| 1. |
- Di Baldassarre, Giuliano, et al.
(författare)
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Integrating Multiple Research Methods to Unravel the Complexity of Human-Water Systems
- 2021
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Ingår i: AGU Advances. - : American Geophysical Union (AGU). - 2576-604X. ; 2:3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Predicting floods and droughts is essential to inform the development of policy in water management, climate change adaptation and disaster risk reduction. Yet, hydrological predictions are highly uncertain, while the frequency, severity and spatial distribution of extreme events are further complicated by the increasing impact of human activities on the water cycle. In this commentary, we argue that four main aspects characterizing the complexity of human-water systems should be explicitly addressed: feedbacks, scales, tradeoffs and inequalities. We propose the integration of multiple research methods as a way to cope with complexity and develop policy-relevant science.Plain Language SummarySeveral governments today claim to be following the science in addressing crises caused by the occurrence of extreme events, such as floods and droughts, or the emergence of global threats, such as climate change and COVID-19. In this commentary, we show that there are no universal answers to apparently simple questions such as: Do levees reduce flood risk? Do reservoirs alleviate droughts? We argue that the best science we have consists of a plurality of legitimate interpretations and a range of foresights, which can be enriched by integrating multiple disciplines and research methods.
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| 2. |
- Di Baldassarre, Giuliano, et al.
(författare)
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Multiple hazards and risk perceptions over time : the availability heuristic in Italy and Sweden under COVID-19
- 2021
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Ingår i: Natural hazards and earth system sciences. - : Copernicus Publications. - 1561-8633 .- 1684-9981. ; 21:11, s. 3439-3447
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Tidskriftsartikel (refereegranskat)abstract
- The severe impact of global crises, such as COVID-19 and climate change, is plausibly reshaping the way in which people perceive risks. In this paper, we examine and compare how global crises and local disasters influence public perceptions of multiple hazards in Italy and Sweden. To this end, we integrate information about the occurrence of hazardous events with the results of two nationwide surveys. These included more than 4000 participants and were conducted in two different phases of the COVID-19 pandemic corresponding to low (August 2020) and high (November 2020) levels of infection rates. We found that, in both countries, people are more worried about risks related to experienced events. This is in line with the cognitive process known as the availability heuristic: individuals assess the risk associated with a given hazard based on how easily it comes to their mind. Epidemics, for example, are perceived as less likely and more impactful in Italy compared to Sweden. This outcome can be explained by cross-country differences in the impact of, as well as governmental responses to, COVID-19. Notwithstanding the ongoing pandemic, people in both Italy and Sweden are highly concerned about climate change, and they rank it as the most likely threat.
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| 3. |
- Pignocchino, Gianmarco, et al.
(författare)
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Public risk perception of air pollution in the general population of Italy and Sweden during the COVID-19 pandemic : Environmental and socio-demographic drivers
- 2023
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Ingår i: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 173
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Tidskriftsartikel (refereegranskat)abstract
- Air pollution is an important anthropogenic hazard due to its effect on human health and the environment. Understanding how the population perceives the risk associated with air pollution is a crucial aspect to inform future policies and communication strategies. The aim of this study is to examine the association between air pollution concentrations and public risk perception of air pollution, also exploring socio-demographic patterns in the general population of Italy and Sweden. To this end, we derived 3-year PM10 average concentrations from ground monitoring stations and integrated with a population-based survey carried out in August 2021 in both countries. Relative perceived likelihood and impact on the individual were considered as domains of risk perception. In addition this, information on direct experience and socio-demographic factors were included as possible determinants of risk perception. Linear regression models were performed to examine the association of PM10 average concentrations at regional level and individual level factors with risk perception domains. In both countries, respondents who live in the most densely populated regions report a higher perceived likelihood of air pollution. Direct experience is the main driver of risk perception in both countries. Being male and smokers in Italy, older age and having left/centre-left political orientation in both countries are associated with a higher perceived likelihood and impact of air pollution. These findings will inform future health and environmental studies regarding the public risk perception of air pollution highlighting individual's awareness and the sociodemographic patterns.
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| 4. |
- Raffetti, Elena, et al.
