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This study, which is based on actual events, presents a dynamic analysis of the development, implementation, and post-implementation review of establishing an enterprise risk management (ERM) system for a U.S. multinational nonprofit firm over a 5-year period, 2015–2020. Using the Risk and Insurance Management Society Risk Maturity Model (RIMS RMM), questionnaire-based risk data and multi-dimensional risk mapping indices are used to identify and prioritize the firm's key strategic risks leading to the development of mitigation strategies whose performance are reviewed post ERM implementation, including during the 2020 Coronavirus pandemic. The results reveal that the firm's risk management system has been ad hoc and uncoordinated. Post-implementation review of the ERM program shows improvements in financial and operating positions resulting from risk diversification, enhanced profitability, exploitation of natural hedges, and improved board governance. The results further show that the recommended mitigation strategies have been effective in managing the adverse impact of the pandemic. Overall, the evidence offered in this study provides further support on the valuation benefits of ERM maturity within a real-world environment. [ABSTRACT FROM AUTHOR]

Purpose: A decline in youth running was observed at the start of the COVID-19 pandemic. We investigated whether the resumption of organized running after social distancing restrictions changed running habits or injury frequency in adolescent runners. Methods: Adolescents (age = 16.1 [2.1] y) who participated in long-distance running activities completed an online survey in the Spring and Fall of 2020. Participants self-reported average weekly running habits and whether they sustained an injury during the Fall 2020 season. Poisson regression models and 1-way analysis of variance compared running habits while Fisher exact test compared differences in frequencies of injuries during Fall 2020 among season statuses (full, delayed, and canceled). Results: All runners, regardless of season status, increased weekly distance during Fall 2020. Only runners with a full Fall 2020 season ran more times per week and more high-intensity runs per week compared with their Spring 2020 running habits. There were no differences in running volume or running-related injury frequency among Fall 2020 season statuses. Conclusions: There were no significant differences in running-related injury (RRI) frequency among runners, regardless of season status, following the resumption of cross-country. Health care providers may need to prepare for runners to increase running volume and intensity following the resumption of organized team activities. [ABSTRACT FROM AUTHOR]

The global COVID-19 pandemic made vulnerable work environments, and campus recreation departments could not avoid its influence. Previous studies focused on strategies and policies for reopening campus recreation facilities and the impacts of recreation programs on students and participants during the pandemic. Relatively little research has explored employees' perceptions about campus recreation departments' challenges and solutions, and employees' work experience during the pandemic has not been fully explored. This study explored employees' work experience related to burnout during the pandemic through semi-structured interviews with campus recreation employees (N = 10). The findings revealed stressors, including extra workload, and lack of interaction, and burnout symptoms, including exhaustion, and cynicism. The findings also revealed that employees utilized individual strategies to manage stressors, and the department made efforts to reduce employees' stress. The findings of this study will provide campus recreation practitioners with a better understanding of employees' experience related to burnout. [ABSTRACT FROM AUTHOR]

This article provides a polyvocal narrative of the development, initial assessment, and ongoing revision of an Informed Self-Placement (ISP) process initially implemented during the COVID pandemic. The authors intersperse collectively narrated description how the ISP unfolded in its first two years with individual reflections on those experiences from a variety of positions and identities. Data so far suggest that this ISP process has narrowed but not fully closed racial equity gaps in first-year writing placement while maintaining enrollments and academic performance in the first-year writing course sequence. Persistent equity issues reside not only in the ISP instrument itself but the systems by which students learn about the ISP and the opportunities they have to complete it.

In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise-i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention-has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions.

BackgroundSocial distancing from the COVID-19 pandemic may have decreased engagement in cardiac rehabilitation (CR) and may have had possible consequences on post-CR exercise maintenance. The increased use of technology as an adaptation may benefit post-CR participants via wearables and social media. Thus, we sought to explore the possible relationships of both the pandemic and technology on post-CR exercise maintenance.ObjectiveThis study aimed to (1) understand CR participation during the COVID-19 pandemic, (2) identify perceived barriers and facilitators to physical activity after CR completion, and (3) assess willingness to use technology and social media to support physical activity needs among older adults with cardiovascular disease.MethodsWe recruited participants aged 55 years and older in 3 different CR programs offered at both public and private hospitals in Northern California. We conducted individual interviews on CR experiences, physical activity, and potential for using technology. We used thematic analysis to synthesize the data.ResultsIn total, 22 participants (n=9, 41% female participants; mean age 73, SD 8 years) completed in-depth interviews. Themes from participants' feedback included the following: (1) anxiety and frustration about the wait for CR caused by COVID-19 conditions, (2) positive and safe participant experience once in CR during the pandemic, (3) greater attention needed to patients after completion of CR, (4) notable demand for technology during the pandemic and after completion of CR, and (5) social media networking during the CR program considered valuable if training is provided.ConclusionsIndividuals who completed CR identified shared concerns about continuing physical activity despite having positive experiences during the CR program. There were significant challenges during the pandemic and heightened concerns for safety and health. The idea of providing support by leveraging digital technology (wearable devices and social media for social support) resonated as a potential solution to help bridge the gap from CR to more independent physical activity. More attention is needed to help individuals experience a tailored and safe transition to home to maintain physical activity among those who complete CR.

To support the ongoing management of viral respiratory diseases while transitioning out of the acute phase of the COVID-19 pandemic, many countries are moving toward an integrated model of surveillance for SARS-CoV-2, influenza virus, and other respiratory pathogens. Although many surveillance approaches catalyzed by the COVID-19 pandemic provide novel epidemiologic insight, continuing them as implemented during the pandemic is unlikely to be feasible for nonemergency surveillance, and many have already been scaled back. Furthermore, given anticipated cocirculation of SARS-CoV-2 and influenza virus, surveillance activities in place before the pandemic require review and adjustment to ensure their ongoing value for public health. In this report, we highlight key challenges for the development of integrated models of surveillance. We discuss the relative strengths and limitations of different surveillance practices and studies as well as their contribution to epidemiologic assessment, forecasting, and public health decision-making.

BACKGROUND: There are knowledge gaps about factors associated with acute kidney injury (AKI) among COVID-19 patients. To examine AKI predictors among COVID-19 patients, a retrospective longitudinal cohort study was conducted between January 2020 and December 2022. Logistic regression models were used to examine predictors of AKI, and survival analysis was performed to examine mortality in COVID-19 patients. RESULTS: A total of 742,799 veterans diagnosed with COVID-19 were included and 95,573 were hospitalized within 60 days following COVID-19 diagnosis. A total of 45,754 developed AKI and 28,573 AKI patients were hospitalized. Use of vasopressors (OR = 14.73; 95% CL 13.96-15.53), history of AKI (OR = 2.22; CL 2.15-2.29), male gender (OR = 1.90; CL 1.75-2.05), Black race (OR = 1.62; CL 1.57-1.65), and age 65+ (OR = 1.57; CL 1.50-1.63) were associated with AKI. Patients who were vaccinated twice and boosted were least likely to develop AKI (OR = 0.51; CL 0.49-0.53) compared to unvaccinated COVID-19 patients. Patients receiving two doses (OR = 0.77; CL = 0.72-0.81), or a single dose (OR = 0.88; CL = 0.81-0.95) were also less likely to develop AKI compared to the unvaccinated. AKI patients exhibited four times higher mortality compared to those without AKI (HR = 4.35; CL 4.23-4.50). Vaccinated and boosted patients had the lowest mortality risk compared to the unvaccinated (HR = 0.30; CL 0.28-0.31). CONCLUSION: Use of vasopressors, being unvaccinated, older age, male gender, and Black race were associated with post COVID-19 AKI. Whether COVID-19 vaccination, including boosters, decreases the risk of developing AKI warrants additional studies.

