Academic literature on the topic 'Masons' Sick Society'

Background and aimParenteral Nutrition (PN) forms the mainstay of nutritional support for extremely low birth weight (ELBW) infants immediately after birth to promote optimal growth and neurodevelopmental outcomes. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published in 2010 indicated that only 24% of neonates received parenteral nutrition that was considered good practice1. NCEPOD, alongside the Paediatric Chief Pharmacists Group Report, highlighted issues with prescribing and administration of PN linked to unnecessary variation in practice between hospitals.1 2 This encourages use of standardised PN with associated guidelines for use and administration. The aim was to be able to provide nutritionally complete PN for preterm and sick term babies in a ready to use formulation, 24 hours a day, 7 days a week without access to an onsite aseptic service and for the nutrition a baby receives to be consistent across the network regardless of which hospital they are in.MethodsThere is a robust network neonatal nutrition group, comprising neonatologists, pharmacists, dietitians and nutrition nurses. The remit of the group was initially to audit their current practice and agree the new standardized formulations and develop guidelines for use. These were based on European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and British Association of Perinatal Medicine (BAPM) guidelines and expert opinion.3 4 Advice on stability and compounding was sought from commercial experts. Assistance to award a contract to supply the network was sought from a group purchasing organisation to ensure capacity planning and cost effectiveness.ResultsConsensus on four concentrated formulations was agreed by the network group and all six units within the network are now successfully using these.ConclusionThis has been a lengthy process but it was possible to establish agreement of a structured set of standard bags that would deliver nutritionally complete PN to the cohort of babies in our network. Re-audit is now underway in house to compare to previous practice and we hope to shortly roll this audit out across the network. Future aspirations are to devise a system to manage stock control across the entire network, work towards reaching national consensus, work with commercial partners to obtain extended expiry with peditrace addition and to work in partnership with commercial companies to formulate licensed products.ReferencesStewart J, Mason G, Smith N, et al. A mixed bag; an enquiry into the care of hospital patients receiving parenteral nutrition. National Confidential Enquiry into Patient Outcome and Death, 2010.Paediatric Chief Pharmacists Group. Improving practice and reducing risk in the provision of parenteral nutrition for neonates and children, 2011.Koletzko B, Goulet O, Hunt J, et al. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). J Pediatr Gastroenterol Nutr 2005;41(Suppl 2):S1–87.British Association of Perinatal Medicine (BAPM). The Provision of Parenteral Nutrition within Neonatal Services - A Framework for Practice, 2016.

After his break with Kinsey, Legman aimed to make a place for himself among New York City intellectuals as a full-time writer and editor on topics of sex. Between 1946 and 1948, he was at work drafting Love & Death, a series of essays on the effects of censorship and repression on American culture. Love & Death was an early foray into the criticism of mass culture and an early content analysis of comic books, detective fiction, and stereotypes of women in mass culture. In it Legman argued that the repression of sex in mass culture inevitably led to a sick and violent society. This chapter shows Legman developing and circulating his essays among New York’s writers and editors, unpacks his negative critique of mass culture, and presents the responses of some of his prominent readers. Although the book was rejected by several dozen publishers, Legman got attention for his views. Through Fredric Wertham, one of the principal psychiatrists in New York City, Legman gave a public lecture on psychoanalytic approaches to comic books. Also discussed is Legman’s marriage to his first wife, Beverley Keith, and the salons they held at their tiny house in the Bronx.

In 1980, high-performance computing was becoming limited by the heat dissipated in semiconductor chips. IBM was introducing a new chip packaging technology that featured a specific thermal conductance of about 5000 W/m2·°C and occupied approximately 1 liter of space in order to cool 300 W. IBM was also developing a superconducting computer technology to circumvent the thermal problem posed by continued scaling of semiconductor chips. The following year, two of us (DBT and RFWP) showed theoretically and experimentally that by scaling down the dimensions of a conventional plate-fin liquid-cooled heat sink to a channel width of ∼50 μm, operating in the laminar flow regime, and integrated within the silicon chip, we could achieve in a laboratory demonstration at least a 20-fold improvement in specific thermal conductance, and more than 1000-fold greater volumetric heat removal. The reception of this advance was mixed, but what really stalled its adoption was the emergence of high-speed low-power CMOS semiconductor circuitry. Two decades later even scaled CMOS circuitry was getting too hot, and various commercialization attempts were then undertaken; some were successful, others not. New commercialization opportunities are now appearing including ones that enable society’s more efficient use of energy. A specific example of one such opportunity will be described, i.e., the use of microchannels in a novel, highly efficient regenerative heat-exchanger configuration, intended for heat-treating low-viscosity liquids for purposes such as pasteurization. Water was successfully heat-treated in continuous-flow tests of an experimental scaled-down prototype ultrahigh-temperature (UHT) pasteurizer incorporating a linear counterflow microchannel (50 μm parallel-plate channel separation) heat exchanger having an integrated electric heater at the hot end. The use of an integral electric heater permitted a unique manifold-less arrangement for reversing the flow directions at the hot end, wherein perfect local mass balance was enforced locally (i.e., between every pair of adjacent counter-flowing microchannels), eliminating a major potential source of flow maldistribution that would have otherwise reduced heat-exchanger effectiveness. Water entered the device at room temperature, steadily heated to 135°C in about 2.5 s, was maintained at 135°C for ∼2.5 s, and then cooled in ∼2.5 s, exiting at no more than 2°C above its original temperature, indicative of high heat-exchanger effectiveness. Heat leaks to ambient air required an excess of heater power, but those could be mostly eliminated in a scaled-up design and with proper attention to exterior insulation. Subsequent tests with milk flowing in heated microchannels revealed that fouling can be a severe problem (perhaps exacerbated by the long-tailed residence-time distribution characteristic of laminar flow), limiting continuous use to less than 2 hours for UHT pasteurization conditions. Conventional high-temperature short-time (HTST) milk pasteurization employs much lower peak temperatures and it is more likely that a practical microchannel system could be constructed for that application.