The effect of pandemic-related stress on the decision-making process for individual outdoor leisure activities

This study investigates the decision-making process for outdoor leisure activities of the Chinese people in the context of COVID-19. An online survey of residents of Heilongjiang Province was conducted in September and October 2020. In total, 441 questionnaires were returned for empirical analysis. The results reveal that fears of contamination and compulsory checking/reassurance-seeking have had a significant impact on the respondents' goal-directed behavior for nature-based outdoor leisure activities during the pandemic. The theoretical contribution is that extended goal-directed behavior expands with the inclusion of emotional variables and can be used to predict individual outdoor activity intention and decision-making process in the COVID-19 situation relating to leisure. This study provides useful insights for public health ministries and local governments in any country to encourage nature-based outdoor leisure activities as a public health policy for the mental health of the people.

Trends in Postpartum Depression before and during the COVID-19 Pandemic and Correlates of Treatment Choices: A Population-Based Retrospective Cohort Study

Objectives: COVID-19-related stressors - including social distancing, material hardship, increased intimate partner violence, and loss of childcare, among others - may result in a higher prevalence of depression among postpartum individuals. This study examines trends in postpartum depression in the US from 2018 to 2022, as well as correlates of treatment choices among women with postpartum depression. Method(s): 1,108,874 women aged 14-64 in the Komodo Healthcare Map with 1+ live birth between April 2018 and December 2021 and had continuous enrollment 2+ years before and 4+ months after the delivery date were included. Prevalence of depression during postpartum (within 3 months after delivery) was calculated before (April 2018-March 2020) and during (April 2020-March 2022) COVID-19. Multinomial logistic regression was used to investigate correlates of treatment choices (no treatment, medication-only, psychotherapy-only, or both). Result(s): The prevalence of postpartum depression increased from 9.7% pre-pandemic to 12.0% during the pandemic (p < 0.001). Among 119,788 women with postpartum depression in 2018-2022, 47.0% received no treatment, 35.0% received medication-only, 10.0% received psychotherapy-only, and 7.4% received both within one month following their first depression diagnosis. Factors associated with an increase in the odds of receiving medication-psychotherapy treatment (vs. no treatment) included older ages;commercial insurance coverage;lower social vulnerability index;history of anxiety or mood disorder during and before pregnancy;and being diagnosed by a nurse practitioner, physician assistant, or behavioral care practitioner (vs. physician). Similar patterns were observed for medication-only and psychotherapy-only treatments. Conclusion(s): In this large, nationally representative sample of US insured population, the prevalence of postpartum depression increased significantly by 2.3 percentage-points during the pandemic (or a relative increase of 23.7%). Nonetheless, almost half of women with postpartum depression received no treatment, and only 7.5% received both medication and psychotherapy. The study highlighted potential socioeconomic and provider variation in postpartum depression treatment.Copyright © 2023

Consumer decisions toward halal purchase before and during COVID-19 pandemic: a grey relational analysis approach

Purpose: The main objective of this research is to investigate the factors that influence consumer purchase decisions for halal products before and during the COVID-19 pandemic, based on the Engel-Kollat-Blackwell (EKB) theory. Design/methodology/approach: The research was conducted as a survey. The influencing factors were determined based on the grey relational analysis (GRA) approach. Findings: The findings indicate before the COVID-19 pandemic, consumers mainly purchased halal products based on four key factors: purchasing experience, certification label, Internet searches and past consumption experience. However, during the pandemic, the ranking and factors have changed to six indicators, which are past consumption experience, purchasing experience, certification labels, standardized specifications, Internet searches and halal certification labels. Research limitations/implications: The study was limited by the sample size and geographical area. Nevertheless, the findings could be further explored by expanding related theories toward understand human decisions based on spiritual beliefs. Practical implications: The findings of this study have important implications for research, practice and society. Understanding the factors influencing halal purchase decisions before and during the pandemic can help businesses, policymakers and halal certification bodies to better cater to consumers' needs and preferences and ensure the continued growth and development of the halal industry. Originality/value: This study evaluates halal purchasing decisions between periods of certainty and uncertainty by using the GRA. Changes in halal consumption and purchase decisions in response to COVID-19 pandemic have become an emerging topic of discovery. The study addresses the gap in the literature regarding changes in consumer decision pattern. © 2023, Emerald Publishing Limited.

