Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974–2007

Objective To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. Methods The prevalence of stunting (height-for-age z score below \22122 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974\201375 (n = 34 409), 1989 (n = 7374), 1996 (n = 4149) and 2006\201307 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Findings Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1 per cent to 7.1 per cent. Prevalence dropped from 59.0 per cent to 11.2 per cent in the poorest quintile and from 12.1 per cent to 3.3 per cent among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators.Conclusion In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis

Spectral linewidth narrowing by a weak squeezed field of an arbitrary bandwidth

We study the spectral and noise properties of the fluorescence field emitted from a two-level atom driven by a beam of squeezed light. For a weak driving field we derive simple analytical formulae for the fluorescence and quadrature-noise spectra which are valid for an arbitrary bandwidth of the squeezed field. We analyse the spectra in the regime where the squeezing bandwidth is smaller or comparable to the atomic linewidth, the area where non-Markovian effects are important. We emphasize that there is a noticable difference between the fluorescence spectra for the thermal and squeezed field excitations. In both cases the spectrum can be narrower than any bandwidth involved in the process. However, as we point out for the squeezed driving field the linewidth narrowing, being much larger than in the thermal-field case, can be attributed to the squeezing of the fluctuations in the driving held. We also calculate the quadrature-noise spectrum of the emitted fluorescence, and find that for a detuned squeezed field the fluorescence spectrum does not reveal the quadrature-noise spectrum. In contrast to the fluorescence spectrum having two peaks, the quadrature-noise spectrum exhibits three peaks. We explain this difference as arising from the competiting three-photon scattering processes. (C) 1998 Elsevier Science B.V. All rights reserved.

Spectral linewidth narrowing by a narrow bandwidth squeezed vacuum in a cavity

The fluorescence spectrum of a strongly driven two-level atom located inside an optical cavity damped by a narrow-bandwidth squeezed vacuum is studied. We use a dressed atom model approach, first applied to squeezed vacuum problems by Yeoman and Barnett, to derive the master equation of the system and discuss the role of the cavity and the squeezed vacuum in the narrowing of the spectral lines and the population trapping effect. We find that in the presence of a single-mode cavity the effect of squeezing on the fluorescence spectrum is more evident in the linewidths of the Rabi sidebands rather than in the linewidth of the central component. Even in the absence of squeezing, the cavity can reduce the linewidth of the central component almost to zero, whereas the Rabi sidebands can be narrowed only to some finite value. In the presence of a two-mode cavity and a two-mode squeezed vacuum the signature of squeezing is evident in the linewidths of all spectral lines. We also establish that the narrowing of the spectral lines is very sensitive to the detuning of the driving field from the atomic resonance. Moreover, we find that the population trapping effect, predicted for the broadband squeezed vacuum case, may appear in a narrow-bandwidth case only if the input squeezed modes are perfectly matched to the cavity modes and if there is non-zero squeezing at the Rabi sidebands.

Phase-dependent fluorescence linewidth narrowing in a three-level atom damped by a finite-bandwidth squeezed vacuum

We examine subnatural phase-dependent linewidths in the fluorescence spectrum of a three-level atom damped by a narrow-bandwidth squeezed vacuum in a cavity. Using the dressed-atom model approach of a strongly driven three-level cascade system, we derive the master equation of the system from which we obtain simple analytical expressions for the fluorescence spectrum. We show that the phase effects depend on the bandwidths of the squeezed vacuum and the cavity relative to the Rabi frequency of the driving fields. When the squeezing bandwidth is much larger than the Rabi frequency, the spectrum consists of five lines with only the central and outer sidebands dependent on the phase. For a squeezing bandwidth much smaller than the Rabi frequency the number of lines in the spectrum and their phase properties depend on the frequency at which the squeezing and cavity modes are centered. When the squeezing and cavity modes are centered on the inner Rabi sidebands, the spectrum exhibits five lines that are completely independent of the squeezing phase with only the inner Rabi sidebands dependent on the squeezing correlations. Matching the squeezing and cavity modes to the outer Rabi sidebands leads to the disappearance of the inner Rabi sidebands and a strong phase dependence of the central line and the outer Rabi sidebands. We find that in this case the system behaves as an individual two-level system that reveals exactly the noise distribution in the input squeezed vacuum. [S1050-2947(97)00111-X].

Narrowing inequalities in infant mortality in Southern Brazil

OBJECTIVE: To determine the trends of infant mortality from 1995 to 1999 according to a geographic area-based measure of maternal education in Porto Alegre, Brazil. METHODS: A registry-based study was carried out and a municipal database created in 1994 was used. All live births (n=119,170) and infant deaths (n=1,934) were considered. Five different geographic areas were defined according to quintiles of the percentage of low maternal educational level (<6 years of schooling): high, medium high, medium, medium low, and low. The chi-square test for trend was used to compare rates between years. Incidence rate ratio was calculated using Poisson regression to identify excess infant mortality in poorer areas compared to higher schooling areas. RESULTS: The infant mortality rate (IMR) decreased steadily from 18.38 deaths per 1,000 live births in 1995 to 12.21 in 1999 (chi-square for trend p<0.001). Both neonatal and post-neonatal mortality rates decreased although the drop seemed to be steeper for the post-neonatal component. The higher decline was seen in poorer areas. CONCLUSION: Inequalities in IMR seem to have decreased due to a steeper reduction in both neonatal and post-neonatal components of infant mortality in lower maternal schooling area.

Secular changes of spinal canal dimensions in Western Switzerland: a narrowing epidemic?

