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Background We piloted a randomised controlled trial (RCT) comparing pregnancy outcomes among women with booking gestational diabetes (GDM) receiving immediate or deferred treatment. Methods Consecutive, consenting women < 20 weeks gestation, with GDM risk factors attending the hospital book-in clinic, completed an oral glucose tolerance test (OGTT). Clinicians were blinded to OGTT results. Women fulfilling World Health Organisation GDM criteria were randomised to either clinic referral /ongoing treatment (Treated Group n  = 11), or no treatment (No Treatment Group n  = 10). Women without ‘Booking GDM’ (‘Decoys’ n  = 58) and those in the No Treatment Group had a repeat OGTT at 24–28 weeks (with GDM treated if diagnosed). Midwives and mothers were asked to complete surveys and attend focus groups before and after the study respectively regarding their experiences and expectations of the study protocol. Results Sufficient women completed each step of the RCT. Gestation at OGTT was late at 18 ± 2 weeks with Treated and No Treatment groups largely similar. At 24–28 weeks gestation, GDM was present in 8/9 (89%) in the No Treatment group and 11/56 (20%) Decoys. NICU admission was highest in the Treated group (36% vs 0% p  = 0.043), largely due to small for gestational age, and Large for Gestational Age babies greatest in the No Treatment group (0% vs 33% p  = 0.030). Conclusion An RCT deferring ‘Booking GDM’ treatment is feasible. Most women with untreated ‘Booking GDM’ in mid 2nd trimester had GDM at 24–28 weeks. Early treatment may have both benefits and harms. A full RCT is needed. Trial registration Australia New Zealand Clinical Trials Registry ACTRN12615000974505. Registered 17th May 2015; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369100&isReview=true Retrospectively Registered.

Background Although efforts to reduce high maternal mortality in countries such as Indonesia tend to focus on addressing health risks among pregnant women, family planning has been shown globally to reduce maternal mortality by reducing both total and higher-risk pregnancies. This article assesses past contributions of family planning to the reduction of maternal mortality in Indonesia and the potential future contribution toward achieving the 2030 SDG maternal mortality goal. Methods The study takes advantage of data from long series of population censuses and large-scale surveys that are available in few other low- and middle-income countries. We use the decomposition method suggested by (Matern Child Health J, 16:456–463, 2012) and regression-based policy simulations to estimate the number of maternal deaths averted during 1970–2017 due to contraceptive use and project potential future contributions to the year 2030. Results It is estimated that between 523,885 and 663,146 maternal deaths were averted from 1970 to 2017 due to contraceptive use, a 37.5–43.1% reduction. If the contraceptive prevalence rate (CPR) were to rise from 63% in 2017 to 70% in 2030 and unmet need for family planning were to fall to from 10 to 7%, an additional 34,621–37,186 maternal deaths would be averted, an 18.9–20.0% reduction. A 2030 CPR of 75% and unmet need for family planning of 5% would result in 51,971–54,536 maternal deaths being averted, a 28.4–29.4% reduction. However, the CPR growth rate would have to nearly double the 2000–2017 rate to reach 70% CPR by 2030 and more than triple to reach 75%. Achieving the most ambitious target would still leave the maternal mortality ratio at 125 in 2030 without corresponding improvements in maternal health services. Conclusions Although substantial reductions in maternal mortality between 1970 and 2017 can be attributed to contraceptive use and further contributions to the year 2030 are probable, smaller contributions are likely due to the already relatively high CPR and the challenges that must be overcome to move the CPR significantly higher. The ability of Indonesia to reach the 2030 SDG maternal mortality target of 70 maternal deaths per 100,000 live births will depend primarily upon health system effectiveness in addressing health risks to women once they are pregnant.

The aim of this article is to review the impact of two British research projects on the policies and practices of local police forces in two former Soviet states: Russia and Ukraine. Using a case study approach, the article explores the ways in which the political, cultural and ideological context within which the police operate, and reform is being attempted, shape attitudes towards reform amongst the police and the public, and the outcomes achieved. The article draws upon an evaluation of the impact of two independent 3-year applied research projects, which aimed to investigate specific crime and policing issues in Russia and Ukraine, implement pilot projects and evaluate their impact in order to make recommendations for more general criminal justice policy reform. The overall results of the projects suggest that, despite significant interest in the concept of police reform and the adoption of western concepts, particularly at the local level, significant barriers to large-scale policy transfer persist, many of which are largely beyond the influence of local practitioners and western reformers. Adapted from the source document.

Background Unmet need for family planning in the Pacific is among the highest in the world. Better understanding of required investments and associated benefits of increased access to family planning in the Pacific may assist prioritisation and funding. Methods We modelled the costs and associated health, demographic and economic impacts of reducing unmet need for family planning between 2010–2025 in Vanuatu and the Solomon Islands. Baseline data were obtained from census reports, Demographic and Health Surveys, and UN agency reports. Using a demographic modelling program we compared a scenario of “no change in unmet need” with two distinct scenarios: 1) all family planning needs met by 2020; and, 2) all needs met by 2050. Results Meeting family planning needs by 2020 would increase prevalence of modern contraception in 2025 from 36.8 to 65.5% in Vanuatu and 28.5 to 37.6% in the Solomon Islands. Between 2010–2025 the average annual number of unintended pregnancies would decline by 68% in Vanuatu and 50% in the Solomon Islands, and high-risk births would fall by more than 20%, averting 2,573 maternal and infant deaths. Total fertility rates would fall from 4.1 to 2.2 in Vanuatu and 3.5 in the Solomon Islands, contributing to slowed population growth and lower dependency ratios. The direct cost of reducing unmet need by 2020 was estimated to be $5.19 million for Vanuatu and $3.36 million for the Solomon Islands between 2010–2025. Preventing unintended pregnancies would save $112 million in health and education expenditure. Conclusions In small island developing states such as Vanuatu and the Solomon Islands, increasing investment in family planning would contribute to improved maternal and infant outcomes and substantial public sector savings.

