On the economic evaluation of online learning in higher education during the COVID-19 pandemic: a willingness-to-accept approach

PurposeThis study, using a contingent valuation approach, aims to shed light on the economic evaluation of online learning during the first wave of the pandemic. Design/methodology/approachA sample of 959 higher education students was asked about their willingness-to-accept (WTA) a monetary compensation for the loss of well-being resulting from the unexpected and mandatory transition to the online space. In explaining WTA determinants, the authors test the appropriateness of the double-hurdle model against the alternative of a Tobit model and find that the factors affecting the participation decision are not the same as those that affect the quantity decision. FindingsResults show that a vast majority of the respondents think that the abrupt transition to online learning is detrimental to them, while those willing to accept a monetary compensation account for 77% of the sample, being the mean WTA between euro448 and euro595. As expected, WTA decreases with income and age, and it increases if some member of the family unit is unemployed. By aggregating the mean WTA by the population affected, total loss of well-being is obtained. Originality/valueTo the best of the authors' knowledge, to date, this method has not been used to value online learning in a WTA framework, much less in the particular context of the pandemic. Thus, based on the understanding that the economic evaluation of online learning could be very useful in providing guidance for decision-making, this paper contributes to the literature on the economic evaluation of higher education.

Influence of COVID-19 Pandemic on Colorectal Cancer Presentation, Management and Outcome during the COVID-19 Pandemic.

The aim of the study was to investigate whether the COVID-19 pandemic and related measures had an influence on colorectal cancer (CRC) presentation, management, and outcomes; it was a retrospective monocentric study. CRC patients undergoing surgery during the COVID-19 pandemic (1 March 2020-28 February 2022) (group B) were compared with patients operated on in the previous two years (1 March 2018-29 February 2020) in the same unit (group A). The primary outcome was to investigate whether there were differences in concern regarding the stage at presentation, as a whole and after dividing groups based on cancer location (right colon cancer, left colon cancer, rectal cancer). Secondary outcomes included differences in the number of patients admitted from emergency departments and emergency surgeries between periods, and differences in the postoperative outcomes. A subanalysis within the pandemic group was conducted on the same outcomes, dividing the aforementioned group based on pandemic trends. Two hundred and eighty (280) were operated on during the study period: 147 in group A and 133 in group B. Stage at presentation was similar between groups; however, the subgroups analysis showed that in the pandemic group, the number of early-stage left colon cancer occurrences almost halves, yet not significantly. Emergency department referral was more common in group B (p-value: 0.003); in group B, they also had longer operations and there was a more frequent use of ostomy. No differences in the number of postoperative complications nor in the postoperative outcomes were found. Patients with CRC were more frequently referred through the emergency department during the COVID-19 pandemic and left-sided cancers appear to be generally diagnosed at a more advanced stage. Postoperative outcomes showed that high specialized colorectal units can deliver standard high-level treatment under high-pressure external conditions.

A Multiplex PCR and DNA-Sequencing Workflow on Serum for the Diagnosis and Species Identification for Invasive Aspergillosis and Mucormycosis.

There has been significant increase in the use of molecular tools for the diagnosis of invasive aspergillosis (IA) and mucormycosis. However, their range of detection may be too limited as species diversity and coinfections are increasing. Here, we aimed to evaluate a molecular workflow based on a new multiplex PCR assay detecting the whole Aspergillus genus and the Mucorales order followed by a species-specific PCR or a DNA-sequencing approach for IA and/or mucormycosis diagnosis and species identification on serum. Performances of the MycoGENIE Aspergillus spp./Mucorales spp. duplex PCR kit were analyzed on a broad range of fungal strains and on sera from high-risk patients prospectively over a 12-month period. The kit allowed the detection of nine Aspergillus species and 10 Mucorales (eight genera) strains assessed. No cross-reactions between the two targets were observed. Sera from 744 patients were prospectively analyzed, including 35 IA, 16 mucormycosis, and four coinfections. Sensitivity varies from 85.7% (18/21) in probable/proven IA to 28.6% (4/14) in COVID-19-associated pulmonary aspergillosis. PCR-positive samples corresponded to 21 A. fumigatus, one A. flavus, and one A. nidulans infections. All the disseminated mucormycosis were positive in serum (14/14), including the four Aspergillus coinfections, but sensitivity fell to 33.3% (2/6) in localized forms. DNA sequencing allowed Mucorales identification in serum in 15 patients. Remarkably, the most frequent species identified was Rhizomucor pusillus (eight cases), whereas it is barely found in fungal culture. This molecular workflow is a promising approach to improve IA and mucormycosis diagnosis and epidemiology.