Three Doses of Covid-19 Vaccines in Pwh: Immunogenicity and Effects on Hiv Reservoir

Background: People with HIV (PWH) older than age 55 have an enhanced risk of complications from SARS-CoV-2 infection. It is unclear whether COVID-19 vaccines with a booster are as durable in terms of immunogenicity in this cohort or whether these vaccines can destabilize HIV reservoirs. Method(s): We prospectively studied 91 PWH on cART aged 55 or over (n=91) and 23 age-matched individuals without HIV (control group, CG) who received three doses of COVID-19 vaccines (D1-D3) over 48 weeks. Participants received combinations of BNT162b2, mRNA-1273, and ChAdOx1. Of PWH, 42 were immune responders (IR), 20 were non-responders (INR), and 3 had a low-level viremia (LLV). Total and neutralizing Abs to SARS-CoV-2 spike (S) and RBD in sera and saliva, frequency of anti-RBD/NTD memory B cells (spectral flow cytometry), S-specific T cell immunity (IFN-g, IL-2 ELISpot) and HIV reservoirs in peripheral CD4+ T cells (IPDA) were measured. Result(s): No significant differences in vaccine regimens or dosing intervals were observed between PWH and CG. Vaccines elicited equally strong anti-S IgG in PWH vs CG in serum and saliva, and RBD IgG in serum. Serum Abs peaked at 4w after D3. Week 48 serum IgG in PWH vs CG were 916 vs 919 BAU/ mL for S (p=0.624) and 706 vs 752 for RBD (p=0.198), respectively. Week 48 median saliva S IgG: 48.1% AUC of the positive control in PWH vs 95.9% for CG (p=0.384). S IgA: 3.83 vs 20.5 in PWH vs CG (p=0.039). Median neutralizing titers post-D2 were significantly lower in PWH than in CG (NT50 82.9 vs 535, p< 0.001). However, after D3, at 48w, PWH had similar titers as CG: 309 vs 269 (p=0.745), mirroring an increase in RBD/NTD-specific B cells in PWH. Anti-S T cell cytokine responses were stronger in IR PWH after D2 and D3 than in CG. Week 48 S IL-2 responses: median 135 SFC/106 PBMC vs 43.8 (p< 0.001), but only 12.5 in INR (p=0.001 vs IR). COVID-19 vaccines did not affect the size of HIV reservoir in PWH (change in median frequency of intact proviruses from baseline: 95.0 vs 90.9, p=0.952), except in three LLV PWH (mean increase 93.7% at 48w). Conclusion(s): PWH aged 55 and over show diminished neutralizing Ab responses to SARS-CoV-2 with two vaccine doses which are 'rescued' after a booster. PWH have lower S-specific IgA in saliva after vaccination which may affect protection. Enhanced S-specific T cell immunity in PWH suggests Th1 imprinting from preexistent HIV infection. COVID-19 vaccines did not destabilize the HIV reservoir in most PWH but may pose potential risk in unsuppressed viremia.

Communication Innovation in the Covid-19 Era

Summary The President and CEO of Vanderbilt University Medical Center and Dean of Vanderbilt University School of Medicine discusses how creating a short TV show, under 5 minutes per episode, captured the attention of his large institution. Covid-19 stripped away traditional patterns of communication, forcing innovation, but even before the pandemic there was a need to learn how to effectively communicate with a big audience: in the format the audience prefers, and conveyed with emotion. Vanderbilt leaders worked with a media company that coached them on teleprompting and speech delivery, which led to a major uptake in engagement. © 2022 Massachusetts Medical Society.

Mental Health and Unhealthy Behaviors among Health College Students during the COVID-19 Pandemic

Objective: The purpose of this study was to examine the associations between mental health concerns, positive and negative feelings, and engagement in unhealthy behaviors among US college students during the pandemic. A secondary purpose was to explore positive changes in health and well-being. Methods: College students completed a 45-item online survey in the fall of 2020 that examined demographics, health literacy, health behaviors, overall health and well-being, and academic and financial impacts. Median-unbiased estimation for odds ratio and exact mid-p method inference methods were conducted using R version 4.0.3. We conducted content analysis for qualitative open-ended survey responses. Results: Gender, degree program, and religiosity were associated with having mental concerns. These socio-demographic variables, along with age and ethnicity, were linked to positive and negative feelings. Participants who felt threatened, afraid, stressed, and sad were likely to report mental concerns. Participants who felt cheerful, calm, rested, and full of interests were likely to report no mental concerns. Students who felt sadder, less calm, and less full of interests were likely to engage in unhealthy behaviors. Conclusions: Findings contribute to an increased understanding of mental health and engagement of unhealthy and healthy behaviors among students informing recommendations for services across campuses and communities.

