BACKGROUND: Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography (CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue (VAT) and markers of increased metabolic risk.METHODS: Visceral Adipose Tissue Area Index (VATI cm 2/m 2) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic (ROC) curves. RESULTS: In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs (p ≤ 0.013). In males and females respectively, a value of VATI of ≥38.7 cm 2/m 2 and ≥24.9 cm 2/m 2 was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC) = 0.702 vs AUC = 0.556 in males and AUC = 0.757 vs AUC = 0.630 in females). CONCLUSION: Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.
Fields neighboring the disciplines of kinesiology and sports science have called for more interdisciplinary work, including the adoption of critical approaches to research. This scoping review explored the degree to which critically-aligned research has developed within these disciplines. The goal was to identify who this research studied, what methods were used, and which theoretical and conceptual frameworks were adopted. Publications between 2010-2022 in six top kinesiology and sports science journals using four databases were searched using keywords to identify critically-aligned research. A multi-step screening process was used to identify and sort articles that adequately fit the criteria of critically-aligned research. The scoping review identified 5666 entries of which 3300 were unique publications. 76 articles were assessed to be critically-aligned. Four themes regarding demographics emerged: Geographic area, gender, race/ethnicity/indigeneity, and inequality/inequity. Regarding methodology, three major theoretical and conceptual frameworks emerged: ecological, socio-economic, and cultural. Overall, a relatively small number of studies fit our search criteria, suggesting that critically-aligned research remains at the margins of the disciplines. For the studies that were critically-aligned, they often centered the Global North and were inconsistent in their application of categories such as race, ethnicity, inequality and equity. These studies were diverse in their methodological approach while relying on ecological, socio-economic, and cultural frameworks. To heed the calls for a more interdisciplinary approach, and to advance the disciplines more generally, kinesiology and sports science should expand their adoption of critical approaches to research.
MULTIFILE
Background: Recent studies suggest that ethnic minority students underperform in standardised assessments commonly used to evaluate their progress. This disparity seems to also hold for postgraduate medical students and GP trainees, and may affect the quality of primary health care, which requires an optimally diverse workforce. Aims: To address the following: 1) to determine to what extent ethnic minority GP trainees are more at risk of being assessed as underperforming than their majority peers; 2) to investigate whether established underperformance appears in specific competence areas; and 3) to explore first and second-generation ethnic minority trainees’ deviations. Design & setting: Quantitative retrospective cohort design in Dutch GP specialty training (start years: 2015–2017). Method: In 2020–2021, the authors evaluated files on assessed underperformance of 1700 GP trainees at seven Dutch GP specialty training institutes after excluding five opt-outs and 165 incomplete datasets (17.4% ethnic minority trainees). Underperformance was defined as the occurrence of the following, which was prompted by the training institute: 1) preliminary dropout; 2) extension of the educational pathway; and/or 3) mandatory coaching pathways. Statistics Netherlands (CBS) anonymised the files and added data about ethnic group. Thereafter, the authors performed logistic regression for potential underperformance analysis and χ2 tests for competence area analysis. Results: Ethnic minority GP trainees were more likely to face underperformance assessments than the majority group (odds ratio [OR] 2.41, 95% confidence interval [CI] = 1.67 to 3.49). Underperformance was not significantly nested in particular competence areas. First-generation ethnic minority trainees seemed more at risk than their second-generation peers. Conclusion: Ethnic minority GP trainees seem more at risk of facing educational barriers than the majority group. Additional qualitative research on underlying factors is essential.
