I'm a pediatrician and epidemiologist at Dalhousie University in Halifax, NS, Canada. My interests are in social and emotional learning in students, early childhood development and global health.
Background One of the key strategies to reducing maternal mortality is provision of emergency obs... more Background One of the key strategies to reducing maternal mortality is provision of emergency obstetric care services. This paper describes the results of improving availability of, and access to emergency obstetric care services in underserved rural Tanzania using associate clinicians. Methods A prospective cohort study of emergency obstetric care was implemented in seven health centres in Morogoro region, Tanzania from July 2016 to June 2019. In early 2016, forty-two associate clinicians from five health centres were trained in teams for three months in emergency obstetric care, newborn care and anaesthesia. Two health centres were unexposed to the intervention and served as controls. Following training, virtual teleconsultation, quarterly on-site supportive supervision and continuous mentorship were implemented to reinforce skills and knowledge. Results The met need for emergency obstetric care increased significantly from 45% (459/1025) at baseline (July 2014 – June 2016) to 119...
Introduction In Tanzania, inadequate access to comprehensive emergency obstetric and newborn care... more Introduction In Tanzania, inadequate access to comprehensive emergency obstetric and newborn care (CEmONC) services is the major bottleneck for perinatal care and results in high maternal and perinatal mortality. From 2015 to 2019, the Accessing Safe Deliveries in Tanzania project was implemented to study how to improve access to CEmONC services in underserved rural areas. Methods A five-year longitudinal cohort study was implemented in seven health centres (HCs) and 21 satellite dispensaries in Morogoro region. Five of the health centres received CEmONC interventions and two served as controls. Forty-two associate clinicians from the intervention HCs were trained in teams for three months in CEmONC and anaesthesia. Managers of 20 intervention facilities, members of the district and regional health management teams were trained in leadership and management. Regular supportive supervision was conducted. Results Interventions resulted in improved responsibility and accountability amon...
Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a rand... more Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a randomized controlled trial
Background One of the key strategies to reducing maternal mortality is provision of emergency obs... more Background One of the key strategies to reducing maternal mortality is provision of emergency obstetric care services. This paper describes the results of improving availability of, and access to emergency obstetric care services in underserved rural Tanzania using associate clinicians. Methods A prospective cohort study of emergency obstetric care was implemented in seven health centres in Morogoro region, Tanzania from July 2016 to June 2019. In early 2016, forty-two associate clinicians from five health centres were trained in teams for three months in emergency obstetric care, newborn care and anaesthesia. Two health centres were unexposed to the intervention and served as controls. Following training, virtual teleconsultation, quarterly on-site supportive supervision and continuous mentorship were implemented to reinforce skills and knowledge. Results The met need for emergency obstetric care increased significantly from 45% (459/1025) at baseline (July 2014 – June 2016) to 119...
Introduction In Tanzania, inadequate access to comprehensive emergency obstetric and newborn care... more Introduction In Tanzania, inadequate access to comprehensive emergency obstetric and newborn care (CEmONC) services is the major bottleneck for perinatal care and results in high maternal and perinatal mortality. From 2015 to 2019, the Accessing Safe Deliveries in Tanzania project was implemented to study how to improve access to CEmONC services in underserved rural areas. Methods A five-year longitudinal cohort study was implemented in seven health centres (HCs) and 21 satellite dispensaries in Morogoro region. Five of the health centres received CEmONC interventions and two served as controls. Forty-two associate clinicians from the intervention HCs were trained in teams for three months in CEmONC and anaesthesia. Managers of 20 intervention facilities, members of the district and regional health management teams were trained in leadership and management. Regular supportive supervision was conducted. Results Interventions resulted in improved responsibility and accountability amon...
Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a rand... more Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a randomized controlled trial
We selected and extensively reviewed 11 SEL programs used in Nova Scotia schools. We used the GRA... more We selected and extensively reviewed 11 SEL programs used in Nova Scotia schools. We used the GRADE approach with two modifications: 1) we gave quasi-experimental designs an intermediate weight between randomized controlled trials and cohort studies, we did not report effect sizes since they were not available for many studies. After review, programs were given a strong or provisional recommendation in favour of use or against use. Five programs were recommended: Promoting Alternative Thinking Strategies (PATHS), Second Step, Caring School Communities (CSC), Roots of Empathy and The Fourth R. Notable programs that had insufficient evidence included Drug Abuse Resistance Education (DARE), Lion's Quest and Options to Anger.
We reviewed bullying prevention programs used in some Nova Scotia schools as well as others ident... more We reviewed bullying prevention programs used in some Nova Scotia schools as well as others identified in a search of scientific literature. Reviewed programs had at least one controlled study published in a peer-reviewed scientific journal, were focussed on reducing bullying or aggression, and were ‘universal’ in scope, with at least some program features addressing schools and organizations as a whole. We evaluated the evidence for program effects objectively and transparently using a rigorous structured approach called GRADE. GRADE allows only four recommendations for program implementation: 1) Strong recommendation for a program; 2) Weak (also called Provisional) recommendation for a program; 3) Weak recommendation against a program; 4) Strong recommendation against a program. Only one of the reviewed programs received a recommendation (weak) for implementation: the WITS program. WITS delivered relatively strong effects at low cost and showed long-term benefits. It also has components that promote healthy relationships. All other programs received weak recommendations against implementation, largely because they were resource-intensive yet delivered little or no reduction in bullying or victimization, or were not feasible in a North American environment.
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Only one of the reviewed programs received a recommendation (weak) for implementation: the WITS program. WITS delivered relatively strong effects at low cost and showed long-term benefits. It also has components that promote healthy relationships. All other programs received weak recommendations against implementation, largely because they were resource-intensive yet delivered little or no reduction in bullying or victimization, or were not feasible in a North American environment.