Caesarean section in critically unwell peri-partum patients with COVID-19: A tertiary centre's experience

Introduction: The COVID-19 pandemic has required clinical teams to function with an unprecedented amount of uncertainty, balancing complex risks and benefits in a highly fluid environment. This is especially the case when considering the delivery of a pregnant woman critically unwell with COVID-19. This is one maternal critical care team's reflections on establishing best practice and a shared mental model when undertaking a Caesarean section in critically unwell patients with COVID-19. Objective(s): We describe our experience of balancing the risks and streamlining the process of this high-risk intervention. Method(s): We used our standard clinical governance forums across four specialties (Obstetrics, Intensive care, Anaesthetics and Neonatology) to identify key challenges and learning points. We developed a working group to combine our learning and develop a shared mental model across the involved teams. Result(s): 1. The decision to deliver must be multidisciplinary involving Obstetrics, Intensive care, Anaesthetics, Neonatology and the patient according to their capacity to participate. The existing structure of twice daily ITU ward rounds could be leveraged as a 'pause' moment to consider the need for imminent delivery and review the risk-benefit balance of continued enhanced pharmacological thromboprophylaxis. 2. We identified a range of scenarios that our teams might be exposed to: 3. Perimortem Caesarean section 4. Critically unwell - unsafe to move to theatre 5. Critically unwell - safe to move to theatre 6. Recreating an obstetric theatre in the ICU Advantages Avoids moving a critically unstable patient, although our experience is increasing moving patients for ECMO. Some forms of maximal non-invasive therapy such as High Flow Nasal Oxygen may require interruption to move to theatre with resultant risk of harm or be difficult to continue in transport mode through a bulky ICU ventilator e.g. CPAP Disadvantages Significant logistics and coordination burden: multiple items of specialist equipment needing to be brought to the ICU. Human factors burden: performing a caesarean section in an unfamiliar environment is a significant increase in cognitive load for participating teams. Environmental factors: ICU side rooms may offer limited space vs the need to control the space if performed on an open unit. Delivering a Neonate into a COVID bubble. Conclusion(s): Developing a shared mental model across the key teams involved in delivering an emergency caesarean section in this cohort of critically unwell patients has enabled our group to own a common understanding of the key decisions and risks involved. We recommend a patient centred MDT decision making model, with a structure for regular reassessment by senior members of the teams involved. In most circumstances the human factors and logistical burden of recreating an operating theatre in the ICU outweighs the risk of transport to theatre. Pre-defined checklists and action cards mitigate the cognitive and logistical burden when multiple teams do perform an operative delivery in ICU. Action cards highlight key aspects of routine obstetric care to be replicated in the ICU environment.

The roles of suicide-related rumination and COVID-19 in suicidal ideation and behaviours: Data from a large-scale youth epidemiological sample in Hong Kong

Suicide remains to be one of the leading causes of death amongst young people worldwide. Help-seeking, however, remains disproportionately suboptimal in the youth population. Identifying more effective and less stigmatizing markers of suicidal ideation and behaviours can be important for improving early engagement and intervention work. We therefore examined the prevalence of suicidal ideation, plan, and attempt in a large epidemiological youth sample in Hong Kong (n = 2540) during the period of 2019-2021, as well as the factors associated with each of these outcomes using separate multivariable logistic regression models. In this sample, the 12-month prevalence of suicidal ideation, plan, and attempt was 20.0%, 4.6%, and 1.3%, respectively. In particular, we found 'suicide-related rumination' to be amongst the only factor that was significant for all three outcomes (p < .010). Using a two-stage approach (i.e., selecting only those with suicidal ideation), we found that suicide-related rumination, poorer cognitive ability, and 12-month major depressive episode were specifically associated with 12-month suicide plan, while environmental factors, including COVID-19 stressors, personal life stressors, poorer family relationships, as well as non-suicidal selfharm, were specifically associated with 12-month suicide attempt. A two-stage approach should be considered in future interventions targeting youth suicide. Suicide-related rumination may be an important marker of overall suicidal risk. The role of environmental stressors in addition to intrinsic vulnerability also need to be emphasized to best support young people at risk.

