Las técnicas y hábitos de estudio en los estudiantes universitarios, una revisión bibliográfica de trabajos realizados desde el año 2013-2023 del Ecuador.

El documento menciona sobre la importancia en aprender hábitos de estudio correctos para los jóvenes universitarios, incluyendo la necesidad de un espacio de estudio tranquilo y organizado, una postura adecuada, la gestión del tiempo y la motivación. También se da a conocer diferentes hábitos de estudio, como el autoaprendizaje y las habilidades de lectura, y factores que pueden afectar los hábitos de estudio, como la relajación, la atención, la concentración y la actitud. Este documento detalla las técnicas y hábitos necesarios para tomar notas efectivas durante las conferencias y otras actividades de aprendizaje. Además, se menciona que las condiciones ambientales, como el ambiente familiar, el entorno físico, la organización del espacio de estudio, el ambiente social y la disponibilidad de recursos del aprendizaje, afectados es necesario conocer las técnicas y hábitos de estudio. Durante la elaboración del título se desarrolló un estudio bibliográfico de análisis de contenido en el ámbito universitario los métodos y hábitos de aprendizaje son elementos esenciales para el éxito académico del estudiante. En la investigación, se realizará un estudio bibliográfico desde un enfoque exploratorio descriptivo, con un enfoque cualitativo y una revisión bibliográfica de trabajos realizados desde el año 2013 hasta 2023 en el Ecuador. Se realizará una búsqueda exhaustiva de estudios, investigaciones y literatura académica relacionada con el tema en indagaciones académicas, bibliotecas digitales y repositorios en línea. La revisión bibliográfica permitirá explorar, describir métodos y hábitos en la educación a los estudiantes universitarios del Ecuador.The document mentions the importance of learning correct study habits for Young university students, including the need for a quiet and organizes study space, proper posture, time management and motivation. It also reveals different types os study habits, such as self-study, and motivation. It also reveals different types of study habits, such as self.study and reading skills, and factors that can affect study habits, such as relaxation, attencio, concentration, and attitude. This document details the techniques and habits necessary mentioned that the environmental conditions, sush as the family environment, the physical environment, the organization of the study space, the social environment and the availability of learning resourses, affected it is necessary to know the thechniques and study habits. During thr elaboration of the title, a bibliographic study of content analysis was developed in the university enviroment, the methods and learning habits are essential elements for the academic success of the student. In the research, a bibliographic study will be carried out frm a desriptive exploratory approach, with a qualitative approach and a bibliographic review of Works carried out from 2013 to 2023 in Ecuador. An exhaustive search of studies, research and academic literatura related to the topic will be carried out in academic inquiries, digital libraries and online repositories. The bibliographic review will allow to explore, describe methods and habits in education to the university students of Ecuador

Estudio correlacional de estilos de aprendizaje de estudiantes con modalidad en ciencias naturales

El presente artículo muestra los resultados de una investigación en la que se identificó el estilo de aprendizaje de un grupo de estudiantes de secundaria con base en los modelos de estilos de aprendizaje propuestos por Kolb (1984), Alonso, Gallego y Honey (1994) y Grasha (1996). Una vez identificado el estilo de aprendizaje predominante de cada uno de los sujetos de la población, según los distintos instrumentos propuestos para tal fin por cada uno de los modelos, se examinó si existe alguna correlación entre las distintas categorías de estilos de aprendizaje propuestas por cada uno de los modelos señalados anteriormente. Los resultados obtenidos no muestran una preferencia de los estudiantes por un único estilo de aprendizaje en cada uno de los modelos estudiados. Se obtuvieron porcentajes altos de preferencias por el estilo activo según el modelo de Alonso, Gallego y Honey, asimilador según el modelo de Kolb y participativo según el modelo de Grasha, sin que los porcentajes obtenidos sean lo suficientemente representativos de la población. Obtenidos los valores de correlación entre cada uno de los estilos de aprendizaje propuestos en cada modelo a través del coeficiente Lambda de Goodman y Kruskal para variables nominales, se encontró que los valores de correlación son prácticamente despreciables, lo que confirmaría, en alguna medida, la independencia de cada uno de los modelos analizados

