International journal of epidemiology
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In the late 1960s, coronary heart disease (CHD) mortality among Finnish men was the highest in the world. From 1972 to 2007, risk factor surveys have been carried out to monitor risk factor trends and assess their contribution to declining mortality in Finland. ⋯ The 80% decline in coronary mortality in Finland mainly reflects a great reduction of the risk factor levels; these in turn have been associated with long-term comprehensive chronic disease prevention and health promotion interventions.
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Review Meta Analysis
Folic acid to reduce neonatal mortality from neural tube disorders.
Neural tube defects (NTDs) remain an important, preventable cause of mortality and morbidity. High-income countries have reported large reductions in NTDs associated with folic acid supplementation or fortification. The burden of NTDs in low-income countries and the effectiveness of folic acid fortification/supplementation are unclear. ⋯ The evidence supports both folic acid supplementation and fortification as effective in reducing neonatal mortality from NTDs.
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Review Meta Analysis
The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality.
Most diarrhoeal deaths can be prevented through the prevention and treatment of dehydration. Oral rehydration solution (ORS) and recommended home fluids (RHFs) have been recommended since 1970s and 1980s to prevent and treat diarrhoeal dehydration. We sought to estimate the effects of these interventions on diarrhoea mortality in children aged <5 years. ⋯ ORS is effective against diarrhoea mortality in home, community and facility settings; however, there is insufficient evidence to estimate the effectiveness of RHFs against diarrhoea mortality.
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The Lives Saved Tool (LiST) projects the magnitude of mortality reduction based on baseline coverage, demographic characteristics and coverage targets. As a validation exercise, we compared neonatal, post-neonatal, infant, child and under-5 mortality reductions as projected by LiST to changes in mortality measured through demographic surveys in Ghana and Mali as part of a recently completed, retrospective evaluation of a child survival programme. ⋯ We consider LiST to be a useful tool given the limitations of the available data. Although the model was a good match in Ghana, we identified several limiting factors with the input data in the Mali projection. This exercise highlights the importance of continually improving the availability of sound demographic, epidemiological and intervention coverage data at district and national levels. More comparative studies are needed to fully assess the strengths and weaknesses of LiST.