The role of integrated thinking in corporate governance during the COVID-19 crisis: perspectives from South Africa

Purpose: This study aims to examine how integrated thinking principles can be used to assist those charged with governance during and after a crisis. Design/methodology/approach: An autoethnographic approach was used to collect and reflect on information related to the economic, social and environmental impact of COVID-19. This was complemented with a bibliometric analysis of academic articles including "corporate governance”, "integrated thinking” and "crisis” as a keyword. This information was used to produce a data mind map of core themes. This was supplemented with a qualitative exploratory approach based on semi-structured interviews with 16 participants comprising preparers of financial statements, board members and corporate governance specialists to obtain insights into using integrated thinking in corporate governance during a crisis. Findings: The results of the study indicate that those charged with governance can use integrated thinking to repurpose their business model by considering a multi-capital and multi-stakeholder perspective to value creation. The study highlights the importance of implementing a holistic capital integration process to gauge risks, capitalise on opportunities and improve business processes in response to a crisis. This can be leveraged by both the private and public sectors to manage a crisis and deal with the long-term indirect impacts of a crisis. Social implications: An integrated thinking approach can be used by both the private and public sectors to bolster confidence, tackle pressing social and environmental challenges and contribute to improved performance relative to the sector. Originality/value: The expert interviews contribute empirical evidence to the profile of mainstream social and environmental accounting literature and offer a practical contribution by offering insights that can directly be used by organisations' investors, non-governmental organisations and other stakeholders to manage a crisis. This paper also advances the sustainability agenda by assessing how a crisis can be managed in the context of a developing economy and advancing normative recommendations which will be broadly applicable to an international audience. © 2023, Lindani Myeza, Dusan Ecim and Warren Maroun.

Prone Ventilation in Intubated Covid-19 Patients: Systematic Review and Meta-Analysis

INTRODUCTION: Prone ventilation is a well-established strategy in patients with severe ARDS as it has been shown to improve survival and mortality. However, in intubated patients with COVID-19 pneumonia, the data are limited, with no substantial evidence supporting its use. This meta-analysis is the first to examine the mortality benefit of prone ventilation in intubated COVID-19 patients. METHOD(S): A systematic search according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in Medline, Embase, and Web of Science databases was conducted in January 2022 for published studies assessing the mortality benefit of prone ventilation in intubated COVID-19 patients. RESULT(S): Four hundred sixty-seven studies were identified. Of those, five studies met the inclusion criteria studies were included. The total number of patients included in the studies was 4247 patients. In four studies, ARDS prevalence was reported. The prone group had a higher prevalence of severe ARDS rates than the supine group. No significant difference was found between prone or supine groups in ICU mortality (OR: 1.39;95%CI: 0.80-2.43;p=0.24). Regarding overall mortality, No difference was detected between the prone or the supine groups (OR: 1.04;95%CI: 0.57-1.87;p = 0.9), with significant heterogeneity (I2= 93;p < 0.001). The length of hospital stay (LOS) was reported in two studies. Our analysis showed that LOS did not differ between the prone and supine groups (SMD: 0.77;95%CI: -0.33-1.86;p=0.17). CONCLUSION(S): Prone ventilation in intubated COVID-19 patients does not offer a mortality benefit. Randomized controlled trials are warranted to confirm this finding and clarify whether specific subpopulations may benefit from prone ventilation.

REVEALING PLATO’S ‘SHADOW KINGDOM’: Rendering Pandemic Risk Explicit in Extinction Engagement

The framework’s focus on enhancing biodiversity, protecting species, protecting ecosystems from biodiversity loss and extinction, and protecting habitats implicitly drives business practices to protect humanity from global and local risks arising from the erosion of ecosystems, species and their habitats. In addition to concerns around transmission of coronavirus from land mammals and bats to humans, there is also scientific evidence that marine mammals, such as dolphins and beluga whales, may carry similar diseases. Institutional investors have, in recent years, escalated their engagement with investee companies on environmental, social and governance issues. The interviewees felt that the voluntary environment for extinction accounting and extinction engagement had failed to encourage adequate practice in these areas and that legislation, a mandatory approach, was now necessary in the wake of the current pandemic. The latest version of the extinction accounting framework and the extinction engagement framework may be adapted to incorporate pandemic risk management. © 2022 selection and editorial matter, Jill Atkins and Martina Macpherson individual chapters.

Airway management in the operating room during the COVID-19 pandemic: The aubmc experience

Severe Acute Respiratory Syndrome‐CoronaVirus‐2 (SARS‐CoV‐2), the virus responsible for the novel Coronavirus disease (COVID-19) is highly contagious. Anesthesiologists, critical care physicians and inhalation therapists, often responsible for managing the airway of patients in respiratory distress or presenting for surgery, are subjected to a high viral load and an increased risk of contracting the virus. Since airway instrumentation is a highly aerosol generating procedure, countries that were first and mostly affected by the novel coronavirus have used their personal experience to establish recommendation guidelines for airway management in order to decrease the disease burden. Moreover, as the pandemic evolved and became a global health emergency, the classical practice of anesthesiology needed to be modified and adequate preparation of all involved healthcare workers became essential. This review describes the stepwise approach to airway management in the known or suspected COVID-19 patient presenting to the operating room. It illustrates the practice modifications that were implemented at the American University of Beirut Medical Center to accommodate the challenges imposed by the pandemic. Adequate anticipation and proper training, emerged as key factors in mitigating the risks in a resource strained country. © 2020, American University of Beirut. All rights reserved.