How to bind together in times of crisis? A research of employee perceived psychological contract in high-star hotels

In the COVID-19 pandemic, the employee-employer relationship in the hospitality industry has been shaken. The psychological contract between employers and employees has changed dramatically during this turbulent time. Extant studies have primarily focused on the impact of crisis on the tourism and hospitality industry at the macro-and meso-levels. However, the impact at the microlevel, e.g. employees' psychological mechanism, is underexplored. Few studies have explored the process of how psychological contract breaches occur during crises, as well as the mechanism of how psychological contract breaches influence employees. Using the multiple-case method and grounded theory, this study explored the content of psychological contract, and the mechanism and outcomes of psychological contract breach in hotel organizations. Six high-star hotels located in Fujian province were selected as our study cases, and their human resource managers, frontline managers and employees were interviewed. The salient dimensions of psychological contract in the crisis were identified, which are income guarantee, safety assurance, job security, specific welfare, and work arrangements. Employees emphasized the transactional obligations (i.e. income, welfare, and job guarantee), and attached far less importance to relational obligations in the crisis setting. Three causes of psychological contract breach were identified: inability, unwillingness, and incongruence. Employees' attribution of this crisis, demographics (i.e. age, education, and position), and personalities(i.e. collectivist mindset) make they respond differently towards the psychological contract breach. Most employees did not blame the hotels for the breach, and attributed the breach to the factors beyond the hotels, thus their negative responses were attenuated. Our study proposes a dynamic model that indicates psychological contract breaches lead to varied employee responses and how psychological contract maintenance occure. Whether hotel employees and management can bind together during the crisis depends on their mutual consideration and fulfillment of corresponding obligations. Hotels that invested in employees during normal times and actively helped employees during crisis times were more likely to motivate employees' loyalty to the hotel. Several remedy strategies are proposed to help hotels develop a sustainable employee-employer relationship during and after the crisis. Our study advances knowledge in hotel crisis management by systematically investigating psychological contract and its influencing mechanism, which helps to build a resilient hotel workforce in crisis time.

Tendency of Student Mobility During Crises: The Sunk Cost Theory Moderated by Emotions and Family Decisions on Studying Overseas

The perceived loss is more complicated when the mental accounting process involves a higher aspiration level (e.g., parents send their children abroad for elite higher education, career success, and permanent residence in the destination country) mixed with an increased possibility of regretting the decision (e.g., the regret induced by the outbreak of pandemic and the low morale of global economy). Instruction languages, textbooks, teaching style, learning environment, and evaluation methods are all essentially distinct between the two school systems. Even for whom stuck in AP- or IB-curriculums of international high schools, with generous family funds, those students can pursue alternative career paths in art performance, entrepreneurship, philanthropy, or take gap years. For other families who have already chosen public schools and then domestic universities, especially working-class families with budget constraints, they are predictable to become risk aversion and avoid the perceived anti-Chinese discrimination and other additional academic, psychological, or social challenges (Yu et al., 2019).

Measuring and Promoting Self-Regulation for Equity and Quality of Online Learning: New Evidence from a Multi-Institutional Survey during COVID-19

Self-regulation is a core concept to understand the metacognitive, motivational, and emotional aspects of learning. The outbreak of COVID-19 resulted in large numbers of courses being shifted online, thus providing a large-scale setting to collect new empirical evidence to shed light on the specific challenges that different learner subgroups struggle with in the authentic online learning environment and then to provide practical implications to improve the learning outcomes by promoting learners' online self-regulation. Based on a survey of 64,949 participants enrolled at 39 universities in a metropolitan city of China during the pandemic, we developed the Undergraduate Online Self-regulated Learning Questionnaire (UOSL), tested the reliability and construct validity of the UOSL items, and then built regression models to estimate the associations between online self-regulation and mastery of eight skills across different subgroups in a diverse student body. Disadvantaged subgroups such as rural, first-generation college students reported significantly lower UOSL scores as well as lower skill mastery in online learning. After controlling self-regulation in the regression model, these gaps related to student demographics have shrunk substantially and some become statistically insignificant (e.g., the gender gap in online skill mastery). The findings highlight the critical role of the targeted interventions of self-regulation to promote equity and enhance quality in the online teaching design and learning support.

Screening of Botanical Drugs against SARS-CoV-2 Entry Reveals Novel Therapeutic Agents to Treat COVID-19.

