The group psychodrama consultation effect on resiliency and spiritual intelligence of Eight grade female students

This study aimed to evaluate the effectiveness of group counseling Psychodrama on spiritual intelligence and resilience of students. For this purpose, 60 secondary school female students in  Tehran were selected based on multi-stage cluster sampling. Then, the patients were selected randomly as 30 in the experimental group and 30 in the control group. In order to analyze data, ANOVA was used as the statistical method of analysis. The results showed that group Psychodrama counseling is effective for resiliency of students, and it has a significant impact on students' spiritual intelligence

Avaliando o comprometimento organizacional dos professores da escola secundária com base na teoria dos dois fatores de higiene de motivos de Herzberg

main aim of the present study is evaluating organizational commitment of secondary school's teachers based on Herzberg's Motive- hygiene two-factor theory. A descriptive-survey method is used in this study. The statistical population of this study included the secondary school's teachers of the education administration of Jahrom city. They were 330 persons at the time of study. The sample size was 178 persons based on Kerjesi-Morgan's table and the sampling was done by a stratified- randomized method. Two questionnaires of organizational commitment (Allen and Meyer) and motive- hygiene two-factor (job expectation) (Lussier) were used for gathering information. The validity and reliability of questionnaires were confirmed. Indexes such as mean and standard deviation, One – Sample T Test, Pearson correlative coefficient, Independent- Samples T – Test, stepwise multivariate regression analysis and One - Way Analysis of Variance of two parts of descriptive statistics and inferential statistics were used for analyzing the data respectively. Results of the analyzed data showed that there is a significant relationship between motive- hygiene factors and organizational commitment. There is no significant difference between hygiene factors of male and female teachers but the rate of hygiene factors of female teachers is more than the male teachers. There is also no significant difference between organizational commitment of male and female teachers but the rate of teachers with associate of arts is more than the teachers with Bachelor of Arts and Master of Arts (or sciences).El objetivo principal del presente estudio es evaluar el compromiso organizacional de los docentes de la escuela secundaria basado en la teoría de Herzberg sobre la motivación de dos factores. Un método de encuesta descriptiva se utiliza en este estudio. La población estadística de este estudio incluyó a los profesores de la escuela secundaria de la administración educativa de la ciudad de Jahrom. Eran 330 personas en el momento del estudio. El tamaño de la muestra fue de 178 personas según la tabla de Kerjesi-Morgan y el muestreo se realizó por un método estratificado y aleatorizado. Se utilizaron dos cuestionarios de compromiso organizacional (Allen y Meyer) y de motivación por motivos de dos factores (expectativa de trabajo) (Lussier) para recabar información. La validez y fiabilidad de los cuestionarios fueron confirmadas. Se usaron índices como media y desviación estándar, prueba T de una muestra, coeficiente correlativo Pearson, prueba T de muestras independientes, análisis de regresión multivariante por pasos y análisis de varianza de una vía de dos partes de estadística descriptiva y estadística inferencial para analizar el datos respectivamente. Los resultados de los datos analizados mostraron que existe una relación significativa entre los factores de higiene motivacional y el compromiso organizacional. No hay una diferencia significativa entre los factores de higiene de los docentes masculinos y femeninos, pero la tasa de factores de higiene de las maestras es más que la de los docentes masculinos. Tampoco hay una diferencia significativa entre el compromiso organizacional de maestros y maestras, pero la tasa de maestros con asociado de artes es más que la de maestros con Licenciatura en Artes y Maestría en Artes (o ciencias).O principal objetivo do presente estudo é avaliar o comprometimento organizacional de professores do ensino médio baseado na teoria de Herzberg sobre a motivação de dois fatores. Um método de pesquisa descritiva é usado neste estudo. A população estatística deste estudo incluiu os professores do ensino médio da administração educacional da cidade de Jahrom. Havia 330 pessoas no momento do estudo. O tamanho da amostra foi de 178 pessoas, de acordo com a tabela de Kerjesi-Morgan, e a amostragem foi realizada por método estratificado e randomizado. Dois questionários de comprometimento organizacional (Allen e Meyer) e motivação foram usados por razões de dois fatores (expectativa de trabalho) (Lussier) para coletar informações. A validade e confiabilidade dos questionários foram confirmadas. índices como média e desvio padrão, amostra teste t, Pearson coeficiente de correlação, t-teste em amostras independentes, análise de regressão multivariada e análise de variância através de duas partes de estatística descritiva e estatística inferencial foram utilizados para analisar o dados, respectivamente. Os resultados dos dados analisados mostraram que existe uma relação significativa entre fatores de higiene motivacional e comprometimento organizacional. Não há diferença significativa entre os fatores de higiene de professores do sexo masculino e feminino, mas a taxa de fatores de higiene das professoras é maior do que a dos professores do sexo masculino. Também não há uma diferença significativa entre o comprometimento organizacional dos professores, mas a taxa de professores de artes associados é mais do que professores com Bachelor of Arts e Master of Arts (ou ciência)

