Italian Areas Research Articles

With new lenses. Transcultural consultation as a tool for multicultural social work. An exploratory case study in Italy

ABSTRACT This qualitative study explores how transcultural consultation is carried out in the social services of a local Italian area. Its purpose is to deepen our understanding of whether this methodology founded on the ethnopsychological approach can be useful in strengthening the cultural competency of social workers. Based on participant observations and semi-structured interviews, this paper illustrates how this tool helps practitioners become more aware of their values and implement more collaborative interventions, through which clients with migratory backgrounds can find a space for the expression and recognition of their internalised cultures. This paper additionally points out similarities and differences between this methodology and other cross-cultural social work models. Although transcultural consultation is conducted by psychotherapists, different application paths are proposed where even social workers can play an active role.

Accumulation of Selected Trace Elements in Shads from Three Lakes: First Insights from Italian Pre-Alpine Area.

The investigation of trace element pollution is important for the environmental assessment and management of lacustrine ecosystems, especially when these represent critical freshwater resources in densely populated areas. In this context, this study determined the levels of 15 trace elements in muscles of shad, Alosa agone (Scopoli 1786), a commercialized zooplanktivourous fish, from three primary, but currently still poorly studied, Italian lakes, namely, Lake Como, Iseo, and Garda. Research findings show that shads present similar trace element accumulation patterns among lakes, except for arsenic, which occurs at lower levels in Lake Como. Results provide evidence also for mercury biomagnification in fish, whereas all the other selected trace elements undergo bio-dilution through the same trophic chain. Maximum allowable limits for foodstuff were exceeded for chromium and selenium in shads, whereas mercury levels exceeded the European Environmental Quality Standard biota. These results highlight the need for regular monitoring activities of trace elements in the biota of these lakes.

Acute pulmonary embolism in hospitalized patients with SARS-CoV-2-related pneumonia: multicentric experience from Italian endemic area.

PurposeTo analyze pulmonary embolism (PE) on chest computed tomography pulmonary angiography (CTPA) in hospitalized patients affected by SARS-CoV-2, according to the severity of lung disease based both on temporal CT features changes and on CT-severity lung involvement (CT-severity score), along with the support of clinical and laboratory findings.MethodsWe retrospectively enrolled a total of 170 patients with confirmed SARS-CoV-2 infection who underwent CTPA examination for PE suspicion. Pulmonary arteries diameters, right ventricle/left ventricle (RV/LV) ratio, presence, absence, and distribution of PE, pulmonary artery obstructive index (PAO index), and lobe involvement were recorded. All CT scans were reviewed to assess temporal CT changes and the COVID CT-severity score.ResultsA total of 76 out of 170 patients (44.7%) developed PE without having any major risk factors for venous thromboembolism. The most severe pulmonary arteries involvement, expressed in terms of PAO Index, occurred in those patients with markedly elevated D-dimer and C-reactive protein (CRP) values and those patients with an advanced temporal stage of lung disease. The majority PE-positive patients were hospitalized in non-intensive wards. PE-positive patients showed a slightly higher hospitalization time in comparison with PE-negative ones. In the three months of study, overall 85.9% of patients were discharged while 14.1% died, of whom 13 PE-positive (54.2%).ConclusionsPatients hospitalized for SARS-CoV-2 infection present a higher cumulative incidence of PE compared to the general population of hospitalized patients, regardless of the severity of lung inflammation or the temporal stage of the disease.Supplementary InformationThe online version contains supplementary material available at (10.1007/s11547-020-01328-2).

Virological surveillance of SARS-CoV-2 in an Italian Northern area: differences in gender, age and Real Time RT PCR cycle threshold (Ct) values in three epidemic periods.

