Initial Years Research Articles

Interpersonal Connections Are Important for Virtual Kidney Transplant Educational Program Development.

Introduction: The Living Donor Navigator program is designed to mitigate disparities in living donor kidney transplantation, although geographic disparities in program participation were observed in the initial years of implementation. The purpose of this study was to understand participant perspectives regarding the use of a virtual option/alternative to expand program participation. Methods: Previous participants of the in-person navigator program were purposively sampled. Using the nominal group technique, a well-structured formative methodology to elicit participant perspectives, 2 meetings were conducted among transplant recipients and advocates (N = 13) to identify and prioritize responses to the question "What things would concern you about participating in a virtual and remote Living Donor Navigator program?" Findings: Mean participant age was 59.3 (9.3) years, and participants were 54% male and 62% white. Education levels varied from less than high school to master's degrees. Participants generated 70 unique responses, of which 36 (51.4%) received prioritization. The top 5 ranked responses of each nominal group technique meeting received approximately 50 percent (47.6% vs. 66.7%, respectively) of the total votes and described the potentially limited interpersonal connections, time conflicts, and differing content in a virtual navigator program compared to the in-person model. Discussion: These data suggest that previous participants were concerned with upholding the original design of the program, thus, virtual living donor kidney transplantation programs should aim to maintain interpersonal connections and consistency of content to ensure adequate programmatic engagement. Future research will focus on program fidelity independent of delivery modality.

Immunosuppressive Therapy and Nutritional Status of Patients after Kidney Transplantation: A Protocol for a Systematic Review.

(1) Background: Kidney transplantation is widely recognized as the most effective method of treating end-stage renal disease. Immunosuppressive therapy plays a pivotal role in the treatment of kidney transplant patients, encompassing all patients (except identical twins), and is administered from organ transplantation until the end of its function. The aim of this systematic review is to identify the evidence of the association between immunosuppressive therapy and nutritional status of patients following kidney transplantation. (2) Methods: This protocol has been designed in line with Preferred Items for Systematic Reviews (PRISMA-P). Our search encompasses several databases, including MEDLINE (via PubMed), EMBASE (Elsevier), Scopus and Web of Science. We intend to include observational studies (cross-sectional, case-control, and cohort designs), randomized controlled trials (RCTs), as well as completed and ongoing non-randomized study designs. We will confine our search to studies published in English within the past decade (from inception to 17 February 2023). Qualitative studies, case studies, and conference reports will be excluded. The selection process will be done in Covidence by two independent reviewers. Data extraction will be conducted using a standardized MS Excel template version 16.0. Quality assessment of included studies will be performed using the Cochrane Risk of Bias tool for randomized trials (RoB2), or the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Risk-of-bias plots will be generated using the web application Robvis. Relevant data that have been extracted from eligible studies will be presented in a narrative synthesis. We expect the studies to be too heterogeneous to perform subgroup analyses. (3) Conclusion: This systematic review will offer insights into the evidence regarding association between immunosuppressive therapy and nutritional status of adult patients (18 years of age or older) within the initial year following kidney transplantation. To our knowledge, there is no systematic review addressing that question.

Evaluation of opioid use disorder treatment outcomes in patients receiving split daily versus once daily dosing of buprenorphine-naloxone

IntroductionIn clinical practice, sublingual (SL) buprenorphine-naloxone is prescribed as once daily or split daily dosing for the management of opioid use disorder (OUD). Evidence is lacking that assesses how split daily buprenorphine-naloxone affects OUD outcomes. This study aims to evaluate how the dosing frequency of SL buprenorphine-naloxone impacts therapy effectiveness when treating patients with OUD. MethodsThis retrospective analysis included adult outpatients prescribed treatment with SL buprenorphine-naloxone for OUD between July 1, 2016, and March 1, 2020. The study excluded patients with sickle cell disease, recent methadone treatment, or pregnancy. We characterized study groups by dosing frequency, either once daily or split dosing. The study compared retention in treatment, medication adherence, adherence to treatment program, and hospital encounters between groups. ResultsThe study screened eight-hundred and seven patients, and included 250 patients newly prescribed SL buprenorphine-naloxone. Fifty-seven patients (22.8 %) were prescribed once daily dosing and 193 patients (77.2 %) were prescribed split daily dosing. The study found no significant differences noted in 12-month rates of treatment retention (52.6 % vs. 45.6 %, p = .35). These outcomes remained similar when assessed at three and six months. Within a year of buprenorphine-naloxone initiation, the study found no differences in the percentage of patients with hospitalizations (26.3 % vs. 38.3 %, p = .10), median number of hospitalizations (2 vs. 2), or proportion of days covered by a prescription ≥80 % (93.3 % vs. 92.0 %, p = .82). ConclusionsIn this study, patients receiving once daily buprenorphine-naloxone had similar treatment outcomes to patients receiving split dosing. Further controlled studies are necessary to evaluate which patients are more likely to benefit from split dosing.

Statin, Ezetimibe, or Fibrate Initiation and Subsequent Use for the Primary and Secondary Prevention of Cardiovascular Diseases among Japanese Patients Aged ≥55 Years: A Nationwide Cohort Study.

The use of lipid-modifying agents (LMAs) other than statins has rarely been reported in real clinical settings. We aimed to compare the initiation and subsequent use of LMA classes for prevention of cardiovascular diseases. Using the national claims database, this retrospective cohort study was conducted on patients aged ≥55 years who initiated to use statins, ezetimibe, or fibrates between Fiscal Years (FYs) 2014 and 2017 as the first pharmacotherapy for dyslipidemia in Japan. A permissible gap for defining persistence was set as the median days of supply of a class to an individual. Kaplan-Meier estimates were calculated for rates. Cohorts for primary prevention without/with risk and secondary prevention comprised 1307438, 908378, and 503059 initiators for statins; 44116, 34206, and 11373 for ezetimibe; and 124511, 96380, and 27751 for fibrates. The persistence rates declined shortly after the therapy initiation regardless of the classes, which was approximately 50% at 1 year for any class for primary prevention without risk. A notable sex difference in terms of persistence rates was observed only for statins of secondary prevention. The restarting rates were similar between prevention settings: approximately 50-60% for statins and 30-40% for ezetimibe and fibrates 1 year after first discontinuation. For ezetimibe and fibrates, approximately 10% of initiators were added or switched to statins within 1 year of initiation. Collectively, any class tended to be discontinued early and some restarted; however, there were some unique classes. The findings are useful for improvement of dyslipidemia therapy.

The IHO Council: Reflections of its first Chairs

At the Third IHO (International Hydrographic Organization) Assembly in 2023, we were struck by the smooth adoption and broad support for the proposals made by and through the IHO Council (the Council). We consider this to be a signature success of the IHO’s governance structure and of the Council in particular. As insiders and as its first two Chairs, we offer some insights and reflections on the initial years of Council for future Council and IHO Members States.

Radiological and clinical evaluation of triple combination modulating therapy effectiveness in adult patients with cystic fibrosis

