predisposition of gender and age group for each variable analyzed.

Displasia fibromuscular en la Argentina. Registro del grupo de trabajo de Hipertensión Secundaria de la Sociedad Argentina de Hipertensión Arterial (SAHARA-DF): proyecto de protocolo y resultados preliminares / Fibromuscular dysplasia in Argentina. A registry from the Secondary Hypertension working group of the Argentine Society of Hypertension (SAHARA-DF): project protocol and preliminary results

En la Argentina no existen datos epidemiológicos sobre displasia fibromuscular. La realización de un registro nacional puede aportar información que conduzca a una actualización de los consensos y recomendaciones para un correcto diagnóstico, evaluación y tratamiento. El Registro Argentino de Displasia Fibromuscular (SAHARA-DF) inició su actividad de recopilación de datos en octubre de 2015. Al año 2019 se confirmaron 49 pacientes (44 mujeres, 38 hipertensos, edad 45,3 ± 17,2 años, 12 con presentación neurológica). Veintidós pacientes tuvieron lesiones vasculares en más de un sitio, a pesar del sesgo diagnóstico por falta de estudios complementarios en casi la mitad de los casos. El sitio afectado más frecuente fue el renovascular, seguido por el carotídeo y el ilíaco, y las lesiones multifocales fueron más frecuentes que las unifocales (35 versus 14, respectivamente). Se constató la presencia de aneurismas asociados en 13 casos y disección arterial en 4 casos. De las 22 angioplastias renales realizadas, 14 fueron con colocación de stent (endoprótesis). En este estudio preliminar de una población argentina se evidencia el carácter sistémico de la enfermedad y se plantea un llamado a actuar en cuanto a la necesidad de debatir el algoritmo diagnóstico y el método de tratamiento. (AU)

In Argentina there are no epidemiological data regarding fibromuscular dysplasia. Building a National Registry may provide information leading to updated consensus and recommendations for a correct diagnosis, assessment and treatment. Data gathering for the Argentine Registry of Fibromuscular Dysplasia (SAHARA-DF) was initiated in October 2015. By 2019, 49 patients were confirmed (44 women, 38 hypertensives, age 45.3 ± 17.2 years, 12 with a neurological presentation). Twenty-two patients had multi-site vascular lesions, in spite of a diagnosis bias due to lack of supporting studies in almost half of the cases. The renovascular site was the most affected, followed by the carotid and iliac sites, and multifocal lesions were more frequent than unifocal (35 versus 14, respectively). Associated aneurysms were found in 13 cases, and arterial dissection in 4. Twenty-two renal angioplasties were performed, 14 with stent placement. In this preliminary study of an Argentinian population, the systemic nature of the disease is evidenced, and a call for action arises regarding the need for discussing the diagnostic algorithm and treatment method. (AU)

Early life adversity, contact with children's social care services and educational outcomes at age 16 years: UK birth cohort study with linkage to national administrative records.

OBJECTIVES: To use record linkage of birth cohort and administrative data to study educational outcomes of children who are looked-after (in public care) and in need (social services involvement), and examine the role of early life factors. SETTING, DESIGN: Prospective observational study of children from the Avon Longitudinal Study of Parents and Children (ALSPAC), which recruited pregnant women in and around Bristol, UK in the early 1990s. ALSPAC was linked to the annual Children Looked-After (CLA) Data Return and Children In Need (CIN) Census. Educational outcomes at 16 years were obtained through linkage to the National Pupil Database (NPD). These included passing 5+ good GCSEs (grades A*-C, including English and Maths). Covariates included early life adversity and social position. PARTICIPANTS: 12 868 ALSPAC participants were linked to the NPD. The sample for the main educational outcomes analyses comprised 9545 children from the ALSPAC core sample who had complete education data. RESULTS: Overall, of the 12 868 ALSPAC participants linked to NPD data, 137 had a CLA record and a further 209 a CIN record during adolescence. These children were more disadvantaged than their peers and had little active study participation beyond infancy. In the main educational outcomes analyses, achievement of 5+ good GCSEs was low in the CLA (OR 0.14, 95% CI 0.05 to 0.35) and CIN (0.11, 0.05 to 0.27) groups relative to their peers. Measured early life factors explained little of this difference. CONCLUSIONS: Data linkage enabled the study of educational outcomes in children with social services contact. These children had substantially worse educational outcomes relative to their peers, for reasons likely to be multifactorial.

