Objective: To monitor pregnancies in women with pre-existent insulin dependent diabetes for pregnancy loss, congenital malformations, and fetal growth in a geographically defined area of north west England. Design: Population cohort study. Setting: 10 maternity units in Cheshire, Lancashire, and Merseyside which had no regional guidelines for the management of pregnancy in diabetic women. Subjects: 462 pregnancies in 355 women with insulin dependent diabetes from the 10 centres over five years (1990-4 inclusive). Main outcome measures: Numbers and rates of miscarriages, stillbirths, and neonatal and postneonatal deaths; prevalence of congenital malformations; birth weight in relation to gestational age. Results: Among 462 pregnancies, 351 (76%) resulted in a liveborn infant, 78 (17%) aborted spontaneously, nine (2%) resulted in stillbirth, and 24 (5%) were terminated. Of the terminations, nine were for congenital malformation. The stillbirth rate was 25.0/1000 total births (95% confidence interval 8.9 to 41

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In an unselected population, the infants of women with pregestational Type 1 diabetes mellitus have 6.4 times the reported risk of a congenital malformation and 5.1 times the reported risk of perinatal mortality than infants in the general population. Further improvements in the management of diabetes and pregnancy in these women are needed if the St Vincent's Declaration target is to be met.

This article describes a questionnaire study to determine why fewer Year 10 school students are interested in physics than in biology. The major general reasons for finding physics uninteresting are that it is seen as difficult and irrelevant. Certain areas within the physics curriculum are considered to be boring by some students, interesting by others. Other physics topics, however, are reported only in terms of being interesting; 'the universe' is an example. Males and females offer different reasons for finding physics boring, with males enjoying practical exercises and females valuing where physics can be seen as relevant.

A 44-item questionnaire was constructed to determine secondary students' views about how useful various specific actions might be at reducing global warming,

One of the aims of environmental education is to persuade people to act in pro-environmental ways. This is particularly important with environmental problems that are believed to be both major and imminent, such as global warming; in such cases it is important that education be effective. There being no clear link between a person's overall environmental awareness and friendliness, this study aims to focus on specific environmental actions. Using quantitative methods to investigate students' beliefs about the usefulness of specific actions and their willingness to adopt them, it has been possible to construct a number of novel indices which indicate the potential effectiveness of education about those specific actions. The findings imply that altering a student's belief about some actions will likely have little effect on their willingness to undertake them. For some of these issues, this was because even those students with only a weak belief in the efficacy of the action were prepared to do it anyway. For others, such as supporting more use of nuclear power, it was because even those students who believed it would reduce global warming would not countenance nuclear energy. Education in these two areas may be ineffective because other incentives or disincentives dominate. For another set of issues, however, the practical benefits of education seemed more positive; increasing recycling, reducing the use of artificial fertilisers and planting more trees are examples of this.

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