Alpha-factor integrated risk parity portfolio strategy in global equity fund of funds

This study proposes a principal alpha-style factor integrated risk parity strategy that can diversify style risk factors and the stock selection risk of external managers in Fund-of-Funds (FoFs) portfolios. First, we separated the style risk factors and stock-specific sources held by each individual fund. Stock-specific sources, referred to as principal alpha portfolios, are extracted through principal component analysis, where the sources are utilized for risk parity in the alpha division. As the parity portfolio was integrated into both the alpha and style factor divisions, we used a Basin-Hopping two-phase optimization technique, which can mitigate the local optimal trap by exploring the surroundings of the sequential quadratic programming solution secondarily. Through this, a more stable integrated risk parity portfolio can be realized. Finally, the suggested integrated risk parity portfolios were simulated with a global fund dataset. The simulation results from 2006 through June 2022 show a more stable risk-return profile than an independently constructed strategy using style risk factors or principal alpha sources, especially in high volatility and down-market periods, such as a global financial crisis or unexpected events like COVID-19. This study can be applied to various areas covering other FoFs and asset allocation strategies by integrating alpha and factor divisions. © 2023 Elsevier Inc.

Prototyping a Spatial Skills AR Authoring Tool for Partially Sighted, Blind, and Sighted Individuals

Spatial skills are critical for understanding the relations among objects and people, playing an important role in how we interact with the world. Spatial relationships are built through interactions with physical objects;however, in computational/online environments, these change to bi-dimensional media and computer-assisted design comprised of 3D representations viewable through a flat screen. Due to spatial immersion and interaction limitations, a traditional 2D and 3D approach presents challenges to partially sighted, blind, and sighted individuals. This paper presents the prototyping of a co-design Augmented Reality (AR) authoring tool by recruiting inclusive emerging affordances of consumer-level AR technologies within the context of current e-learning provisions in subject matters, including inclusive design, engineering design, game hardware design, and health sciences. This work has been inspired by the COVID-19 pandemic that has shown the need to level the field in inclusive design for teaching a subject typically oriented to the sighted. Our prototype allows users to create e-learning content for visualization, interaction, collaboration, and inclusive learning. Future work will investigate our tool's impact on skills development and content creation. © 2022 IEEE.

The Influence of Responsible Leadership on Strategic Agility: Cases from the Taiwan Hospitality Industry

The COVID-19 pandemic has taken business uncertainty to an unprecedented level and put business agility and leadership under harsh tests, confronting a diverse and complicated stakeholder reality. Through original interview data and case studies from the hospitality industry in Taiwan collected and compiled since the beginning of the COVID-19 pandemic in 2020, the present research explores how strategic agility can be built, fostered, and enhanced through responsible leadership and CSR initiatives during a time of grand challenges in the hospitality industry. We also discuss and highlight the role played by one stakeholder, namely, the local government, in contributing to strategic agility through reinforcing and possibly enabling responsible leadership during hardships. This paper sheds light both empirically and theoretically on the roles played by business leaders in contributing to strategic agility, which, in turn, helps to build a more socially responsible organization. © 2023 by the authors.

The TraceTogether Matrix Has You – Surveillance, Rationalisation and Tactics of Governance in Singapore's COVID-19 App

In the heat of the COVID-19 pandemic, Singapore rolled out TraceTogether;a contact-tracing mobile app that uses proximity sensing to track the movements of its population. TraceTogether was initially voluntary, and used solely for contact tracing. By December 2020, the system became mandatory. This sparked a mass adoption that made TraceTogether possibly the most successful application in Singapore's Smart Nation initiative. When it emerged in January 2021 that the data had been used by the police for criminal investigation, images of a totalitarianism sprang to mind, where technology permits the state an invasive awareness of the movement of individuals. In this paper, we defer from common arguments that Singaporeans are intrinsically trusting of the government or have been conditioned to accept ‘Big Brother' modes of surveillance. Instead, we argue that the success of TraceTogether reflects a Singapore society that, through the rationalisation of surveillance, willingly participates in their own surveillance. In uncovering the genealogy of media discourse that surrounds TraceTogether, we highlight that it is the regular practice of voluntary surveillance, of subscribing oneself to the apparatuses of state control, rather than specific technologies, that characterises the Singapore surveillance state. We describe a matrix of reason, layered-on and normalised through media discourse, that exemplifies what Foucault has termed ‘governmentality', which asserts a government's power of control not over, but within, citizens. © Creative Commons Attribution 3.0 Australia licence.