Big Data in Cancer Research: Real-World Resources for Precision Oncology to Improve Cancer Care Delivery.

In oncology, the term "big data" broadly describes the rapid acquisition and generation of massive amounts of information, typically from population cancer registries, electronic health records, or large-scale genetic sequencing studies. The challenge of using big data in cancer research lies in interdisciplinary collaboration and information processing to unify diverse data sources and provide valid analytics to harness meaningful information. This article provides an overview of how big data approaches can be applied in cancer research, and how they can be used to translate information into new ways to ultimately make informed decisions that improve cancer care and delivery.

Completeness of a newly implemented general cancer registry in northern France: Application of a three-source capture-recapture method.

BACKGROUND: Completeness, timeliness and accuracy are important qualities for registries. The objective was to estimate the completeness of the first two years of full registration (2008/2009) of a new population-based general cancer registry, at the time of national data centralisation. METHODS: Records followed international standards. Numbers of cases missed were estimated from a three-source (pathology labs, healthcare centres, health insurance services) capture-recapture method, using log-linear models for each gender. Age and place of residence were considered as potential variables of heterogeneous catchability. RESULTS: When data were centralized (2011/2012), 4446 cases in men and 3642 in women were recorded for 2008/2009 in the Registry. Overall completeness was estimated at 95.7% (95% CI: 94.3-97.2) for cases in men and 94.8% (95% CI: 92.6-97.0) in women. Completeness appeared higher for younger than for older subjects, with a significant difference of 4.1% (95% CI: 1.4-6.7) for men younger than 65 compared with their older counterparts. Estimates were collated with the number of cases registered in 2014 for the years 2008/2009 (4566 cases for men/3755 for women), when additional structures had notified cases retrospectively to the Registry. These numbers were consistent with the stratified capture-recapture estimates. CONCLUSION: This method appeared useful to estimate the completeness quantitatively. Despite a rather good completeness for the new Registry, the search for cases among older subjects must be improved.

The association between quality measures of medical university press releases and their corresponding news stories-Important information missing.

BACKGROUND: The news media is a key source for health and medical information, and relies to a large degree on material from press releases (PR). Medical universities are key players in the dissemination of PRs. This study aims to 1) explore the relation between the quality of press releases (PRs) from medical universities and their corresponding news stories (NSs) and 2) to identify the likelihood that specific scientific and interest-raising measures appear or are omitted in PRs and NSs. METHODS AND FINDINGS: In this retrospective study using quantitative content analysis, PRs (n = 507) from 21 medical universities in Germany, the Netherlands, Sweden, the USA and the UK were retrieved. Of all PRs, 33% had media coverage, resulting in 496 NSs. With two codebooks, 18 scientific (e.g. reporting the study design of the study correctly) and 7 interest-raising measures (e.g. words like 'ground-breaking') were evaluated in the PRs and NSs. For all measures the percentage of presence in NSs and PRs was calculated, together with a Mean PR Influence Factor. Quality of PRs and NSs was defined as a score, based on 12 of the 18 scientific measures. Mean (SD) NS quality score was 6.5 (1.7) which was significantly lower than the PR score of 8.0 (1.5). The two quality scores were significantly correlated. Quality measures that were frequently omitted included reporting important study limitations (present in 21% of PRs, 21% of NSs), funding (59% of PRs, 7% of NSs) and conflicts of interest (16% of PRs, 3% of NSs). We did not evaluate the quality of the scientific papers (SPs), and can therefore not determine if the quality of PRs and NSs is associated with the quality of SPs. CONCLUSIONS: This large study of medical university press releases and corresponding news stories showed that important measures of a scientific study such as funding and study limitations were omitted to a very large extent. The lay public and health personnel as well as policy makers, politicians and other decision makers may be misled by incomplete and partly inaccurate representations of scientific studies which could negatively affect important health-related behaviours and decisions.

