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Article ; Online: Project design and technology trade-offs for implementing a large-scale sexual and reproductive health mHealth intervention: Lessons from Sierra Leone.

Chukwu, Emeka / Gilroy, Sonia / Dickson, Kim Eva

Frontiers in digital health

2023 Volume 5, Page(s) 1060376

Abstract: Background: The Coronavirus 2019 (COVID-19) pandemic threatened decades of progress in sexual and reproductive health (SRH) and gender-based violence as attendance at health facilities plummeted and service uptake dwindled. Similarly, misinformation ... ...

Abstract	Background: The Coronavirus 2019 (COVID-19) pandemic threatened decades of progress in sexual and reproductive health (SRH) and gender-based violence as attendance at health facilities plummeted and service uptake dwindled. Similarly, misinformation regarding COVID-19 was rife. The demographics in Sierra Leone are diverse in the education, economic, and rural/urban divide. Telecommunications coverage, phone ownership, and preference for information access medium also vary greatly in Sierra Leone. Aim: The aim of the intervention was to reach Sierra Leoneans at scale with information about SRH during the early stages of the COVID-19 pandemic. This paper presents the approach and insights from designing and implementing a large-scale mobile health (mHealth) messaging campaign. Method: Between April and July 2020, a cross-sectional multichannel SRH messaging campaign was designed and launched in Sierra Leone. Through a secondary analysis of project implementation documents and process evaluation of the messaging campaign report, the project design trade-offs and contextual factors for success were identified and documented. Result: A total of 1.16 million recorded calls were initiated and 35.46 million text messages (short message service, SMS) were sent to telecommunication subscribers through a two-phased campaign. In phase one, only 31% of the 1,093,606 automated calls to 290,000 subscribers were picked up, dropping significantly at 95% confidence level ( Discussion and conclusion: The design and implementation of a large-scale messaging campaign is a complex endeavor that requires research, collaboration with other diverse stakeholders, and careful planning. Key success ingredients are the number of messages to be delivered, the format, cost considerations, and whether engagement is necessary. Lessons for similar low-and-middle-income countries are discussed.
Language	English
Publishing date	2023-03-13
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-253X
ISSN (online)	2673-253X
DOI	10.3389/fdgth.2023.1060376
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Article ; Online: Water Supply Risk in the United States 2015-2050 Considering Projected Changes in Population and Thermoelectric Power Demand.

Dickson, Kerim E / Dzombak, David A

Environmental science & technology

2019 Volume 53, Issue 24, Page(s) 14113–14122

Abstract: Examination of water supply risk is important to identify areas of potential insecurity and prioritize allocation of resources. This work builds on and advances a previous U.S. water supply risk analysis developed at county-scale resolution, which did ... ...

Abstract	Examination of water supply risk is important to identify areas of potential insecurity and prioritize allocation of resources. This work builds on and advances a previous U.S. water supply risk analysis developed at county-scale resolution, which did not account for water flow between counties and identified some counties on major rivers as being at high risk. This limitation is addressed in the present study. The analysis utilized data from U.S. Geological Survey water use reports to assess current water supply risk and also projected water supply risk in 2050. Flow volumes were calculated using the Water Supply Sustainability Index (WaSSI) tool developed by the USDA Forest Service, enabling the analysis to account for changes in climate and hydrology and changes in water demand. A modified Water Risk Index (WRI) was formulated, including five factors to which scaled values were assigned. Results indicate that accounting for natural transfers of water in counties in addition to local precipitation reduced the risk profile of many counties, with a maximum of 36 classified as high or very high risk, compared to over 400 identified in the highest risk category in the previous analysis.
MeSH term(s)	Climate Change ; Forecasting ; Hydrology ; Rivers ; United States ; Water Supply
Language	English
Publishing date	2019-12-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1520-5851
ISSN (online)	1520-5851
DOI	10.1021/acs.est.9b02435
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Article ; Online: Interbasin water transfers in the United States and Canada.

Siddik, Md Abu Bakar / Dickson, Kerim E / Rising, James / Ruddell, Benjamin L / Marston, Landon T

Scientific data

2023 Volume 10, Issue 1, Page(s) 27

Abstract: Interbasin water transfers (IBTs) can have a significant impact on the environment, water availability, and economies within the basins importing and exporting water, as well as basins downstream of these water transfers. The lack of comprehensive data ... ...

Abstract	Interbasin water transfers (IBTs) can have a significant impact on the environment, water availability, and economies within the basins importing and exporting water, as well as basins downstream of these water transfers. The lack of comprehensive data identifying and describing IBTs inhibits understanding of the role IBTs play in supplying water for society, as well as their collective hydrologic impact. We develop three connected datasets inventorying IBTs in the United States and Canada, including their features, geospatial details, and water transfer volumes. We surveyed the academic and gray literature, as well as local, state, and federal water agencies, to collect, process, and verify IBTs in Canada and the United States. Our comprehensive IBT datasets represent all known transfers of untreated water that cross subregion (US) or subdrainage area (CA) boundaries, characterizing a total of 641 IBT projects. The infrastructure-level data made available by these data products can be used to close water budgets, connect water supplies to water use, and better represent human impacts within hydrologic and ecosystem models.
Language	English
Publishing date	2023-01-13
Publishing country	England
Document type	Dataset ; Journal Article
ZDB-ID	2775191-0
ISSN	2052-4463 ; 2052-4463
ISSN (online)	2052-4463
ISSN	2052-4463
DOI	10.1038/s41597-023-01935-4
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Article ; Online: Cannabis constituents reduce seizure behavior in chemically-induced and scn1a-mutant zebrafish.

Thornton, Cammi / Dickson, Kennedy E / Carty, Dennis R / Ashpole, Nicole M / Willett, Kristine L

Epilepsy & behavior : E&B

2020 Volume 110, Page(s) 107152

Abstract: Current antiepileptic drugs (AEDs) are undesirable for many reasons including the inability to reduce seizures in certain types of epilepsy, such as Dravet syndrome (DS) where in one-third of patients does not respond to current AEDs, and severe adverse ... ...

Abstract	Current antiepileptic drugs (AEDs) are undesirable for many reasons including the inability to reduce seizures in certain types of epilepsy, such as Dravet syndrome (DS) where in one-third of patients does not respond to current AEDs, and severe adverse effects that are frequently experienced by patients. Epidiolex, a cannabidiol (CBD)-based drug, was recently approved for treatment of DS. While Epidiolex shows great promise in reducing seizures in patients with DS, it is used in conjunction with other AEDs and can cause liver toxicity. To investigate whether other cannabis-derived compounds could also reduce seizures, the antiepileptic effects of CBD, Δ9-tetrahydrocannabinol (THC), cannabidivarin (CBDV), cannabinol (CBN), and linalool (LN) were compared in both a chemically-induced (pentylenetetrazole, PTZ) and a DS (scn1Lab
MeSH term(s)	Acyclic Monoterpenes/therapeutic use ; Animals ; Animals, Genetically Modified ; Anticonvulsants/therapeutic use ; Cannabidiol/therapeutic use ; Cannabinoids/therapeutic use ; Cannabinol/therapeutic use ; Cannabis ; Dose-Response Relationship, Drug ; Dronabinol/therapeutic use ; NAV1.1 Voltage-Gated Sodium Channel/genetics ; Pentylenetetrazole/toxicity ; Seizures/chemically induced ; Seizures/drug therapy ; Seizures/genetics ; Zebrafish ; Zebrafish Proteins/genetics
Chemical Substances	Acyclic Monoterpenes ; Anticonvulsants ; Cannabinoids ; NAV1.1 Voltage-Gated Sodium Channel ; Zebrafish Proteins ; scn1laa protein, zebrafish ; Cannabidiol (19GBJ60SN5) ; Dronabinol (7J8897W37S) ; Cannabinol (7UYP6MC9GH) ; linalool (D81QY6I88E) ; cannabidivarin (I198VBV98I) ; Pentylenetetrazole (WM5Z385K7T)
Language	English
Publishing date	2020-06-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2020.107152
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Article ; Online: Formative Study of Mobile Phone Use for Family Planning Among Young People in Sierra Leone: Global Systematic Survey.

Chukwu, Emeka / Gilroy, Sonia / Addaquay, Kojo / Jones, Nki Nafisa / Karimu, Victor Gbadia / Garg, Lalit / Dickson, Kim Eva

JMIR formative research

2021 Volume 5, Issue 11, Page(s) e23874

Abstract: Background: Teenage pregnancy remains high with low contraceptive prevalence among adolescents (aged 15-19 years) in Sierra Leone. Stakeholders leverage multiple strategies to address the challenge. Mobile technology is pervasive and presents an ... ...

