Southwest United States Research Articles

Geometric morphometric analysis of projectile points from the Southwest United States

Geometric morphometric analysis of projectile points from the Southwest United States

Extragenital Sexually Transmitted Infections Testing During COVID-19 Pandemic Among Youth Involved in the Juvenile Justice System.

Studies have shown lower screening for sexually transmitted infections (STIs) during the COVID-19 pandemic. It is unclear how the pandemic affected STI testing among juvenile justice-involved youth, especially for extragenital gonorrhea and chlamydia. Retrospective chart review was conducted between March 2020 and June 2021 utilizing electronic health records of youth seen at a preadjudication facility in the southwest United States. Rates of extragenital testing were compared with prepandemic rates. Overall, 574 youth were observed; 86% were male, mean age was 15.4 years, and 48.6% were Black. Of the youth reporting performing oral sex, 57% were tested for oropharyngeal STIs compared to 33.5% in 2018 to 2019. Twenty percent of those reporting anal receptive sex were tested for rectal infections compared to 25.9% before the pandemic. Pandemic testing for oropharyngeal STIs increased but rectal testing decreased. Overall, testing rates remained low.

Impact of climate change in Mexican winegrape regions

AbstractWe analysed the current climate of seven winegrowing regions of Mexico and their possible changes during the 21st century. Various bioclimatic indices were calculated with observations and simulations over a wide domain that covers Mexico and the south and southwest United States. We used two regional climate models (RegCM4.7 and RCA4) for historical (1981–2010), near future (NF: 2021–2050) and far future (FF: 2070–2099) periods under two greenhouse gas emissions scenarios (RCP2.6 and RCP8.5). Both models reproduced the main characteristics of the Mediterranean and semiarid climates typical of the winegrape regions with some biases. Despite the errors, the models suggest similar future changes during the growing season (GS: April–October) in winegrape regions. Increases in temperature (~1.2°C) are expected in the NF, which could produce an early start from the growth (mid‐March) season to the harvest. More significant changes are expected in the FF under the RCP8.5 scenario; temperature during April–October may increase ~4°C, and growing degree‐days (GDD) and minimum temperature could also increase (~700 and 4.5°C, respectively), especially in the northern Mexican high plateau, substantially reducing the suitable areas for viticulture. In Baja California (BC) the suitable years for viticulture may decline by 30%–50%, suggesting an increase in the interannual uncertainty. Moreover, in BC and California the number of cool nights (Tmin < 12°C) could be reduced during the current harvest season (September) affecting winegrape acidity and flavour. Therefore, the viticulture sector and the wine industry may need to implement early adaptation/mitigation measures to overcome these possible changes and winegrape phenology shifts.

Disparities in outcomes of COVID-19 hospitalizations in native American individuals.

This study aimed to investigate COVID-19-related disparities in clinical presentation and patient outcomes in hospitalized Native American individuals. The study was performed within 30 hospitals of the Banner Health system in the Southwest United States and included 8,083 adult patients who tested positive for SARS-CoV-2 infection and were hospitalized between 1 March 2020 and 4 September 2020. Bivariate and multivariate analyses were used to assess racial and ethnic differences in clinical presentation and patient outcomes. COVID-19-related hospitalizations in Native American individuals were over-represented compared with non-Hispanic white individuals. Native American individuals had fewer symptoms at admission; greater prevalence of chronic lung disease in the older adult; two times greater risk for ICU admission despite being younger; and 20 times more rapid clinical deterioration warranting ICU admission. Compared with non-Hispanic white individuals, Native American individuals had a greater prevalence of sepsis, were more likely to require invasive mechanical ventilation, had a longer length of stay, and had higher in-hospital mortality. Native American individuals manifested greater case-fatality rates following hospitalization than other races/ethnicities. Atypical symptom presentation of COVID-19 included a greater prevalence of chronic lung disease and a more rapid clinical deterioration, which may be responsible for the observed higher hospital mortality, thereby underscoring the role of pulmonologists in addressing such disparities.

