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      Effects of Simulated Interventions to Improve School Entry Academic Skills on Socioeconomic Inequalities in Educational Achievement

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          Abstract

          Randomized controlled trial evidence shows that interventions before age 5 can improve skills necessary for educational success; the effect of these interventions on socioeconomic inequalities is unknown. Using trial effect estimates, and marginal structural models with data from the Avon Longitudinal Study of Parents and Children ( =  11,764, imputed), simulated effects of plausible interventions to improve school entry academic skills on socioeconomic inequality in educational achievement at age 16 were examined. Progressive universal interventions (i.e., more intense intervention for those with greater need) to improve school entry academic skills could raise population levels of educational achievement by 5% and reduce absolute socioeconomic inequality in poor educational achievement by 15%.

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            The Technology of Skill Formation

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              Breastfeeding and child cognitive development: new evidence from a large randomized trial.

              The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant. To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years. Cluster-randomized trial, with enrollment from June 17, 1996, to December 31, 1997, and follow-up from December 21, 2002, to April 27, 2005. Thirty-one Belarussian maternity hospitals and their affiliated polyclinics. A total of 17,046 healthy breastfeeding infants were enrolled, of whom 13,889 (81.5%) were followed up at age 6.5 years. Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF. Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence, and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects. The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group; P < .001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (-3.3 to +9.1) for performance IQ, and +5.9 (-1.0 to +12.8) for full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing. These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development. isrctn.org Identifier: ISRCTN37687716.
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                Author and article information

                Journal
                Child Dev
                Child Dev
                cdev
                Child Development
                BlackWell Publishing Ltd (Oxford, UK )
                0009-3920
                1467-8624
                November 2014
                18 October 2014
                : 85
                : 6
                : 2247-2262
                Affiliations
                [1 ]University of Adelaide
                [2 ]University of Bristol
                Author notes
                Correspondence concerning this article should be addressed to Catherine R. Chittleborough, School of Population Health, University of Adelaide, Adelaide, SA 5005, Australia. Electronic mail may be sent to catherine.chittleborough@ 123456adelaide.edu.au .

                We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The work in this article is funded by a grant from the UK Economic and Social Research Council (RES-060-23-0011), The UK Medical Research Council (Grant 74882), and the Wellcome Trust (Grant 076467), and the University of Bristol provided core support for ALSPAC. DAL works in a unit that receives support from the UK Medical Research Council (MC_UU_12013/5). JWL is supported by an Australia Fellowship from the National Health and Medical Research Council of Australia (570120). CRC and MNM were supported by funds from the Australia Fellowship awarded to JWL. The funding bodies had no role in the decision to publish or the content of this article. The views expressed in this article are those of the authors and not necessarily those of any of the funders.

                Article
                10.1111/cdev.12309
                4257067
                25327718
                b6d517c7-3a74-43c9-9482-aa8f5f6751f0
                © 2014 The Authors. Child Development published by Wiley Periodicals, Inc. on behalf of Society for Research in Child Development.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Empirical Articles

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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