Blood lead and preeclampsia: A meta-analysis and review of implications.

BACKGROUND: Multiple cross-sectional studies suggest that there is an association between blood lead and preeclampsia. OBJECTIVES: We performed a systematic review and meta-analysis to summarize information on the association between preeclampsia and lead poisoning. METHODS: Searches of Medline, Web of Science, Scopus, Pubmed, Science Direct and ProQuest (dissertations and theses) identified 2089 reports, 46 of which were downloaded after reviewing the abstracts, and 11 studies were evaluated as meeting the selection criteria. Evaluation using the ROBINS-I template (Sterne, et al., 2016), indicated moderate risk of bias in all studies. RESULTS: We found that blood lead concentrations were significantly and substantially associated with preeclampsia (k = 12; N = 6069; Cohen's d = 1.26; odds ratio = 9.81; odds ratio LCL = 8.01; odds ratio UCL = 12.02; p = 0.005). Eliminating one study produced a homogeneous meta-analysis and stronger estimates, despite the remaining studies coming from eight separate countries and having countervailing risks of bias. CONCLUSIONS: Blood lead concentrations in pregnant women are a major risk factor for preeclampsia, with an increase of 1µg/dL associated with a 1.6% increase in likelihood of preeclampsia, which appears to be the strongest risk factor for preeclampsia yet reported. Pregnant women with historical lead exposure should routinely have blood lead concentrations tested, especially after mid-term. Women with concentrations higher than 5µg/dL should be actively monitored for preeclampsia and be advised to take prophylactic calcium supplementation. All pregnant women should be advised to actively avoid lead exposure.

How can the perceptions and experiences of medical educator stakeholders inform selection into medicine? An interpretative phenomenological pilot study.

This article was migrated. The article was marked as recommended. Background Attempts to utilise the experiences of stakeholders to better inform selection into medicine are rare in the literature. Published scholarship to date reflects a myriad of competing goals for selecting and graduating 'good doctors' amidst increasingly complex health care environments. This includes debates around what is the 'good doctor', selection methods, health care decision-making, the doctor-patient relationship, patient-centredness, professionalism and stakeholder experiences with doctors. Within the complexity manifested by these multiple dimensions, decisions about the characteristics and capabilities on which selection should be based may have privileged some stakeholder groups over others, with patient experiences particularly de-emphasised. The aims of this pilot study were to focus on front-line medical educators as stakeholders whose experiences might be valuable for informing selection into medicine and to inform a larger-scale study of the topic from the perspectives of a more diverse group of stakeholders, including patients. Method Fourteen (14) medical educator participants were recruited for a semi-structured group interview at an international conference for health professional educators. The audio-recording was transcribed verbatim and the raw data were de-identified and organised with the aid of computer assisted data analysis software. Coding was initiated and Smith's interpretative phenomenological analytical (IPA) method employed ( Smith, Flowers, & Larkin, 2009). Results Initial analysis yielded four broad phenomenological themes: perceptions of 'good doctors', selection processes, selection-related challenges and possible solutions. The more deeply experiential data were captured in an analytical commentary of first-person accounts that may be useful for informing future selection strategies. Participant experiences mirrored the major debates in medical selection but their accounts revealed a negativity and cynicism about the topic that was concerning and warrants further investigation. Conclusion This study contributes to medical student selection research through offering an account of the 'lived experiences' of front-line medical educator stakeholders.

How best practices are copied, transferred, or translated between health care facilities: A conceptual framework.

INTRODUCTION: In spite of significant investment in quality programs and activities, there is a persistent struggle to achieve quality outcomes and performance improvements within the constraints and support of sociopolitical parsimonies. Equally, such constraints have intensified the need to better understand the best practice methods for achieving quality improvements in health care organizations over time.This study proposes a conceptual framework to assist with strategies for the copying, transferring, and/or translation of best practice between different health care facilities. PURPOSE: Applying a deductive logic, the conceptual framework was developed by blending selected theoretical lenses drawn from the knowledge management and organizational learning literatures. FINDINGS: The proposed framework highlighted that (a) major constraints need to be addressed to turn best practices into everyday practices and (b) double-loop learning is an adequate learning mode to copy and to transfer best practices and deuteron learning mode is a more suitable learning mode for translating best practice. We also found that, in complex organizations, copying, transferring, and translating new knowledge is more difficult than in smaller, less complex organizations. We also posit that knowledge translation cannot happen without transfer and copy, and transfer cannot happen without copy of best practices. Hence, an integration of all three learning processes is required for knowledge translation (copy best practice-transfer knowledge about best practice-translation of best practice into new context). In addition, the higher the level of complexity of the organization, the more best practice is tacit oriented and, in this case, the higher the level of K&L capabilities are required to successfully copy, transfer, and/or translate best practices between organizations. PRACTICE IMPLICATIONS: The approach provides a framework for assessing organizational context and capabilities to guide copy/transfer/translation of best practices. A roadmap is provided to assist managers and practitioners to select appropriate learning modes for building success and positive systemic change.

