Air Pollution from Global Health to Individual Risk Factor-Is It Time for Enviropathies in Everyday Clinical Practice?

While the link between cardiovascular and respiratory conditions and air pollution is well-known, recent studies provided a growing body of evidence that polluted air, particularly air with high levels of particulate matter with a diameter smaller than 2.5 micrometers (PM 2.5), can have a range of negative impacts on health, both in terms of mortality and morbidity. It is time to emphasize the role of environmental factors as contributory factors or determinants of both global and individual health levels, and to consider them together as a health priority, as enviropathies (meant as pathologies caused, triggered or worsened by environmental exposure). Bringing attention to harmful air pollution exposure has fostered population studies, which developed accurate quantification of environmental exposure in polluted regions, aiding our understanding of the dose-response relationship between pollutants and diseases. Those efforts have influenced local and global health policy strategies. Now we face the challenge of controlling environmental pollution and limiting individual exposure to prevent or avoid serious health risks. Is it time for enviropathies in everyday clinical practice

Is air pollution affecting the disease activity in patients with systemic lupus erythematosus? State of the art and a systematic literature review

Objective: It has been documented that several major components of air pollution, including trace elements and polycyclic aromatic hydrocarbons, are associated with the prevalence of systemic lupus erythematosus (SLE). However, the impact of air pollution on the SLE disease activity is still elusive. In this paper, we review the current evidence investigating the link between air pollution, especially when measured as PM2.5, and SLE severity and activity. Methods: A detailed literature search was applied a priori to the Ovid MEDLINE In-Process and Other Non-Indexed Citation 1986 to present. Presented abstracts from the European League Against Rheumatism and American College of Rheumatology (ACR)/Association for Rheumatology Health Professionals (ARHP) Annual Meetings (2011-2018) were also screened. Results: Out of a total of 1354 papers retrieved from search and references list for detailed evaluation, data from 652 patients with SLE from three studies were analyzed. Two studies had an observational longitudinal design, counting for 348 patients with a follow-up of 24 months and 79 months. Retrieved studies differed for disease activity assessment and air pollution quantifications. Conclusion: Current evidence suggests that variations in air pollution may influence the disease activity in patients with SLE. However, the sample size, methodological biases, and differences across the studies make further research mandatory. Understanding the increased burden of SLE and its complications, not only from a medical, but also from a socio-demographic perspective, including an exposure to pollutants, should have implications for resource allocation and access to subspecialty care

Collective Action and Social Innovation in the Energy Sector: A Mobilization Model Perspective

This conceptual paper applies a mobilization model to Collective Action Initiatives (CAIs) in the energy sector. The goal is to synthesize aspects of sustainable transition theories with social movement theory to gain insights into how CAIs mobilize to bring about niche-regime change in the context of the sustainable energy transition. First, we demonstrate how energy communities, as a representation of CAIs, relate to social innovation. We then discuss how CAIs in the energy sector are understood within both sustainability transition theory and institutional dynamics theory. While these theories are adept at describing the role energy CAIs have in the energy transition, they do not yet offer much insight concerning the underlying social dimensions for the formation and upscaling of energy CAIs. Therefore, we adapt and apply a mobilization model to gain insight into the dimensions of mobilization and upscaling of CAIs in the energy sector. By doing so we show that the expanding role of CAIs in the energy sector is a function of their power acquisition through mobilization processes. We conclude with a look at future opportunities and challenges of CAIs in the energy transition.This research was conducted under the COMETS (Collective action Models for Energy Transition and Social Innovation) project, funded by the Horizon 2020 Framework Program of the European Commission, grant number 837722

Multimorbidity and SARS-CoV-2–Related Outcomes: Analysis of a Cohort of Italian Patients

