Construct-level predictive validity of educational attainment and intellectual aptitude tests in medical student selection: meta-regression of six UK longitudinal studies

Background: Measures used for medical student selection should predict future performance during training. A problem for any selection study is that predictor-outcome correlations are known only in those who have been selected, whereas selectors need to know how measures would predict in the entire pool of applicants. That problem of interpretation can be solved by calculating construct-level predictive validity, an estimate of true predictor-outcome correlation across the range of applicant abilities. Methods: Construct-level predictive validities were calculated in six cohort studies of medical student selection and training (student entry, 1972 to 2009) for a range of predictors, including A-levels, General Certificates of Secondary Education (GCSEs)/O-levels, and aptitude tests (AH5 and UK Clinical Aptitude Test (UKCAT)). Outcomes included undergraduate basic medical science and finals assessments, as well as postgraduate measures of Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) performance and entry in the Specialist Register. Construct-level predictive validity was calculated with the method of Hunter, Schmidt and Le (2006), adapted to correct for right-censorship of examination results due to grade inflation. Results: Meta-regression analyzed 57 separate predictor-outcome correlations (POCs) and construct-level predictive validities (CLPVs). Mean CLPVs are substantially higher (.450) than mean POCs (.171). Mean CLPVs for first-year examinations, were high for A-levels (.809; CI: .501 to .935), and lower for GCSEs/O-levels (.332; CI: .024 to .583) and UKCAT (mean = .245; CI: .207 to .276). A-levels had higher CLPVs for all undergraduate and postgraduate assessments than did GCSEs/O-levels and intellectual aptitude tests. CLPVs of educational attainment measures decline somewhat during training, but continue to predict postgraduate performance. Intellectual aptitude tests have lower CLPVs than A-levels or GCSEs/O-levels. Conclusions: Educational attainment has strong CLPVs for undergraduate and postgraduate performance, accounting for perhaps 65% of true variance in first year performance. Such CLPVs justify the use of educational attainment measure in selection, but also raise a key theoretical question concerning the remaining 35% of variance (and measurement error, range restriction and right-censorship have been taken into account). Just as in astrophysics, ‘dark matter’ and ‘dark energy’ are posited to balance various theoretical equations, so medical student selection must also have its ‘dark variance’, whose nature is not yet properly characterized, but explains a third of the variation in performance during training. Some variance probably relates to factors which are unpredictable at selection, such as illness or other life events, but some is probably also associated with factors such as personality, motivation or study skills

Association between body mass index and mental health among Scottish adult population: a cross-sectional study of 37,272 participants

<b>Background:</b> The evidence is conflicting as to whether body mass index (BMI) is associated with mental health and, if so, to what extent it varies by sex and age. We studied mental health across the full spectrum of BMI among the general population, and conducted subgroup analyses by sex and age.<p></p> <b>Method:</b> We undertook a cross-sectional study of a representative sample of the Scottish adult population. The Scottish Health Survey provided data on mental health, measured by the General Health Questionnaire-12 (GHQ), BMI, demographic and life-style information. Good mental health was defined as a GHQ score <4, and poor mental health as a GHQ score ≥4. Logistic regression models were applied. Results Of the 37 272 participants, 5739 (15.4%) had poor mental health. Overall, overweight participants had better mental health than the normal-weight group [adjusted odds ratio (OR) 0.93, 95% confidence interval (CI) 0.87–0.99, p = 0.049], and individuals who were underweight, class II or class III obese had poorer mental health (class III obese group: adjusted OR 1.26, 95% CI 1.05–1.51, p = 0.013). There were significant interactions of BMI with sex (p = 0.013) and with age (p < 0.001). Being overweight was associated with significantly better mental health in middle-aged men only. In contrast, being underweight at all ages or obese at a young age was associated with significantly poorer mental health in women only.<p></p> <b>Conclusions:</b> The adverse associations between adiposity and mental health are specific to women. Underweight women and young women who are obese have poorer mental health. In contrast, middle-aged overweight men have better mental health.<p></p&gt