“Empowerment” a possible utopia to rebuild humanization in critical care units

Objetivo: Indagar sobre la humanización del Cuidado, sus barreras y la aplicación de los Modelos de Empoderamiento (Empowerment) en las Unidades de Cuidado Crítico, que permitan fortalecer las políticas de humanización del Cuidado institucional. Materiales y Métodos: Estudio mixto de orden secuencial. Fase I: Revisión Integrativa de Literatura Científica y Fase II: Cualitativa: descriptiva fenomenológica, con sustento teórico en los modelos de Watson, Spreitzer y Kanter y el método de triangulación de datos. Se realizaron 10 entrevistas semiestructuradas a enfermeras que laboraban en Unidades de Cuidado Intensivo en la ciudad de Manizales y 5 encuestas a pacientes que egresaron de estas unidades. La información fue analizada mediante el uso de la contrastación de categorías emergentes encontradas en la red de datos, deconstrucción, y análisis e interpretación de datos. Resultados: La Teoría del Cuidado Transpersonal de Jean Watson, es un constructo que sella la práctica clínica de enfermería; el "Empowerment" es un modelo integrativo de la colectividad organizacional, a través del cual enfermería asume el liderazgo participativo; lo anterior permitió suscitar una aproximación empírica, para una posible generalización del fenómeno y una propuesta de mejoramiento institucional. Conclusiones: El empoderamiento como herramienta disciplinar permite afrontar las dificultades en la identidad del rol del profesional y la adherencia de la Teoría del Cuidado Humano de Watson, en yuxtaposición a la Taxonomía de Diagnósticos Enfermeros NANDA, se convierten en una propuesta que permite trascender las barreras del cuidado en las Unidades de Cuidado Crítico.Objective: To inquire about humanization of Care, its barriers and implementation of "Empowerment" Models in Critical Care Units, in order to strengthen humanization policies of Institutional Care. Materials and Methods: Mixed Study of sequential order. Phase I: Integrative Review of Scientific Literature and Phase II: Qualitative, phenomenological, descriptive, with theoretical supported on Watson, Spreitzer and Kanter's Models and the data triangulation method. Ten (10) semi-structured interviews were carried out with nurses who worked in Critical Care Units (ICU) in the city of Manizales and five (5) patients who had left these units were surveyed. The information was analyzed by contrasting emerging categories found in the data network, deconstruction, and the analysis and interpretation of data. Results: Jean Watson's Theory of Transpersonal Caring is a construct that brands the nursing clinical practice: "Empowerment" is an integrative model of organizational community, through which, nursing assumes a participative leadership. This allowed promoting an empirical approach for a possible generalization of the phenomenon and a proposal for institutional improvement. Conclusions: Empowerment as disciplinary tool that allows facing difficulties in identity in the professional role and the adherence of Watson's Theory of Human Care in yuxtaposition to the Taxonomy of NANDA Nursing Diagnoses becomes a proposal to transcend the barriers of care in the Intensive Care Units

Soro positividade à Toxocara spp. em alunos atópicos da Universidade dos Llanos

Introduction: The frequent or seasonal expositions to parasitic worms that do not provoke chronic infections are associated to an increase of allergic inflammation, situation that could be extrapolated to human toxocariasis. The objective of this research was to determine the frequency of Toxocara spp seropositivity among atopic students and the relationship between atopy and seropositivity to Toxocara spp. Materials and methods: Observational and cross-sectional study using 90 students by convenience from the Nursing, Farmacy, Veterinary, and Animal Science programs at the Universidad de los Llanos that according to the completion of the ISSAC phase III questionnaire are presumed to suffer from an atopic disease. In order to perform an allergy skin test in them, extracts from Blomia tropicalis and Dermatophagoides pteronyssius were used. The students that tested positive got a blood test to count the eosinophils and the in-house enzyme immunoassay for IgG anti-Toxocara spp. Results: From the 90 students with records of atopic diseases, only 33,3% were positive to one or the two dust mites in the allergy skin test. Their eosinophils count in the blood test were normal 66.6%, medium 26.7% and moderate 6.7%. The frequency of seropositivity to Toxocara spp. was 73.3% (DO 1,009 cut-off). The OR between atopy and seropositivity to Toxocara spp. corresponded to 1.18 (CI 95% 0,24-5,7). Discussion: Colombia is one of the countries with high endemicity of toxocariasis with prevalences between 40.4–54.4%, a fact that is confirmed according to the frequency of seropositives to Toxocara spp. found in atopic people in the study. Conclusions: No relationship between atopy and seropositivity to Toxocara spp. was found.Introducción: Las exposiciones frecuentes o estacionales a helmintos que no provocan infecciones crónicas se asocian a un aumento de la inflamación alérgica, situación que podría extrapolarse a la toxocariasis humana. El objetivo de esta investigación fue determinar la frecuencia de seropositivos a Toxocara spp. entre estudiantes atópicos y la relación entre atopia y seropositividad a Toxocara spp. Materiales y métodos: Estudio observacional transversal donde por conveniencia se seleccionaron 90 estudiantes de los programas de Enfermería, Regencia en Farmacia y MVZ de la Universidad de los Llanos que según diligenciamiento del cuestionario ISAAC fase III se presume sufren de enfermedad atópica; para desarrollar en ellos la prueba de hipersensibilización alérgica cutánea (PHAC), utilizando extractos de Blomia tropicalis y Dermatophagoides pteronyssius. En los estudiantes positivos a esta prueba, se tomaron muestras sanguíneas para el recuento de eosinófilos e inmunoensayo in-house para IgG anti-Toxocara spp. Resultados: De los 90 estudiantes con antecedentes de enfermedad atópica, solo el 33,3% fueron positivos para uno o ambos ácaros del polvo en la PHAC y su recuento de eosinófilos en sangre fue normal 66,6%, medio 26,7% y moderado 6,7%. La frecuencia de seropositividad a Toxocara spp. fue del 73,3% (DO 1,009 cut-off). La OR entre atopia y seropositividad a Toxocara spp. fue 1,18 (IC95% 0,24-5,7). Discusión: Colombia es uno de los países con alta endemicidad de toxocariasis con prevalencias entre 40.4–54.4%, dato confirmado según la frecuencia de seropositivos a Toxocara spp. encontrada en personas atópicas en estudio. Conclusiones: No se encontró relación entre atopia y seropositividad a Toxocara spp.Introdução: as exposições frequentes ou estacionais a helmintos que não desenvolvem infeções crônicas associam-se com o incremento de inflamação alérgica, situação que poderia evoluir a toxocaríase humana. O objetivo dessa pesquisa foi determinar a frequência de soro positividade à Toxocara spp. entre alunos atópicos e a relação entre atopia e soro positividade à Toxocara spp. Materiais e métodos: Estudo observacional transversal onde por conveniência estudaram-se 90 alunos dos programas de enfermagem, regência em farmácia e medicina veterinária da Universidade dos Llanos que segundo o preenchimento do questionário ISAAC fase III presumiam padecer doença atópica. Para desenvolver a prova de hiper sensibilidade alérgica cutânea (PHAC), usaram-se extratos de Blomia tropicalis e Dermatophagoides pteronyssius. Os alunos com teste positivo, foram analisados por meio de amostra sanguínea para contagem de eosinófilos e imunoensaio in-house para IgG anti-Toxocara spp. Resultados: dos 90 alunos analisados, só 33,3% foram positivos para um ou ambos ácaros no PHAC. A contagem de eosinófilos em sangue foi normal (66,6%), média (26,7%) e moderada (6,7%). A frequência de soro positividade para à Toxocara spp. foi de 73,3% (DO 1,009 cut-off). O OR relacionando atopia e soro positividade à Toxocara spp. foi de 1,18 (IC95% 0,24-5,7). Discussão: Colômbia é um dos países endêmicos para toxocaríase com prevalências entre 40.4 e 54,4%, informação confirmada com os achados desse estudo. Conclusões: Não foi encontrada relação estadística entre atopia e soro positividade à Toxocara spp

