Engaging university students in online learning: a regional comparative study from the perspective of social presence theory

This study investigates the factors influencing university students' online learning engagement from three distinct aspects, namely, behavioural, cognitive and emotional engagement. A comparison is drawn from university students in Asia who embraced online learning during the COVID-19 pandemic. An online survey was conducted on 495 university students in Mainland China, Hong Kong and Malaysia during the surge of the COVID-19 Omicron variant, which was considered more infectious but less deadly than previous variants. A consistent positive relationship between Satisfaction and Academic Performance is found in all the regions. Malaysia presents a unique situation as compared to Mainland China and Hong Kong whereby no association was found between Social Context and Online communication towards Student Engagement. The novelty of this study is attributed to the integration of Social Presence Theory in Student Engagement through the nature of online learning as a coping strategy to halt the spread of COVID-19 during the Omicron variant surge. © 2023, Beijing Normal University.

Care-flow connect: ’paper out of pocket campaign’ – use of technology to ensure SBAR handover

1343 Figure 1[Figure omitted. See PDF]ResultsEffective handovers with social distancing was maintained. It helped maintain closed clear communication loops and minimized error. It offered clarity in the content of information shared consistently across teams. Tertiary care conversations were captured effectively and documented.The process was well embraced with medical teams, 50% nursing staff felt it was easily accessible however some still had a concerns about network connectivity. Paper was out of pocket with handovers.Challenges were the need for training with skill updates, access and connectivity issues and protected time to update handovers.QI process helped raise the awareness within the Team with use of surveys to review practice, to build consistency and share good practice. 1343 Figure 2[Figure omitted. See PDF]ConclusionThe Careflow connect process since its introduction with the Covid Technology boom in Healthcare has ensured safe and effective patient care;driven by SBAR based consistent and clear handover process. Introduction of white boards on the ward, since Feb 2021 has helped focus consistency in process and change as a team. Strengthening change was achieved with positive team attitudes, behaviours and engagement. Visibility of QI methods, timely and ease of access to technology was a driving force for effective patient care. Patient safety was positively influenced by effective handover of care processes between teams with paper out of pocket.

Impact of SARS-CoV2 pandemic onto acute ST-elevation myocardial infarction care and patient outcomes in a large tertiary cardiac center

Background: SARS-CoV2 pandemic has caused major impact on patient care worldwide. We experienced a surge of cases beginning March 2020 leading to the government imposing a movement control order, more commonly known as 'lockdown' starting 18th March 2020. As such, various changes were implemented by our center to the clinical pathway for STEMI patients including using thrombolysis as the preferred initial treatment modality. Purpose: We aim to determine the impact of SARS-CoV2 pandemic on the clinical outcome of acute STEMI patients in our center which is a large regional tertiary hospital for cardiology. Methods and results: This is a single center retrospective cross-sectional study from 1st January 2020 until 31st May 2020. We compared clinical outcomes of patients admitted for acute STEMI before (group 1) and after (group 2) 15th March 2020 which is the date our center implemented changes to our STEMI care pathway. A total of 172 cases of acute STEMI was admitted to our center during this period. Admission for STEMI was noticeably lower after the lockdown implementation (group 1, n = 97 vs group 2, n = 75). The median time from symptom to presentation at our center did not differ between the two groups being 4.15h[2.78,7.28] vs 4.42h[2.97,8.01] p = 0.702, suggesting no outof- hospital delays in management. Majority of the patients in group 1 (n = 75, 77.2%) received primary percutaneous coronary intervention (PCI) vs only 17 (22.7%) in group 2. Most in group 2 (n = 54, 72%) received thrombolytic therapy and subsequently underwent coronary intervention within the same admission. This shows a shift in the preferred initial treatment modality for STEMI at our center during this period. The door to balloon time for patients undergoing primary PCI during this period was also numerically higher in group 2 but the difference was not statistically significant at 46min [38,63] vs 59min [45,72], p = 0.063, most likely due to the additional preparation needed in terms of SARS-CoV2 testing and personal protective equipment (PPE) prior to the procedure. The primary composite endpoint of in-hospital mortality and cardiogenic shock between the two groups (17.5% vs 24.3%, p = 0.275) did not show any significant difference. The incidence of inhospital mortality and cardiogenic shock were 4.1% vs 6.7% (p = 0.458) and 15.5% vs 21.9% (p = 0.281) respectively. Conclusions: This study suggests that thrombolysis as the preferred initial treatment modality for STEMI could be a reasonable temporary measure during the initial phase of a global pandemic to reduce infection risk of healthcare providers without compromising patient outcomes until adequate PPE and testing modalities are available for primary PCI to be performed safely. A follow-up study is needed to determine the long-term outcome of these patients.