ObjectivesPrevious studies showed the clinical effectiveness of elexacaftor-tezacaftor-ivacaftor (ETI) in cystic fibrosis (CF) patients and a recently published study evaluated twelve CF patients that performed chest and sinus computed tomography (CT) examinations and showed that ETI decreased pulmonary and sinus morphological abnormalities after one year of treatment. The aim of the present study was to evaluate the role of CFTR modulator therapy in improving radiological and clinical scores one year after ETI therapy initiation in a wider CF patient population. Materials and methodsBetween January 2020 and December 2022, 44 CF adult patients received elexacaftor-tezacaftor-ivacaftor (ETI) therapy for at least one year and underwent a chest CT examination at our hospital before and one year after ETI therapy initiation. Experienced radiologists who were blinded to the treatment assessed the images in consensus. The Brody-II score (BSII), the Lund-Mackay score (LM score) and the Sheikh-Lind CT sinus disease severity scoring system (SL score) were evaluated. Clinical scores such as cystic fibrosis clinical score (CFCS), Cystic Fibrosis Questionnaire-Revised (CFQ-R) score, the 22-item SinoNasal Outcome Test (SNOT-22) questionnaire and the CF-specific 28-modal abdominal symptom score (CFAbd-Score) were evaluated. Forced expiratory volume in 1 ​s (FEV1) and forced vital capacity (FVC) were also assessed. Paired samples t-tests were used to compare differences before and after one year of ETI therapy initiation, and Pearson's correlation coefficient was used to evaluate changes in FEV1 and total BSII and in FVC and total BSII. ResultsTotal BIIS one year after ETI initiation showed statistically significant lower scores (−6.0 p, p ​< ​0.0001). In particular, mucous plugging (−15.8 p, p ​< ​0.0001), peribronchial thickening (−16.2 p, p ​< ​0.0001) and parenchyma (−0.3 p, p ​= ​0.0397) showed statistically significant lower scores. LM score, SL score, FEV1, FVC, CFCS, CFQ-R, SNOT-22 and CFAbd-Score showed statistically significant lower scores one year after ETI initiation (p ​< ​0.0001). The correlation between ΔFEV1 and Δtotal BSII was statistically significant and moderate (r ​= ​−0.5188, p ​= ​0.0003), and the correlation between ΔFVC and Δtotal BSII was statistically significant and weak (r ​= ​−0.3160, p ​= ​0.0367). ConclusionEvolution of imaging findings on CT during follow-up closely correlate with improved clinical scores and functional data one year after ETI therapy initiation, indicating that CT may be a useful adjunct during follow-up of CF patients under this treatment as an objective measure of disease improvement.

Uptake of palliative care services in patients with non-small cell lung cancer receiving immune checkpoint inhibitor therapy: The Mayo Clinic Florida experience.

269 Background: There are strong data showing that patients (pts) with metastatic non-small cell lung cancer (NSCLC) receiving chemotherapy experience better quality of life (QOL) and longer overall survival (OS) when palliative care (PC) services are integrated early in their treatment course. Therefore, at our cancer center, pts with stage IV NSCLC have been referred to PC by oncology providers. In this study, we evaluated the uptake of PC services, specifically in pts with NSCLC who received immune checkpoint inhibitors (ICIs). ICIs have been considered to have less severe or less frequent adverse effects as compared to chemotherapy, possibly leading to fewer referrals to PC. Methods: We conducted a retrospective review of all pts at the Mayo Clinic Cancer Center in Florida who received single-agent ICI therapy for the treatment of stage IV NSCLC at any point between July 1, 2015, and July 1, 2022. The primary aim was to evaluate the uptake of PC services before or during treatment with ICIs. Descriptive statistics were used to characterize pt demographics and outcomes. Results: 129 pts were identified. 53.4% were male, and 46.6% were female. The majority of pts (84.4%) were white. 62 pts (48.0%) were seen by a PC provider before or during ICI treatment; 41 of these (31.7%) were seen by PC after starting ICI therapy. When grouped by year of ICI initiation, 30/73 pts (41.0%) treated between 2015 and June 2018 were seen by a PC provider, as compared to 15/31 pts (48.3%) treated between July 2018 and June 2020 and 17/25 pts (68.0%) treated between July 2020 and July 2022. Interestingly, the majority of pts who received PC services in the 2020-2022 group (12/17, or 70.5%) were seen by a PC provider for the first time prior to ICI initiation, whereas the majority of pts who received PC services prior to July 2020 (37/45, or 82.2%) were seen by a PC provider for the first time after ICI initiation. The mean number of PC visits increased from 1.59 in the 2015-2018 group to 1.84 in the 2018-2020 group and 4.96 in the 2020-2022 group. Conclusions: Uptake of PC services in pts with stage IV NSCLC receiving single-agent ICIs at our cancer center has increased over time, which is encouraging. Nevertheless, the numbers remain suboptimal, with less than 70% of pts receiving PC services. We plan to develop a multidisciplinary quality improvement project involving implementation of a mechanism to ensure that most patients with stage IV NSCLC, regardless of the type of systemic treatment they receive, are receiving PC services.