BackgroundCannabis use before the COVID-19 pandemic for many involved sharing prepared cannabis for inhalation, practices that were less prevalent during the pandemic. State-level COVID-19 containment policies may have influenced this decrease. This study examined the extent to which the intensity of state-level COVID-19 policies were associated with individual-level cannabis sharing. Findings have the potential to guide harm reduction policies for future respiratory pandemics and seasonal respiratory virus waves.MethodsThis study used cross-sectional individual-level data from the COVID-19 Cannabis Study, an anonymous U.S.-based web survey on cannabis use disseminated during the early phase of the pandemic (Full sample N = 1,883). We combined individual-level data with state-level policy data from Kaiser Family Foundation's State COVID-19 Data and Policy Actions for three time-points from June to August 2020 that overlapped with the survey period. Cannabis sharing was dichotomized as any versus no sharing. We adapted a previously published coding framework to score the intensity of COVID-19 policies implemented in each U.S. state and averaged the policy score across the time period. We then used Poisson regression models to quantify the associations of the average state-level COVID-19 policy score with cannabis sharing during the pandemic.ResultsParticipants (n = 925) reporting using inhalation as a mode for cannabis use were included in this analysis. Most respondents were male (64.1%), non-Hispanic White (54.3%), with a mean age of 33.7 years (SD 8.8). A large proportion (74.9%) reported sharing cannabis during the pandemic. Those who shared cannabis more commonly lived in states with a lower average policy score (16.7, IQR 12.3-21.5) compared to those who did not share (18.6, IQR 15.3-25.3). In adjusted models, the prevalence ratio of any cannabis sharing per every 5-unit increase in the average COVID-19 policy score was 0.97 (95% CI 0.93, 1.01).ConclusionsFewer individuals shared cannabis in states with more intense COVID-19 containment policies compared to those in states with less intense policies. Individuals who use cannabis may be willing to make changes to their behavior and may further benefit from specific and directed public health messaging to avoid sharing during respiratory infection outbreaks.

Libraries play an essential role in fostering sustainable development by providing equal access to information. Since the beginning of the 1990s, libraries have engaged in various activities designed to reduce their environmental impact; these libraries are referred to as "green libraries. During the Covid Pandemic, authors are discussing establishing a green library in the Rajagiri Business School (RBS). This is a novel concept in a business school setting, because not much has been published in this area yet and will contribute to our commitment to achieving the United Nations Sustainable Development Goal initiative. In this paper, an attempt has been made to discuss the proposal and model for designing a green library with respect to the UN’s Sustainable Development Goal. RBS should pioneer in implementing green initiatives in business school libraries and serve as a model for other libraries in India and abroad. Researchers believe that this model will be an insightful document for decision-makers in setting a greener and more aesthetic library for the academic community.

The COVID-19 pandemic has had serious implications on the health and well-being of student-athletes. The present study explored the athletic experiences of NCAA Division II college athletes during the competitive hiatus caused by the pandemic, as well as in their return to sport participation. Twenty male and female student-athletes from a variety of sports (freshman = 2, sophomores = 4, seniors = 9, and graduate = 5) participated in semistructured interviews to explore how the pandemic affected their athletic identity, anxiety, and mental health. Through the use of thematic content analysis, the following major themes were identified: (a) influence of COVID on athletic identity, (b) increased anxiety during COVID, (c) social aspects of sport participation, and (d) factors that influence mental health. Findings indicated a combination of positive and negative effects on the athletic identity, anxiety, and mental health and well-being of student-athletes. [ABSTRACT FROM AUTHOR]

We find that job vacancies in local government appear to be a widespread and significant problem for the public sector affecting a wide range of occupations across wage levels and educational requirements. We offer suggested policy solutions raised by subject matter experts and other reports and analyses on job vacancy challenges in local government.

BACKGROUND: Injuries, the leading cause of death in children 1-17 years old, are often preventable. Injury patterns are impacted by changes in the childs environment, shifts in supervision, and caregiver stressors. The objective of this study was to evaluate the incidence and proportion of injuries, mechanisms, and severity seen in Pediatric Emergency Departments (PEDs) during the COVID-19 pandemic. METHODS: This multicenter, cross-sectional study from January 2019 through December 2020 examined visits to 40 PEDs for children

Teachers’ willingness to strike represents not just a resurgence of union power, but also their determination to call attention to the dire consequences of decades of California’s underinvestment in K-12 education.

No abstract

There is evidence that pet owners experienced benefits during the COVID-19 pandemic and also struggled with pet-related stressors. Notably, almost all of these studies were conducted with predominantly cisgender and heterosexual samples. This is problematic, as evidence suggests that individuals who belong to marginalized groups, such as LGBTQ+ emerging adults, have been disproportionately affected by stressors associated with the pandemic. This qualitative study explores the unique experiences of LGBTQ+ emerging adults who lived with a pet during the COVID-19 pandemic. Additionally, we sought to identify resources needed to assist LGBTQ+ emerging adult pet owners during the pandemic. The sample included 65 participants aged 18–21 years who had lived with one or more pets within the past year (Mean age = 19.5 years; 36.9% transgender/gender diverse; 40% minoritized racial/ethnic identity). We conducted semi-structured interviews consisting of 18 questions (including five COVID-specific questions). Two authors coded and analyzed the interviews using template analysis. Then, the authors used a thematic analysis approach to organize codes into themes, identify patterns of meaning, and examine relations between themes. Four themes emerged related to the experience of living with a pet during the pandemic. Almost all participants said that their pets provided various types of support to them. Many participants stated that their pets also added stress to their lives during the pandemic. Some participants attributed the changes in their pet’s behavior and/or attitude to pandemic-related quarantines. More than half of the participants discussed changes in their relationship with their pet, with the majority claiming their relationship became stronger. Two themes emerged that related to necessary resources: greater community-based resources (e.g., low-cost veterinary care, pet-friendly outdoor spaces) and more government resources (e.g., better access to information, more material and financial support). Participants offered suggestions for ways to alleviate pet-related stressors, such as developing community-based programs (e.g., pet food pantries, mutual aid programs). There is the opportunity for collaboration between researchers and practitioners in piloting these community programs, as well as implications for policy makers to advocate for policies supportive of LGBTQ+ emerging adult pet owners (e.g., university pet policies, housing policies).

It is well established that a variety of physical distancing measures are invaluable as part of the overall response to pandemics. COVID-19 is the most recent such pandemic, a respiratory disease transmitted through interaction, necessitating steps to minimize or eliminate the potential for exposure. Of course, this is driven by a desire to keep the economy moving, allow for social activity, continue education, support the livelihoods of individuals, etc. Regional science and supporting analytics have an important role in managing activity through the development and application of methods that enable spatial interaction that mitigates transmission. This paper details methods to plan for physical distancing at micro-scales, enabling the return of social, economic, entertainment, etc. activities. Geographic information systems combined with spatial optimization offers important spatial coronametrics for the mitigation of risk in disease transmission. Applications detailing office space occupancy and travel along with room seating are highlighted.

This empirical content analysis of news coverage by New Mexico’s largest-circulation daily newspapers of Native American leaders before and during the Covid-19pandemic – a total of 1,314 articles – reveals stark disproportionality. Six of the eight dailies increased news coverage of the Navajo Nation president, with the statewide-circulation Albuquerque Journal stepping up its efforts dramatically. Arguably, the state’s Apache presidents and Pueblo governors were subjected to erasure via denial of difference, as the voice of the Navajo Nation president was effectively substituted for those of his Apache and Pueblo counterparts. Recommendations are offered to reduce the problem.

To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13-21 years) and adult self-report and caregiver-report on 3-12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3-12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The pandemic’s myriad effects on the U.S. economy will be the subject of research and attention for many years to come. In this report, we delve into some of the pandemic’s impacts by focusing on one question: How did the COVID-19 pandemic affect technology adoption in U.S. warehouses?

BackgroundLimited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.MethodsThis is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.Results1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32-1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70-6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83-12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63-3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20-2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66-3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89-22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.ConclusionsUsing one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients.FundingThis study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.Clinical trial numberCCC19 registry is registered on ClinicalTrials.gov, NCT04354701.

Background: The objectives of this systematic review were to synthesize qualitative evidence on the impacts of COVID-19 restrictions on physical activity (PA) for children and youth, and explore factors perceived to influence those impacts. Methods: Five databases (MEDLINE, Embase, SPORTDiscus, ERIC, and CINAHL) were searched initially in June 2021 and updated in December 2021 to locate qualitative articles considering COVID-19 restrictions and PA for children and youth (≤18 y old), in any setting. Eligibility, quality assessments, and data extraction were completed by 2 independent reviewers. Data were synthesized using meta-aggregation with confidence of findings rated using ConQual. Results: After screening 3505 records, 15 studies were included. Curriculum-based PA, organized sport, and active transportation were negatively impacted by COVID-19 restrictions. Negative changes were affected by COVID-19 exposure risks, inadequate instruction, poor access, screen time, and poor weather. Unstructured PA was inconsistently impacted; outdoor unstructured PA increased for some. Positive changes were facilitated by family co-participation, availability of outdoor space, and perceived mental health benefits. Conclusion: Qualitative data indicated restrictions had a predominantly negative impact on PA for children and youth, but inconsistent impacts on unstructured PA. The improved contextual understanding offered by our review will be foundational knowledge for health strategies moving forward. [ABSTRACT FROM AUTHOR]

Background: The effect of the 2020 COVID-19 lockdown on athlete sleep and training behavior is documented, albeit without a worldwide soccer-specific focus. Method: Soccer (football) players (N = 1639; 30 countries; age 22.5 [5.7] y; 81% ≤25 y; 56% male; 30% elite; 66% Muslim) answered a retrospective, cross-sectional questionnaire related to their behavioral habits before and during COVID-19 lockdown (survey period July to September 2020), including (1) Pittsburgh Sleep Quality Index PSQI, (2) Insomnia Severity Index (ISI), (3) bespoke questions about training behaviors, and (4) Muslim player focused sleep and training behavior questions. Results: During lockdown (compared to prelockdown), PSQI (P <.001; moderate effect size [ES]) and ISI (P <.001; moderate ES) scores were higher in the overall sample and in elite versus nonelite (PSQI: P <.05; small ES and ISI: P <.001; small ES), >25 years versus ≤25 years (PSQI: P <.01; small ES and ISI: P <.001; moderate ES), females versus males (PSQI: P <.001; small ES), <1 month versus >1 month lockdown (PSQI: P <.05; small ES and ISI: P <.05; small ES), and players maintaining versus reducing training intensity (PSQI: P <.001; moderate ES and ISI: P <.001; small ES). Muslim players (41%) reported unfavorable sleep and/or training behaviors during Ramadan in lockdown compared to lockdown outside of Ramadan. Conclusions: Specific subgroups appear more vulnerable to lockdown effects, with training-intensity maintenance moderating negative effects relative to sleep. Policy and support (respectful of subgroup nuances) during lockdown-like challenges that facilitate training (including intensity) appear prudent, given their favorable relationship with sleep, mental health, and physical health, in the present data and elsewhere. [ABSTRACT FROM AUTHOR]

