ORCID Profile
0000-0002-1069-4224
Current Organisations
Monash Health
,
Swinburne University of Technology
,
University of Melbourne
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Publisher: Australian Nursing and Midwifery Federation
Date: 28-02-2022
Publisher: American Thoracic Society
Date: 15-06-2015
Publisher: Microbiology Society
Date: 09-2020
DOI: 10.1099/JMM.0.001238
Abstract: Introduction. The SARS-CoV-2 pandemic of 2020 has resulted in unparalleled requirements for RNA extraction kits and enzymes required for virus detection, leading to global shortages. This has necessitated the exploration of alternative diagnostic options to alleviate supply chain issues. Aim. To establish and validate a reverse transcription loop-mediated isothermal lification (RT- LAMP) assay for the detection of SARS-CoV-2 from nasopharyngeal swabs. Methodology. We used a commercial RT-LAMP mastermix from OptiGene in combination with a primer set designed to detect the CDC N1 region of the SARS-CoV-2 nucleocapsid (N) gene. A single-tube, single-step fluorescence assay was implemented whereby 1 µl of universal transport medium (UTM) directly from a nasopharyngeal swab could be used as template, bypassing the requirement for RNA purification. Amplification and detection could be conducted in any thermocycler capable of holding 65 °C for 30 min and measure fluorescence in the FAM channel at 1 min intervals. Results. Assay evaluation by assessment of 157 clinical specimens previously screened by E-gene RT-qPCR revealed assay sensitivity and specificity of 87 and 100%, respectively. Results were fast, with an average time-to-positive (Tp) for 93 clinical s les of 14 min ( sd ±7 min). Using dilutions of SARS-CoV-2 virus spiked into UTM, we also evaluated assay performance against FDA guidelines for implementation of emergency-use diagnostics and established a limit-of-detection of 54 Tissue Culture Infectious Dose 50 per ml (TCID 50 ml −1 ), with satisfactory assay sensitivity and specificity. A comparison of 20 clinical specimens between four laboratories showed excellent interlaboratory concordance performing equally well on three different, commonly used thermocyclers, pointing to the robustness of the assay. Conclusion. With a simplified workflow, The N1 gene Single Tube Optigene LAMP assay (N1-STOP-LAMP) is a powerful, scalable option for specific and rapid detection of SARS-CoV-2 and an additional resource in the diagnostic armamentarium against COVID-19.
Publisher: Wiley
Date: 02-2017
DOI: 10.1111/VOX.12490
Abstract: Plasma transfusions are a frequent treatment worldwide, but many studies have reported a wide variation in the indications to transfuse. Recently, an international paediatric study also showed wide variation in frequency in the use of plasma transfusions: 25% of the centres transfused plasma to >5% of their patients, whereas another 25% transfused plasma to <1% of their patients. The objective of this study was to explore the factors associated with different plasma transfusion practices in these centres. Online survey sent to the local investigators of the 101 participating centres, in February 2016. Four areas were explored: beliefs regarding plasma transfusion, patients' case-mix in each unit, unit's characteristics, and local blood product transfusion policies and processes. The response rate was 82% (83/101). 43% of the respondents believed that plasma transfusions can arrest bleeding, whereas 27% believe that plasma transfusion can prevent bleeding. Centres with the highest plasma transfusion rate were more likely to think that hypovolaemia and mildly abnormal coagulation tests are appropriate indications for plasma transfusions (P = 0·02 and P = 0·04, respectively). Case-mix, centre characteristics or local transfusion services were not identified as significant relevant factors. Factors influencing plasma transfusion practices reflect beliefs about indications and the efficacy of transfusion in the prevention and management of bleeding as well as effects on coagulation tests. Educational and other initiatives to target these beliefs should be the focus of research.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 31-08-2020
DOI: 10.1111/JOCN.15442
Publisher: RCN Publishing Ltd.
Date: 09-05-2019
Publisher: SAGE Publications
Date: 29-01-2021
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.PMN.2017.10.006
Abstract: To identify interventions aimed at helping parents manage their child's pain at home and to establish which aspects of interventions were effective. Integrative narrative review. MEDLINE, CINAHL Plus, PsychINFO, PsychArticles, AMED, PubMed, Scopus and Web of Knowledge databases were searched in 2016. This narrative synthesis followed Centre for Reviews and Dissemination and Economic and Social Research Council guidance. Reasons attributed to intervention success were analyzed using content analysis. From 2,534 papers, 17 were included. A majority were randomized controlled trials (n = 13) and most addressed postoperative pain (n = 15). A range of interventions were found that directly targeted parents, including child-parent interactions and health care professional-parent interactions, as well as complex interventions. Three studies were successful in reducing child pain at home and seven in increasing appropriate analgesic drug administration. Analysis of reasons attributed to interventions success revealed characteristics of interventions, components of parental pain management, and key features of research that aid researchers in designing and evaluating interventions. Risk of bias was present because of inadequate randomization, lack of a control group, and underpowered studies. Nurses should be aware that targeting parents directly is the most effective way of reducing child pain at home. Nurses need to advocate for effective analgesics for their child patients because the ineffectiveness of many interventions was attributed to inadequate analgesic drugs. Once this is achieved, success in increasing analgesic drug administration is most likely reached via parent-targeted interventions and those targeting health care professional-parent interactions. Successful interventions will be tailored to the child and adequately powered. Including a measure of sedation will ensure sedation is not mistaken for analgesic effectiveness. Interventions should address multiple facets of pain management and include a measure of pain over a period as opposed to a snapshot in time.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.NEPR.2018.06.012
Abstract: Professional, financial and ethical reasons necessitate nursing improves its understanding of student attrition. Previous studies identify causes of attrition as multifactorial. However, few studies focus on children's nursing. This study aimed to explore causes of pre-registration children's nursing attrition. Exploring the causes of attrition was achieved through quantitative and qualitative approaches. Three years of quantitative data relating to attrition rates and causes was obtained. These data informed semi-structured interviews of children's nursing students, from four London universities. These students had faced challenges and either 'left' (n = 5) or 'stayed on' (n = 13) their pre-registration programme. Most attrition occurred in the first year of programmes and was primarily due to academic failure or personal circumstances clinical placements also played a role. Emergent themes were 'expectations of pre-registration children's nursing' 'realities of a pre-registration children's nursing course', and 'factors that influence students leaving or staying on the course'. Many participants reported a reluctance to disclose issues while on their course. Support to continue on the programme was frequently obtained away from university and students described relying on self-determination to complete programmes. Findings indicated several areas of potential improvement for student support including targeted interventions focusing on a student's first year and reducing variation in support services provided.
Publisher: SAGE Publications
Date: 23-11-2019
Publisher: Springer Science and Business Media LLC
Date: 20-06-2023
DOI: 10.1186/S12909-023-04371-5
Abstract: Cognitive and implicit biases negatively impact clinicians’ decision-making capacity and can have devastating consequences for safe, effective, and equitable healthcare provision. Internationally, health care clinicians play a critical role in identifying and overcoming these biases. To be workforce ready, it is important that educators proactively prepare all pre-registration healthcare students for real world practice. However, it is unknown how and to what extent health professional educators incorporate bias training into curricula. To address this gap, this scoping review aims to explore what approaches to teaching cognitive and implicit bias, for entry to practice students, have been studied, and what are the evidence gaps that remain. This scoping review was guided by the Joanna Briggs Institute (JBI) methodology. Databases were searched in May 2022 and included CINAHL, Cochrane, JBI, Medline, ERIC, Embase, and PsycINFO. The Population, Concept and Context framework was used to guide keyword and index terms used for search criteria and data extraction by two independent reviewers. Quantitative and qualitative studies published in English exploring pedagogical approaches and/or educational techniques, strategies, teaching tools to reduce the influence of bias in health clinicians' decision making were sought to be included in this review. Results are presented numerically and thematically in a table accompanied by a narrative summary. Of the 732 articles identified, 13 met the aim of this study. Most publications originated from the United States ( n= 9). Educational practice in medicine accounted for most studies ( n= 8), followed by nursing and midwifery ( n= 2). A guiding philosophy or conceptual framework for content development was not indicated in most papers. Educational content was mainly provided via face-to-face (lecture/tutorial) delivery ( n= 10). Reflection was the most common strategy used for assessment of learning ( n= 6). Cognitive biases were mainly taught in a single session ( n= 5) implicit biases were taught via a mix of single ( n= 4) and multiple sessions ( n= 4). A range of pedagogical strategies were employed most commonly, these were face-to-face, class-based activities such as lectures and tutorials. Assessments of student learning were primarily based on tests and personal reflection. There was limited use of real-world settings to educate students about or build skills in biases and their mitigation. There may be a valuable opportunity in exploring approaches to building these skills in the real-world settings that will be the workplaces of our future healthcare workers.
Publisher: Wiley
Date: 11-12-2007
DOI: 10.1111/J.1460-9592.2007.02359.X
Abstract: The characteristics of the electroencephalogram (EEG) during anesthesia in children are poorly described. An understanding of the EEG during anesthesia may help explain and predict the performance of EEG-derived depth of anesthesia monitors in children. This study aims to describe the association between age and some basic characteristics of the EEG during nonstandardized anesthesia in children and infants. Sixty-four children aged 9 days to 12 years were enrolled in this observational physiological study. Anesthesia was given at the discretion of the anesthetist. EEG was recorded from after induction to emergence using a BRM2 brain monitor ''BrainZ Instruments, Auckland, New Zealand'' in parietal and frontal montages. For comparison, 90% spectral edge frequency (SEF-90) and power were determined at three points (equilibrium during anesthesia, when the volatile agent was discontinued and at emergence), and children were ided into three age groups (0-6 months, 6-24 months and 2-12 years). Fifty-seven children had artifact-free EEG data. From equilibrium to emergence the mean forehead power decreased substantially in children aged 2-12 years (3171-153 microV(2), P < 0.001) and 6-24 months (756-140 microV(2), P < 0.001) but no difference was found in infants aged 0-6 months (93-63 microV(2), P = 0.4). From equilibrium to emergence mean forehead spectral edge frequency increased in children aged 2-12 years (10.8-13.7 Hz, P = 0.01) but no change was found in children aged 6-24 months (12.7-12.7 Hz, P = 0.9) or 0-6 months (9.45-7.26 Hz, P = 0.08). Throughout emergence, infants demonstrated a discontinuous EEG pattern with intermittent bursts separated with low litude. During anesthesia, the EEG in infants is fundamentally different from the EEG in older children. This study supports the need for specific infant-derived algorithms if EEG-derived anesthesia depth monitors are to be used in infants.
Publisher: RCN Publishing Ltd.
Date: 07-12-2022
Publisher: Cambridge University Press (CUP)
Date: 27-10-2023
DOI: 10.1017/ICE.2023.198
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.NEDT.2015.11.017
Abstract: To improve journal club participation, innovative approaches are required but few have been described. It was unknown if adding an element of competition, to an established journal club, would increase nurses' participation. To explore the impact on attendance and participation in a hospital-wide nursing journal club through the introduction of an element of competition. A descriptive exploratory study. An Australian specialist tertiary paediatric hospital with over 1600 nurses. In 2013, 12 hospital wards/departments were randomly assigned a month each to present journal club. Nurses were supported to evaluate an article according to a published framework. A predetermined rubric guided marking. Post competition, all hospital nurses received an anonymous online survey invitation. Demographic, Likert scale and qualitative data were collected. Questions elicited attitudes and perceived barriers or facilitators to participation in the journal club. Compared to 2012, there was a statistically significant increase in journal club attendance (2013 median=20.5 [IQR=18.2, 27.7] vs. 2012 median=9 [IQR=6.5, 12.5], Mann-Whitney U test, p<0.01). Full online survey responses were received from 289/1674 (response rate 17.3%) of sent invitations (Non-Attendees n=224, Attendees n=65 (including 18 presenters). Overall, Attendees reported journal club had a positive impact on their professional engagement. Presenters rated the journal club format highly as it developed skills and increased their confidence in journal club presentation. Emergent themes were time and location, engagement, topics and content. A competition format can increase nurses' journal club attendance and participation. Further work is required to establish applicability of this format to other settings.
Publisher: SAGE Publications
Date: 26-02-2022
Publisher: Springer Science and Business Media LLC
Date: 24-05-2022
DOI: 10.1186/S12904-022-00949-W
Abstract: Bispectral index (BIS) monitoring uses electroencephalographic data as an indicator of patients’ consciousness level. This technology might be a useful adjunct to clinical observation when titrating sedative medications for palliative care patients. However, the use of BIS in palliative care generally, and in the UK in particular, is under-researched. A key area is this technology’s acceptability for palliative care service users. Ahead of trialling BIS in practice, and in order to ascertain whether such a trial would be reasonable, we conducted a study to explore UK palliative care patients’ and relatives’ perceptions of the technology, including whether they thought its use in palliative care practice would be acceptable. A qualitative exploration was undertaken. Participants were recruited through a UK hospice. Focus groups and semi-structured interviews were conducted with separate groups of palliative care patients, relatives of current patients, and bereaved relatives. We explored their views on acceptability of using BIS with palliative care patients, and analysed their responses following the five key stages of the Framework method. We recruited 25 participants. There were ten current hospice patients in three focus groups, four relatives of current patients in one focus group and one in idual interview, and eleven bereaved relatives in three focus groups and two in idual interviews. Our study participants considered BIS acceptable for monitoring palliative care patients’ consciousness levels, and that it might be of use in end-of-life care, provided that it was additional to (rather than a replacement of) usual care, and patients and/or family members were involved in decisions about its use. Participants also noted that BIS, while possibly obtrusive, is not invasive, with some seeing it as equivalent to wearable technological devices such as activity watches. Participants considered BIS technology might be of benefit to palliative care as a non-intrusive means of assisting clinical assessment and decision-making at the end of life, and concluded that it would therefore be acceptable to trial the technology with patients.
Publisher: SAGE Publications
Date: 06-10-2020
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.AUCC.2017.02.001
Abstract: Pain and sedation protocols are suggested to improve the outcomes of patients within paediatric intensive care. However, it is not clear how protocols will influence practice within in idual units. Evaluate a nurse led pain and sedation protocols impact on pain scoring and analgesic and sedative administration for post-operative cardiac patients within a paediatric intensive care unit. A retrospective chart review was performed on 100 patients admitted to a tertiary paediatric intensive care unit pre and post introduction of an analgesic and sedative protocol. Stata12 was used to perform Chi-squared or Student's t-test to compare data between the groups. Post protocol introduction documentation of pain assessments increased (pre protocol 3/24h vs post protocol 5/24h, p=0.006). Along with a reduction in administration of midazolam (57.6mcg/kg/min pre protocol vs 24.5mcg/kg/min post protocol, p=0.0001). Children's pain scores remained unchanged despite this change, with a trend towards more scores in the optimal range in the post protocol group (5 pre protocol vs 12 post protocol, p=0.06). Introducing a pain and sedation protocol changed bedside nurse practice in pain and sedation management. The protocol has enabled nurses to provide pain and sedation management in a consistent and timely manner and reduced the dose of midazolam required to maintain comfort according to the patients COMFORT B scores. In idual evaluation of practice change is recommended to units who implement nurse led analgesic and sedative protocols to monitor changes in practice.
