Preventing abusive head trauma: what do frontline healthcare workers (HCW) know about normal infant crying?

It is well reported that one of the main precipitants of abusive head trauma (AHT) is frequent and consistent periods of crying. The cornerstones in the management of excessive infant crying are reassurance and education. Our study showed a knowledge deficit in frontline healthcare workers (HCW) understanding of normal infant crying.

Meta-analysis: the prophylactic use of tranexamic acid to reduce blood loss during caesarean delivery.

Introduction: The 2022 national guideline on The Prevention and Management of Primary Postpartum Haemorrhage (PPH) recommended consideration of prophylactic tranexamic acid (TXA) for women who are at high PPH risk undergoing caesarean section (CS). This meta-analysis reviews the basis for this recommendation.

Method: PubMed, OVID Medline, EMBASE, Science Citation Index, Scopus, CENTRAL, and ClinicalTrials.

Craic, Ceoil agus COVID-19: the impact of 'Fleadh Cheoil na hÉireann' on presentations to the local emergency department.

Aims: Fleadh Cheoil Na hÉireann, the world's largest Irish music festival, was held in Mullingar in August 2023, gathering a crowd of nearly 600,000 people. Our aim was to assess the impact on presentations to the local emergency department (ED).

Methods: We performed a retrospective case analysis on all presentations to the ED at Regional Hospital Mullingar (RHM) from 23/7/2023 to 02/09/2023.

Predictors of radiographic pneumonia in febrile children with cancer presenting to the emergency department.

Background: Fever is a common presenting complaint to the pediatric emergency department (PED), especially among oncology patients. While bacteremia has been extensively studied in this population, pneumonia has not. Some studies suggest that chest X-ray (CXR) does not have a role in the investigation of neutropenic fever in the absence of respiratory symptoms, yet non-neutropenic pediatric oncology patients were excluded from these studies.

CT brain interpretation in paediatric trauma.

The management of head trauma is an essential component of working in Emergency Medicine, be it a paediatric, adult or mixed emergency department. Between 33% and 50% of the 1.4 million people who attend UK emergency departments (ED) annually with a head injury are children.

Central venous sinus thrombosis in a young girl with ulcerative colitis.

Paediatric central venous sinus thrombosis (CVST) is an uncommon but important life-threatening complication of inflammatory bowel disease (IBD). As the incidence of IBD has increased in the last four decades, paediatricians need to be aware of this complication. There is currently no consensus on when children with IBD should receive prophylactic anticoagulation.

Improving otoscopy education and diagnostic accuracy: A prospective interventional study.

Objective: To assess and improve otoscopy examination skills across various medical specialities who perform otoscopy during their professional practice.

Methods: A pre-intervention survey was created using www.surveymonkey.

Dexmedetomidine sedation for a dental extraction in a patient with known difficult airway.

Fibrodysplasia ossificans progressiva is an autosomal dominant condition that causes cervical spine fusion and ankylosis of the temporomandibular joint, resulting in anaesthetic challenges. Awake tracheal intubation with flexible bronchoscopy is recommended for general anaesthetics required by patients with this disease. This case report describes the novel approach of using dexmedetomidine sedation in combination with local anaesthesia to allow dental extraction of the fifth and seventh upper left teeth in a patient with fibrodyplasia ossificans progressive, who had a known difficult airway and profound thrombocytopenia.

What do rates of deposition of dental cementum tell us? Functional and evolutionary hypotheses in red deer.

Cementum is a bone connective tissue that provides a flexible attachment for the tooth to the alveolar bone in many mammalian species. It does not undergo continuous remodelling, unlike non-dental bone, which combined with its growth pattern of seasonal layering makes this tissue uniquely suitable as a proxy for tracking changes in body repair investment throughout an animal´s life. We tested functional and sexual selection hypotheses on the rate of cementum deposition related to the highly polygynous mating strategy of red deer.

Re-mating across years and intralineage polygyny are associated with greater than expected levels of inbreeding in wild red deer.

The interaction between philopatry and nonrandom mating has important consequences for the genetic structure of populations, influencing co-ancestry within social groups but also inbreeding. Here, using genetic paternity data, we describe mating patterns in a wild population of red deer (Cervus elaphus) which are associated with marked consequences for co-ancestry and inbreeding in the population. Around a fifth of females mate with a male with whom they have mated previously, and further, females frequently mate with a male with whom a female relative has also mated (intralineage polygyny).

Shared spatial effects on quantitative genetic parameters: accounting for spatial autocorrelation and home range overlap reduces estimates of heritability in wild red deer.

Social structure, limited dispersal, and spatial heterogeneity in resources are ubiquitous in wild vertebrate populations. As a result, relatives share environments as well as genes, and environmental and genetic sources of similarity between individuals are potentially confounded. Quantitative genetic studies in the wild therefore typically account for easily captured shared environmental effects (e.

Indirect genetics effects and evolutionary constraint: an analysis of social dominance in red deer, Cervus elaphus.

