Therapeutic itinerary of patients with chronic renal failure under dialytic treatment

Objective: To know the therapeutic itinerary of patients with chronic renal failure (CRF) under dialytic treatment. Method: This is a descriptive and exploratory study, with qualitative nature, performed in 40 patients with chronic renal failure who underwent dialysis in a clinic located in the municipality of NatalRN. The data collection was held through semi-structured interviews. Results: The study showed that the therapeutic itinerary of the interviewed patients was marked by the discovery of the renal disease, search for health care, dialytic treatment and future prospects. Conclusion: it was notorious that the majority of the interviewed were belatedly referred to the specialist, when the renal function is already largely affected, which often requires a dialytic treatment or even the accomplishment of urgent admissions. The transplantation was characterized as hope for a better quality of life and release from the dialytic therapy

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified