The Vehicle, Spring 1984

Vol. 25, No. 2 Table of Contents The OpeningKathy Fordpage 3 PaintThomas B. Waltrippage 3 PhotographLisa Fresepage 4 City as Castigating AnimalJerry McAnultypage 5 LimitsMichelle Mitchellpage 6 In SilenceKeila Tooleypage 6 PhotographLisa Fresepage 7 Indian CreekJerry McAnultypage 8 The Right Idea about RainMichelle Mitchellpage 8 Van Gogh\u27s Young Male PeasantKeila Tooleypage 9 AbigailMaggie Kennedypage 9 CleaningJennifer K. Soulepage 10 Heat WaveJerry McAnultypage 11 VigilJanet Gracepage 11 Hatred of ClownsMichelle Mitchellpage 12 Trees in the YardKeila Tooleypage 13 Lost on Back RoadsToby Mirabellipage 13 The Death of My Father\u27s HandsGina Grillopage 14 Soft LandingMaggie Kennedypage 14 Incident in the Generic AisleMaggie Kennedypage 15 Happy Well-adjusted Individuals, ConsideringJennifer K. Soulepage 16 Old ManGina Grillopage 17 It Doesn\u27t MatterTed Boonepage 18 A Love Poem for Charles DonaldCathy Moepage 18 David Willey at Whitman WharfSue Oiler Millerpage 19 I Am the ArtsBrenda Renee Drummerpage 20 Mothers and DaughtersJennifer K. Soulepage 22 ScratchesMichelle Mitchellpage 26 SedativeStacey Flanniganpage 26 Calloused HandJanet Gracepage 27 Cool CatStacey Flanniganpage 27 For My History Teacher, Miss WilhelmCathy Moepage 28 Short Poem for Chris\u27s EyesBob Zordanipage 28 MissingMichelle Mitchellpage 29 Over ThereGraham Lewispage 30 Strange BedfellowsMaggie Kennedypage 31 Retired PlumberMichelle Mitchellpage 32 Rumors of War DeadKathy Fordpage 33 Night LightsKeila Tooleypage 33 Fish on the Train TracksJerry McAnultypage 34 DaddyKeily Tooleypage 34 A Message to the MessengerAmy Eadespage 35 Dancing AloneKathy Bowerpage 36 HandsMaggie Kennedypage 36 The Key to the Ladies\u27s RoomMichelle Mitchellpage 37 Crashing the BlueStacey Flanniganpage 37 The Cradle will FallMichelle Mitchellpate 38 One IslandKeila Tooleypage 38 Black Walnut PaintSue Oiler Millerpage 39 SerendipityGraham Lewispage 40 Cover ArtLisa Fresehttps://thekeep.eiu.edu/vehicle/1045/thumbnail.jp

The Vehicle, Fall 1980

Vol. 22, No. 1 Table of Contents UntitledSusan Mehlpage 4 MitchJohn Stockmanpage 5 HallwayAndy Leszczynskipage 6 At The MoviesElise Hempelpage 8 HaikuAngie Patrickpage 8 On MagnoliasThersa Kennypage 9 NeighborJohn Stockmanpage 10 WetCathy Georgepage 10 HaikuThersa Kennypage 10 The Speed QueenCarolyn Perrypage 11 A ThoughtThersa Kennypage 14 The Stone Belongs to the LakeRobert Schumacherpage 15 Driving South of WinnipegJerry McAnultypage 16 Travels with the ExecutionerPeter Lindemanpage 17 NightwingLaura Muellerpage 18 Thoughts of an Uninterested StudentDru Seftonpage 19 Rainbird\u27s ManMary McDanielpage 20 EffortlessKevin Stottpage 25 Where the Waves SoundTheresa Whitesidepage 26 \u2745Ray Wallacepage 28 Epigram #1P. James Kruegerpage 28 UntitledSusan Mehlpage 29 RerunsAngie Patrickpage 30 SunsetGloria Rhoadspage 34 Return of the NativeRay Wallacepage 35 The GuitarJoanne Dunnepage 35 In Grandmother\u27s BedroomElise Hempelpage 36 Cindy Poem No. 3John Stockmanpage 36 Dust in the DarkLaura Muellerpage 37 Suspension BridgeLaura Henrypage 39 WavesLeslie Garnerpage 39 Oyama: a Setting and a GirlJerry McAnultypage 40 the middle of the nightKevin Stottpage 41 Old State RoadLaura Henrypage 43 Dairy QueenJohn Stockmanpage 43 Art CoverDennis Wunsch Pen and ink drawingRose Huberpage 3 PhotographIrene Brownpage 7 PhotographIrene Brownpage 27 PhotographIrene Brownpage 42 Pen and ink drawingRose Huberpage 44https://thekeep.eiu.edu/vehicle/1036/thumbnail.jp

The Vehicle, Spring 1980

Vol. 3, No. 2 Table of Contents White LanguageStarla Stensaaspage 4 The Grand Canyon at SunsetElisabeth Cristpage 5 WitheringSheila Kattypage 5 In Defense of the DandelionKathleen Alakspage 6 HaikuScott Fishelpage 7 Double SolitaireCathy Georgepage 8 AdolescenceNancy Douglaspage 9 Sunrises as SunsetsRobert Schumacherpage 9 War Is Not All HellChris Goerlichpage 11 Young SoldierRobert Swansonpage 11 Without Really Looking For ThemSheila Kattypage 12 JourneyJean Wallacepage 15 I Barely Remember the Poet/TeacherStarla Stensaaspage 16 To SearchKaren Buchananpage 17 Four-Hundred and Twenty-Four DaysAnnette Heinzpage 19 Killing CarpJerry McAnultypage 20 War of the WillsLaurel Anzelmopage 21 Life of a Sexual MetaphorChris Goerlichpage 23 Hazy Days in Mid-JulyKaren Buchananpage 24 August\u27s EndCynthia Rozminpage 24 Visiting GrandmotherRobert Swansonpage 26 UntitledNancy Van Cleavepage 27 The AlbinoDenise Davinroypage 27 This ChristmasRobert Schumacherpage 28 Burnt OfferingGinny Stroheckerpage 29 Long-term VacationDenise Davinroypage 29 Storm\u27s EveJeffrey Stousepage 30 Lovers: A Weaver in the StatesStarla Stensaaspage 31 Gitchegumme BeachScott Fishelpage 32 Dear Husband, What Do You Think?Katherine Adamspage 33 Cat\u27s Eve InnCynthia Rozminpage 34 BassScott Fishelpage 34 Fall Morning in the Okanagan ValleyJerry McAnultypage 35 MusicMary McDanielpage 36 AnticipationNancy Douglaspage 41 Don\u27t Let Your Bread LoafJohn Stockmanpage 41 The FieldElise Hempelpage 42 the g.a.Carla Vitezpage 42 Quality in Search of An AuthorRobert Schinaglpage 43 February 9thLisa Livingstonpage 44 By A Pond in SpringJohn Stockmanpage 46 Night SoundsJeffrey Stousepage 47 Art CoverKaren Dankovich PhotographCindy Hubbarttpage 3 PhotographScott Fishelpage 10 PhotographLisa Larsonpage 18 EtchingKaren Dankovichpage 25 PhotographScott Fishelpage 30 PhotographScott Fishelpage 40 PhotographCindy Hubbarttpage 45 PhotographCindy Hubbarttpage 48https://thekeep.eiu.edu/vehicle/1037/thumbnail.jp

The Vehicle, Spring 1980

Vol. 3, No. 2 Table of Contents White LanguageStarla Stensaaspage 4 The Grand Canyon at SunsetElisabeth Cristpage 5 WitheringSheila Kattypage 5 In Defense of the DandelionKathleen Alakspage 6 HaikuScott Fishelpage 7 Double SolitaireCathy Georgepage 8 AdolescenceNancy Douglaspage 9 Sunrises as SunsetsRobert Schumacherpage 9 War Is Not All HellChris Goerlichpage 11 Young SoldierRobert Swansonpage 11 Without Really Looking For ThemSheila Kattypage 12 JourneyJean Wallacepage 15 I Barely Remember the Poet/TeacherStarla Stensaaspage 16 To SearchKaren Buchananpage 17 Four-Hundred and Twenty-Four DaysAnnette Heinzpage 19 Killing CarpJerry McAnultypage 20 War of the WillsLaurel Anzelmopage 21 Life of a Sexual MetaphorChris Goerlichpage 23 Hazy Days in Mid-JulyKaren Buchananpage 24 August\u27s EndCynthia Rozminpage 24 Visiting GrandmotherRobert Swansonpage 26 UntitledNancy Van Cleavepage 27 The AlbinoDenise Davinroypage 27 This ChristmasRobert Schumacherpage 28 Burnt OfferingGinny Stroheckerpage 29 Long-term VacationDenise Davinroypage 29 Storm\u27s EveJeffrey Stousepage 30 Lovers: A Weaver in the StatesStarla Stensaaspage 31 Gitchegumme BeachScott Fishelpage 32 Dear Husband, What Do You Think?Katherine Adamspage 33 Cat\u27s Eve InnCynthia Rozminpage 34 BassScott Fishelpage 34 Fall Morning in the Okanagan ValleyJerry McAnultypage 35 MusicMary McDanielpage 36 AnticipationNancy Douglaspage 41 Don\u27t Let Your Bread LoafJohn Stockmanpage 41 The FieldElise Hempelpage 42 the g.a.Carla Vitezpage 42 Quality in Search of An AuthorRobert Schinaglpage 43 February 9thLisa Livingstonpage 44 By A Pond in SpringJohn Stockmanpage 46 Night SoundsJeffrey Stousepage 47 Art CoverKaren Dankovich PhotographCindy Hubbarttpage 3 PhotographScott Fishelpage 10 PhotographLisa Larsonpage 18 EtchingKaren Dankovichpage 25 PhotographScott Fishelpage 30 PhotographScott Fishelpage 40 PhotographCindy Hubbarttpage 45 PhotographCindy Hubbarttpage 48https://thekeep.eiu.edu/vehicle/1037/thumbnail.jp

The Vehicle, Spring 1984

Vol. 25, No. 2 Table of Contents The OpeningKathy Fordpage 3 PaintThomas B. Waltrippage 3 PhotographLisa Fresepage 4 City as Castigating AnimalJerry McAnultypage 5 LimitsMichelle Mitchellpage 6 In SilenceKeila Tooleypage 6 PhotographLisa Fresepage 7 Indian CreekJerry McAnultypage 8 The Right Idea about RainMichelle Mitchellpage 8 Van Gogh\u27s Young Male PeasantKeila Tooleypage 9 AbigailMaggie Kennedypage 9 CleaningJennifer K. Soulepage 10 Heat WaveJerry McAnultypage 11 VigilJanet Gracepage 11 Hatred of ClownsMichelle Mitchellpage 12 Trees in the YardKeila Tooleypage 13 Lost on Back RoadsToby Mirabellipage 13 The Death of My Father\u27s HandsGina Grillopage 14 Soft LandingMaggie Kennedypage 14 Incident in the Generic AisleMaggie Kennedypage 15 Happy Well-adjusted Individuals, ConsideringJennifer K. Soulepage 16 Old ManGina Grillopage 17 It Doesn\u27t MatterTed Boonepage 18 A Love Poem for Charles DonaldCathy Moepage 18 David Willey at Whitman WharfSue Oiler Millerpage 19 I Am the ArtsBrenda Renee Drummerpage 20 Mothers and DaughtersJennifer K. Soulepage 22 ScratchesMichelle Mitchellpage 26 SedativeStacey Flanniganpage 26 Calloused HandJanet Gracepage 27 Cool CatStacey Flanniganpage 27 For My History Teacher, Miss WilhelmCathy Moepage 28 Short Poem for Chris\u27s EyesBob Zordanipage 28 MissingMichelle Mitchellpage 29 Over ThereGraham Lewispage 30 Strange BedfellowsMaggie Kennedypage 31 Retired PlumberMichelle Mitchellpage 32 Rumors of War DeadKathy Fordpage 33 Night LightsKeila Tooleypage 33 Fish on the Train TracksJerry McAnultypage 34 DaddyKeily Tooleypage 34 A Message to the MessengerAmy Eadespage 35 Dancing AloneKathy Bowerpage 36 HandsMaggie Kennedypage 36 The Key to the Ladies\u27s RoomMichelle Mitchellpage 37 Crashing the BlueStacey Flanniganpage 37 The Cradle will FallMichelle Mitchellpate 38 One IslandKeila Tooleypage 38 Black Walnut PaintSue Oiler Millerpage 39 SerendipityGraham Lewispage 40 Cover ArtLisa Fresehttps://thekeep.eiu.edu/vehicle/1045/thumbnail.jp

The Vehicle, Fall 1980

Vol. 22, No. 1 Table of Contents UntitledSusan Mehlpage 4 MitchJohn Stockmanpage 5 HallwayAndy Leszczynskipage 6 At The MoviesElise Hempelpage 8 HaikuAngie Patrickpage 8 On MagnoliasThersa Kennypage 9 NeighborJohn Stockmanpage 10 WetCathy Georgepage 10 HaikuThersa Kennypage 10 The Speed QueenCarolyn Perrypage 11 A ThoughtThersa Kennypage 14 The Stone Belongs to the LakeRobert Schumacherpage 15 Driving South of WinnipegJerry McAnultypage 16 Travels with the ExecutionerPeter Lindemanpage 17 NightwingLaura Muellerpage 18 Thoughts of an Uninterested StudentDru Seftonpage 19 Rainbird\u27s ManMary McDanielpage 20 EffortlessKevin Stottpage 25 Where the Waves SoundTheresa Whitesidepage 26 \u2745Ray Wallacepage 28 Epigram #1P. James Kruegerpage 28 UntitledSusan Mehlpage 29 RerunsAngie Patrickpage 30 SunsetGloria Rhoadspage 34 Return of the NativeRay Wallacepage 35 The GuitarJoanne Dunnepage 35 In Grandmother\u27s BedroomElise Hempelpage 36 Cindy Poem No. 3John Stockmanpage 36 Dust in the DarkLaura Muellerpage 37 Suspension BridgeLaura Henrypage 39 WavesLeslie Garnerpage 39 Oyama: a Setting and a GirlJerry McAnultypage 40 the middle of the nightKevin Stottpage 41 Old State RoadLaura Henrypage 43 Dairy QueenJohn Stockmanpage 43 Art CoverDennis Wunsch Pen and ink drawingRose Huberpage 3 PhotographIrene Brownpage 7 PhotographIrene Brownpage 27 PhotographIrene Brownpage 42 Pen and ink drawingRose Huberpage 44https://thekeep.eiu.edu/vehicle/1036/thumbnail.jp