Abstract	Background: Teenage pregnancy remains high with low contraceptive prevalence among adolescents (aged 15-19 years) in Sierra Leone. Stakeholders leverage multiple strategies to address the challenge. Mobile technology is pervasive and presents an opportunity to reach young people with critical sexual reproductive health and family planning messages. Objective: The objectives of this research study are to understand how mobile health (mHealth) is used for family planning, understand phone use habits among young people in Sierra Leone, and recommend strategies for mobile-enabled dissemination of family planning information at scale. Methods: This formative research study was conducted using a systematic literature review and focus group discussions (FGDs). The literature survey assessed similar but existing interventions through a systematic search of 6 scholarly databases. Cross-sections of young people of both sexes and their support groups were engaged in 9 FGDs in an urban and a rural district in Sierra Leone. The FGD data were qualitatively analyzed using MAXQDA software (VERBI Software GmbH) to determine appropriate technology channels, content, and format for different user segments. Results: Our systematic search results were categorized using Grading of Recommended Assessment and Evaluation (GRADE) into communication channels, audiovisual messaging format, purpose of the intervention, and message direction. The majority of reviewed articles report on SMS-based interventions. At the same time, most intervention purposes are for awareness and as helpful resources. Our survey did not find documented use of custom mHealth apps for family planning information dissemination. From the FGDs, more young people in Sierra Leone own basic mobile phones than those that have feature capablilities or are smartphone. Young people with smartphones use them mostly for WhatsApp and Facebook. Young people widely subscribe to the social media-only internet bundle, with the cost ranging from 1000 leones (US $0.11) to 1500 leones (US $0.16) daily. Pupils in both districts top-up their voice call and SMS credit every day between 1000 leones (US $0.11) and 5000 leones (US $0.52). Conclusions: mHealth has facilitated family planning information dissemination for demand creation around the world. Despite the widespread use of social and new media, SMS is the scalable channel to reach literate and semiliterate young people. We have cataloged mHealth for contraceptive research to show SMS followed by call center as widely used channels. Jingles are popular for audiovisual message formats, mostly delivered as either push or pull only message directions (not both). Interactive voice response and automated calls are best suited to reach nonliterate young people at scale.
Language	English
Publishing date	2021-11-12
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/23874
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Article ; Online: Reducing neonatal mortality in resource poor settings.

Dickson, Kim Eva / Chopra, Mickey

BMJ (Clinical research ed.)

2012 Volume 344, Page(s) e2197

MeSH term(s)	Child Health Services/methods ; Female ; Humans ; Infant Mortality ; Patient Acceptance of Health Care ; Perinatal Mortality ; Pregnancy
Language	English
Publishing date	2012-03-21
Publishing country	England
Document type	Comment ; Editorial
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.e2197
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Article ; Online: Contraception determinants in youths of Sierra Leone are largely behavioral.

Labat, Aline / Medina, Marta / Elhassein, Mohammed / Karim, Afrina / Jalloh, Mohammad B / Dramaix, Michèle / Zhang, Wei-Hong / Alexander, Sophie / Dickson, Kim E

Reproductive health

2018 Volume 15, Issue 1, Page(s) 66

Abstract: Background: Sexual initiation occurs early in Sierra Leone. This study aims to analyze the determinants of condom and/or contraceptive use among a representative sample of young persons (10 to 24 years) in Sierra Leone.: Methods: This is a secondary ... ...

Abstract	Background: Sexual initiation occurs early in Sierra Leone. This study aims to analyze the determinants of condom and/or contraceptive use among a representative sample of young persons (10 to 24 years) in Sierra Leone. Methods: This is a secondary analysis of data from a study conducted to monitor the implementation of a UNFPA package of interventions directed to improve SRH in young people of Sierra Leone. This assessment was conducted in 2016 at the end of the Ebola outbreak. In consequence, determinants linked to healthy lifestyle behaviors and UNFPA interventions were explored in addition to the usual determinants: socio demographic and sexual lifestyle. This study is a household quantitative survey with open ended questions used to illustrate and complete the analysis. Results: A total of 1409 young people were interviewed: of these, 216 boys and 381 girls were sexually active. Those who were pregnant or wished for pregnancy were excluded, leaving 194 boys and 268 girls for the analysis of determinants. The proportion of young people using neither condom nor other contraception at their last sexual intercourse in the whole sample was 40.5% and there was no statistically significant difference between boys and girls (42.3 vs 39.2; P = 0.504). Determinants were assessed and, after multivariable analysis, results differed between boys and girls and showed the importance of behavioral aspects. Four determinants were common to boys and girls: literacy, distance, negotiation capacity and hand washing. However, the distance factor for girls was to the health facility and for boys it was to school. Three more determinants remained in the boy's model: sleeping under a bednet, number of sexual partners and knowledge of contraceptive methods. Opinions about condoms and contraception revealed important barriers; opposition to contraceptive use was the main reason for non-use for both boys and girls, while lack of access was an important reason for boys. Conclusion: There is a need to reach out to the 40% of young people who are sexually active and neither pregnant nor with pregnancy desire, and are not using condom or contraception.
MeSH term(s)	Adolescent ; Adult ; Child ; Condoms/utilization ; Contraception/psychology ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Life Style ; Male ; Pregnancy ; Sexual Behavior/psychology ; Young Adult
Language	English
Publishing date	2018-04-19
Publishing country	England
Document type	Journal Article
ISSN	1742-4755
ISSN (online)	1742-4755
DOI	10.1186/s12978-018-0504-9
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Article ; Online: Preparing to introduce new maternal immunizations in low- and lower-middle-income countries: A report from the Bill & Melinda Gates Foundation convening "Allies in Maternal and Newborn Care"; May 3-4, 2018.

