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Objective: Investigate maternal and neonatal outcomes following waterbirth. Design: Retrospective cohort study, with propensity score matching to address confounding. Setting: Community births, United States. Sample: Medical records‐based registry data from low‐risk births were used to create waterbirth and land birth groups (n = 17 530 each), propensity score‐matched on >80 demographic and pregnancy risk covariables. Methods: Logistic regression models compared outcomes between the matched waterbirth and land birth groups. Main outcome measures: Maternal: immediate postpartum transfer to a hospital, any genital tract trauma, severe (3rd/4th degree) trauma, haemorrhage >1000 mL, diagnosed haemorrhage regardless of estimated blood loss, uterine infection, uterine infection requiring hospitalisation, any hospitalisation in the first 6 weeks. Neonatal: umbilical cord avulsion; immediate neonatal transfer to a hospital; respiratory distress syndrome; any hospitalisation, neonatal intensive care unit (NICU) admission, or neonatal infection in the first 6 weeks; and neonatal death. Results: Waterbirth was associated with improved or no difference in outcomes for most measures, including neonatal death (adjusted odds ratio [aOR] 0.56, 95% CI 0.31–1.0), and maternal or neonatal hospitalisation in the first 6 weeks (aOR 0.87, 95% CI 0.81–0.92 and aOR 0.95, 95% CI 0.90–0.99, respectively). Increased morbidity in the waterbirth group was observed for two outcomes only: uterine infection (aOR 1.25, 95% CI 1.05–1.48) (but not hospitalisation for infection) and umbilical cord avulsion (aOR 1.57, 95% CI 1.37–1.82). Our results are concordant with other studies: waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. New study demonstrates #waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. @TheUpliftLab @BovbjergMarit @31415926abc @NICHD_NIH. New study demonstrates #waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. @TheUpliftLab @BovbjergMarit @31415926abc @NICHD_NIH. [ABSTRACT FROM AUTHOR]

Cedar Rapids, IA, offers a unique case study in planning for increased resilience. In 2008, Cedar Rapids experienced severe flooding. Rather than simply rebuilding, the city of Cedar Rapids began to invest in a resilient flood control system and in the revitalization of its Downtown neighborhood. This paper develops a Computable General Equilibrium (CGE) model for the regional economy of Cedar Rapids to quantify 'resilience dividends': net co-benefits of investing in increased resilience. A resilience dividend includes benefits to the community even if another disaster does not occur. We build a CGE model of Cedar Rapids at two different time periods: one in 2007, before the flooding, and one in 2015, after the flooding and initial investment in resilience. We show that a positive economic shock to the economy results in larger co-benefits for key economic indicators in 2015 than in 2007. Our approach illustrates how co-benefits are distributed throughout the economy. [ABSTRACT FROM AUTHOR]

Young adults enrolled in collegiate agricultural programs are a critical audience for agricultural health and safety training. Understanding the farm tasks that young adults engage in is necessary for tailoring health and safety education. The project analyzed evaluation survey responses from the Gear Up for Ag Health and Safety™ program, including reported agricultural tasks, safety concerns, frequency of discussing health and safety concerns with healthcare providers, safety behaviors, and future career plans. The most common tasks reported included operation of machinery and grain-handling. Most participants intended to work on a family-owned agricultural operation or for an agribusiness/cooperative following graduation. Reported safety behaviors (hearing protection, eye protection, and sunscreen use when performing outdoor tasks) differed by gender and education type. Male community college and university participants reported higher rates of “near-misses” and crashes when operating equipment on the roadway. One-third of participants reported discussing agricultural health and safety issues with their medical provider, while 72% were concerned about the health and safety of their family and co-workers in agriculture. These findings provide guidance for better development of agricultural health and safety programs addressing this population—future trainings should be uniquely tailored, accounting for gender and educational differences. [ABSTRACT FROM AUTHOR]

