Mapping 123 million neonatal, infant and child deaths between 2000 and 2017 Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low-and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations. Gains in child survival have long served as an important proxy measure for improvements in overall population health and development 1,2. Global progress in reducing child deaths has been heralded as one of the greatest success stories of global health 3. The annual global number of deaths of children under 5 years of age (under 5) 4 has declined from 19.6 million in 1950 to 5.4 million in 2017. Nevertheless, these advances in child survival have been far from universally achieved, particularly in low-and middle-income countries (LMICs) 4. Previous subnational child mortality assessments at the first (that is, states or provinces) or second (that is, districts or counties) administrative level indicate that extensive geographical inequalities persist 5-7. Progress in child survival also diverges across age groups 4. Global reductions in mortality rates of children under 5-that is, the under-5 mortality rate (U5MR)-among post-neonatal age groups are greater than those for mortality of neonates (0-28 days) 4,8. It is relatively unclear how these age patterns are shifting at a more local scale, posing challenges to ensuring child survival. To pursue the ambitious Sustainable Development Goal (SDG) of the United Nations 9 to "end preventable deaths of newborns and children under 5" by 2030, it is vital for decision-makers at all levels to better understand where, and at what ages, child survival remains most tenuous.

BackgroundThere is a controversy about the association between vitamin D and cardiovascular diseases (CVDs). The effect of serum 25-OH-vitD on the risk of CVDs was evaluated.MethodsMajor electronic databases including Scopus, Science Direct, and PubMed were searched. All prospective cohort studies on the relationship between vitamin D status and CVDs conducted between April 2000 and September 2017 were included, regardless language. The study participants were evaluated regardless of their age, sex, and ethnicity. The Newcastle-Ottawa Scale was used to assess the quality of the studies. Two investigators independently selected the studies and extracted the data. The designated effects were risk ratio (RR) and hazard ratio (HR). The random effects model was used to combine the results.ResultsA meta-analysis of 25 studies with 10,099 cases of CVDs was performed. In general, a decrease in the level of vitamin D was associated with a higher relative risk of CVDs (incidence-mortality combined) (RR = 1.44, 95% CI: 1.24–1.69). This accounts for 54% of CVDs mortality rate (RR = 1.54, 95% CI: 1.29–1.84(. However, no significant relationship was observed between the vitamin D status and incidence of CVDs (RR = 1.18, 95% CI: 1–1.39). In general, low serum vitamin D level increased the risk of CVD by 44% (RR = 1.44, 95% CI: 1.24–1.69). It also increased the risk of CVD mortality (RR = 1.54, 95% CI: 1.29–1.84) and incidence rates (RR = 1.18, 95% CI: 1–1.39).ConclusionsThe findings showed that vitamin D deficiency increases the CVDs mortality rate. Due to the limited number of studies on patients of the both genders, further research is suggested to separately evaluate the effect of vitamin D status on CVD in men and women.

No abstract

Background and Objective: Post-term pregnancy (gestational age of ≥294 days [≥42 weeks] is associated with increased perinatal morbidity and mortality. The present study was conducted to compare the effect of vaginal capsule of evening primrose oil and misoprostol on cervical ripening of nulliparous women with post-term pregnancy. Materials and Methods: This research has been conducted with the one-blind randomized trial method on 130 pregnant women with post-term pregnancy visiting to the labor ward of sanandaj Besat Hospital. Samples were divided into two groups of intervention and control with the randomized allocation method. The intervention group receiving 500 mgvaginal evening primrose capsule and 25 micrograms of sublingual misoprostol, and the control group receiving a placebo-vaginal capsule and 25 micrograms of misoprostol sublingually. Data collecting tools include: demographic specifications questionnaire and Bishop Checklist. Data was analyzed through SPSS software version 21 and by using Chi-square, T-test, covariance analysis, one-way ANOVA, and repeated measures. P <0.05 was considered significant. Results: The results showed that the mean Bishope scores of the subjects in the intervention group were significantly higher than the control group (p <0.05). There was no significant difference in uterine contractions, fetal heart rate and vital signs between two groups (p> 0.05). Conclusion: The results of the present study showed that vaginal capsule of evening primrose oil is effective on the rate of cervical ripening in post-term pregnancies. Also, no significant effect on was observed on fetal heart rate, uterine contractions, and vital signs of the mother.

Background & Aim: Psychiatric wards are stressful environments. Resilience can help psychiatric nurses cope with their occupational stress. The aim of the study was to examine the relationship of mental health with resilience among psychiatric nurses. Materials & Methods: This cross-sectional descriptive-correlational study was conducted in 2017 on a sample of sixty nurses purposively recruited from all wards of Qods psychiatric hospital, Sanandaj, Iran. Study data were collected using a demographic questionnaire, the 28-item General Health Questionnaire, and the 25-item Connor-Davidson Resilience Scale. The data were analyzed via the SPSS software v. 16.0 through conducting the independent-sample t test, the one-way analysis of variance, and the multiple linear regression analysis. The level of significance was set at less than 0.05. Results: In total, sixty psychiatric nurses (34 males and 26 females) with a mean age of 33.23±5.45 participated in this study. The mean scores of their mental health and resilience were 57.35±11.12 and 63.9±14.05, respectively. Resilience had significant relationships with age (0.025), marital status (P = 0.013), and work shift (P = 0.005). Moreover, among the subscales of mental health, only the mean score of the anxiety and insomnia subscale had significant relationship with resilience, so that each one point increase in the mean score of this subscale was associated with a 1.029-point increase in the mean score of resilience (P = 0.036). Conclusion: Psychiatric nurses’ resilience can be promoted through managing their stress and promoting their mental health.