(författare)
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COVID-19 vaccine hesitancy in Sweden and Italy : The role of trust in authorities
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:6, s. 803-809
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Tidskriftsartikel (refereegranskat)abstract
- Background: The success of vaccination campaigns against COVID-19 infection is vital for moving from a COVID-19 pandemic to an endemic scenario. We aimed to unravel the influence of the risk perception of epidemics along with individual and contextual factors on adherence to COVID-19 vaccination campaigns in Italy and Sweden.Methods: We compared the results of two nationwide surveys carried out in August 2021 across four domains of epidemic risk perception: perceived likelihood, perceived impact on the individual and perceived individual and authority knowledge. The roles of individual and contextual determinants were also explored.Results: The survey included 2144 participants in Sweden (52.3% women) and 2010 in Italy (52.6% women). In both countries, we found that trust in authorities was one of the main drivers of this process, with two-fold increased odds of being vaccinated. Being highly educated and having a higher relative income were associated with a higher adherence to the vaccination campaign (for relative income OR = 1.44, 95% CI 1.23–1.67 in Sweden and OR = 1.18, 95% CI 1.04–1.34 in Italy; for education OR = 1.90, 95% CI 1.30–2.77 in Sweden and OR = 1.47, 95% CI 1.09–1.97 in Italy), whereas a right and centre-right compared with a left and centre-left political orientation was negatively related to vaccination adherence (OR = 0.41, 95% CI 0.25–0.67 in Sweden and OR = 0.47, 95% CI 0.33–0.68 in Italy).Conclusions: Increasing trust in authorities, along with an equal global distribution of vaccine doses, can contribute to accelerating vaccination campaigns around the world and, in turn, to move towards an endemic scenario.
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| 5. |
- Raffetti, Elena, et al.
(författare)
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Epidemic risk perceptions in Italy and Sweden driven by authority responses to COVID-19
- 2022
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1, s. 9291-
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Tidskriftsartikel (refereegranskat)abstract
- Understanding public risk perception is an essential step to develop effective measures reducing the spread of disease outbreaks. Here we compare epidemic risk perceptions during two different periods of the COVID-19 pandemic in Italy and Sweden. To this end, we analyzed the results of two nationwide surveys carried out in both countries in two periods characterized by different infection rates: August (N = 4154) and November 2020 (N = 4168). Seven domains of epidemic risk perception were considered: likelihood along with (individual and population) impact, preparedness, and knowledge. The role of the context and period was explored in stratified and formal interaction analyses. In both countries, we found an intensification in epidemic risk perception from August to November 2020. Being male, older and having a higher relative income were associated with a lower perception of the likelihood of epidemics, while excess mortality was marginally related to higher odds. Compared to Sweden, Italy had a higher increase in perception of likelihood and impact, and a concurrent decrease in preparedness and knowledge. The different authority response to the COVID-19 pandemic is associated with a different change over time in risk perception. Regional differences in terms of excess mortality only marginally explained differences in risk perception.
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| 6. |
- Agosti, Edoardo, et al.
(författare)
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Quantitative Anatomic Comparison of Endoscopic Transnasal and Microsurgical Transcranial Approaches to the Anterior Cranial Fossa
- 2022
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Ingår i: Operative Neurosurgery. - : Congress of Neurological Surgeons. - 2332-4252 .- 2332-4260. ; 23:4, s. e256-e266
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several microsurgical transcranial approaches (MTAs) and endoscopic transnasal approaches (EEAs) to the anterior cranial fossa (ACF) have been described.OBJECTIVE: To provide a preclinical, quantitative, anatomic, comparative analysis of surgical approaches to the ACF.METHODS: Five alcohol-fixed specimens underwent high-resolution computed tomography. The following approaches were performed on each specimen: EEAs (transcribriform, transtuberculum, and transplanum), anterior MTAs (transfrontal sinus interhemispheric, frontobasal interhemispheric, and subfrontal with unilateral and bilateral frontal craniotomy), and anterolateral MTAs (supraorbital, minipterional, pterional, and frontotemporal orbitozygomatic approach). An optic neuronavigation system and dedicated software (ApproachViewer, part of GTx-Eyes II—UHN) were used to quantify the working volume of each approach and extrapolate the exposure of different ACF regions. Mixed linear models with random intercepts were used for statistical analyses.RESULTS: EEAs offer a large and direct route to the midline region of ACF, whose most anterior structures (ie, crista galli, cribriform plate, and ethmoidal roof) are also well exposed by anterior MTAs, whereas deeper ones (ie, planum sphenoidale and tuberculum sellae) are also well exposed by anterolateral MTAs. The orbital roof region is exposed by both anterolateral and lateral MTAs. The posterolateral region (ie, sphenoid wing and optic canal) is well exposed by anterolateral MTAs.CONCLUSION: Anterior and anterolateral MTAs play a pivotal role in the exposure of most anterior and posterolateral ACF regions, respectively, whereas midline regions are well exposed by EEAs. Furthermore, certain anterolateral approaches may be most useful when involvement of the optic canal and nerves involvement are suspected.
