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1.
  • Lozano, Rafael, et al. (författare)
  • Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
  • 2018
  • Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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3.
  • Reitsma, Marissa B., et al. (författare)
  • Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015 : a systematic analysis from the Global Burden of Disease Study 2015
  • 2017
  • Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 389:10082, s. 1885-1906
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed. Methods We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI). Findings Worldwide, the age-standardised prevalence of daily smoking was 25.0% (95% uncertainty interval [UI] 24.2-25.7) for men and 5.4% (5.1-5.7) for women, representing 28.4% (25.8-31.1) and 34.4% (29.4-38.6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11.5% of global deaths (6.4 million [95% UI 5.7-7.0 million]) were attributable to smoking worldwide, of which 52.2% took place in four countries (China, India, the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smoking-attributable DALYs in low-SDI to middle-SDI geographies between 2005 and 2015. Interpretation The pace of progress in reducing smoking prevalence has been heterogeneous across geographies, development status, and sex, and as highlighted by more recent trends, maintaining past rates of decline should not be taken for granted, especially in women and in low-SDI to middle-SDI countries. Beyond the effect of the tobacco industry and societal mores, a crucial challenge facing tobacco control initiatives is that demographic forces are poised to heighten smoking's global toll, unless progress in preventing initiation and promoting cessation can be substantially accelerated. Greater success in tobacco control is possible but requires effective, comprehensive, and adequately implemented and enforced policies, which might in turn require global and national levels of political commitment beyond what has been achieved during the past 25 years.
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4.
  • Gallardo Fernández, Gloria L., 1953-, et al. (författare)
  • Granjeras del Mar : Luchas y Sueños en Coliumo
  • 2018
  • Bok (refereegranskat)abstract
    • The aim of the book is to make visible the history and aspirations of the Union of Independent Workers of Artisanal Fishermen, Shore Harvesters and Seaweed collectors, Caleta Coliumo − which in spite of its masculine name is composed only of women. In doing so the authors hope to contribute to supporting the Union’s ongoing struggle to secure productive livelihoods and contribute more widely to coastal sustainability in the region. These are goals that we think should involve partnerships between scientists, fishing organizations and local, regional and national authorities. The book is also a contribution to the general discussion on the Áreas de Manejo y Explotación de Recursos Bentónicos (AMERB) and especially to the entry of women into fishing in Chile.More particularly, this book focuses on the experience of women in Coliumo, in southern Chile (Bío-Bío region), who in the heat of the struggle for coastal resources with fishermen from an adjacent fishing cove, organized themselves and were successful in applying for and obtaining exclusive use rights in coastal marine areas under the system of Territorial Rights of Use for Fishing (TURFs). Gaining entitlements to TURFs soon evolved into a new struggle for resources, this time among women aligned with different fishing unions in Coliumo. The outcome of this struggle was the creation of a second TURFs, again governed only by an all-women fishing union. This demonstrated once again, that in addition to the women’s role as seaweed collectors, they were able to effectively exercise their recently acquired negotiation and managerial skills. These were capacities that even local fishermen came to admire. What began as a conflict with fishermen from another cove, became an avenue where two all-women fishing unions became managers of two TURFs entitlements in the village.  The women’s capacities to effectively manage their TURFs entitlements and related resources has resulted in increases in income and enhanced standing in their communities. The fishing union examined in the study will soon be moving up the value chain from seaweed collectors to producers. With the support of the State, there are also plans to develop small-scale algae aquaculture. Through the collective exercise of their own agency the women of Coliumo have empowered themselves not only as fishers and workers but also as resource managers, entrepreneurs and community leaders.
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5.
  • Couldry, N., et al. (författare)
  • Media, communication and the struggle for social progress
  • 2018
  • Ingår i: Global Media and Communication. - : Sage Publications. - 1742-7665 .- 1742-7673. ; 14:2, s. 173-191
  • Tidskriftsartikel (refereegranskat)abstract
    • This article discusses the role of media and communications in contributing to social progress, as elaborated in a landmark international project – the International Panel on Social Progress. First, it analyses how media and digital platforms have contributed to global inequality by examining media access and infrastructure across world regions. Second, it looks at media governance and the different mechanisms of corporatized control over media platforms, algorithms and content. Third, the article examines how the democratization of media is a key element in the struggle for social justice. It argues that effective media access – in terms of distribution of media resources, even relations between spaces of connection and the design and operation of spaces that foster dialogue, free speech and respectful cultural exchange – is a core component of social progress.
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6.