STUDY DESIGN: Computed tomography-based anatomical study. OBJECTIVE: To study the secular changes in lumbar spinal canal dimensions. SUMMARY OF BACKGROUND DATA: Development of symptomatic lumbar spinal stenosis, among other factors, is related to the dimensions of the bony canal. The canal reaches its adult size early on in life. Several factors, including protein intake, may influence its final dimensions. As with increases in human stature from improvements of socioeconomic conditions, we hypothesized that adult bony canal size has also grown larger in recent generations. METHODS: This study analyzes computed tomographic reconstructions from 184 subjects performed for either trauma (n = 81) or abdominal pathologies (n = 103) and born either between 1940 and 1949 (n = 88) or 1970 and 1979 (n = 96). The cross-sectional area of the bony canal was digitally measured at the level of the pedicle (i.e., at a level not influenced by degenerative changes) for each lumbar vertebra. Intra- and interobserver reliability was assessed. RESULTS: Intra- and interobserver measurement reliability were excellent (interclass correlation coefficient = 0.87) and good (interclass correlation coefficient = 0.61), respectively. Contrary to our hypothesis, the 1940-1949 generation patient group exhibited larger lumbar canals at all levels as compared with the 1970-1979 group. Statistically this difference was highly significant (P < 0.001) and particularly pronounced in the trauma subgroup. CONCLUSION: Given that human stature evolution has stabilized and adult height is established during the first 2 years of long bone growth, it is possible that antenatal factors are responsible for this surprising finding. Maternal smoking and age may be possible explanations. This finding may have significant implications. An increasing number of patients may emerge with lumbar spinal stenosis as degenerative changes develop, putting a strain on health resources. Further studies in different population groups and countries will be important to further confirm this trend. LEVEL OF EVIDENCE: 3.

Challenges for the New Century Schools for All and Narrowing Gaps through Transformation Pedagogies

La pedagogia ha tractat la qüestió de gènere i d’educació? I si és el cas, de quina manera? Quins han estat els resultats? Tant el valor de l’educació com el de gènere foren qüestionats i revisats al començament del segle XX. Els resultats d’aquelles reflexions i les batalles lluitades per millorar les condicions, comencen a sentir-se cent anys més tard. Aquest article inclourà primerament una visió general de la situació de la dona en l’educació en l’àmbit mundial. En segon lloc, se centrarà en els enfocaments pedagògics transformacionals que de manera gradual comencen a introduir-se en els sistemes educatius convencionals —també en algunes universitats i programes de traducció—, secundats d’una banda pels principis de democràcia, diàleg, carnaval, experimentació i (socio) constructivisme, i per la neurociència i la psicologia de l’altra. És evident que aquests enfocaments desafien la discriminació i afavoreixen la creació de ponts, no tan sols entre gèneres, sinó també entre etnicitats i classes social

Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974-2007

Objective To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. Methods The prevalence of stunting (height-for-age z score below 2 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974-75 (n = 34 409), 1989 (n = 7374), 1996 (n = 4149) and 2006-07 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Findings Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1% to 7.1%. Prevalence dropped from 59.0% to 11.2% in the poorest quintile and from 12.1% to 3.3% among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators. Conclusion In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis.

Thermally activated exchange narrowing of the Gd3+ ESR fine structure in a single crystal of Ce1-xGdxFe4P12 (x approximate to 0.001) skutterudite

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Exchange narrowing effects in the EPR linewidth of Gd diluted in Ce compounds

Anomalous thermal behavior on the EPR linewidths of Gd impurities diluted in Cc compounds has been observed. In metals, the local magnetic moment EPR linewidth, Delta H, is expected to increase linearly with the temperature. In contrast, in CexLa1-xOs2 the Gd EPR spectra show a nonlinear increase. In this work, the mechanisms that are responsible for the thermal behavior of the EPR lines in CexLa1-xOs2 are examined. We show that the exchange interaction between the local magnetic moments and the conduction electrons are responsible for the narrowing of the spectra at low temperatures. At high temperatures, the contribution to the linewidth of the exchange interaction between the local magnetic moments and the Ce ions has an exponential dependence on the excitation energy of the intermediate valent ions. A complete fitting of the EPR spectra for powdered samples is obtained, (C) 1998 American Institute of Physics. [S0021-8979(98)39911-9].

Narrowing the gap of personalized medicine in emerging countries: the case of multiple endocrine neoplasias in Brazil

The finished version of the human genome sequence was completed in 2003, and this event initiated a revolution in medical practice, which is usually referred to as the age of genomic or personalized medicine. Genomic medicine aims to be predictive, personalized, preventive, and also participative (4Ps). It offers a new approach to several pathological conditions, although its impact so far has been more evident in mendelian diseases. This article briefly reviews the potential advantages of this approach, and also some issues that may arise in the attempt to apply the accumulated knowledge from genomic medicine to clinical practice in emerging countries. The advantages of applying genomic medicine into clinical practice are obvious, enabling prediction, prevention, and early diagnosis and treatment of several genetic disorders. However, there are also some issues, such as those related to: (a) the need for approval of a law equivalent to the Genetic Information Nondiscrimination Act, which was approved in 2008 in the USA; (b) the need for private and public funding for genetics and genomics; (c) the need for development of innovative healthcare systems that may substantially cut costs (e.g. costs of periodic medical followup); (d) the need for new graduate and postgraduate curricula in which genomic medicine is emphasized; and (e) the need to adequately inform the population and possible consumers of genetic testing, with reference to the basic aspects of genomic medicine.