La didattica a distanza nell’Italia diseguale. Criticità e differenze territoriali durante la prima ondata Covid-19

none4noLe misure intraprese dal governo italiano per il contenimento della prima ondata Covid-19 hanno avuto importanti ricadute sul mondo della scuola. Il diffuso ricorso alla didattica a distanza (DAD), pur avendo permesso un certo grado di continuità didattica in una situazione emergenziale, è stato accompagnato da numerose criticità che si sono innestate sulle condizioni di vulnerabilità preesistenti. Considerando le importanti disuguaglianze territoriali che caratterizzano il contesto nazionale, questo lavoro approfondisce alcuni impatti dell’implementazione emergenziale della DAD tra le regioni italiane. L’articolo fornisce misura delle relazioni tra alcuni elementi di divario territoriale e una serie di criticità – tra cui i livelli di partecipazione e le problematiche di apprendimento degli studenti, le principali difficoltà riscontrate dagli insegnanti e il loro grado di soddisfazione – che sono state rilevate attraverso una web-survey somministrata a un campione di oltre 3.000 insegnanti.openBazzoli, Nico; Barberis, Eduardo; Carbone, Domenico; Dagnes, JoselleBazzoli, Nico; Barberis, Eduardo; Carbone, Domenico; Dagnes, Josell

Interleukin 28 polymorphisms and hepatocellular carcinoma development after direct acting antiviral therapy for chronihepatitis c

Background & Aims: Cirrhotic patients with hepatitis C virus (HCV) infection remain at risk of developing hepatocellular carcinoma (HCC) even after the sustained virologic response (SVR). We aimed to evaluate whether the IL28 (rs12979860) single nucleotide polymorphism (SNP) may constitute a predisposing genetic factor and to identify the SVR patients at risk of HCC. Methods: Two hundred patients undergoing DAAs treatment for chronic hepatitis C with advanced fibrosis (F3-F4) were consecutively enrolled. Besides normal routine laboratory testing for HCV, patients’ sera were evaluated also for retinol, retinol-binding protein 4 and the following SNPs: PNPLA3 (rs738409), TM6SF2 (rs58542926), MBOAT7 (rs641738), IL28B (rs12979860), TIMP-1 (rs4898), TIMP-2 (rs8179090), NF-kB promoter (rs28362491). Statistical analyses were conducted using Stata/SE 14.2 statistical software (Stata Corp, College Station, TX). Results: Almost all patients (197/200) obtained SVR24. Seventeen patients had a previous history of treated HCC before DAAs. Six patients developed HCC recurrence and five patients developed de novo HCC after a mean period of 18 months since EOT. All these patients had SVR. A significant association between IL28B – TT genotype and HCC development after DAAs therapy was observed (OR 4.728, CI 95% 1.222 – 18.297, p=0.024). Conclusion: IL28B rs12979860 polymorphism was significantly associated with HCC development after DAAs. Assessment of this SNP may better identify patients at risk of developing HCC after treatment. Further prospective studies are required to confirm these hypotheses

The relationship between safety net activities and hospital financial performance

<p>Abstract</p> <p>Background</p> <p>During the 1990's hospitals in the U.S were faced with cost containment charges, which may have disproportionately impacted hospitals that serve poor patients. The purposes of this paper are to study the impact of safety net activities on total profit margins and operating expenditures, and to trace these relationships over the 1990s for all U.S urban hospitals, controlling for hospital and market characteristics.</p> <p>Methods</p> <p>The primary data source used for this analysis is the Annual Survey of Hospitals from the American Hospital Association and Medicare Hospital Cost Reports for years 1990-1999. Ordinary least square, hospital fixed effects, and two-stage least square analyses were performed for years 1990-1999. Logged total profit margin and operating expenditure were the dependent variables. The safety net activities are the socioeconomic status of the population in the hospital serving area, and Medicaid intensity. In some specifications, we also included uncompensated care burden.</p> <p>Results</p> <p>We found little evidence of negative effects of safety net activities on total margin. However, hospitals serving a low socioeconomic population had lower expenditure raising concerns for the quality of the services provided.</p> <p>Conclusions</p> <p>Despite potentially negative policy and market changes during the 1990s, safety net activities do not appear to have imperiled the survival of hospitals. There may, however, be concerns about the long-term quality of the services for hospitals serving low socioeconomic population.</p