Heart Transplantation (ht) from Active and Recently Active Covid19 Donors

HT centers may avoid donors with Covid19 (Cov19) infection due to uncertain risk of virus transmission and possibility of virus mediated myocardial injury. We investigated Cov19 donor utilization, transplant characteristics and early post HT outcomes in the U.S. Between May 2020-June 2022, n=27,862 donors in UNOS had data available on Cov19 NAT tests and organ disposition. Since donors may get Cov19 testing multiple times prior to organ retrieval, additional data on multiple Cov19 NAT was requested and analyzed. Donors were classified Cov19-donors if NAT+ at any time during terminal hospitalization, and subclassified as Active Cov19(A-Cov19) if NAT+ at organ procurement and 'Recently Active Cov19' (rA-Cov19) if NAT+ initially but NAT negative prior to organ retrieval. HT outcomes using Cov19 and nonCov19 donors were compared by Kaplan Meier (KM) and Cox hazards ratio (HR). Prior to organ retrieval, 27,862 donors had 60,699 Cov19 NAT tests done. Of these, n=1445 were Cov19 donors, n=125 indeterminate and n=26,292 nonCov19. Of Cov19 donors, n=1017 were A-Cov19 and n=428 rA-Cov19. 309 HTs used hearts from Cov19 donors and 239 (n=150 A-Cov19, n=89 rA-Cov19) met study criteria. Compared to nonCov19, Cov19 donors used for adult HT were younger [30(23-37) vs 32(25-40)yrs] and mostly male (80.3% vs 72.1%), p<0.05. Otherwise, HTs from Cov19 and nonCov19 donors were similar in recipient age, race, etiology, UNOS status, BMI, LVAD, ECMO use;and donor LVEF, and DCD status. HTs from Cov19 and nonCov19 donors had similar survival up to 3 months [CoxHR=1.23(0.63-2.39), p=0.54, adjusted for baseline characteristics, Fig1A]. Survival was also statistically similar in A-Cov19 and rA-Cov19 donor HT cohorts [CoxHR=1.47(0.40-5.48), p=0.56, Fig1B]. HTs from Cov19 donors increased from n=5 in May-Dec 2020 to n=207 in Jan-June 2022, p<0.05 for trend. Data on Cov19 treatment was not available. In the largest analysis to date, HTs from selective Cov19 donors had acceptable early outcomes. Longer follow up is needed. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pathophysiologic mechanism for MYOcarditis in COVID-19 VAccinations ('MYOVAx' Study)

Objective: This is the first prospective cohort study in Singapore to investigate the COVID-19 vaccine-associated myocarditis to understand its pathophysiology. Introduction: Acute myocarditis and other cardiovascular symptoms have been observed to be associated with the two mRNA-based coronavirus disease 2019 (COVID-19) vaccines-namely Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273)-currently in-use in Singapore. The mechanisms through which myocarditis occurs are unknown, hence our study aims to understand the pathophysiology of myocarditis associated with COVID-19 vaccines. Method(s): Patients with onset of cardiac manifestations were recruited from multiple hospital outpatient clinics between November 2021 and September 2022. Clinical history and physical examination data was collected with blood sample collection, echocardiography, 12-lead electrocardiogram (ECG), coronary angiography and magnetic resonance imaging (MRI) at recruitment and 6-month follow-up. Analysis of biomarkers, genetic, serological and MRI data was conducted. Result(s): As of 6 September 2022, a total of 5 patients have been enrolled (4 males, 1 female). The most commonly reported symptoms across all patients were chest pain/discomfort (80%), followed by palpitations (40%). MRI evidence of myocarditis has been detected in 2 (50%) of the male patients, of which both reported two or more symptoms occurring 1-2 days post-vaccination. Both patients have each received at least two doses of either the Pfizer-BioNTech BNT162b2 vaccine or Moderna mRNA-1273 vaccine. Their MRI findings were consistent with myocarditis. On late gadolinium enhancement (LGE) imaging, epicardial enhancement at the basal inferolateral segment and mid-wall enhancement at the apical anterior, lateral and inferior walls were observed in one patient. Patchy, mid-wall LGE in the basal inferior/inferolateral wall was observed in the other patient. No MRI evidence of myocarditis was available for the sole female patient. Conclusion(s): While more data is needed to definitively prove the association of the two mRNA-based Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273 COVID-19 vaccines with post-vaccination myocarditis, we believe our findings may support further investigations to enable risk stratification for vaccine-associated myocarditis and identify potential preventative strategies accordingly.