Work injuries in internal migrants to Alberta, Canada. Do workers' compensation records provide an unbiased estimate of risk?

INTRODUCTION: It is not known whether out-of-province Canadians, who travel to Alberta for work, are at increased risk of occupational injury. METHODS: Workers' compensation board (WCB) claims in 2013 to 2015 for those injured in Alberta were extracted by home province. Denominator data, from Statistics Canada, indicated the numbers from Alberta and Newfoundland and Labrador (NL) employed in Alberta in 2012. Both datasets were stratified by industry, age, and gender. Logistic regression estimated the risk of a worker from NL making a WCB claim in 2013 or 2014, stratified by time lost from work. Bias from under-reporting was examined in responses to injury questions in a cohort of trades' workers across Canada and in a pilot study in Fort McMurray, Alberta. RESULTS: Injury reporting rate in workers from NL was lower than those from Alberta, with a marked deficit (odds ratio [OR] = 0.17; 95% confidence interval [CI], 0.12-0.27) for injuries resulting in 1 to 30 days off work. Among the 1520 from Alberta in the trades' cohort, 327 participants reported 444 work injuries: 34.5% were reported to the WCB, rising to 69.4% in those treated by a physician. A total of 52 injuries in Alberta were recorded by 151 workers in the Fort McMurray cohort. In logistic regression, very similar factors predicted WCB reporting in the trades and Fort McMurray cohorts, but those from out-of-province or recently settled in Alberta were much less likely to report (OR = 0.02; 95% CI, 0.00-0.40). CONCLUSION: Differential rates of under-reporting explain in part the overall low estimates of injuries in interprovincial workers but not the deficit in time-loss 1 to 30 days.

Trends and patterns of deaths, injuries and intentional disabilities within the Libyan armed conflict: 2012-2017.

BACKGROUND: The consequences of armed conflicts impose considerable burdens on the economy and health care services, particularly in countries that are not equipped to deal with them, such as in the Middle-East, and North African countries. Little is known about the burden of mortality and injury resulting from the Libyan armed conflict. This study aimed to determine the trends and patterns of mortality, injury and disabilities directly associated with the Libyan armed conflict and analyze the geographic variation within the country during 2012-2107. METHODS: Data on conflict-related deaths, injuries, and disabilities were obtained from the national registry offices. The information included date, place, and demographic information. A questionnaire was also used to obtain information from the affected individuals and their families. National and regional trends of mortality, injury and disabilities were calculated. Spatial analysis was performed using geographic data available on all documented cases to analyze clustering of mortality and injury. RESULTS: A total of 16,126 deaths and 42,633 injuries were recorded with complete information during the Libyan conflict from 2012 till 2017. The overall mortality rate was 2.7/1000 population and injury rate was 7.1/1000. The overall male-to-female ratio of mortality and injury was 4.4:1; 42.3% were single and aged 20-30 years old, and 26.4% were aged 31-40 years. Moreover, injuries resulted in death in 20.1% of cases and disability in 33.5% of the cases. Most of the disabilities were caused by blasts, while gun shots resulted in more deaths. The overall mortality and injury rates were highest during 2015-2017. These rates were highest in the eastern region. Injuries were most concentrated in Benghazi and Derna in the east, followed by Sert and Musrata in the central region. CONCLUSIONS: Conflict-related mortality, injury and disability has inflicted a heavy burden on the Libyan society that may persist for a long time. The rates of these casualties varied in time and place. National, well-planned efforts are needed to address this serious situation and its consequences.

Perception of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement of authors publishing reviews in nursing journals: a cross-sectional online survey.

