Total hip replacement is underutilized among elderly deprived individuals. Disadvantaged patients seem more vulnerable to acute adverse medical events after surgery. The evidence of unmet need and poor prognosis of low social class people has important implications for health care policy.

Background: Several studies have shown an association between nitrogen dioxide (NO2) and mortality. In Italy, the EpiAir multicentric study, “Air Pollution and Health: Epidemiological Surveillance and Primary Prevention,” investigated short-term health effects of air pollution, including NO2.Objectives: To study the individual susceptibility, we evaluated the association between NO2 and cause-specific mortality, investigating individual sociodemographic features and chronic/acute medical conditions as potential effect modifiers.Methods: We considered 276,205 natural deaths of persons > 35 years of age, resident in 10 Italian cities, and deceased between 2001 and 2005. We chose a time-stratified case-crossover analysis to evaluate the short-term effects of NO2 on natural, cardiac, cerebrovascular, and respiratory mortality. For each subject, we collected information on sociodemographic features and hospital admissions in the previous 2 years. Fixed monitors provided daily concentrations of NO2, particulate matter ≤ 10 μm in aerodynamic diameter (PM10) and ozone (O3).Results: We found statistically significant associations with a 10-μg/m3 increase of NO2 for natural mortality [2.09% for lag 0–5; 95% confidence interval (CI), 0.96–3.24], for cardiac mortality (2.63% for lag 0–5; 95% CI, 1.53–3.75), and for respiratory mortality (3.48% for lag 1–5; 95% CI, 0.75–6.29). These associations were independent from those of PM10 and O3. Stronger associations were estimated for subjects with at least one hospital admission in the 2 previous years and for subjects with three or more specific chronic conditions. Some cardiovascular conditions (i.e., ischemic heart disease, pulmonary circulation impairment, heart conduction disorders, heart failure) and diabetes appeared to confer a strong susceptibility to air pollution.Conclusions: Our results suggest significant and likely independent effects of NO2 on natural, cardiac, and respiratory mortality, particularly among subjects with specific cardiovascular preexisting chronic conditions and diabetes.

Background and Objective: Hot and cold temperatures significantly increase the risk of death in many regions of the world. Different measures of temperature, including minimum, maximum and apparent temperature, have been used in previous research. Which temperature measure is the best predictor of mortality is not known. Methods: We used mortality data from 106 cities in the US NMMAPS study (years 1987-2000). We examined the association between temperature and mortality using Poisson regression and fitted a non-linear spline for temperature. We examined five measures of temperature, the effect of including relative humidity, and various degrees of freedom for the temperature spline. The best model was defined as that with the minimum absolute residual. The residuals were calculated using crossvalidation. Results: Maximum temperature was selected as the best temperature measure the most often (40 cities in the Ն65-year age group), and apparent temperature the least often (8 cities in the Ͻ65-year age group). Maximum temperature was the best measure in 10 out of 12 months in both age groups. Geographically, maximum temperature was the best measure in cold regions, and minimum temperature in warm regions. Humidity was important in almost every city in the Ն65 year age group. The seasonal variation in humidity showed a surprising peak in usefulness in winter. Conclusion: Apparent temperature is no better than standard measures of temperature in predicting mortality. Maximum temperature was generally the best measure in cold climates and minimum temperature in warm climates. Humidity is an important predictor of mortality in the elderly and its effect should be estimated separately from temperature.

An important effect of PM10 on hospitalizations for cardiac diseases was found in Italian cities. Sex and older age were susceptibility factors.

Despite a rapid increase in immigration from low-income countries, studies on immigrants' mortality in Italy are scarce. We aimed to describe differences in all and cause-specific mortality among immigrants and Italians residing in Turin and Reggio Emilia (Northern Italy), two cities participating in the Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS). We used individual data from the municipal population registers linked to the cause of death registers. All people aged 1-64 years residing between 2001 and 2010 were enrolled (open cohort) and followed up until 2013. The mortality of citizens from high migratory pressure countries (as a whole, and for each macro-area group) was compared with that of Italians; differences were estimated by Poisson regression adjusted by age and calendar year mortality rate ratios (MRRs), and by age-standardized mortality ratios for the analysis of cause-specific mortality. Compared with Italians, immigrants had lower overall mortality (MRR for men: 0.82, 95 % CI: 0.75-0.90; for women: 0.71, 95 % CI: 0.63-0.81). Sub-Saharan Africans experienced a significant higher mortality than Italians (MRR for men 1.29, 95 % CI: 1.03-1.61; for women: 1.70, 95 % CI: 1.22-2.36). Higher mortality for immigrants compared to Italians was observed for infectious diseases, congenital anomalies, some site-specific tumours and homicide mortality. Our study showed heterogeneity in mortality across the macro-areas of origin, and in particular Sub-Saharan Africans seemed to be a vulnerable population. The extension to other cohorts of IN-LiMeS will allow the health status of immigrants and vulnerable groups to be studied and monitored in more depth.

Abstract. Due to their large worldwide adoption, Social Network Sites (SNSs) have been widely used in many global events as an important source to spread news and information. While the searchability and persistence of this information make it ideal for sociological research, a quantitative approach is still challenging because of the size and complexity of the data. In this paper we provide a first analysis of Friendfeed, a well-known and feature-rich SNS. Research frameworkSocial Network Sites (SNSs) are undoubtedly one of the most interesting phenomena that bring together new technologies and social practices. They are going through an incredibly fast growth all over the world despite the fact many obstacles like the digital divide still exist. Despite this global success it would be hard to define a single global leader of the SNSs. Facebook, which counts more than 300 million single users mostly clustered in Europe and in the US, is surely a big player but QQ, with a high concentration of users in China, has an even larger user base. It seems that cultural diversity and local identity lead toward the choice of a specific SNS, while the shift toward the adoption of a SNS-model for online interpersonal communications seems to be global [1].Due to this large worldwide adoption, SNSs have been widely used in many global events as an important source to spread news and information. From the terroristic attack in Mumbai in 2008 to the so-called Twitter revolution in Iran in 2009 SNSs proved several times to be a reliable way to communicate and to spread information in a quick and relatively efficient way. Within this scenario the sociological analysis of SNS based communication is still largely based on a qualitative ethnographic approach aimed at investigating living practices and uses of the SNS [2,3,4]. This approach gave us the opportunity to gain an effective insight in SNS users' lives, motivations and communicative strategies but failed in giving us a general description of how SNSs work and deal, as complex entities, with the diffusion of information.

ObjectiveTo assess whether recent declines in cardiovascular mortality have benefited all socioeconomic groups equally and whether these declines have narrowed or widened inequalities in cardiovascular mortality in Europe.MethodsIn this prospective registry-based study, we determined changes in cardiovascular mortality between the 1990s and the early 2010s in 12 European populations by gender, educational level and occupational class. In order to quantify changes in the magnitude of differences in mortality, we calculated both ratio measures of relative inequalities and difference measures of absolute inequalities.ResultsCardiovascular mortality has declined rapidly among lower and higher socioeconomic groups. Relative declines (%) were faster among higher socioeconomic groups; absolute declines (deaths per 100 000 person-years) were almost uniformly larger among lower socioeconomic groups. Therefore, although relative inequalities increased over time, absolute inequalities often declined substantially on all measures used. Similar trends were seen for ischaemic heart disease and cerebrovascular disease mortality separately. Best performer was England and Wales, which combined large declines in cardiovascular mortality with large reductions in absolute inequalities and stability in relative inequalities in both genders. In the early 2010s, inequalities in cardiovascular mortality were smallest in Southern Europe, of intermediate magnitude in Northern and Western Europe and largest in Central-Eastern European and Baltic countries.ConclusionsLower socioeconomic groups have experienced remarkable declines in cardiovascular mortality rates over the last 25 years, and trends in inequalities can be qualified as favourable overall. Nevertheless, further reducing inequalities remains an important challenge for European health systems and policies.

Our findings suggest that a fee-free population-based organized mammography screening programme with active invitation of the whole target population could be effective in reducing differences in survival in the population targeted by the screening.