Background and aim of the work:Coronavirus Disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global public health emergency. The aim of this study was to investigate cases characteristics and Real Time RT PCR cycle threshold (Ct) values distribution of COVID-19 in an Italian Northern area during three periods: first period, February-May 2020; second period, June-August 2020; third period, September 2020-February 2021.Methods:Real Time RT PCR was used to detect SARS-CoV-2 in respiratory samples (oro/nasopharyngeal swabs).Results:A total of 254,744 samples were tested during the study period. Out of 20,188 positive samples (7.92%), 10,303 were females (51.04%) and 9,885 were males (48.96%). The percentage of positivity varied during the three different periods: 14.1% in the first period, 1.4% in the second and 9.2% in the third. The lowest Ct values were observed in the first phase of pandemic, with an overall average of 25.64. Overall average of the Ct values was lower in males than in females, 26.29 ± 6.04 and 26.84 ± 5.99 respectively. The oldest patients recorded lower Ct values.Conclusions:The findings of our study represent further evidence in support of the fact that male sex and older age showed lower Ct values, which means higher viral loads and higher infectious potential. These knowledges are useful to better understand the epidemiological aspects of COVID-19 and to perform effective Public Health Policies.

Web Reputation of Protected Areas as Tourism Destinations: a Case Study

The purpose of this study is to investigate the reasons why tourist inflows in three Italian protected areas, endowed with valuable natural and cultural heritage, are below their potential. These sites participate in the European Regional Development Project EXCOVER, that aims at developing sustainable tourism in underrated Adriatic areas. To this goal, it is important to investigate the reputation of the sites among the general public, especially in the imaginary of people who have never visited it, to understand and change what keeps tourists away. This task is brought about through a semantic analysis of online reviews, that are crucial in the construction of non-visitors’ imaginary about a destination and influence travel choices. Customers’ reviews are scraped from TripAdvisor through a code written on-purpose. Topics are modelled through an unsupervised machine learning algorithm, chosen because a consolidated theoretical model of destination reputation is still missing, so reviews are allowed to tell what is relevant to reviewers, without prior constraints. Moreover, to the exploratory aim of this study, online opinions are not considered as answers to predetermined questions, but as free instances of word-of-mouth. The resulting proxies of web reputation are compared across time and space, to get the information needed to devise effective tourism development strategies and marketing initiatives. The originality of this contribution lays in the investigation of the web reputation of protected areas still to be developed into tourism destination. Moreover, it may provide some hint useful to the formulation of a solid theoretical model of destination reputation.

Retrospective short-term forecasting experiment in Italy based on the occurrence of strong (fore) shocks

SUMMARYIn a recent work, we computed the relative frequencies with which strong shocks (4.0 ≤ Mw < 5.0), widely felt by the population were followed in the same area by potentially destructive main shocks (Mw ≥ 5.0) in Italy. Assuming the stationarity of the seismic release properties, such frequencies can be tentatively used to estimate the probabilities of potentially destructive shocks after the occurrence of future strong shocks. This allows us to set up an alarm-based forecasting hypothesis related to strong foreshocks occurrence. Such hypothesis is tested retrospectively on the data of a homogenized seismic catalogue of the Italian area against a purely random hypothesis that simply forecasts the target main shocks proportionally to the space–time fraction occupied by the alarms. We compute the latter fraction in two ways (i) as the ratio between the average time covered by the alarms in each area and the total duration of the forecasting experiment (60 yr) and (ii) as the same ratio but weighted by the past frequency of occurrence of earthquakes in each area. In both cases the overall retrospective performance of our forecasting algorithm is definitely better than the random case. Considering an alarm duration of three months, the algorithm retrospectively forecasts more than 70 per cent of all shocks with Mw ≥ 5.5 occurred in Italy from 1960 to 2019 with a total space–time fraction covered by the alarms of the order of 2 per cent. Considering the same space–time coverage, the algorithm is also able to retrospectively forecasts more than 40 per cent of the first main shocks with Mw ≥ 5.5 of the seismic sequences occurred in the same time interval. Given the good reliability of our results, the forecasting algorithm is set and ready to be tested also prospectively, in parallel to other ongoing procedures operating on the Italian territory.

Floating Offshore Wind Farms in Italy beyond 2030 and beyond 2060: Preliminary Results of a Techno-Economic Assessment

At the end of 2019, 10.5 GW of wind capacity was installed in Italy, all onshore. The National Integrated Climate and Energy Plan sets a target of 18.4 GW of onshore wind capacity and 0.9 GW of offshore wind capacity by 2030. Significant exploitation of offshore wind resources in Italy is expected after 2030, using floating wind turbines, suitable for water depths greater than 50 m. This technology is at the demonstration phase at present. Results of a preliminary techno-economic assessment of floating wind plants in Italian marine areas in a medium (2030) and long-term (2060) scenario are presented. In 2030, a reference park with 10 MW wind turbines will be defined, and parametric costs, depending on distance from shore, were assessed. In 2060, possible wind resource variations due to climate change, and cost reductions due to large diffusion of the technology were considered in three case studies. The economic model used was the simple Levelized Cost of Energy (sLCoE). Different values of Weighted Average Cost of Capital (WACC) were considered too. The results show LCoEs comparable to the ones expected for the sector in 2030. In 2060, even in the more pessimistic scenario, wind resource decreases will be abundantly compensated by expected cost reductions.