Shear-free, Irrotational, Geodesic, Anisotropic Fluid Cosmologies

General relativistic anisotropic fluid models whose fluid flow lines form a shear-free, irrotational, geodesic timelike congruence are examined. These models are of Petrov type D, and are assumed to have zero heat flux and an anisotropic stress tensor that possesses two distinct non-zero eigenvalues. Some general results concerning the form of the metric and the stress-tensor for these models are established. Furthermore, if the energy density and the isotropic pressure, as measured by a comoving observer, satisfy an equation of state of the form $p = p(\mu)$, with $\frac{dp}{d\mu} \neq -\frac{1}{3}$, then these spacetimes admit a foliation by spacelike hypersurfaces of constant Ricci scalar. In addition, models for which both the energy density and the anisotropic pressures only depend on time are investigated; both spatially homogeneous and spatially inhomogeneous models are found. A classification of these models is undertaken. Also, a particular class of anisotropic fluid models which are simple generalizations of the homogeneous isotropic cosmological models is studied.Comment: 13 pages LaTe

Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population), were studied. The Clinical Interview Schedule-Revised (CIS-R) was used to determine the prevalence of common mental disorders (CMDs). Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health

Can we predict the duration of an interglacial?

Differences in the duration of interglacials have long been apparent in palaeoclimate records of the Late and Middle Pleistocene. However, a systematic evaluation of such differences has been hampered by the lack of a metric that can be applied consistently through time and by difficulties in separating the local from the global component in various proxies. This, in turn, means that a theoretical framework with predictive power for interglacial duration has remained elusive. Here we propose that the interval between the terminal oscillation of the bipolar seesaw and three thousand years (kyr) before its first major reactivation provides an estimate that approximates the length of the sea-level highstand, a measure of interglacial duration. We apply this concept to interglacials of the last 800 kyr by using a recently-constructed record of interhemispheric variability. The onset of interglacials occurs within 2 kyr of the boreal summer insolation maximum/precession minimum and is consistent with the canonical view of Milankovitch forcing pacing the broad timing of interglacials. Glacial inception always takes place when obliquity is decreasing and never after the obliquity minimum. The phasing of precession and obliquity appears to influence the persistence of interglacial conditions over one or two insolation peaks, leading to shorter (~ 13 kyr) and longer (~ 28 kyr) interglacials. Glacial inception occurs approximately 10 kyr after peak interglacial conditions in temperature and CO2, representing a characteristic timescale of interglacial decline. Second-order differences in duration may be a function of stochasticity in the climate system, or small variations in background climate state and the magnitude of feedbacks and mechanisms contributing to glacial inception, and as such, difficult to predict. On the other hand, the broad duration of an interglacial may be determined by the phasing of astronomical parameters and the history of insolation, rather than the instantaneous forcing strength at inception

Very long optical path-length from a compact multi-pass cell

The multiple-pass optical cell is an important tool for laser absorption spectroscopy and its many applications. For most practical applications, such as trace-gas detection, a compact and robust design is essential. Here we report an investigation into a multi-pass cell design based on a pair of cylindrical mirrors, with a particular focus on achieving very long optical paths. We demonstrate a path-length of 50.31 m in a cell with 40 mm diameter mirrors spaced 88.9 mm apart - a 3-fold increase over the previously reported longest path-length obtained with this type of cell configuration. We characterize the mechanical stability of the cell and describe the practical conditions necessary to achieve very long path-lengths

Predictive validity of the UK clinical aptitude test in the final years of medical school:a prospective cohort study

Peer reviewedPublisher PD

Resilience Management: A Framework for Assessing and Improving the Resilience of Organisations

Resilient Organisations Research Report 2007/01Organisations today are increasingly aware of the need to prepare for the unexpected. High profile international events of the last decade, such as the September 11th terrorist attacks, the Indian Ocean tsunami, Hurricane Katrina and the emerging threat of a pandemic all serve to remind organisations that the unimaginable can and does happen. Stories emerge from these events of organisations that survived or failed; at first glance there does not appear to be a particular pattern. Some survivors had excellent disaster response plans in place; others had none, surviving purely on the merits of strong leadership and the commitment and determination of staff. Many organisations that are devastated simply never reopen again; others evolve so radically that they are hard to recognise from their pre-crisis form. This research project seeks to explore what it is that makes some organisations more able to survive a major crisis than others, and suggests a framework for both evaluating and improving the resilience of individual organisations