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<b> Aim:</b> The aim of the study was to analyze the impact of the COVID-19 pandemic and the related change of the teaching mode from stationary to distance learning on the severity of voice-related ailments among teachers. </br></br> <b> Materials and methods:</b> A questionnaire survey of teachers was conducted to assess voice disorders during stationary and remote work using the Vocal Tract Discomfort (VTDs) scale and Numeric Rating Scale (NRS), and the respondents' subjective feelings were assessed. Demographic and environmental factors associated with voice work were examined. Data on sickness absence, which were obtained from the "Health Needs Maps 2020" Ministry of Health's, were also analyzed. Responses were subjected to statistical analysis. A P-value level below 0.05 was considered statistically significant. </br></br> <b>Results:</b> 128 teachers participated in the survey. The overall assessment of voice disorders using VTDs and NRS scales showed no statistically significant differences for complaints between stationary and remote work. Detailed analysis revealed more se-vere voice disorders in teachers working more than 6 months remotely (P = 0.049) and having more than 20 lessons per week (P = 0.012). Subjective assessment confirmed a significantly lower percentage of teachers reporting voice disorders when wor-king remotely compared to stationary (P = 0.043). This resulted in less sickness absence and a 40% decrease in sick leave related to voice disorders in 2020 compared to 2019. </br></br> <b>Conclusions:</b> During the remote learning period of the COVID-19 pandemic, teachers reported lower severity of voice disor-ders and this influenced the reduction of sickness absences. There were no statistically significant differences in voice complaints as assessed by VTDs and NRS scales for both teaching modes. Several factors affecting the severity of vocal tract disorders were identified - the number of class hours per week (>20) for stationary teaching and a long period of remote teaching (>6 months).
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COVID-19 , Occupational Diseases , Voice Disorders , COVID-19/epidemiology , Humans , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Pandemics , Voice Disorders/diagnosis , Voice Disorders/epidemiology , Voice QualityABSTRACT
BACKGROUND: Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health. METHODS: We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis. RESULTS: Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2-26.2) before lockdown, 25.5% (20.0-30.3) in May and 28.2% (21.2-35.2) in September. CONCLUSIONS: Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.
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INTRODUCTION: The AAMC transitioned to virtual interview formats for the 2020-2021 residency match. This study aims to examine the impact of the 100% virtual interview format for the 2020-2021 residency match on both application and match changes for multiple surgical specialties, including neurosurgery (NS), orthopedic surgery (OS), plastic surgery (PS), general surgery (GS), thoracic surgery (TS), and vascular surgery (VS). METHODS: Cross-sectional study comparing application and match changes between the in-person 2019-2020 and virtual 2020-2021 residency match cycles for different surgical specialties. RESULTS: There was an overall increase in the number of applicants for 5 of the surgery specialties but not VS, and an overall increase in the number of applications per residency program across all specialties. The average number of applications per applicant also increased, except in TS. There were no major match changes except in TS, which saw an increase in number of spots filled by MDs to nearly 100% from 84.2% in the previous cycle. CONCLUSION: The switch to the 100% virtual 2020-2021 residency match interview format was associated with an overall increase in the number of applications per program and number of applications per applicant across multiple surgical specialties. There was a decrease in the number of applicants to VS and an increase in the number of applications per applicant. The switch to a virtual interview format in 2020-2021 was also associated with an increase in TS spots filled by MDs to almost 98%, increasing the already concerning TS match disparity for DO and IMG applicants.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic struck global health systems with overgrowing demands in many fields of health care; yet, reproductive care, particularly pregnancy care remains a special focus of interest. Pregnancy is a major physiologic change that alters temporarily normal function of many organs, and specifically the immune system. Therefore, pregnant women are more susceptible to respiratory pathogens compared to the others. The current pandemic may have serious consequences on pregnancy whether directly or indirectly. In the present review, direct and indirect possible adverse effects of SARS-CoV-2 infection on female reproductive system by focusing on pregnancy and delivery has been discussed in details. In addition, the pregnancy consequences and whether maternal infection can affect infants were deliberated. The adverse impact of luck down and related psychological complications and obesity on pregnant women were discussed as well. Finally, the effects of SARS-CoV-2 vaccination on maternal health and pregnancy outcome was analyzed.
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BACKGROUND: Despite advances in online education during the COVID-19 pandemic, its impact on surgical simulation remains unclear. The aim of this study was to compare the costs and resources required to maintain simulation training in the pandemic and to evaluate how it affected exposure of medical students to simulation during their surgical clerkship. METHODS: The number of learners, contact hours, staff hours, and costs were collected from a multi-departmental simulation center of a single academic institution in a retrospective fashion. Utilization and expenditure metrics were compared between the first quarter of academic years 2018-2020. Statistical analysis was performed to evaluate potential differences between overall resource utilization before and during the pandemic, and subgroup analysis was performed for the resources required for the training of the third-year medical students. RESULTS: The overall number of learners and contact hours decreased during the first quarter of the academic year 2020 in comparison with 2019 and 2018. However, the staff hours increased. In addition, the costs for PPE increased for the same periods of time. In the subgroup analysis of the third-year medical students, there was an increase in the number of learners, as well as in the staff hours and in the space required to perform the simulation training. DISCUSSION: Despite an increase in costs and resources spent on surgical simulation during the pandemic, the utilization by academic entities has remained unaffected. Further studies are required to identify potential solutions to lower simulation resources without a negative impact on the quality of surgical simulation.
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INTRODUCTION: The epidemiology of respiratory syncytial virus (RSV) infection has changed during the COVID-19 pandemic. Our objectives were to describe the RSV epidemic in 2021 and compare it with the previous years to the pandemic. METHODS: Retrospective study performed in Madrid (Spain) in a large paediatric hospital comparing the epidemiology and clinical data of RSV admissions during 2021 and the two previous seasons. RESULTS: 899 children were admitted for RSV infection during the study period. During 2021, the outbreak peaked in June and the last cases were identified in July. Previous seasons were detected in autumn-winter. The number of admissions in 2021 was significantly lower than in previous seasons. There were no differences between seasons regarding age, sex or disease severity. CONCLUSION: RSV hospitalizations during 2021 in Spain moved to summer with no cases in autumn and winter 2020-2021. Unlike other countries, clinical data were similar between epidemics.
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Educational institutions in Saudi Arabia extended e-learning until the third semester of the academic calendar to prevent the spread of COVID-19 infection and to achieve 70% inoculation for the Saudi population. This study assesses the impact of extended e-learning and other associated stressors on the emotional health of university students in Saudi Arabia. An online cross-sectional survey collected data between the months of January-March 2021. The emotional signs of stress were measured by using a subset of items from the COVID-19 Adolescent Symptom and Psychological Experience Questionnaire (CASPE). Data about demographic variables, educational characteristics and academic performance were also collected. A regression analysis was performed to determine predictors of emotional health. A total of 434 university students including females (63%) and males (37%) provided responses. One-third of students (33%) indicated that the COVID-19 pandemic and its resulting changes including online distance studies greatly influenced their daily lives in a negative way. The regression analysis demonstrated that female students and students with average academic performance had increased vulnerability to experience emotional signs of stress (p < 0.05). The factors 'Not going to university' and 'Not having a routine life' were significant predictors of stress responses (p < 0.01) and (p < 0.001) respectively. E-learning during the COVID-19 pandemic made it possible for students to complete their studies as per academic calendar; simultaneously, it increased the vulnerability to experience stress, particularly for female students and students with average academic performance. These findings imply that academic advising and counseling services should be more readily available during digital studies to support at risk students.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) surge has enabled the widespread usage of telemedicine (TM) and presents a unique opportunity to determine the hand surgery patients' perception of care using validated patient satisfaction scores. METHODS: Electronic surveys were distributed to patients aged 18 years and older who underwent a video TM encounter with a single surgeon at an academic medical center during the initial COVID-19 surge (March 23 to October 22, 2020). The study-specific questions were derived from the Press Ganey (PG) Medical Practice TM Survey and compared with institutional PG Outpatient Medical Practice Survey data. Three cohorts were defined: pre-COVID face-to-face, post-COVID TM, and post-COVID face-to-face. RESULTS: Thirty of 65 TM patients (46.2%) responded. No differences in sex, age, or visit type were identified between cohorts. The TM cohort was more likely to live greater than 300 miles from the institution. Median response for all cohorts for the PG care provider and overall experience responses were "very good," and no differences were identified between cohorts. Patient satisfaction with their TM experience was high with median satisfaction scores for arranging and connecting to a TM visit, talking with the provider over a video connection, and having the provider understand the clinical problem were "very good." Patients in the TM cohort reported no difference in preference for face-to-face or TM visits. CONCLUSIONS: Patients are satisfied with TM as a substitute for face-to-face visits suggesting that TM can possibly be used to deliver comparable patient experience for hand surgery encounters.