Leishmania infantum Seroprevalence in Cats From Touristic Areas of Italy and Greece

Leishmaniosis by Leishmania infantum is a major zoonotic Vector-Borne Disease (VBD) in terms of geographic distribution, pathogenicity and zoonotic potential. While dogs are the main reservoir of L. infantum, the infection in cats is poorly understood although increasingly reported from enzootic and non-enzootic areas. The Mediterranean basin is a key area for leishmaniosis and includes touristic spots that require continuous surveillance for VBDs in consideration of the growing tendency of tourists to travel with their pets. This study evaluated L. infantum seroprevalence in cats living in selected touristic localities of Italy and Greece. A total of 269 cat serum samples from three Sites i.e., 76, 40, and 153 from Adriatic Coast of Abruzzo, Italy (Site A), Giglio Island, Tuscany, Italy (Site B), and Mykonos Island, Greece (Site C), respectively, were included in the survey. Sera samples were subjected to an indirect immunofluorescence antibody assay for the detection of anti-L. infantum specific IgG. Associations between possible risk factors and seropositivity to L. infantum were statistically evaluated. Antibodies against L. infantum were detected in eight out of 269 (3.0%) cats tested i.e., 4/76 (5.3%), 1/40 (2.5%), and 3/153 (2.0%), from sites A, B, and C, respectively. A statistical association between anti-L. infantum antibodies and cohabitation with dogs was shown. This study indicates that feline populations living in the examined Italian and Greek touristic areas are exposed to L. infantum and that they may contribute to the circulation of L. infantum, enhancing the risk of infection for dogs and humans.

Appendicitis in Children in a Large Italian COVID-19 Pandemic Area.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the routine activities of pediatric surgical centers, and it determined the reduction of admissions in the pediatric emergency departments (PED). We reviewed the records of patients affected by acute appendicitis (AA) during the COVID-19 pandemic period in a large Italian COVID-19 pandemic area.Methods: Data regarding demographics, age, macroscopic and microscopic findings, and time between symptom onset and PED admission of patients affected by confirmed AA in the period between March and April 2020 were considered. The data were compared with those obtained during the same period of 2019, 2018, and 2017 in the included centers. Data were quoted as median (range) or absolute number. Non-parametric statistical tests were used to compare groups. A p ≤ 0.05 was regarded as significant. Since only anonymous data have been used and the data storage meets current data protection regulations, ethical committee approval was not required for this study.Results: Eighty-six patients underwent surgical appendectomy for AA between February 20th, 2020 and April 20th, 2020; 32.5% were complicated appendicitis and 67.5% were uncomplicated. Fifty-three patients were males and 33 were females. Patients' age ranged from 3 to 17 years and the median age was 10 years. The median time between the onset of symptoms and the admission in PED was 1.85 days. The average time between the symptom onset and PED admission was 1.8 days.Conclusions: Although fear from the COVID-19 pandemic determined a delayed diagnosis of serious pediatric diseases, the increasing prevalence and severity of AA were not demonstrated in the most COVID-19-affected areas of Italy.

Fingerprint of climate change in precipitation aggressiveness across the central Mediterranean (Italian) area

Rainfall erosivity and its derivative, erosivity density (ED, i.e., the erosivity per unit of rain), is a main driver of considerable environmental damages and economic losses worldwide. This study is the first to investigate the interannual variability, and return periods, of both rainfall erosivity and ED over the Mediterranean for the period 1680–2019. By capturing the relationship between seasonal rainfall, its variability, and recorded hydrological extremes in documentary data consistent with a sample (1981–2015) of detailed Revised Universal Soil Loss Erosion-based data, we show a noticeable decreasing trend of rainfall erosivity since about 1838. However, the 30-year return period of ED values indicates a positive long-term trend, in tandem with the resurgence of very wet days (> 95th percentile) and the erosive activity of rains during the past two decades. A possible fingerprint of recent warming is the occurrence of prolonged wet spells in apparently more erratic and unexpected ways.