Stress reactions and health problems in hospital personnel during the COVID-19 pandemic-A longitudinal, multicenter study

Background: The overarching aim of the study was to (1) investigate how working with COVID-19 patients has impacted work environment, and (2) to identify how factors in the work environment impact adverse health outcomes among hospital personnel (HP), throughout the four waves of the pandemic. Material(s) and Method(s): In a web-based survey altogether 2472 HP participated from four large university hospitals in Norway, whereof N = 680 in April-June 2020 (T1), N = 1073 in December-January 2020/2021 (T2), N = 818 in April-May 2021 (T3), and N = 972 in December 2021-February 2022 (T4). At each time point participants reported on pandemic related work tasks, work environment and adverse health outcomes. Somatic symptoms, psychological distress, posttraumatic stress symptoms and burnout served as outcomes of multivariable linear regression models. The percentage of responders involved in ICU treatment of COVID-19 patients varied between 21% and 40% from T1-T4. Result(s): Reported stressors altered in strength during the 4 waves. Preliminary results indicate that exposure to patients with COVID-19 was associated with more frequent experience of work environmental factors. Compared to colleagues not working with patients with COVID-19 HP reported challenges related to professional competency and training, predictability in teams and work environment, manageable workload, adequate help and support for work stress management, user-friendliness of Personal Protection Equipment and infection protection safety. Furthermore, these environmental factors were associated with symptoms of psychological unhealth on at least one timepoint. Conclusion(s): The results may help guide organizational efforts to maintain professional competency and to reduce stress more efficiently among hospital personnel at different stages in response to long-term crises.

Ethnic, racial and migrant inequalities in respiratory health

Disparities in the incidence, prevalence, and morbidity and mortality rates of many respiratory diseases are evident among ethnic groups. Biological, cultural and environmental factors related to ethnicity can all contribute to the differences in respiratory health observed among ethnic minority groups, but the inequalities observed are most commonly due to lower socioeconomic position. People who migrate within a country or across an international border may experience an improvement in respiratory health associated with improvements in socioeconomic position. However, migrants may also experience worse health outcomes in destination countries, as they are faced by barriers in language and culture, discrimination, exclusion and limited access to health services. While some high-quality studies investigating ethnicity and respiratory health are available, further research into ethnic differences is needed. Improving the recording of ethnicity in health records, addressing barriers to accessing respiratory healthcare and improving cultural literacy more generally are some of the ways that inequalities can be tackled.Copyright © ERS 2023.

Future challenges and their impact on respiratory health and lung cancer

Air pollution, climate and population health are closely related in terms of their impacts on respiratory health and lung cancer. Air pollutants contribute to the exacerbation of chronic respiratory problems such as COPD and asthma. Air pollutants are also toxic and carcinogenic, initiating and promoting lung cancer development. Climate change in relation to environmental pollution affects the geographical distribution of food supply and diseases such as pneumonia in adults and children. The threat of air pollution, and hence global warming and climate changes, and their effects on population and respiratory health, is an imminent threat to the world and deserves immediate and sustainable combating strategies and efforts. The goals are to increase public awareness and engagement in action, with alignment of international collaboration and policy, and with steering towards further research. Now is the prime time for international collaborative efforts on planning and actions to fight air pollution and climate change before it is too late.Copyright © ERS 2021.

Influence of environmental and demographic factors on the transmission and mortality rate of COVID19 in India

COVID-2019 has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization due to the global spread of 2019-nCOV at an exponential rate (WHO). Scientists have hypothesized the reduction in transmission rate at warm and humid environment whereas facilitate rapid transmission at cold and dry environment. Hence in this work, we examine the combined impact of environmental and demographic factors along with the implementation of lockdown by the Government of India on the transmission rate of 2019-nCoV. Our analyses indicated a lower mortality rate in spite of higher population density in India compared to other countries and lower exponential growth factor after lockdown compared to before lockdown. The containment of transmission and mortality rate may be attributed to the favorable environment and median population age, respectively. Even though, to significantly reduce the outbreak, individuals, the media, and healthcare organizations are necessary to work together. © 2023 Author(s).

