A methodology for assessing spatio-temporal dynamics of flood regulating services

open5sìThe effects of land use alteration, migration and urbanization are key aspects in flood management, as human activities can strongly influence the capacity of ecosystems to provide flood regulating ecosystem services and determine their demand. This study analyzes spatio-temporal dynamics of flood regulating ecosystem services to support watershed management planning. A methodology for mapping the supply and demand of flood regulation is proposed and applied to the Arno River basin, in central Italy. The spatial explicit analysis of flood regulating ecosystem services supply is carried out with SWAT - Soil and Water Assessment Tool, whose outputs are synthetized by two indicators to evaluate the retention capacity of each land use class originating from CORINE data sets. Quantification of demand for flood regulating ecosystem services is based on flood hazard classes derived from the existing local flood management plans (i.e., PAI-Piano per l'Assetto Idrogeologico and PGRA-Piano di Gestione del Rischio Alluvioni). Supply and demand data are then combined to obtain budget maps of flood regulating ecosystem services and their evolution, between 1990 and 2018. The results show how both demand and supply of ecosystem services have changed in the last decades, highlighting the main hotspots at the catchment and subcatchment scales. With the increasing urbanization, the demand values have grown in the Arno floodplains, where residential, industrial and commercial zones are located. At the same time, land use changes have altered the water regulation supply, resulting in a generalized decrease of the basin capacity to provide flood regulation services. The maps and tables obtained show the fundamental role of forest and other vegetated areas whose protection is a priority to assure future flood regulation and associated co-benefits (e.g., regulation of air quality, reduction of erosion, improvement of water quality, wood fuel). The assessment of flood regulating here proposed is a powerful tool for decision makers to improve flood regulation and provides a sound base of knowledge to identify and locate flood prevention and mitigation measureArticle Number: 107963openMori, Stefano; Pacetti, Tommaso; Brandimarte, Luigia; Santolini, Riccardo; Caporali, EnricaMori, Stefano; Pacetti, Tommaso; Brandimarte, Luigia; Santolini, Riccardo; Caporali, Enric

Untersuchung von Wasser-Land-Ökosystemen für das integrierte Management von Wassereinzugsgebieten

Environmental crisis, food insecurity and climate change are increasingly showing that human actions let the control variables of several planetary boundaries leave the safe operating space. A radical change in the human development paradigm is needed to maintain the ecosystem capacity for supporting human well-being. Due to its high connectivity, water plays a key role within the ecosystems and it is strictly related to the production of basic services that support human wellbeing, such as food provisioning or energy production (the so-called Nexus). This suggests the necessity of analyzing the interconnections and feedbacks among water, land and energy management to promote a more resilient coupling of environment and society. A new language is needed to improve the existing water management and to promote a new approach where water is a single component of a multiple integrated system. The main objective of this thesis is to investigate interrelationships among water, energy and land management in human-water systems to improve their management and to translate a general Nexus approach into operative frameworks. A multi scale approach is adopted, integrating hydrological modelling with the evaluation of Ecosystem Services and the Water Footprint analysis. Different case studies are elaborated to assess, from an innovative perspective, the interrelations of water management with the other natural resources.Umweltkrisen, Nahrungsmittelunsicherheit und Klimawandel zeigen zunehmend, dass menschliches Handeln die Steuerungsgrößen mehrerer Grenzen dieses Planeten den sicheren Handelsraum verlassen lässt. Es ist ein radikaler Paradigmenwechsel der menschlichen Entwicklung notwendig, um die Fähigkeit des Ökosystems zur Unterstützung des menschlichen Wohlbefindens zu erhalten. Aufgrund seiner hohen Konnektivität spielt Wasser eine Schlüsselrolle innerhalb der Ökosysteme und steht in engem Zusammenhang mit der Produktion von Basisdienstleistungen, die das menschliche Wohlbefinden unterstützen, wie z.B. Nahrungsmittelversorgung oder Energieerzeugung (der so genannte Nexus). Dies legt die Notwendigkeit nahe, die Zusammenhänge und Rückkopplungen zwischen Wasser-, Land- und Energiemanagement zu analysieren, um eine widerstandsfähigere Kopplung von Umwelt und Gesellschaft zu fördern. Eine neue Sprache ist notwendig, um das bestehende Wassermanagement zu verbessern und einen neuen Ansatz zu fördern, bei dem Wasser eine einzige Komponente eines integrierten Systems ist. Das Hauptziel dieser Arbeit ist es, Zusammenhänge zwischen Wasser-, Energie- und Landmanagement in Mensch-Wasser-Systemen zu untersuchen, um deren Management zu verbessern und einen allgemeinen Nexus-Ansatz in operative Rahmenbedingungen zu übersetzen. Es wird ein mehrstufiger Ansatz verfolgt, der die hydrologische Modellierung mit der Bewertung von Ökosystemdienstleistungen und der Wasserfußabdruckanalyse integriert. Verschiedene Fallstudien werden erarbeitet, um die Zusammenhänge der Wasserwirtschaft mit den anderen natürlichen Ressourcen aus einer innovativen Perspektive zu bewerten

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Water-Dependent Ecosystems in Italy

Water is a key element of all the ecosystems and creates a complex web of connections between nature and society that need to be properly understood and quantified. Ecosystem services assessment, combining ecology with economic evaluation, can help identify holistic management strategies that preserve the ecosystems multifunctionality while enhancing the benefits produced by water. In the last decades, Italy has moved towards the adoption of an “(eco)systemic approach” in natural resources management, from local pilot experiences (for instance, Regional Law no. 13/1997 in Piedmont) up to the recognition of the importance of Natural Capital and its accounting in the national legislation (the 2015 Collegato Ambientale). In between, several experiences of innovative management practices, such as Payments for Ecosystem Services, have been experimented. The overview here presented aims at giving evidence of the work done so far, highlighting the limits and potential of introducing the concept of ecosystem services to support watershed management

Floods and food security: A method to estimate the effect of inundation on crops availability

reserved3noThe inner connections between floods and food security are extremely relevant, especially in developing countries where food availability can be highly jeopardized by extreme events that damage the primary access to food, i.e. agriculture. A method for the evaluation of the effects of floods on food supply, consisting of the integration of remote sensing data, agricultural statistics and water footprint databases, is proposed and applied to two different case studies. Based on the existing literature related to extreme floods, the events in Bangladesh (2007) and in Pakistan (2010) have been selected as exemplary case studies. Results show that the use of remote sensing data combined with other sources of onsite information is particularly useful to assess the effects of flood events on food availability. The damages caused by floods on agricultural areas are estimated in terms of crop losses and then converted into lost calories and water footprint as complementary indicators. Method results are fully repeatable; whereas, for remote sensed data the sources of data are valid worldwide and the data regarding land use and crops characteristics are strongly site specific, which need to be carefully evaluated. A sensitivity analysis has been carried out for the water depth critical on the crops in Bangladesh, varying the assumed level by ±20%. The results show a difference in the energy content losses estimation of 12% underlying the importance of an accurate data choice.Pacetti, Tommaso; Caporali, Enrica*; Rulli, Maria CristinaPacetti, Tommaso; Caporali, Enrica; Rulli, Maria Cristin