  • Gallardo Fernández, Gloria L., 1953-, et al. (författare)
  • Monetary stabilisation policies and militarisation : The effects on social and class structure in Argentina, Chile and Uruguay (1950-1985)
  • 2012
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • This paper analyses the origins of neoliberalism in the Southern Cone; a process that has its origin in the period 1955-65 with the implementation of monetary stabilization policies, followed later by the structural adjustment programs. Both the monetary stabilization and the structural adjustment policies were global macroeconomic mechanisms to restructure the dynamic of capital accumulation and economic power relations. By promoting a freer flow of capital, the economic stabilisation policies facilitated the entry of foreign capital into the economies of the Southern Cone, predisposing the economies of the Southern Cone to the process of internationalisation of production and financial capital, which began to take shape after World War II more rigorously.This process can be understood within a double transformation of capital as 1) the destruction of the domestic bourgeoisie; a process of relative concentration of capital; and 2) the internationalization of finance capital; a process of absolute concentration or centralization of capital. Military rule was a necessary conditions for the project and process of ‘peripheral privatization’ through which capital was accumulated, but not mainly through the productive circuit of capital (M-C-M+). This process thus took place within a global transformation in the process of concentration of capital characterised by a shift in the domain that provided the productive sphere towards the financial and commercial spheres as mean to secure the valorization of capital, requiring the liberalization of international credits and financial markets, thus setting the bases for the expansion of neoliberalism as an accumulation regime, globally and within Latin America. Therefore neoliberalism and globalization found their grounds in Latin America’s ephemeral ‘national developmentalism’ promoted by ECLAC (United Nations Economic Commission for Latin America and the Caribbean).
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7.
  • Gallardo Fernández, Gloria L., 1953-, et al. (författare)
  • Prospects of equitable and sustainable seaweed aquaculture : a case study of changing gender and socio-economic relations in Maullín, Chile
  • 2024
  • Ingår i: Maritime Studies. - : Springer Science+Business Media B.V.. - 1872-7859 .- 2212-9790. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • This article examines the development of marine tenure in the Maullín River, Chile. It starts with the emergence of artisanal red algae (Gracilaria chilensis) gathering and the changes resulting from the governmental ad hoc allocation of small-scale aquaculture concessions. We aim to track this transition, its drivers, effects on the work organization, gender relations, market relations and the sustainability/equity challenges currently confronting the community. We use a feminist political ecology approach to direct our multi-method data collection strategy and to analyse the empirical material. The State by enabling local tenure for the development of marine aquaculture concessions played an influential role in Maullín community attaining de facto territorial tenure. This led to the establishment of residential aquaculture communities while facilitating the integration of women in aquaculture activities. We see both steps as positive economic and social development opportunities in Maullín. While marine tenure has provided livelihood chances, low prices caused by the producers’ disadvantaged market position and the lack of supportive alliance building pose ongoing problems. We conclude that these factors are serious challenges to the sustainability of aquacultural livelihoods at Maullín River. While the case depicts aspects of women’s empowerment such as their engagement in developing potential post-production innovation ideas, entrepreneurial abilities to conduct market transactions as well as their better competence in literacy, math and financial expertise, there is still a long way to reach gender equality in the male-dominated aquacultural sector. © 2024, The Author(s).
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8.
  • Lojo Rodríguez, L. M., et al. (författare)
  • Limitrophy in contemporary literatures in English
  • 2023
  • Ingår i: European Journal of English Studies. - : Routledge. - 1382-5577 .- 1744-4233. ; 27:3, s. 361-371
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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9.
  • Mackenbach, J. P., et al. (författare)
  • Variations in the relation between education and cause-specific mortality in 19 European populations : A test of the "fundamental causes" theory of social inequalities in health
  • 2015
  • Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 127, s. 51-62
  • Tidskriftsartikel (refereegranskat)abstract
    • Link and Phelan have proposed to explain the persistence of health inequalities from the fact that socioeconomic status is a "fundamental cause" which embodies an array of resources that can be used to avoid disease risks no matter what mechanisms are relevant at any given time. To test this theory we compared the magnitude of inequalities in mortality between more and less preventable causes of death in 19 European populations, and assessed whether inequalities in mortality from preventable causes are larger in countries with larger resource inequalities.We collected and harmonized mortality data by educational level on 19 national and regional populations from 16 European countries in the first decade of the 21st century. We calculated age-adjusted Relative Risks of mortality among men and women aged 30-79 for 24 causes of death, which were classified into four groups: amenable to behavior change, amenable to medical intervention, amenable to injury prevention, and non-preventable.Although an overwhelming majority of Relative Risks indicate higher mortality risks among the lower educated, the strength of the education-mortality relation is highly variable between causes of death and populations. Inequalities in mortality are generally larger for causes amenable to behavior change, medical intervention and injury prevention than for non-preventable causes. The contrast between preventable and non-preventable causes is large for causes amenable to behavior change, but absent for causes amenable to injury prevention among women. The contrast between preventable and non-preventable causes is larger in Central & Eastern Europe, where resource inequalities are substantial, than in the Nordic countries and continental Europe, where resource inequalities are relatively small, but they are absent or small in Southern Europe, where resource inequalities are also large.In conclusion, our results provide some further support for the theory of "fundamental causes". However, the absence of larger inequalities for preventable causes in Southern Europe and for injury mortality among women indicate that further empirical and theoretical analysis is necessary to understand when and why the additional resources that a higher socioeconomic status provides, do and do not protect against prevailing health risks.
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