The aim of this article is to review the impact of two British research projects on the policies and practices of local police forces in two former Soviet states: Russia and Ukraine. Using a case study approach, the article explores the ways in which the political, cultural and ideological context within which the police operate, and reform is being attempted, shape attitudes towards reform amongst the police and the public, and the outcomes achieved. The article draws upon an evaluation of the impact of two independent 3-year applied research projects, which aimed to investigate specific crime and policing issues in Russia and Ukraine, implement pilot projects and evaluate their impact in order to make recommendations for more general criminal justice policy reform. The overall results of the projects suggest that, despite significant interest in the concept of police reform and the adoption of western concepts, particularly at the local level, significant barriers to large-scale policy transfer persist, many of which are largely beyond the influence of local practitioners and western reformers. Reprinted by permission of Springer

This chapter presents an overview of the role of police reform in building justice in Russia. Since becoming an independent state in 1991, the Russian Federation has sought to reform various component parts of its criminal justice system, including the police, or the militia (Militsiya in Russian) as it was still named until very recently. Many of the reforms envisaged for the militia were ambitious and appeared - on paper at least - to propose the development of democratic policing structures and organisations, where the priority would be to serve the public rather than the state (Beck and Robertson 2009a). Concomitantly, the expectation was that the militia would be compelled by existing legislation (specifically related to the militia/police, their role in public office and, more generally the Russian Criminal Code) to adhere to, as well as uphold, the rule of law. However, the implementation of reforms has been inconsistent and increasingly suggestive of a 'one step forward and two steps back' process, whereby some of the more positive proposed developments have been hampered or eroded by inertia, a lack of political will and an apparent tendency to retreat to past practices and ideologies (Beck and Robertson 2005). Most significantly, perhaps, during the last few years, attention has increasingly been focused on militia abuse of their powers, that is criminal and deviant acts committed while both on and off duty, the seriousness of which eventually resulted in calls for reform. The focus of this chapter will be on the latest wave of reform that resulted in the coming into force of the new 'Law on the Police' in March 2011, and the key problems that still present obstacles in terms of the police making a meaningful and lasting contribution to the building of justice in Russia. These include police brutality, police corruption and a continued lack of independent oversight of the police. In conclusion, it is suggested that, although the police undoubtedly have a key role to play in the building of justice, the hit- and-miss results of police reform to date, as well as early indicators and assessments of the new law and its implementation, may indicate another missed opportunity for the development of genuine democratic policing and, consequently, for the police making a lasting contribution to the building of justice in the Russian Federation. This will doubtless continue to be the case until police power 'without limits' is subjugated to the rule of law.

Methods and results We recorded the number of titles containing at least one colon in the first 100 original or short reports in the BMJ, Lancet, and New England Journal of Medicine every five years from 1970 to 1995. Comparisons between journals showed a significant difference in the rates of increase between the New England Journal of Medicine (slope 0.006 (95% confidence interval -0.036 to 0.048)) and both the Lancet (slope 0.35 (0.17 to 0.53); t=3.74, df=1, P<0.001) and the BMJ (slope 0.72 (0.35 to 1.09); t=3.72, df=1, P<0.001).

Background: In a problem-based learning ( PBL ) program, students are encouraged to develop self-motivation, self-con® dence, communication sk ills and problem-solving sk ills. Measuring these attributes when selecting students into medical schools is a formidable task . A dmission to medical school typically depends upon students′ academic achievement in their prior education. In the past 3 years the College of Medicine and Medical Science ( CMMS ) at the A rabian Gulf University, which has a PBL curriculum, adopted an admission policy that utiliz es ® nal high school scores, a written admission examination in English and science, as well as a structured interview. Objective: To determine the extent to which the admissions measures predict academic achievement in the ® rst year of studies at CMMS. Design: Prediction study of prospectively collected data. Final cumulative score for all subjects at the end of the ® rst year was the main dependent variable analyzed. Subjects: A ll students admitted to the college during the academic year 1998± 1999. Results: The written admission science examination scores had the highest correlation ( r=0.663, p50.05 ) with the Y ear 1 ® nal cumulative score. A lthough the admission interview focused on non-cognitive student attributes, which may or may not affect the students′ academic performance, its score had a statistically signi® cant, if low, correlation with the Y ear 1 ® nal cumulative score ( r=0.275, p50.012 ). A pproxim ately 59% of the total variability of the Y ear 1 ® nal cumulative scores could be explained by the admission examination scores in science and English and the high school scores. Conclusion: Procedures for selecting students who are most lik ely to succeed academically in the initial year at an innovative medical school deserve further study and probably should include both academic performance and non-academic attributes.

Deciding to place political articles - in this case letters on the presidential campaign - only on the Internet compromises its existence since it thrives off of the freedom and integrity of the Constitution.