The heterogeneity of Covid-19 learning loss across Italian primary and middle schools

This paper investigates the heterogeneous impact of school closures during Covid-19 pandemic in Italy on academic performance across different schools, grades, subjects and groups of students. Our analysis utilises an innovative dataset that combines administrative data on standardised tests in grades 5 and 8 with a specifically-designed survey that collects information about teachers' practices between February and June 2020. Firstly, by employing a multilevel (mixed-effects) model, we estimate the extent of learning loss and examine its variability across schools, for students in primary and middle levels during the school year 2020/21. The findings confirm that learning loss has been considerable (between 0.05 and 0.27 SD) although heterogeneity across disciplines and grades exists - higher in English in grade 5, and in mathematics and reading in grade 8. Secondly, as a main contribution of the paper, we explore the mechanisms behind the substantial differences observed across schools, which can be explained by the ability of teachers in using digital tools and evaluating their students, as well as by the leadership role exerted by school principals.

Online or on-campus? Analysing the effects of financial education on student knowledge gain

This paper describes the results of an experiment conducted in a technical university in Italy in 2019, involving the implementation and evaluation of an innovative short course on financial education. The programme applied a novel approach based on online learning and its effectiveness is compared against the effects of a traditional on-campus lecture, within an experimental setting. The findings indicate that the programme is effective: one week after taking the course, the students improved their pre-course test scores by about 4 points out of 10. No statistically significant difference in gains is found between students assigned to the online vs the on-campus mode of learning, suggesting a potential positive role of digital learning in this specific setting. An exploratory analysis of factors associated with the outcome reveal that the course has been particularly beneficial for those students initially less interested in finance.

Teaching away from school: do school digital support influence teachers' well-being during Covid-19 emergency?

The Covid-19 pandemic coerced the closure of most schools around the world and forced teachers and students to change teaching and learning methods. Emergency Remote Teaching (ERT) generated consequences to teachers and students in terms of learning outcomes and personal well-being. This study focuses on teachers' individual and working environment well-being in ERT conditions and intends to explore which factors related to the provision of digital equipment and the implementation of digital strategies by schools explain the school effect on both typologies of well-being during the Covid-19 emergency. To do so, data collected in the Responses to Educational Disruption Survey (REDS) across three countries were used, and a two-step analysis was conducted. A first step involves the use of linear mixed effect models to assess the school effect on teachers individual and working environment well-being. In the second step Regression Trees (RT) are used to investigate which factors and policies related to digital tools explained the identified school effects. The results show that schools and countries played a role in determining teachers perceived well-being during the Covid-19 disruption, in particular the school level explains more than 7% of the work environment well-being and 8% of individual one. In the second step of the analysis results show that a high positive effect on school environment well-being is observed when the school's activity is not influenced by policies limiting the use of online tools and when teacher's readiness for remote teaching, like the development of technical skills and the provision of internet access and digital devices, is met. To the best of our knowledge, this is the first study that evaluates the impact of digital tactics and instruments provided by schools on teachers' well-being on a large scale.

The educational effects of emergency remote teaching practices-The case of covid-19 school closure in Italy

The disruption caused by the Covid-19 pandemic generated an unprecedented situation, in which digital learning, in the form of Emergency Remote Teaching, was the only possible form of schooling. Italy soon decided to close schools as a measure to counter the spread of the virus. Although the Ministry of Education suggested general guidelines, school principals and teachers were autonomous in deciding how to best organise their educational activities. The first objective of our study is to identify subgroups of teachers, based on the use of digital tools during the Covid-19 emergency. Secondly, we explore how subgroups differ in terms of teachers' satisfaction and students' performance. To this end, we integrate information from an ad hoc survey completed by 1,407 primary and lower secondary teachers in Italy, with the students' standardised test scores provided by INVALSI. Data have been analysed through a 3-step latent class analysis. The findings reveal that one third of the teachers showed resistance to the use of digital technologies and focused mainly on asynchronous teaching. Teachers that used a broader set of digital instruments, instead, were more satisfied with their teaching practices. A more articulated use of technology for teaching activities was also positively associated with higher students' performance in 2021.

Workplace violence among healthcare workers, a multicenter study in Italy

OBJECTIVES

The purpose of this study is to assess the prevalence and determinants of workplace violence and the sociodemographic risk factors associated.

STUDY DESIGN

This was a multicenter cross-sectional study.