Study of body composition analysis in the view of obesity prognosis

Chronic overweight is characterized by significant elevations in abdominal fat as well as changes in the composition of fat free mass, particularly total body fluids and its interstitial compartment. The applied in the real restrictions placed by morbid obesity, as well as changes in body content from those of healthy weight, provide enormous hurdles to fat percentage assessment. This research concentrates on some of the research and practice challenges connected with using popular fat percentage measures, and it finds available evidence on suitable approaches for use in extremely obese people. There is already little scientific literature on which body composition measures may be utilised confidently in very obese people. A typical 3 model that combines readings of body mass by air - assisted plethysmography and total body liquid by bio-electrical impedance could provide metrics of percentage body fat in the extremely obese that are significant compared to a conventional, technically skilled 3 storage area prototype that requires infrastructure including such isotopic ratios mass spectrometry as well as important technological knowledge. This study focuses on a few fundamental issues that investigators and physicians confront when doing anthropometric studies on highly obese individuals. A 3 basic framework that is efficient and simple to implement shows potential for usage in this community. Nonetheless, more study on this and other suitable techniques of fat percentage measurement in a broad sample of extremely overweight adults is required. © 2023 Author(s).

Research progress on influence of environmental and meteorological parameters on transmission of coronavirus disease 2019

Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is spreading rapidly around the world and has become a global pandemic. Meteorological factors have been recognized as one of the critical factors that influence the epidemiology and transmission of infectious diseases. In this context, the World Meteorological Organization and scholars at home and abroad have paid extensive attention to the relationships of environment and meteorology with COVID-19. This paper systematically collected and sorted out relevant domestic and foreign studies, and reviewed the latest research progress on the impact of environmental and meteorological factors on COVID-19, classifying them into typical meteorological factors (such as temperature, humidity, and wind speed), local environmental factors (such as indoor enclosed environment, ventilation, disinfection, and air conditioning), and air pollution. Current research evidence suggests that typical meteorological factors, local environmental factors, and air pollutants are closely related to the transmission of COVID-19. However, the results of different studies are still divergent due to uncertainty about the influencing mechanism, and differences in research areas and methods. This review elucidated the importance of environmental and meteorological factors to the spread of COVID-19, and provided useful implications for the control of further large-scale transmission of COVID-19 and the development of prevention and control strategies under different environmental and meteorological conditions.Copyright © 2022, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

How to Build Confidence in Vaccines

Despite overwhelming evidence of vaccine effectiveness in preventing serious vaccine preventable diseases (VPDs), lack of confidence in vaccines is a major threat to the prevention and control of VPDs and antimicrobial resistance globally. Vaccine hesitancy and antimicrobial resistance are inter-related, with high levels of vaccination uptake being a vital pillar of antimicrobial stewardship. Parallel with the COVID-19 pandemic, another 'infodemic' of uncertainty, misunderstanding, lack of trust and loss of confidence in vaccines unfolded. While regulatory authorities are mandated to ensure the safety, efficacy and quality of all approved vaccines, public confidence in vaccine safety and effectiveness is compromised by social media reports, falsely blaming vaccines for serious adverse events following immunisation. Hence, transparent public communication and education on vaccine safety;the risk-benefit balance;and causality assessment outcomes, are essential. A key factor in this context is people's perception of risk, especially where the fear of vaccines has replaced the fear of a VPD. Understanding the factors driving vaccine hesitancy and moving people from the point of being hesitant to the point of accepting vaccination, requires collective multi-pronged strategies from all levels of society, including political, social, religious and educational role players. Targeted approaches should be evidence-based, context-specific, culturally sensitive and tailored for the community, integrating individual, social and environmental factors. While healthcare professionals are the public's most trusted source of information for vaccination decision- making, they are not immune against believing misinformation and developing vaccine hesitancy. Consequently, they must be empowered with the necessary knowledge, skills and confidence to respond appropriately to questions and persuade the public to demand vaccination for themselves and their children. This presentation will focus on strategies to build vaccine confidence and acceptance, promote trust in the healthcare system, and address fears about the consequences of vaccination, aimed at driving vaccine uptake and preventing antimicrobial resistance.Copyright © 2023

Understanding the influences on clinical decisions regarding ventilation of critically ill COVID-19 patients