There is limited research exploring agricultural workers' own perspectives on the relative importance of the hazards and stressors they experience. There is also a lack of evidence on whether this reporting differs by method of elicitation. Finally, very little research exists on how to improve mail survey response rates among agricultural workers. We examined health and safety concerns and psychological stressors among Midwestern farmers. We assessed whether these reports varied by survey mode (mail survey versus inperson survey). The efficacy of two different types of incentives to enhance mail survey response rates among agricultural workers was also investigated. In 2018, a needs assessment survey was developed and mailed to a random sample of farm owner-operators in Iowa, Ohio, and Missouri, with randomly assigned prepaid or promised monetary incentives. In-person surveys were conducted among farm owner-operators and hired workers at three regional farm shows in Iowa, Minnesota, and Nebraska. The mail survey response rates were compared by incentive type. Content analysis was used to generate themes associated with health and safety concerns and psychological stressors, which were then ranked by frequency counts. Chi-square tests were used to analyze variation in the distribution of these themes by survey mode. The response rate for the $1 prepaid incentive was double that of the $10 promised incentive. Content analysis identified 13 health and safety concerns and eight psychological stressors. Chemicals, equipment/tools, and health outcomes were the most frequently noted health and safety concerns. Finances, climate/weather, and farm workload and management were the most frequently noted psychological stressors. Although there was considerable overlap in survey responses across mail and in-person respondents, important differences by sample and survey mode characteristics were observed. The results can support a variety of stakeholders in prioritizing and developing interventions and educational resources to address health and safety concerns and psychological stressors among Midwestern farmers. Our findings also contribute to the evidence base on primary data collection methods for agricultural workers. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify cultural models of breast cancer held by Saudi women and to explore how these may influence early detection and treatment-seeking behaviors. Data were collected via semi-structured interviews with breast cancer survivors (n=20) from two Western cities in Saudi Arabia. Respondents were recruited through social networking, using purposive, snowball sampling. Illness narratives elicited during interviews were transcribed, coded and then analyzed using a modified grounded theory approach. Results suggest that fatalism, perceived threats to traditional role fulfillment, and a preference for traditional therapies commonly mark the breast cancer experiences of Saudi women, influencing their early detection and treatment-seeking behaviors. A more nuanced understanding of emic viewpoints could help to improve public health messaging and intervention strategies in Saudi Arabia. [ABSTRACT FROM AUTHOR]

In this article, I examine the clinical practices engaged in by U.S. homebirth midwives and their clients from the beginning of pregnancy through to the immediate postpartum period, deconstructing them for their symbolic and ritual content. Using data collected from open-ended, semistructured interviews and intensive participant-observation, I describe the roles ritual plays in the construction, performance, and maintenance of birth at home as a transgressive rite of passage. As midwives ritually elaborate approaches to care to capitalize on their semiotic power to transmit a set of counterhegemonic values to participants, they are attempting, quite self-consciously, to peel away the fictions of medicalized birthing care. Their goal: to expose strong and capable women who "grow" and birth babies outside the regulatory and self-regulatory processes naturalized by modern, technocratic obstetrics. Homebirth practices are, thus, not simply evidence-based care strategies. They are intentionally manipulated rituals of technocratic subversion designed to reinscribe pregnant bodies and to reterritorialize childbirth spaces (home) and authorities (midwives and mothers). [ABSTRACT FROM AUTHOR]

Abstract Background The novel isoxazoline molecule fluralaner provides 12 weeks activity against fleas and 8 to 12 weeks against tick infestations according to label claims. Methods This blinded, multi-center study in client-owned dogs evaluated the flea control provided by a single oral fluralaner treatment (25–56 mg/kg; Bravecto™, Merck Animal Health) compared to a control group administered three oral spinosad (30 – 60 mg/kg; Comfortis®, Elanco) treatments at 4-week intervals together with an amitraz collar (9%, Preventic®, Virbac). Households were randomized (3:1 ratio) to either fluralaner (224 dogs, 118 households) or control (70 dogs, 39 households). Within households, one primary dog with at least 10 live fleas at enrollment was randomly selected for whole body flea counts every 4 weeks through Week 12; all dogs were followed for safety until Week 12. Fluralaner dogs received two additional doses at Weeks 12 and 24 for further safety and palatability observations through Week 26. Results Geometric mean flea count reductions from baseline for the fluralaner group at Weeks 4, 8, and 12 were 99.7%, 99.8%, and 99.8%, respectively; and 96.1%, 99.5%, and 99.6% for the spinosad controls. Percentages of flea-free primary dogs at Weeks 4, 8, and 12 were 91.1%, 95.4%, and 95.3% for the fluralaner group; and 44.7%, 88.2%, and 84.4% for the controls; the differences were significant at Weeks 4 (P