http://hdl.handle.net/10453/35218 2026-09-21T04:07:58Z http://hdl.handle.net/10453/196016 Title: Prospective Observational Study of Infants' Physiological and Behavioral Responses to Nurse-Delivered Care After Surgery. Authors: Griffiths, N; Sinclair, L; Laing, S; Spence, K; Jyoti, J; James-Nunez, K; Popat, H Abstract: OBJECTIVE: To investigate infants' physiological and behavioral responses during routine nurse-delivered care following surgery. DESIGN: Cross-sectional observational study. SETTING: Surgical NICU. PARTICIPANTS: Infants (N = 45) who underwent major neonatal surgery after 34 weeks gestation for congenital anomalies. METHODS: We used bedside monitoring sources to capture continuous heart rate (HR) data and video-recorded nurse-delivered care episodes. We defined physiological stress as a change in mean HR of 10 bpm or more across pre-, during, and post-nurse-delivered care. Two independent reviewers evaluated infant state, stress, and self-regulation behaviors. We analyzed 99,840 HR data points and 1608 min of infant behavior video data. We used correlation to explore relationships among variables and used analysis of variance (ANOVA) methods and t tests to explore effects of care on infant responses within and between groups. RESULTS: In total, 24 participants (53.3%) had gastrointestinal surgery, 11 (24.4%) had cardiac surgery, and 10 (22.2%) had respiratory/esophageal surgery. Nurse-delivered care significantly affected HR. Changes in mean HR (bpm) varied across groups, with a mean change of 15.3 (SD = 12.88) for gastrointestinal surgery, a mean change of 11.8 (SD = 10.94) for cardiac surgery, and a mean change of 11.3 (SD = 8.19) for respiratory/esophageal surgery (ps' < .018). All groups exhibited behavioral stress indicators, including squirm, splay, and limb extension. Infants who had cardiac surgery exhibited vocal sounds more frequently than twitching of extremities (p = .019). CONCLUSION: Infants demonstrated physiological and behavioral stress during post-surgical nurse-delivered care. We observed variation between surgical groups that may represent the differing effects of congenital anomalies. Education about expected responses of infants with specific surgical conditions would equip nurses to better mitigate infant stress post-surgical responses. 2025-07-01T00:00:00Z http://hdl.handle.net/10453/195939 Title: Transperineal prostate biopsy under local vs general anaesthesia: a cost-effectiveness analysis. Authors: Roberts, MJ; Arora, S; Yao, HH; Hogan, D; Dias, B; O'Connell, HE; Wetherell, D; Zargar, H; Kwok, M; McGeorge, SP; Pearce, A; Yaxley, J; Tuffaha, H Abstract: OBJECTIVES: To estimate the cost effectiveness of local anaesthetic (LA) transperineal prostate biopsy (TPB) compared to general anaesthetic (GA) TPB, considering both hospital/health system and societal perspectives. PATIENTS AND METHODS: Individual-patient data from a prospective pilot study of 80 patients who underwent LA (n = 40) or GA (n = 40) TPB according to patient preference was used. A cost-effectiveness analysis was conducted using a decision tree model considering cancer detection rates, perioperative and return to work considerations between LA and GA TPB. The economic model included costs associated with consumables, device (capital, maintenance) and personnel for each approach. Cost-effectiveness was evaluated in terms of the incremental cost/quality-adjusted life-years (QALYs) and incremental net monetary benefit. Probabilistic and one-way sensitivity analyses were performed. RESULTS: Clinical parameters were generally similar between groups, including overall (55%) and significant (35% vs 23%; P = 0.32) cancer detection and procedure-specific duration (20 vs 21 min; P = 0.53). Total procedure and recovery durations were longer in the GA group by 8 min (P < 0.001) and 32.5 min (P < 0.001), respectively. Participants in the LA group returned to work earlier than the GA group (2 vs 4 days; P = 0.046). There was a marginal gain in QALYs between the LA and GA groups (0.82385 vs 0.82383), but LA TPB had lower costs (Australian dollars [AU$]715.80 vs AU$1673.58), with an estimated average cost savings of ~AU$959. From the societal perspective, driven by the reduction in productivity loss, the average cost savings with LA TPB were ~AU$1639. Sensitivity analyses showed the probability of LA being cost effective was 100%, while utilisation of operating theatre for GA TPB was the main driver of cost difference. CONCLUSION: Performing TPB via the LA approach would be cost-saving from both hospital and societal perspectives without reducing the accuracy of the biopsy. 