Introduction: National Service Evaluations of COVID-19 ARDS care in the US and UK showed significant variability in clinical practice, and adherence to existing guidelines. To better understand the basis for this, we explored factors influencing decision-making around mechanical ventilation in COVID-19. Method(s): We conducted interprofessional focus groups identifying factors that influenced decision-making through thematic analysis. From this, we developed a questionnaire to validate these themes with a larger sample of critical care professionals across the UK. Kruskal- Wallis or Mann-Whitney U tests were used for data analysis. Result(s): There were 179 complete responses from doctors, nurses and physios. In their usual practice, 66% of clinicians reported adherence to national ARDS guidelines. However, 80% thought COVID-19 ARDS presented differently to their previous clinical knowledge/experience of ARDS and 72% thought deviating from usual practice was necessary. Doctors were more likely to think deviation was necessary (p < 0.001) but there was no difference across level of ICU experience (p = 0.845). Clinicians reported their ventilatory decision-making was most influenced by disease factors, followed by team then contextual and least by environmental factors (p < 0.001). Disease factor was seen as most important across profession and experience level. During COVID-19, 68% of clinicians reported not being confident in their ventilatory decision-making;however, clinicians who felt COVID-19 ARDS presentation fitted with their previous clinical knowledge/experience of ARDS reported greater confidence (p < 0.001). Confidence was not affected by experience (p = 0.522) or profession (p = 0.294) (Fig. 1). Conclusion(s): Clinicians were influenced by the uncertain understanding of COVID-19 ARDS, especially when they considered previous experiences to be less relevant. In the event of another novel disease, developing a consistent, understandable clinical models of disease should be prioritised to optimise decision making.

Mental Health Perspectives of Youth & Young Adults at a Medical Sciences University in Bhutan

Purpose of Study: Since 1972, Bhutan has followed the philosophy of Gross National Happiness (GNH) - an alternative to GDP which quantifies the holistic wellness of its citizens' as opposed to the production of materials as a metric of the nation's development & prosperity. Nonetheless, the government identified youth and young adult (YYA) mental health to be a major/increasing point of concern from a 2015 national survey, indicating need for a closer look at Bhutan's mental health burden. By exploring YYA perspectives of mental health via an online survey, we hope to inform resource creation, support existing infrastructure, & guide future research. Methods Used: Survey questions were developed via collaboration of Canadian and Bhutanese shareholders to ensure cultural appropriateness and relevance. In all, 11 demographics questions, 17 10-point Likert scale questions, and 7 written answer questions were included in the survey. Students enrolled at university in Thimphu, Bhutan, between the ages of 18-25 inclusive and who are Bhutanese citizens or who have lived the majority of their life in the country were recruited via email. 289 participants consented to & completed the online survey via Qualtrics. Survey responses were quantitatively analyzed in R-Studio, save for written responses still under qualitative analysis in NVivo and not included in this discussion. Summary of Results: On average, YYA indicated feeling sad, anxious, and/or depressed more frequently than they perceived peers/family to feel the same. Strong agreement was seen regarding treatability of mental health conditions (median of 9 on 10-point Likert scale). Environmental factors, adverse childhood experiences, & personal weakness were noted to have detrimental impacts on wellbeing. The majority of respondents indicated positive familial relationships & confidence in parents to understand/support mental health issues, with medians for all family-related 10-point Likert scale questions being above 7.5. Most respondents agreed they were able to get through difficult times and be self-reliant, with all associated 10-point Likert questions having a median over 5 for moderate agreement. A general positive response to using apps or websites as mental health resources was noted. Relating to COVID-19, minimal negative outcomes in terms of diet, anxiety/depression, home life, & substance use were reported. Strong agreement (median of over 7.5 on 10-point Likert scale) was noted with regard to increases in domestic violence as a result of the pandemic. Conclusion(s): Differences between self-ratings and perceptions of others' mental health by Bhutanese YYA indicate a lack of open communication about the topic. Directing resources towards discussions about mental health may be beneficial - especially if technologically accessible. Impacts of the pandemic may continue to develop as Bhutan emerges from lockdown protocols;increasing domestic violence is a primary concern of Bhutanese YYA meriting research.

CASE REPORT: Immigrants and evolving food allergies

Case report Background: We present a case of coconut allergy as a rare evolving food allergy among immigrants. Case presentation: A 3-year-old girl, on treatment for asthma, was referred to the allergy clinic due to possible reactions to salmon and coconut. Due to COVID restrictions, the initial consultation was conducted by telephone. Reportedly, she developed hives and wheeze after eating salmon and coconut products. During the face-to-face review, it was noted that the child's paternal side of the family was of ethnic minorities. The patient had cradle cap as a baby, and coconut oil was applied for treatment as advised by family back home. During a hospital-based coconut challenge, she developed puffy eyes, and on subsequent consumption of coconut macaroon, she developed hives. The child was diagnosed with coconut allergy. Face-to-face assessment and food cultural awareness are essential for clinical diagnosis. Discussion(s): Allergy is a multifactorial illness affected by epigenetic, environmental factors, eczema during infancy and food culture. Studies suggest that the risk of allergy can be highest in immigrants to culturally stable food, particularly with delayed early taste during weaning. The dual allergen hypothesis proposes that early cutaneous exposure to food protein through damaged skin barrier can lead to sensitisation and allergy and that early oral exposure to food induces tolerance. Conclusion(s): Further research on understanding the interaction between epigenetics of the allergic disease and the environment is needed as is an understanding of how the movement of populations and different culture habits can affect the incidence of food allergy. In the meantime, is promoting healthy skin barrier and early food introduction enough to prevent food allergies.

