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John LeBlanc

Dalhousie University, Medicine, Faculty Member

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I'm a retired pediatrician at Dalhousie University in Halifax, NS, Canada. My interests are in social and emotional learning in students, early childhood development and global health. I no longer practice pediatrics, but I am still active in research and teaching.

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Angelo Nyamtema

Jos Van Roosmalen

CLEMENTINA ATUGONZA KAIRUKI

The University of Dodoma, Tanzania

Sheillah Matinhure

Kyoto University

Gaetano Azzimonti

Muhimbili University of Health and Allied Sciences (MUHAS)

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Papers by John LeBlanc

Improving access, quality and safety of caesarean section services in underserved rural Tanzania: The impact of knowledge translation strategies

African Journal of Reproductive Health, Jul 6, 2021

This research was designed to study different approaches to improve access to, and quality of cae... more This research was designed to study different approaches to improve access to, and quality of caesarean section services in underserved Tanzania and translate evidence into practice. In 2016, 42 associate clinicians from five health centers were trained in teams for three months in comprehensive emergency obstetric and neonatal care and anesthesia followed by post-training supportive supervision and mentorship. From 2016-2019, 2,179 caesarean sections were performed in the intervention and 969 in the control health centers. Catchment population-based caesarean section rates increased significantly in all five intervention health centers and were more than 10% in three facilities. The risk of a woman dying from complications of caesarean section in the intervention health centers was 2.3 per 1,000 caesarean sections (95% CI 0.7-5.3). This educational program was adopted by the government and can be used to meet the demand for caesarean section services in other underserved areas in Africa.

Improving access to emergency obstetric care in underserved rural Tanzania: a prospective cohort study

BMC Pregnancy and Childbirth

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...

Recommendation on instrument-based screening for depression during pregnancy and the postpartum period

Canadian Medical Association Journal

Depression during pregnancy and the postpartum period can have far-reaching impacts on the child-... more Depression during pregnancy and the postpartum period can have far-reaching impacts on the child-bearing individual and their infant, as well as on parent-infant interactions and relationships with partners. 1 Consequences for the child-bearing individual include increased likelihood of future anxiety or depression, lower quality of life, increases in risky behaviours (e.g., tobacco smoking or alcohol consumption) and suicidal ideation. 1 Impacts on the infant could include delays in physical and mental development, such as cognitive and language de velopment, and overall infant health concerns. 1 Impacts on parent-infant interactions can include reduced breastfeeding and poor parent-infant bonding. 1,2 Diagnostic criteria for major depressive disorder require patients to have at least 5 symptoms, including depressed mood or diminished interest in activities, and to be experiencing significant distress or functional impairment nearly every day for at least 2 weeks. 3 Symptoms may include significant weight or appetite change, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt, reduced concentration or indecisiveness, and thoughts of death or suicidal ideation. 3 A 2005 systematic review estimated that the point prevalence of major depression during pregnancy and postpartum ranges from 1% to 6% at different time points (from the first trimester of pregnancy to 1 year postpartum), based on 2-6 studies at any given time point (n = 111 to 2104 participants). 4 A 2008 national survey from the United States of more than 14 000 participants aged 18-50 years reported that the 12-month period prevalence of depression was 8% among pregnant individuals and 9% in postpartum individuals, compared with 8% among nonpregnant individuals. 5

Scale up and strengthening of comprehensive emergency obstetric and newborn care in Tanzania

PLOS ONE

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...

Requirements and costs for scaling up comprehensive emergency obstetric and neonatal care in health centres in Tanzania

African Journal of Reproductive Health, Jul 6, 2021

Additional file 5: of Screening for depression in women during pregnancy or the first year postpartum and in the general adult population: a protocol for two systematic reviews to update a guideline of the Canadian Task Force on Preventive Health Care

Search strategy for pregnant and postpartum women. (DOCX 18 kb)

Additional file 4: of Screening for depression in women during pregnancy or the first year postpartum and in the general adult population: a protocol for two systematic reviews to update a guideline of the Canadian Task Force on Preventive Health Care

Search strategy for general adult population. (DOCX 18 kb)

Additional file 6 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 6:. Stakeholder and peer review feedback.docx (24 KB)

