Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassifi cation. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6–40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7–1·9 million) in 2005, to 1·2 million deaths (1·1–1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued eff orts from governments and international agencies in the next 15 years to end AIDS by 2030.

Granskning av riktlinjer vid Sveriges förlossningskliniker gällande sfinkterskada i samband med förlossning : Innehållsanalys med en kombination av en deduktiv och induktiv ansats

Background: Sphincter injury is serious complication in connection to vaginal childbirth. Desire to avoid vaginal birth again is seen in women who previously suffered from a sphincter injury. Objective: To identify and evaluate obstetric guidelines in Sweden regarding sphincter injury in relation to childbirth Method: Content analysis with a combination of a deductive and inductive approach. Results: The most frequently occurring risk factors and prevention with help of perineal protection were described in the guidelines. The physician made diagnosis and repaired the sphincter injury at the theatre.  Complications such as coital pain and anal incontinence were described in the guidelines. Paracetamol and diclofenac was most common analgesic regimen given for pain. Prophylaxis such as antibiotic treatment and laxative were common. Information given to women was described. Follow-up by physician, midwife and physiotherapist was recommended after four weeks to six months. For future birth a cesarean section was recommended. Conclusion: The guidelines were constructed in the same way and had to a large extent similar content. The authors of the present work recommend a national guideline.

Styrning och ideologiska dilemman i Skolverkets skolutveckling : exemplet ANDT-undervisning

Governing and ideological dilemmas in drug education Drug education (ANT) in Swedish schools has a history over decades. Here, the pedagogical approaches fluctuated between transfer of solid knowledge from the teacher to the pupil, and working with values and have a more pupil-driven teaching – a classic dichotomy. Rhetoric about the school’s way of teaching has thus always been ambivalent and subject to reexamination. The study analyses various textual material on ANT education. As a methodological tool Billigs concept Ideological dilemmas is used, which is a fruitful way to identify the rhetorical building blocks of (school) politics, but also to analyse political talk in more detail. The article analyses the ideological dilemmas under three dichotomies: Knowledge vs. values, teacher control vs. learner control, and prevention vs. promotion. Throughout we can see this question of how teaching could be successful, given the tension between authority and democracy. The article concludes by relating this basic ideological dilemma in a wider discursive context of governance in our time. 

Fan Culture as an Informal Learning Environment : Presentation of a NGL project

Fan culture is a subculture that has developed explosively on the internet over the last decades. Fans are creating their own films, translations, fiction, fan art, blogs, role play and also various forms that are all based on familiar popular culture creations like TV-series, bestsellers, anime, manga stories and games. In our project, we analyze two of these subculture genres, fan fiction and scanlation. Amateurs, and sometimes professional writers, create new stories by adapting and developing existing storylines and characters from the original. In this way, a "network" of texts occurs, and writers step into an intertextual dialogue with established writers such as JK Rowling (Harry Potter) and Stephanie Meyer (Twilight). Literary reception and creation then merge into a rich reciprocal creative activity which includes comments and feedback from the participators in the community. The critical attitude of the fans regarding quality and the frustration at waiting for the official translation of manga books led to the development of scanlation, which is an amateur translation of manga distributed on the internet.  Today, young internet users get involved in conceptual discussions of intertextuality and narrative structures through fan activity. In the case of scanlation, the scanlators practice the skills and techniques of translating in an informal environment. This phenomenon of participatory culture has been observed by scholars and it is concluded that they contribute to the development of a student’s literacy and foreign language skills. Furthermore, there is no doubt that the fandom related to Japanese cultural products such as manga, anime and videogames is one of the strong motives for foreign students to start learning Japanese. This is something to take into pedagogical consideration when we develop web-based courses. Fan fiction and fan culture make it ​​possible to have an intensive transcultural dialogue between participators throughout the world and is of great interest when studying the interaction between formal and informal learning that puts the student in focus

E-learning opens the door to the global community. Novice users experiences of e-learning in a Somali University

E-learning has become one of the primary ways of delivering education around the globe. In Somalia, which is a country torn within and from the global community by a prolonged civil war, University of Hargeisa has in collaboration with Dalarna University in Sweden adopted, for the first time, e-learning. This study explores barriers and facilitators to e-learning usage, experienced by students in Somalia’s higher education, using the University of Hargeisa as case study. Interviews were conducted with students to explore how University of Hargeisa’s novice users perceived elearning, and what factors positively and negatively affected their e-learning experiences. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was used as a framework for interpreting the results. The findings show that, in general, the students have a very positive attitude towards e-learning, and they perceived that e-learning enhanced their educational experience. The communication aspect was found to be especially important for Somali students, as it facilitated a feeling of belonging to the global community of students and scholars and alleviated the war-torn country’s isolation. However, some socio-cultural aspects of students’ communities negatively affected their e-learning experience. This study ends with recommendations based on the empirical findings to promote the use and enhance the experience of e-learning in post conflict Somali educational institutions