Recent Trends in Maternal, Newborn, and Child Health in Brazil: Progress Toward Millennium Development Goals 4 and 5

We analyzed Brazil`s efforts in reducing child mortality, improving maternal and child health, and reducing socioeconomic and regional inequalities from 1990 through 2007. We compiled and reanalyzed data from several sources, including vital statistics and population-based surveys. We also explored the roles of broad socioeconomic and demographic changes and the introduction of health sector and other reform measures in explaining the improvements observed. Our findings provide compelling evidence that pro-active measures to reduce health disparities accompanied by socioeconomic progress can result in measurable improvements in the health of children and mothers in a relatively short interval. Our analysis of Brazil`s successes and remaining challenges to reach and surpass Millennium Development Goals 4 and 5 can provide important lessons for other low- and middle-income countries. (Am J Public Health. 2010;100:1877-1889. doi:10.2105/AJPH.2010.196816)

Investigating Environmental Determinants of Diet, Physical Activity, and Overweight among Adults in Sao Paulo, Brazil

There is worldwide recognition that the burden of noncommunicable diseases (NCDs) and obesity-related health problems is rapidly increasing in low- and middle-income countries. Environmental determinants of obesity are likely to differ between countries, particularly in those undergoing rapid socioeconomic and nutrition transitions such as Brazil. This study aims to describe some built environment and local food environment variables and to explore their association with the overweight rate and diet and physical activity area-level aggregated indicators of adults living in the city of Sao Paulo, the largest city in Brazil. This formative study includes an ecological analysis of environmental factors associated with overweight across 31 submunicipalities of the city of Sao Paulo using statistical and spatial analyses. Average prevalence of overweight was 41.69% (95% confidence interval 38.74, 44.64), ranging from 27.14% to 60.75% across the submunicipalities. There was a wide geographical variation of both individual diet and physical activity, and indicators of food and built environments, favoring wealthier areas. After controlling for area socioeconomic status, there was a positive correlation between regular fruits and vegetables (FV) intake and density of FV specialized food markets (r = 0.497; p < 0.001), but no relationship between fast-food restaurant density and overweight prevalence was found. A negative association between overweight prevalence and density of parks and public sport facilities was seen (r = -0.527; p < 0.05). Understanding the relationship between local neighborhood environments and increasing rates of poor diet, physical activity, and obesity is essential in countries undergoing rapid economic and urban development, such as Brazil, in order to provide insights for policies to reduce increasing rates of NCDs and food access and health inequalities.

A revision of the spider genera Chaetopelma ausserer 1871 and Nesiergus simon 1903 (Araneae, theraphosidae, ischnocolinae)

Chaetopelma Ausserer 1871 and Nesiergus Simon 1903 are revised. Cratorrhagus Simon 1891 is considered a junior synonym of Chaetopelma. Cratorrhagus tetramerus (Simon 1873) and the female of Cratorrhagus concolor (Simon 1873) are conspecific with C. olivaceum (C. L. Koch 1841). Ischnocolus gracilis Ausserer 1871, Ischnocolus syriacus Ausserer 1871, Chaetopelma shabati Hassan 1950 and Ischnocolus jerusalemensis Smith 1990 are also treated here as junior synonyms of C. olivaceum. Chaetopelma adenense Simon 1890 is proposed as a junior synonym of Ischnocolus jickelii L. Koch 1875. Chaetopelma gardineri Hirst 1911 is transferred to Nesiergus. Hence, Chaetopelma comprises three valid species: C. olivaceum (C. L. Koch 1841); C. karlamani Vollmer 1997; C. concolor (Simon 1873) n. comb. from the Middle East and northeastern Africa. Nesiergus, which appears endemic to the Seychelles archipelago, now comprises three valid species: N. gardineri (Hirst 1911) n. comb.; N. halophilus Benoit 1978; N. insulanus Simon 1903.