Modeling the Agility of Education Departments with a Digital Transformation Approach

Purpose: The purpose of this study is to provide a model of organizational agility in Fars education departments with a digital transformation approach. Methodology: This study is applied research from the perspective of the purpose of agile modeling of education departments' digital transformation strategy. Based on the data collection method, it is mixed research that was done by qualitative-quantitative methods. The participants include experts familiar with the structure and organizational relationships in education. Using the purposive sampling method, 15 people participated in this study. The main tools for collecting data are interviews and questionnaires. The interview consisted of 6 initial questions in a semi-structured manner. Content analysis has been used to identify the underlying categories of the research. The structural-interpretive modeling method has been used to design the initial model. Data were performed in the qualitative phase with ATLAS TI software and the quantitative phase with MicMac software. Results: Using qualitative analysis, the views of experts were identified through content analysis, and 5 categories and 19 components were identified. Then, based on the interpretive structural model, a model was designed for organizational agility of the Department of Education. There are 5 main themes of maturity, visionary leadership, structural flexibility, knowledge-based and socialism, and 19 organizing themes in this model. Conclusion: Education as a knowledge-creating organization acts in a coordinated and directional manner by creating an agile environment, thus providing the necessary platform for increasing the flow of information to create new knowledge and increase added value in its economic fields

Phytochemical Attributes of Some Dried Fig (Ficus carica L.) Fruit Cultivars Grown in Iran

In the present study, total phenolic, total flavonoids, total anthocyanins, total antioxidant capacity, total soluble solids, colour parameters (such as L*, a*, b*, C*, and H°) and phenolic compounds, including catechin, total catechin, quercetin-3- glucoside, total quercetin, and chlorogenic acid of nine dried fig fruit cultivars in Fars province, Iran, were studied since only limited information on that topic is available in the literature. Results showed that the total phenolic content in ‘Khafrak’ cultivar was significantly higher than other examined cultivars. Regarding to the values of total antioxidant capacity, there were no statistically significant differences among the majority of cultivars except between ‘Khafrak’ and ‘Rowno’. Except for ‘Khafrak’ and ‘Rowno’, TF content in ‘Sigoto’ was significantly higher than the other examined cultivars. Anthocyanin content in all cultivars was negligible and it was not detected in some cultivars. Based on colorimetric results, the lightest skin color was observed in ‘Shahanjir’, while the darker color was in ‘Seyah’. Significant differences were determined among the cultivars with respect to the distribution of phenolic compounds. Catechin and total quercetin contents in ‘Matti’ were significantly higher than the other examined cultivars. Results suggest that chlorogenic acid played a trifling role in determination of antioxidant capacity of the fruits. In addition, the cluster analysis based on Euclidean distance with Unweighted pair-group method using arithmetic average (UPGMA) method separated the cultivars into three main groups

Moderate to low knowledge and Positive Attitude towards Medicinal Plants leads to High Consumption of these Plants during Pregnancy

Background: In recent years, the use of medicinal plants in developing countries has increased significantly. However, these plants can cause adverse effects on the mother and fetus. This study aimed to investigate the frequency of use, knowledge, and attitude towards the use of medicinal plants in pregnant women. Methods: This descriptive–analytical study was performed in 2020 on 290 pregnant women referring to Shahroud health center. The first part of the questionnaire included demographic information and the second part included information related to knowledge, attitude, behavior, reasons for using medicinal plants, source of information, etc. The significant level was set at 0.05. Results: 61% of the participants had used the medicinal plants at least once during pregnancy. Most pregnant women had moderate knowledge (50%) and a positive attitude (73.1%) towards the use of medicinal plants. Behavior was significantly associated with knowledge (Pvalue=0.011) and attitude (Pvalue=0.014). The most common problem during pregnancy that caused the use of medicinal plants was heartburn (43.4%) and the main reason for the use of these plants was the availability of them at home or taking from acquaintances (36.6%). 57.2% had obtained their information about medicinal plants from the family. Conclusions: Due to the relatively high frequency of the use of medicinal plants during pregnancy and low knowledge about it, informing and increasing knowledge about medicinal plants during pregnancy is very important. Keywords: Pregnancy, Pregnant women, Medicinal plants, knowledg

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

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions