Publications by authors named "Emma Bryce"
Introduction: A significant burden of unmet pediatric surgical disease exists in low- and middle-income countries. We sought to assess the associations between the installation of a pediatric operating room (OR) and clinical and economic outcomes for families with children in Ethiopia.
Methods: A retrospective cohort study was performed of children who underwent elective surgery in a tertiary-level Ethiopian public hospital, comparing patient outcomes before and after OR installation in August 2019.
Article Synopsis
- The study aimed to create and validate a mortality risk prediction algorithm for pediatric surgery patients in 14 low- and middle-income countries using data from KidsOR sites.
- Using a SuperLearner machine learning model, the algorithm successfully analyzed data from over 21,000 patients, achieving a post-operative mortality rate of 3.1% and demonstrating excellent predictive accuracy with a cross-validated AUC of 0.945.
- The findings suggest that while the algorithm performs well across different sites, it may require re-calibration when used in new locations, potentially benefiting clinical practices and resource management in pediatric surgical care globally.
Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa.
PLOS Glob Public Health
March 2024
The unmet need for pediatric surgery imposes enormous health and economic consequences globally, predominantly shouldered by Sub-Saharan Africa (SSA) where children comprise almost half of the population. Lack of knowledge about the economic impact of improving pediatric surgical infrastructure in SSA inhibits the informed allocation of limited resources towards the most cost-effective interventions to bolster global surgery for children. We assessed the cost-effectiveness of installing and running two dedicated pediatric operating rooms (ORs) in a hospital in Nigeria with a pre-existing pediatric surgical service by constructing a decision tree model of pediatric surgical delivery at this facility over a year, comparing scenarios before and after the installation of the ORs, which were funded philanthropically.
View Article and Find Full Text PDFMany organisms live in fragmented populations, which has profound consequences on the dynamics of associated parasites. Metapopulation theory offers a canonical framework for predicting the effects of fragmentation on spatiotemporal host–parasite dynamics. However, empirical studies of parasites in classical metapopulations remain rare, particularly for vector-borne parasites.
View Article and Find Full Text PDFBackground: Out-of-pocket healthcare costs leading to catastrophic healthcare expenditure pose a financial threat for families of children undergoing surgery in Sub-Saharan African countries, where universal healthcare coverage is often insufficient.
Methods: A prospective clinical and socioeconomic data collection tool was used in African hospitals with dedicated pediatric operating rooms installed philanthropically. Clinical data were collected via chart review and socioeconomic data from families.
Article Synopsis
- The study examines the impact of the COVID-19 pandemic on surgical volumes for pediatric patients in low- and middle-income countries (LMICs), highlighting a significant reduction in surgeries.
- A survey, conducted among pediatric surgeons in sub-Saharan Africa and Ecuador, revealed that public hospitals had longer wait times, with a median waitlist of 90 patients and an average wait of 2 months for elective surgeries.
- The findings indicate that long surgical wait times persist in LMICs, adversely affecting surgical access, and underline the need for resource scaling and monitoring strategies to address these delays, especially in the wake of COVID-19.
Successful health systems comprise good outcomes, accessibility and availability. Surgery is the service that cuts across many treatment scenarios, yet in low- and middle-income countries 90% of people cannot access it. Estimates using most recent population data suggest that 1.
View Article and Find Full Text PDFBackground: There is a large unmet children's surgical need in low- and middle-income countries (LMICs). This study examines the impact of installing dedicated pediatric operating rooms (ORs) on surgical volume at National Hospital Abuja, a hospital in Abuja, Nigeria.
Methods: A Non-Governmental Organization installed two pediatric ORs in August 2019.
Background: The impact of the COVID-19 pandemic on surgical care delivery in low- and middle-income countries (LMIC) has been challenging to assess due to a lack of data. This study examines the impact of COVID-19 on pediatric surgical volumes at four LMIC hospitals.
Methods: Retrospective and prospective pediatric surgical data collected at hospitals in Burkina Faso, Ecuador, Nigeria, and Zambia were reviewed from January 2019 to April 2021.
A prototype of a scalable and potentially low-cost stacked array piezoelectric deformable mirror (SA-PDM) with 35 active elements is presented in this paper. This prototype is characterized by a 2 μm maximum actuator stroke, a 1.4 μm mirror sag (measured for a 14 mm × 14 mm area of the unpowered SA-PDM), and a ±200 nm hysteresis error.
View Article and Find Full Text PDFAims: To determine the prevalence of potentially inappropriate medications (PIMs) in older people aged 65 years and over who were admitted to hospital, and to examine the medications and medication classes that comprised these PIMs with use of the Screening Tool of Older Person's Prescriptions.
Method: Using a retrospective clinical audit design, the medical records of 100 older patients were randomly selected and examined for the prevalence and characteristics of PIMs. The audit was undertaken of patients admitted over a 12-month period to an Australian public teaching hospital.