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Resumen El objetivo de este trabajo fue indagar el impacto de la pandemia de la covid-19 en el acceso de personas trans a tratamientos hormonales en los servicios de salud pública de la provincia de Córdoba, Argentina. En los meses de junio/julio de 2020, se realizaron 16 entrevistas telefónicas a personas trans en proceso de hormonización y usuarias de servicios públicos de salud, a profesionales sanitarios de dispositivos específicos de atención a personas trans, integrantes de organizaciones sociales y de gestión. Se aplicó un análisis temático que identificó tres temas y subtemas: 1) Estar a la deriva en relación al tratamiento hormonal: Reestructuración de servicios de salud; Sentimientos de incertidumbre; 2) Lo necesito, el cuerpo lo pide: suministro de hormonas: Significados en torno al tratamiento; Estrategias y resistencias; 3) Oportunidad de visibilizar fallas estructurales: las hormonas como la punta del iceberg: Déficit en las políticas públicas: en pandemia desde hace muchos años; Exclusiones del CIStema de salud. Se concluyó que la pandemia acarreó un grave retroceso para los derechos de las personas trans. Sin embargo, se identificaron estrategias claves de acceso, vinculadas principalmente a las organizaciones y activistas trans y travestis.
Abstract The purpose of this research was to study the impact of covid-19 pandemic on transgender people's access to healthcare and hormone gender-affirming treatments in public healthcare services of the province of Córdoba, Argentina. Between June/July-2020, sixteen telephone interviews were conducted with people in gender-affirming hormone treatments in public healthcare services, professionals, members of social organizations and management. A thematic analysis was carried out, identifiying three themes and sub-themes: 1) Being adrift in relation to hormonal treatment: Restructuring of healthcare services; Feelings of uncertainty. 2) I need it, the body asks for it: supply of hormones: Meanings around treatment; Strategies and resistance. 3) Opportunity to make visible structural failures: hormones as the tip of the iceberg: Deficit in public policies: in a pandemic for many years; Exclusions from the CISHealthcare System. We conclude that the pandemic implied a serious setback for transgender people's rights. However, strategies were identified, mainly linked to transgender organizations and activists, which were key to access.
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Inclusive digital financial services should welcome older populations and make them beneficiaries of the digital and financial revolution. To understand older adults' experience of using digital financial tools, we conducted an online survey of 268 older internet users aged 60 or above from urban areas of 14 Chinese provinces after China's nationwide COVID-19 lockdown in 2021. Our results revealed that older internet surfers were active in digital financial activities and engaged most with activities that were highly compatible with their lifestyles. Active users significantly differed from inactive users in sociodemographics, confirming that a digital divide related to social stratification exists among older internet users. Digital finance active users were also distinguished from inactive users' attitudes and perceptions toward digital finance. Logistic regression results indicated that perceived usefulness, access to proper devices for digital finance, risk perceptions, and perceived exclusion if not using technology were associated with their adoption of these advanced tools. Older adults reported the perceived inconvenience of in-person financial services during the lockdown. They also expressed a willingness to participate in relevant training if provided. The findings of this study could help aging-related practitioners to understand older adults' engagement in digital finance and guide policy and project design in the area of financial inclusion of the aging population.
