Using non-nutritive sucking to support feeding development for premature infants: A commentary on approaches and current practice

Non-nutritive sucking is often used with premature infants by either using a pacifier or an expressed breast nipple to support the introduction and development of early oral feeding. The pattern of non-nutritive sucking is distinct in that it involves two sucks per second in contrast to nutritive sucking which is one suck per second. Although some literature has identified that non-nutritive sucking has some benefit for the premature infant’s feeding development, it is not entirely clear why such an approach is helpful as neurologically, activation of non-nutritive and nutritive skills are different. A summary is presented of the main approaches that use non-nutritive sucking with reference to the literature. This paper also considers other factors and beneficial approaches to managing the introduction of infant feeding. These are: the infant’s toleration of enteral feeds pre oral trials, overall development and gestational age when introducing oral experiences, developing swallowing skills before sucking, physiological stability, health status, as well as the development and interpretation of infant oral readiness signs and early communication

Review essay – New directions in queer theory: recent theorizing in the work of Lynne Huffer, Leo Bersani and Adam Phillips, and Lauren Berlant and Lee Edelman

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Managing eating and drinking difficulties (dysphagia) with children who have learning disabilities: What is effective?

People who work with children who have neurological and learning disabilities frequently need to manage the health and emotional risks associated with eating, drinking and swallowing (dysphagia). Some approaches can support children to develop oral feeding competence or to maximise their ability to maintain some oral intake supplemented with tube feeding. However, some clinicians feel that oral-motor exercises can support eating and drinking skills as well as speech and language development, whereas there is little evidence to support this. The implied “beneficial” association between oral-motor exercises, speech and swallowing skills gives a false impression in terms of future outcomes for parents and carers of children with learning disabilities. This paper considers oral-motor approaches in the remediation of dysphagia and the need for a cultural shift away from this view. Realistic and useful outcomes for people with learning disabilities need to be an essential part of therapeutic intervention

Co‐operative cross‐platform courseware development

The UKMCC (UK Mathematics Courseware Consortium) is a Consortium funded under TLTP (Training and Learning Technology Programme) to produce courseware for service mathematics teaching, using the SEFI (Société Européenne pour la Formation des Ingénieurs) syllabus. There are agreed courseware design guidelines and a simple courseware management system which allows cross‐referencing. Courseware is divided into modules, with an author as implementer for each. On any one hardware platform, a variety of authoring languages is possible. Across hardware platforms, the design guidelines ensure that conversion is possible, and will preserve look and feel. We argue here that these arrangements provide a basis for continued co‐operation between authors and future development as the technology changes

Constraints on the Growth and Spin of the Supermassive Black Hole in M32 From High Cadence Visible Light Observations

We present 1-second cadence observations of M32 (NGC221) with the CHIMERA instrument at the Hale 200-inch telescope of the Palomar Observatory. Using field stars as a baseline for relative photometry, we are able to construct a light curve of the nucleus in the g-prime and r-prime band with 1sigma=36 milli-mag photometric stability. We derive a temporal power spectrum for the nucleus and find no evidence for a time-variable signal above the noise as would be expected if the nuclear black hole were accreting gas. Thus, we are unable to constrain the spin of the black hole although future work will use this powerful instrument to target more actively accreting black holes. Given the black hole mass of (2.5+/-0.5)*10^6 Msun inferred from stellar kinematics, the absence of a contribution from a nuclear time-variable signal places an upper limit on the accretion rate which is 4.6*10^{-8} of the Eddington rate, a factor of two more stringent than past upper limits from HST. The low mass of the black hole despite the high stellar density suggests that the gas liberated by stellar interactions was primarily at early cosmic times when the low-mass black hole had a small Eddington luminosity. This is at least partly driven by a top-heavy stellar initial mass function at early cosmic times which is an efficient producer of stellar mass black holes. The implication is that supermassive black holes likely arise from seeds formed through the coalescence of 3-100 Msun mass black holes that then accrete gas produced through stellar interaction processes.Comment: 8 pages, 3 figures, submitted to the Astrophysical Journal, comments welcom