Impact of lockdowns on paediatric asthma hospital presentations over three waves of COVID-19 pandemic

The impact of COVID-19 pandemic on paediatric asthma, the most common chronic condition of childhood, in Australia remains unknown. In a multicentre study, we examined the impact of COVID-19 on paediatric asthma in New South Wales Australia. Method(s): Time series analysis was performed to determine trends in asthma hospital presentations in children aged 2-17 years in pre-pandemic (Jan 2015-Dec 2019) and COVID-19 pandemic years (Jan 2020-August 2021) using emergency department and hospital admission datasets from two large tertiary paediatric hospitals. Result(s): In the pre-pandemic years there were in total 492,863 hospital presentations in children aged 2-17 years, of these 13,160 (2.67%) were due to asthma and in pandemic years there were 163,521 hospital presentations of which 3,364 (2.05%) were due to asthma. We observed a significant decrease in asthma hospital presentations during lockdown periods of COVID-19 pandemic including April (68.85%), May (69.46%) and December (49.00%) of 2020 and August 2021 (66.59%) compared to pre-pandemic predictions. The reduction in asthma hospital presentation in April-May of 2020 and August 2021 was observed across all the age-groups excluding children aged 2-5 years. Conclusion(s): While this decline may be associated with reduced exposure to outdoor environmental factors from restricted movement due to lockdowns, such an approach is not feasible or sustainable in the absence of an infectious disease outbreak. Therefore further research to determine the positive factors associated with this observed pattern will help develop strategies to build a resilient health system.

Characterizing Antibiotic Use in Patients with Hematologic and Oncologic Malignancies Transitioned to Comfort Measures Only (CMO) During Hospital Admission

Background. Antimicrobial treatment at the end of life is common. However, there is limited evidence on whether antimicrobial use during hospice care provides symptom palliation or contributes to discomfort. We sought to further investigate antimicrobial use at the transition toCMO in immunocompromised patients with active malignancies. Methods. We conducted a retrospective cohort study of patients with active malignancies over 18 years of age admitted to Beth Israel Deaconess Medical Center from 3/1/2018 to 3/1/2021, who were transitioned to CMO. From hospital databases and from subsequent chart review, we examined: receipt of antimicrobials at any point in the admission;indication for antimicrobials;timing of CMO order;underlying hematologic/ oncologic diagnosis;and concomitant COVID-19 diagnosis. Among the patients who received antimicrobials, we identified patients on antibiotics 48 hours prior to and after CMO order placement. Patients were excluded if CMO orders were reversed. Results. 384 patients met study criteria. The mean age was 67 years, and 50.5% patients were female. 31.8% of patients carried a hematologic malignancy diagnosis while the remaining had solid tumor diagnoses. 88% patients received antimicrobials at any point during their hospitalization. Of the patients who received antimicrobials during their admission, 84% received them in the 48 hours prior to transition to CMO and 15.3% continued receiving antimicrobials after CMO transition. Patients received a mean of 5.7 antibiotics. Most common indications for antimicrobials included pneumonia (22.2%), intra-abdominal infections (13.6%), sepsis (13.3%), and prophylaxis (3.5%), but most (39.8%) received antimicrobials for more than one infection or indication. Conclusion. Hospitalized patients with active malignancy at the end of life are heavily exposed to antimicrobials. The majority of patients transitioned to CMO receive antimicrobials during their last hospital admission, and a significant subset (15.3%) continue antimicrobials after placement on CMO. Further studies are needed to investigate the potential benefits and harms of continuing antimicrobials in CMO patients, as decisions are complex and individualized.

