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Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021
Full text linkBackground
Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021.
Methods
We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures—borrowing strength from predictive covariates and across age, time, and geography—and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs).
Findings
Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1–16·5), to 515 000 (425 000–614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3–44·9), from 5·46 million (4·62–6·45) in 2000 to 7·74 million (6·51–9·2) in 2021. We estimated 34 400 (25 000–45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000–467 000). In children younger than 5 years, there were 81 100 (58 800–108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021.
Interpretation
Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.publishedVersio
A Holistic Analysis of Team Dynamics Using Relational Coordination as the Measure regarding Student Athlete Total Load: A Cross-Sectional Study
Full text linkBackground: Despite its small population, Norway wins a disproportionately large number of medals in international competitions. Therefore, it has been thought that the Norwegian sports model and sports school programs are influential in developing young Norwegian athletes to achieve such results. Today, more than 110 Norwegian private and public schools offer the elite sports program in Norway. Most student athletes attending those schools combine their high school education with elite sports, where they attend training sessions at both school and clubs. The number of people involved with the student athlete on a daily basis (i.e., other student athletes, club coaches, school coaches, schoolteachers, parents, and health personnel) indicate the importance of optimal communication and coordination. However, to the authors’ knowledge, no previous studies have explored communication and coordination among this population group. Therefore, the primary objective of this study was to use a holistic analysis of team dynamics using the Relational Coordination Survey as a measure to explore the relational coordination within and between student athletes, club coaches, and school coaches. A secondary objective of this study was to explore student athletes’, club coaches’, and school coaches’ relational coordination with schoolteachers, parents, and health personnel. In addition, the study aimed to explore differences in student athletes’ relational coordination with their significant others according to sport, school, performance level, sex, and school year.
Methods: The quality of relational coordination was measured by a cross-sectional questionnaire of student athletes (n = 345), club coaches (n = 42), and school coaches (n = 25) concerning training load and life load. Multiple one-way analyses of variance were used to assess differences between groups.
Results: The results show that student athletes, club coaches, and school coaches perceived moderate to weak relational coordination with parents, schoolteachers, and health personnel. Student athletes’ relational coordination score with parents was the only strong score observed. Furthermore, the results reveal notable differences in student athletes’ relational coordination with the roles according to their characteristics.
Conclusions: The findings suggest a potential for enhancing relationships and communication within and between the significant roles involved with student athletes. The results further indicate that those involved with the student athlete should consider a holistic approach to enhance communication and coordination, including physical, psychological, and other life factors, for optimal student athlete management and development. More resources are necessary to facilitate effective communication and coordination regarding the student athlete’s total load.publishedVersio
Building an open-source system test generation tool: lessons learned and empirical analyses with EvoMaster
Full text linkResearch in software testing often involves the development of software prototypes. Like any piece of software, there are challenges in the development, use and verification of such tools. However, some challenges are rather specific to this problem domain. For example, often these tools are developed by PhD students straight out of bachelor/master degrees, possibly lacking any industrial experience in software development. Prototype tools are used to carry out empirical studies, possibly studying different parameters of novel designed algorithms. Software scaffolding is needed to run large sets of experiments efficiently. Furthermore, when using AI-based techniques like evolutionary algorithms, care needs to be taken to deal with their randomness, which further complicates their verification. The aforementioned represent some of the challenges we have identified for this domain. In this paper, we report on our experience in building the open-source EvoMaster tool, which aims at system-level test case generation for enterprise applications. Many of the challenges we faced would be common to any researcher needing to build software testing tool prototypes. Therefore, one goal is that our shared experience here will boost the research community, by providing concrete solutions to many development challenges in the building of such kind of research prototypes. Ultimately, this will lead to increase the impact of scientific research on industrial practice.publishedVersio
A bird in the hand: empirically grounded archetypes of collaborative innovation in the public sector
Full text linkNormative approaches have dominated research on collaborative innovation arrangements in the public sector, but actual practices remain underexplored and uncategorized. We conducted an inductive, in-depth study of 35 collaborative innovation arrangements originating from the public sector and categorized them into overarching archetypes. In creating this empirically grounded typology of collaborative innovation archetypes, we found that public organizations prefer project- and programme-based development archetypes, and focus primarily on co-exploration activities. Moreover, such organizations lack experience using the collaborative arrangements suggested in the recent theoretical literature, but they actively use effectual reasoning, which previous studies largely have overlooked.A bird in the hand: empirically grounded archetypes of collaborative innovation in the public sectorpublishedVersio
Bærekraftig ledelse: En studie av Quiet Quitting og mental helse hos fremtidens arbeidstakere
Full text linkFormålet med oppgaven har vært å undersøke hvordan dagens ledere kan fremme bærekraftig ledelse og motvirke Quiet quitting, herunder å fremme god mental helse. Vi har på bakgrunn av dette formulert følgende problemstilling: “Hvordan kan ledere skape en organisasjon som møter fremtidige arbeidstakeres krav og behov til en bærekraftig arbeidsplass, og dermed bidra til god mental helse og økt engasjement?»