Additional file 3 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 3:. Search strategies.docx (27 KB)

Additional file 4 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 4:. Draft screening forms.docx (19 KB)

Additional file 2 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 2:. PRISMA-P 2015 checklist.docx (21 KB)

Original Research Article

Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a rand... more

Impact of depressive symptoms and sleep on academic performance in adolescents

Prediction and Early Intervention Model of Low School Performance for Impoverished Children

Journal of Emotional and Behavioral Disorders, 2006

The impact of a school incident tracking system on disruptive behaviours in the elementary school children: A randomized controlled trial

PsycEXTRA Dataset

Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry

Canadian Journal of Cardiology, 2009

How to cite TSpace items Always cite the published version, so the author(s) will receive recogni... more How to cite TSpace items Always cite the published version, so the author(s) will receive recognition through services that track citation counts, e.g. Scopus. If you need to cite the page number of the author manuscript from TSpace because you cannot access the published version, then cite the TSpace version in addition to the published version using the permanent URI (handle) found on the record page. This article was made openly accessible by U of T Faculty. Please tell us how this access benefits you. Your story matters.

Cyberbullying and Suicide: A Retrospective Analysis of 22 Cases

$Research paper thumbnail of Preterm birth and the future risk of orthopedic fracture$

Preterm birth and the future risk of orthopedic fracture

Pediatric Research, 2020

Screening for depression in women during pregnancy or the first year postpartum and in the general adult population: a protocol for two systematic reviews to update a guideline of the Canadian Task Force on Preventive Health Care

Systematic Reviews, 2019

Background: In 2018, the World Health Organization reported that depression is the most common ca... more Background: In 2018, the World Health Organization reported that depression is the most common cause of disability worldwide, with over 300 million people currently living with depression. Depression affects an individual's physical health and well-being, impacts psychosocial functioning, and has specific negative short-and long-term effects on maternal health, child health, developmental trajectories, and family health. The aim of these reviews is to identify evidence on the benefits and harms of screening for depression in the general adult population and in pregnant and postpartum women.

The Epidemiology of Cyberbullying and Suicide

Paediatrics and Child Health, 2013

conclusions: National reporting rates per population for seizure were stable over the study perio... more

Improving access, quality and safety of caesarean section services in underserved rural Tanzania: The impact of knowledge translation strategies

African Journal of Reproductive Health, Jul 6, 2021

This research was designed to study different approaches to improve access to, and quality of cae... more This research was designed to study different approaches to improve access to, and quality of caesarean section services in underserved Tanzania and translate evidence into practice. In 2016, 42 associate clinicians from five health centers were trained in teams for three months in comprehensive emergency obstetric and neonatal care and anesthesia followed by post-training supportive supervision and mentorship. From 2016-2019, 2,179 caesarean sections were performed in the intervention and 969 in the control health centers. Catchment population-based caesarean section rates increased significantly in all five intervention health centers and were more than 10% in three facilities. The risk of a woman dying from complications of caesarean section in the intervention health centers was 2.3 per 1,000 caesarean sections (95% CI 0.7-5.3). This educational program was adopted by the government and can be used to meet the demand for caesarean section services in other underserved areas in Africa.

Improving access to emergency obstetric care in underserved rural Tanzania: a prospective cohort study

BMC Pregnancy and Childbirth

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...

Recommendation on instrument-based screening for depression during pregnancy and the postpartum period

Canadian Medical Association Journal

Depression during pregnancy and the postpartum period can have far-reaching impacts on the child-... more Depression during pregnancy and the postpartum period can have far-reaching impacts on the child-bearing individual and their infant, as well as on parent-infant interactions and relationships with partners. 1 Consequences for the child-bearing individual include increased likelihood of future anxiety or depression, lower quality of life, increases in risky behaviours (e.g., tobacco smoking or alcohol consumption) and suicidal ideation. 1 Impacts on the infant could include delays in physical and mental development, such as cognitive and language de velopment, and overall infant health concerns. 1 Impacts on parent-infant interactions can include reduced breastfeeding and poor parent-infant bonding. 1,2 Diagnostic criteria for major depressive disorder require patients to have at least 5 symptoms, including depressed mood or diminished interest in activities, and to be experiencing significant distress or functional impairment nearly every day for at least 2 weeks. 3 Symptoms may include significant weight or appetite change, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt, reduced concentration or indecisiveness, and thoughts of death or suicidal ideation. 3 A 2005 systematic review estimated that the point prevalence of major depression during pregnancy and postpartum ranges from 1% to 6% at different time points (from the first trimester of pregnancy to 1 year postpartum), based on 2-6 studies at any given time point (n = 111 to 2104 participants). 4 A 2008 national survey from the United States of more than 14 000 participants aged 18-50 years reported that the 12-month period prevalence of depression was 8% among pregnant individuals and 9% in postpartum individuals, compared with 8% among nonpregnant individuals. 5