By determining access to limited resources, social dominance is often an important determinant of fitness. Thus, if heritable, standard theory predicts mean dominance should evolve. However, dominance is usually inferred from the tendency to win contests, and given one winner and one loser in any dyadic contest, the mean proportion won will always equal 0.

Variances and covariances of phenological traits in a wild mammal population.

In a seasonal environment, there are multiple aspects of timing, or phenology, that contribute to an individual's fitness. Several studies have shown a genetic basis to variation between individuals in breeding time, but we know little about the heritability of other phenological traits in wild populations. Furthermore, the presence of genetic correlations between phenological variables could act to constrain or promote any response to selection, but less is known of the multivariate genetic relationships underlying phenological traits in the wild.

The relationship between tooth wear, habitat quality and late-life reproduction in a wild red deer population.

1. Molar tooth wear is considered an important proximate mechanism driving patterns of senescence in ungulates but few studies have investigated the causes of variation in molar wear or their consequences for reproductive success. 2.

Antler size in red deer: heritability and selection but no evolution.

We present estimates of the selection on and the heritability of a male secondary sexual weapon in a wild population: antler size in red deer. Male red deer with large antlers had increased lifetime breeding success, both before and after correcting for body size, generating a standardized selection gradient of 0.44 (+/- 0.

Estimating the prevalence of inbreeding from incomplete pedigrees.

A previous review of inbreeding in natural populations suggested that close inbreeding (inbreeding coefficient f = 0.25) is generally rare in wild birds and mammals. However, the review did not assess rates of moderate inbreeding (f = 0.

Antler length of yearling red deer is determined by population density, weather and early life-history.

In red deer, yearling antler length is a largely nutrition-mediated phenotypic character, and is therefore sometimes used as an indirect estimate of range quality and population condition. However, the parameters affecting yearling antler length have been little studied. We analyse the contributions of density, weather and maternal effects on yearling antler length of 581 individual stags born 1970-1996 on the Isle of Rum (Scotland).

Sex differences in weather sensitivity can cause habitat segregation: red deer as an example.

Sex differences in habitat use (habitat segregation) are widespread in sexually dimorphic ungulates. A possible cause is that males are more sensitive to weather than females, leading to sex differences in sheltering behaviour (the 'weather sensitivity hypothesis'). However, this hypothesis has never been tested.

Heritability of fitness in a wild mammal population.

Classical population genetics theory predicts that selection should deplete heritable genetic variance for fitness. We show here that, consistent with this prediction, there was a negative correlation between the heritability of a trait and its association with fitness in a wild population of red deer (Cervus elaphus) and there was no evidence of significant heritability of total fitness. However, the decline in heritability was caused, at least in part, by increased levels of residual variance in longevity and, hence, in total fitness: in this population, longevity is known to be heavily influenced by environmental factors.

Early determinants of lifetime reproductive success differ between the sexes in red deer.

In polygynous, sexually dimorphic species, sexual selection should be stronger in males than in females. Although this prediction extends to the effects of early development on fitness, few studies have documented early determinants of lifetime reproductive success in a natural mammal population. In this paper, we describe factors affecting the reproductive success of male and female red deer (Cervus elaphus) on the island of Rum, Scotland.

The relationship between habitat choice and lifetime reproductive success in female red deer.

In non-territorial species, individuals can move freely and should be distributed in an ideal free manner between habitats and areas with respect to resources that influence lifetime reproductive success (LRS). Consequently, no relationship between diet quality and LRS should be expected. However, there have been no attempts to test this prediction.

Population density affects sex ratio variation in red deer.

Many mammal populations show significant deviations from an equal sex ratio at birth, but these effects are notoriously inconsistent. This may be because more than one mechanism affects the sex ratio and the action of these mechanisms depends on environmental conditions. Here we show that the adaptive relationship between maternal dominance and offspring sex ratio previously demonstrated in red deer (Cervus elaphus), where dominant females produced more males, disappeared at high population density.

Cohort variation in male survival and lifetime breeding success in red deer.

We investigated cohort differences in the lifetime breeding success and survival of male red deer Cervus elaphus L. in an increasing population on the Isle of Rum, Scotland. There were significant differences in survival through different stages of the life span between 15 cohorts of males, ranging between: 0.

Microsatellites reveal heterosis in red deer.

The fitness consequences of inbreeding and outbreeding are poorly understood in natural populations. We explore two microsatellite-based variables, individual heterozygosity (likely to correlate with recent inbreeding) and a new individual-specific internal distance measure, mean d2 (focusing on events deeper in the pedigree), in relation to two measures of fitness expressed early in life, birth weight and neonatal survival, in 670 red deer calves (Cervus elaphus) born on the Isle of Rum between 1982 and 1996. For comparison, we also analyse inbreeding coefficients derived from pedigrees in which paternity was inferred by molecular methods.

Density-related changes in sexual selection in red deer.

In sexually dimorphic mammals, high population density is commonly associated with increased mortality of males relative to females and with female-biased adult sex ratios. This paper investigates the consequences of these changes on the distribution of male breeding success, the intensity of competition for females and the opportunity for sexual selection. After the red deer (Cervus elaphus L.