The Benefits That a Novel Antimicrobial Provides When Viewed From an Insurance Value Perspective

Objectives: Traditional health economic evaluations of antimicrobials and other therapeutics such as vaccines currently underestimate their value to wider society. It can be supplemented by additional value elements including insurance value, which captures the value of a novel antimicrobial in preventing or mitigating impacts of adverse risk events such as those related to Covid-19 and antimicrobial resistance (AMR). Despite being commonplace in other sectors, constituents of the impacts and approaches for estimating insurance value of therapeutics have not been investigated. Method(s): This study assessed the insurance value of a novel antimicrobial, from the operational healthcare costs and several wider population health and societal perspectives. This was done by: (1) identifying risk events pertaining to 4 relevant scenarios: ward closures, unavoidable shortage of conventional antimicrobials, viral respiratory pandemics and catastrophic AMR, through literature review and multidisciplinary expert workshops, (2) parameterising constituent mitigable costs and frequencies of the risk events, and (3) applying a Monte Carlo simulation model for extreme events, and a dynamic disease transmission model. Modelling was implemented in Excel and R. Result(s): The mean insurance value across all scenarios and perspectives was 718m over a 10-year period, should AMR levels remain unchanged, where only 134m related to operational healthcare costs. The viral respiratory pandemics and catastrophic AMR scenarios contributed most to this value (290m and 297m respectively). This overall value would be 50-70% higher if AMR levels steadily increased or if a more risk-averse view (1-in-10 year downside) of future events is taken. Conclusion(s): The insurance value of a novel antimicrobial can be systematically modelled, and substantially augments their traditional health economic value in normal circumstances. These approaches are generalisable to any health intervention, and form a framework for health systems and governments to recognise broader value in health technology assessments and increase resilience by planning for adverse scenarios. Copyright © 2022

Investigating Synchronous & Asynchronous Feedback in an Elementary School Maker Education Classroom

Providing and receiving feedback is a crucial aspect of K-12 education, and is foundational to building a strong student-educator relationship in project-based learning. Previous research has highlighted the importance of student documentation, thus we study the implementation of a mobile application prototype (CoCreator App) that encourages student documentation along with features for asynchronous educator feedback. We observed and analyzed how educators provided synchronous feedback when conversing in-person with students. Our analysis indicates a variety of differences between synchronous and asynchronous feedback. Asynchronous feedback was typically used for praise and encouragement, but also offered additional opportunities for educators to notice student struggles that may not have been visible in class. Synchronous feedback was largely used to provide process-oriented feedback. Looking ahead as the COVID-19 pandemic prevails, we suggest practices and workflows for maker educators to consider as they provide both synchronous and asynchronous feedback in interdisciplinary (and potentially hybrid) learning environments. © ISLS.

