Early in the coronavirus disease 2019 (COVID-19) pandemic, the CDC recommended collection of a lower respiratory tract (LRT) specimen for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing in addition to the routinely recommended upper respiratory tract (URT) testing in mechanically ventilated patients. Significant operational challenges were noted at our institution using this approach. In this report, we describe our experience with routine collection of paired URT and LRT sample testing. Our results revealed a high concordance between the 2 sources, and that all children tested for SARS-CoV-2 were appropriately diagnosed with URT testing alone. There was no added benefit to LRT testing. Based on these findings, our institutional approach was therefore adjusted to sample the URT alone for most patients, with LRT sampling reserved for patients with ongoing clinical suspicion for SARS-CoV-2 after a negative URT test.

We investigate allocation of funds by citizens across management options addressing impairments to coastal water quality. We study systematic variation in citizen allocation of funds to adaptive versus preventative strategies including the impact of referundum choices and test whether allocations will be impacted by cuing in the design of the referendum. Two key policy insights from our results: citizens who vote no on a water quality referendum have different preferences over allocating funds and providing cues to voters influenced allocation behavior. These results can assist decision makers in thinking about language used to communicate coastal water quality issues, particularly budget referenda.

We estimate a bivariate probit model using data from a survey of Maine and New Hampshire beachgoers to (i) assess the impact of exposure to and contact with beach waters on safety information-seeking behaviors, and (ii) compare information-seeking behaviors for surf conditions and water quality information. We find that individuals who engage in certain high-contact recreation activities (i.e., swimming, fishing, surfing) are more likely to seek out safety information and that some potential drivers of this behavior affect searches differently for surf conditions versus water quality information.

Sustainability science is an emerging field directed at advancing sustainable development. Informed by recent scholarship and institutional experiments, we identify key roles for economists and encourage their greater participation in this research. Our call to collaborative action comes from positive experiences with the Sustainability Solutions Initiative based at the University of Maine, where economists collaborate with other experts and diverse stakeholders on real-world problems involving interactions between natural and human systems. We articulate a mutually beneficial setting where economists’ methods, skills, and norms add value to the problem-focused, interdisciplinary research of sustainability science and where resources, opportunities, and challenges from science bolster economic research specifically and land/sea grant institutions broadly.

As many local and state governments in the United States grapple with increasing growth pressures, the need to understand the economic and institutional factors underlying these pressures has taken on added urgency. From an economic perspective, individual land use decisions play a central role in the manifestation of growth pressures, as changes in land use pattern are the cumulative result of numerous individual decisions regarding the use of lands. In this study, the issue of growth management is addressed by developing a spatially disaggregated, microeconomic model of land conversion decisions suitable for describing residential land use change at the rural-urban fringe. The model employs parcel-level data on land use in Calvert County, Maryland, a rapidly growing rural-urban fringe county. A probabilistic model of residential land use change is estimated using a duration model, and the parameter estimates are employed to simulate possible future growth scenarios under alternative growth management scenarios. Results suggest that “smart growth” objectives are best met when policies aimed at concentrating growth in target areas are implemented in tandem with policies designed to preserve rural or open space lands.

This paper presents a case study of the economic damages to homeowners in a northern New Jersey community due to an exotic forest insect—the hemlock woolly adelgid. Hedonic property value methods are used to estimate the effect of hemlock health on property values. A statistically significant relationship between hemlock health and residential property values is established. Moreover, there are some signs of spillover impacts from hemlock decline, as negative effects are realized on the parcels where the declining hemlock stands are located as well as on neighboring properties. These results give some indication of the benefits of potential control programs and strategies and also show support for community- or neighborhood-based programs in residential settings.

This paper examines the effects of local workforce creativity on county-level earnings. Descriptive analysis of the data shows that most of the high-creativity counties in the United States are part of metropolitan areas, and that employee earnings are high in these places. Regression results indicate that, other things being equal, workforce creativity enhances county-level labor earnings. However, the returns to creativity that we found can be confirmed only in the urban context. An extension of the analysis suggests that the creative workforce wage premium may be capturing the effects of “technical workforce creativity” on earnings.

A 57-year-old, previously healthy tourist sustained closedhead trauma during a high-speed motor vehicle collision. She was found unconscious at the scene with a Glasgow coma scale score of 3. She suffered a multitude of injuries including frontal scalp lacerations and cervical cord injury. Upon arrival at the hospital, she suffered cardiopulmonary arrest of up to 12 minutes without a perfusing rhythm and was intubated.

Globally, unplanned pregnancies and sexually transmitted infections (STIs) persist as significant threats to women’s reproductive health. Barriers to the use of modern contraceptives by women might inhibit uptake of novel woman-controlled methods for preventing STIs/HIV. Use of modern contraceptives and perceptions and attitudes towards contraceptive use were investigated among women in Antananarivo, Madagascar, using qualitative research. The hypothetical acceptability of the diaphragm – a woman-controlled barrier contraceptive device that also holds promise of protecting against STIs/HIV – was assessed. Women consecutively seeking care for vaginal discharge at a public health clinic were recruited for participation in a semi-structured interview (SSI) or focus group discussion (FGD). Audiotaped SSIs and FGDs were transcribed, translated and coded for predetermined and emerging themes. Of 46 participating women, 70% reported occasional use of male condoms, mostly for preventing pregnancy during their fertile days. Although women could name effective contraceptive methods, only 14% reported using hormonal contraception. Three barriers to use of modern contraceptives emerged: gaps in knowledge about the range of available contraceptive methods; misinformation and negative perceptions about some methods; and concern about social opposition to contraceptive use, mainly from male partners. These results demonstrate the need for programmes in both family planning and STI prevention to improve women’s knowledge of modern contraceptives and methods to prevent STI and to dispel misinformation and negative perceptions of methods. In addition, involvement of men will probably be a critical component of increased uptake of woman-controlled pregnancy and STI/HIV prevention methods and improved health.

Tribunals, now recognized as key institutions of the Welfare State, are attracting a good deal of attention. Despite a growing volume of criticism little systematic research has been undertaken into the way they actually function. Since almost every British citizen has rights of appeal to national insurance local tribunals (NILTs) it would seem that they constitute a good starting point. An earlier article presented a general view of NILTs. This paper examines the way the appeal system works from several different perspectives. Difficulties encountered by ordinary citizens at various stages in the appeal process are discussed. The research findings on attendance, representation and success rates are analysed. Attendance by the appellant at the hearing of his appeal is shown to be of particular significance. It is also clear that expansion of facilities for providing advice and representation would be advantageous to appellants. Problems connected with expansion of these facilities are discussed, and an ‘ideal type’ representative is outlined. This leads to a discussion of different tribunal models and a ‘participation model’ is developed. Finally, some implications of the research findings for the development of social policy are considered.

Tribunals are at the centre of a growing controversy concerning citizen rights in welfare. In the first of two articles, attention is drawn to some of the salient features of this controversy and particularly to those aspects concerning national insurance local tribunals (NILTs). A special analysis of D.H.S.S. records is presented giving a picture of the distribution of the work of NILTs over different benefit categories, of success rates, of the extent of attendance by appellants and of representation. Generally the analysis suggests that NILTs are more varions and less confined by law and regulation than is often assumed. Findings from surveys of chairmen, members and appellants are also presented. Men constitute the great majority of those concerned with NILTs and there are some striking contrasts between varions groups in age and education. People who serve NILTs are shown to be active in a wide range of community activities and particularly in professional organizations, trade unions and local politics.