Development of Wasted Non-woven Fabric Mask (NFM) Disposal Machine

Since the outbreak of the Covid-19 pandemic, masks have been widely used as a personal protective equipment (PPE) to prevent respiratory infection. A major type of masks used is non-woven fabric mask (NFM), which is currently classified as domestic waste and mostly disposed to general rubbish bins then eventually sent to the already saturating landfills. Moreover, the contaminated NFM is not disinfected properly during the disposal, which increases the risks of viral transmission and pollutes the environment. To alleviate the existing pressure to the environment, the amount of used NFM being disposed to landfills should be reduced. This paper studied the feasibility of recycling the used NFM and developed a prototype of disposal machine as the primary recycling process. By inserting the used NFM into the disposal machine, the masks can be shredded, disinfected and packed for further recycling processes. © 2022 IEEE.

Association of Molnupiravir and Nirmatrelvir-Ritonavir with preventable mortality, hospital admissions and related avoidable healthcare system cost among high-risk patients with mild to moderate COVID-19

Background Real-world data is currently limited on the association between oral antiviral therapy and healthcare system burden in patients with mild-to-moderate COVID-19. This study aims to evaluate the clinical and cost effec-tiveness of Molnupiravir and Nirmatrelvir-ritonavir use in reducing mortality in this population. Methods This is a retrospective cohort study involving 54,355 COVID-19 patients during February 22-March 31,2022 in Hong Kong. Inverse probability of treatment weighting (IPTW) was used to adjust patient characteristics. Our exposure of interest was Molnupiravir/Nirmatrelvir-Ritonavir prescription, with all-cause mortality as the pri-mary outcome. IPTW-adjusted multivariate regressions were used to estimate treatment impact on clinic re -atten-dance and unplanned admissions. Finally, attributed cost and incremental cost-effectiveness ratios (ICER) were estimated. Findings In the outpatient cohort (N = 33,217, 61.1%), 16.1% used Molnupiravir and 13.4% used Nirmatrelvir-Ritona-vir, while in the inpatient cohort (N = 21,138, 38.9%), 3.8% used Molnupiravir and 1.3% used Nirmatrelvir-Ritonavir. IPTW-adjusted Cox model estimated that Molnupiravir (hazard ratio (HR)(95%CI)=0.31 (0.24-0.40), P< 0.0001) and Nirmatrelvir-Ritonavir (HR=0.10 (95%CI 0.05-0.21), P< 0.0001) were significantly associated with a reduced mortality hazard. In the outpatient cohort, both antiviral prescriptions were associated with reduced odds for unplanned hospital admissions (Molnupiravir: odds ratio (OR) =0.72 (0.52-0.98), P=0.039;Nirmatrelvir-Ritonavir: OR=0.37 (0.23-0.60), P<0.0001). Among hospitalised patients, both antiviral prescriptions were associated with sig-nificant reductions in the odds ratios for 28-days readmission (Molnupiravir: OR=0.71 (0.52-0.97), P=0.031;Nirma-trelvir-Ritonavir: OR=0.47 (0.24-0.93), P=0.030). ICERs for death averted for Molnupiravir stood at USD493,345.09 in outpatient settings and USD2,629.08 in inpatient settings. In outpatient settings, Nirmatrelvir-ritonavir cost USD331,105.27 to avert one death, but saved USD5,502.53 to avert one death in comparison with standard care. Interpretation In high-risk patients in Hong Kong with mild-to-moderate COVID-19, Molnupiravir and Nirmatrel-vir-Ritonavir prescriptions were associated with reduced all-cause mortality and significant cost savings.

Two-stage Examinations in STEM: A Narrative Literature Review

Written, invigilated examinations are valued for their reliability, economy and academic integrity. Nevertheless, examinations are problematic. Final, summative examinations can disadvantage students who experience assessment anxiety, and students may not receive useable feedback. An alternative is the two-stage examination, where a traditional examination is followed by a group examination with similar questions. Students gain peer feedback on their examination performance, and can meaningfully apply this feedback. Use of this format in tertiary STEM education in universities has indicated that students prefer the format, although it has been little studied in Australia. Furthermore, its effects on reducing stress and fostering deeper learning are not well understood. The COVID-19 pandemic and switch to online learning has provided us with an opportunity to review our assessment practices and has led to a new willingness to test different examination formats. Here we provide a narrative review of the results of previous studies on two-stage examinations and, based on this and our experience teaching in large-cohort introductory biology courses at an Australian university, we propose a formula for employing them in this context. © 2022,International Journal of Innovation in Science and Mathematics Education.All Rights Reserved.