Factors affecting the recovery of Mexican wolves in the Southwest United States

Abstract Recovering and maintaining large carnivore populations is a global conservation challenge that requires better knowledge of the factors affecting their populations, particularly in shared landscapes (i.e. non‐protected areas where people occupy and or utilize the land). The Mexican wolf (Canis lupus baileyi) is an endangered wolf subspecies being recovered on shared landscapes in the Southwest United States and Mexico. We used data from the U.S. program to model population growth, evaluate the impact of management removal and illegal killing relative to other demographic factors, and test hypotheses about factors influencing rates of management removal and illegal killing. From 1998 to 2019, the population growth averaged 12% per year. Rates of natural reproduction, illegal killing and other mortality remained consistent over the 22 years; while releases, translocations and management removals varied markedly between two time periods, phase 1:1998–2007 and phase 2:2008–2019. The number of wolves removed for conflict management was higher during phase 1 (average ~ 13 per year, rate = 24.8%) than phase 2 (average of ~5 per year, rate = 5.2%). This decrease in management removal resulted in the wolf population resuming growth after a period of population stagnation. Two factors influenced this decrease, a change in policy regarding removal of wolves (stronger modelling support) and a decrease in the number of captive‐reared adult wolves released into the wild (weaker modelling support). Illegal mortality was relatively constant across both phases, but after the decrease in management removal, illegal mortality became the most important factor (relative importance shifted from 28.2% to 50.1%). Illegal mortality was positively correlated with rates of reintroduction and translocation of wolves and negatively correlated with the rate of management removal. Synthesis and applications. Using management removal to reduce human–carnivore conflict can have negative population impacts if not used judiciously. Recovering and maintaining carnivore populations in shared landscapes may require greater tolerance of conflict and more emphasis on effective conflict prevention strategies and compensation programs for affected stakeholders.

The Relationship between Anthropometrics and Performance among Collegiate Rodeo Athletes

Due to a limited number of informative articles available on collegiate rodeo and its athletes, the purpose of this work was to examine the relationship between anthropometric measurements and physical fitness of rodeo athletes; to add to the limited literature focused on a physical profile of rodeo athletes. Within the protocol of university IRB guidelines, 14 (20.86 ± 1.17 years; 178.2 ± 7.85 cm; 86.48 ± 21.39 Kg) male rodeo athletes at a division I school located in the Southwest United States participated in two consecutive six-week resistance training programs. Anthropometric data and fitness performance data from each participating athlete were gathered. The following data were collected: body fat percentage, lean body mass (LBM), vertical jump height, T-test, 300-yard shuttle times, barbell back squat, bench press, trap bar deadlift one repetition maximums (1RMs), single- hand reaction time, and multi-hand reaction time. Research methods included exploratory analysis - including means and standard deviations - to enable a correlational analysis. Descriptive data analysis revealed that the trap bar deadlift 1RM had a significant relationship with the bench press 1RM (r=0.874, p=0.005) and back squat 1RM (r=0.938, p=0.002). Likely due to limited experience performing resistance training, 1RM performances were possibly based on increased neuromuscular efficiencies – i.e., a ‘learning effect’. This study offers new and unique information upon the modern rodeo athlete which can help exercise science practitioners design more efficient training programs.

Riparian vegetation response amid variable climate conditions across the Upper Gila River watershed: informing Tribal restoration priorities

Riparian systems across the Southwest United States are extremely valuable for the human and ecological communities that engage with them. However, they have experienced substantial changes and stresses over the past century, including non-native vegetation expansion, vegetation die-offs, and increased fire activity. Vegetation management approaches, such as ecological restoration, may address some of these stressors as well as reduce the risk of future impacts. We apply remote sensing to inform restoration priorities along the upper Gila River within the San Carlos Apache Reservation and Upper Gila River watershed. First, we develop a spatially and temporally explicit trend analysis across three observed climate periods (1985–1993, 1993–2014, 2014–2021) using the Landsat-derived indices to quantify changes in riparian vegetation conditions. These maps can be used to identify areas potentially more at risk for degradation. Second, we analyze changes in riparian vegetation within a climate framework to better understand trends and the potential effect of climate change. Vegetation greenness has largely increased throughout the watershed despite intensifying drought conditions across our study period, though areas within the lower watershed have shown increased stress and higher rates of wildfire and other disturbances over the past 5-years. Nevertheless, small-scale restoration activities appear to show improving vegetation conditions, suggesting efficacy of these restoration activities. Results from this study may be integrated with restoration objectives to develop a restoration plan that will help riparian vegetation communities adapt to change.