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Virtual online teaching was adopted at the Iraqi educational institutions: schools and universities when COVID-19 break out. It was the only alternative to revival the education sector after locking down schools and universities by the condition of the quarantine. The scenario of locking down schools and universities after the spread of COVID-19 pandemic pushed stakeholders and decision makers to switch the educational process to the online mode (Thi1 &Minh, 2021). This sudden shift arose many issues and challenges which was faced by both teachers as well as learners, soon questions about the validity and authenticity of the educational process and outcomes were raised. The current study seeks to uncover hidden issues and challenges which English language teachers at Diyala University encounter at this critical period 2019-2022. A semi-structured interview was utilized as the instrument of this small scale qualitative and descriptive study. The qualitative raw data obtained from the interview transcripts were thematically coded and analyzed. The finding were interpreted in two directions: first: failure of the new online teaching process in obtaining the desired educational outcomes outlined by the ministries of education and higher education due to several reasons: uncontrolled examination session which led to student cheating and resulted in unauthentic grading marks. In addition to internet connection issues which is added to the teachers burden and affect negatively EFL teaching process. Secondly: it was proven that online teaching can be beneficial in the sense that it can save time and effort if new strategies of assessment were adopted, intensive training courses for teachers as well as students were applied, in addition to providing good internet service for both student and teacher. © 2023 Otjivanda Presse.Essen. All rights reserved.
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This paper discusses the performance analysis of learner behavior through online learning using Learning Management System (LMS). The analysis is performed based on the survey of lecturers and students activities. The parameters of survey consist of the problems discussion which arise in the online learning, the level of student absorption of lecture material, the level of student attendance, and the feedback on lecturer performance carried out by students. Problems that arise in the online learning include lecturers are not being able to control as much as 37%, network disturbances are as much as 22%, students having difficulty understanding lecture material are as much as 19% which are indicated by students with D score of 10%, C score of 60%, and B score of 30%. Meanwhile 17% of students use LMS and the remaining 5% have no problems with the online learning. On the other hand, students have difficulty obtaining connection for online learning of 45%, do not have a quota of 28%, and lazy of 17%. Lecturer performance feedback carried out by students based on competency parameters of pedagogic, personality, professionalism, and social shows very good score. © 2023 IEEE.
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In efforts to curb the spread of COVID-19, many countries have implemented a variety of lockdown and quarantine measures. With substantially reduced face-to-face interactions, many people may have relied heavily on social media for connection, information, and entertainment. However, little is known about the psychological and physical health implications of social media use during strict lockdown. The current study investigates the associations of social media use with psychological well-being and physical health among Wuhan residents (N = 1214). Our findings showed that non-COVID related self-disclosure was positively associated with psychological well-being, while COVID related information consumption and sharing were negatively associated with psychological well-being. Further, more generic use of social media was associated with lower psychological well-being, which in turn related to more somatic symptoms. Quarantined people used social media more frequently than non-quarantined people. Importantly, the negative association between social media use and psychological well-being was significantly stronger for quarantined people than unquarantined people. [ FROM AUTHOR] Copyright of Information, Communication & Society is the property of Routledge 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 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 . (Copyright applies to all s.)
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The Covid-19 pandemic brought many businesses to a standstill as international travel restriction was imposed across countries in addition to a national lockdown. Firm performances were depressed due to reduced order and output. This study examines whether digitalization has mitigated the negative impact of the Covid-19 pandemic on Malaysia's manufacturing sector. Using sales as the performance yardstick of 24 industrial sectors from January to December 2020, our result shows that manufacturing sales performance was negatively related to the Covid-19 pandemic. However, the adverse impact of Covid-19 was mitigated with a higher level of digitalization. The mitigating role of digitalization remains robust in further analysis. This study has managed to quantify the mitigating effect of Covid-19 on manufacturing sectors. As a policy implication, the government should expedite the introduction of the 5G network, promote digital adoption across all sectors to ensure business continuity and provide an effective response mechanism in any pandemic or crisis. © 2023, University of Wollongong. All rights reserved.