Preadmission use of DPP4i reduced risk of hyperinflammatory syndrome, in-hospital death or invasive mechanical ventilation in COVID-19 patients with type 2 diabetes: A territory-wide retrospective cohort study

OBJECTIVE: T2DM patients with COVID-19 were associated with increased risk of hyperinflammation and hence poor prognosis. Inconclusive evidence suggested that dipeptidyl peptidase-4 inhibitors (DPP4i) may have anti-inflammatory effect and preventing SARS-CoV-2 viral entry. This territory-wide retrospective cohort study evaluated the clinical outcomes associated with the pre-admission use of DPP4i for T2DM patients with COVID-19. METHODS: Patients with T2DM admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong were observed from date of admission until the date of in-hospital death, hospital discharge or data cut-off date (30th April 2021). Exposure was defined as receiving DPP4i treatment from 90 days prior admission to the day before admission for COVID-19. The primary outcome was the incidence rate of hyperinflammatory syndrome. Multivariable logistic regression models weighted by inverse probability of treatment weighting using the propensity score were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes for exposure versus nonexposure. RESULTS: Out of 1214 eligible patients at a median follow-up of 16 days with 30,035 person-days, 107 patients received DPP4i prior to COVID-19 hospitalization. Preadmission use of DPP4i was associated with a lower risk of hyperinflammatory syndrome (OR = 0.56, 95%CI 0.45 to 0.69, P < 0.001), composite outcome of in-hospital death or the need of invasive mechanical ventilation (OR = 0.71, 95%CI 0.54 to 0.93, P = 0.013) and reduced length of hospital stay among survivors (-4.82 days, 95%CI -6.80 to -2.84, P < 0.001). Moreover, DPP4i users incurred significantly lower cumulative healthcare costs from day-7 (US$7,877 vs US$10,246, P < 0.001) to day-90 (US$26,310 vs US$39,482, P < 0.001) than control. CONCLUSION: Our study may have shed light regarding hyperinflammatory dynamics in mild-to-moderate COVID-19 patients with T2DM, which may be informative to these patient cohorts and associated clinicians. However, prospective studies are necessary to further elucidate the potential role of DPP4i in the pathophysiology of T2DM and COVID-19.

Clinical outcomes associated with early in-hospital use of metformin, dipeptidyl peptidase-4 inhibitor or insulin in COVID-19 patients with type 2 diabetes: A territory-wide retrospective observational study

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is associated with worse outcomes for patients with COVID-19. Commonly used glucose-lowering medications, metformin, dipeptidyl peptidase-4 inhibitor (DPP4i), or insulin, were found to impact the level of inflammatory and cytokine, therefore potentially influence the clinical outcomes in SARS-CoV-2 infected patients. Concerns remain on the early in-hospital use of these medications. This territory-wide retrospective observational study evaluated clinical improvement, virality, acidosis, hypoglycemia, hyperinflammation status, composite clinical outcomes associated with use of metformin, DPP4i, or insulin for hospitalized T2DM patients with COVID-19 infection. METHODS: Baseline covariate between the two groups were balanced by multiple imputation followed by inverse probability of treatment weighting for propensity score. Multivariable cox proportional hazard models were performed to estimate hazard ratios (HR) and their 95% confidence intervals (CI) of time-to-event outcomes. Exposure was defined as receiving glucose-lowering drug class within 3 days of admission. RESULTS: After propensity-score weighting, baseline characteristics were generally balanced. Metformin users (n = 609) were associated with quicker time to clinical improvement (HR = 1.41, 95%CI 1.19 to 1.65, P < 0.001), hospital discharge (HR = 1.43, 95%CI 1.20 to 1.69, P < 0.001) and recovery (HR = 2.09, 95%CI 1.42 to 3.06, P < 0.001), shorter hospital length of stay among survivors (-6.45 days, 95%CI -8.34 to -4.56, P < 0.001), reduced costs from 30-days onward, lower risk of composite outcome (HR = 0.41, 95%CI 0.23 to 0.74, P = 0.003) and macrophage activation (HR = 0.64, 95%CI 0.47 to 0.87, P < 0.004) when compared to non-metformin users. Shorter hospital length of stay was also observed in DPP4i users (n = 144) compared with non-DPP4i users (-5.32 days, 95%CI to 7.30 to -3.34, P < 0.001). Insulin users (n = 414) have greater risk of hypoglycemia during admission (HR = 2.61, 95%CI 1.23 to 5.53, P = 0.013) when compared to non-insulin users. CONCLUSION: Metformin and DPP4i have exhibited association with improved clinical outcomes while insulin has proved to be associated with increased risk of hypoglycemia for in hospitalized T2DM patients with COVID-19.

