Browsing by Subject "Surgery"
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Item An exploration of parental, nurse, and physician perceptions of family-centered care and the pediatric surgical process(2012-08) Calfa, Nicolina Ann; McCarthy, Christopher J.; Lawson, Karla; Drum, David; Jones, Barbara; Tharinger, DeborahThe purpose of this study was to assess parental and medical staff perceptions of the implementation of family-centered care during the surgical process at a pediatric hospital. Both children and parents experience hospitalization as a stressful process often characterized by painful, frightening medical procedures, interactions with strangers, and a loss of control and decision-making abilities. Medical staff members can play a vital role in alleviating parental distress by providing clear and consistent communication, support, and collaboration with parents throughout their child’s hospital care and recovery. Therefore, this study specifically sought to examine parental and medical staff members’ perceptions of the provision and importance of three types of social support: informational, emotional, and instrumental. This study also sought to examine the relationship between parental perceived provision and importance of social support and parental perceived stress. Qualitative questions were utilized to gather additional information regarding parents’ and medical staff members’ experiences throughout the surgical process. The sample for this study included 117 parents of surgical patients and 51 medical staff members (nurses, surgeons, and anesthesiologists) at a pediatric hospital in the southwestern United States. The quantitative data were analyzed using Mann-Whitney U Tests, Kruskal-Wallis Tests, and correlational analysis. Qualitative data were examined to identify major themes that have supported and contrasted with the quantitative results. The findings of this study revealed statistically significant differences between the perceived provision and importance of social support types among participant groups. Results also indicated statistically significant associations between parental perceptions of the provision and importance of social support type and parental perceived stress. These significant findings serve to inform care for families during the surgical process and guide future research in this area.Item Femtosecond laser nanoaxotomy lab-on-a-chip for in-vivo nerve regeneration studies(2010-12) Guo, Xun, doctor of mechanical engineering; Ben-Yakar, AdelaSurgery of axons in C. elegans using ultrafast laser pulses, and observing their subsequent regrowth opens a new frontier in neuroscience, since such research holds a great potential for the development of novel therapies and cures to neurodegenerative diseases. In order to make the required large-scale genetic screenings in C. elegans possible and thus obtain statistically significant biological data, an automated laser axotomy system needs to be developed. Microfluidic devices hold the promise of improved throughput by integrating different functional modules into a single chip. The first step to developing a microfluidic device for laser axotomy is to devise an on-chip worm trapping method, which maintains a high degree of immobilization to sever axons without using anesthetics. In this thesis, we present a novel method that uses a thin, deflectable PDMS membrane that individually traps worms in a microfluidic device. Axons can successfully be severed with the same accuracy as those using conventional paralyzing techniques. This device also incorporates recovery chambers for housing worms after surgery and for time-lapse imaging of axonal regrowth without the repeated use of anesthetics. Towards accomplishing an automated, high-throughput laser axotomy system, we developed an improved microfluidic design based on the same mechanical immobilization technique. This second generation device allows for serially processing of a large quantity of worms rapidly using a semi-automated system. Integrated to the opto-mechanical platform, a software program utilizing image processing techniques is developed. This semi-automated program can automatically identify the location of worms, their neuronal cell bodies, focus on the axons of interest, and align the laser beam with the axon via a PID based viso-servo feedback algorithm. Statistic data demonstrate that there is no significant difference in axonal reconnection rates between surgeries performed on-chip and using anesthetics. To improve flow control, a three-dimensional novel microfluidic valve structure is designed and fabricated. This novel valve structure allows for a complete sealing of the flow channel, without degrading optical conditions for imaging and laser ablation in the trapping area. Finally, we developed a prototypical microfluidic assembly that will eventually be able to interface a well-plate to automatically deliver population of worms from individual wells to the automated chip for axotomy. This interface consists of a microfluidic multiplexer to significantly reduce the number of solenoid valves needed to individually address each well.