Publisher: Elsevier BV
Date: 10-2023
Publisher: SAGE Publications
Date: 08-04-2020
Abstract: Children with cancer experience pain throughout their cancer trajectory. Pain has short- and long-term negative consequences for children physically and psychologically. Children with cancer spend more time at home with their families and less time in hospital. While this has benefits for quality of life, it shifts responsibility for pain management from healthcare professionals to parents. Little is known about parents’ pain management abilities in this setting. This study aimed to understand how parents of children with cancer manage their child’s pain at home. A convergent, parallel, mixed methods design including pain diaries, surveys and interviews was used. Participants were parents of children with cancer on active treatment recruited from one tertiary cancer centre. Each data collection method was analysed separately and then integrated. Parents frequently under-medicate their child’s pain at home. Practical barriers including the analgesic context and children finding medications unpalatable led parents to prefer non-pharmacological interventions. Attitudinal and practical barriers result in parents having an “empty toolbox” of pharmacological interventions. Consequently non-pharmacological interventions are essential to parents managing their child’s cancer pain at home.
Publisher: SAGE Publications
Date: 03-2020
Publisher: Springer Science and Business Media LLC
Date: 06-10-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2012
Publisher: Elsevier BV
Date: 08-2023
Publisher: Elsevier BV
Date: 12-2023
Publisher: Wiley
Date: 25-11-2015
DOI: 10.1111/WVN.12119
Abstract: This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at ournal/10.1111/(ISSN)1741-6787.
Publisher: Wiley
Date: 10-03-2014
DOI: 10.1111/PAN.12366
Abstract: Electroencephalogram (EEG) based depth of anesthesia algorithms developed in the adult population have not demonstrated the same reliability when applied to infants. This may be due to frequency changes occurring in the EEG during development. Amplitude-integrated EEG (aEEG) is based primarily in the time domain and hence may have greater utility in infants. To investigate the relationship between age adjusted Minimal Alveolar Concentration (MAC) multiples and aEEG in children under 2 years of age. The aEEG, Spectral Edge Frequency 90% (SEF90) and Bispectral Index™ (BIS) were investigated in a prospective study of children <2 years of age. After anesthetic induction, and caudal block administration, EEG data were collected simultaneously with BrainZ BRM2™ and BIS™ monitors. Using a randomized crossover design, children received up to three age adjusted concentrations of sevoflurane: 0.75, 1 and 1.25 MAC. After 15 min of stable anesthetic delivery EEG readings were obtained. Prediction Probability (Pk ) and correlation coefficients were calculated for each EEG parameter. From 51 children 102 stable anesthetics concentrations were obtained. For all age groups Pk of aEEG to multiple of age adjusted MAC was 0.81. The aEEG is unlikely to be a useful measure of anesthesia depth in young children.
Publisher: SAGE Publications
Date: 03-2012
DOI: 10.1177/0310057X1204000210
Abstract: Processed electroencephalography is used in adults to guide anaesthesia, but the algorithms used may not apply to infants. Knowledge of infants’ electroencephalogram (EEG) responses to anaesthetics is fragmentary. An earlier pilot study suggested litude-integrated EEG (aEEG) may be a useful measure of anaesthetic effect. The aim of this study was to determine how aEEG changes between awake and anaesthetised children of varying ages and to compare the response to that seen with Spectral Edge Frequency 90% (SEF90). A prospective observational study of children receiving a general anaesthetic was conducted. Anaesthetic regimen remained at the discretion of the treating anaesthetist. EEG data were collected using the BrainZ ReBrim™ monitor using forehead and biparietal montages. SEF90 and aEEG were compared across age groups, EEG montage and between awake and anaesthetised states. A total of 178 children (aged 24 days to 14 years) were recruited. All aEEGs were greater during anaesthesia compared to when awake and this difference varied with age. Only children older than two years showed lower SEF90 while anaesthetised compared to when awake. SEF90 from children younger than six months was higher during anaesthesia compared to when awake. Analysis of parietal and forehead EEG montages revealed age-related differences. These findings suggest that SEF90 and aEEG can discriminate between awake and anaesthetised states in older children. In younger children aEEG changes are less pronounced and SEF90 either cannot discriminate between states or responds paradoxically. The aEEG may be marginally better than other EEG parameters in measuring anaesthetic depth in children.