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| 7. |
- Galanti, Maria Rosaria, et al.
(författare)
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School environment and mental health in early adolescence - a longitudinal study in Sweden (KUPOL)
- 2016
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Longitudinal studies indicate strong associations between school proficiency and indicators of mental health throughout adulthood, but the mechanisms of such associations are not fully elucidated. The Kupol study is a prospective cohort study in Sweden set up in order to: (i) describe the association of school pedagogic and social environment and its specific dimensions with the risk of mental ill-health and psychiatric disorders in adolescence; (ii) evaluate the direct effects of school pedagogic and social environment on mental health and the effects mediated by the individual's academic achievements; and (iii) assess if school pedagogic and social environment are associated with mental ill-health through epigenetic mechanisms, in particular those involving genes regulating the response to stress.Methods: The Kupol cohort at baseline consists of 3959 children attending the 7th grade of compulsory school (13-14 years old) in 8 regions of central Sweden in the school years 2013-2014 or 2014-2015. Three follow-up surveys in subsequent years are planned. Teachers' and students' perceptions of the culture, climate and ethos of their schools, and students' mental ill-health are assessed at the whole school level by annual questionnaire surveys. In order to conduct epigenetic analyses saliva specimens are collected from a nested sample of students at inception and two years later. Further, class-, family-and child-level information is collected at baseline and during each year of follow-up. Self-reported information is being complemented with register data via record-linkages to national and regional health and administrative registers.Discussion: The topic being investigated is new, and the sample constitutes the largest adolescent cohort in Sweden involved in an ad hoc study. Epigenetic analyses centered on environmental cues to stress response are a thoroughly new approach. Finally a notable feature is the multi-informant and multi-method data collection, with surveys at the school, class, family, and student level. Collaboration and data access: interested investigators should contact the coordinating centre. Additional information is available on the study's website, http://kupolstudien.se/.
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| 8. |
- Lindersson, Sara, et al.
(författare)
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The wider the gap between rich and poor the higher the flood mortality
- 2023
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Ingår i: Nature Sustainability. - : Springer Nature. - 2398-9629.
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Tidskriftsartikel (refereegranskat)abstract
- Economic inequality is rising within many countries globally, and this can significantly influence the social vulnerability to natural hazards. We analysed income inequality and flood disasters in 67 middle- and high-income countries between 1990 and 2018 and found that unequal countries tend to suffer more flood fatalities. This study integrates geocoded mortality records from 573 major flood disasters with population and economic data to perform generalized linear mixed regression modelling. Our results show that the significant association between income inequality and flood mortality persists after accounting for the per-capita real gross domestic product, population size in flood-affected regions and other potentially confounding variables. The protective effect of increasing gross domestic product disappeared when accounting for income inequality and population size in flood-affected regions. On the basis of our results, we argue that the increasingly uneven distribution of wealth deserves more attention within international disaster-risk research and policy arenas.
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| 9. |
- Manu, Diana-Maria
(författare)
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Functional epigenetic analyses in the context of psychiatric health in adolescence
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Adolescence is a unique and formative period for learning and developing skills and abilities for adulthood. The prevalence of mental health problems in adolescents is estimated to 10-20%, being a major risk for suicide, social and academic impairments. Suicide is the third leading cause of death in older adolescents (15-19 years). Genetic studies suggest that gene-environment interaction contributes to molecular mechanisms of the differential risks for psychiatric disorders and epigenetic marks such as DNA methylation (DNAm) and non-coding RNA (ncRNA) are likely involved. In this doctoral thesis, we investigated how the environmentally modifiable factors are associated with genetic variation, anxiety disorders, depression and suicidal behavior. Using well described bioinformatic and statistical methods, e.g. DNAm preprocessing techniques, gene ontology enrichment, chromatin state inference, correlation of DNAm in blood and brain tissues and eQTL effect, we uncovered functional differential DNAm, meQTL and eQTL associations in the context of depression, generalized anxiety and suicidal thoughts in multiple datasets. First, in an epigenome-wide study, we identified associations between psychiatric-related SNPs and DNAm at CpG sites located within enhancer regions in hippocampus. Then, using a targeted approach by including CpG sites with cross tissue relevance, we found and replicated an association between differentially DNAm at one genomic locus and risk for generalized anxiety disorder. The functional role of the CpG site was supported by the observed association between DNAm shifts and mRNA expression in blood, together with its location within regulatory chromatin state in brain. In a longitudinal epigenome-wide study, we identified changes in DNAm levels at the gene promoter for risk for depression. Moreover, in blood, DNAm at one CpG site was associated with suicidal behavior and mRNA expression, which may be genetically controlled. These findings could be translated in the brain as differentially DNAm and mRNA expression levels at the same locus were observed for major depression in post-mortem tissue brain. Lastly, we identified meQTL and micro-RNA (miRNA) eQTL involved in depression in whole blood and brain. Gene ontology terms of the predicted target genes for one miRNA involved behavioral fear and defense response, presynaptic signal transductions, and presynaptic active zone organization. Overall, this thesis investigated and demonstrated a complementary influence of genetic and epigenetic factors underlying pathogenesis of psychiatric disorders.
