A Fragilidade do Capital Social como Fator Prejudicial ao Desenvolvimento do Turismo na Quarta Colônia - RS

O presente artigo tem como objetivo apresentar reflexões sobre os obstáculos que tem dificultado a consolidação do turismo na Quarta Colônia, território na região central do Rio Grande do Sul, Brasil. O pressuposto que guiou a investigação baseia-se em que estes obstáculos estão em boa medida relacionados à debilidade do capital social no território. O embasamento teórico atendeu principalmente às noções de: a) Desenvolvimento Territorial, b) Capital Social e c) Turismo. Para a análise da constituição do capital social buscou-se evidenciar a recorrência  das categorias teóricas operacionais: Relações de Confiança, Cooperação e Ação Coletiva. A opção metodológica foi a pesquisa qualitativa, com lócus empírico no território de Santa Maria – Quarta Colônia, tendo como recorte o período temporal a partir do ano de 1995. A pesquisa de campo, contemplando as etapas de observações e aplicação de entrevistas semiestruturadas com os atores locais, foi realizada no período de 2013 a 2014. Em termos de resultados, inferiu-se que são frágeis as relações entre os atores, quase inexistentes as ações coletivas no âmbito do turismo, apresentando relatos individualistas e de competição entre eles, o que tem tornado débil o capital social no território. Conclui-se que a fragilidade do capital social é um dos principais fatores que dificultam a superação dos obstáculos para maior consolidação do turismo e de suas repercussões no desenvolvimento do território

A presença do Curso de Gestão de Turismo na Fronteira Jaguarão/Rio Branco (Brasil-Uruguai) e perspectivas do pós-pandemia

This paper aims to portray some relevant aspects of the trajectory of the Higher/university Course in Technology in Tourism Management at the Federal University of Pampa, campus Jaguarão / RS. It also intends to describe the contribution of the course to the region, reflecting the current moment of the actions performed by its body of lectures and students. Besides, it brings out the prospects for the development of the post-pandemic tourism for its host city. The study starts from yearnings, concerns and reflections formulated by lecturers, coordinators and former coordinators of the Course of Tourism Management. Methodologically, it is characterized as a qualitative and applied research, with exploratory and descriptive objectives, and bibliographic and documentary procedures focusing on a case study. The analysis was carried out seeking to identify activities and information in the documents, based on questions of interest. As main results, stand out the initiatives related to the events promoted by the Course of Tourism Management during the pandemic and the emergency remote education, as well as scientific researches published in articles and undergraduate dissertations, alongside applied projects which have promoted discussions on varied and relevant themes, focused on the recovery of the sector, carried out from the perspective of an inclusive and ethical tourism, with a view to the integral insertion of the community in this activity.Este artículo tiene como objetivo retratar algunos de los aspectos relevantes de la trayectoria del “Curso Superior de Tecnologia de Gestão em Turismo” de la Universidad Federal de Pampa, campus Jaguarão/RS, así como describir el aporte del curso a la región, demostrando el momento actual de las acciones realizadas por el cuerpo docente y discente del curso y las perspectivas de desarrollo del turismo na pos pandemia del Covid 19 para su ciudad anfitriona. Este texto se origina de las ansiedades, inquietudes y reflexiones formuladas por docentes, coordinadores y ex coordinadores del curso de Gestión Turística. Metodológicamente se caracteriza por ser una investigación de enfoque cualitativo, carácter aplicado, objetivos exploratorios y descriptivos, procedimientos bibliográficos, documentales y estudio de casos. El análisis se realizó buscando identificar las actividades desarrolladas y la información fáctica en los documentos, con base en preguntas de interés. Como principales resultados se destacan las iniciativas relacionadas con los eventos promovidos por el Curso de Gestión Turística durante la pandemia y la educación remota de emergencia, así como las investigaciones científicas publicadas en artículos y conclusiones del curso, bien como proyectos aplicados, que han promovido discusiones sobre diversos temas, enfocado a la recuperación del sector, en la perspectiva de un turismo inclusivo y ético, con vista a la inserción integral de la comunidad.Cet article vise à décrire certains des aspects pertinents de la trajectoire du cours supérieur de technologie en gestion du tourisme à l'Université fédérale de Pampa, campus Jaguarão/RS, ainsi qu'à décrire la contribution du cours à la région, démontrant le moment actuel des actions menées par le corps professeur et étudiant du cursus et des perspectives de développement touristique dans l'après-pandémie du Covid 19 pour sa ville d'accueil. Cet écrit s'appuie sur des angoisses, des préoccupations et des réflexions formulées par des enseignants, des animateurs et anciens animateurs du cours Management du Tourisme. Méthodologiquement, il se caractérise comme une recherche qualitative, de nature appliquée, avec des objectifs exploratoires et descriptifs, des procédures bibliographiques et documentaires et une étude de cas. L'analyse a été réalisée en cherchant à identifier les activités réalisées et les informations factuelles contenues dans les documents, sur la base de questions d'intérêt. Comme principaux résultats, les initiatives liées aux événements promus par le cours de gestion du tourisme pendant la pandémie et l'enseignement à distance d'urgence se distinguent, ainsi que la recherche scientifique publiée dans des articles et des documents de conclusion de cours, ainsi que dans des projets appliqués qui ont favorisé des discussions sur divers thèmes, visant à la récupération du secteur, dans la perspective d'un tourisme inclusif et éthique, en vue de l'insertion intégrale de la communauté.Este artigo objetiva retratar alguns dos aspectos relevantes da trajetória do Curso Superior de Tecnologia em Gestão do Turismo da Universidade Federal do Pampa, campus Jaguarão/RS, bem como descrever a contribuição do curso para a região, demonstrando o momento atual das ações executadas pelo corpo docente e discente do curso e as perspectivas de desenvolvimento do turismo na pós-pandemia de Covid 19 para a sua cidade sede. Essa escrita parte de anseios, inquietações e reflexões formuladas por docentes, coordenadoras e ex coordenadoras do curso de Gestão de Turismo. Metodologicamente, é caracterizado como uma pesquisa qualitativa, de natureza aplicada, com objetivos exploratórios e descritivos, procedimentos bibliográficos e documentais e estudo de caso. A análise foi realizada buscando identificar atividades desenvolvidas e informações factuais nos documentos, a partir de questões de interesse. Como principais resultados, ressaltam-se as iniciativas relacionadas aos eventos promovidos pelo curso de Gestão de Turismo durante a pandemia e o ensino remoto emergencial, além de pesquisas científicas publicadas em artigos e trabalhos de conclusão de curso, bem como em projetos aplicados que tenham promovido discussões sobre temáticas diversas, voltadas à recuperação do setor, na perspectiva de um turismo inclusivo e ético, com vistas à inserção integral da comunidade