THE COVID-19 PANDEMIC AND MENTAL HEALTH: EFFECTS OF SOCIAL SUPPORT AND SELF-REGULATION

Social support has been widely associated with various morbidity and mortality. How does social support availability help youths cope with the global pandemic of Covid-19 and maintain their mental well-being? Utilizing data from a UK national birth cohort, namely the Millennium Cohort Study, this research investigated the joint role of social support availability and self-regulation against such major life stressors, inclusding G × E mechanisms. Results from 4095 cohort members (399 males (47.20%) and 2602 females (63.54%), others refused to report) suggested that social support availability at the outburst of Covid-19 pandemic, as well as age 7 emotional self-regulation (rated by cohort members' parents) contributes to youths' better mental health (viz., mental well-being and non-specific psychological distress) shortly after the outburst of Covid-19 (;B;s > 0.072, ps < .018). Most importantly, age 7 cognitive self-regulation and social support availability jointly predicted better their well-being 4 months later after the local outbursts of pandemic (for mental well-being, B = 0.309, p = .017, 95% CI = [0.056, 0.562];and for non-specific psychological distress, B =-0.299, p = .043, 95% CI = [-0.587,-0.011]). Johnson-Neyman plots (false discovery rate limited) suggested that it was those high but not low in cognitive self-regulation that benefited more from the perceived social support availability. Within the ranges of significance (81.19% for mental well-being and 80.94% for non-specific psychological well-being), social support availability positively predicted mental health and such effect increased gradually as the increase of age 7 cognitive self-regulation. Findings filled in the research gap such that social support and self-regulation have been investigated separately as two coping mechanisms, by revealing that self-regulation (i.e., internal resources) determines the utility of social support availability (i.e., external resources). Findings here inspired new research questions for the field, such as whether relevant developmental trajectories of self-regulation and social support might intertwin to cast on health trajectories, and whether these processes are subject to potential G × E interactions such as the exposure to childhood adversity or relevant genetic risks. Models to examine these hypotheses will be discussed.

A Randomized-controlled Simulation based Pilot Trial of Patient Barrier Devices on Resuscitation Quality for Patients Under Investigation for COVID-19

Background: The COVID-19 pandemic had placed constraints on cardiopulmonary resuscitation (CPR), including early intubation, minimizing bag-valve mask ventilation1, and using protective equipment and barriers during resuscitation. Patient barrier devices have been introduced in emergency departments and operating rooms, consisting of plastic drapes over the patient9, or the use of an acrylic box.2 Both of these adjuncts reduce aerosolization of oropharyngeal particles from the patient, and can facilitate video-based intubation.2,3 However, it is unknown whether these devices help or hinder the ultimate resuscitation quality in cardiopulmonary arrest patients. Our specific question addresses the effect of a patient barrier device and COVID-19 resuscitation recommendations on resuscitation quality. We hypothesize that a simple patient barrier consisting of a plastic drape reduces healthcare worker (HCW) contamination without affecting resuscitation quality. Methods: This was a single-center randomized controlled pilot trial, in which in-hospital teams of 4 to 6 HCWs were randomized to either use a plastic drape (intervention) or no plastic drape (control) for a simulated adolescent cardiopulmonary arrest. The manikin was modified to emanate simulated viral particles (GloGerm®, Moab, UT) from the trachea detectable using ultraviolet light. Teams managed a cardiopulmonary arrest until intubation, using Personal Protective Equipment (PPE) and PALS/ACLS algorithms. Data were captured via arbitrated video review. Resuscitation data included time-to-bagging, time-to-intubation, and chest compression quality metrics - depth, rate, and lean. Contamination data were collected visually, marking the number of PPE equipment with visible fluorescence. Mean NASA-TLX and NOTECHS scores measured workload and team performance. Descriptive and univariate statistics were used to determine differences between intervention and control teams. Results: Fifteen simulations were conducted from 2020 to 2021;one was excluded from analysis as a performance outlier, leaving 7 intervention vs. 7 control teams. Scenarios lasted an average of 10.4+/- 3 minutes. Time-to-bagging, time-to-intubation, and intubation duration were not different between groups (72.1+/-22.4 vs 56.7+/-30.9 sec, 536+/-289 vs 544+/-127 sec, 78.9+/-73.0 vs 95.7+/-113 sec, p>0.3), and CPR quality for mean depth, rate, and lean were also not different (36.1+/-11.6 vs 30.9+/-13.2 cm, 108+/-13 vs 112+/-8/min, 8.7+/-5.2 vs 4.5+/-4.3 cm, p>0.14). Contamination rates were lower for the intubating physician (2.3+/-0.5 vs 4.1+/-0.9 surfaces, p<0.001) and for all participants (2.8+/-0.7 vs 3.7+/-0.9 surfaces, p=0.05) when using a barrier. No other contamination rate changes were observed. Participants noted no differences in team performance (22.4+/-1.6 vs 20.8+/-1.8, p=0.5) but a slight trend towards higher workload with the plastic barrier (+9.5+/-7.7 vs -0.1+/-11.5, p=0.09). Conclusion: The use of a plastic drape as a patient barrier appears to reduce simulated virus contamination for HCWs, particularly for the intubation physician during a simulated cardiopulmonary arrest without affecting resuscitation performance. Perceived workload increases with the drape, and further studies are needed to substantiate these findings in larger samples and in different settings.

