Analysis of the Digital Educational Scenario in Italian High Schools during the Pandemic: Challenges and Emerging Tools

During the COVID-19 pandemic, educational institutions around the world were forced to move from face-to-face lessons to distance learning. The application of distance learning fostered the use of new tools and applications that impacted the school system and produced several challenges to be addressed. This paper provides an analysis of distance learning tools that have been used during COVID-19 in Italian schools and the related emerging needs and challenges. A quantitative survey was carried out by using a standardized online questionnaire that involved 420 Italian teachers of different ages, gender, and teaching areas. This survey collected information about experiences, opportunities, and challenges of distance learning, used tools, and students' inclusion and involvement. In addition, this work analyses emerging technologies and how they can be integrated into distance learning tools to overcome the identified challenges.

Towards Quality Digital Learning: Lessons Learned during COVID-19 and Recommended Actions-The Teachers' Perspective

The research focuses on identifying challenges and lessons from distance learning experiences in Italy during COVID-19, on opportunities emerging from a more digitalized school in the post-COVID-19 crisis, and on preparedness for potential future emergencies. The study aims to analyze different teachers' experiences, perceptions, and perspectives on distance learning and provide suggestions for addressing crises and emergencies. An online survey based on a semi-structured questionnaire was conducted targeting primary and secondary school teachers and including schools whose students are only from urban contexts and schools where students are also from rural areas. The main results indicated that teachers were resilient and proactive and found strategies and good practices to deal with distance learning, although several open technological and pedagogical challenges remain unsolved. Finally, some recommended priority actions for stakeholders and policymakers have been provided to face these challenges and ensure inclusive and equitable quality education.

Racial disparities in prostate cancer treatment in a multi-institutional regional collaborative

INTRODUCTION AND OBJECTIVE: Minority communities disproportionately shouldered poor COVID-19 outcomes, however the impact of the pandemic on prostate cancer (PCa) surgery is unknown. To that end, we sought to determine the racial impact on PCa care during the first wave of the pandemic. METHODS: Using a multi-institutional collaborative we evaluated practice patterns for Black and White patients with untreated non-metastatic PCa during the initial COVID-19 lockdown (March-May 2020) compared to prior (March-May 2019). Patient and practice characteristics were compared by race using Fisher's exact and Pearson's chi-square to compare categorical variables and Wilcoxon rank sum to evaluate continuous covariates. We determined the covariate-adjusted impact of year and race on surgery, using logistic regression models with a race year interaction term. RESULTS: Among the 647 men with non-metastatic PCa, 269 received care during the pandemic and 378 prior. Surgery was significantly less likely in Black men (1.3% v 25.9%;p<0.001), despite similar COVID-19 risk factors, biopsy Gleason grade group, and comparable surgery rates prior (17.7% vs. 19.1%;p=0.75). Black men had higher PSA (8.8 vs. 7.2 p=0.04) and were younger (38.2% vs. 24.4% <60 yr;p=0.09). Regression results demonstrated an 94% reduced odds of surgery (OR=0.06, 95% CI 0.007-0.43;p=0.006) for Black patients, with no change for White patients (OR=1.41, 95% CI 0.89-2.21;p=0.142), after adjusting for covariates. Changes in surgical volume varied by site (33% increase to complete shutdown), with sites that experienced the largest reduction in cancer surgery, caring for a greater proportion of Black patients (figure). CONCLUSIONS: In a large multi-institutional regional collaborative, odds of prostatectomy declined only among Black patients during the initial wave of the COVID-19 pandemic. While localized prostate cancer does not require immediate treatment, this study illuminates systemic inequities within healthcare. Public health efforts are needed to fully recognize the unintended consequence of diversion of cancer resources to the pandemic in order to develop balanced mitigation strategies as viral rates continue to fluctuate.

Prostate cancer treatment disparities during the COVID-19 pandemic, lessons from a multi-institutional collaborative

Background: Minority communities have been disproportionately affected by COVID-19, however the impact of the pandemic on prostate cancer (PCa) treatment is unknown. To that end, we sought to determine the racial impact on PCa surgery during the first wave of the COVID-19 pandemic. Methods: After receiving institutional review board approval, the Pennsylvania Urologic Regional Collaborative (PURC) database was queried to evaluate practice patterns for Black and White patients with untreated non-metastatic PCa during the initial lockdown of the COVID-19 pandemic (March-May 2020) compared to prior (March-May 2019). PURC is a prospective collaborative, which includes private practice and academic institutions within both urban and rural settings including regional safety-net hospitals. As data entry was likely impacted by the pandemic, we limited our search to only practices that had data entered through June 1, 2020 (5 practice sites). We compared patient and disease characteristics by race using Fisher's exact and Pearson's chi-square to compare categorical variables and Wilcoxon rank sum to evaluate continuous covariates. Patients were stratified by risk factors for severe COVID-19 infection as described by the CDC. We determined the covariate-adjusted impact of year and race on surgery, using logistic regression models with a race∗year interaction term. Results: 647 men with untreated nonmetastatic PCa were identified, 269 during the pandemic and 378 from the year prior. During the pandemic, Black men were significantly less likely to undergo prostatectomy compared to White patients (1.3% v 25.9%;p < 0.001), despite similar COVID-19 risk-factors, biopsy Gleason grade group, and comparable surgery rates prior (17.7% vs. 19.1%;p = 0.75). White men had lower pre-biopsy PSA (7.2 vs. 8.8 vs. p = 0.04) and were older (24.4% vs. 38.2% < 60yr;p = 0.09). The regression model demonstrated an 94% decline in odds of surgery(OR = 0.06 95%CI 0.007-0.43;p = 0.006) for Black patients and increase odds of surgery for White patients (OR = 1.41 95%CI 0.89-2.21;p = 0.142), after adjusting for covariates. Changes in surgical volume varied by site (33% increase to complete shutdown), with sites that experienced the largest reduction in cancer surgery, caring for a greater proportion of Black patients. Conclusions: In a large multi-institutional regional collaborative, odds of PCa surgery declined only among Black patients during the initial wave of the COVID-19 pandemic. While localized prostate cancer does not require immediate treatment, the lessons from this study illuminate systemic inequities within healthcare, likely applicable across oncology. Public health efforts are needed to fully recognize the unintended consequence of diversion of cancer resources to the pandemic in order to develop balanced mitigation strategies as viral rates continue to fluctuate.