No abstract

Agency for Healthcare Research and Quality.

The double burden of malnutrition, defined here as households with a stunted child and an overweight mother (SCOM), is a growing problem in Guatemala. We explored the magnitude of SCOM and the identification of socio-economic factors associated with this malnutrition duality. From the 2000 Living Standards Measurement Study from Guatemala, we obtained a sample of 2492 households with pairs of children 6–60 months and their mothers (18–49 years) and estimated the prevalence of SCOM. Economic characteristics of this sample were assessed with the Concentration Index (CI). Results revealed higher prevalence of child stunting, but a lower prevalence of maternal overweight among the poor compared to the rich households. Economic inequality in child stunting was greater than economic inequality in maternal overweight (CI = −0.22 vs. +0.14). SCOM pairs were more prevalent among the poor and middle SES groups as compared to the rich households. A multivariate logistic regression model showed that SCOM was more likely to occur in households from the middle consumption quintile than in those from the first quintile (odds ratio = 1.7). The findings reported here add new insights into the complex phenomenon observed in households with both extremes of the malnutrition continuum, and support the need for the identification of economic, social and biological interventions aimed at, on the one hand, the prevention of this duality of the malnutrition in those households where it is still non-existent, and on the other hand, to deter or correct the economic, social and biological environments where those mother-child dyads are already affected by such phenomena.

Importance: Sensorineural hearing loss is the third leading cause of years lived with disability worldwide. Cochlear implants may provide a viable alternative to hearing aids for this type of hearing loss. The Coverage and Analysis Group at the Centers for Medicare & Medicaid Services was interested in an evaluation of recently published literature on this topic. In addition, this metaanalysis is to our knowledge the first to evaluate qualityof-life (QOL) outcomes in adults with cochlear implants.Objective: To evaluate the communication-related outcomes and health-related QOL outcomes after unilateral or bilateral cochlear implantation in adults with sensorineural hearing loss. Study Selection: Published studies of adult patients undergoing unilateral or bilateral procedures with multichannel cochlear implants and assessments using openset sentence tests, multisyllable word tests, or QOL measures.Data Extraction: Five researchers extracted information on population characteristics, outcomes of interest, and study design and assessed the studies for risk of bias. Discrepancies were resolved by consensus.Results: A total of 42 studies met the inclusion criteria. Most unilateral implant studies showed a statistically significant improvement in mean speech scores as measured by open-set sentence or multisyllable word tests; meta-analysis revealed a significant improvement in QOL after unilateral implantation. Results from studies assessing bilateral implantation showed improvement in communication-related outcomes compared with unilateral implantation and additional improvements in sound localization compared with unilateral device use or implantation only. Based on a few studies, the QOL outcomes varied across tests after bilateral implantation. Conclusions and Relevance:Unilateral cochlear implants provide improved hearing and significantly improve QOL, and improvements in sound localization are noted for bilateral implantation. Future studies of longer duration, higher-quality reporting, and large databases or registries of patients with long-term follow-up data are needed to yield stronger evidence.

BackgroundThe identification of predictors for body image distortion would be an especially important first step in targeting a vulnerable population and developing a nutrition intervention program. We aimed to investigate the prevalence of body image distortion and the factors associated with body image distortion among Korean high school students.MethodsWe selected 20,264 normal weight high school students from the 10th Korea Youth Risk Behavior Web-based Survey using nationally representative data in 2014. With multivariate logistic regression, we assessed the association of body image distortion with individual demographic and socio-economic factors, weight control behaviors, and mental health characteristics.ResultsThe over-estimation group of body weight status, compared with the correct estimation group, was significantly more likely to be a 3rd year high school student [adjusted odds ratio (AOR): 1.27, 95 % confidence interval (CI): 1.16–1.39], to be female [AOR: 3.52, 95 % CI: 3.25–3.81], to employ unhealthy weight control behaviors [AOR: 1.54, 95 % CI: 1.37–1.72], and to have a sadness [AOR: 1.25, 95 % CI: 1.16–1.35] and suicidal ideation [AOR: 1.20, 95 % CI: 1.08–1.33]. The under-estimation group, compared with the correct estimation group, was significantly less likely to be female [AOR: 0.23, 95 % CI: 0.21–0.25] and to employ unhealthy weight control behaviors [AOR: 0.50, 95 % CI: 0.43–0.59] but were more likely to have a sadness [AOR: 1.12, 95 % CI: 1.03–1.21] and suicidal ideation [AOR: 1.12, 95 % CI: 1.00–1.25].ConclusionsNot only the over-estimation but also the under-estimation of body weight is prevalent among high school students in South Korea. Body image distortion was significantly associated with sadness and suicidal ideation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2703-z) contains supplementary material, which is available to authorized users.