The Vehicle, Fall 1981

Vol. 23, No. 1 Table of Contents Maples At My HomeGary Ervinpage 4 I Remember (after Anne Sexton)Susan Mehlpage 5 Where Do They Put Their ArmsKathleen Alakspage 6 Sweet AdversityAlissa Finleypage 7 Love At Baskin-RobbinsCindy Fritzpage 9 What IfJohn Stockmanpage 10 Shaking HandsScott Fishelpage 12 The SouvenirKathleen Alakspage 13 Kelowna City Park At NightJerry McAnultypage 14 Canadian EuphoriaB.L. Davidsonpage 14 Water PaintingIsabel M. Parrotpage 15 Clearwater BeachSusan Mehlpage 16 SeaprintsJerry McAnultypage 17 Elegy For An Illinois TownJohn Stockmanpage 17 DepreciatingLaura Sharppage 18 U.S. Steel South WorksDiane Bartuspage 19 Blue BeadsB.L. Davidsonpage 20 Top HatVicki Ewingpage 21 29 Cent PoemSusan Mehlpage 24 Morning In OctoberCindy Fritzpage 26 PrerequisiteDevon Flesorpage 26 InvalidLynn Sronkoskipage 27 Nushagak Bay HarvestB.L. Davidsonpage 28 August, 1967Cathy Georgepage 29 The ParkSusan Burkpage 30 Summer of \u2778: With LoveDonna L. Lewispage 32 RhubarbScott Fishelpage 33 I\u27ll get it... Cathy Georgepage 34 The Night PeopleLenore Howardpage 35 Falling AsleepKaren Smithpage 38 Getting Life Off Your ShouldersStacey Flanniganpage 38 Thirst, and the anticipation of a week\u27s vacation in late summerCathy Georgepage 39 Art Cover Michelle Howe Pen and Ink DrawingIrene Brownpage 3 PhotographGregory A. Molchanpage 11 PhotographRuth Zurerzyckipage 15 PhotographGregory A. Molchanpage 25 Pen and Ink DrawingChristi Fullerpage 31 Pen and Ink DrawingChristi Fullerpage 40https://thekeep.eiu.edu/vehicle/1038/thumbnail.jp

The Vehicle, Fall 1981

Vol. 23, No. 1 Table of Contents Maples At My HomeGary Ervinpage 4 I Remember (after Anne Sexton)Susan Mehlpage 5 Where Do They Put Their ArmsKathleen Alakspage 6 Sweet AdversityAlissa Finleypage 7 Love At Baskin-RobbinsCindy Fritzpage 9 What IfJohn Stockmanpage 10 Shaking HandsScott Fishelpage 12 The SouvenirKathleen Alakspage 13 Kelowna City Park At NightJerry McAnultypage 14 Canadian EuphoriaB.L. Davidsonpage 14 Water PaintingIsabel M. Parrotpage 15 Clearwater BeachSusan Mehlpage 16 SeaprintsJerry McAnultypage 17 Elegy For An Illinois TownJohn Stockmanpage 17 DepreciatingLaura Sharppage 18 U.S. Steel South WorksDiane Bartuspage 19 Blue BeadsB.L. Davidsonpage 20 Top HatVicki Ewingpage 21 29 Cent PoemSusan Mehlpage 24 Morning In OctoberCindy Fritzpage 26 PrerequisiteDevon Flesorpage 26 InvalidLynn Sronkoskipage 27 Nushagak Bay HarvestB.L. Davidsonpage 28 August, 1967Cathy Georgepage 29 The ParkSusan Burkpage 30 Summer of \u2778: With LoveDonna L. Lewispage 32 RhubarbScott Fishelpage 33 I\u27ll get it... Cathy Georgepage 34 The Night PeopleLenore Howardpage 35 Falling AsleepKaren Smithpage 38 Getting Life Off Your ShouldersStacey Flanniganpage 38 Thirst, and the anticipation of a week\u27s vacation in late summerCathy Georgepage 39 Art Cover Michelle Howe Pen and Ink DrawingIrene Brownpage 3 PhotographGregory A. Molchanpage 11 PhotographRuth Zurerzyckipage 15 PhotographGregory A. Molchanpage 25 Pen and Ink DrawingChristi Fullerpage 31 Pen and Ink DrawingChristi Fullerpage 40https://thekeep.eiu.edu/vehicle/1038/thumbnail.jp

Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.

BACKGROUND: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimers disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION: Population growth, increased average age of the worlds population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING: Bill & Melinda Gates Foundation

Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.

BACKGROUND: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING: Bill & Melinda Gates Foundation