Creating value: sustainability and accounting for non-financial matters in the pre- and post-corona environment

Purpose: This paper aims to introduce the special issue on “sustainability and accounting for non-financial matters: qualitative and quantitative research approaches”. This special issue was organised at the time when the entire globe was affected by the Coronavirus and accordingly, this paper has taken this opportunity to discuss the implications of this pandemic on accounting for non-financial issues, especially in relation to sustainability accounting research and practice. Design/methodology/approach: An analysis of public documents and limited academic research on the Coronavirus was undertaken in this paper to highlight how life as it existed has fundamentally changed. The authors also review the papers published in this special issue and identifies research opportunities arising from the current environment. Findings: The onslaught of the Coronavirus provides both challenges and opportunities for the practice of, and research into, accounting for non-financial matters, such as sustainability. The papers published in this special issue promote understanding and linking of sustainability reporting practices, to creating firm values, as well as identifying current and emerging challenges. The special issue explores criteria for the construction of accounting technology that is consistent with agnostic-based critical accounting and accountability, a business case for managers and practitioners to formulate strategic and management control systems in response to climate change issues, legitimacy and the use of photographs in sustainability reporting to create value, effective disclosures of business and sustainability ethics practiced by the firm for reputation building and value creation, indigenous accounting in mining companies, public sector policy framing of non-financial value, the barriers to sustainability reporting because of lack of awareness and knowledge and inadequate regulatory support in developing countries and the significance of sustainability accounting education to improve sustainability reporting practices in developing countries. Research limitations/implications: Future research opportunities in relation to the impact of the Coronavirus on accounting for non-financial value are identified. Given that COVID-19 is a societal matter, the practical implications of the Coronavirus in accounting for non-financial value creation are highlighted. The Coronavirus has challenged the existing economic paradigm and non-financial issues will capture the attention of corporations, other institutions, civil society and governments. Practical implications: The Coronavirus has challenged the existing economic paradigm and non-financial issues will capture the attention of corporations, other institutions, civil society and governments. Social implications: Given that COVID-19 is a societal matter, the practical implications of the Coronavirus in accounting for non-financial value creation are highlighted. Originality/value: This study, to the knowledge, is one of the pioneer academic studies that has explored the implications of the Coronavirus on accounting for non-financial value. In addition, this special issue includes papers that highlight how non-financial reporting matters are increasingly being given attention by companies to enhance business practices on sustainability through different perspectives. © 2021, Emerald Publishing Limited.

The Critical Importance of Old World Fruit Bats for Healthy Ecosystems and Economies

Despite extensive documentation of the ecological and economic importance of Old World fruit bats (Chiroptera: Pteropodidae) and the many threats they face from humans, negative attitudes towards pteropodids have persisted, fuelled by perceptions of bats as being pests and undesirable neighbours. Such long-term negativity towards bats is now further exacerbated by more recent disease-related concerns, particularly associated with the current COVID-19 pandemic. There remains an urgent need to investigate and highlight the positive and beneficial aspects of bats across the Old World. While previous reviews have summarised these extensively, numerous new studies conducted over the last 36 years have provided further valuable data and insights which warrant an updated review. Here we synthesise research on pteropodid-plant interactions, comprising diet, ecological roles, and ecosystem services, conducted during 1985-2020. We uncovered a total of 311 studies covering 75 out of the known 201 pteropodid species (37%), conducted in 47 countries. The majority of studies documented diet (52% of all studies;67 pteropodid species), followed by foraging movement (49%;50 pteropodid species), with fewer studies directly investigating the roles played by pteropodids in seed dispersal (24%;41 pteropodid species), pollination (14%;19 pteropodid species), and conflict with fruit growers (12%;11 pteropodid species). Pteropodids were recorded feeding on 1072 plant species from 493 genera and 148 families, with fruits comprising the majority of plant parts consumed, followed by flowers/nectar/pollen, leaves, and other miscellaneous parts. Sixteen pteropodid species have been confirmed to act as pollinators for a total of 21 plant species, and 29 pteropodid species have been confirmed to act as seed dispersers for a total of 311 plant species. Anthropogenic threats disrupting bat-plant interactions in the Old World include hunting, direct persecution, habitat loss/disturbance, invasive species, and climate change, leading to ecosystem-level repercussions. We identify notable research gaps and important research priorities to support conservation action for pteropodids. © Copyright © 2021 Aziz, McConkey, Tanalgo, Sritongchuay, Low, Yong, Mildenstein, Nuevo-Diego, Lim and Racey.