Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. METHODS: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING: Bill & Melinda Gates Foundation

Demystifying Mobile Banking App Security Through Gender, Education, Privacy, and Trust Intervention

The escalating of mobile banking apps has decongested the banking hall, especially in developing countries, and the penetration of mobile banking apps is crucial for both financial institutions and customers. This study reviewed existing relevant literature from the Web of Science to position this study well and dwelled on a theoretical foundation for the exposition of the interrelation of trust and privacy as an antecedent of mobile banking app security. The quantitative method was employed and banking customers data using SmartPLS 3.0 version with different data analysis techniques such as structural equation modelling, multigroup data analysis, interaction effects, and importance-performance analysis. This study results show the intervention of gender and education. It also indicates that the orientation and persuasion of banking customers to the point of higher trust is a determinant of security assurance of using mobile banking apps. This study discusses the theoretical and managerial impacts with the limitation of the study and projects into the future

Statistical Analysis on Students’ Performance

This research uses Cohen’s Kappa to examine the performance of students in the Faculty of Science, University of Ilorin. The data was collected from eight departments in the faculty and it covers the performance of students measured by their Grade Point Average (GPA) and Cumulative Grade Point Average (CGPA) in both their first and final year between 2000-2006 academic sessions. It is of interest to determine the proportion of students that improved on their performance, dropped from the class of grade point which they started with and those that maintained their performance using psychometrics approach. Also, the strength of agreement that exist between the first and the final year was examined

Bibliometric structured review of tuberculosis in Nigeria

The tuberculosis burden is growing in Nigeria along with its population. For example, Nigeria has the sixth highest TB burden globally, with an estimated 4.3 per cent multi-drug resistance in new cases. This study builds on the existing study that examined academic involvement in tuberculosis research. The study in question focused on global medical literature related to tuberculosis, but the non-visibility of some low and middle-income countries in the bigger global picture motivated this present study. Every year, over 245,000 Nigerians succumb to tuberculosis (TB), with approximately 590,000 new cases reported (of these, around 140,000 are also HIV-positive). This study carried out an academic publication evaluation with the VOS viewer tool to map bibliometric data for scholarly articles published between 1991 and 2021 on tuberculosis research and used the Biblioshiny app for analytics and plots of authors, sources, and documents to explore the descriptive statistics of tuberculosis literature. The present study delineates that England has the highest collaborating country with Nigeria in the study of tuberculosis over the years and according to the report, the University of Nigeria, the University of Ibadan, and Nnamdi Azikwe University are Nigerian institutions with extensive collaborations. This study concludes with managerial implications for future actions

Non-Bayesian and Bayesian estimation for Lomax distribution under randomly censored with application

This paper centers on the examination of the Lomax distribution in the context of randomly censored data. Our primary objectives include deriving maximum likelihood estimators and constructing confidence intervals based on the Fisher information matrix for the unknown parameters in the context of randomly censored data. Furthermore, we develop Bayes estimators utilizing gamma priors, considering both squared error and general entropy loss functions. We also calculate Bayesian credible intervals for the parameters. To offer practical insights, we apply these methods to a real-world dataset subject to random censorship. Finally, for comparative purposes, we conduct a Monte Carlo simulation to assess the various estimation techniques introduced in this study

Do teamwork experience and self-regulated learning determine the performance of students in an online educational technology course?

This study uses the quantitative research approach to examine the connection between students’ teamwork experience, self-regulated learning, technology self-efficacy, and performance in an online educational technology course. Sixty-three (63) students participated in this study. The study data were collected through an online questionnaire that included background information, course satisfaction, motivation strategies for learning, and online technology self-efficacy, to study the variables’ interactions using quantitative research. To realize this study’s aims, multivariate regression and correlation approaches were employed to analyze the online students’ data. The multivariate regression analysis results show a relationship between self-regulated learning, the online course level, and the number of online courses that the students have completed. Right self-regulated learning strategies in online courses motivate students to strive for a good teamwork experience, leading to increased interest in online learning. In addition, the results also show that there is a relationship between satisfaction and the level of the online course. Achieving good grades makes the student more satisfied and improves the level of technology use. Finally, this study established a relationship between the students’ motivation and the online course level. Therefore, teachers and course designers should implement learning objects that promote students’ engagement and motivation in online learning environments.Validerad;2021;Nivå 2;2021-09-01 (johcin)</p

The Impact of Age and Income in Using Mobile Banking Apps

The banking business relates with their customers during the weekly business days, but only a few pay close attention to the importance of demography variables especially in the area of technology use. This study intends to classify the relationship between age and mobile banking app usage, income and the types of device used for mobile banking app, income and the choice for the device brand used for a mobile banking app. It also employed social stratification theory and quantitative methods with Chi-square test and discriminant analysis through SPSS V25. The results show the significant association of age with mobile banking app use and income with the type of mobile devices used for the mobile banking app while the income had an insignificant association with the device brand. The banking sectors need to put inequality income distribution into consideration, and the age differences as these variables impact the use of mobile technology for banking transactions. The study discussed the theoretical contribution, managerial insights, limitations, and made proposals for future study

The emotional job-stress of COVID-19 on nurses working in isolation centres: a machine learning approach

Motivated by the present global coronavirus pandemic with its multiple mental health and adverse psychosocial effects on frontline nurses, enormous research on the ecology and epidemiology of COVID-19 has been carried out. However, there is the sparsity of work done in the psychosocial context and the associated mental health impact of COVID-19. This article provides an overview of the scientific evidence and predicts the emotional health impact of the disease. Qualitative and quantitative data were collected from 543 frontline nurses working in quarantine facilities and were analyzed using machine learning platforms. Two different classifiers (Multinomial Naïve Bayes algorithm and Support Vector Machine) were compared with three human coders for text analysis. The Multinomial Naïve Bayes algorithm was inferior to the Support Vector Machine though both performed better in predicting emotions than humans in this study. The result suggests an increase in levels of fear, anxiety, worry and sadness during the periods of quarantine. Sadness is the most profound emotional impact. The studies promote machine learning to be used to predict social phenomenon. Impliedly, developing a better and more robust digital psychiatry intervention model mechanism to support existing psychological first aid will positively impact on the emotional and mental health disorders