Multiple‐choice response formats are troublesome, as an item is often scored as solved simply because the examinee may be lucky at guessing the correct option. Instead of pertinent Item Response Theory models, which take guessing effects into account, this paper considers a psycho‐technological approach to re‐conceptualizing multiple‐choice response formats. The free‐response format is compared with two different multiple‐choice formats: a traditional format with a single correct response option and five distractors (‘1 of 6’), and another with five response options, three of them being distractors and two of them being correct (‘2 of 5’). For the latter format, an item is scored as mastered only if both correct response options and none of the distractors are marked. After the exclusion of a few items, the Rasch model analyses revealed appropriate fit for 188 items altogether. The resulting item‐difficulty parameters were used for comparison. The multiple‐choice format ‘1 of 6’ differs significantly from the multiple‐choice format ‘2 of 5’, while the latter does not differ significantly from the free‐response format. The lower difficulty of items ‘1 of 6’ suggests guessing effects.

Childhood obesity is an increasing health care problem associated with insulin resistance and low-level systemic inflammation, which can ultimately lead to diabetes. Evidence for efficacy of therapeutic intervention programs on the early development of obesity associated sequelae is moderate. This paper investigates the effect of a multidisciplinary short-term intervention program on insulin resistance and metaflammation in childhood obesity. Two hundred and 36 overweight or obese children and adolescents between the ages of 10 and 14 were included in a prospective 5 months intervention study, which included sports, psychotherapy, and nutritional counseling. Primary endpoints were the effects on body mass index standard deviation score (BMI-SDS) and homeostatic model assessment of insulin resistance (HOMA-IR), key secondary endpoints were the levels of C-reactive protein (CRP), leptin, and adiponectin. At baseline, a substantial proportion of participants showed signs of insulin resistance (mean HOMA-IR 5.5 ± 3.4) despite not meeting the diagnostic criteria for diabetes, and low-level inflammation (mean CRP 3.9 mg/l ± 3.8 mg/l). One hundred and 95 participants (83%) completed the program resulting in a significant reduction in BMI-SDS, HOMA-IR, CRP, and leptin and a significant increase in adiponectin (mean change compared to baseline −0.14, −0.85, −1.0 mg/l, −2.8 ng/ml, and 0.5 µg/ml, respectively; p < 0.001 each). Effects on BMI-SDS, HOMA-IR, CRP, and adiponectin were largely independent whereas leptin was positively correlated with BMI-SDS and total fat mass before and after intervention (r = 0.56 and 0.61, p < 0.001 each). Short-term multidisciplinary intervention successfully Mayerhofer et al. Insulin Resistance in Childhood Obesity improved body composition, insulin sensitivity, low-level systemic inflammation, and the adipokine profile in childhood obesity. Our findings highlight the immediate connection between obesity and the pathophysiology of its sequelae, and emphasize the importance of early intervention. Continued lifestyle modification is likely necessary to consolidate and augment the long-term effects.

Es werden die beiden Intelligenz-Testbatterien HAWIK-IV und AID 2 in Bezug auf Hochbegabungsdiagnostik gegenübergestellt. Ausgegangen wird von zwei Modellen der Hochbegabungsdiagnostik. Dem traditionellen Ansatz einerseits – (kognitive) Hochbegabung liegt vor bei einem IQ > 130 – und dem „Wiener Diagnosemodell zum Hochleistungspotenzial“ andererseits. Letzteres postuliert in Anlehnung an das „Münchner Hochbegabungsmodell“ zusätzlich zu Begabungsfaktoren, wie vor allem der Intelligenz, bestimmte Persönlichkeits- sowie Umweltmerkmale als Moderatoren der Leistungsmanifestation. Die Abhandlung von HAWIK-IV und AID 2 ergibt, dass keine von beiden Testbatterien beiden Modellen gleichermaßen gerecht wird, sondern der HAWIK-IV eher im Sinne der traditionellen Hochbegabungsdiagnostik einsetzbar ist, der AID 2 besonders gut für eine förderungsorientierte Diagnostik im Sinne des „Wiener Diagnosemodells zum Hochleistungspotenzial“. Somit muss in der Praxis zuerst entschieden werden, welchem Modell man sich verpflichtet fühlt, um danach die optimale Intelligenz-Testbatterie auszuwählen.

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