Det er mange faktorer som påvirker dette og hensikten med oppgaven har vært å identifisere hvilke behov som er mest fremtredende. Vi har særlig valgt å fokusere på hvilke behov som har en positiv påvirkning på mental form, da dette er assosiert med god mental helse og økt engasjement. Litteraturen omkring Quiet quitting tilsier at hovedårsakene til tilstanden nettopp er dårlig mental helse og lavt engasjement. Utgangspunktet for oppgaven er målgruppen unge voksne, i alderen 19−29 år. Studien er gjennomført basert på blandede metoder. Som følge av dette har vi delt oppgaven i to faser, herunder en kvalitativ og en kvantitativ del. Innledningsvis har vi presentert relevant bakgrunn og teoretiske perspektiver, som bidrar til å belyse oppgavens formål, og sette oppgaven i et samfunnsaktuelt perspektiv.
Funnene våre tilsier at kompetanseutvikling, engasjement og work-life balance har en signifikant positiv påvirkning på mental helse. Dette er dermed sentrale behov ledere må imøtekomme for å sikre god mental helse og bærekraftig ledelse. Samtidig er det viktig at behovet for meningsfullt arbeid blir ivaretatt, da det har en positiv signifikant sammenheng med mental form. Unge voksne verdsetter respekt, integritet og empati hos sine ledere, og bærekraftig ledelse oppfattes å kunne møte deres behov, selv uten påvirkningskraft.
På bakgrunn av disse funnene, og i tråd med oppgavens formål, har vi utarbeidet forslag til konkrete tiltak ledere kan ta i bruk for å møte ovennevnte behov og dermed bidra til god mental helse, økt engasjement og trivsel, og derav sikre bærekraftig ledelse. Hensikten med dette er at vi ønsket at oppgaven skulle ha praktisk relevans for dagens og fremtidens ledere, ved at vi har undersøkt dagens situasjon blant unge voksne og presenterte løsninger på utfordringene
Comparing Interactive Retrieval Approaches at the Lifelog Search Challenge 2021
Full text linkThe Lifelog Search Challenge (LSC) is an interactive benchmarking evaluation workshop for lifelog retrieval systems. The challenge was first organised in 2018 aiming to find the system that can quickly retrieve relevant lifelog images for a given semantic query. This paper provides an analysis of the performance of all 17 systems participating in the 4th LSC workshop held at the 2021 Annual ACM International Conference on Multimedia Retrieval (ICMR). LSC’21 was the largest effort at comparing different approaches to interactive lifelog retrieval systems seen thus far. Findings from the challenge suggest that many different interactive factors contribute to the success (or otherwise) of participating teams. In this paper, we provide an overview of the LSC’21 challenge, introduce each team’s approach and explore these factors in depth and offer clues on how to develop a high-performing interactive lifelog search engine.publishedVersio
Ledelse ved bruk av hjemmekontor
Full text linkMed en økning av hjemmekontor som arbeidsform har det oppstått behov for å utforske hvordan ledere kan bygge tillitsfulle relasjoner med ansatte ved fjernarbeid. Oppgaven har formulert følgende problemstillingen for å undersøke temaet: Hvordan kan ledere bygge tillitsfulle leder-medarbeider-relasjoner med ansatte på hjemmekontor, og hvordan påvirkes jobbtilfredsheten?
