Based on the research activity within the ISLE International Sustainability Network, this paper represents a step forward aiming to find some contacts points in the experiences some international cases (USA, Brazil, Italy and France) have grown in the development of agritourism in mountain contexts. Despite the singular differences and the national specificities, agritourism is generally considered a particular form of social innovation in agriculture and rural development of mountainous areas, aiming at recomposing the natural and the human dimensions within the framework of a new sustainable way of doing agriculture. At the basis of the research is the hypothesis that agritourism operations are slowly and gradually shifting towards a new perspective/model. Some years ago, agritourism was traditionally viewed as a way for farmers to integrate or diversify their incomes. Nowadays instead—as the diversity of practice has grown and new values have emerged—the range of farmers’ motivations has become much broader. Some of these motivations include not only economic issues but also social, environmental and cultural ones, while addressing a more comprehensive idea of community-based and sustainable development. Case studies from South Carolina (USA), from Italian mountain regions, from Santa Catarina State in Brazil and from France are illustrated in which different innovation perspectives are highlighted.

Agritourism is a growing area of the tourism sector with many positive social and economic benefits for farmers, their communities, and for tourists. While researchers have been studying the phenomenon for several decades, factors that lead to profitable outcomes for agritourism operators are still not well understood, hindering the effectiveness of agritourism development and the systems of support available to farmers. Using a survey of 1834 farms and ranches open to visitors in the United States, the goal of this study is to identify the factors that influence the profitability of agritourism operations. This study shows that several factors have positive associations with increased agritourism profitability, such as the number of years of experience of the operator, farm scale (acreage and total farm revenue), providing on-farm product sales, and offering events and entertainment. Off-farm product sales and being a female operator have a negative association with profitability in agritourism. We discuss the implications of our findings on agritourism operators, suggest their utility for tourism planning and rural community development professionals, and offer suggestions for future research.

In recent years, neonatal abstinence syndrome (NAS) rates have increased rapidly across the United States, rising from 1.2 (2000) to 5.8 (2012) per 1000 hospital births annually. Because most NAS infants are treated in an intensive care setting, associated hospital charges are high and continue to escalate, rising on average from $39,400 in 2000 to $66,700 in 2012. An innovative NAS treatment program, which includes early-initiated methadone therapy, rooming-in, and combined inpatient/outpatient weaning in a low-acuity nursery, has been in place since 2003 at a large Southeastern hospital. The program has proven safe, effective and low cost for treating infants of ≥35 weeks gestational age whose mothers used long-acting opioids. Given that 81% of NAS cases in the United States are funded by Medicaid programs and that the cost burden is rising rapidly, researchers considered the potential saved charges associated with implementing the same program in other hospitals state- and nationwide. Researchers used regression models to project state and national NAS birth rates from 2015–2025 and to predict future NAS charges under current treatment protocols. Three scenarios were developed to compare the potential saved charges of implementing the innovative NAS treatment program across the state and nation with assumptions related to the percent of NAS infants eligible for the program, percent funded by Medicaid, and fluctuations in average length of stay. The potential saved charges are substantial, creating a compelling case for policy makers and hospitals in the pursuit of safe, effective, and cost-conscious NAS care.

Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted. Per birth, mean hospital charges were $10,946.96; mean costs were $5,908.93. Conclusion This study is the first to describe an early treatment model in a low-acuity nursery to prevent severe neonatal opioid withdrawal. The described model may be safe, effective, low-cost, and feasible for replication.