Association of traumatic events with levels of psychological distress and depressive symptoms in male asylum seekers and refugees resettled in Italy

BackgroundIn recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, public health and mental health implications. The aim of this study is to (1) describe the level of psychological distress and frequency of psychiatric disorders in a sample of male asylum seekers and refugees across different ethnic groups resettled in Italy; (2) establish whether the number of traumatic events experienced before, during and after the migration process is associated with level of psychological distress and depressive symptoms.MethodsIn two large Italian catchment areas, over a period of 1 year a consecutive series of male asylum seekers and refugees, aged 18 or above and included in the Italian protection system, were screened for psychological distress and psychiatric disorders using validated questionnaires.ResultsDuring the study period, 252 male asylum seekers or refugees were recruited. More than one-third of the participants (34.5%) showed clinically relevant psychological distress, and one-fourth (22.2%), met the criteria for a psychiatric diagnosis, mainly Post Traumatic Stress Disorder and depressive disorders. The number of traumatic events turned out to be a risk factor for both clinically relevant psychological distress and depressive disorders. Receiving good social support emerged as a protective factor, while migrants with unclear status were at higher risk of psychological distress than those holding or awaiting a permission.DiscussionIn an unselected sample of male asylum seekers and refugees, after around 1 year of resettlement in Italy, the frequency of psychological distress and psychiatric disorders was substantial and clinically relevant. The association between traumatic events, especially post-migration problems, and mental health conditions suggests the need of developing services to assist refugees and asylum seekers to address the multi-faceted problems they experience, such as social support in host country, legal problems concerning permit status and asylum procedure, and family reunification, as well as addressing trauma and mental health issues.

Telehealth approach for amyotrophic lateral sclerosis patients: the experience during COVID-19 pandemic.

Specialized multidisciplinary ALS care has been shown to extend survival and improve patient's and caregiver's quality of life. During the COVID-19 pandemic, the management of patients suddenly changed and telemedicine has been proven to be as effective as outpatient care. We elaborate the experience with Telemedicine of a Tertiary ALS Center from an Italian geographical area with high infectious risk during the COVID-19 pandemic. 19 patients were evaluated in telemedicine by a multidisciplinary team including a neurologist (clinical evaluation, intercurrent events, and drug prescriptions); a dietician (diet and weight monitoring); a psychologist (psychological assessment and support); and a physiotherapist (physiotherapy treatment and device prescription). Telemedicine was performed using the online platform "IoMT Connected Care Platform (Ticuro Reply)." All patients reported a positive perception of talking face to face with healthcare professionals and were satisfied with how the team understood their problems. During video televisits, there was a change in the patient's medication regimen in 11/19; 2/19 required pneumological evaluation and started NIV; and 9/16 patients required prescription of devices. The mean monthly decline of ALSFRS-R before televisit was 0.88 (SD 1.17) and during televisit of 0.49 (SD 0.75). Bodyweight and daily caloric content remain stable. Reduction in HADS scores and stability in ALSAQ-40 were observed. Our study positively reproduced the multidisciplinary approach currently used with ALS patients, trying to stabilize the functional and metabolic status and improving the psychological one. Future directions include a personalized telemedicine program according to the patient's needs.

A GIS-Based Multicriteria Index to Evaluate the Mechanisability Potential of Italian Vineyard Area

Planting criteria of new vineyards should comply with rational and sustainable criteria, taking into account the potential mechanisability of existing viticultural areas. However, an established methodology for this assessment is still lacking. This study aimed at analysing the parameters which influence the vineyard mechanisability, with the objective to propose a new mechanisability index. The mechanisability index proposed was based on GIS-analysis of landscape and management parameters such as mean slope, shape of the vineyard block, length-width ratio, headland size, training system and row spacing. We identified a sample of 3686 vineyards in Italy. Based on the above-mentioned parameters, vineyards were categorised by their level of mechanisability (l.m.) into four classes. Moreover, we analysed the correlation between l.m. and economic indicators (area planted with vineyard and wine production). Results showed that the main factors limiting the mechanisability potential of some Italian regions are the elevated slopes, horizontal training systems and narrow vine spacings. The l.m. showed a moderate positive correlation with the size of vineyards and the volume and value of production. The methodology presented in this study may be easily applied to other viticultural areas around the world, serving as a management decision-making tool.

