Campania and cancer mortality: An inseparable pair? The role of environmental quality and socio-economic deprivation

The region of Campania in Southern Italy features high levels of socio-economic deprivation and low levels of environmental quality. A vast strand of the scientific literature has tried to verify whether poor environmental quality and widespread socio-economic deprivation might explain the high cancer mortality rates (CMRs) observed, especially in the municipalities – infamously labelled as the ‘Land of Fires’ – that were hit most severely by the crisis. While some studies managed to identify links between these two confounding factors and cancer mortality, the evidence is overall mixed. Interesting information may be drawn from the observation of municipal data: in spite of previous claims, some municipalities featuring high environmental quality and low socio-economic deprivation also display high CMRs, while other Campanian municipalities facing disastrous environmental and socio-economic conditions are characterised by low CMRs. These figures, in contrast to common sentiment and previous studies, need to be investigated thoroughly in order to assess the exact role of the confounding factors. In this work, we aim to identify the municipalities where confounding factors act as driving forces in the determination of high CMRs through an original multi-step analysis based on frequentist and Bayesian analysis. Pinpointing these municipalities could allow policymakers to design targeted and effective policy measures aimed at reducing cancer mortality

A Regional Perspective on Social Exclusion in European Regions: Context, Trends and Policy Implications

Social exclusion has become a popular topic in the policy agendas of European governments, especially after the global financial crisis of 2007–2009 hit the continent as hard as it could. The existing literature highlights the presence of spatial patterns in social exclusion, although previous contributions consist of local or national level studies, lacking a broader continental perspective. This work resorts to regional data covering 20 EU countries and aims to characterise the nature of spatial patterns, distinguishing between spatial heterogeneity and pure spatial autocorrelation. Using the Spatial Markov Chain Matrix, we find that the strong clusterisation process unfolded by previous studies tends to become less intense if the role of socio-economic covariates is taken into account. Socio-economic factors represent in other words a containment cage that reduces the extent of neighbour influence. Net of the covariates, we identify clusters of regions in Southern Europe where high levels of social exclusion constitute a structural problem, calling for long-term public intervention. The policy implications of our findings are then outlined

A Regional Perspective on Social Exclusion in European Regions: Context, Trends and Policy Implications

Social exclusion has become a popular topic in the policy agendas of European governments, especially after the global financial crisis of 2007–2009 hit the continent as hard as it could. The existing literature highlights the presence of spatial patterns in social exclusion, although previous contributions consist of local or national level studies, lacking a broader continental perspective. This work resorts to regional data covering 20 EU countries and aims to characterise the nature of spatial patterns, distinguishing between spatial heterogeneity and pure spatial autocorrelation. Using the Spatial Markov Chain Matrix, we find that the strong clusterisation process unfolded by previous studies tends to become less intense if the role of socio-economic covariates is taken into account. Socio-economic factors represent in other words a containment cage that reduces the extent of neighbour influence. Net of the covariates, we identify clusters of regions in Southern Europe where high levels of social exclusion constitute a structural problem, calling for long-term public intervention. The policy implications of our findings are then outlined

Corporate governance and sustainability in water utilities. The effects of decorporatisation in the city of Naples, Italy

The recent economic literature has largely investigated sustainability in the provision of public utilities, highlighting the role of governance models in the determination of economic results. Little attention however has been devoted to the social and environmental dimensions of sustainability. In Italy, a long‐lasting debate on governance structures in the water sector has been fuelled by scholars and policymakers for more than 30 years, whereas the first (and unique) experiment involving the return of full public management in water provision is taking place in the city of Naples. The present work analyses this peculiar case study, aiming to assess the effects of a major governance shift that occurred in the early 2010s—that is, decorporatisation—in terms of economic, social and environmental sustainability. We resort to a bundle of qualitative and quantitative techniques to address the research question and our exploratory results suggest that decorporatisation was overall beneficial: Although little changed in terms of economic sustainability, the social and environmental dimensions benefitted from the shift in governance

Language as a proxy for cultural change. A contrastive analysis for French and Italian lexicon on male homosexuality

Discrimination against LGBT people represents a significant and long-standing societal problem that occurs in several forms, including lexical discrimination, which consists in frequent usage of discriminatory epithets. Lexical discrimination produces a vicious circle where speakers grow subconsciously accustomed to abusive language and marginalisation becomes institutionalised. A vast literature has tackled lexical discrimination, providing several country-level studies. The cases of France and Italy are described as very different: while the French experience is centred around grassroot mobilisation, Italy features a traditional strategy of silence. This work aims to verify such difference empirically. Using a rich and detailed dataset, we apply time series analysis on the frequencies of usage of the terms that characterise male homosexuality. Our results highlight some similarities and some differences between the French and the Italian case, stressing the importance of lexical resemantisation that occurred in France but not in Italy

Knotless PEEK and double-loaded biodegradable suture anchors ensure comparable clinical outcomes in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study