Eye tracking technology to enhance learning experience in simulation training for COVID-19 pandemic

Introduction: Eye-tracking technology provided new insight into training and debriefing. Novel studies applied eye-tracking technology on clinical simulation training such as neonatal airway management and postpartum hemorrhage. Differences between novices and expert on gaze behavior were demonstrated. The use of eye-tracking technology in clinical simulation training had not been discussed in Asia. The acceptance and usefulness in training and debriefing remain unknown in the Asian region. Objective: This article explores the acceptance and potential use of eye-tracking technology in clinical simulation training in Asian culture. Method: Ten classes of clinical simulation training on enhanced preparedness of healthcare for COVID-19 were held from 2 April to 29 May 2020. In all, 109 doctors and nurses attended the training with average class size of 11. Each class ran two different scenarios with participants playing one and then observing another. One participant wore eye-tracking device in each scenario. The first-person eye-tracking view was shown in real time by the four-screen B-line medical system. All participants filled in six questions concerning the use of eye-tracking device at the end of the course. Written comment about the course was entered as free text. Result (Likert-type scale out of 6): (1) Eye-tracking is a good feedback tool for training (5.12), and eye-tracking technology enhances (2) my understanding of Crew Resource Management (5.12), (3) my understanding of clinical assessment via understanding gaze behaviors of participants and experts (5.13), (4) my understanding of case management (5.10), and (5) my overall learning experience (5.09);(6) I recommend the use of eye-tracking technology in simulation training (5.14). Thirteen (11.9%) out of 109 written comments related to eye-tracking technique were received with examples: The eye-tracing technology is a really good learning experience. More could be elaborated. I would recommend eye-tracking to improve the training. Eye-tracking is very useful and would like it to be tried more by other teammates. Conclusion: The use of eye-tracking technology in clinical simulation training enhances the learning experience of participants. It is a useful feedback tool for both wearers and observers. Healthcare professionals are willing to explore the use of eye tracking device and recommend its use in clinical simulation training.

SEROLOGICAL RESPONSES TO SARS-COV-2 VACCINATION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A PROSPECTIVE COHORT STUDY

