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Condie J, Northstone K, Major-Smith D, Halstead I. Exploring associations between the Big Five personality traits and cognitive ability with COVID-19 vaccination hesitancy and uptake among mothers and offspring in a UK prospective cohort study. Vaccine 2024; 42:2817-2826. [PMID: 38521675 DOI: 10.1016/j.vaccine.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/17/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Vaccines reduce the severity of symptoms, and risk of hospitalisation and death from infectious diseases. Yet, vaccination hesitancy persists. Research identifying psychological risk factors for vaccination hesitancy is limited and reports conflicting results. This study sought to address these inconsistencies and explore the role of personality and cognitive ability in COVID-19 vaccination hesitancy and uptake in a prospective cohort study. METHODS Data came from young adults (Generation-1; G1) and their mothers (Generation-0; G0) in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multinomial logistic regressions, adjusting for several sociodemographic confounders, were used to explore whether personality and cognitive ability were associated with COVID-19 vaccination hesitancy and uptake. 4,960 G1 and 4,853 G0 mothers were included in the study population. FINDINGS Among G1, 38.4% exhibited vaccination hesitancy, yet 91.9% of the cohort received the vaccine. In adjusted models, higher levels of openness, agreeableness, conscientiousness, and cognitive ability were associated with an increased probability of wanting the vaccine. Similarly, higher levels of agreeableness, openness and cognitive ability were associated with an increased probability of vaccination uptake. However, the evidence of associations with vaccine uptake were generally weaker than with vaccination hesitancy. 56.7% of the offspring who did not want the vaccine either received the vaccine or intended to, whilst 43.3% still had no intention.Among G0 mothers, 25.6% were vaccination hesitant, yet 99.0% of the cohort received the vaccine. 3.1% said they did not want the vaccine; approximately 80% of these either received the vaccine or intended to. We found inconclusive evidence for an association between cognitive ability and vaccination hesitancy among G0 mothers. INTERPRETATION This study identified psychological factors associated with vaccination hesitancy and uptake. If these associations are causal, these findings may help design more effective vaccination hesitancy interventions.
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Affiliation(s)
- Jennifer Condie
- Centre for Trials Research, Cardiff University, Cardiff, Neuadd Meirionnydd CF14 4YS, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Daniel Major-Smith
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Isaac Halstead
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
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Robinson JA, Sandow RJ, Piazza R. Introducing the keyconcept approach to the analysis of language: the case of regulation in COVID-19 diaries. Front Artif Intell 2023; 6:1176283. [PMID: 37808621 PMCID: PMC10552565 DOI: 10.3389/frai.2023.1176283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/20/2023] [Indexed: 10/10/2023] Open
Abstract
Using the Mass Observation corpus of 12th of May Diaries, we investigate concepts that are characteristic of the first coronavirus lockdown in the UK. More specifically, we extract and analyse concepts which are distinctive of the discourses produced in May 2020 in relation to concepts used in the 10 previous years, 2010-2019. In the current paper we focus on the concept of regulation, which we identify through a novel approach to querying semantic content in large datasets. Typically, linguists look at keywords to understand differences between two datasets. We demonstrate that taking the perspective of a keyconcept rather than the keyword in linguistic analysis is a beneficial way of identifying trends in broader patterns of thoughts and behaviours which reflect lived-experiences that are particularly prominent of a given dataset, which, in this current paper, is the COVID-19 era dataset. In order to contextualise the keyconcept analysis, we investigate the discourses surrounding the concept of regulation. We find that diarists communicate collective experience of limited individual agency, surrounded by feelings of fear and gratitude. Diarists' reporting on events is often fragmented, focused on new information, and firmly placed in a temporal frame.
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Affiliation(s)
- Justyna A. Robinson
- School of Media, Arts and Humanities, University of Sussex, Brighton, United Kingdom
| | - Rhys J. Sandow
- Department of Language and Linguistic Science, University of York, York, United Kingdom
| | - Roberta Piazza
- School of Media, Arts and Humanities, University of Sussex, Brighton, United Kingdom
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Haver A, Krampe H, Danbolt LJ, Stålsett G, Schnell T. Emotion regulation moderates the association between COVID-19 stress and mental distress: findings on buffering, exacerbation, and gender differences in a cross-sectional study from Norway. Front Psychol 2023; 14:1121986. [PMID: 38427783 PMCID: PMC10325689 DOI: 10.3389/fpsyg.2023.1121986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 02/01/2024] Open
Abstract
Background Maintaining good mental health is important during a crisis. However, little attention has been given to how people achieve this, or how they evaluate emotions associated with stressors, such as the COVID-19 pandemic. This study aims to (1) investigate whether emotion regulation, in particular cognitive reappraisal and suppression, moderates the relationship between COVID-19 stress and general mental distress and (2) examine gender differences in the interrelations between COVID-19 stress, emotion regulation, and mental distress. Methods Data from a population in Norway (n = 1.225) were collected using a cross-sectional survey during the early months of the COVID-19 pandemic. Emotion regulation was measured using the Emotion Regulation Questionnaire Scale (ERQ), COVID-19 stress with the COVID-19 Stress Scale, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS. Results There was a strong association between COVID-19 stress and general mental distress (r = 0.61). The moderation analyses showed substantial moderation effects of cognitive reappraisal and suppression on the relationship between COVID-19 stress and mental distress. Cognitive reappraisal served as a buffer (p = 0.001) and suppression (p = 0.002) exacerbated the relation between COVID-19 stress and mental distress. Men had higher scores of suppression (p < 0.001), and women had higher scores of cognitive reappraisal (p = 0.025). The buffering effect of cognitive reappraisal presented itself only in women (p < 0.001), while the exacerbation effect of suppression appeared only in men (p < 0.001). Conclusion The current study suggests that COVID-19 pandemic-related stress is easier to deal with for those who have the tendency to cognitively reappraise. In contrast, suppression is associated with symptoms of depression and anxiety. The prevention of mental distress can be supported by guiding people about the importance of using healthy emotion regulation strategies, as well as helping them to become more aware of the way they interpret and regulate their emotions. Gender differences in emotion regulation suggest gender awareness, e.g., tailored programs for men and women.
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Affiliation(s)
- Annie Haver
- Faculty of Social Sciences, Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway
- School of Psychology, Faculty of the Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Henning Krampe
- Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lars Johan Danbolt
- MF Norwegian School of Theology, Religion and Society, Majorstuen, Oslo, Norway
- Centre for Psychology of Religion, Innlandet Hospital Trust, Brumunddal, Norway
| | - Gry Stålsett
- MF Norwegian School of Theology, Religion and Society, Majorstuen, Oslo, Norway
- Modum Bad Psychiatric Center, Vikersund, Norway
| | - Tatjana Schnell
- MF Norwegian School of Theology, Religion and Society, Majorstuen, Oslo, Norway
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Tyrol, Austria
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Pilch I, Turska-Kawa A, Wardawy P, Olszanecka-Marmola A, Smołkowska-Jędo W. Contemporary trends in psychological research on conspiracy beliefs. A systematic review. Front Psychol 2023; 14:1075779. [PMID: 36844318 PMCID: PMC9945548 DOI: 10.3389/fpsyg.2023.1075779] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
Background The number of psychological studies on conspiracy beliefs has been systematically growing for about a dozen years, but in recent years, the trend has intensified. We provided a review covering the psychological literature on conspiracy beliefs from 2018 to 2021. Halfway through this period, the COVID-19 pandemic broke out, accompanied by an explosion of movements based on conspiracy theories, intensifying researchers' interest in this issue. Methods Adhering to PRISMA guidelines, the review systematically searched for relevant journal articles published between 2018 and 2021. A search was done on Scopus and Web of Science (only peer-reviewed journals). A study was included if it contained primary empirical data, if specific or general conspiracy belief(s) were measured and if its correlation with at least one other psychological variable was reported. All the studies were grouped for the descriptive analysis according to the methodology used, the participants' characteristics, the continent of origin, the sample size, and the conspiracy beliefs measurement tools. Due to substantial methodological heterogeneity of the studies, narrative synthesis was performed. The five researchers were assigned specific roles at each stage of the analysis to ensure the highest quality of the research. Results Following the proposed methodology, 308 full-text articles were assessed for eligibility and 274 articles (417 studies) meeting the inclusion criteria were identified and included in the review. Almost half of the studies (49.6%) were conducted in European countries. The vast majority of the studies (85.7%) were carried out on samples of adult respondents. The research presents antecedents as well as (potential) consequences of conspiracy beliefs. We grouped the antecedents of conspiracy beliefs into six categories: cognitive (e.g., thinking style) motivational (e.g., uncertainty avoidance), personality (e.g., collective narcissism), psychopathology (e.g., Dark Triad traits), political (e.g., ideological orientation), and sociocultural factors (e.g., collectivism). Conclusion and limitations The research presents evidence on the links between conspiracy beliefs and a range of attitudes and behaviors considered unfavorable from the point of view of individuals and of the society at large. It turned out that different constructs of conspiracy thinking interact with each other. The limitations of the study are discussed in the last part of the article.