OBJECTIVE: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement has been developed as a guideline for reporting systematic reviews and meta-analyses. Despite the prevalent use of the PRISMA statement in medicine and nursing, no studies have examined authors' perception of it. The purpose of this study is to explore the perception of the PRISMA statement of authors who published reviews, meta-analyses, or both in nursing journals. DESIGN: Cross-sectional descriptive study. METHODS: An online survey was conducted among authors who published reviews, meta-analyses, or both in nursing journals between 2011 and 2017. The selected authors' email addresses were extracted from the PUBMED database. A questionnaire-with a 10-point Likert scale (1-not important at all to 10-very important)-was developed to elicit their responses regarding their perception of not only the PRISMA statement as a whole, but also the individual items therein. RESULTS: Invitations were sent to 1960 valid email addresses identified, with 230 responses (response rate: 11.7%) and 181 completed responses (completion rate: 9.2%). The average perceived importance of the PRISMA statement was 8.66 (SD=1.35), while the perceived importance for the individual items ranged from 7.74 to 9.32. Six items were rated significantly higher than the average rating, whereas one item was rated significantly lower. CONCLUSION: Most respondents perceived the PRISMA statement as important. Items related to information sources, selection, search-flow presentation, summary of findings, limitations and interpretation were deemed more important while the registration was deemed less so.

Diminutive fleet-footed tyrannosauroid narrows the 70-million-year gap in the North American fossil record.

To date, eco-evolutionary dynamics in the ascent of tyrannosauroids to top predator roles have been obscured by a 70-million-year gap in the North American (NA) record. Here we report discovery of the oldest Cretaceous NA tyrannosauroid, extending the lineage by ~15 million years. The new taxon-Moros intrepidus gen. et sp. nov.-is represented by a hind limb from an individual nearing skeletal maturity at 6-7 years. With a ~1.2-m limb length and 78-kg mass, M. intrepidus ranks among the smallest Cretaceous tyrannosauroids, restricting the window for rapid mass increases preceding the appearance of colossal eutyrannosaurs. Phylogenetic affinity with Asian taxa supports transcontinental interchange as the means by which iconic biotas of the terminal Cretaceous were established in NA. The unexpectedly diminutive and highly cursorial bauplan of NA's earliest Cretaceous tyrannosauroids reveals an evolutionary strategy reliant on speed and small size during their prolonged stint as marginal predators.

Human lifespan records are not remarkable but their durations are.

Has the maximum human lifespan been reached? The current record stands at 122 years, 164 days and has held for over 20 years and is more than four and three quarter years higher than the previous record. The value and persistence of this record have surprised some researchers, with some even questioning its veracity. There have been previous attempts in the literature to answer questions about how long this record might stand and whether it is truly exceptional but the focus has been mainly on the record ages, using ad hoc tools. This article contributes in two new ways. First we study lifespan records via the (inter-) record times and second we make use of specific tools from statistical Records Theory. We find that the occurrence of the present record was not surprising. We estimate around a 25% chance that the record would have survived until now and around a one in five chance that it will survive until 2050, demonstrating remarkable persistence.

Indicators for estimating trends in alcohol-related assault: evaluation using police data from Queensland, Australia.

Monitoring levels of alcohol-related harm in populations requires indicators that are robust to extraneous influence. We investigated the validity of an indicator for police-attributed alcohol-related assault. We summarized offence records from Queensland Police, investigated patterns of missing data, and considered the utility of a surrogate for alcohol-related assault. Of 242 107 assaults from 2004-2014, in 35% of cases the drug used by the offender was recorded as 'unknown'. Under various assumptions about non-random missingness the proportion of assaults judged to be alcohol-related varied from 30%-65%. We found a sharp increase in missing data from 2007 suggesting the downward trend from that point is artefactual. Conversely, we found a stable and increasing trend using a time-based surrogate. The volume of missing data and other limitations preclude valid estimation of trends using the police indicator, and demonstrate how misleading results can be produced. Our analysis supports the use of an empirically-based surrogate indicator.