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| 10. |
- Raffetti, Elena, et al.
(författare)
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Cortisol Concentration as Predictor of Tobacco Initiation in Adolescents: Results From a Population-Based Swedish Cohort
- 2021
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Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X. ; 68:4, s. 758-764
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Stress potentiates the smoking reward, decreases the ability to resist smoking, and increases the risk of smoking relapse in adulthood. This study aimed to clarify if salivary cortisol, as an indicator of stress, may be prospectively associated with the onset and phenotype of tobacco use in adolescents. Methods This study was based on a cohort of Swedish adolescents, among whom saliva specimens were collected from a nested sample. We included adolescents with salivary cortisol measurements and without a history of tobacco use (n = 381, aged 13–14 years). Quartiles of morning and afternoon cortisol concentration and cortisol area under the curve were considered as predictors. We categorized tobacco use according to the product mainly used: cigarette smoking, snus use, or either type of tobacco. For each product use, two outcomes were considered: initiation and duration of use. Poisson regression models were used to calculate rate ratios. Results A quartile increase in morning cortisol levels and cortisol area under the curve was consistently associated with a 1.2- to 1.4-fold increased risk of initiation of cigarette smoking snus use, or any tobacco use. Similar results were obtained examining the dose–response relationship and using the duration of use as outcome. No associations were apparent between afternoon cortisol concentration and any of the outcomes. All associations were similar between sexes. Conclusions Morning cortisol concentration, an indicator of hypothalamic–pituitary–adrenal axis activation, is prospectively associated with tobacco use in adolescents. Whether this activation indicates the cumulative effect of stressors during the life course remains to be elucidated.
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| 11. |
- Raffetti, Elena, et al.
(författare)
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Country differences in the cross-sectional associations between smoking and depressive symptoms in adolescence
- 2022
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 32:6, s. 913-918
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the present study was to compare the cross-sectional association between smoking and depressive symptoms among adolescents between Sweden and Italy, two countries historically characterized by different norms about tobacco use and different tobacco control efforts. Methods: A cross-sectional study including 3283 adolescents 15–16 years of age participating in the Swedish KUPOL study and 1947 same-age adolescents from the Italian BE-TEEN study. Current smoking was defined as any smoking in the past 30 days. Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale for Children (CES-DC) and the internalizing score of the Strengths and Difficulties Questionnaire (SDQ). Country differences were explored in stratified and interaction analyses. Results: Current smoking was associated with a 2- to 3-fold increased odds of depressive symptoms among Swedish adolescents using both CES-DC and SDQ internalizing scale. Among Italian adolescents, slightly lower increased odds of 1.5–2.5 for depressive symptoms with smoking were found using the CES-DC but not the SDQ scale. Both multiplicative and additive interactions for country were significant. The association between smoking and depressive symptoms was weaker among Italian compared with Swedish adolescents for both scores. Conclusions: Countries with different tobacco norms and control show different associations between smoking and depressive symptoms in adolescence, probably due to different psychosocial profiles of smokers. These findings need to be considered when planning tobacco prevention programmes, e.g. by focusing on early detection of mental health distress among adolescents in settings with declining smoking prevalence and restrictive tobacco control environments.
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| 12. |
- Raffetti, Elena, et al.
(författare)
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DNA methylation of the glucocorticoid receptor gene predicts substance use in adolescence: longitudinal data from over 1000 young individuals.
