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Cognitive gaps between children of different socioeconomic backgrounds are particularly significant in the developing world. We propose and use a new decomposition strategy to measure the contribution of early childhood and school influences to the cognitive gap between urban and rural eight-year-old children in Peru. This strategy accounts for the relation between family choices and skill inputs and is less prone to biases than those employed before. We find that school influences occurring between ages 6 and 8, account for a significant share of urban/rural cognitive gap (around 35%). The share attributable to early childhood influences is important but no larger than 50%. Because skill depreciates, only a fraction of the gap (70–80%) is carried forward to the next period. Therefore, inequalities in school environments are sustaining a cognitive gap that would otherwise be smaller and this explains why differences that emerge during early childhood can remain unchanged after children start school. [ABSTRACT FROM AUTHOR]

Background Status dystonicus (SD) is a life-threatening complication in which episodes of dystonic movements become increasingly frequent and severe, requiring urgent hospital admission, and can lead to respiratory, metabolic, and bulbar complications. Pharmacologic treatment has been the mainstay management for this complication; however, many refractory patients will still require further treatment. Deep brain stimulation (DBS) is an established therapeutic strategy that has been used for dystonia, and now it has been proposed to be used for SD. Methods In this case series, we describe our experience with early DBS placement in 5 patients with SD to control symptoms that are refractory to pharmacologic therapy. In addition, we present a literature review of this therapy in the treatment of SD. Results Before discharge, symptomatic relief (decrease of dystonic movements and resolution of abnormal postures) was evidenced in all patients with a median of 3 days (interquartile range, 1–7) after surgery was performed. A follow-up Unified Dystonia Rating Scale score and Burke-Fahn-Marsden rating scale motor subscale score, at 6 months after hospital discharge with values being inferior to 20 and 30, respectively, for all cases. None of the patients had a recurrence of SD in the last follow-up period. Conclusions DBS surgery is a suitable, versatile, reversible and adequate therapy in the treatment of SD that is refractory to initial pharmacologic treatment. [ABSTRACT FROM AUTHOR]