Cognitive-behavioral therapy for panic disorders.

This article discusses the treatment of panic disorder in terms of cognitive behavioral psychotherapy. Panic disorder is one of the most common anxiety disorders. The etiology of panic disorder assumes the coexistence of genetic and environmental factors. Panic attacks often accompany other mental and somatic diseases. The constant feeling of intense anxiety with a number of somatic symptoms affects the deterioration of everyday functioning, significantly reducing one's quality of life. The global situation caused by SARS-CoV-2 may correlate with the increase in the incidence of panic disorder. The introduction of appropriate therapeutic interventions at the earliest possible stage of the disease gives patients a chance for long-term remission. So far, it has been proven that the best results of pharmacological treatment are achieved thanks to the antidepressant and benzodiazepine drug groups. One of the non-pharmacological interventions with the highest clinical effectiveness is cognitive-behavioral psychotherapy. Compared to other trends, cognitive- behavioral therapy is characterized by the most reliable research proving its high effectiveness. Psychotherapy of panic disorders in the cognitive-behavioral approach includes a complete conceptualization of the patient's problem, taking into account individual theoretical models. Treatment of panic attacks is based on a protocol which takes into account both cognitive and behavioral interventions, e.g. psychoeducation, cognitive restructuring, breathing training, relaxation exercises and both interoceptive and in vivo exposures. Research results indicate that this therapy is an alternative form of treatment for panic disorders. Sources indicate that the effectiveness of interventions based on cognitive-behavioral therapy is comparable to that of pharmacotherapy.Copyright © 2022 Termedia Publishing House Ltd.. All rights reserved.

A Review Study on Associated Factors Ofmyopia Amongschool Goingchildren

Myopia is a prevalent yet confusingocular disorder. Myopia,formerlyconsidered abenignrefractivecondition, is nowassociatedwithanincreasedriskofdevelopingseveraloculardisorders,evenatmodestlevels.Myopiaisaglobalproblemthatexpe rts have documented. Despite the fact that the specific cause of myopia remains a mystery, it appears to be a combinationof genetic and environmental factors, making the prevention and treatment of the condition difficult and highly personalised.Myopia can have a positive impact on both the quality of life and the health of the eyes if it is prevented. Progressive additionlenses (PAL), topical atropine, ortho-k (orthokeratology) lenses and multifocal contact lenses are some of the most commoncontrol options currently available. Myopia has gained prominence in optometry studies as a result of its high prevalence. It ismore common for children to suffer from problems, such as extreme myopia and myopic macular degeneration, if they begindevelopingmyopiaatanearlyage.Thepurposeofthisstudywillbetoconductaninquiryintotheepidemiologyandriskfactorsfor myopiainschool-agedchildren(aged 6-19years)aroundtheworld.Copyright © 2022, Anka Publishers. All rights reserved.

Online Sensory Marketing: Developing Five-Dimensional Multi-Sensory Brand Experiences and its Effectiveness

The online environment has long been a sensory interaction between a brand or product and its consumers through visual imagery and sonic elements. While newer technologies have developed that cater to a customer's more psychological need for haptics (touch), gestation, and olfaction, brands have not explored its true potential. Immersions and other forms of Human-Computer interaction have vastly developed and present scope for more than just a single sense for online consumers. While brands are employing these multisensory interfaces (vs. single-sensory) in certain product categories, it remains to be seen whether customers who unknowingly experience sensations online want to adapt to it. Several product categories could find multisensory elements beneficial. This study aims to delve deeper and understand the motivations of such behavior and identify the need for a customer to engage all its senses beyond the traditional visuals and sound while interacting with brands virtually for a more holistic experience. While external environmental factors such as pandemics have resulted in the inevitable loss of physical touchpoints, the aim is to determine whether sensory elements beyond images and sounds will benefit customer engagement.Copyright © 2022 Novyi Russkii Universitet. All rights reserved.