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In addition to the ongoing COVID-19 pandemic, India, Myanmar and Thailand face a myriad of crises that pose a serious challenge to each society's democracy, development and equality. The chapter probes into the influence external powers may have on the region's democratic progress by asking the following questions: What are the implications of China's rise for the rest of Asia, and in particular, India, Myanmar and Thailand? Has China or the US contributed to the recent illiberal trends in the region? In any case, the effect of US-China relations in the region's security, development and the respect of democratic values will have an enduring and profound influence on Asia after the pandemic. As the world moves towards meeting UN Sustainable Development Goals (SDGs), it is up to India, Myanmar, Thailand and other countries in Asia to also uphold them, including democratic values. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.
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Introduction. Since March 2020, the introduction of a self-isolation regime and significant restrictions on personal contacts at work and school in connection with the COVID-19 pandemic has led to an expansion of the introduction of information technologies and a sharp restriction of direct interpersonal communication. The introduction of these restrictions has had a stressful effect on the body of both workers and students of various age groups, including young people. For a successful analysis of the impact of COVID-19 restrictions on the psychophysiological state of these categories of young workers and students, it seems appropriate to assess the state of maladaptation, self-assessment of nervous and somatic well-being. The study aims to assess the impact on the adaptive psychophysiological parameters of young trade workers and students of the changed working and study conditions against the background of the COVID–19 epidemic situation (self-isolation). Materials and methods. The object of the study was two groups of people who have a wide range of communication with colleagues and people around them, but differ in the content of their activities: students and trade workers. Scientists have conducted the study in two stages: before the pandemic (2013) and during the pandemic (December 2020) due to drastic changes in the algorithm of existence and work/study. We have examined 119 students aged 20–24 years (RGSU). There were 61 people at the first stage of the study (2013), there were 58 people at the second stage (2020, December). The second group (trade workers): 66 people aged 20–29 years. At the first stage of the study (2013), 34 people were included, at the second stage — 32 people. Experts have carried out the assessment of the psychophysiological parameters of the examined according to the questionnaire of neuropsychiatric maladjustment (ONPD). The condition for inclusion in the groups in 2020–2021 is the absence of a history of transferred COVID-19. Results. During the tense epidemic situation (2019-2021), against the background of the spread of COVID-19 and forced self-isolation of all population groups, the lifestyle has radically changed. Face-to-face communication has been minimized, but communication using information technology in all spheres of life (daily life, study, work) has increased dramatically. The researchers found that among the surveyed population groups (students and sales workers), the spread of signs of mental discomfort increased. Limitations. The study was limited to a sample of age groups: 20–24 years for students, 20–29 years for trade workers (in both periods). Conclusion. The calculation of the odds ratio (OR) allowed us to establish with a high degree of confidence that signs of mental discomfort, including asthenic and depressive signals, were significantly more often recorded during the period of self-isolation in both study groups: for students who are on distance learning (December 2020 compared to 2013): the coefficient of OR=5.4, (χ2=14.7;p<0.001);for sales workers: coefficient OR=15.0;(χ2=9.5;p<0.001). Ethics. Questions whose content does not meet ethical standards were not included in the study, as a result of which the conclusion of the biomedical ethics committee or other documents was not required. © 2023, Izmerov Research Institute of Occupational Medicine. All rights reserved.