Analysis Of The Effect Of Loading On Parallel Generator Work At PT. Mitrabara Adiperdana Tbk

Genset is a combination of two different devices: the engine as a rotating device and the generator as a generating device. Genset at PT. Mitrabara Adiperdana. Tbk is used as a backup when the electricity source from PLN goes out. Due to fluctuating loads, an ample power supply is needed when the conveyor is operating, so more than one generator is needed to supply electricity according to load demand. To meet the power needs at PT. Mitrabara Adiperdana. Tbk, 2 gensets with a capacity of 500 kVA and 3 gensets with a capacity of 800 kVA were synchronize. Generator synchronization aims to obtain optimal power, good efficiency and efficient specific fuel consumtion (SFC). When 5 generator units were paralleled, the lowest efficiency was 19.2% with an SFC of 0.48 liters/kWh in September with a capacity of 800 kVA, while the highest efficiency was 62.98% with an SFC of 0.15 liters/kWh in July with a capacity of 800 kVA. The calculation result, when given the same loading, obtained the lowest efficiency of 1% with an SFC of 9.3 liters/kWh in August with a capacity of 500 kVA and the highest efficiency of 51.45% with an SFC of 0.18 liters/kWh in August with a capacity og 800 kVA. The calculation result show that the efficiency is affected by the amount of output power, the difference in the initial year of operation, anf the difference in several parameters of the nmaplate. Meanwhile, the generator’s Specific Fuel Consumtion (SFC) is influenced by the output and hours meter.

Effect of groundwater flow on thermal performance of SBTES systems

In this study the influence of different groundwater flow conditions on the short- and long-term thermal performance of SBTES system is studied. Numerical analyses of a SBTES system are performed using COMSOL with four groundwater table depths and with four groundwater velocities. The study evaluates the thermal performance of SBTES in terms of the average temperature, heat stored, and system efficiency over a 10-year operational period. The results indicate that high groundwater velocity (1 × 10−5 m s−1) has a detrimental effect on the thermal performance of SBTES, causing significant reduction in the stored heat. Medium groundwater velocity (1 × 10−7 m s−1) with the groundwater table at half the depth of SBTES has an insignificant effect during the initial years of operation but causes significant reduction in heat stored over the long term. The study also highlights the potential of heat loss resulting from high velocity groundwater flow taking place below the SBTES. The findings suggest that groundwater flow plays a critical role in the thermal performance of SBTES, and long-term analysis is necessary to evaluate the impact.

Linking Response to Intervention and Identification of a Specific Learning Disability

We investigated state and national trends in the enrollment of students ages 6 to 21 under the specific learning disability (SLD) category across 15 consecutive school years (2005–2006 to 2019–2020). We used multi-level modeling to estimate the effects of state and time on SLD enrollment and conducted a policy analysis of three states (Rhode Island, Kansas, and New Mexico) to examine changes in SLD policy (including Response to Intervention) in conjunction with trends in enrollment. Results indicate significant differences in SLD enrollment between states in the initial year and significant decreases in SLD enrollment over time, but no significant differences in the change in SLD enrollment between states. Results from the policy analysis suggest that the state policy context (including legal requirements in the SLD evaluation process), type of RTI model, and method of SLD evaluation can affect SLD enrollment. We discuss these results within the context of increased variability in RTI models.

