A Community Conversation on Adolescent Pregnancy and Parenting Services: Networks of Support, Gatekeepers to Care, and Non-Compulsory Fathering in a Black Urban Community

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serves as a barrier to accessing prenatal care. Overall, participants want health agencies to uphold their formal social contracts with the community, but to entrust informal services to community members who have the necessary insight and expertise to deliver support and information that is usable in their social context

Life on the Fringe: Muskoxen in the Alaskan Arctic

The Arctic is experiencing some of the most dramatic temperature changes on the planet. Species at the edge of their range often confront conditions that differ from those in the center–to the extent that the persistence of peripheral populations might be more challenged if bioclimatic factors rule. An indisputable Arctic-adapted species are muskoxen (Ovibos moschatus) which occur at their historic southwestern terminus in Arctic Alaska. We instigated a multi-year project to assess sources of variation in demography, attendant life-histories, and vital rates by contrasting populations on National Park Service and adjacent lands at Bering Land Bridge and Cape Krusenstern. A major challenge of Arctic work is expense; in lieu of handling large numbers of animals, we present a simple non-invasive method to predict body mass in young and sub-adults. We used photogrammetry to document head sizes at known distances and angles on more than 300 wild muskoxen from four age cohorts( 1 to 3 yrs, and older). With head size parameters calibrated on captive individuals, 85 percent of the variance in body mass was explained for animals < 4 yrs of age. Accuracy diminished at > 65 meters and as animals reached puberty, the latter because nutrients allocated for skeletal growth are re-directed to meet reproductive demands. We believe that our ability to associate changes in mass/yr with abiotic and biological factors and survival will enhance opportunities to test hypotheses about causes and correlates of variation in population persistence

A new framework for flood adaptation: introducing the Flood Adaptation Hierarchy

Traditional flood risk paradigms and associated strategies are no longer sufficient to address global flood adaptation challenges due to climate change and continued development in floodplains. The current flood adaptation approach is failing to take advantage of the benefits provided by intact ecosystems and perpetuates social and economic inequities, leaving those who are most vulnerable at highest risk. Rooted in the experiences of the United States, we propose a new framework, the Flood Adaptation Hierarchy, which prioritizes outcomes into six tiers. Overall, the tiers distinguish between nature and nature-based solutions, with preference given to natural ecosystems. The most important outcome in our hierarchy is to avoid risk by protecting and restoring natural floodplains; next, eliminate risk by moving communities away from danger; and then to accommodate water with passive measures and active risk reduction measures. We include, but deprioritize, a defense of community assets using nature-based engineering and hardened engineering. Throughout the hierarchy, we provide guidance on the equity considerations of flood adaptation decision making and highlight “impacts,” “resources,” and “voices” as important equity dimensions. Implementing the framework through an iterative process, using justification criteria to manage movement among tiers, alongside equity considerations, will support adaptation to changing environmental and social conditions and contribute to risk reduction at scale. Though this approach is focused on U.S. flood management and adaptation, prioritizing risk reduction, elimination of risk, and accommodation of hazards over the defense against threats not only has global applicability to flood adaptation, but should also be evaluated for applicability to other climate-driven challenges

Association of Fetal Abdominal–Head Circumference Size Difference With Shoulder Dystocia: A Multicenter Study

Abstract Objective This study aims to determine if shoulder dystocia is associated with a difference in the fetal abdominal (AC) to head circumference (HC) of 50 mm or more noted on antenatal ultrasound. Study Design A multicenter matched case–control study was performed comparing women who had shoulder dystocia to controls who did not. Women with vaginal births of live born nonanomalous singletons ≥ 36 weeks of gestation with an antenatal ultrasound within 4 weeks of delivery were included. Controls were matched for gestational age, route of delivery, and diabetes status. Results We identified 181 matched pairs. Only 5% of the fetuses had an AC to HC of ≥ 50 mm. The proportion of AC to HC difference of ≥ 50 mm was significantly higher in shoulder dystocia cases (8%) than controls (1%, p = 0.002). With multivariate regression, the three significant factors associated with shoulder dystocia were AC to HC ≥ 50 mm (odds ratio [OR], 7.3; confidence interval [CI], 1.6–33.3; p = 0.010), femur length (OR, 1.1; CI, 1.0–1.2; p = 0.002), and induced labor (OR, 1.8; CI, 1.1–3.1; p = 0.027). Conclusion A prenatal ultrasound finding of a difference in AC to HC of ≥ 50 mm while uncommon is associated with shoulder dystocia