Background: The immune response of SARS-CoV-2 vaccines is uncertain in those with Inflammatory Bowel Disease (IBD) due to a diverse array of immune-modifying therapies that vary in the mechanism of immunosuppression. Aim: We aimed to quantify the serological response to SARS-CoV-2 vaccines in those with IBD and determine antibody levels across varying therapeutic options. Methods: Individuals with IBD who received a first and/or second dose of a COVID-19 vaccine (Pfizer-BioNTech, Moderna, and/or AstraZeneca) were assessed for serological response (1–8 weeks after first dose;1–8 weeks after second dose, 8–18 weeks after second dose, 18+ weeks after second dose) using the SARS-CoV-2 IgG II Quant assay to the receptor-binding domain of the SARS-CoV-2 spike protein. The cohort was stratified based on age, sex, vaccine received, IBD type, IBD therapeutic, and prior confirmed diagnosis of COVID-19. The primary outcome was seroconversion defined as IgG levels of ³50 AU/mL. Secondarily, we evaluated the geometric mean titer (GMT) with 95% confidence intervals (CI). Results: Table 1 describes the characteristics of individuals with IBD (n=466) with serological data following the first dose (n=247) and/or second dose (n=413) of a COVID-19 vaccine. After 1–8 weeks following first dose of the vaccine, 81.4% seroconverted, with the lowest first-dose conversion rates in patients taking anti- TNF monotherapy (80.3%), anti-TNF combination therapy (51.5%), and corticosteroids (50.0%) (Table 1). Overall, 98.4% of the cohort seroconverted within 1–8 weeks of the second dose. Over time, seropositive rates decreased with 95.8% seroconversion within 8– 18 weeks of the second dose and 90.5% after 18 weeks. Seroconversion after second dose was consistently high across all medication classes (range: 94.6%–100.0%), except for oral corticosteroids (62.5%). GMT levels significantly increased (p<0.0001) from first dose (1825 AU/mL [95% CI: 981, 2668 AU/mL]) to second dose at 1–8 week (9059 AU/mL [7698, 10420 AU/mL]) but fell significantly (p<0.0001) to 3649 AU/mL (95% CI: 2562, 4736 AU/ mL) 8–18 weeks from second dose and 2527 AU/mL (95% CI: 883, 4172 AU/mL) 18+ weeks after second dose (Table 1, Figure 1). GMT levels 1–8 weeks after second dose were higher in those with prior COVID-19 (16,770 AU/mL), but lower in those receiving anti- TNF combination therapy (4231 AU/mL) and oral corticosteroids (5996 AU/mL) (Table 1). Conclusion: Seroconversion rates following full-regimen vaccination are high in patients with inflammatory bowel disease across all medication classes except for anti-TNF combination therapy and oral corticosteroids. Antibody titres and seroconversion rates tend to decrease after eight weeks post-full vaccination, which is consistent across medication classes. (Table Presented) Table 1. Patient and vaccine characteristics, seroconversion rates, and geometric mean titres by prior PCR-confirmed COVID-19 status for each medication class. (Figure Presented) Figure 1. Log-transformed anti-SARS-CoV-2 spike antibody concentration per vaccine category. Black points represent GMTs while narrow black bars represent bounds of 95% CI associated with each GMT. Solid blue line represents threshold for positive seroconversion [ln (50 AU/mL)].

A THIRD DOSE OF SARS-COV-2 VACCINE YIELDS HIGH ANTIBODY LEVELS COMPARED TO TWO DOSE VACCINATION SCHEDULE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Background: The immune response to a two-dose regimen of SARS-CoV-2 vaccination in those with Inflammatory Bowel Disease (IBD) has been consistently high in emerging research. Serological responses following a third dose have yet to be established. Aim: We aimed to quantify the serological response to a third dose of SARS-CoV-2 vaccines in those with IBD and compare to responses after a two-dose regimen. Methods: Individuals with IBD who have received at least two doses of a COVID-19 vaccine were assessed for serological response using the SARS-CoV-2 IgG II Quant assay to the receptor-binding domain of the SARSCoV- 2 spike protein at least eight weeks after second dose and then after third dose. The primary outcome was seroconversion defined as IgG levels of ≥50 AU/mL. Secondarily, we evaluated the geometric mean titer (GMT) with 95% confidence intervals (CI). Outcomes were stratified by prior COVID-19 history. A Wilcoxon rank sum test was used to compare antibody titres following 3rd dose vaccination and titres following 2nd dose vaccination. For patients with both post-2nd and post-3rd vaccination serology, the difference in antibody titres between doses was determined and the mean difference was tested using one-sample Student's t-tests. Results: Table 1 describes the characteristics of individuals with IBD (n = 271) with serological data following the corresponding dose for those with 2nd dose vaccination (n = 175) compared to those with a 3rd dose of vaccine (n = 96). Seroconversion following 3rd dose vaccination occurred for all individuals (100.0%), compared to a 94.4% seroconversion rate at least eight weeks following 2nd dose vaccination (range: 8 to 35 weeks post-2nd dose). GMT for the post-3rd dose cohort (16424 AU/mL [13437, 19411 AU/mL]) was significantly higher (p<0.0001) than the post-2nd dose cohort (3261 AU/mL [2356, 4165 AU/mL] (Table 1, Figure 1b). Individual titres as a function of time following 2nd dose vaccination are seen in Figure 1a for both 3rd dose and 2nd dose cohorts. For individuals with serology following both 2nd dose and 3rd dose vaccination (n = 82), seroconversion rates increased from 97.6% to 100.0% after the 3rd dose. GMT following post-3rd dose vaccination also increased with a mean difference in antibody titres between post-3rd dose and post-2nd dose vaccination of 11384 AU/mL (8541, 14228 AU/mL, p < 0.0001). This difference was significant for both individuals with prior COVID-19 history (11682 AU/mL [95% CI: 8618, 14746 AU/mL, p<0.0001]) and individuals without (8194 AU/mL [95% CI: 988, 15400 AU/mL]). Conclusion: Seroconversion rates and antibody response following third dose vaccination are substantially increased as compared to second dose in patients with IBD. Third dose vaccination can counter the decrease in antibody concentration over time following a two-dose regimen. (Table Presented) Table 1. Patient characteristics, vaccine type, seroconversion rates, and geometric mean titres by prior COVID-19 status for post-3rd dose and post-2nd dose cohorts