An escalating pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has severely impacted global health. There is a severe lack of specific treatment options for diseases caused by SARS-CoV-2. In this study, we used a pseudotype virus (pv) containing the SARS-CoV-2 S glycoprotein to screen a botanical drug library containing 1037 botanical drugs to identify agents that prevent SARS-CoV-2 entry into the cell. Our study identified four hits, including angeloylgomisin O, schisandrin B, procyanidin, and oleanonic acid, as effective SARS-CoV-2 S pv entry inhibitors in the micromolar range. A mechanistic study revealed that these four agents inhibited SARS-CoV-2 S pv entry by blocking spike (S) protein-mediated membrane fusion. Furthermore, angeloylgomisin O and schisandrin B inhibited authentic SARS-CoV-2 with a high selective index (SI; 50% cytotoxic concentration/50% inhibition concentration). Our drug combination studies performed in cellular antiviral assays revealed that angeloylgomisin O has synergistic effects in combination with remdesivir, a drug widely used to treat SARS-CoV-2-mediated infections. We also showed that two hits could inhibit the newly emerged alpha (B.1.1.7) and beta (B.1.351) variants. Our findings collectively indicate that angeloylgomisin O and schisandrin B could inhibit SARS-CoV-2 efficiently, thereby making them potential therapeutic agents to treat the coronavirus disease of 2019.

A risk score based on baseline risk factors for predicting mortality in COVID-19 patients.

BACKGROUND: To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources. METHODS: 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses. RESULTS: Eight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts. CONCLUSIONS: The OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.

Metformin Is Associated with Higher Incidence of Acidosis, but Not Mortality, in Individuals with COVID-19 and Pre-existing Type 2 Diabetes.

The safety and efficacy of anti-diabetic drugs are critical for maximizing the beneficial impacts of well-controlled blood glucose on the prognosis of individuals with COVID-19 and pre-existing type 2 diabetes (T2D). Metformin is the most commonly prescribed first-line medication for T2D, but its impact on the outcomes of individuals with COVID-19 and T2D remains to be clarified. Our current retrospective study in a cohort of 1,213 hospitalized individuals with COVID-19 and pre-existing T2D indicated that metformin use was significantly associated with a higher incidence of acidosis, particularly in cases with severe COVID-19, but not with 28-day COVID-19-related mortality. Furthermore, metformin use was significantly associated with reduced heart failure and inflammation. Our findings provide clinical evidence in support of continuing metformin treatment in individuals with COVID-19 and pre-existing T2D, but acidosis and kidney function should be carefully monitored in individuals with severe COVID-19.

Clinical Characteristics and Outcomes of Type 2 Diabetes Patients Infected with COVID-19: A Retrospective Study.

Diabetes and its related metabolic disorders have been reported as the leading comorbidities in patients with coronavirus disease 2019 (COVID-19). This clinical study aims to investigate the clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes in COVID-19 patients with or without diabetes. This retrospective study included 208 hospitalized patients (≥ 45 years old) with laboratory-confirmed COVID-19 during the period between 12 January and 25 March 2020. Information from the medical record, including clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes, were extracted for the analysis. 96 (46.2%) patients had comorbidity with type 2 diabetes. In COVID-19 patients with type 2 diabetes, the coexistence of hypertension (58.3% vs 31.2%), coronary heart disease (17.1% vs 8.0%), and chronic kidney diseases (6.2% vs 0%) was significantly higher than in COVID-19 patients without type 2 diabetes. The frequency and degree of abnormalities in computed tomography (CT) chest scans in COVID-19 patients with type 2 diabetes were markedly increased, including ground-glass opacity (85.6% vs 64.9%, P < 0.001) and bilateral patchy shadowing (76.7% vs 37.8%, P < 0.001). In addition, the levels of blood glucose (7.23 mmol·L-1 (interquartile range (IQR): 5.80-9.29) vs 5.46 mmol·L-1 (IQR: 5.00-6.46)), blood low-density lipoprotein cholesterol (LDL-C) (2.21 mmol·L-1 (IQR: 1.67-2.76) vs 1.75 mmol·L-1 (IQR: 1.27-2.01)), and systolic pressure (130 mmHg (IQR: 120-142) vs 122 mmHg (IQR: 110-137)) (1 mmHg = 133.3 Pa) in COVID-19 patients with diabetes were significantly higher than in patients without diabetes (P < 0.001). The coexistence of type 2 diabetes and other metabolic disorders is common in patients with COVID-19, which may potentiate the morbidity and aggravate COVID-19 progression. Optimal management of the metabolic hemostasis of glucose and lipids is the key to ensuring better clinical outcomes. Increased clinical vigilance is warranted for COVID-19 patients with diabetes and other metabolic diseases that are fundamental and chronic conditions.

In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19.

Statins are lipid-lowering therapeutics with favorable anti-inflammatory profiles and have been proposed as an adjunct therapy for COVID-19. However, statins may increase the risk of SARS-CoV-2 viral entry by inducing ACE2 expression. Here, we performed a retrospective study on 13,981 patients with COVID-19 in Hubei Province, China, among which 1,219 received statins. Based on a mixed-effect Cox model after propensity score-matching, we found that the risk for 28-day all-cause mortality was 5.2% and 9.4% in the matched statin and non-statin groups, respectively, with an adjusted hazard ratio of 0.58. The statin use-associated lower risk of mortality was also observed in the Cox time-varying model and marginal structural model analysis. These results give support for the completion of ongoing prospective studies and randomized controlled trials involving statin treatment for COVID-19, which are needed to further validate the utility of this class of drugs to combat the mortality of this pandemic.

Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes.

Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D.