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Highlights from this issue
  1. Ian Wacogne, Edition Editor
  1. ian.wacogne{at}

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I've written here before about how each issue ranges from the sublime to the ridiculous. This is a misuse of the saying—certainly at the ridiculous end—but the phrase captures well for me the range of reading experience you'll get in this issue.

Take, for instance, the paper by Lydia Forestier-Zhang and Nick Bishop on understanding basic bone mechanics (see page 2). When these authors approached me to write this, I wondered if it would be of relevance to readers, and was persuaded by them that it was. I'm pleased that they did so; I've sat in many safeguarding meetings explaining why I'm concerned that a child's bone has fractured, and this gives me a more sound backing to, as the authors put it, the reasons why some bones break and others don't, given the same trauma and force. This paper gives a great summary of an extremely complex area in five short pages. The box ‘What the general paediatrician should understand for safeguarding’ is a really good start to why this paper is worth your time and reflection. Also, for those of you who love your calcium and vitamin D—which, to be fair, should be all of us, Claire Wood and Tim Cheetham have a great summary of the NICE guidance for vitamin D supplementation (see page 43).

Felicity Katz, Elizabeth Leith and Eleni Paliokosta have written a really helpful fifteen minute consultation on children not going to school (see page 21). As an acute general paediatrician I would have to confess that this is something that I often neglect to take notice of; Table 1 and figure 2 of this paper really helped me untangle my thinking and emphasise that if I were more mindful of it, I might be able to direct children appropriately to the help they need.

By the time this edition is in print the bronchiolitis season should be past. However, it's never too soon to begin looking at how you're going to handle the onslaught next year; Emma Caffrey Osvald and Jane Clarke cover the NICE guideline (see page 46), and Neil Caldwell and Ceri Townsend look at RSV prophylaxis in our Pharmacy update section (see page 38).

When I'm talking with potential authors, a question I often ask is ‘What would you like to stop people from doing?’ I'm sure you can imagine the vehemence of the replies, some of which are not printable. I daresay you have a few thoughts yourself—in which case, do please get in touch; it's one of the ideas we've built around the Interpretations section. When I had this conversation with Francis Bu'Lock she was quite clear; it was the over-investigation of faints which irritated her. Now, she is a tertiary cardiologist which means that she doesn't see the demographic of patients that you and I see, but her paper with Michael Harris is really helpful (see page 26); we can see what worries a cardiologist, and try to apply this to our practice. Box 4—the red flag symptoms—is really helpful, as is the whole paper, which is why this becomes my Editor's choice this month.

Lastly, in addition to the other great papers, take a look at the image from the cover and in figure 2 of Hutchinson, Arthurs and Sebires Research in practice paper on postmortem research (see page 54). One of the many great joys I have in life is being astounded by technology, and this is a micro CT image of a 5.1 gram fetal heart. The rest of the article will also astound you.

If you want to write something, please do get in touch, and have a look at the blog:

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