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Background We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care. Methods Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020–30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included. Results Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P =.005) and hospitalization was longer (P =.01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P =.40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19. Conclusions In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities. [ABSTRACT FROM AUTHOR]

Background Clinical differences between critical illness from influenza infection vs coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients. Methods We compared demographics, clinical characteristics, and outcomes of US children (aged 8 months to 17 years) admitted to the intensive care or high-acuity unit with influenza or COVID-19. Using mixed-effects models, we assessed the odds of death or requiring life support for influenza vs COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity. Results Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median, 5.2 years vs 13.8 years), less likely to be non-Hispanic Black (14.5% vs 27.6%) or Hispanic (24.0% vs 36.2%), and less likely to have ≥1 underlying condition (66.4% vs 78.5%) or be obese (21.4% vs 42.2%), and a shorter hospital stay (median, 5 days vs 7 days). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life support in children with influenza vs COVID-19 were similar (adjusted odds ratio, 1.30; 95% confidence interval,.78–2.15; P =.32). Conclusions Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19. [ABSTRACT FROM AUTHOR]

Background Pfizer-BioNTech COVID-19 vaccine received emergency use authorization for persons ≥ 16 years in December 2020 and for adolescents 12–15 years in May 2021. Despite the clear benefits and favorable safety profile, vaccine uptake in adolescents has been suboptimal. We sought to assess factors associated with COVID-19 non-vaccination in adolescents 12–18 years of age. Methods Between June 1, 2021 and April 29, 2022, we assessed factors associated with COVID-19 non-vaccination in hospitalized adolescents ages 12–18 years enrolled in the Overcoming COVID-19 vaccine effectiveness network. Demographic characteristics and clinical information were captured through parent interviews and/or electronic medical record abstraction; COVID-19 vaccination was assessed through documented sources. We assessed associations between receipt of the COVID-19 vaccine and demographic and clinical factors using univariate and multivariable logistic regression and estimated adjusted odds ratios (aOR) for each factor associated with non-vaccination. Results Among 1665 hospitalized adolescents without COVID-19, 56% were unvaccinated. Unvaccinated adolescents were younger (median age 15.1 years vs. 15.4 years, p  < .01) and resided in areas with higher social vulnerability index (SVI) scores (median 0.6 vs 0.5, p  < .001) than vaccinated adolescents. Residence in the Midwest [aOR 2.60 (95% CI: 1.80, 3.79)] or South [aOR 2.49 (95% CI: 1.77, 3.54)] US census regions, rarely or never receiving influenza vaccine [aOR 5.31 (95% CI: 3.81, 7.47)], and rarely or never taking precautions against COVID-19 [aOR 3.17 (95% CI: 1.94, 5.31)] were associated with non-vaccination against COVID-19. Conclusions Efforts to increase COVID-19 vaccination of adolescents should focus on persons with geographic, socioeconomic, and medical risk factors associated with non-vaccination. [ABSTRACT FROM AUTHOR]

Background It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered. Methods Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated. Results Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December). Conclusion Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies. [ABSTRACT FROM AUTHOR]

The article informs that Pfizer-BioNTech vaccine, currently authorized for persons aged ≥5 years, provides a high level of protection against severe COVID-19 in persons aged 12–18 years. It is noted taht Vaccine effectiveness against multisystem inflammatory syndrome in children, which can occur 2–6 weeks after SARS-CoV-2 infection, has remained uncharacterized.

Rising infrastructure costs for water providers and the rising cost of water for households pose several challenges for water providers, policy makers, and the research community. Consumers may utilize several strategies for coping with rising water costs including reduced water use or spending reductions on other household goods and services. To provide a first glance at the link between rising water bills and consumer spending, this study analyzes data from a household survey in the United States to understand how consumers may change spending behavior given various water bill increase scenarios. Results of this analysis provide insights into the demographics of households likely to be affected, the industries that could be affected, and at what bill increase levels these trends are most pronounced. While additional research on this topic is needed, these results suggest a stronger emphasis on long-term water management planning and allocation of resources to building and maintaining water infrastructure may be required. For utilities, this means a consideration of nonrevenue sources of funds to pay for rising water costs and strategies for making water more affordable for customers without deferring infrastructure improvements. [ABSTRACT FROM AUTHOR]

The United States (U.S.) has experienced persistent truck driver shortages for the past several decades, as demand for truckers has increased while individuals willing to fill driving jobs have decreased. Studies in the transportation literature have not examined industry views on driver shortages, which are expected to become more severe, in combination with trucking industry perspectives on the impact of automated vehicles (AVs) on driving jobs. This study addresses these knowledge gaps through focus groups with trucking industry participants (N = 67) working in three organizational levels (25 upper-level management or owners, 20 supervisors or dispatchers, and 22 drivers) and a supplemental online survey. Using an inductive thematic analysis approach, findings indicate that companies struggle to address driver shortages because of difficulties recruiting younger workers related to quality-of-life issues, job requirements, and low rates of pay. AVs were thought to be a potential solution to the driver shortage, although there will be a continued need for drivers to perform certain tasks. The potential changes in industry positions could attract new workers but would require older workers to adapt to using new technology. From a workforce development perspective, training programs targeting technicians and drivers can help prepare the trucking workforce for an autonomous future. • Automated vehicles (AVs) may be a solution to address ongoing driver shortages. • Many respondents projected AVs would reduce the size of the U.S. workforce. • Most respondents thought AVs would not impact their company's workforce size soon. • The aging workforce is thought to be a major contributor to driver shortages. • Companies are actively trying to retain drivers by accommodating their concerns. [ABSTRACT FROM AUTHOR]