DNA Methylation of FKBP5 as Predictor of Overall Survival in Malignant Pleural Mesothelioma.

Simple SummaryOur study is the first one to investigate DNA methylation changes in white blood cells (WBCs) from easily accessible peripheral blood as malignant pleural mesothelioma (MPM) survival biomarker. The Cox proportional hazards regression model highlighted that the methylation status of the CpG dinucleotide cg03546163 is an independent marker of prognosis in MPM patients with a better performance than traditional inflammation-based scores such as lymphocyte-to-monocyte ratio (LMR). Biological validation and replication showed that epigenetic changes at the FKBP5 gene were robustly associated with overall survival (OS) in MPM cases. The identification of simple and valuable prognostic markers for MPM will enable clinicians to select patients who are most likely to benefit from aggressive therapies and avoid subjecting non-responder patients to ineffective treatment.Malignant pleural mesothelioma (MPM) is an aggressive tumor with median survival of 12 months and limited effective treatments. The scope of this study was to study the relationship between blood DNA methylation (DNAm) and overall survival (OS) aiming at a noninvasive prognostic test. We investigated a cohort of 159 incident asbestos exposed MPM cases enrolled in an Italian area with high incidence of mesothelioma. Considering 12 months as a cut-off for OS, epigenome-wide association study (EWAS) revealed statistically significant (p value = 7.7 × 10−9) OS-related differential methylation of a single-CpG (cg03546163), located in the 5′UTR region of the FKBP5 gene. This is an independent marker of prognosis in MPM patients with a better performance than traditional inflammation-based scores such as lymphocyte-to-monocyte ratio (LMR). Cases with DNAm < 0.45 at the cg03546163 had significantly poor survival compared with those showing DNAm ≥ 0.45 (mean: 243 versus 534 days; p value< 0.001). Epigenetic changes at the FKBP5 gene were robustly associated with OS in MPM cases. Our results showed that blood DNA methylation levels could be promising and dynamic prognostic biomarkers in MPM.

Dietary patterns and oesophageal cancer: a multi-country latent class analysis

BackgroundThe considerable differences in food consumption across countries pose major challenges to the research on diet and cancer, due to the difficulty to generalise and reproduce the dietary patterns identified...

Direct healthcare costs of chronic kidney disease management in Italy: What cost-savings can be achieved with higher biosimilar uptake and more appropriate use of erythropoiesis-stimulating agents?

Erythropoiesis-stimulating agents (ESAs), are used for treating chronic kidney disease (CKD)-related anemia, contributing to CKD costs. The study was aimed at investigating direct healthcare costs of CKD patients treated with ESAs and the potential savings achievable by increasing the use of biosimilars and preventing inappropriate ESA use. A multi-center, cohort study was conducted using claims databases of five large Italian geographic areas. Yearly mean direct healthcare costs per patient were estimated, stratifying by CKD stage. The total yearly cost and potential savings related to ESA use were estimated: (a) considering 25/50/75% of originator ESA substitution with biosimilars; (b) eliminating inappropriate ESA dispensing. During the study period, the ESA-related yearly mean cost represented 17% of total yearly costs in stage I-III, decreasing to 13% in stage IV-V and 6% in dialysis. Among originator users, assuming a 25% of biosimilar uptake, the annual cost-savings of ESA treatment would represent 10.5% of total ESA costs in CKD stage I-V and 7.7% in dialysis. Among incident ESA users for which hemoglobin levels were available, 9% started inappropriately ESA treatment, increasing to 62.0% during the first year of maintenance therapy. Hypothesizing prevention of the first inappropriate ESA dispensing, the total yearly cost-savings would amount to €35 772, increasing to €167 641 eliminating the inappropriate dispensing during maintenance therapy. Higher use of lowest cost ESA, prevention of inappropriate ESA use as well as other strategies aimed at slowing down the progressive renal impairment are essential for minimizing clinical and economic burden of CKD.

