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Objective Teenagers are susceptible to delivering small-for-gestational-age (SGA) infants. Previous studies suggest that maternal growth may contribute, as a result of preferential nutrient partitioning to the mother. We investigated the impact of maternal growth on birthweight in pregnant teenagers in the UK, and examined endocrine mediators of nutrient partitioning. Design A prospective observational multicentre study, About Teenage Eating, conducted between 2004 and 2007. Setting Four hospitals in socially-deprived areas of Manchester and London. Population A total of 500 pregnant adolescents (14–18 years of age) with a singleton pregnancy were recruited at 10–21 weeks of gestation, with follow-up studies on 368 subjects. A cohort of 80 pregnant adults (25–40 years of age) provided a control group for determining growth. Methods Skeletal growth, weight gain and skinfold thickness were measured from first to third trimester, together with maternal levels of micronutrients and metabolic hormones: insulin-like growth factor (IGF) system and leptin. Dietary analyses were performed. Main outcome measure SGA birth. Results Maternal growth was not associated with SGA birth: growing mothers delivered more large-for-gestational-age infants (OR 2.51; P < 0.05). Growers had greater weight gain ( P < 0.001), fat accrual ( P < 0.001) and red cell folate concentrations ( P < 0.01) than non-growers. Maternal IGF-I ( P < 0.01) and leptin ( P < 0.001) were positively associated with maternal and fetal growth, whereas IGF-I ( P < 0.001) was negatively associated. Teenagers that were underweight at booking or with low weight gain were at greater risk of SGA birth. Conclusions Maternal growth was not detrimental to fetal growth in this UK population of teenagers. Greater weight gain and higher concentrations of IGF-I in growing teenagers may provide anabolic drive for maternal and fetal growth. [ABSTRACT FROM AUTHOR]

Doctors and medical students are more likely to make errors in drug dose calculations when the strengths of drug solutions are expressed as ratios or percentages. We have already described how a doctor's specialty influences their drug dose calculation skills, having surveyed almost 3000 doctors in an online survey. Better teaching of drug administration skills or reinforcement of existing skills would appear to be needed. We sought to identify doctors that might benefit particularly from such teaching by other means than specialty alone, by subjecting existing data to further analysis. Almost 3000 doctors subscribing to a UK-based internet content provider had participated in an online questionnaire concerning drug-dose calculation. Each doctor's score in the multiple choice questionnaire was cross referenced with demographic data obtained from the hosts of the original survey whilst maintaining anonymity. Newly and recently qualified doctors, and doctors working in the community, struggled most with the calculations (p < 0.0001). There were also highly significant differences in the performances of doctors from different medical schools (p < 0.0001). As a new training programme for junior doctors is being introduced in the UK; we recommend that drug administration skills are given a prominent place in the curriculum, and again call for the standardisation of ampoule labelling to mass concentration. [ABSTRACT FROM AUTHOR]

There is an increasing recognition that medication errors are causing a substantial global public health problem, as many result in harm to patients and increased costs to health providers. However, study of medication error is hampered by difficulty with definitions, research methods and study populations. Few doctors are as involved in the process of prescribing, selecting, preparing and giving drugs as anaesthetists, whether their practice is based in the operating theatre, critical care or pain management. Anaesthesia is now safe and routine, yet anaesthetists are not immune from making medication errors and the consequences of their mistakes may be more serious than those of doctors in other specialties. Steps are being taken to determine the extent of the problem of medication error in anaesthesia. New technology, theories of human error and lessons learnt from the nuclear, petrochemical and aviation industries are being used to tackle the problem. [ABSTRACT FROM AUTHOR]