A SYSTEMATIC REVIEW ON THE EFFECT OF ENVIRONMENTAL FACTORS ON COVID-19 CASES

A global pandemic known as COVID-19 now threatens public health systems worldwide. The COVID-19 virus is spread by many sources, including environmental factors. Infectious diseases are transmitted and are resistant to certain environmental factors, including temperature, humidity, wind speed and population density. Through preferred reporting items for systematic reviews and meta-analyses, a study on the effects of environmental factors on the spread of COVID-19 cases in Asia was carried out to provide evidence-based knowledge and serve as a basis for health care and preventative guidelines (PRISMA). Search databases like Web of Science (WoS), Scopus and PubMed were used to find the data. A total of 52 full-text papers, 1,780 s and 16 systematic review articles were examined. The results indicate a clear correlation between environmental factors, population density and the occurrence of COVID-19. These findings suggest that environmental factors may play a role in the distribution of COVID-19 in Asia © Penerbit UMT

Viral enteritis in cattle: To well known viruses and beyond

Livestock products supply about 13 percent of energy and 28 percent of protein in diets consumed worldwide. Diarrhea is a leading cause of sickness and death of beef and dairy calves in their first month of life and also affecting adult cattle, resulting in large economic losses and a negative impact on animal welfare. Despite the usual multifactorial origin, viruses are generally involved, being among the most important causes of diarrhea. There are several viruses that have been confirmed as etiological agents (i.e., rotavirus and coronavirus), and some viruses that are not yet confirmed as etiological agents. This review summarizes the viruses that have been detected in the enteric tract of cattle and tries to deepen and gather knowledge about them.Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Visual Fatigue and Technostress in AgroIndustries Standards: Case Study

Introduction: The test applied to the students of the Agroindustry career of the National University of Chimborazo presents previous visual diseases in: 33.3 % myopia, 5.1 % astigmatism, 0.5 % presbyopia, referring to the use of the computer we have: 54.9 % of 2 to 4 hours, 39 % of 4 to 8 hours and 6.2 % more than 8 hours which can cause visual fatigue. This research aims to determine the level of visual computer syndrome when applying the CVSS 17 test and technostress by applying the NTP 730 test. The reliability of the instruments is 0. 693 good and 0.959 mu and good, and the reliability of 0.916 and 0.931 which is very good respectively. The result of visual fatigue is 29.2% symptomatic and 70.8% asymptomatic. Regarding technostress, 55.4% is low, 35.9% is medium, and 8.7% is high. The conclusions are determined: the existence of visual fatigue determines the presence of ocular and visual symptoms which will cause short-term affections to the organ of sight and referring to technostress there is resistance to the use of technology. The presence of visual fatigue is associated with the tele study due to the high frequency of computer use and other environmental factors, theCovid 19 pandemic is one of the factors that has contributed to the phenomenon under study, so it is necessary to implement preventive measures.Copyright © 2023, Anka Publishers. All rights reserved.

The Impact of Internal Environment Factors in Achieving Strategic Agility During COVID- 19 Pandemic at Jordanian Commercial Banks: The Moderating Role of Information Technology

To remain competitive in today's uncertain business environment, banks must develop capabilities that enable them to adapt and respond quickly to market changes. Therefore, this study aims to examine the impact of internal environmental factors on achieving strategic agility through the moderating role of information technology at the Jordanian Commercial Banks. Out of the 13 banks, 10 took part in the survey. Internal environmental factors being investigated include agile human resources, organizational structure, and organizational culture. The 240 middle and first-line managers who worked at the headquarters of the 10 banks made up the sampling unit. To get the information and data needed, 240 questionnaires were sent out, and 203 of them could be used for statistical analysis. The results indicate a statistically significant impact of internal environmental factors in achieving strategic agility. The findings of the moderation hypothesis also reveal that information technology as a moderator has improved the impact of internal environmental factors in achieving banks' strategic agility by 0.04. The results show that the agility of human resources has the highest impact in achieving banks' strategic agility. Consequently, it was recommended to enhance the skills and competencies of the banks' staff and to equip them with the needed training courses to be able to adapt to change successfully. © 2022 WITPress. All rights reserved.