Improving the care of preterm infants: before, during, and after, stabilisation in the delivery room

Introduction Up to 10% of infants require stabilisation during transition to extrauterine life. Enhanced monitoring of cardiorespiratory parameters during this time may improve stabilisation outcomes. In addition, technology may facilitate improved preparation for delivery room stabilisation as well as NICU procedures, through educational techniques. Aim To improve infant care 1) before birth via improved training, 2) during stabilisation via enhanced physiological monitoring and improved practice, and 3) after delivery, in the neonatal intensive care unit (NICU), via improved procedural care. Methods A multifaceted approach was utilised including; a combination of questionnaire based surveys, mannequin-based investigations, prospective observational investigations, and a randomised controlled trial involving preterm infants less than 32 weeks in the delivery room. Forms of technology utilised included; different types of mannequins including a CO2 producing mannequin, qualitative end tidal CO2 (EtCO2) detectors, a bespoke quantitative EtCO2 detector, and annotated videos of infant stabilisation as well as NICU procedures Results Manual ventilation improved with the use of EtCO2 detection, and was positively assessed by trainees. Quantitative EtCO2 detection in the delivery room is feasible, EtCO2 increased over the first 4 minutes of life in preterm infants, and EtCO2 was higher in preterm infants who were intubated. Current methods of heart rate assessment were found to be unreliable. Electrocardiography (ECG) application warrants further evaluation. Perfusion index (PI) monitoring utilised in the delivery room was feasible. Video recording technology was utilised in several ways. This technology has many potential benefits, including debriefing and coaching in procedural healthcare, and warrants further evaluation. Parents would welcome the introduction of webcams in the NICU. Conclusions I have evaluated new methods of improving infant care before, during, and after stabilisation in the DR. Specifically, I have developed novel educational tools to facilitate training, and evaluated EtCO2, PI, and ECG during infant stabilisation. I have identified barriers in using webcams in the NICU, to now be addressed prior to webcam implementation.

Nanofiber control of ultracold quantum gases

While a great amount of attention is being given to the development of nanodevices, both through academic research and private industry, the field is still on the verge. Progress hinges upon the development of tools and components that can precisely control the interaction between light and matter, and that can be efficiently integrated into nano-devices. Nanofibers are one of the most promising candidates for such purposes. However, in order to fully exploit their potential, a more intimate knowledge of how nanofibers interact with single neutral atoms must be gained. As we learn more about the properties of nanofiber modes, and the way they interface with atoms, and as the technology develops that allows them to be prepared with more precisely known properties, they become more and more adaptable and effective. The work presented in this thesis touches on many topics, which is testament to the broad range of applications and high degree of promise that nanofibers hold. For immediate use, we need to fully grasp how they can be best implemented as sensors, filters, detectors, and switches in existing nano-technologies. Areas of interest also include how they might be best exploited for probing atom-surface interactions, single-atom detection and single photon generation. Nanofiber research is also motivated by their potential integration into fundamental cold atom quantum experiments, and the role they can play there. Combining nanofibers with existing optical and quantum technologies is a powerful strategy for advancing areas like quantum computation, quantum information processing, and quantum communication. In this thesis I present a variety of theoretical work, which explores a range of the applications listed above. The first work presented concerns the use of the evanescent fields around a nanofiber to manipulate an existing trapping geometry and therefore influence the centre-of-mass dynamics of the atom. The second work presented explores interesting trapping geometries that can be achieved in the vicinity of a fiber in which just four modes are allowed to propagate. In a third study I explore the use of a nanofiber as a detector of small numbers of photons by calculating the rate of emission into the fiber modes when the fiber is moved along next to a regularly separated array of atoms. Also included are some results from a work in progress, where I consider the scattered field that appears along the nanofiber axis when a small number of atoms trapped along that axis are illuminated orthogonally; some interesting preliminary results are outlined. Finally, in contrast with the rest of the thesis, I consider some interesting physics that can be done in one of the trapping geometries that can be created around the fiber, here I explore the ground states of a phase separated two-component superfluid Bose-Einstein condensate trapped in a toroidal potential.