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1016/J.ICCN.2012.01.010
Abstract: This paper aims to bring together current evidence regarding the use of depth of anaesthesia monitors (DoAM) as objective measures of sedation for paediatric intensive care (PIC) patients. Delivering appropriate dosages of sedative agents, to in idual PIC patients, is important to reduce the many risks of over- or under-sedation. Although based on adult anaesthesia, DoAMs could offer increased objectivity to the titration of sedative agents for children in PIC. This article synthesises the current available evidence from studies investigating DoAM use in the PIC environment. Literature regarding DoAM use in PIC was reviewed, from 1996 and August 2011, after EMBASE, PubMed, CINAHL and ProQuest Dissertation & Theses Database were searched using key search terms. Fourteen original research articles addressing sedation assessment using DoAMs in PIC were identified. The main findings were that DoAMs generally have a moderate or poor correlation with sedation scores and their performance varies in varying clinical settings. DoAMs do not make reliable conclusions about depth of sedation of in idual PIC children, and can be influenced by children's age. Evidence to support DoAMs in the PIC setting is currently not sufficient to advocate their routine use in clinical practice.
Publisher: SAGE Publications
Date: 22-08-2019
Abstract: The use of observational measures to assess palliative care patients’ level of consciousness may improve patient care and comfort. However, there is limited knowledge regarding the validity and reliability of these measures in palliative care settings. To identify and evaluate the psychometric performance of observational level of consciousness measures used in palliative care. Systematic review PROSPERO registration: CRD42017073080. We searched six databases until November 2018, using search terms combining subject headings and free-text terms. Psychometric performance for each identified tool was appraised independently by two reviewers following established criteria for developing and evaluating health outcome measures. We found 35 different levels of consciousness tools used in 65 studies. Only seven studies reported information about psychometric performance of just eight tools. All other studies used either ad hoc measures for which no formal validation had been undertaken ( n = 21) or established tools mainly developed and validated in non-palliative care settings ( n = 37). The Consciousness Scale for Palliative Care and a modified version of the Richmond Agitation–Sedation Scale received the highest ratings in our appraisal, but, since psychometric evidence was limited, no tool could be assessed for all psychometric properties. An increasing number of studies in palliative care are using observational measures of level of consciousness. However, only a few of these tools have been tested for their psychometric performance in that context. Future research in this area should validate and/or refine the existing measures, rather than developing new tools.
Publisher: Elsevier BV
Date: 02-2021
Publisher: SAGE Publications
Date: 27-03-2020
Abstract: Congenital heart disease (CHD) is the most common birth defect. Little is known of the impact of having a sibling with CHD. Available literature documents negative impact of having a sibling with other chronic conditions. This literature review considers empirical evidence investigating the impact of having a sibling with CHD. Twelve databases were searched, and 202 articles retrieved. Eleven articles met the inclusion criteria and were subject to data extraction, quality appraisal, and narrative synthesis. Three themes emerged: changes in normal life, impact on siblings, and factors affecting the extent of impact on siblings. Only one intervention study was identified, 5 of 10 studies were conducted over 20 years ago, and only 4 studies included children as participants. Evidence suggests siblings of children with CHD experience adverse life changes which lead to negative impacts in several domains. Evidence is inconclusive regarding mitigating factors of these impacts. Further research is needed to understand the experiences of being a sibling of a child with CHD.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: Ghana
No related grants have been discovered for Maryza Graham.