The design and management of a supply chain (SC) in a global pandemic require a different approach than those used for more spatially restricted risks, such as earthquakes. A successful SC design and management plan should consider pandemic spatiotemporal characteristics as well as its effects on production and logistical operations, and on the SC workforce at risk. In this paper, a stochastic mixed integer linear programming model is developed to maximise the conditional value at risk (CVaR) of SC profit given a set of pandemic scenarios. An exemplar SC network from the literature is utilised, along with randomly generated pessimistic and optimistic pandemic scenarios. The proposed model is demonstrated by obtaining SC designs for different cases pertaining to pandemic influence and strategic policies. The resultant SC designs are used to contrast the performance of management plans across different pandemic scenarios and for different levels of workforce at risk. Supply chains for socially critical products, such as ventilators, are studied separately to examine the impact of SC network expansion on maximizing satisfied demand. Finally, we investigate the effects of diversifying network node locations across different administrative regions on SC performance. Several managerial insights are presented for SC planners to aid in creating viable designs and management plans. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic severely tested the resilience and robustness of supply chains for medically critical items and various common household goods. Severe and prolonged shortages of personal protective equipment (PPE) and ventilators in the United States have revealed vulnerabilities in the supply chains of such essential products in a time of need. Consequently, corporations have felt public pressure to rethink their supply chains. We begin this paper by examining the underlying causes of the prolonged shortages of critical products in the US as well as government’s and some companies’ initial response. Drawing from the lessons learned from the COVID pandemic, we propose a research agenda and opportunities to develop responsive supply chains to fight future pandemics. These opportunities revolve around measures that are intended to improve the supply chain responsiveness of essential products to combat future pandemics and other major public health emergencies. [ABSTRACT FROM AUTHOR]

This essay analyzes the 2007 board game Pandemic in light of the COVID-19 global pandemic. The essay explores the connections between the reality of Pandemic and the play of COVID-19. To do this, it uses Ian Bogost's interpretation of systems (both real and imagined) to invite a dialectic of reality and game simulation. The interaction of such systems, in a game whose theme became real, highlights a major tenet of game studies—the borders between reality and games are thin, blurred, and mobile, if they exist at all. Games, in their simulation of the real, are mimetic, and, in turn, reality has become gamified. The essay examines the board game and highlights its mechanics, which include cooperation and mitigation of risk. It also explores how the game and reality blur their borders in this instance of play, inviting further study into the ramifications of simulated games and the fantasy of the real. [ABSTRACT FROM AUTHOR]

Objectives: This manuscript presents a systematic review of the impact of the COVID-19 pandemic on head and neck cancer (HNC) patients. A meta-analysis was made to compare the number of treated/operated HNC patients in the pre-COVID-19 era versus the COVID-19 era. This investigation was based on previous reports showing a delay in the diagnosis and treatment of new cases of cancer during the pandemic. Worsening in cancer prognosis would be expected as a result of the delayed treatments. Method and materials: An electronic search was conducted using the PubMed/MEDLINE, Embase, Web of Science, Scopus, and The Cochrane Library databases. Relevant articles were selected based on specific inclusion criteria. Results: A total of 8,942 HNC patients were included. A higher prevalence in male (1,873) in comparison to female (1,695) was observed considering 3,568 patients. Regarding staging, the majority of cases were stage III to IV. The treatment type more frequently described was surgery. Positive diagnosis for COVID-19 in the pre-oncologic treatment was reported for 242 patients, and for post-oncologic treatment in 119 patients. Mortality by COVID-19 was reported for 27 HNC patients. The meta- analysis revealed a significantly smaller number of surgeries/ oncologic treatments of HNC patients performed (2,666) in the COVID-19 era when compared to the pre-COVID-19 era (3,163) (Mantel--Haenszel odds ratio = 0.81, 95% CI = 0.65 to 1.00, P = .05). Conclusion: The impact of the COVID-19 pandemic on HNC patients occurred mainly in the number of surgeries/ oncologic treatments, showing a significantly smaller number of surgeries/oncologic treatments performed in the COVID-19 era rather than the pre-COVID-19 era. [ABSTRACT FROM AUTHOR]