A comparison of optimal peak clipping and load shifting energy storage dispatch control strategies for event-based demand response

Buildings, specifically large commercial buildings, are key contributors to the increasing electrical energy demand that is taxing the reliability of an ageing U.S. power grid. Through utility sponsored demand response programs and electrical energy storage systems, large buildings can simultaneously save money on their electricity bill and improve power grid reliability – with little to no change in their operations. Few studies have explored demand response benefits and appropriate control strategies for large commercial buildings. In this study, optimal peak clipping and load shifting control strategies of a Li-ion battery energy storage system are formulated and analyzed over 2 years of 15-minute interval demand data for a large commercial building in the Southwest United States. Furthermore, this analysis assesses the discounted payback period of a Li-ion battery energy storage system while considering cases with and without enrollment in the local utility’s event-based demand response program. Degradation in the Li-ion battery energy storage system’s rated power and capacity are considered throughout this analysis. Key findings in this study show that enrollment in event-based demand response can provide a reasonable (<10 years) discounted payback period of Li-ion battery energy storage systems.

Genetic variation in a tepary bean (Phaseolus acutifolius A. Gray) diversity panel reveals loci associated with biotic stress resistance.

Tepary bean (Phaseolus acutifolius A. Gray), indigenous to the arid climates of northern Mexico and the Southwest United States, diverged from common bean (Phaseolus vulgaris L.), approximately 2 million years ago and exhibits a wide range of resistance to biotic stressors. The tepary genome is highly syntenic to the common bean genome providing a foundation for discovery and breeding of agronomic traits between these two crop species. Although a limited number of adaptive traits from tepary bean have been introgressed into common bean, hybridization barriers between these two species required the development of bridging lines to alleviate this barrier. Thus, to fully utilize the extant tepary bean germplasm as both a crop and as a donor of adaptive traits, we developed a diversity panel of 422 cultivated, weedy, and wild tepary bean accessions which were then genotyped and phenotyped to enable population genetic analyses and genome-wide association studies for their response to a range of biotic stressors. Population structure analyses of the panel revealed eight subpopulations and the differentiation of botanical varieties within P. acutifolius. Genome-wide association studies revealed loci and candidate genes underlying biotic stress resistance including quantitative trait loci for resistance to weevils, common bacterial blight, Fusarium wilt, and bean common mosaic necrosis virus that can be harnessed not only for tepary bean but also common bean improvement.

Triggering conditions, runout, and downstream impacts of debris flows following the 2021 Flag Fire, Arizona, USA

Debris flows pose a serious threat to communities in mountainous areas, particularly in the years following wildfire. These events have been widely studied in regions where post-wildfire debris flows have been historically frequent, such as southern California. However, the threat of post-wildfire debris flows is increasing in many regions where detailed data on debris-flow physical properties, volume, and runout potential are sparse, such as the Southwest United States (Arizona and New Mexico). As the Southwest becomes more vulnerable to these hazards, there is an increasing need to better characterize the properties of post-wildfire debris flows in this region and to identify similarities and differences with nearby areas, particularly southern California, where there is a greater abundance of data. In this paper, we study the characteristics and downstream impacts of two post-wildfire debris flows that initiated following the 2021 Flag Fire in northern Arizona, United States. We gathered data regarding soil hydraulic properties, rainfall characteristics, watershed response, and debris-flow initiation, runout, volume, grain size, and downstream impacts during the first two monsoon seasons following the containment of the Flag Fire. We also applied established debris-flow runout and volume models that were developed in southern California to our study watershed and compared the output with observations. In the first monsoon season following the fire, there were two post-wildfire debris flows, one of which resulted in damage to downstream infrastructure, and one major flood event. We found that, while more intense rainfall is required to generate debris flows at our study site compared to southern California, burned watersheds in northern Arizona are still susceptible to debris flows during storms with low recurrence intervals in the first year following fire. During the second monsoon season, there were no major runoff events, despite more intense storms. This indicates that the temporal window for heightened debris-flow susceptibility at our study area was less than one year, due to the recovery of soil hydraulic properties and vegetation regrowth. We also found that the debris-flow properties at our study site, such as volume, mobility, and grain size distribution, may differ from those in other regions in the western United States, including southern California, potentially due to regional differences in rainfall characteristics and sediment supply. Differences in rainfall characteristics and sediment supply may have also influenced the performance of the debris-flow runout and volume models, which overpredicted the observed runout distance by 400 m and predicted a volume more than 17 times greater than what was observed.