Deduktiv tilnærming og et deskriptivt forskningsdesign tas i bruk for å knytte studien til tidligere forskning. Datainnsamlingen baseres på ett tverrsnittstudie som ble utført gjennom en digital kvantitativ spørreundersøkelse. Totalt var det 155 respondenter til undersøkelsen, og dataen ble analysert ved hjelp av analyseverktøyet IBM SPSS Statistics.
Studien viser at tillitsfulle leder-medarbeider-relasjoner på hjemmekontor kan bygges gjennom kommunikasjon, anerkjennelse og tilgjengelighet fra lederen. For å opprettholde sterke relasjoner bør leder gi støtte, veiledning og autonomi til ansatte som jobber hjemmefra. Funnene viser at tillit har positiv innvirkning på jobbtilfredshet, spesielt gjennom samarbeid med kollegaer. Studiens begrensninger inkluderer utvalgets representativitet, mulige ekskluderte faktorer og selvrapporteringsbias. Disse metodiske overveielsene bør tas i betraktning ved tolkning og generalisering av resultatene.
Masteroppgaven bidrar til forståelsen av tillitsbygging og leder-medarbeider-relasjoner i hjemmekontorkontekst, og har relevans for organisasjoner som står overfor økt bruk av fjernarbeid. Resultatene kan bidra til å videreutvikle praksis og retningslinjer for ledere som ønsker å skape tillit og styrke relasjoner med ansatte på hjemmekontor.
Videre forskning bør fokusere på ulike yrkesgrupper for å få dypere forståelse av hvordan hjemmekontor påvirker studiens tema i ulike arbeidsmiljøer. Ulike lederperspektiver bør inkluderes for å få dypere innsikt i hvordan relasjonen oppfattes og utvikles fra begge sider. Sammenligning av ulike lederstiler, bruk av kvalitative studier og longitudinelle design vil bidra til mer helhetlig forståelse av effekten til hjemmekontor. Forskningen bør også se på hvordan ulike ansettelsesrelasjoner påvirker tillitsbyggingen i sammenheng med hjemmekontor
Exploring the role of social media literacy in adolescents' experiences with personalization: A Norwegian qualitative study
Full text linkSocial media platforms rely on algorithms to filter and select content, thereby personalizing every individual's social media experience. Many use social media without awareness of this personalization and its impact, pointing to a need to both understand and improve literacy among active social media users. This qualitative study addresses adolescents' social media literacy through an investigation of their experiences with personalization on social media, aiming for a nuanced perspective of their outcomes. A thematic analysis of eight focus group interviews with 47 students aged 15–19 years uncovered two main themes: (1) diverse levels of adolescents' awareness and familiarity with personalization and (2) positive, negative, and mixed emotions toward personalization. Theme one uncovered that although the adolescents were largely unfamiliar with the terminology, when prompted, most of them could provide examples of personalization, whereas theme two revealed that adolescents appreciated relevant content and yet were uneasy about certain features.publishedVersio
Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021
Full text linkBackground
Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050.
Methods
Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively.
Findings
In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%.
Interpretation
Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.publishedVersio
Smart Shopping Carts to Increase Healthier Food Purchase: A Conjoint Experiment
Full text linkShopping carts, in general, should be suitable for carrying smart technology in the retail store environment. Also, a smart shopping cart can present verbal motivating stimuli to increase healthier food purchases. A conjoint experiment was used to test with a hypothetical purchasing task for young consumers (n=91) the potential of motivating stimulus on smart shopping carts to influence healthier purchases when buying frozen pizza. The results show a positive impact for all stimuli stemming from the smart shopping cart, three of which were health-based. This shows that stimuli revealing dynamic and personalized data through smart technology in a physical grocery retail setting have the potential to outperform traditional brand statements. Our conjoint experiment increased young consumers’ likelihood of choosing a healthier frozen pizza. This result demonstrates that verbal stimuli on smart shopping carts can function as motivating augmentals on young adult consumers’ healthier food p urchases and are in line with the market positioning and customer-service focus of many retailers and brands today, emphasizing a social marketing standing.publishedVersio