Sobanjo-Ter Meulen, Ajoke / Liljestrand, Jerker / Lawn, Joy E / Hombach, Joachim / Smith, Jeffrey / Dickson, Kim E / Munoz, Flor M / Omer, Saad B / Williams, B Adam / Klugman, Keith P

Vaccine

2020 Volume 38, Issue 28, Page(s) 4355–4361

Abstract: New strategies will be critical to reduce infant mortality and severe morbidity - there are still 5.2 million newborn deaths and stillbirths each year. The decline in newborn mortality has not kept pace with the reduction in under-five deaths and is ... ...

Abstract	New strategies will be critical to reduce infant mortality and severe morbidity - there are still 5.2 million newborn deaths and stillbirths each year. The decline in newborn mortality has not kept pace with the reduction in under-five deaths and is slowest in low- and lower-middle-income countries (LMICs). Maternal immunization is a promising intervention to protect infants when they are most vulnerable - in utero and their first few months of life, before they can receive their own vaccines. Successfully introducing new vaccines for pregnant women in LMICs will require collaboration between two fields - (1) immunization and (2) maternal, newborn and child health - that use different service delivery approaches, operate under different policy and funding paradigms, and are not always integrated. In May 2018, stakeholders from these distinct communities convened to identify challenges and opportunities associated with delivering new maternal immunizations. Participants agreed that antenatal care is a logical platform. However, in many resource-constrained settings, antenatal care providers are already overburdened, and most women do not receive the recommended number of antenatal visits. Implementing maternal immunization could help increase antenatal care attendance by offering an additional safe and effective intervention that women value. Substantial effort is needed to demonstrate the benefits of maternal immunization to decision-makers and providers, and to ensure that countries and health systems are ready for introduction. To that end, participants identified the following priorities: assure coherence of policies for introducing new vaccines for pregnant women and strengthen maternal health interventions; generate demand for existing, recommended, and new maternal vaccines; conduct socio-behavioral, health systems and implementation research to shape optimal vaccine delivery strategies; and strengthen antenatal and perinatal care quality. To achieve these aims, collaboration across fields will be essential. Given that new maternal vaccines are advancing in clinical development, time is of the essence.
MeSH term(s)	Child ; Developing Countries ; Female ; Humans ; Immunization ; Infant ; Infant, Newborn ; Pregnancy ; Prenatal Care ; Vaccination ; Vaccines
Chemical Substances	Vaccines
Language	English
Publishing date	2020-05-14
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2020.04.075
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Zs.A 1930: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Institutionalising maternal and newborn quality-of-care standards in Bangladesh, Ghana and Tanzania: a quasi-experimental study.

BMJ global health

2022 Volume 7, Issue 9

Abstract: Introduction: Facility interventions to improve quality of care around childbirth are known but need to be packaged, tested and institutionalised within health systems to impact on maternal and newborn outcomes.: Methods: We conducted cross-sectional ...