Fifty years of hemodialysis in Ghana—current status, utilization and cost of dialysis services

BackgroundKidney failure is common in Ghana. Haemodialysis (HD) is the most common treatment modality for survival. Although, HD has been available in Ghana for 50 years, the majority of patients who develop kidney failure cannot access it. We describe the state of HD, dialysis prevalence, its utilization and cost of HD after fifty years of dialysis initiation in Ghana.MethodsA situational assessment of HDs centres in Ghana was conducted by surveying nephrologists, doctors, nurses and other health care professionals in HD centres from August to October 2022. We assessed the density of HD centres, number of HD machines, prevalence of nephrologists, number of patients receiving HD treatment and the cost of dialysis in private and government facilities in Ghana.ResultsThere are 51 HD centres located in 9 of the 16 regions of Ghana. Of these, only 40 centres are functioning, as 11 had shut down or are yet to operate. Of the functioning centres most (n = 26, 65%) are in the Greater Accra region serving 17.7% of the population and 7(17.5%) in the Ashanti region serving 17.5% of the population in Ghana. The rest of the seven regions have one centre each. The private sector has twice as many HD centers (n = 27, 67.5%) as the public sector (n = 13,32.5%). There are 299 HD machines yielding 9.7 HD machines per million population (pmp) with a median of 6 (IQR 4–10) machines per centre. Ghana has 0.44 nephrologists pmp. Currently, 1195 patients receive HD, giving a prevalence of 38.8 patients pmp with 609(50.9%) in the private sector. The mean cost of HD session is US $53.9 ± 8.8 in Ghana.ConclusionThere are gross inequities in the regional distribution of HD centres in Ghana, with a low HD prevalence and nephrology workforce despite a high burden of CKD. The cost of haemodialysis remains prohibitive and mainly paid out-of-pocket limiting its utilization.

Analysis of the capital structure of startups in light of the tradeoff and pecking Order theories

Purpose: Startups have significant differences compared to other companies. They have many intangible assets (e.g., team tenure and experience of founders), are risky, and tend not to generate profits in their initial years (Heirman &amp; Clarysse, 2007; Weber &amp; Zulehner, 2009). Does the startups’ financing choice also differ from that of traditional companies? We analyzed the capital structure of startups in their first years of life based on the classic tradeoff and pecking order theories. Methodology/approach: We collected data on 40 startups in the city of Ribeirão Preto, São Paulo, Brazil, through a questionnaire on the profiles of the founders, company characteristics, bottom-line performance and financing sources. The data collected covered the year of founding and the three subsequent years. Findings: The results indicated that these startups mainly financed themselves through the founders’ capital in all four years covered. Only in the third year did they start using resources generated internally, indicating pecking order adherence. However, the presence of angel investors and government subsidies contrasted with the absence of bank debt. In line with the tradeoff theory, bank debt was not a viable financing option in the early years of these firms since they had low profitability and high risk. Theoretical/methodological contributions: We offer a theoretical contribution by analyzing the adequacy of traditional financial theories in the specific context of startups. Originality: The finance literature about startups is scarce, and few studies have analyzed these companies from the capital structure theoretical perspective. Social contributions / for management: We provide a panorama of the financing of startups to support their financial planning regarding fundraising.

The effect of venture capital backing on innovation in newly public firms

We study the effect of VC-backing on innovation in newly public firms and find that it is negatively related to patents produced and citations received within the initial years following an IPO – our estimates indicate that VC-backed firms produce 13% fewer patents than nonVC-backed firms within the first year post-IPO. Our findings suggest that this adverse effect is a consequence of VCs timing their portfolio companies’ IPOs at the peak of innovation followed by a decline post-IPO. Additionally, VC-backing leads to higher growth in sales and productivity in newly public firms pointing to a shift in VC focus from creating into commercializing innovation post-IPO. We address endogeneity concerns with an instrumental variables approach.

Medical students' knowledge about curriculum development and implementation in public and private medical institutes.