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Affiliation(s)
- Irena Pilch
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Agnieszka Turska-Kawa
- Faculty of Social Sciences, Institute of Political Science, University of Silesia in Katowice, Katowice, Poland,*Correspondence: Agnieszka Turska-Kawa,
| | - Paulina Wardawy
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Agata Olszanecka-Marmola
- Faculty of Social Sciences, Institute of Political Science, University of Silesia in Katowice, Katowice, Poland
| | - Wiktoria Smołkowska-Jędo
- Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
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Rhodes RE, Hamilton K. Three years on, COVID-19 is still relevant. Psychol Health 2022; 37:1431-1435. [PMID: 36715311 DOI: 10.1080/08870446.2022.2159345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia
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Quandt SA, Smith SA, Talton JW, Chen H, Laurienti PJ, Arcury TA. Change and Continuity in Preventive Practices Across the COVID-19 Pandemic Among Rural and Urban Latinx Immigrant Worker Families. HYGIENE (BASEL, SWITZERLAND) 2022; 2:200-211. [PMID: 36465586 PMCID: PMC9704367 DOI: 10.3390/hygiene2040018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND (1)The COVID-19 pandemic has put essential workers at high risk for contracting the disease. This study documents situational compliance with public health recommendations such as masking and social distancing among rural and urban Latinx families, with the goal of understanding change over time in COVID-19 risk reduction behaviors. METHODS (2)Respondents for 67 rural families and 44 urban families responded to repeated telephone surveys at three time points in the first year of the pandemic, providing data on use of masks and social distancing by themselves and family members while interacting with others at home, work, and in the community. Cumulative logistic regression models were employed to compare changes in risk behaviors between rural and urban groups over time. RESULTS (3)While group descriptive results indicated behaviors that posed low risk at each time point, regression models revealed greater change between time points for rural than urban residents. Rural residents also had gendered patterns. CONCLUSIONS (4)Patterns of change appear to reflect structural issues such as seasonal labor demand and gender roles more than pandemic fatigue or changing public health recommendations. The findings suggest that structural factors play a role in individuals complying with public health prevention measures for COVID-19.
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Affiliation(s)
- Sara A Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Sydney A Smith
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Jennifer W Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Haiying Chen
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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Kaliterna Lipovčan L, Prizmić-Larsen Z, Franc R. Differences between COVID-19-vaccinated and unvaccinated participants from Croatia. Croat Med J 2022; 63. [PMID: 36597562 PMCID: PMC9837719 DOI: 10.3325/cmj.2022.63.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AIM To compare Croatian participants vaccinated against coronavirus disease 2019 (COVID-19) and unvaccinated participants in terms of socio-demographic, personal, social, and COVID-19-related variables. METHODS From August till December 2021, 721 (465 vaccinated and 256 unvaccinated) participants completed an online survey about socio-demographic (age, sex income, education, marital status), personal (well-being indicators, personality measures and health), social (trust in experts, trust in government), and COVID-19-related characteristics (fear of COVID-19, history of COVID-19 infection). Differences between the groups were assessed with discriminant analysis. RESULTS The variables that best discriminated between vaccinated and unvaccinated participants were higher trust in experts, no history of COVID-19 infection, older age, higher fear of COVID-19, and intellect. Conclusion The study points to the importance of trust in experts in the promotion of COVID-19 vaccine.
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Affiliation(s)
| | | | - Renata Franc
- Ivo Pilar Institute of Social Sciences, Zagreb, Croatia
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Nahavandi N, Gorji MA. The impact of inspection policies on reducing disease prevalence in public buildings: A systems dynamics approach. BUILDING AND ENVIRONMENT 2022; 223:109398. [PMID: 35937086 PMCID: PMC9338836 DOI: 10.1016/j.buildenv.2022.109398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/21/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
The occurrence of the COVID-19 pandemic revealed new dimensions of urban resilience to communities. Failure to implement health protocols in public buildings has had a significant impact on the spread of the disease, and inspection has become necessary to enforce the rules. This study presents different inspection policies of public buildings to reduce disease prevalence. It evaluates and compares the implementation of these policies in the long run based on the systems dynamics approach. First, baseline modeling was performed without inspection to analyze the proposed policies, and disease prevalence was investigated. Then various proposed inspection and fines policies, including fixed inspection and fines rate (FIFF), fixed inspection rate with the variable fine rate (FIVF), and variable inspection and fines rate (VIVF), are introduced, and their system dynamics models are presented. The impact of each inspection policy on the violations rate and disease prevalence in public buildings has been investigated using long-term simulation. Based on the results, regulatory agencies can significantly reduce the rate of violations in public buildings and improve urban resilience to the epidemic by adopting proper inspection policies. The results can help city managers to adopt appropriate inspection policies.
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Affiliation(s)
- Nasim Nahavandi
- Department of Industrial and Systems Engineering, Tarbiat Modares University, P.O. Box 14117-13116, Tehran, Iran
| | - Mohammad-Ali Gorji
- Department of Industrial and Systems Engineering, Tarbiat Modares University, P.O. Box 14117-13116, Tehran, Iran
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Schnell T, Krampe H. Meaningfulness protects from and crisis of meaning exacerbates general mental distress longitudinally. BMC Psychiatry 2022; 22:285. [PMID: 35448989 PMCID: PMC9023037 DOI: 10.1186/s12888-022-03921-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Reactions to the COVID-19 pandemic are diverse, and both mental distress and existential crises can arise. The identification of protective and exacerbating factors and their progress over time is therefore highly relevant. The current study examined longitudinal protective effects of meaningfulness and exacerbating effects of crisis of meaning on general mental distress. METHODS N = 431 participants from Germany and Austria (mean age: 42 years) completed an online survey in both April/May (T1) and July/August 2020 (T2). After determining temporal stability or changes in meaningfulness, crisis of meaning, and general mental distress (PHQ-4), we examined whether (i) meaningfulness and (ii) crisis of meaning, measured at T1, incrementally predicted PHQ-4 at T2, beyond baseline levels of PHQ-4. We further tested (iii) a within-subject mediation of temporal changes in PHQ-4 by changes in crisis of meaning. RESULTS Meaningfulness prospectively predicted lower PHQ-4, and crisis of meaning predicted higher PHQ-4. From the first wave of the pandemic until a slowdown three months later, meaningfulness was stable, and crisis of meaning and PHQ-4 decreased. Changes in crisis of meaning mediated the changes in PHQ-4. CONCLUSIONS Meaningfulness appears to have a protective, and crisis of meaning an exacerbating effect on psychological distress, as shown here for the time of the first pandemic wave until three months later. Attention to existential experiences of meaningfulness and loss of meaning thus proves relevant to the clinical and public health context. Measures that support meaningfulness will help coping with crises of meaning, which in turn supports overcoming general mental distress.
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Affiliation(s)
- Tatjana Schnell
- Psychology of Religion and Existential Psychology, Social Sciences, MF Specialized University, Gydas vei 4, 0363, Oslo, Norway. .,Institute of Psychology, Existential Psychology Lab, University of Innsbruck, Innrain 52, 6020, Innsbruck, Austria.
| | - Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Lorettu L, Mastrangelo G, Stepien J, Grabowski J, Meloni R, Piu D, Michalski T, Waszak PM, Bellizzi S, Cegolon L. Attitudes and Perceptions of Health Protection Measures Against the Spread of COVID-19 in Italy and Poland. Front Psychol 2021; 12:805790. [PMID: 35035377 PMCID: PMC8754188 DOI: 10.3389/fpsyg.2021.805790] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/07/2021] [Indexed: 01/04/2023] Open
Abstract
Background: During the first wave of the COVID-19 pandemic (April to May 2020), 6,169 Polish and 939 Italian residents were surveyed with an online questionnaire investigating socio-demographic information and personality traits (first section) as well as attitudes, position, and efficacy perceptions on the impact of lockdown (second section) and various health protection measures enforced (third section). Methods: The "health protection attitude score" (HPAS), an endpoint obtained by pooling up the answers to questions of the third section of the survey tool, was investigated by multiple linear regression models, reporting regression coefficients (RC) with 95% confidence intervals (95% CI). Results: Concerns for business and health due to COVID-19 were associated with a positive attitude toward risk reduction rules. By contrast, male sex, concerns about the reliability of information available online on COVID-19 and its prevention, along with the feeling of not being enough informed on the transmissibility/prevention of SARS-CoV-2 were associated with a negative attitude toward risk mitigation measures. Discussion: A recent literature review identified two social patterns with different features in relation to their attitude toward health protection rules against the spread of COVID-19. Factors positively associated with adherence to public health guidelines were perceived threat of COVID-19, trust in government, female sex, and increasing age. Factors associated with decreased compliance were instead underestimation of the COVID-19 risk, limited knowledge of the pandemic, belief in conspiracy theories, and political conservativism. Very few studies have tested interventions to change attitudes or behaviors. Conclusion: To improve attitude and compliance toward risk reduction norms, a key intervention is fostering education and knowledge on COVID-19 health risk and prevention among the general population. However, information on COVID-19 epidemiology might be user-generated and contaminated by social media, which contributed to creating an infodemic around the disease. To prevent the negative impact of social media and to increase adherence to health protection, stronger content control by providers of social platforms is recommended.
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Affiliation(s)
- Liliana Lorettu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Mastrangelo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Joanna Stepien
- Department of Socio-Economic Geography, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Jakub Grabowski
- Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdańsk, Gdańsk, Poland
| | - Roberta Meloni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Davide Piu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Tomasz Michalski
- Department of Regional Development, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Przemyslaw M. Waszak
- Department of Hygiene and Epidemiology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Luca Cegolon
- Department of Medical, Surgical & Health Sciences, University of Trieste, Trieste, Italy
- University Health Authority Giuliano-Isontina (ASUGI), Public Health Department, Trieste, Italy
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