Physical disruption of intervertebral disc promotes cell clustering and a degenerative phenotype

© 2019, The Author(s). To test the hypothesis that physical disruption of an intervertebral disc disturbs cell-matrix binding, leading to cell clustering and increased expression of matrix degrading enzymes that contribute towards degenerative disc cell phenotype. Lumbar disc tissue was removed at surgery from 21 patients with disc herniation, 11 with disc degeneration, and 8 with adolescent scoliosis. 5 μm sections were examined with histology, and 30-µm sections by confocal microscopy. Antibodies were used against integrin α5beta1, matrix metalloproteinases (MMP) 1, MMP-3, caspase 3, and denatured collagen types I and II. Spatial associations were sought between cell clustering and various degenerative features. An additional, 11 non-herniated human discs were used to examine causality: half of each specimen was cultured in a manner that allowed free ‘unconstrained’ swelling (similar to a herniated disc in vivo), while the other half was cultured within a perspex ring that allowed ‘constrained’ swelling. Changes were monitored over 36 h using live-cell imaging. 1,9-Di-methyl methylene blue (DMMB) assay for glycosaminoglycan loss was carried out from tissue medium. Partially constrained specimens showed little swelling or cell movement in vitro. In contrast, unconstrained swelling significantly increased matrix distortion, glycosaminoglycan loss, exposure of integrin binding sites, expression of MMPs 1 and 3, and collagen denaturation. In the association studies, herniated disc specimens showed changes that resembled unconstrained swelling in vitro. In addition, they exhibited increased cell clustering, apoptosis, MMP expression, and collagen denaturation compared to ‘control’ discs. Results support our hypothesis. Further confirmation will require longitudinal animal experiments

Reading leadership through Hegel’s master/slave dialectic: towards a theory of the powerlessness of the powerful

YesThis paper develops a theory of the subjectivity of the leader through the philosophical lens of Hegel’s master/slave dialectic and its recent interpretation by the philosopher Judith Butler. This is used to analyse the working life history of a man who rose from poverty to a leadership position in a large company and eventually to running his own successful business. Hegel’s dialectic is foundational to much Western thought, but in this paper, I rashly update it by inserting a leader in between the master, whose approval the leader needs if s/he is to sustain self-hood, and the follower, who becomes a tool that the leader uses when trying to gain that elusive approval. The analysis follows the structure of Butler’s reading of the Dialectic and develops understanding of the norms that govern how leaders should act and the persons they should be. Hard work has become for leaders an ethical endeavour, but they grieve the sacrifice of leisure. They enjoy a frisson of erotic pleasure at their power over others but feel guilt as a result. They must prove their leadership skills by ensuring their followers are perfect employees but at the same time must prove their followers are poor workers who need their continued leadership. This leads to the conclusion that the leader is someone who is both powerful and powerless. This analysis is intended not to demonize leaders, but to show the harm that follows the emphasis on leadership as a desirable and necessary organizational function

Altitude Limits for Rotating Vector Model Fitting of Pulsar Polarization

Traditional pulsar polarization sweep analysis starts from the point dipole rotating vector model (RVM) approximation. If augmented by a measurement of the sweep phase shift, one obtains an estimate of the emission altitude (Blaskiewicz, Cordes, & Wasserman). However, a more realistic treatment of field line sweepback and finite altitude effects shows that this estimate breaks down at modest altitude ~ 0.1R_{LC}. Such radio emission altitudes turn out to be relevant to the young energetic and millisecond pulsars that dominate the \gamma-ray population. We quantify the breakdown height as a function of viewing geometry and provide simple fitting formulae that allow observers to correct RVM-based height estimates, preserving reasonable accuracy to R ~ 0.3R_{LC}. We discuss briefly other observables that can check and improve height estimates