To assess the knowledge of undergraduate medical students about curriculum development and implementation. A quantitative descriptive study was conducted at a public sector institute and a private sector institute from September, 2022 to December, 2022. Simple random sampling was used and all the undergraduate MBBS students were included in study. Sample size was calculated using open epi and keeping confidence interval at 95% as 316 for FMU students and 218 for AFMDC students. Ethical approval was taken from FMU and permission to collect data was obtained from AFMDC. A Questionnaire was made and distributed among the students and data obtained was analyzed using SPSS 25.0. Two hundred and forty-seven (49.4%) participants responded that the students don't have any say in their curriculum, 400 (80%) were of the view that the students must have their opinion in the curriculum and 397 (79.4%) said that students must be involved in the process of planning and implementation of curriculum. When asked about the areas of deficiencies in the current curriculum, 101 (20.2%) pointed new skill, 84 (16.8%) indicated New information, new skills, teaching Methodology and effective teachers, 68 (13.6%) said teaching methodology while 51 (10.2%) indicated new skills and teaching methodology both. Five main themes were identified from the comments of students regarding curriculum, its development and implementation including; 1. Content revision, 2. Teaching methodologies, 3. Assessment, 4. Guidance and orientation and 5. Teacher student relationship. The undergraduate medical students are aware of the terms related to curriculum, its development and implementation but they are not being involved in any of this process. Content revision, clinical integration from initial years, quality assessment and faculty development are few areas that need improvement from students' perspectives.

Austerity urbanism, local government debt-drive, and post COVID predicaments in Britain

Abstract Conditions of local governance in the aftermath of the global financial crisis are often discussed as reflections of ‘austerity urbanism’. What forms of mutations have taken place in austerity urbanism after the initial years of spending cuts at the local level? This article investigates this question by focusing on the uneven geographies of post-austerity debt-drive in Britain. It is shown that austerity urbanism in Britain was somewhat peculiarly combined with debt-driven ‘entrepreneurialism’ several years after the introduction of extensive budgetary cuts. The local debt-drive was instigated by austerity-urbanism as a way of resolving the challenge of financing local services and development. The relatively low level of initial debt stock among local governments, very attractive borrowing terms and various regulatory changes facilitated the expansion of borrowing. Using debt stock data for over 300 local governments, it is demonstrated how debt build-up evolved to create financial difficulties for around 40 per cent of local governments. The Covid-19 pandemic, with its severe impacts on local revenues, exposed the debt-driven local development projects, leading to rescue operations and efforts to curb borrowing through new rules and regulations. For deeper international insights into the dynamics of debt-financing and urban development in times of crises, further research is needed to complement existing research in Britain and the USA, where relatively greater evidence exists.

Research as an epistemological status of supervised internship in teaching: Challenges in times of pandemic

As a general objective of this article, we seek to discuss the internship as a field of knowledge that requires an epistemological status based on overcoming the reproduction of instrumental practices. To this end, an experience report from the Internship discipline is used. Supervised Teaching of the Initial Years of Elementary Education of the Degree in Pedagogy at a private college in Curitiba/PR held during 2020, the first year of the Covid-19 pandemic. The first part of the text proposes a discussion on the epistemological principles that constitute the supervised internship in teacher training, followed by a brief scenario of the impact of the Covid-19 pandemic on education, followed by a report on the experience carried out during the year 2020 with interns from the Pedagogy course, describing the theoretical-methodological proposal of the Supervised Internship discipline and how the research activities were proposed and developed. Finally, a discussion is presented about the need for the supervised internship to overcome the simple technical instrumentation based on copying models observed in the classroom to construct a critical attitude of the educator in relation to his work. and the pedagogical proposal of different educational levels, based on research as a methodological axis.

The Development and Implementation of a School-Based Dental Sealant Program for Hawaii Public Schools.

School-based dental sealant programs are noted to increase sealant uptake among children, especially those from low-income families and those living in rural and underserved areas. However, nationally school-based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school-based dental sealant program for Title 1 public schools in Hawaii. The Hawaii Keiki: Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school-based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program success. The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019-2020), which presented challenges due to the COVID-19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020-2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021-2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY 2022-2023. Taking advantage of strategic partnerships and key interprofessional team members, a school-based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care.

The Effect of Organizational Climate on Sell‐side Analyst Turnover and Performance

This paper investigates whether and how organizational climate (OC) in brokerage firms affects analyst turnover and performance. We find that firms with a lower‐rated OC have a higher likelihood of analyst turnover. Also, when analysts leave and switch brokerage firms, they are more likely to move to a firm with a higher‐rated OC and will deliver more accurate forecasts after switching firms. However, the performance improvements in better‐rated OC firms are significant only for the initial years of the analysts’ employment in the new firms. We also show that OC‐related analyst turnover negatively affects the performance of incumbent analysts, especially for those non‐All‐Star incumbent analysts, while these adverse performance effects are also transitory and last for two years only. Thus, our findings indicate that OC only has a short‐lived effect on the behaviour of both leaving and remaining analysts, which challenges the long‐held assumption that investments in a positive OC will always be associated with lower employee turnover and higher individual performance. We explain our results as arising from the high levels of labour mobility within the brokerage industry and the transparency of analyst forecasts as a public performance measure.

The impact of the anthropause caused by the COVID-19 pandemic on beach debris accumulation in Maui, Hawaiʻi

The COVID-19 pandemic and subsequent travel restrictions led to a considerable reduction in tourism and human activity on Maui, presenting a unique opportunity to study debris accumulation on local beaches during changing levels of human activities. Standardized daily debris accumulation surveys were completed at two beach sites in Maui, Hawai ‘i before (2017) as well as throughout the initial year of the pandemic (2020–2021) and allowed for the assessment of pandemic-related restrictions on marine debris accumulation trends. Throughout the pandemic, reduced beach use due to higher lockdown levels had significant impacts on debris accumulation at both sites, but only one of the two sites experienced a significant decrease (~ 90% reduction) in debris accumulation rates when compared to the same months in 2017. Daily accumulation rates across two sites increased from an average of 16 items/100 m during peak lockdown levels to 43 items/100 m when restrictions eased. The observed fluctuations in debris accumulation rates, driven by changes in tourism and travel restrictions during the COVID-19 pandemic emphasize the importance of proactive measures to protect the natural environment, including source reduction and effective legislation for waste prevention. By addressing both local and remote sources of debris and focusing on reducing waste at its source, it is possible to mitigate the impacts of debris accumulation on coastal environments and marine life in Hawaiʻi.

The Many Pollutant Identities of Carbon Dioxide: Global Climate Monitoring and Air Pollution Research in New Zealand, 1968–1975

In the late 1960s, New Zealand and the United States collaborated to establish a southern hemispheric carbon dioxide (CO 2 ) monitoring station on New Zealand’s coastal cliffs. The New Zealand CO 2 Project, as it came to be known, is an underappreciated landmark in the history of environmental monitoring. The archival record of its early years reveals the extent to which efforts to measure atmospheric carbon dioxide concentrations interacted closely with one of the most hotly debated political issues of the mid-twentieth century: urban air pollution. The designation of CO 2 as air pollution on a planetary scale had profound legal implications in an era in which clean air legislation increasingly brought air pollution within the scope of governmental regulation, and administrative agencies began to jostle for control of the monitoring enterprise. The precise nature of CO 2 as an air pollutant, however, was difficult to pin down. In these initial years of concerted carbon dioxide monitoring, when the lines between climate science and air pollution research were still blurred, CO 2 developed its many pollutant identities. The nature of these identities – and the ways in which scientists and science administrators negotiated their boundaries – retain their relevance today, as nations continue to link air pollution and climate legislation in the twenty-first century.