Patógenos fúngicos en lesiones dermatológicas de grandes y pequeñas especies animales en clínicas veterinarias y refugios animales en Bogotá D.C.

The aim of this study was to determine the presence of fungal pathogens from dermatological lesions of large and small animal species in veterinary clinics and animal shelters in Bogotá, Colombia. From a total of 30 canines, 15 felines and 2 equines, skin scraping samples (31) and otic (26) and skin (44) swabs were obtained, which were analysed by direct examination, culture and identification at the species level. Microsporum canis and Malassezia spp were mainly identified. According to the animal species, M. canis (21.4%) predominated in felines and Malassezia pachydermatis (32.1%) in canines. According to the type of sample, a higher frequency of M. canis was detected in skin scraping (21.4%) and Malassezia spp in ear swabbing (21.4%).El objetivo del presente estudio fue determinar la presencia de patógenos fúngicos a partir de lesiones dermatológicas en grandes y pequeñas especies animales en clínicas veterinarias y refugios animales de Bogotá, Colombia. De un total de 30 caninos, 15 felinos y 2 equinos se obtuvieron muestras de raspado de piel (31) e hisopados óticos (26) y de piel (44), que fueron analizadas mediante examen directo, cultivo e identificación a nivel de especie. Se determinó la presencia de Microsporum canis y Malassezia spp. Según la especie animal predominaron M. canis (21.4%) en felinos y Malassezia pachydermatis (32.1%) en caninos. Según el tipo de muestra se detectó mayor frecuencia de M. canis en raspado de piel (21.4%) y Malassezia spp en hisopado ótico (21.4%)

Emotion Regulation and Attitudes Toward Conflict in Colombia: Effects of Reappraisal Training on Negative Emotions and Support for Conciliatory and Aggressive Statements

Control of negative emotions (e.g., anger and fear) by political cues perpetuate intractable conflict by mobilizing public support for aggressive actions. Halperin et al. (2013) found that reappraisal – an adaptive form of emotion regulation – decreased negative emotions triggered by anger-inducing information related to the Israeli–Palestinian conflict, and increased support for conciliatory statements. We tested these effects in the context of the conflict between the Colombian government and the Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo (FARC-EP). Reappraisal training reduced negative emotions produced by a presentation that illustrated FARC’s violent actions, and increased support for conciliatory statements (with overall moderate effect magnitudes). We also found that negative emotions mediated the effects of reappraisal on the support for aggressive and conciliatory statements. These findings indicate a high degree of generality of the phenomena, especially considering the differences between the Israeli–Palestinian conflict and the Colombian conflict. Our findings also show promise for replicating these effects on other types of intergroup conflicts and guiding effective public policy

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe

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

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\ub75th percentile and 100 as the 97\ub75th 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\ub74 (IQR 35\ub74–67\ub73), ranging from a low of 11\ub76 (95% uncertainty interval 9\ub76–14\ub70) to a high of 84\ub79 (83\ub71–86\ub77). 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

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning