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IntroductionShort interpregnancy interval (IPI) has been linked to adverse pregnancy outcomes. WHO recommends waiting at least 2 years after a live birth and 6 months after miscarriage or induced termination before conception of another pregnancy. The evidence underpinning these recommendations largely relies on data from low/middle-income countries. Furthermore, recent epidemiological investigations have suggested that these studies may overestimate the effects of IPI due to residual confounding. Future investigations of IPI effects in high-income countries drawing from large, population-based data sources are needed to inform IPI recommendations. We aim to assess the impact of IPIs on maternal and child health outcomes in high-income countries.Methods and analysisThis international longitudinal retrospective cohort study will include more than 18 million pregnancies, making it the largest study to investigate IPI in high-income countries. Population-based data from Australia, Finland, Norway and USA will be used. Birth records in each country will be used to identify consecutive pregnancies. Exact dates of birth and clinical best estimates of gestational length will be used to estimate IPI. Administrative birth and health data sources with >99% coverage in each country will be used to identify maternal sociodemographics, pregnancy complications, details of labour and delivery, birth and child health information. We will use matched and unmatched regression models to investigate the impact of IPI on maternal and infant outcomes, and conduct meta-analysis to pool results across countries.Ethics and disseminationEthics boards at participating sites approved this research (approval was not required in Finland). Findings will be published in peer-reviewed journals and presented at international conferences, and will inform recommendations for optimal IPI in high-income countries. Findings will provide important information for women and families planning future pregnancies and for clinicians providing prenatal care and giving guidance on family planning.

The association between a single interpregnancy interval (IPI) and birth outcomes has not yet been explored using matched methods. We modeled the odds of preterm birth, being small for gestational age, and having low birth weight in a second, live-born infant in a cohort of 192,041 sibling pairs born in Western Australia between 1980 and 2010. The association between IPI and birth outcomes was estimated from the interaction between birth order and IPI (with 18-23 months as the reference category), using conditional logistic regression. Matched analysis showed the odds of preterm birth were higher for siblings born following an IPI of

Introduction: The 10-item Kessler Psychological Distress Scale (K10) is used to screen adolescents for mental disorders in Australian clinical practice; however, there are no Australian adolescent normative data. Methods: Data were drawn from a nationally representative sample (N = 2964) of Australian adolescents (11–17 years). This study had three aims: (1) to examine concurrent validity between the K10 and Strengths and Difficulties Questionnaire (SDQ) emotional symptoms subscale, (2) to establish normative Australian adolescent K10 data and (3) to determine optimal K10 cut-off scores for screening for major depressive disorder (MDD) via receiver operator characteristic curve analysis and stratum-specific likelihood ratios. Results: The K10 and SDQ emotional symptoms scales were moderately correlated (rs = 0.63, p < 0.001). Older female adolescents reported higher total K10 scores compared with younger female adolescents (15–17 years: M = 20.2, standard error [SE] = 0.3; 11–14 years: M = 16.8, SE = 0.3) and male adolescents (11–14 years: M = 16.6, SE = 0.2; 15–17 years: M = 16.0, SE = 0.2). K10 scores to optimally discriminate those with and without MDD varied by age and sex and had low specificities. Stratum-specific likelihood ratios indicated adolescents with a K10 score of ≥ 30 will have a 12.9 (95% confidence interval = [10.2, 16.2]) increased likelihood of MDD. Conclusion: The K10 has utility for assessing psychological distress in health care and epidemiological research in Australian adolescents. Adolescents with K10 scores in the 'very high' range are at increased risk of MDD. Further assessment of these young people is indicated to identify those with or at risk of developing MDD. [ABSTRACT FROM AUTHOR]

Background: Incidental gastrointestinal tract (GIT) uptake is found in up to 6.3% of patients undergoing positron emission tomography (PET). This may be physiologic or pathologic and requires endoscopic assessment. Aim: To determine the diagnostic yield of endoscopy in this setting and characterise PET avidity as a predictor of clinically significant findings. Methods: We retrospectively reviewed all consecutive patients undergoing upper endoscopy or colonoscopy for incidental 18FDG PET positivity in the GIT. Results: A total of 255 patients (62% male, median age 67 years) underwent colonoscopy or sigmoidoscopy for 276 separate areas of PET avidity in the colon. Malignancy was found in 44 cases (16%), and a significant polyp was found in an additional 103 cases (37%). Neoplastic change was found more often in the case of intense compared with non‐intense PET avidity (odds ratio (OR) 3.40, 95% confidence interval (CI) 1.95–5.93, P < 0.001), and in focal compared with diffuse uptake (OR 5.97, 95% CI 2.9–12.2, P < 0.001). Upper GIT endoscopy was performed in 75 patients (46 male, median age 63 years) for 77 isolated areas with PET avidity. Malignancy was found in 16 cases (21%), and all were new primary lesions. Numerically, malignant findings were more common in intense (29.7%) than non‐intense (12.5%) PET avidity (OR 2.96, 95%, CI 0.92–9.57, P = 0.069). Conclusions: Both focal and intense colonic 18FDG uptake correlate strongly with a high‐risk polyp or malignant lesion. Up to 21% of all gastroscopies performed for evaluation of incidental PET uptake diagnosed a new primary malignancy. These referrals need appropriate triaging and timely endoscopic assessment. [ABSTRACT FROM AUTHOR]

Multilevel modeling was carried out on national value-added data to study the effects of single-sex education on the progress of pupils from 2002 Key Stage 3 to 2004 GCSE. The analysis suggests that pupils in a selective environment achieve higher progress in single-sex schools; however, the advantage of single-sex schooling seems to decrease with increasing pupils' prior attainment (for girls) or with increasing school "selectiveness" (for boys). These phenomena might be a result of a ceiling effect, as pupils with high prior attainment at Key Stage 3 cannot improve as much as pupils with lower initial attainment. There was also strong evidence suggesting that pupils achieve higher progress in the independent sector compared to grammar education. On the other hand, in a non-selective environment only pupils with lower prior attainment and those attending schools with a full range of abilities seem to benefit from single-sex education. (Contains 10 tables.)

There is no published empirically based research on the new GCE synoptic assessment. Consequently no published research has been undertaken on its role, how it is taught or how pupils are prepared for the assessment. Neither is there a published evaluation of the effectiveness of teaching the synoptic units. It is these issues which are addressed in the present study. One hundred and twenty-five chemistry teachers replied to a questionnaire about the teaching strategies that they used and how they prepared candidates for A2 assessments. The analysis of the questionnaire responses found that it is the type of assessment--coursework or examination--that closely corresponded with the teaching strategies, perceived learning outcomes and approaches to preparing pupils for A2 assessments. The questionnaire responses were merged with GCSE and A level results. A series of multilevel models were fitted to identify any relationship between relative progress from mean GCSE scores to A level unit results and the questionnaire responses. Only significant results are presented and discussed. The synoptic unit and another A2 unit were assessed by a traditional written examination. Teaching the latter unit separately to other units and teachers' question spotting related to lower relative progress from mean GCSE to A level examination results. For the synoptic unit, teachers' question spotting related to a lower relative progress from mean GCSE to unit marks. For this unit the following related to higher relative progress from mean GCSE to synoptic unit results: (i) the teachers using grade descriptors to inform their preparation of pupils for the assessment; (ii) including the whole of the AS curriculum in revision sessions. For the coursework, the following related to higher relative progress from mean GCSE to unit marks: (i) pupils doing worked examples or exercises; (ii) teachers using statistical information about examination performance prepared by an external organisation for their centre. The following are appended: (1) The role of the synoptic unit in chemistry; and (2) Questions and responses to the chemistry questionnaire given as means (or % Yes) and frequencies. (Contains 8 tables and 5 notes.)

The awarding bodies and their regulator carry out research to maintain the equivalence of examination standards. However, some criticisms remain, suggesting that examination boards may be lowering standards in specifications (syllabuses) in order to attract more centres (schools or colleges). This article reports our investigations on whether centres that decide to change their specifications do so to a specification with a higher percentage of candidates achieving grade C and above, based on the argument that such specification is easier. Using GCSE English data for the years 2000-2003, we show that there is insufficient evidence for this assumption; instead, alternative explanations may be more plausible. We then consider whether centres that changed their specifications improve their mean level of performance more than centres that did not change. There was not enough evidence for this second assumption either.

One of the objectives of Curriculum 2000 is to increase the breadth of the curriculum followed by 16-19 year olds. In this paper A level and AS uptake for the years 2001 and 2002 are considered. There was considerable diversity in the uptake of A levels, with nearly 21,000 different combinations of A levels being present in 2002 A level results. Although it is true that biology, chemistry and mathematics is the most common combination of A levels, only 2.2 per cent of candidates took this precise combination. There has been a decline in the percentage of candidates taking three science A levels. In 2002, when only A levels are considered, 35 per cent of candidates could be described as specialists, falling to 21 per cent when AS results are included. AS qualifications appear to have been successful in broadening the curriculum.