A meta-analysis of adult-rated child personality and academic performance in primary education.

BACKGROUND: Personality is reliably associated with academic performance, but personality measurement in primary education can be problematic. Young children find it difficult to accurately self-rate personality, and dominant models of adult personality may be inappropriate for children. AIMS: This meta-analysis was conducted to determine the validity of the Five-Factor Model (FFM) of personality for statistically predicting children's academic performance. SAMPLE: Literature search identified 12 reports, with cumulative sample sizes ranging from 4,382 (19 correlations) to 5,706 (23 correlations) for correlations with Emotional Stability and Conscientiousness respectively. METHOD: Hunter-Schmidt random-effects meta-analysis was used, and moderators were tested using sample-weighted regression. RESULTS: When compared with self-rated measures, adult-rated Conscientiousness and Openness were more strongly correlated with academic performance, but adult-rated Agreeableness was less strongly correlated. Q-set-based assessments had lower validity, which appeared to explain moderating effects of rating source. Moderating effects were not found for age, year of education (grades 1-7), or language within which the study was conducted. CONCLUSIONS: Conscientiousness and Openness had two of the strongest correlations with academic performance yet reported, comparable with previous meta-analytic correlations of academic performance with instructional quality, cognitive ability, and feedback. The FFM appears to be valid for educational research with children. Openness, which has no counterpart in models of children's temperament, should be further researched with children. Future research should examine the measurement of childhood personality, its relationship with intelligence, the extent to which it is malleable in primary education, and its causal relationship with academic performance.

The Eysenckian personality factors and their correlations with academic performance.

BACKGROUND. The relationship between personality and academic performance has long been explored, and a recent meta-analysis established that measures of the five-factor model (FFM) dimension of Conscientiousness have similar validity to intelligence measures. Although currently dominant, the FFM is only one of the currently accepted models of personality, and has limited theoretical support. In contrast, the Eysenckian personality model was developed to assess a specific theoretical model and is still commonly used in educational settings and research. AIMS. This meta-analysis assessed the validity of the Eysenckian personality measures for predicting academic performance. SAMPLE. Statistics were obtained for correlations with Psychoticism, Extraversion, and Neuroticism (20-23 samples; N from 8,013 to 9,191), with smaller aggregates for the Lie scale (7 samples; N= 3,910). METHODS. The Hunter-Schmidt random effects method was used to estimate population correlations between the Eysenckian personality measures and academic performance. Moderating effects were tested using weighted least squares regression. RESULTS. Significant but modest validities were reported for each scale. Neuroticism and Extraversion had relationships with academic performance that were consistent with previous findings, while Psychoticism appears to be linked to academic performance because of its association with FFM Conscientiousness. Age and educational level moderated correlations with Neuroticism and Extraversion, and gender had no moderating effect. Correlations varied significantly based on the measurement instrument used. CONCLUSIONS. The Eysenckian scales do not add to the prediction of academic performance beyond that provided by FFM scales. Several measurement problems afflict the Eysenckian scales, including low to poor internal reliability and complex factor structures. In particular, the measurement and validity problems of Psychoticism mean its continued use in academic settings is unjustified.

A meta-analysis of the five-factor model of personality and academic performance.

This article reports a meta-analysis of personality-academic performance relationships, based on the 5-factor model, in which cumulative sample sizes ranged to over 70,000. Most analyzed studies came from the tertiary level of education, but there were similar aggregate samples from secondary and tertiary education. There was a comparatively smaller sample derived from studies at the primary level. Academic performance was found to correlate significantly with Agreeableness, Conscientiousness, and Openness. Where tested, correlations between Conscientiousness and academic performance were largely independent of intelligence. When secondary academic performance was controlled for, Conscientiousness added as much to the prediction of tertiary academic performance as did intelligence. Strong evidence was found for moderators of correlations. Academic level (primary, secondary, or tertiary), average age of participant, and the interaction between academic level and age significantly moderated correlations with academic performance. Possible explanations for these moderator effects are discussed, and recommendations for future research are provided.