2025-07-01T00:00:00Z http://hdl.handle.net/10453/195916 Title: Psychological distress and coping mechanisms due to the COVID-19 pandemic among the adult population in Bo Sierra Leone. A cross-sectional study. Authors: James, PB; Osborne, A; Bah, FS; Bah, AJ; Kangbai, JB; Yendewa, GA Editors: Omona, K Abstract: Psychological distress is widely recognized as a significant health concern that poses a potential risk to the overall mental wellbeing of individuals. This study investigated the psychological distress associated with the COVID-19 pandemic and the coping methods employed by adults in Bo district, Sierra Leone. This research used a snapshot approach (cross-sectional design) to describe the prevalence of psychological distress during the COVID-19 pandemic among 502 adults residing in Bo district, Sierra Leone. We collected study data using a structured questionnaire that comprised of participant's demographics, Kessler Psychological Distress Scale (K10), Fear of COVID-19Scale (FCV-19S), Brief Resilient Coping Scale (BRCS), and Duke-UNC Functional Social Support instrument. We used backward stepwise binary logistic regression to identify the key factors linked to psychological distress. The average psychological stress score was 22.96±11.35, with approximately one-third of participants (n = 160, 31.9%) exhibiting very high levels of psychological distress. The mean score for fear of COVID-19 was 29.71±6.84, with the majority (n = 420,83.7%) being fearful of COVID-19. The mean score for the Brief Resilient Coping Mechanism was 12.49±4.51, with half of the participants considered low resilient copers (n = 257,51.2%). The mean score for functional social support was 25.35±8.85, with (n = 240, 47.8%) having increased social support. Individuals with a known health condition [aOR = 4.415, 95% CI = 1.859-10.484], who provided care to a family member/patient with known/suspected COVID-19 [aOR = 4.485, 95% CI = 1.575-12.775], who knew someone who died from COVID-19 [aOR = 3.117, 95% CI = 1.579-6.154], with an increased fear of COVID-19 [aOR = 4.344, 95% CI = 2.199-8.580] had higher odds of moderate to severe psychological distress. Moderate resilient copers [aOR = 0.523, 95% CI = 0.296-0.925] had lower odds of psychological distress compared to the low resilient copers. Participants with increased social support had lower odds of psychological distress than those with low support [aOR = 0.253, 95% CI = 0.147-0.434]. A significant proportion of the study cohort residing in Bo, Sierra Leone, experienced high levels of mental stress because of the COVID-19 pandemic. This study shows the importance of designing and implementing programs that minimize COVID-19 stressors and enhance the coping skills and social support network. 2025-01-01T00:00:00Z http://hdl.handle.net/10453/195905 Title: Pre-service education for registered nurses on mandatory reporting of child maltreatment: An integrative review. Authors: Stenson, S; Hutton, A; Fenton, A; Grant, J Abstract: PROBLEM: The aim of this review is to examine the international literature about pre-service education for registered nurses and identify how it prepares them for their role as mandatory reporters of child maltreatment, to be applied to an Australian context. METHODS: All peer-reviewed papers about nurses' pre-service education on legally mandated reporting of child maltreatment written in English were eligible. Papers based on nurses working in various settings were included, from both Australian and international sources between 1994 to present. Literature search was performed between June-July 2021, and repeated in July 2023. 18 papers that met the eligibility criteria were included. They included 7 quantitative studies, 3 qualitative studies, 2 mixed-method studies, 5 literature reviews and 1 peer-reviewed discussion paper. RESULTS: The resultant papers came from Australia (n = 3), USA (n = 3), Taiwan (n = 3), India (n = 1), Brazil (n = 1), The Philippines (n = 1), Iran (n = 1), Hong Kong (n = 1), Saudi Arabia (n = 1), Korea (n = 1), UK (n = 1), and The Netherlands (n = 1). Publication dates ranged from 2005 to 2020. Key themes identified were insufficiencies in education leading to barriers to nursing making mandatory reports. CONCLUSIONS: To remove barriers to making mandatory reports, nurses' education on mandatory reporting of child maltreatment should challenge nurses' attitudes and perceptions, be structured and use evidence-based pedagogy, and be delivered preservice. IMPLICATIONS: Structured and pedagogically sound preservice education for nurses about mandatory reporting of child maltreatment is recommended. Education should offer opportunities for nurses to challenge their attitudes and preconceptions about child maltreatment. 2025-01-01T00:00:00Z