The use of mindfulness or contemplative-based approaches has escalated across many sectors and has been the subject of increasing research interest, so it's not surprising it is now finding its way into education. This paper reports some key insights gained from a quarter-long mindfulness project implemented over eight weeks in a large community college writing center in Omaha, Nebraska. This paper will describe the initial professional development day when the writing center consultants learned about the pedagogical and theoretical value of mindfulness and its relevance to higher education. This paper will then present the quarter-long project, during which the theories behind mindfulness were put into daily practice in the writing center. Writing center consultants were asked to take part in weekly mindfulness exercises both in the writing center and at home. Questionnaires were administered by the Writing Center Coordinator to collect anonymous consultant feedback each week, in addition to a final questionnaire to measure the project's effectiveness. This cowritten paper will describe each phase of the project from both the Writing Center Coordinator and the consultant perspectives. The findings of this project have led the Coordinator to incorporate a mindfulness-based foundation into their Writing Center philosophy and enforced their commitment to student-driven pedagogy. [ABSTRACT FROM AUTHOR]

While basic access to clean water is critical, another important issue is the affordability of water access for people around the globe. Prior international work has highlighted that a large proportion of consumers could not afford water if priced at full cost recovery levels. Given growing concern about affordability issues due to rising water rates, and a comparative lack of work on affordability in the developed world, as compared to the developing world, more work is needed in developed countries to understand the extent of this issue in terms of the number of households and persons impacted. To address this need, this paper assesses potential affordability issues for households in the United States using the U.S. EPA’s 4.5% affordability criteria for combined water and wastewater services. Analytical results from this paper highlight high-risk and at-risk households for water poverty or unaffordable water services. Many of these households are clustered in pockets of water poverty within counties, which is a concern for individual utility providers servicing a large proportion of customers with a financial inability to pay for water services. Results also highlight that while water rates remain comparatively affordable for many U.S. households, this trend will not continue in the future. If water rates rise at projected amounts over the next five years, conservative projections estimate that the percentage of U.S. households who will find water bills unaffordable could triple from 11.9% to 35.6%. This is a concern due to the cascading economic impacts associated with widespread affordability issues; these issues mean that utility providers could have fewer customers over which to spread the large fixed costs of water service. Unaffordable water bills also impact customers for whom water services are affordable via higher water rates to recover the costs of services that go unpaid by lower income households. [ABSTRACT FROM AUTHOR]

• Investigate the connection between broadband and new business activity. • Instrumental variables approach based on development of the Internet by the U.S. military. • Broadband availability was associated with an increase in new business activity. • Broadband was associated net creation of new businesses. • Broadband may have crowded out business activity in the manufacturing industry. Research investigating the linkages between broadband and new business activity in countries around the world produce mixed results related to important nuances in this relationship pertaining to industry characteristics, geography, and the skill level of the workforce. Given these nuances, the goal of this study is to investigate the connection between broadband availability and new business activity, building on regional and rural-focused studies within the United States. Specifically, our paper conducts a nationwide assessment of the relationship between broadband and new business activity, in the early years of broadband in the late 1990s/early 2000s when it had the most potential to disrupt industries and open up new entrepreneurial opportunities. Using an instrumental variables approach based on the development of the Internet by the U.S. military, we estimate the impact of broadband availability on total and net new business creation. Results suggest that access to broadband was associated with an increase in new business activity and net creation of new businesses. We also find evidence that access to broadband was important in the creation of businesses in knowledge- oriented industries who benefited from the rise of the Internet. At the same time, we also find broadband may have crowded out business activity in the manufacturing industry. Combined, our results suggest disruptive innovations related to broadband Internet connections are important for small business creation in many, but not all industries. Given these linkages, expanding access to broadband may help generate new business activity and business growth. [ABSTRACT FROM AUTHOR]

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Research analyzing perceptions of water services has focused on water quality, water safety, and the propensity to consume water from different sources. It has not assessed perceptions of water costs. To address this knowledge gap, this study collected nationally representative survey data from households in the United States about water issues and incorporated these data into logistic regression models. In doing so, our study advances the water and public policy literature in three ways. One, it addresses the need for household resolution information about water issues given the absence of data at this scale in the United States. Two, it creates and utilizes one-of-a-kind survey data to understand the perceptions of household water bills and the drivers of these perceptions. Three, we assess the impact of proposed solutions to improve water affordability on household perceptions of water costs. Model results indicate low-income and households in underrepresented groups were more likely to perceive their water bills to be too high. The perception of water costs also varied geographically. From a policy perspective, model results indicate utilities can positively affect perceptions of water bills via the frequency of water billing and provision of payment assistance programs. [ABSTRACT FROM AUTHOR]

To evaluate actions taken to implement the Telecommunications Act of 1996, the primary goal of which was to foster competition in the industry, the FCC created a standardized form (Form 477) to collect information about broadband deployment and competition in local telephone service. These data represent the best publicly available record of broadband provision in the United States. Despite the potential benefits offered by this database, there are several nuances to these data related to shifting geographies and reporting requirements that uncorrected, prevent them from being used as an uninterrupted time series for longitudinal analyses. Given the analytical challenges associated with the FCC Form 477 data, the purpose of this paper is to present a solution to the fragmented nature of these data which prevents meaningful longitudinal analyses of the digital divide. Specifically, this paper develops and describes a procedure for producing an integrated broadband time series (BITS) for the last decade (2008-2018). This includes the procedures for using these data, their value to social and economic analysis, and their underlying limitations. The core contribution of this paper is the creation of data infrastructure for investigating the evolution of the digital divide., Competing Interests: The authors have declared that no competing interests exist.