Between 2007 and 2013 in the United States, the adoption of the 39-week rule caused a progressive reduction in the proportion of term births occurring before the 39th week of gestation. During the same interval the United States experienced a significant increase in its rate of term stillbirth. This study raises the possibility that the 39-week rule may be causing unintended harm. Additional studies of the actual impact of the adoption of the 39-week rule on major childbirth outcomes are urgently needed. Pressures to enforce the 39-week rule should be reconsidered pending the findings of such studies.
Cell-free DNA testing is a recently introduced method for screening pregnant women for fetal trisomy, which is associated with some common significant genetic diseases, as well as the sex of the fetus. The case described here demonstrates the connection between the ultrasound "vanishing twin" phenomenon and the misdiagnosis of prenatal sex using cell-free DNA testing. (
Women play a significant role in Pennsylvania production agriculture, thereby exposing themselves to occupational health risks. The goal of this cross-sectional study was to assess the incidence of health conditions with a possible zoonotic origin in this underserved population. A written survey was sent to a stratified, random sample of dairy farms in Pennsylvania (n = 3709) using a modified version of the Dillman method. In addition to demographic data, the survey was used to collect information on the occurrence of zoonotic diseases, gastrointestinal illnesses, respiratory problems, dermatoses, and women's reproductive health issues. Of the 624 respondents, 10.4% (n = 65) reported that they had contracted a disease from an animal. Interestingly, only 9 respondents indicated that they had suffered from foodborne illnesses in the past year including salmonellosis (n = 1), campylobacteriosis (n = 1), and gastroenteritis due to Escherichia coli (n = 1). A risk factor associated with difficulty breathing was the lack of use of a breathing mask, whereas ventilation in the free stall area appeared to offer a protective effect. Difficulty breathing was reported by 9.8% (n = 61) of the respondents. Risk factors associated with skin disorders included raising fruits and/or vegetables, raising swine, and not wearing gloves when milking. The findings of the study suggest that many of the illnesses and conditions could have been acquired by working with dairy animals and their environment. Based on the findings of this study, additional investigations on the causes and prevention of these illnesses are warranted.
The goal of this study was to determine what tasks women perform, behaviors that could result in exposure to zoonotic disease, and preventative measures practiced by women on dairy farms. A written survey was sent to a stratified, random sample of dairy farms in Pennsylvania (n = 3709) using a modified version of the Dillman method. The tasks most commonly performed by the respondents (n = 624) included milking (70.8%), feeding (60.6%), and cleaning stalls (42.6%). The use of personal protective equipment was infrequent. Gloves were always worn when milking by 32.7%. More respondents, 96.5%, changed their clothes at least sometimes before working in the barn as compared to when leaving the barn. Handwashing was always performed by 86.7% after assisting with delivering calves, whereas 71.1% always washed their hands after milking. Eating and drinking in the barn were practiced by 45.0% and 72.0%, respectively. Veterinary obstetric drugs were administered by 28.2% of the respondents. Most of the respondents, 89.7%, indicated that they felt they had minimal to no risk of contracting a disease from the animals with which they worked.
These results suggest that migrant workers present with medical problems that are similar to those of the general primary care population. Many problems were recurrent and represented common chronic medical conditions.
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