Reações de cicloadição : uma abordagem teórica e aplicações em síntese orgânica

Este artigo aborda os principais aspectos teóricos das reações de cicloadição, considerando a teoria de orbitais moleculares e a teoria de perturbações. Além disso, as reações de Diels-Alder e as reações 1,3-dipolares (cicloadições térmicas [4+2]) são detalhadas e exemplos de aplicações dessas reações são apresentados.This review reports the theoretical approach of the main aspects of cycloaddition reactions, considering the molecular orbital and perturbation theories. Moreover, Diels-Alder and 1,3-dipolar reactions (thermal [4+2] cycloadditions) are detailed and some examples of their application are described

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

O saber-fazer do turismo na revitalização de sítios históricos urbanos : um estudo das Praças da Alfândega e da Matriz na cidade de Porto Alegre / RS

O presente estudo é uma análise em torno das contribuições que o saber-fazer do turismo, enquanto prática social pode trazer para o fortalecimento das propostas de revitalização em sítios históricos urbanos. Reflexões da ordem da apropriação do turismo pelos planejadores urbanos nos processos de revitalização de sítios históricos, são analisadas na perspectiva da crítica ao viés da mercantilização do patrimônio cultural. Sendo assim, esta dissertação aproxima as questões da essencialidade do patrimônio e do fenômeno turístico pertinentes à apropriação turística nos sítios históricos urbanos na constituição desta oferta patrimonial destinada a visitante e visitado. A metodologia adotada é a pesquisa qualitativa, de caráter exploratório, tendo como estudo de caso o Sítio Histórico da cidade de Porto Alegre/ RS, no recorte da Praça da Alfândega e da Praça da Matriz e seus respectivos entornos. As técnicas da coleta de dados são: pesquisas bibliográfica e documental, levantamento fotográfico e entrevistas semiestruturadas. Os agentes informantes estão organizados em torno de três categorias: os anfitriões, os planejadores e os agenciadores. A apropriação do turismo por parte dos planejadores, evidenciada durante a pesquisa, demonstrou estar centrada, quase que exclusivamente, em ações de recuperação e melhorias da materialidade do Sítio Histórico Urbano e não em propostas que tratem as sociabilidades sob o ponto de vista das essencialidades do fenômeno turístico. Considera-se que o planejamento das revitalizações deve ampliar seus instrumentos de participação, para que o patrimônio se torne propulsor da união de laços entre os povos, elevando a auto-estima das populações e contribuindo para a solidariedade do encontro entre visitantes e visitados, na ubiqüidade do turismo sustentável e hospitaleiro.This study is an analysis on the contributions that the tourism knowhow, while being a social practice may bring for the strengthening of restoration propositions in historical urban places. Reasoning on the appropriation of tourism by the urban planners in the restoration processes of historical places, are analyzed in the perspective of criticism through the mercantilization of the cultural patrimony perspective. Thus, this dissertation approximates the issues of essentiality of patrimony and the tourism phenomenon related to the tourism appropriation of the historical urban places in the constitution of this patrimonial offer destined the visiting and the visited. The methodology adopted is the qualitative research, with an exploratory character, having as a study case the Historical Place of the city of Porto Alegre / RS, in the section of the Alfândega Square and the Matriz Square and its respective surroundings. The data collecting techniques are: bibliographic and documental researches, photographic research and semi-structured interviews. The informing agents are organized around three categories: the hosts, the planners and the agents. The appropriation of tourism by the planners, noted during the research, revealed being centered, almost exclusively, in actions of restoring and improving of the hardware in the Historic Urban Place and not in propositions that deal with the sociability in the point of view of the essentialities of the tourism phenomenon. Considering that the planning of the restorations should enlarge its participation instruments, so that the patrimony becomes a supporter of connections among peoples, rising their self-esteem and contributing for the solidarity of the meeting among visiting and visited, in the ubiquity of a sustainable and hospitable tourism

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

BackgroundFuture trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050.MethodsUsing forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline.FindingsIn the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]).InterpretationGlobally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions.FundingBill & Melinda Gates Foundation.</p