A Mixed Methods Exploration of Postsecondary Education Students’ Environmental Awareness and Worldviews

Postsecondary education students are positioned to contribute to solving complex environmental problems present in the world today. This convergent mixed methods study aimed to explore environmental worldviews for undergraduate and graduate students at a public four-year university in the Southwest United States. The revised New Ecological Paradigm (NEP-R) Scale, demographic questions, and three open-ended questions were implemented in an online survey to explore participants’ environmental worldviews. Using descriptive and non-parametric statistical analyses, the results of an online survey revealed that overall participants (N = 513) reported pro-environmental worldviews, and factors such as age and gender influenced environmental worldview scores. Moreover, identifying major and minor themes after coding responses to open-ended questions broadened the understanding of students’ environmental worldviews in the context of experiencing higher education. Although the present study had limitations, the findings can assist postsecondary educational leaders, faculty, and practitioners in developing and implementing pro-environmental or sustainability-oriented policies, practices, and programs on higher education campuses.

Topographic information improves simulated patterns of post-fire conifer regeneration in the southwest United States.

The western United States is projected to experience more frequent and severe wildfires in the future due to drier and hotter climate conditions, exacerbating destructive wildfire impacts on forest ecosystems such as tree mortality and unsuccessful post-fire regeneration. While empirical studies have revealed strong relationships between topographical information and plant regeneration, ecological processes in ecosystem models have either not fully addressed topography-mediated effects on the probability of plant regeneration, or the probability is only controlled by climate-related factors, for example, water and light stresses. In this study, we incorporated seedling survival data based on a planting experiment in the footprint of the 2011 Las Conchas Fire into the Photosynthesis and EvapoTranspiration (PnET) extension of the LANDIS-II model by adding topographic and an additional climatic variable to the probability of regeneration. The modified algorithm included topographic parameters such as heat load index and ground slope and spring precipitation. We ran simulations on the Las Conchas Fire landscape for 2012-2099 using observed and projected climate data (i.e., Representative Concentration Pathway 4.5 and 8.5). Our modification significantly reduced the number of regeneration events of three common southwestern conifer tree species (piñon, ponderosa pine, and Douglas-fir), leading to decreases in aboveground biomass, regardless of climate scenario. The modified algorithm decreased regeneration at higher elevations and increased regeneration at lower elevations relative to the original algorithm. Regenerations of three species also decreased in eastern aspects. Our findings suggest that ecosystem models may overestimate post-fire regeneration events in the southwest United States. To better represent regeneration processes following wildfire, ecosystem models need refinement to better account for the range of factors that influence tree seedling establishment. This will improve model utility for projecting the combined effects of climate and wildfire on tree species distributions.

Translating critical reflection into collective action: The mediating role of Asian American racial identity ideological values.

Throughout U.S. history, Asian Americans engaged in various forms of collective action to challenge systems of oppression. Despite this, few studies challenge the stereotype that Asian Americans are apolitical and uninterested in collective action and focus on psychological correlates of Asian Americans'collective action. Collective action may be motivated by critical reflection on racism and inequality, which may induce shifts in racial identity ideological values that lead Asian Americans to align with minoritized groups. The current study examines whether Asian American racial identity ideological values-specifically, Asian American Unity, Interracial Solidarity, and Transnational Critical Consciousness-help explain why critical reflection is linked to collective action among Asian Americans. Multiple mediation analyses suggested that, among Asian American college students in the Southwest United States(N = 272), beliefs about Interracial Solidarity and Asian American Unity mediated the relationship between critical reflection (i.e., Critical Reflection on Racism and Perceived Inequality) and collective action (i.e., Support for Black Lives Matter and Sociopolitical Participation). Transnational Critical Consciousness did not mediate the relationship between critical reflection and collective action. This study highlights how Asian American unity and interracial solidarity beliefs underlie Asian Americans'critical reflection and collective action.

HPV Vaccine Misperceptions Among Hispanics/Latinos in Southern California.

Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites. HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score. Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01). Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.

34 Evaluation of Socioeconomic Status and Burn Injuries: A Retrospective Review From a Desert Burn Center

Abstract Introduction Incidence of burn injury rate appears to be affected by socioeconomic status (SES). Previous studies have indicated that patients with low SES have an increased risk of unintentional burn injuries. However, this association has not been explored robustly in the Southwest United States. This study aims to investigate the relationship between SES and burn injuries amongst patients in the Southwest United States. Methods A retrospective registry review was performed on all burn injury admissions to our ABA verified burn center from January 1, 2017 to December 31, 2021. Their zip code was then inputted into the Distressed Communities Index (DCI). This is a national database that stratifies communities by zip code into quintiles, indicating overall distress. The DCI was used as a measure of SES as it reflects employment status, education level, poverty rate, median income, business growth, and housing vacancies. Patients who did not report an accurate residential zip code or reported a zip code not included in the DCI were excluded. Many clinical variables were reviewed within each quintile including age, gender, total body surface area (TBSA), ICU days, hospital length of stay (LOS), ventilator days, surgical interventions, and discharge disposition. Student’s t-test and Chi-squared tests were used to compare groups, and statistical significance was defined at p &amp;lt; 0.05. Results A total of 1,323 patients were identified in the study period. The most distressed quintile accounted for 481 (36.4%) admissions. Flame and contact burns were the most common etiology overall (46.5%), as well as within each quintile (Figure 1). The distribution of burn injury etiology was statistically significant by age, %TBSA, gender, race, and ethnicity (p &amp;lt; 0.001, Table 1); however, it was not significant by SES (p = 0.202). Burn severity, categorized as less than or equal to second degree burns, or greater than or equal to third degree burns, showed significance when compared to age, LOS, ICU days, ventilator days, and total surgical interventions performed (p &amp;lt; 0.001). However, the association between SES and burn severity was not found to be significant (p = 0.886). Conclusions The two most distressed quintiles represented over half of the burn admissions. A lower SES did not contribute to increased burn severity or utilization of healthcare resources. This study highlighted differences in burn injuries between age, gender, race, and ethnicity. Applicability of Research to Practice Identifying communities at increased risk for burn injuries can help with public health initiatives, focused on awareness and prevention of these injuries.

Influence of Stationary Waves on Precipitation Change in North American Summer during the Last Glacial Maximum

Abstract Paleo-proxy reconstructions reveal a moistening of the American Southwest during the Last Glacial Maximum (LGM; 21 ka). However, the primary mechanisms driving the moistening trend are still debated, with relatively few studies focused on hypotheses related to synoptic changes in precipitation. Analysis of the Paleoclimate Intercomparison Model Project (PMIP3) simulations shows enhancement of precipitation in the southwest and south-central United States during the winter and summer. Here, we suggest that summertime eastward phase shifting of stationary waves at the LGM enhanced precipitation in the south-central United States and dried the southeastern United States. Mechanism denial experiments performed with version 3 of the Hadley Centre Coupled Model (HadCM3) indicate that the thermodynamic effect of the Laurentide Ice Sheet forced eastward phase shifting of stationary waves. By comparing a synthesis of LGM proxies to the PMIP3 ensemble, we find models that compare more favorably to the reconstructions simulate a weaker Laurentide ice thermodynamic effect, smaller eastward phase shifting of stationary waves, and weaker jet stream anomalies. Significance Statement Our study is motivated by the impact of climate change on hydroclimate in North America, especially in the semiarid areas near the southwestern United States, and the persistent problem of significant disagreements among CMIP model projections. Yet modern models and observations alone cannot tell us the likeliest climate change outcome in this region. Here we analyze precipitation during the LGM reconstructed from proxies and as simulated by the PMIP3, which reveal a precipitation trend with wetting in the southwestern United States and drying in the southeastern United States. Our interpretation of the PMIP3 simulations involves application of simple theories for midlatitude stationary waves, and indicates that the LGM precipitation is generated by the phase shift of stationary waves from the enhancement of jet speeds. Our model–data comparison also suggests that in the PMIP3 simulations, weak LGM jet stream anomalies, due to weak polar amplification, compare more favorably to the proxies.

Abrupt transitions in a southwest USA desert grassland related to the Pacific Decadal Oscillation.

Prediction of abrupt ecosystem transitions resulting from climatic change will be an essential element of adaptation strategies in the coming decades. In the arid southwest USA, the collapse and recovery of long-lived perennial grasses have important effects on ecosystem services, but the causes of these variations have been poorly understood. Here we use a quality-controlled vegetation monitoring dataset initiated in 1915 to show that grass cover dynamics during the 20th century were closely correlated to the Pacific decadal oscillation (PDO) index. The relationship out-performed models correlating grasses to yearly precipitation and drought indices, suggesting that ecosystem transitions attributed only to local disturbances were instead influenced by climate teleconnections. Shifts in PDO phase over time were associated with the persistent loss of core grass species and recovery of transient species, so recovery of grasses in aggregate concealed significant changes in species composition. However, the relationship between PDO and grass cover broke down after 1995; grass cover is consistently lower than PDO would predict. The decoupling of grass cover from the PDO suggests that a threshold had been crossed in which warming or land degradation overwhelmed the ability of any grass species to recover during favorable periods.

Examining Mental Health, Academic, and Economic Stressors During the COVID-19 Pandemic Among Community College and 4-Year University Students.

Objective: The COVID-19 global pandemic has created severe, long-lasting challenges to college students in the United States (US). In the present study, we assessed mental health symptomatology (depression, anxiety, life stress), academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Method: A total sample of 361 college students (Mage = 22.26, SD = 5.56) was gathered from a community college (N = 134) and mid-size public university (N = 227) in Southwest US, both designated as Hispanic Serving Institutions. Results: Pearson and point biserial correlations indicated associations between mental health symptomatology, academic challenges, and economic stress, including expected delays in graduation. Multivariate analysis revealed that community college students had statistically significantly higher scores on anxiety F(1, 312) = 5.27, p = .02, = .01 than 4-year university students, as well as key differences with respect to academic challenges. Chi Square analyses revealed that Latinx families experienced greater economic hardships, including job loss or reduced work hours (χ2 (1, N = 361) = 28.56, p = .00) than other ethnic/racial groups. Conclusions/Contributions: Findings revealed that community college students faced disparately negative mental health symptomatology, academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Further, Latinx students' families experienced significant economic hardship that may have impacted students' academic progress and future planning.

Where Did Redlining Matter? Regional Heterogeneity and the Uneven Distribution of Advantage

This article analyzes the regional variation in outcomes of a seemingly standardized federal neighborhood valuation principle used in home mortgage insurance grading. The objective is to highlight the contingent discriminatory and economic conditions that mediated heterogeneous housing outcomes across different parts of the United States. How did city and regional economic and demographic growth patterns vary before and during the mortgage insurance program implemented through the Federal Housing Administration (FHA)? How might this have shaped loan guarantee patterns? How does preexisting racial housing discrimination relate to outcomes? Adopting an orientation that centers on Whiteness and the benefits of mortgage finance for certain groups and neighborhoods, this analysis uses a Bayesian hierarchical framework to investigate the degree of the FHA’s influence between 1940 and 1970, here proxied by the Home Owners’ Loan Corporation maps, on A or B (“AB”) graded neighborhoods versus C graded neighborhoods in different cities. This article studies how home values and homeownership change over time and whether there are regional variations in the influence of these grades. It also studies what longitudinal socioeconomic patterns might explain the persistence or decline of the AB effect over time. Findings show cities in the West Coast, Southwest, and northern central United States that saw the most housing construction also had the highest proportions of FHA loans to overall dwelling units. There is also a distinctive consistency and persistence of benefit on home value and homeownership to AB graded neighborhoods in these cities, possibly owing to regional shifts in the industrial landscape.

Association of quality of prenatal care with contraceptive planning in a United States population: a retrospective cohort study

BackgroundUnderstanding how prenatal care influences planned postpartum contraception can help guide shared decision-making. This study looks to examine the association of the quality of prenatal care with planned postpartum contraception.MethodsThis is a retrospective cohort study conducted in a single tertiary, academic urban institution in the southwest United States. The institutional review board (IRB) for human research at Valleywise Health Medical Center approved this study. Using a validated measure of prenatal care, the Kessner index, prenatal care was classified as adequate, intermediate, or inadequate. The World Health Organization (WHO) protocol for contraceptive effectiveness was used to classify contraceptives as very effective, effective, and less effective. The planned contraceptive choice was determined at the time of hospital discharge after delivery by discharge summary. Chi-squared testing and logistic regression were used to measure associations between the adequacy of prenatal care and contraceptive planning.ResultsThis study included 450 deliveries, 404 (90%) patients with adequate prenatal care, and 46 (10%) patients without adequate (intermediate or inadequate) prenatal care. There was not a statistically significant difference in planning for very effective or effective methods of contraception at hospital discharge between adequate (74%) and non-adequate (61%) prenatal care groups (p = 0.06). There was no association between the adequacy of prenatal care and the effectiveness of contraceptive planning after controlling for age and parity (aOR = 1.7, 95% CI 0.89–3.22).ConclusionsMany women chose very effective and effective methods of postpartum contraception; however, there was no statistically significant association between the quality of prenatal care and planned contraception at hospital discharge.