Abstract	Introduction: Facility interventions to improve quality of care around childbirth are known but need to be packaged, tested and institutionalised within health systems to impact on maternal and newborn outcomes. Methods: We conducted cross-sectional assessments at baseline (2016) and after 18 months of provider-led implementation of UNICEF/WHO's Every Mother Every Newborn Quality Improvement (EMEN-QI) standards (preceding the WHO Standards for improving quality of maternal and newborn care in health facilities). 19 hospitals and health centres (2.8M catchment population) in Bangladesh, Ghana and Tanzania were involved and 24 from adjoining districts served for 'comparison'. We interviewed 43 facility managers and 818 providers, observed 1516 client-provider interactions, reviewed 12 020 records and exit-interviewed 1826 newly delivered women. We computed a 39-criteria institutionalisation score combining clinical, patient rights and cross-cutting domains from EMEN-QI and used routine/District Health Information System V.2 data to assess the impact on perinatal and maternal mortality. Results: EMEN-QI standards institutionalisation score increased from 61% to 80% during EMEN-QI implementation, exceeding 75% target. All mortality indicators showed a downward trajectory though not all reached statistical significance. Newborn case-fatality rate fell significantly by 25% in Bangladesh (RR=0·75 (95% CI=0·59 to 0·96), p=0·017) and 85% in Tanzania (RR=0.15 (95% CI=0.08 to 0.29), p<0.001), but not in Ghana. Similarly, stillbirth (RR=0.64 (95% CI=0.45 to 0.92), p<0.01) and perinatal mortality in Tanzania reduced significantly (RR=0.59 (95% CI=0.40 to 0.87), p=0.007). Institutional maternal mortality ratios generally reduced but were only significant in Ghana: 362/100 000 to 207/100 000 livebirths (RR=0.57 (95% CI=0.33 to 0.99), p=0.046). Routine mortality data from comparison facilities were limited and scarce. Systematic death audits and clinical mentorship drove these achievements but challenges still remain around human resource management and equipment maintenance systems. Conclusion: Institutionalisation of the UNICEF/WHO EMEN-QI standards as a package is feasible within existing health systems and may reduce mortality around childbirth. Critical gaps around sustainability must be fundamental considerations for scale-up.
MeSH term(s)	Bangladesh/epidemiology ; Cross-Sectional Studies ; Female ; Ghana ; Humans ; Infant, Newborn ; Pregnancy ; Standard of Care ; Tanzania
Language	English
Publishing date	2022-09-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2022-009471
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Article: Understanding and treating women with schizophrenia during pregnancy and postpartum--Motherisk Update 2008.

Solari, Hugo / Dickson, Katharine E / Miller, Laura

The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique

2009 Volume 16, Issue 1, Page(s) e23–32

Abstract: This article provides a synopsis of clinically relevant data pertaining to sexuality, pregnancy, the postpartum period, parenting and family planning in women with schizophrenia. Based on this information, we propose recommendations for the non- ... ...

Abstract	This article provides a synopsis of clinically relevant data pertaining to sexuality, pregnancy, the postpartum period, parenting and family planning in women with schizophrenia. Based on this information, we propose recommendations for the non-pharmacological management of these patients. Along with the deinstitutionalization of people with severe and persistent mental illness, there has been a concurrent increase in relative fertility in women with schizophrenia.Understanding the nature and experience of sexuality in women with schizophrenia helps elucidate the context in which pregnancies occur.Schizophrenia does not diminish sexual desire or activity. However, the quality and relational context of sexuality may be markedly different.Pregnancy appears to worsen mental health in a subset of women with schizophrenia. Psychotic denial of pregnancy is a symptom that poses especially high risks for poor outcomes if not addressed. Psychoeducation can reduce the risks of pregnancy complications for women with schizophrenia. Short-term, focused psychotherapy can be useful for some pregnant women with schizophrenia. Some modifications need to be made in the inpatient treatment of pregnant patients with schizophrenia. In the postpartum period, women can be especially susceptible for acute exacerbation of their schizophrenia. With regards to parenting, many women will provide intermittent parenting for their children while others will lose custody of their children. Those mothers with schizophrenia who do raise their children may face unique challenges in parenting.Both positive and negative symptoms can interfere with the demands of being a parent.A comprehensive parenting assessment of the patient can provide guidance for the implementation of supportive services. Proactive family planning could reduce the high rate of unwanted pregnancies, as women with schizophrenia tend to have more limited knowledge of their contraceptive options.
MeSH term(s)	Family Planning Services ; Female ; Humans ; Parenting/psychology ; Patient Education as Topic ; Postpartum Period/psychology ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/epidemiology ; Pregnancy Complications/therapy ; Psychotherapy ; Schizophrenia/diagnosis ; Schizophrenia/epidemiology ; Schizophrenia/therapy ; Schizophrenic Psychology ; Social Support ; United States/epidemiology
Language	English
Publishing date	2009
Publishing country	Canada
Document type	Journal Article ; Review
ZDB-ID	1397692-8
ISSN	1198-581X
ISSN	1198-581X
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