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Background: Infantile Spasms (IS) is a rare epilepsy syndrome with characteristic features, and a strong consensus regarding treatment strategies. Clinical care pathways provide standardized and evidence-based patient care, support care quality and improve patient outcomes. Standardized electronic notes may support data collection and quality. After the concurrent implementation of an IS pathway and standardized electronic note at the Alberta Children’s Hospital in 2015, improvements in patient outcomes and quality of care were anticipated. Methods: A single-centre, retrospective chart review of patients diagnosed with Infantile spasms in Alberta, Canada from 2011-2019 was completed. Patient characteristics and outcomes were analyzed by pre-pathway and post-pathway implementation status. Results: Rates of 3-month spasm remission, and of remission without relapse did not significantly differ between pre- and post-pathway cohorts. Rates of 2-week spasm remission were not obtainable from a significant proportion of pre-pathway patient records when compared to the post-pathway group, indicating patient record quality improved following the electronic note implementation. A significant proportion of patients received Prednisolone as their first treatment for IS post-pathway implementation compared to pre-pathway (p<0.001). Conclusions: A single-centre experience with concurrent implementation of an IS pathway and standardized electronic note demonstrated no significant changes in patient outcomes. Potential improvements for patient care are identified.

Sociality in mole rats has been suggested to have evolved as a response to the widely dispersed food resources and the limited burrowing opportunities that result from sporadic rainfall events. In the most arid regions, individual foraging efficiency is reduced, and energetic constraints increase. In this study, we investigate seasonal differences in burrow architecture of the social Cryptomys hottentotus hottentotusin a mesic region. We describe burrow geometry in response to seasonal weather conditions for two seasons (wet and dry). Interactions occurred between seasons and colony size for the size of the burrow systems, but not the shape of the burrow systems. The fractal dimension values of the burrow systems did not differ between seasons. Thus, the burrow complexity was dependent upon the number of mole rats present in the social group.

Species may become obligate cooperative breeders when parents are unable to raise their offspring unassisted. We measured the daily energy expenditure of mothers, helpers and offspring during peak lactation in cooperatively breeding meerkats Suricata suricattausing the doubly labelled water technique. Lactating mothers expended more energy per day than allo–lactating subordinate females, non–lactating females or suckling offspring. Metabolizable energy intakes of lactating mothers were calculated from isotope–based estimates of offspring milk energy intake, and were not significantly different from the previously suggested maximal limit for mammals. Allo–lactating females were the only category of animals that lost weight during the period of study, probably because they spent more time babysitting than non–lactating females. Daily energy expenditure (DEE) of lactating mothers increased with litter size but decreased with the number of helpers. Calculations show that for every 10 helpers, even in the absence of allo–lactators, mothers are able to reduce their DEE during peak lactation by an amount equivalent to the energy cost of one pup. These results indicate that helpers have beneficial energetic consequences for lactating mothers in an obligate cooperatively breeding mammal.