George F. Henning

The association between the regular use of preventive labour induction and improved term birth outcomes: findings of a systematic review and meta‐analysis

Despite a lack of high‐quality evidence, the use of ‘non‐indicated’ term labour induction is increasingly restricted throughout the world.

Occupational health characteristics of women on dairy farms in Pennsylvania.

ABSTRACT 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 womens 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.

Vanished Twins and Misdiagnosed Sex: A Case Report with Implications in Prenatal Counseling Using Noninvasive Cell-Free DNA Screening

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.

Reason for Visit: Is Migrant Health Care that Different?.

PURPOSE The purpose of this pilot study was to determine the reasons for which migrant agricultural workers in Pennsylvania seek health care. METHODS Participants were individuals 14 years of age and over, actively involved in agricultural labor and presenting for medical care at 6 migrant health care centers. Bilingual health care providers randomly selected and interviewed the participants. FINDINGS The most commonly reported reason for visiting the health care provider was for physical examination. The most frequent acute problems were related to the musculoskeletal and integumentary systems. Frequently cited problems in the medical history were hypertension, musculoskeletal/back pain, and gastrointestinal conditions. Most medications being taken were for cardiovascular or pain-related problems. CONCLUSIONS 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.

Occupational Health Behaviors and Habits of Women on Dairy Farms in Pennsylvania

ABSTRACT 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.

A Multi-State Analysis of Early-Term Delivery Trends and the Association With Term Stillbirth Trends in Stillbirth by Gestational Age in the United States, 2006-2012 Stillbirth and the 39-Week Rule: Can We Be Reassured?

2015. That this is seen across populations and decades demonstrates this risk of stillbirth as the inherent biology of pregnancy and independent of arbitrary definitions of “term” or of some point in gestational age, whether 39 weeks or 38 or 40 weeks. This continued failure to recognize that, at term, remaining undelivered results in an ever-increasing risk of stillbirth does not serve our patients well. Biology rarely pays much heed to arbitrary rules and definitions, as this latest report documents. The challenge we face becomes not only to understand and recognize the underlying phenomena of term stillbirth, but to develop a reasonable and coherent approach to patient management as it relates to gestational age, incorporating the known data of fetal, maternal, and neonatal outcomes. It is unlikely any one-sizefits-all recommendation regarding management at term will be best. Individualized determinations based on patientspecific factors likely will be the preferred approach. It is essential that this discussion takes place.

Human-Animal Medicine: Clinical Approaches to Zoonoses, Toxicants and Other Shared Health Risks, by Peter M. Rabinowitz and Lisa A. Conti: Missouri: Saunders, 2010, 432 pp.,

One Medicine/One Health is a concept that is emerging from the medical community as the landscape of health care evolves and changes. The most recent and widely supported recognition of this fundamental concept stems from the creation of the One Health Initiative Task Force by the American Veterinary Medical Association. This action received almost simultaneous official recognition and endorsement by the American Medical Association. Recent events, including hurricane Katrina, the occurrence of H1N1/H5N1 influenza strains, and recent outbreaks of hemorrhagic viruses, have served to emphasize the critical importance of this field. Human-Animal Medicine represents a key piece in the development of this discipline and collaboration. Human-Animal Medicine provides a factual academic foundation for the field. The initial seven and final five chapters provide the conceptual and factual basis of the interaction and interface of medicine as it relates to humans and animals. Although the superficial recognition of the importance of zoonotic disease is basic to all medical public health and agricultural training (as well as numerous other disciplines), these chapters describe and develop the breadth and depth of the true relationship of all aspects of human and animal health. Authored by numerous recognized experts in the field, these chapters are a concise, yet scholarly and complete illustration of the entire landscape of One Medicine/One Health. The remainder of the book provides a reference for many of the more common zoonotic diseases as well as basic aspects of environmental health. The latter is approached through chapters on common toxic and problematic environmental exposures. These sections of the book share a common and unique approach to the individual clinical entities. In addition to generally concise and readable summaries, key points are provided for public health, veterinary, and human health professionals. This unique approach adds to the value of this book as a reference. To my knowledge, this information cannot be found in such an easily accessed and organized format. Another very clinically useful aspect of these sections is the liberal use of tables to present key diagnostic and treatment information summaries. They greatly enhance the value of this book as a practical, handy reference for the busy clinician. It is this combination of focus, organization, and user-friendliness that gives this text and reference an advantage over the numerous Web-based reference texts. Will One Health emerge as a key component of 21st century medical care or will it fade into the shadows of health reform and diminishing public health funding? Hopefully, this text and reference will help propel the field to the forefront of the future of what truly is One Medicine in the totality of Global Health.

99.95 hardcover.

Abstract Introduction: This survey was undertaken to determine the most important health and safety needs of farmers and rural citizens of Pennsylvania. Methods: In June of 2004, a one-page questionnaire was distributed by mail to 32,700 members of the Pennsylvania Farm Bureau as an attachment to their monthly newsletter. Results: The lack of affordable health care insurance was overwhelmingly cited as the most important unmet health care need (73%). No other issue was chosen by more than 10 percent of respondents. This lack of affordable health insurance was also cited as the most important health or safety problem to be addressed in the respondents communities (71%). When asked the most important health or safety problem affecting them as individuals or their community, the respondents chose “no major problem or need” as the most frequent response (46%). The issue of affordable health insurance was not an option for this question. The predominant concern regarding the lack of affordable health insurance was consistent across all regions of the Commonwealth and for farmers as well as residents of all community sizes sampled. Discussion: This study would indicate that the lack of affordable health insurance is the preeminent health and safety issue for many Pennsylvania farmers and rural citizens.