Scale up and strengthening of comprehensive emergency obstetric and newborn care in Tanzania

PLOS ONE

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...

Requirements and costs for scaling up comprehensive emergency obstetric and neonatal care in health centres in Tanzania

African Journal of Reproductive Health, Jul 6, 2021

Additional file 5: of Screening for depression in women during pregnancy or the first year postpartum and in the general adult population: a protocol for two systematic reviews to update a guideline of the Canadian Task Force on Preventive Health Care

Search strategy for pregnant and postpartum women. (DOCX 18 kb)

Additional file 4: of Screening for depression in women during pregnancy or the first year postpartum and in the general adult population: a protocol for two systematic reviews to update a guideline of the Canadian Task Force on Preventive Health Care

Search strategy for general adult population. (DOCX 18 kb)

Additional file 6 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 6:. Stakeholder and peer review feedback.docx (24 KB)

Additional file 3 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 3:. Search strategies.docx (27 KB)

Additional file 4 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 4:. Draft screening forms.docx (19 KB)

Additional file 2 of Screening for depression in children and adolescents: a protocol for a systematic review update

Additional file 2:. PRISMA-P 2015 checklist.docx (21 KB)

Original Research Article

Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a rand... more

Impact of depressive symptoms and sleep on academic performance in adolescents

Prediction and Early Intervention Model of Low School Performance for Impoverished Children

Journal of Emotional and Behavioral Disorders, 2006

The impact of a school incident tracking system on disruptive behaviours in the elementary school children: A randomized controlled trial

PsycEXTRA Dataset

Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry

Canadian Journal of Cardiology, 2009

How to cite TSpace items Always cite the published version, so the author(s) will receive recogni... more How to cite TSpace items Always cite the published version, so the author(s) will receive recognition through services that track citation counts, e.g. Scopus. If you need to cite the page number of the author manuscript from TSpace because you cannot access the published version, then cite the TSpace version in addition to the published version using the permanent URI (handle) found on the record page. This article was made openly accessible by U of T Faculty. Please tell us how this access benefits you. Your story matters.

Cyberbullying and Suicide: A Retrospective Analysis of 22 Cases

$Research paper thumbnail of Preterm birth and the future risk of orthopedic fracture$

Preterm birth and the future risk of orthopedic fracture

Pediatric Research, 2020

Screening for depression in women during pregnancy or the first year postpartum and in the general adult population: a protocol for two systematic reviews to update a guideline of the Canadian Task Force on Preventive Health Care

Systematic Reviews, 2019

Background: In 2018, the World Health Organization reported that depression is the most common ca... more Background: In 2018, the World Health Organization reported that depression is the most common cause of disability worldwide, with over 300 million people currently living with depression. Depression affects an individual's physical health and well-being, impacts psychosocial functioning, and has specific negative short-and long-term effects on maternal health, child health, developmental trajectories, and family health. The aim of these reviews is to identify evidence on the benefits and harms of screening for depression in the general adult population and in pregnant and postpartum women.

The Epidemiology of Cyberbullying and Suicide

Paediatrics and Child Health, 2013

conclusions: National reporting rates per population for seizure were stable over the study perio... more

Social Emotional Learning SEL programs for children and youth, an evidence based guide

by John LeBlanc, Nirupa Varasarathan, and Tanya Bilsbury

Dalhousie University Faculty of Medicine, 2013

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.

Bullying Prevention Programs for Children Youth an evidence based guide

Dalhousie University Faculty of Medicine, 2016

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.