Purpose: To compare the clinical outcome of arthroscopic capsulolabral repair for traumatic anterior shoulder instability with PEEK knotless and knotted biodegradable suture anchors. Methods: Arthroscopic stabilization was performed in 78 patients with recurrent traumatic anterior shoulder instability. They were divided into 2 groups of 39 patients each, according to suture anchors used: knotless PEEK anchors in group 1, and biodegradable anchors in group 2. Exclusion criteria were: instability without dislocation, posterior or multidirectional instability, glenoid bone loss > 20%, off-track lesions, concomitant rotator cuff tears and previous surgery. The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) self-administered questionnaire. Secondary outcomes were: Work-DASH, Sport-DASH, Rowe score, recurrent instability and subsequent surgery. The following independent variables were considered: age, gender, dominance, generalized ligamentous hyperlaxity, duration of symptoms, age at first dislocation, number of dislocations, type of work, type of sport, sports activity level, capsule-labral injury pattern, SLAP lesion and number of anchors. Differences between groups for numerical variables were analyzed by use of the Student’s t-test or Mann–Whitney U-test. Fisher’s exact test was used for analysis of categorical variables. Significance was set at p < 0.05. Results: Seven patients (9%) were lost at follow-up, 5 from group 1 and 2 from group 2. Follow-up ranged from 36 to 60 months (median: 44; IQR: 13). Comparison between groups did not show significant differences for each independent variable considered. No differences could be found either for DASH (n.s.) or Rowe (p = n.s.) scores between the two groups. Overall recurrence rate was 7%. Three re-dislocations were reported in group 1 and two in group 2 (n.s.). Only one patient in each group underwent re-operation. Conclusions: The study showed no significant differences in clinical outcomes after arthroscopic treatment of traumatic anterior shoulder instability using PEEK knotless or biodegradable knotted anchors at mid-term follow-up. Level of evidence: I

SPADA: A project to study the effectiveness of shielding materials in space

The SPADA (SPAce Dosimetry for Astronauts) project is a part of an extensive teamwork that aims to optimize shielding solutions against space radiation. Shielding is indeed an irreplaceable tool to reduce exposure of crews of future Moon and Mars missions. We concentrated our studies on two flexible materials, Kevlar R� and Nextel R,� because of their ability to protect human space infrastructures from micrometeoroids. We measured radiation hardness of these shielding materials and compared to polyethylene, generally acknowledged as the most effective space radiation shield with practical applications in spacecraft. Both flight test (on the International Space Station and on the Russian FOTON M3 rocket), with passive dosimeters and accelerator-based experiments have been performed. Accelerator tests using high-energy Fe ions have demonstrated that Kevlar is almost as effective as polyethylene in shielding heavy ions, while Nextel is a poor shield against high-charge and -energy particles. Preliminary results from spaceflight, however, show that for the radiation environment in low-Earth orbit, dominated by trapped protons, thin shields of Kevlar and Nextel provide limited reduction

Soft tissue non-Hodgkin lymphoma of shoulder in a HIV patient: a report of a case and review of the literature

The risk of developing lymphoma is greatly increased in HIV infection. Musculoskeletal manifestations of the human immunodeficiency virus (HIV) are common and are sometimes the initial presentation of the disease. Muscle, bone, and joints are involved by septic arthritis, myopathies and neoplasms. HIV-related neoplastic processes that affect the musculoskeletal system include Kaposi's sarcoma and non-Hodgkin's lymphoma, the latter being mainly localized at lower extremities, spine and skull

Stiffness in total knee arthroplasty

Stiffness is a relatively uncommon complication after total knee arthroplasty. It has been defined as a painful limitation in the range of movement (ROM). Its pathogenesis is still unclear even if some risk factors have been identified. Patient-related conditions may be difficult to treat. Preoperative ROM is the most important risk factor, but an association with diabetes, reflex sympathetic dystrophy, and general pathologies such as juvenile rheumatoid arthritis and ankylosing spondylitis has been demonstrated. Moreover, previous surgery may be an additional cause of an ROM limitation. Postoperative factors include infections, arthrofibrosis, heterotrophic ossifications, and incorrect rehabilitation protocol. Infections represent a challenging problem for the orthopaedic surgeon, and treatment may require long periods of antibiotics administration. However, it is widely accepted that an aggressive rehabilitation protocol is mandatory for a proper ROM recovery and to avoid the onset of arthrofibrosis and heterotrophic ossifications. Finally, surgery-related factors represent the most common cause of stiffness; they include errors in soft-tissue balancing, component malpositioning, and incorrect component sizing. Although closed manipulation, arthroscopic and open arthrolysis have been proposed, they may lead to unpredictable results and incomplete ROM recovery. Revision surgery must be proposed in the case of well-documented surgical errors. These operations are technically demanding and may be associated with high risk of complications; therefore they should be accurately planned and properly performed

Reliability of forced internal rotation and active internal rotation to assess lateral instability of the biceps pulley

PURPOSE: the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). METHODS: a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. RESULTS: the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. CONCLUSIONS: painful FIR in the presence of a postero-superior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. LEVEL OF EVIDENCE: level I, validating cohort study with good reference standards