http://hdl.handle.net/10453/35218 2026-08-06T16:37:08Z 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 http://hdl.handle.net/10453/195904 Title: Preservice education for interprofessional public health responses to child maltreatment: Australian stakeholder perspectives of key regulatory, sociocultural and professional challenges Authors: Lines, LE; Kakyo, TA; McLaren, H; Cooper, M; Sivertsen, N; Hutton, A; Zannettino, L; Hartz, D; Grant, J Abstract: Background: Child maltreatment is an international public health issue that requires interprofessional collaboration across all sectors providing services for children and families. Effective collaborative interprofessional responses are underpinned by professionals who are equipped with knowledge, skills and values to respond to children’s complex health, wellbeing and developmental needs. However, little is known about how health and welfare professionals are equipped during preservice education to prepare for interprofessional public health responses to child maltreatment. Purpose: Using a qualitative World Café approach, this study aimed to engage key professional stakeholders in discussions about what is needed in child protection interprofessional education for preservice health and welfare professionals in Australia. Research Design and Study Sample: Three online roundtables were held with a total of twenty-five participants, inclusive of nurses, midwives, and social workers, in education, research, and practice. Data Analysis: Inductive analysis identified how the interplay of broader political, sociocultural and regulatory factors results in failure to equip graduates for interprofessional public health responses to child maltreatment. Results: Key challenges included a perceived lack of leadership from governments, no shared interprofessional definitions, inadequate resourcing for early support, and local barriers to implementing interprofessional education. Coordinated national leadership by and across governments and professional regulatory bodies was identified as essential to underpin a shared vision and adequate resources for sustained change. Conclusions: As change gathers momentum, higher education institutions are optimally positioned to address challenges of interprofessional education for public health responses to child maltreatment for all professionals who will work with children. Ongoing commitment is needed across all sectors, including government, professional regulators and higher education, to establish a shared vision that underpins interprofessional understanding of roles and core knowledge, skills and values for graduates. 2025-06-01T00:00:00Z