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The outbreak of the COVID-19 pandemic in early 2020 has brought tremendous challenges to higher education teaching and learning. Much attention has been put on online course construction and delivery to ensure the effectiveness of online learning. However, higher education assessment deserves more attention as it is also significantly impacted by the sudden switch from face-to-face to online. To examine how higher education institutions responded to the challenges in higher education assessment during the pandemic, this chapter conducted a case study of postgraduate programs at Lingnan University (LU) in Hong Kong to explore an appropriate assessment framework for online learning in a liberal arts education context. Through a quantitative approach, this study surveyed taught postgraduate students to explore the effectiveness, efficiency, and fairness of the assessment approaches applied by LU faculty members in the online and hybrid-mode classes. This case study aims to provide insights for improving higher education assessment under the pandemic crisis. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Like all public utility, swimming pools had been treated with special procedures during the COVID19 pandemic. In addition to the basic rules (social distance + hand disinfection + masks), applicable to all citizens, the managers of swimming pools were obliged to reduce the number of swimmers and to increase the effects of water treatment. Monitoring, control and rapid response to unfavourable changes in the quality of swimming pool water are the basis for minimizing the risk of disease transmission or exposure of bathers to pathogens. The main purpose of this work is to analyse and compare the quality of swimming pool water in a municipal outdoor swimming pool complex, before (2018-2019) and during the COVID-19 pandemic (2020-2021). Water samples taken from a paddling pool for children (CP), a recreational pool (RP), and a sports pool (SP) were analysed. The results of the research, based on real case studies, were compared with the documents on water quality in swimming pools in force at the time. An analysis was carried out to determine the relationships between swimming pool water quality before and during the COVID-19 pandemic. The tested parameters determining the quality of water were physico-chemical parameters (temperature, pH, redox, and bacteriological parameters (colony forming units CFU of Pseudomonas aeruginosa, Escherichia coli, Legionella sp.). Based on the results of the analysis of the parameters mentioned-above, the validation of the procedures applied during the COVID-19 hazard and their impact on the quality of swimming pool water were evaluated. The results of the pool water quality tests were discussed with particular emphasis on disinfection by-products (THM and combined chlorine). Detailed analysis showed better water quality in the first year of the pandemic (2020) compared to 2018-2019 (before COVID-19) and 2021 (the second year of COVID-19 pandemic). The following parameters were found to be significantly different: THM (before 0.069 mg/L and during 0.034 mg/L), free chlorine (before 0.86 mg/L and during 0.66 mg/L), and redox potential (before 667 and during 713 mV).
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In the early occurrence of the Covid-19 pandemic, Indonesian and the world regarded Bali having a unique mechanism. Balinese or Bali residents are assumed excellently immune or difficulty infected from Covid-19. Interestingly, Balinese do not show overwhelmed panic as occurs in other areas although the Covid-19 cases in Bali are not low. There are various reasons why Balinese's actions to protect their health consider beliefs, religion, and culture. This paper is a survey of the Balinese's distinctive perception and behavior to face Covid-19. The information was gained from comments, opinions, and information about typical behavior posted on mass media and social media. The main source of the information was the WhatsApp groups of Banjar community (60 people), Bali academicians (76 people), Hindu organization alumni (113 people), and Bali medical staff (30 people). This study collected the information and conversations during early months of the pandemic in 2020 and 2021 when the Covid-19 cases skyrocketed and the government implemented the Community Activities Restrictions Enforcement (PPKM). This study concludes that the belief in the power of nature makes the sincerity and acceptance more easily appear. Moreover, tradition strengthens the trust. Support in social life also increases cooperative actions to the rules or advices of the Bali government and the custom village assembly to protect society from the pandemic.Copyright © 2021 Muslim OT et al.
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Implicit psychological contract (PC) represents the dynamic employee-employer relationship, and unlike explicit human resource (HR) practices, PC is an underexplored topic in the crisis management literature. By capturing the dual perspective of hotel employers and employees through interviews, this study investigates the content of PCs and breaches of PCs during the COVID-19 pandemic crisis. The study identifies salient dimensions of employer obligations such as safety assurance and of employee obligations such as personal protection. While employees emphasized the transactional contracts to protect their individual interests, the employers tried to balance the transactional and relational contracts. The study proposes a dynamic PC breach model that indicates contract breaches lead to varied responses through a complex interpretation process. In general, the study suggests that ensuring mutual consideration is the best way for hotel employees and employers to pull through a crisis. (PsycInfo Database Record (c) 2023 APA, all rights reserved)