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- Naghavi, Mohsen, et al.
(författare)
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Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 385:9963, s. 117-171
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
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| 2. |
- Networked Learning Editorial Collective, (NLEC), et al.
(författare)
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Networked Learning in 2021: A Community Definition
- 2021
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Ingår i: Postdigital Science and Education. - : Springer. - 2524-4868 .- 2524-485X. ; 3, s. 326-369
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Tidskriftsartikel (refereegranskat)abstract
- Introduction (Networked Learning Editorial Collective): Since the turn of this century, much of the world has undergone a tectonic socio-technological change. Computers have left the isolated basements of research institutes and entered people's homes. Network connectivity has advanced from slow and unreliable modems to high-speed broadband. Devices have evolved: from stationary desktop computers to ever-present, always-connected smartphones. These developments have been accompanied by new digital practices, and changing expectations, not least in education, where enthusiasm for digital technologies has been kindled by quite contrasting sets of values. For example, some critical pedagogues working in the traditions of Freire and Illich have understood computers as novel tools for political and social emancipation, while opportunistic managers in cash-strapped universities have seen new opportunities for saving money and/or growing revenues. Irrespective of their ideological leanings, many of the early attempts at marrying technology and education had some features in common: instrumentalist understanding of human relationships with technologies, with a strong emphasis on practice and 'what works'.It is now clear that, in many countries, managerialist approaches have provided the framing, while local constraints and exigencies have shaped operational details, in fields such as e-learning, Technology Enhanced Learning, and others waving the 'Digital' banner. Too many emancipatory educational movements have ignored technology, burying their heads in the sand, or have wished it away, subscribing toa new form of Luddism, even as they sense themselves moving to the margins. But this situation is not set in stone. Our postdigital reality results from a complex interplay between centres and margins. Furthermore, the concepts of centres and margins 'have morphed into formations that we do not yet understand, and they have created (power) relationships which are still unsettled. The concepts … have not disappeared, but they have become somewhat marginal in their own right.' (Jandrić andHayes 2019) Social justice and emancipation are as important as ever, yet they require new theoretical reconfigurations and practices fit for our socio-technological moment.In the 1990s, networked learning (NL) emerged as a critical response to dominant discourses of the day. NL went against the grain in two main ways. First, it embarked on developing nuanced understandings of relationships between humans and technologies; understandings which reach beyond instrumentalism and various forms of determinism. Second, NL embraced the emancipatory agenda of the critical pedagogy movement and has, in various ways, politically committed to social justice (Beaty et al. 2002; Networked Learning Editorial Collective 2020). Gathered around the biennial Networked Learning Conference,1 the Research in NetworkedLearning book series,2 and a series of related projects and activities, the NL community has left a significant trace in educational transformations over the last few decades.Twenty years ago, founding members of the NL community offered a definition of NL which has strongly influenced the NL community’s theoretical perspectives and research approaches (Goodyear et al. 2004).3 Since then, however, the world has radically changed. With this in mind, the Networked Learning Editorial Collective (NLEC) recently published a paper entitled 'Networked Learning: InvitingRedefinition' (2020). In line with NL's critical agenda, a core goal for the paper was to open up a broad discussion about the current meaning and understandings of NL and directions for its further development.The current collectively authored paper presents the responses to the NLEC's open call. With 40 contributors coming from six continents and working across many fields of education, the paper reflects the breadth and depth of current understandings of NL. The responses have been collated, classified into main themes, and lightly edited for clarity. One of the responders, Sarah Hayes, was asked to write aconclusion. The final draft paper has undergone double open review. The reviewers, Laura Czerniewicz and Jeremy Knox, are acknowledged as authors.Our intention, in taking this approach, has been to further stimulate democratic discussion about NL and to prompt some much-needed community-building.
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