The Construction and Implementation of Wireless Network Online Learning System Based on Edge Computing

In the critical period of COVID-19 epidemic prevention, universities are required to stop all in-person classes. These issues have a huge impact on wireless network education. In additional, the traditional wireless network laboratory construction also has the problem of high hardware investment. To address these issues, we propose a novel wireless network online learning system (WNOLS) based on edge computing (EC). Firstly, we realize the simultaneous operation of multiple virtual network devices (VNDs) on the same physical device through EC and virtualization technology. Secondly, we design a unified experimental resource description method based on XML format, which is parsed by the parser and executed by the topology switcher to realize the rapid deployment of the experimental environment. An isolated design of in-band and out-of-band networks to avoid mutual interference between administrative and experimental data is proposed. Furthermore, we present a blended learn-ing mode integrating online learning and project-based learning in the field of wireless network teaching. The practice results show that the WNOLS effectively alleviates the impact of the epidemic on the offline classes and improves the learning efficiency of learners. Besides, compared with the traditional approach, it reduces the total fixed investment cost by 30.25%.

Impact of a Real-Time Electronic Alert on Antibiotic Treatment Duration for Pneumonia in Hospitalized Patients

Background. Limiting antibiotic prescribing to the shortest effective duration reduces antibiotic-associated adverse events and resistance. Up to two-thirds of patients receive excessive durations of therapy for pneumonia. This study evaluated the effect of a stewardship intervention to reduce excess antibiotic duration for inpatients with pneumonia. Methods. A dashboard was developed to generate real-time alerts when inpatients at an academic medical center received antibiotics with an indication of community- or hospital-acquired pneumonia for more than 5 or 7 days, respectively. From November 2019 through April 2021, alerts were regularly reviewed by the antibiotic stewardship (AS) team and intervened upon when patients exceeded the guideline recommended duration of therapy for pneumonia without additional indications for continuing antibiotics. We compared inappropriate duration of therapy pre- and post-implementation of the dashboard by calculating the mean number of excess days of antibiotics beyond the recommended duration. Patients with SARS-CoV-2 infection and patients on hospital services that care for patients with cysticfibrosis, bronchiectasis, or immunocompromising conditions were excluded. Four other hospitals within the same health system that did not utilize the dashboard generated alerts served as a comparison group. Results. During the intervention period, the AS team reviewed 834 patients with dashboard alerts and documented 115 interventions. For alerts reviewed without intervention, reasons for lack of intervention included active Infectious Diseases consult, additional infection diagnosis requiring a longer duration, and delayed clinical improvement. In the post-implementation period there was a mean of 1.28 excess days of antibiotics for pneumonia compared to the pre-implementation mean of 1.36 excess days. In comparison, aggregating data from the hospitals not utilizing the dashboard, there was a mean of 0.67 excess days post-intervention, compared to a mean 0.62 days pre-intervention. Conclusion. The pneumonia dashboard is a potentially valuable stewardship tool which may reduce excess days of antibiotics for pneumonia. The dashboard's impact may be improved by daily review and excluding patients with additional infection diagnoses.

Modeling variants of the COVID-19 virus in Hawai‘i and the responses to forecasting

In this paper we introduce a model for the spread of COVID-19 which takes into account competing SARS-CoV-2 mutations as well as the possibility of reinfection due to fading of vaccine protection. Our primary focus is to describe the impact of the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variants on the state of Hawai‘i and to illustrate how the model performed during the pandemic, both in terms of accuracy, and as a resource for the government and media. Studying the effect of the pandemic on the Hawaiian archipelago is of notable interest because, as an isolated environment, its unique geography affords partially controlled travel to and from the state. We highlight the modeling efforts of the Hawai‘i Pandemic Applied Modeling Work Group (HiPAM) which used the model presented here, and we detail the model fitting and forecasting for the periods from July 2021 to October 2021 (Delta surge) and from November 2021 to April 2022 (Omicron surge). Our results illustrate that the model was both accurate when the forecasts were built on assumptions that held true, and was inaccurate when the public response to the forecasts was to enforce safety measures that invalidated the assumptions in the model. © 2023 the Author(s), licensee AIMS Press.

Introduction: Translation in the time of #COVID-19

Social media have gone unprecedentedly viral in response to the outbreak of COVID-19 pandemic, impacting the practice and reception of translation and communication in the areas of trust management, social co-operation and knowledge production. Examining the excursus of translation both in relation to biomedical communication and outside its boundaries, the chapters in this volume are set to answer the overriding question: How is translation functioning through and with social media communication in response to the cascading crises triggered by the coronavirus? This introduction summarizes the chapters under two broader themes: Communication as translation, and translation as communication, while searching for potential pathways to explore translation and social media beyond language and communication. © 2022 selection and editorial matter, Tong King Lee and Dingkun Wang;individual chapters, the contributors.