Impact of Covid 19 on the Academic Performance of Undergraduate Students using Performance Prism Model

The Performance Prism model has been developed in close co-operation by the Centre for Business Performance at Cranfield School of Management (formerly at University of Cambridge) and the Process Excellence Core Capability Group of Andersen Consulting.The Performance Prism (PP) is referred to by its Cranfield University developers as a ‘second generation’ scorecard and management framework. The unique characteristic of the Performance Prism is that it uses as its starting point all of an organisation’s stakeholders, including investors, customers and intermediaries, employees, suppliers, regulators and communities, rather than strategy. According to Performance prism proponents, strategy should follow from stakeholder analysis. The Performance Prism framework also focuses on the reciprocal relationship between the organisation and its stakeholders, as opposed to just stakeholder needs. The Performance Prism allows organisations to develop strategies, business processes and measures geared to the specific needs of all important stakeholder groups. By considering a broad stakeholder perspective that includes regulators and business communities, the performance prism enables an organisation to more directly address the risks and opportunities in its business environment. Using the Performance prism to develop measures for each relevant stakeholder facilitates the communication and implementation of strategy. RELEVANCE OF THIS PAPER: 1. By identifying the different needs of the stakeholders, performance prism model helps to develop measures for each relevant stakeholder to facilitate the communication and implementation of strategies. 2. By studying the strategies and the processes adopted by the colleges to meet those needs of the stakeholders, the most outdated strategy can be eliminated and help the organisation to retain the useful strategies. This research paper will use Primary data collection using open Questionnaire. Secondary data collection will be based on the journals, articles, e-books, and newsletter etc. © 2022

Community Health in the Global and Asia-Pacific Context

Community health is the health status, including physical and mental wellbeing, of a group of people within a defined geographic region. Factors like population size, economy, politics, social and culture play important roles on affecting the health of a community. Health care systems vary across the globe and there is a huge performance disparity between high-income and low-income countries and regions. Developed and wealthy countries in Americas and Europe like United States, Netherlands and United Kingdom have sufficient finance to support their health care systems, while many countries in the Asia-Pacific are once being identified as being in short of resources to support health care developments. In fact, regions like Australia, Singapore and Hong Kong have well-developed health care systems and China, too, has made great achievements in improving the health status of the population. Facing continuous threats to global health, ranging from growing of noncommunicable diseases, outbreaks of emergent infectious diseases, such as Ebola, to the latest pandemic of COVID-19, health care systems in all countries are facing the challenges in tackling these worldwide health issues. There is an urgent need to strengthen the equity of access to medical care and resources so that citizens are protected from diseases and can maintain a healthy living. © 2022 selection and editorial matter, Ben Y.F. Fong and Martin C.S. Wong;individual chapters, the contributors.

