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  • 1
    Keywords: QUANTIFICATION ; mechanisms ; MRI ; MASS INDEX ; metabolic syndrome ; WAIST CIRCUMFERENCE ; TISSUE DISTRIBUTION ; ABDOMINAL OBESITY ; CARDIOVASCULAR RISK ; VISCERAL FAT
    Abstract: BACKGROUND: In epidemiological studies, measures of body fat generally are obtained through anthropometric indices such as the body mass index (BMI), waist (WC), and hip circumferences (HC). Such indices, however, can only provide estimates of a person's true body fat content, overall or by adipose compartment, and may have limited accuracy, especially for the visceral adipose compartment (VAT). OBJECTIVE: To determine the extent to which different body adipose tissue compartments are adequately predicted by anthropometry, and to identify anthropometric measures alone, or in combination to predict overall adiposity and specific adipose tissue compartments, independently of age and body size (height). METHODS: In a sub-study of 1,192 participants of the German EPIC (European Prospective Investigation into Cancer and Nutrition) cohorts, whole-body MRI was performed to determine adipose and muscle tissue compartments. Additional anthropometric measurements of BMI, WC and HC were taken. RESULTS: After adjusting for age and height, BMI, WC and HC were better predictors of total body volume (TBV), total adipose tissue (TAT) and subcutaneous adipose tissue (SAT) than for VAT, coronary adipose tissue (CAT) and skeletal muscle tissue (SMT). In both sexes, BMI was the best predictor for TBV (men: r = 0.72 [0.68-0.76], women: r = 0.80 [0.77-0.83]) and SMT (men: r = 0.52 [0.45-0.57], women: r = 0.48 [0.41-0.54]). WC was the best predictor variable for TAT (r = 0.48 [0.41-0.54]), VAT (r = 0.44 [0.37-0.50]) and CAT (r = 0.34 [0.26-0.41]) (men), and for VAT (r = 0.42 [0.35-0.49]) and CAT (r = 0.29 [0.22-0.37]) (women). BMI was the best predictor for TAT (r = 0.49 [0.43-0.55]) (women). HC was the best predictor for SAT (men (r = 0.39 [0.32-0.45]) and women (r = 0.52 [0.46-0.58])). CONCLUSIONS: Especially the volumes of internal body fat compartments are poorly predicted by anthropometry. A possible implication may be that associations of chronic disease risks with the sizes of internal body fat as measured by BMI, WC and HC may be strongly underestimated.
    Type of Publication: Journal article published
    PubMed ID: 24626110
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  • 2
    Publication Date: 2015-10-15
    Description: Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure.Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination.Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.
    Description: Zielsetzung: Seit 2011 wird in der Schweiz eine neue nationale Schlussprüfung in Humanmedizin mit einem strukturierten klinisch-praktischen Teil im OSCE Format durchgeführt. Der vorliegende Beitrag beschreibt, aus Sicht der nationalen Arbeitsgruppe, die essentiellen Schritte der Erstellung, Durchführung und Auswertung der Eidgenössischen Prüfung Clinical Skills (EP CS) sowie der jeweils eingesetzten Qualitätssicherungsmassnahmen. Schliesslich werden zentrale Erkenntnisse der vergangenen Jahre vorgestellt. Methodik: Basierend auf den Prinzipien der Aktionsforschung wird die EP CS kontinuierlich weiter entwickelt. Auf der Grundlage systematisch dokumentierter Erfahrungen aus den Vorjahren werden in der Arbeitsgruppe anstehende Fragen diskutiert, daraus resultierende Lösungsansätze konkretisiert (Planung), in der Prüfung umgesetzt (Implementation) und anschliessend evaluiert (Reflexion). Die vorgestellten Ergebnisse sind das Produkt dieses iterativen Vorgehens. Ergebnisse: Die EP CS wird durch Fachexperten aller Fakultäten und Fachrichtungen in einem mehrstufigen Prozess erstellt. Die Prüfung wird dezentral in Deutsch und Französisch durchgeführt und besteht aus zwölf interdisziplinären Stationen pro Kandidat. Als wichtige Qualitätssicherungsmassnahmen haben sich das nationale Review Board (inhaltliche Validierung) und die Treffen der Schauspielpatienten-Trainer (Standardisierung) erwiesen. Die statistischen Auswertungen zeigen eine gute Messzuverlässigkeit und weisen auf die Konstruktvalidität der Prüfung hin. Zu den zentralen Erkenntnissen der vergangenen Jahre gehört, dass die konsequente Umsetzung der Prinzipien der Aktionsforschung zur erfolgreichen Weiterentwicklung der Prüfung beiträgt.Schlussfolgerung: Der zentral koordinierte, kollaborativ-iterative Prozess mit Einbindung von Fachexperten aus allen Fakultäten trägt wesentlich zur Qualität der EP CS bei. Die hier vorgestellten Prozesse und Erkenntnisse können für andere nützlich sein, welche Ähnliches vorhaben.
    Keywords: national final examination ; licensing examination ; summative assessment ; OSCE ; action research ; nationale Schlussprüfung ; lizenzierende Prüfung ; summatives Assessment ; OSCE ; Aktionsforschung ; ddc: 610
    Language: English
    Type: article
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