Background: Since the outbreak of the COVID-19 pandemic, identifying the main risk factors has been imperative to properly manage the public health challenges that the pandemic exposes, such as organizing effective vaccination campaigns. In addition to gender and age, multimorbidity seems to be one of the predisposing factors coming out of many studies investigating the possible causes of increased susceptibility to SARS-CoV-2 infection and adverse outcomes. However, only a few studies conducted have used large samples. Objective: The objective is to evaluate the association between multimorbidity, probability to be tested, susceptibility, and severity of SARS-CoV-2 infection in the Piedmont population (Northern Italy, about 4 million inhabitants). For this purpose, we considered five main outcomes: access to swab, positivity to SARS-CoV-2, hospitalization, ICU admission, and death within 30 days from the first positive swab. Methods: Data were obtained from different Piedmont health-administrative databases. Subjects aged between 45 and 74 years and infections diagnosed between February and May 2020 were considered. Multimorbidity was defined both with the Charlson Comorbidity Index (CCI) and by identifying patients with previous comorbidities such as diabetes, and oncological, cardiovascular, and respiratory diseases. Multivariable logistic regression models (adjusted for age and month of infection and stratified by gender) were performed for each outcome. Analyses were also conducted by separating two age groups (45-59 and 60-74 years). Results: Out of 1,918,549 subjects, 85,348 performed at least one swab, 12,793 tested positive for SARS-CoV-2, 4,644 were hospitalized, 1,508 were admitted to the ICU, and 749 died within 30 days from the first positive swab. Individuals with a higher CCI had a higher probability of being swabbed but a lower probability of testing positive. We observed the same results when analyzing subjects with previous oncological and cardiovascular diseases. Moreover, especially in the youngest group, we identified a greater risk of being hospitalized and dying. Among comorbidities considered in the study, respiratory diseases seem to be the most likely to increase the risk of having a positive swab and worse disease outcomes. Conclusions: Our study shows that patients with multimorbidity, although swabbed more frequently, are less likely to result infected with SARS-CoV-2, probably due to greater attention on protective methods. Moreover, a history of respiratory diseases is a risk factor for a worse prognosis of COVID-19. Nonetheless, whatever comorbidities affect the patients, a strong dose-response effect was observed between an increased score of CCI and COVID-19 hospitalization, ICU admission, and death. These results are important in terms of public health because they help in identifying a group of subjects that are more prone to worse SARS-CoV-2 outcomes. This information is important for promoting targeted prevention and developing policies for the prioritization of public health interventions

Collective action and social innovation in the energy sector: a mobilization model perspective

This conceptual paper applies a mobilization model to Collective Action Initiatives (CAIs) in the energy sector. The goal is to synthesize aspects of sustainable transition theories with social movement theory to gain insights into how CAIs mobilize to bring about niche-regime change in the context of the sustainable energy transition

Exploring Institutional and Socio-Economic Settings for the Development of Energy Communities in Europe

Energy communities (ECs), intended as collective action initiatives in the energy field involving citizens’ participation, have been gaining relevance for the past decades as an alternative way to organize the energy chain to challenge the incumbent system. With Europe’s recently adopted Clean Energy Package, ECs found a formal recognition by the European Union as potential actors of the transition of the energy system towards a wider and more decentralized use of renewable sources. Although the potential role of ECs in the transition is therefore hardly questionable, a thorough comprehension of the enabling factors that might foster their diffusion and scaling up is still lacking. Through a comparative analysis of the evolutionary trajectories in six EU countries regarding their energy systems, their regulatory frameworks and their historical evolution of ECs, namely through the example of cooperative models, this paper aims at providing some preliminary evidence about the factors and dynamics that seem to have played, and may play, a role in hampering or facilitating EC model diffusion. Attention is therefore specifically paid to three dimensions of analysis referring to: the energy mix and market structure; the institutional and policy landscape; the wider social attitudes towards environmental issues and cooperation among citizens. In addition to providing a wide comparison of different EU countries, the paper shows that the historical evolution pathways have to be carefully taken into account to understand what might trigger ECs exploitation in the EU