On the economic evaluation of online learning in higher education during the COVID-19 pandemic: a willingness-to-accept approach

Purpose: This study, using a contingent valuation approach, aims to shed light on the economic evaluation of online learning during the first wave of the pandemic. Design/methodology/approach: A sample of 959 higher education students was asked about their willingness-to-accept (WTA) a monetary compensation for the loss of well-being resulting from the unexpected and mandatory transition to the online space. In explaining WTA determinants, the authors test the appropriateness of the double-hurdle model against the alternative of a Tobit model and find that the factors affecting the participation decision are not the same as those that affect the quantity decision. Findings: Results show that a vast majority of the respondents think that the abrupt transition to online learning is detrimental to them, while those willing to accept a monetary compensation account for 77% of the sample, being the mean WTA between €448 and €595. As expected, WTA decreases with income and age, and it increases if some member of the family unit is unemployed. By aggregating the mean WTA by the population affected, total loss of well-being is obtained. Originality/value: To the best of the authors’ knowledge, to date, this method has not been used to value online learning in a WTA framework, much less in the particular context of the pandemic. Thus, based on the understanding that the economic evaluation of online learning could be very useful in providing guidance for decision-making, this paper contributes to the literature on the economic evaluation of higher education. © 2022, Salvador del Saz-Salazar, Salvador Gil-Pareja and María José García-Grande. Published in Applied Economic Analysis.

Acute appendicitis in elderly during Covid-19 pandemic.

PURPOSE: During the past months, the Italian Government has reduced the restrictions and access to hospitals. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations during the pandemic, it is useful to assess how the current situation is influencing the management of elderly with acute appendicitis. METHODS: Between February 2020 and December 2020, all patients older than 68 years old undergone appendectomy were included. Surgical approach, hospital stay, post-operative complications, radiology reports, and histologic examination were included in the retrospective analysis and compared with a same sample of the same period before the pandemic. RESULTS: Twenty-seven patients underwent appendectomy for acute appendicitis during the pandemic and 34 patients in the pre-outbreak period. Laparoscopic approach was completed in 51.8% of the cases, while conversion to laparotomy in 22.3% of patients and open procedure in the 25.9%, before the pandemic 73.6%, 14.7%, and 11.7%, respectively. During the pandemic, complicated appendicitis occurred in 59.3% of the cases (26.5% before the outbreak). One patient was treated for a pelvic abscess, while no minor complications were detected. No mortality rate was reported, with a mean hospital stay of 5.64 days during the outbreak and 4.21 days before the pandemic. CONCLUSION: Our data highlighted a partial delay in diagnosis in the elderly group, and an increase in complicated appendicitis also demonstrated by the need for conversion to laparotomy.

Sclerotherapy with 3% polidocanol foam for third- and fourth-degree hemorrhoids as "bridge treatment" during the COVID-19 pandemic in Italy.

PURPOSE: In Italy, colorectal surgery has been strongly affected with the vast majority (90%) of operations treating benign diseases, with an estimated overall 12-week cancellation rate of 72%. Little is known on how to best manage patients with benign diseases and the consequences this interruption of care will have in post-pandemic times. Proctologic diseases have social, psychological, and healthcare repercussions for their high incidence and great impact on the quality of life. METHODS: We decided to treated 10 urgent cases affected from III- and IV-degree hemorrhoids with 3% polidocanol foam in attempt to reduce hemorrhoidal symptoms while waiting for surgery so called "bridge treatment". RESULTS: During the follow-up no complications were occurred, and all patients had resolution of bleeding and pruritus with a mean VAS of 1 (range, 0-1). CONCLUSIONS: This treatment could reduce the bleeding that is the main symptom from which patients suffer and for which they underwent proctological evaluation and surgery. According to our preliminary experience in the impossibility of accessing the surgery during the COVID-19 pandemic, ST could be considered as the treatment of choice in those patients who are suffering from grade III- and IV-degree hemorrhoids while waiting for surgery.