METHODS

The study was performed using self-compiled Italian version of the World Health Organization's questionnaire on workplace violence online by filling in a Google form. The survey was opened from May 2018 to March 2020 and lasted 5-10 min.

RESULTS

The sample consists of 3659 healthcare workers, of which 2525 (69%) are females, 1446 (39.5%) are nurses, and 2029 (55.5%) are health workers from northern Italy. The most frequent age group of the sample is 50-54 years (16.7%). A total of 366 (10%) healthcare workers are victims of physical aggression at work in the last 12 months, of which 6.3% with a weapon. The risk of being a victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (odds ratio [OR] 1.72, 95% confidence interval [CI]: 1.36-2.17), work in southern Italy (OR 1.59, 95% CI: 1.10-2.28), and being a nurse (OR 2.56, 95% CI: 2.01-3.25). The risk of being a victim of physical aggression at work with a weapon in the last 12 months is significantly associated with work in southern Italy (OR 9.33, 95% CI: 3.83-22.73). A total of 1723 (47.1%) of healthcare workers declare to be a victim of verbal aggression at work in the last 12 months. The risk of being a victim of verbal aggression at work in the last 12 months is significantly associated with the following independent variables: work in northern Italy (adjusted OR [aOR] 1.54, 95% CI: 1.32-1.81), work in southern Italy (aOR 3.68, 95% CI: 2.90-4.68), and be more than 55 years old (aOR 0.73, 95% CI: 0.63-0.85).

CONCLUSIONS

The study underlines that the problem of verbal and physical aggression against healthcare workers is still central and is a further starting point for research. The prevalence of violence is difficult to assess because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is needed to develop effective control strategies at the individual, hospital, and national levels to prevent aggression and improve the conditions of victims.

Studying the Experience of Care Through Latent Class Analysis: An Application to Italian Neonatal Intensive Care Units

Though many data on the experience of care of patients and caregivers are collected, they are rarely used to improve the quality of health care delivery. One of the main causes is the widespread struggle in interpreting and enhancing these data, requiring the introduction of new techniques to extract intelligible, meaningful, and actionable information. This research explores the potentiality of the latent class analysis (LCA) statistical model in studying experience data. A cross-sectional survey was administered to 482 parents of infants hospitalized in several Italian neonatal intensive care units. Through a 3-step LCA, four subgroups of parents with specific experience profiles, sociodemographic characteristics, and levels of satisfaction were identified. These were composed of parents who reported (1) a positive experience (36%), (2) problematic communication with unit staff (30%), (3) limited access to the unit and poor participation in their baby's care (26%), and (4) a negative experience (8%). Through its explorative segmentation, LCA can provide valuable information to design quality improvement interventions tailored to the specific needs and concerns of each subgroup.

School principals' managerial behaviours and students' achievement

Purpose

This research investigates the impact of managerial practices implemented by Italian school principals on students' outcomes, using micro-data provided by the National Evaluation Committee for Education (INVALSI) for 2013/14 school year.

Design/methodology/approach

Employing an educational production function, the authors regress a set of student and school's characteristics, enriched by information from a questionnaire filled by school principals to estimate student's score at grade 8 (last year of junior secondary school), also taking into account student's prior achievement (at grade 6 – first year of junior secondary school).

Findings

Indicators about managerial practices have positive coefficients, but low statistical significance. Stronger associations between management variables and test scores are detected for low-SES schools.

Originality/value

The research presented here is particularly innovative in the Italian context, where little evidence exists about the impact of managerial skills in education, though institutional reforms are leading towards a strengthening of school principal's leadership role. In this paper, the authors move a first step by describing managerial practices and their diffusion in different schools and geographical areas within the country. The authors focus the attention on the role of managerial practices (what principals do) and not on the managerial skills (what principals are able to do).

Photothermal sensitization of amelanotic melanoma cells by Ni(II)-octabutoxy-naphthalocyanine

Incubation of B78H1 amelanotic melanoma cells with a potential photothermal sensitizer, namely, liposome-incorporated Ni(II)-octabutoxy-naphthalocyanine (NiNc), induces an appreciable cellular accumulation of the naphthalocyanine, which is dependent on both the NiNc concentration and the incubation time. No detectable decrease in cell survival occurs upon red-light irradiation (corresponding to the longest-wavelength absorption bands of NiNc) in a continuous-wave (c.w.) regime of the naphthalocyanine-loaded cells. On the other hand, 850 nm irradiation with a Q-switched Ti:sapphire laser operating in a pulsed mode (30 ns pulses, 10 Hz, 200 mJ/pulse) induces an efficient cell death. Thus, ca. 98% decrease in cell survival is obtained upon 5 min irradiation of cells that have been incubated for 48 h with 5.1 microM NiNc. The efficiency of the photoprocess is strongly influenced by the NiNc cell incubation time prior to irradiation. Photothermal sensitization with NiNc appears to open new perspectives for therapeutic applications, as suggested by preliminary in vivo studies with C57/BL6 mice bearing a subcutaneously implanted amelanotic melanoma.

Irradiation of amelanotic melanoma cells with 532 nm high peak power pulsed laser radiation in the presence of the photothermal sensitizer Cu(II)-hematoporphyrin: a new approach to cell photoinactivation

Cu(II)-hematoporphyrin (CuHp) was efficiently accumulated by B78H1 amelanotic melanoma cells upon incubation with porphyrin concentrations up to 52 microM. When the cells incubated for 18 h with 13 microM CuHp were irradiated with 532 nm light from a Q-switched Nd: YAG laser operated in a pulsed mode (10 ns pulses, 10 Hz) a significant decrease in cell survival was observed. The cell photoinactivation was not the consequence of a photodynamic process, as CuHp gave no detectable triplet signal upon laser flash photolysis excitation and no decrease in cell survival was observed upon continuous wave irradiation. Thus, it is likely that CuHp sensitization takes place by photothermal pathways. The efficiency of the photoprocess was modulated by different parameters; thus, while varying the amount of added CuHp in the 3.25-26 microM range had little effect, pulse energies larger than 50 mJ and irradiation times of at least 120 s were necessary to induce a cell inactivation of about 50%. The porphyrin-cell incubation time prior to irradiation had a major influence on cell survival, suggesting that the nature of the CuHp microenvironment can control the efficiency of photothermal sensitization.

High efficiency of benzoporphyrin derivative in the photodynamic therapy of pigmented malignant melanoma

Benzoporphyrin derivative monoacid ring A (verteporfin, BPD-MA) when intravenously injected (5.5 micromol kg(-1)) to C57/BL6 mice bearing a subcutaneously transplanted B1 melanoma gave a maximal accumulation in the tumour within 1-3 h with recoveries of 1.84-1.96 micromol kg(-1). Irradiation of BPD-MA-loaded melanoma with 690-nm light from a dye laser at 3 h and 9 h post injection induced tumour necrosis and delay of tumour growth of 28 and 14 days respectively. The response of the tumour to BPD-MA photosensitization was enhanced by pretreatment with 1064-nm light from a pulse-operated Nd:YAG laser, which caused a selective breakdown of melanosomes.

Treatment of malignant melanoma by high-peak-power 1064 nm irradiation followed by photodynamic therapy

Irradiation of B16 pigmented melanoma subcutaneously transplanted in C57 mice with a single 650 mJ pulse (10 ns) of 1064 nm light from a Q-switched Nd: YAG laser caused instantaneous bleaching of the pigmented tissue. Visual and histological examination of the resulting gray-colored tumor revealed the breakdown of melanosomes with no detectable alteration of the normal and tumor-overlying skin. Histological examination of the irradiated tumor showed some degree of vascular damage; the depth of the photodamage was not affected by the successive delivery of three consecutive light pulses. The bleached tumor grew at a modestly slower rate but the high-peak-power (HPP) laser treatment did not affect the tumor concentration of a photodynamic sensitizer Si(i.v.)-naphthalocyanine (isoBO-SiNc) intravenously injected 24 h before Nd:YAG irradiation. Treatment of the B16 pigmented melanoma by photodynamic therapy (PDT: 1 mg/kg isoBO-SiNc, 300 mW/cm2, 520 J/cm2) from a 774 nm diode laser immediately after the 1064 nm irradiation resulted in a 16 day delay of tumor regrowth, which was markedly longer than the delay (ca 6 days) obtained after PDT under identical conditions without the preirradiation. Thus, pretreatment of pigmented tumors with HPP 1064 nm light appears to enhance their susceptibility to conventional PDT. The tumor response was further enhanced by repeating the combined HPP/PDT treatment at an interval of 10 days (regrowth delay: 27 days), as well as by applying hyperthermia immediately after HPP/PDT (regrowth delay: ca 34 days).

Photoinactivation of amelanotic and melanotic melanoma cells sensitized by axially substituted Si-naphthalocyanines

The photosensitizing activity of the new far-red absorbing naphthalocyanine SiNc [OSi (n-C10H21)3] [OSi(CH3)2(CH2)3N(CH3)2], (DAP-SiNc), and of its analogue SiNc [OSi(i-C4H9)2(n-C18H37)]2, (IsoBO-SiNc), was studied with two cell variants of B16 melanoma, the amelanotic clone B78H1 and the highly pigmented B16F1 cells. Upon excitation with a 776 nm diode laser, DAP-SiNc appeared to be a markedly more efficient photosensitizer than isoBO-SiNc. The higher photoefficiency of DAP-SiNc was likely to reflect its accumulation in significantly larger amounts by both cell types, as well as a much smaller tendency to undergo aggregation when bound to the cells. In any case, melanotic cells were less sensitive to the photoinactivating action of DAP-SiNc: the protective action of melanin was a consequence of an optical filtering of the 776 nm light and an appreciable shortening of the DAP-SiNc triplet lifetime (40 microseconds for the amelanotic vs. 17 microseconds for the melanotic cells). Functional and morphological studies on irradiated cells showed that cell death due to DAP-SiNc photosensitization was mainly correlated with the modification of targets located in the lysosomes and the cytoplasmic membrane.

Pharmacokinetic and phototherapeutic properties of axially substituted Si(IV)-tetradibenzobarreleno-octabutoxyphthalocyanines

Three Si(IV)-tetradibenzobarreleno-octabutoxyphthalocyanines (TDiBOPcs) bearing different axial ligands on the metal ion were studied for their tumour-localizing and-photosensitizing properties after i.v. injection via a Cremophor emulsion (0.35 mumol kg-1 b.w.) to Balb/c mice bearing an intramuscularly implanted MS-2 fibrosarcoma. In all cases, the maximum tumour accumulation of the photosensitizer (0.8-1.9 nmol g-1 of tissue) was found at 24 h after injection. The efficiency and selectivity of tumour targeting appeared to be dependent on the nature of the axial ligands; optimal values of these parameters were obtained in the case of the bis(trihexyl-siloxy)-substituted Si(IV)-TDiBOPc, which gave a 7-9 tumour/muscle ratio of phthalocyanine concentration at 24-48 h after injection. The extent of tumour response to PDT treatment was correlated with the concentration of the photosensitizer in the tumour tissue: upon 740 nm irradiation (180 mW cm-2, 200 J cm-2) at 48 h after injection of 0.35 mumol kg-1 of Si(IV)-TDiBOPc-C6H13, the tumour growth exhibited a delay of about 7 days.

Effect of photosensitizer delivery system and irradiation parameters on the efficiency of photodynamic therapy of B16 pigmented melanoma in mice

Previous studies (Biolo et al., Photochem. Photobiol. 59, 362-365, 1994) showed that liposome-delivered Si(IV)-naphthalocyanine (SiNc) photosensitizes B16 pigmented melanoma subcutaneously transplanted in C57 mice to the action of 776 nm light. However, the efficacy of the phototreatment was limited by a lack of selectivity of tumor targeting by SiNc as well as by incomplete necrosis of the neoplastic mass. The present investigations show that the use of a different delivery system (Cremophor emulsion vs liposomes of dipalmitoylphosphatidylcholine) causes no significant increase in the selectivity of tumor targeting for three injected doses of SiNc (0.5, 1, 2 mg/kg). However, upon 776 nm light irradiation (300 mW/cm2; 520 J/cm2), the delay in the rate of tumor growth was maximal (7-8 days) for the highest naphthalocyanine dose. On the other hand, a remarkable improvement in the tumor response was obtained by inducing an intratumoral temperature increase to 44 degrees C immediately after PDT. The thermal effect appeared to be due to photoexcitation of melanin by 776 nm light (550 mW/cm2; 520 J/cm2) and subsequent partial conversion of absorbed energy into heat.

Effect of axial ligation and delivery system on the tumour-localising and -photosensitising properties of Ge(IV)-octabutoxy-phthalocyanines

Four Ge(IV)-octabutoxy-phthalocyanines (GePcs) bearing two alkyl-type axial ligands were assayed for their pharmacokinetic properties and phototherapeutic efficiency in Balb/c mice bearing an intramuscularly transplanted MS-2 fibrosarcoma. The GePcs were i.v. injected at a dose of 0.35 mumol kg-1 body weight after incorporation into either Cremophor emulsions or small unilamellar liposomes of dipalmitoyl-phosphatidylcholine (DPPC). Both the nature of the delivery system and the chemical structure of the phthalocyanine were found to affect the behaviour of the GePcs in vivo. Thus, Cremophor-administered GePcs invariably yielded a more prolonged serum retention and a larger association with low-density lipoproteins (LDLs) as compared with the corresponding liposome-delivered phthalocyanines. This led to a greater efficiency and selectivity of tumour targeting. These effects were more pronounced for those GePcs having relatively long alkyl chains (hexyl to decyl) in the axial ligands. Maximal tumour accumulation (0.67 nmol per g of tissue) was found for Ge-Pc(hexyl)2 at 24 h after injection. Consistently, the Ge-Pc(hexyl)2, administered via Cremophor, showed the highest phototherapeutic activity towards MS-2 fibrosarcoma.

Unusually high affinity of Zn(II)-tetradibenzobarrelenooctabutoxy-phthalocyanine for low-density lipoproteins in a tumor-bearing mouse

An important factor in determining the efficacy of photosensitizing compounds in photodynamic therapy of tumors is the level to which tumors take up the photosensitizers after systemic injection. This parameter seems to be related to the transport modalities of the photosensitizer in the bloodstream. In this work the photosensitizer Zn(II)-tetradibenzobarrelenooctabutoxyphthalocyanine was shown to have an unprecedentedly high association with low-density lipoproteins (71% of the phthalocyanine in the plasma) when delivered in Cremophor micelles to tumor-bearing mice. This was accompanied by a particularly high tumor uptake at 24 h post-injection.

Effect of the delivery system on the biodistribution of Ge(IV) octabutoxy-phthalocyanines in tumour-bearing mice

The pharmacokinetic properties of the Ge(IV)-octabutoxy-phthalocyanines (GePc) with two axially ligated triethylsiloxy (GePcEt) or trihexyl-siloxy (GePcHex) chains were studied in BALB/C mice bearing a transplanted MS-2 fibrosarcoma. The GePcs were delivered to mice after incorporation into unilamellar liposomes of dipalmitoyl phosphatidylcholine (DPPC) or in an emulsion of Cremophor-EL. The Cremophor delivered GePcs were cleared from the blood circulation at a much slower rate than the liposome-delivered GePcs. At the same time, Cremophor induced a slower and reduced uptake of the GePcs in the liver and spleen while it greatly enhanced the uptake in the tumour as compared to liposomes. Maximum tumour uptake was observed at 24 h post-injection and was equivalent to 0.67 and 0.50 nmol/g, respectively, for the Cremophor delivered GePcHex and GePcEt. The corresponding values for the liposome-delivered drugs were approximately one fourth of that observed with Cremophor.

Photodynamic therapy of B16 pigmented melanoma with liposome-delivered Si(IV)-naphthalocyanine

The possibility of extending photodynamic therapy to the treatment of highly pigmented neoplastic lesions was tested by using Si(IV)-naphthalocyanine (SiNc) as a tumor-localizing agent. Si(IV)-naphthalocyanine displays intense absorbance at 776 nm (epsilon = 5 x 10(5) M-1 cm-1), where melanin absorption becomes weaker. As an experimental model we selected B16 pigmented melanoma subcutaneously transplanted to C57BL mice. Upon injection of 0.5 or 1 mg kg-1 of liposome-incorporated SiNc, maximal accumulation of the photosensitizer in the tumor was observed at 24 h with recoveries of 0.35 and 0.57 microgram g-1, respectively. However, the tumor targeting by SiNc shows essentially no selectivity, since the photosensitizer concentrations in the skin (peritumoral tissue) were very similar to those found in the tumor at all postinjection times examined by us. Irradiation of SiNc-loaded melanoma with 776 nm light from a diode laser at 24 h postinjection induces tumor necrosis and delay of tumor growth. The effect appears to be of purely photochemical nature at dose rates up to 260 mW cm-2; at higher dose rates, thermal effects are likely to become important.