- 2021
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Ingår i: Translational psychiatry. - : Springer Science and Business Media LLC. - 2158-3188. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Early life stress has been linked to increased methylation of the Nuclear Receptor Subfamily 3 Group C Member 1 (NR3C1) gene, which codes for the glucocorticoid receptor. Moreover, early life stress has been associated with substance use initiation at a younger age, a risk factor for developing substance use disorders. However, no studies to date have investigated whether NR3C1 methylation can predict substance use in young individuals. This study included adolescents 13-14 years of age that reported no history of substance use at baseline, (N=1041; males=46%). Participants contributed saliva DNA samples and were followed in middle adolescence as part of KUPOL, a prospective cohort study of 7th-grade students in Sweden. Outcome variables were self-reports of (i) recent use, (ii) lifetime use, and (iii) use duration of (a) alcohol, (b) tobacco products, (c) cannabis, or (d) any substance. Outcomes were measured annually for three consecutive years. The predictor variable was DNA methylation at the exon 1F locus of NR3C1. Risk and rate ratios were calculated as measures of association, with or without adjustment for internalizing symptoms and parental psychiatric disorders. For a subset of individuals (N=320), there were also morning and afternoon salivary cortisol measurements available that were analyzed in relation to NR3C1 methylation levels. Baseline NR3C1 hypermethylation associated with future self-reports of recent use and use duration of any substance, before and after adjustment for potential confounders. The overall estimates were attenuated when considering lifetime use. Sex-stratified analyses revealed the strongest association for cigarette use in males. Cortisol analyses revealed associations between NR3C1 methylation and morning cortisol levels. Findings from this study suggest that saliva NR3C1 hypermethylation can predict substance use in middle adolescence. Additional longitudinal studies are warranted to confirm these findings.
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| 13. |
- Raffetti, Elena, et al.
(författare)
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Sustainable transformations for healthcare systems in a changing climate
- 2024
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Ingår i: Cell Reports Sustainability. - : Elsevier. - 2949-7906. ; 1:3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Climate extremes are unprecedented straining healthcare systems and intensifying pre-existing issues. This commentary addresses lack of (1) knowledge on unintended health consequences of adaptation actions, (2) interdisciplinary research frameworks, and (3) forward-looking, context-based scenarios. Collaboration across natural, medical, and social sciences can facilitate shifts toward more sustainable and equitable healthcare.
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| 14. |
- Raffetti, Elena
(författare)
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The association between smoking behaviour and depressive symptoms in adolescence : the role of biology and of societal influences
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Tobacco use is common among people who suffer from depressive symptoms. This cooccurrence is associated with several negative health outcomes. The present thesis will contribute to the understanding of if, how, and in which contexts this specific association occurs in early adolescence. We investigated the longitudinal association between tobacco use and depressive symptoms, the potential biological mechanisms behind this association and the extent to which the social context modifies the co-occurrence of these two major health determinants. Data are obtained from the KUPOL study, a population-based cohort of Swedish adolescents. The evaluation of the social context also includes data from the Italian BE-TEEN study. Study I. The possible association between smoking or snus use and depressive symptoms was examined in 3,195 KUPOL study participants. Smoking behaviour was associated with an increased risk of the onset of depressive symptoms among adolescents. Study II. We explored the possible involvement of activation of the hypothalamic-pituitaryadrenocortical axis, measured through salivary cortisol concentration, in the pathway from cigarette smoking to depressive symptoms in 409 KUPOL study participants. There was no evidence for an association between cigarette smoking and the hypothalamic-pituitaryadrenocortical axis levels of activity, and the latter did not predict an increased risk of the onset of depressive symptoms. Study III. Salivary cortisol concentration as a predictor of the onset of tobacco use was investigated in 381 KUPOL study participants. Morning cortisol concentration was associated with an increased risk of smoking and snus initiation as well as duration of use. These findings suggest an association between activation of the hypothalamic-pituitary-adrenocortical axis and tobacco use. Study IV. We evaluated the presence of the association between smoking and depressive symptoms in a restrictive (Sweden) and in a non-restrictive (Italy) tobacco control environment including 3,283 Swedish and 1,947 Italian participants. Cross-sectional associations between smoking and depressive symptoms were found in both the restrictive and non-restrictive tobacco control environments, with the strongest association in the former. Conclusions. This thesis indicates that smoking behaviour is a predictor of the development of depressive symptoms in adolescence. The pathways behind this longitudinal association are not clear. Seemingly, the hypothalamic-pituitary-adrenocortical axis is not implicated in the process from smoking to depressive symptoms. However, findings indicate that the initial activation of the hypothalamic-pituitary-adrenocortical axis may be linked to smoking onset. This opens up for new research avenues on dysregulation of the response to stressors, such as adverse life events, and smoking onset at a young age. Finally, translating this emerging knowledge into prevention programmes may help to develop context-specific interventions and to direct efforts towards specific subgroups of adolescents at high risk of tobacco use and depressive problems.
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