Trend Of Education Research In Pre And Post Covid19 Pandemic

Education research trends are related to the style of types or their directions conditioned by social demand or the specificity of cultural changes at a given time and place (Potyrala, 2020). Accordingly, educational tendencies are of certain regularities with outlines in the development of ideas related to education and upbringing showing perspectives that can be predicted by describing models, planning research on future processes, as well as taking preventive measures. Before the turn of the century, the education research was delving on the evolution of traditional face-to-face education towards digital education with the advancement of the technologies in developing 21st century students coming from the alpha, Y and Z generations. Trilling and Fadel (2009) foresaw the 21st century student need learning traditionally school subjects with contemporary content themes to be combined with the 21st century skills.

The Silver Linings of COVID-19 and Racism Pandemics?

The coronavirus disease (COVID-19) pandemic has brought health and social disparities to the fore, and intensified bias and racism in the U.S. and globally. In the context of discriminatory rhetoric and anti-Asian sentiments voiced by prominent political figures, Asian Americans have been disproportionately targeted with injustice, scapegoating, and overt racism. Amid heightened sociocultural stress and national divisiveness, the present study explored whether "silver linings" might be found in the form of increased ethnic-racial identity exploration, ethnic-racial socialization, and civic engagement. Survey data from 200 Asian American parents of adolescents (58% mothers;63% foreign born, 37% U.S. born) suggest that awareness of discrimination against Asian Americans post-COVID-19 was associated with greater identity exploration and fewer socialization messages that minimize the importance of race. Awareness of discrimination against other minoritized groups (i.e., Native and Black Americans, Latinxs) was associated with greater post-COVID-19 activism. Additional socialization messages (i.e., promotion of equality, cultural pluralism) were associated with lifetime discrimination experiences and parent gender. Although negative consequences of the pandemic are indisputable, our results offer a small glimmer of hope in terms of building resistance and momentum. What is the public significance of this article? In the face of ethnic-racial bias and racism post-coronavirus disease (COVID-19), Asian American parents of adolescents explore their ethnic-racial identities, communicate positive ethnic-racial socialization messages to their children, and engage in community activism. Although negative consequences of the pandemic are indisputable, there do appear to be "silver linings" that can build resistance and civic engagement.

Perceived Social Support and Depression Among Occupational Therapists in Hong Kong During COVID-19 Pandemic.

OBJECTIVE: This study aimed to determine the prevalence of depression and the level of perceived social support among occupational therapists during the pandemic, and to identify any associations between depression and perceived social support. METHODS: Using convenience and snowball sampling, occupational therapists aged ≥18 years who were working in Hong Kong and able to read and understand Chinese were invited to participate in a survey between January 2021 and April 2021 (during the fourth wave of COVID-19 pandemic). Data collected included age, sex, education level, employment status, marital status, living status, level of perceived social support (measured by the Multidimensional Scale of Perceived Social Support [MSPSS-C]) and level of depression (measured by the Patient Health Questionnaire-9 [PHQ-9]). RESULTS: 87 occupational therapists completed the survey. The mean MSPSS-C score was 67.87; 88.5% of participants had a high level of perceived social support. The mean PHQ-9 score was 4.67; 59.8% of participants had no or minimal depression and 11.5% of participants had clinical depression. The MSPSS-C score negatively correlated with the PHQ-9 score (rs = -0.401, p < 0.001). In regression analysis, the MSPSS-C score was associated with the PHQ-9 score (F(1, 85) = 44.846, r = 0.588, p < 0.001). About 34.5% of the variance of the PHQ-9 score was accounted for by the MSPSS-C score. CONCLUSION: Higher level of perceived social support is associated with lower level of depression. Social support might serve as a protective factor for depression among occupational therapists in Hong Kong during the pandemic.