Emotional assistance in thalassaemia: pilot implementation of a standard protocol

This study aims to describe the creation process of standard procedures to make possible multicentre studies related to emotional aspects of thalassaemic patients, their families and caregivers; and the pilot phase of the routine implementation. The objectives defined to perform this goal are: i) develop routines to assess and manage/treat emotional issues; ii) adjust the ABRASTA - Brazilian Association of Thalassaemia computer system to the input of collected data and its compilation; iii) conduct a pilot implementation of the routines; iv) discuss the whole process and propose next steps. Forty patients were assisted following the above mentioned routines of psychological evaluation, follow-up assistance and management of specific emotional issues. Conclusions are that the routines are adequate to enable multicenter research to compare findings and develop specific interventions to Thalassaemia patients, their families and caregivers; information gathered through them is an important means of supporting medical doctors and other members of the professional team, both in the therapeutic planning and in the communication process with patients and families; finally, considering the nature of the information, psychologists and psychiatrists are the most indicated professionals to perform the assessment and the interventions related to emotional issues, due to their professional background, training and specific skills that allow a free and candid communication with the patients and their families.&nbsp;本研究旨在描述标准程序的创造过程，来进行关于地中海贫血患者、其家属和照顾者情感方面可能的多中心研究；以及例程实施的试点阶段。 为实现此目的而定下的目标有： 1）制定例程评估和管理/处理情感问题；2）调整巴西地中海贫血病协会（ABRASTA）计算机系统， 输入收集到的数据并对其进行编辑；3）对例程进行试点实施；4）讨论整个过程并提出下一步行动。 遵照上述特殊情感问题的心理评估、随访协助和管理的例程，曾协助过四十名患者。 结论为该例程足以确保多中心研究，以比较结果和为地中海贫血患者、其家属和照顾者制定具体的干预措施；通过他们收集的信息是支持治疗医生和专业团队的其他成员的重要途径，这些支持体现在治疗计划、以及和患者及其家属交流的过程中；最后，考虑到这些信息的性质，心理专家和精神病专家是最明显的专业人士来进行的有关情感问题的评估和干预，因为他们具备专业背景、专业训练和特殊技能，这些使得他们能够和患者及其家属进行自由和真正的交流。</p

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions. © Copyright

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 &amp;lt;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. © 2023, The Author(s)