A proposed methodology to evaluate the influence of climate change on drinking water treatments and costs.

Drinking water (DW) production treatments can be affected by climate change, in particular intense rainfall events, having an impact on the availability and quality of the water source. The current study proposes a methodology for the evaluation of the costs of the different treatment steps for surface water (SW) and groundwater (GW), through the analysis and quantification of the main cost items. It provides the details to count for strong variations in the key quality parameters of inlet water following severe rainfalls (namely turbidity, iron, manganese, and E. coli). This methodology is then applied to a large drinking water treatment plant (DWTP) in Italy, which treats both SW, around 70 %, and GW, around 30%. It discusses the overall DW production costs (from 7.60 c€/m3 to 10.43 c€/m3) during the period 2019-2021 and analyzes the contributions of the different treatment steps in water and sludge trains. Then it focuses on the effects on the treatments of significant variations in SW turbidity (up to 1863 NTU) due to intense rainfalls, and on the daily costs of DW with respect to the average (baseline) costs evaluated on the annual basis. It emerges that, when SW has low turbidity levels, the energy-based steps have the biggest contribution on the costs (final pumping 22 % for SW and 10 % for GW, withdrawal 15 % and 14 %, respectively), whereas at very high turbidity levels, sludge greatly increases, and its treatment and disposal costs become significant (up to 14 % and 50 %). Efforts are being made to adopt the best strategies for the management of DWTPs in these adverse conditions, with the aim to guarantee potable water and optimize water production costs. A mitigation measure consists of increasing GW withdrawal up to the authorized flow rate, thus reducing SW withdrawal. In this context, the study is completed by discussing the potential upgrading of the DWTP by only treating GW withdrawn from riverbank filtration. The DW production cost would be 7.76 c€/m3, which is lower than that seen for the same year (2021) with the current plant configuration (8.32 c€/m3).

Post-Traumatic Outcomes among Survivors of the Earthquake in Central Italy of August 24, 2016. A Study on PTSD Risk and Vulnerability Factors.

Central Italy suffered from the earthquake of 2016 resulting in great damage to the community. The purpose of the present study was to determine the long-term traumatic outcomes among the population. A preliminary study aimed at obtaining the Italian translation of the first 16 item of HTQ IV part [1] which was administered, 20 months after the disaster, at 281 survivors. In backward stepwise logistic regressions models, we estimated among the respondent's characteristics and event-related variables the best predictors of Post-Traumatic Stress Disorder (PTSD).A Confirmatory Factor Analysis (CFA) revealed a HTQ five-factors solution as best model, with satisfactory indexes of fit. HTQ held a positive correlation with both the SQD-P (r = .65, p < .05) and SQD-D subscales (r = .47, p < .05). ROC analysis suggested an area of .951 (95% CI = .917-.985) for the PTSD prediction. Basing on sensibility (.963) and specificity (.189), the best cut-off of 2.0 allowed discriminating for PTSD positive cases. After 20 months of the earthquake, the estimate prevalence of PTSD among the survivors is of 21.71% with a consistent and graded association between exposure variables and vulnerability factors (gender, age, exposure to death and home damage) and PTSD symptoms.

Suicide in the Early Stage of Schizophrenia.

Suicide is a relevant leading cause of death among patients affected by schizophrenia. Even if suicidal ideation may be present in different stages of disease, some differences have been described between the risk of suicide in patients experiencing first episode of psychosis and those with long-term schizophrenia. It is particularly higher during the first year of illness and reaches a steady decline over the following years. Suicidal ideation and attempts may also be common among subjects with subthreshold psychotic experiences. Factors associated with the risk of suicide in the early phase of schizophrenia are previous suicidal attempts and social aspects: the lack of social support and stable relationships, social drift after the first episode, and social impairment. Also, several psychotic symptoms (suspiciousness, paranoid delusions, mental disintegration and agitation, negative symptoms, depression and hopelessness, and command hallucinations) and substance abuse are associated with higher risk of suicide. It has been described that perfectionism and good levels of insight among individuals who have recently developed psychotic symptoms are significantly associated with higher numbers of suicidal attempts. Moreover, recent evidences show that prefrontal cortex-based circuit dysfunction may be related to suicide in the early stage of schizophrenia. This narrative review summarizes available evidences on suicide in the early stage of schizophrenia and deals with issues to be further studied and discussed.

Posttraumatic stress disorder six months after an earthquake: findings from a community sample in a rural region in Italy.

BACKGROUND AND AIMS: Various studies assessed rates of post-traumatic stress disorder (PTSD) following natural disasters including earthquakes. Yet, samples were often non-representative or small or both. This study aims to assess the prevalence of PTSD and predictors of PTSD 6 months after an earthquake in a rural region of Italy. METHODS: A questionnaire was handed out to a representative sample of approximate 3,000 people in the region of Molise in Italy 6 months after an earthquake in October/November 2002. The questionnaire assessed socio-demographic characteristics, aspects of the event, the experience of symptoms immediately after the earthquake, and symptoms of PTSD. RESULTS: Questionnaires of 2,148 people were returned, representing a response rate of 73.7%. The final analysis was based on 1,680 people. The screening tool provided a PTSD prevalence rate of 14.5%. Male gender, age under 55 years, and better school education predicted lower rates of PTSD. More variance was explained when psychological symptoms of immediately after the event were also included as predictors. CONCLUSION: The findings on predictors are consistent with the literature. Whilst personal characteristics explain only a small variance of PTSD six months after the event, early psychological distress allows a better prediction of who is likely to have PTSD 6 months later.