Heritage Community Resilience: towards new approaches for urban resilience and sustainability

The value of cultural heritage and its transmission for “making cities and human settlements inclusive, safe, resilient and sustainable” is an integral part of the UN Agenda 2030 and the new international policy for Disaster Risk Reduction 2015–2030. Nonetheless, the role of culture for these important challenges is an issue that current scientific literature on resilience has not yet sufficiently investigated. Starting from the concept of Heritage Community, elaborated in the Council of Europe's Framework Convention on the Value of Cultural Heritage for Society (Framework convention on the value of cultural heritage for society, 2005), along with the hypothesis of its role for Community Resilience, this study elaborates a conceptual framework in which “Heritage Community Resilience” is defined. It is both a target and a process in which cultural heritage supports the building of a community able to prevent, cope with and recover from disturbances and/ or disasters. Through a survey of several case studies on heritage-driven practices in Italian inner peripheral areas, the research aims to define the specific characteristics of Heritage Community Resilience as well as identify any critical actors and variables, strategies and governance mechanisms, which influence both Heritage Community and Community Resilience. It predicts the challenges and highlights the potential that culture and heritage can develop for Community Resilience, towards further perspectives of resilient circular city.

Crises redefined: towards new spaces for social innovation in inner areas?

ABSTRACT This article explores the relationship between the emergence of a ‘crisis society', social innovation and community resilience in Italian inner areas. Arguing that the concept of ‘crisis society' – as a further development of a ‘risk society’ – can help to frame both the increasing of uncertainty and the possibility for social change, the paper outlines a theoretical reflection on how context of crisis can influence social arrangements and forms of solidarity. In particular, it proposes to adopt the analytical lenses of social innovation and community resilience to discuss the relation between crisis, local dynamism and collective action. Secondly, it identifies Italian inner areas as an interesting field of research were to analyse how innovative initiatives and narratives can emerge in context of crisis, with a special focus on the Covid-19 pandemic. Without denying the negative consequences of this crisis, this early research paper sheds light on how crisis can be redefined on a double level. Firstly, by opening new windows of opportunities for collective action and bottom-up resilience. Secondly, by reframing inner areas, usually represented as vulnerable territories, as spaces where the creative capacity of local community can emerge. Finally, the paper identifies further trajectories of investigation for empirical research.

Actors in Social Agriculture Cooperatives Combating Organized Crime in Southern Italy: Cultivating the Ground

Southern Italy suffers from a high poverty rate, unemployment, emigration flows, and a strong presence of organized crime in the field of agriculture. This study seeks to investigate the potential of social enterprises as driving forces for the legal and eco-social development of fragile Southern Italian areas. To work in such challenging contexts requires the development of a high level of resilience, which implies the ability to adapt to difficulties and to overcome crises by coming out stronger than before. The initiatives we detected in Southern Italy are examples for the strength that can come from ideal motivations. In the case of social agriculture initiatives in Southern Italy counteracting organized crime, these motivations are an indispensable condition for their survival and growth. The accumulation of problems and difficulties, however, risks corroding motivations of the actors. This can lead to the withdrawal of members, which can have a serious impact on these small organizations. Thus, idealism is a necessary condition to face the challenges of legal and social environmental development, but it is not sufficient on its own, except in the short term, to allow social enterprises to emerge from extremely precarious conditions. Idealism can support resilience, but by itself, it cannot create a sustainable change. There is, therefore, the need to invest in these social enterprises, in the training of the actors involved, and in the selection and acquisition of the skills for strengthening the efficiency and sustainability of businesses and to foster horizontal structures of mutuality and solidarity to create a supportive environment for these social enterprises and their mission.

Modeling Local BES Indicators by Copula-Based Bayesian Networks

In Italy, the measure of the Equitable and Sustainable Well-being is provided by the Italian Institute of Statistics by means of a dashboard of basic and composite indicators. To investigate the dependence structure between the different domains of well-being, we propose the use of Non-Parametric Bayesian Networks based on the normal copula distribution, that allow to explore the conditional independence relationships between the composite indicators. The main advantage of the non-parametric models is that, as opposed to the parametric approach, they do not require any assumption on the marginal distributions of the variables. The proposed model is applied to the Equitable and Sustainable Well-being indicators measured at the provincial level and enriches the analysis of well-being by inspecting similarities and differences between Italian urban areas and territories.