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Abstract Background currently road accidents are mostly monitored through mortality and injury rates. This paper reports the methodology and the results of a project set forth by the European Union (EU) and coordinated by the WHO aimed at identifying and evaluating a core set of indicators to monitor the causal chain of road accident health effects. The project is part of the ECOEHIS (Development of Environment and Health Indicators for European Union Countries). Methods a group of experts (WG), identified 14 indicators after a review of the information collected at the EU level, each of them representing a specific aspect of the DPSEEA (Driving, Pressure, State, Exposure, Effect, Action) model applied and adapted to the road accidents. Each indicator was scored according to a list of 16 criteria chosen by the WG. Those found to have a high score were analysed to determine if they were compatible with EU legislation and then tested in the feasibility study. Results 11 of the 14 indicators found to be relevant and compatible with the criteria of selection were proposed for the feasibility study. Mortality, injury, road accident rate, age of vehicle fleet, and distance travelled are the indicators recommended for immediate implementation. Conclusion after overcoming the limitations that emerged (absence of a common definition of death by road accident and injury severity, underestimation of injuries, differences in information quality) this core set of indicators will allow Member States to carry out effective internal/external comparisons over time.

Cigarette smoking is the single most important preventable cause of death and illness. Smoking cessation is associated with substantial health benefits, but weight gain after smoking cessation is perceived to be a barrier against quitting smoking. The aim of the study was to analyse predictors of weight gain after smoking cessation. The sample included 1067 residents, aged 18-70 years, in a health district of Rome who answered to an anonymous postal questionnaire. Among them 482 were former smokers; 398 provided lifetime histories of both body weight and smoking and were considered in the analysis. 52.5% (49.3% M; 60.5% F) reported weight gain after smoking cessation; among these 25.4% reported a weight gain > or =5 kg. The multivariate logistic regression analysis showed a direct association between female gender (OR 1.9, CI 95% 1.1-3.2), age - 45 years (45-65 years: OR 2.5, CI 95% 1.4-4.4; > 64 years OR 2.1, CI 95% 1.0-4.0), number of cigarettes per day >20/day (OR 3.8, CI 95% 1.3-11.5) and weight gain after smoking cessation. The relevance of weight gain following smoking cessation suggests that health benefits associated with smoking cessation may to some extent be negated by the detrimental effects on health of associated weight gain. Smoking cessation programmes should therefore consider incorporating follow-up support to prevent weight gain; regular measurements of body weight together with dietary indications and increase of physical activity are basic factors to implement in the intervention of smoking cessation.

The aims of this study were: 1) to evaluate a training course on smoking cessation techniques offered to general practitioners of the RMB Local Health Unit (Rome, Italy) 2) to evaluate the feasibility of delivering brief counseling interventions during routine primary care practice and 3) to evaluate factors associated with modification of smoking habits. In total, 166 GPs participated in the training courses. Of these 60 GPs (36.1%) voluntarily agreed to take part in the study. A total of 3280 patients were enrolled and given a brief counseling intervention ("ask-advise"). Six months later the same patients were asked to complete a questionnaire, 24% responded. Approximately 24% of those who responded had quit smoking and over 43% had either reduced the number of cigarettes or attempted to quit. Of the subjects who modified their smoking behaviour (quit, attempted to quit, or reduced the numbers of cigarettes smoked) following the "ask-advise" intervention, 10% had also used drug therapy, while approximately 4% did so only with their doctor's assistance. Smoking cessation interventions incorporated into routine consultations in general practice are feasible and relevant from a public health perspective.

Background: currently road accidents are mostly monitored through mortality and injury rates. This paper reports the methodology and the results of a project set forth by the European Union (EU) and coordinated by the WHO aimed at identifying and evaluating a core set of indicators to monitor the causal chain of road accident health effects. The project is part of the ECOEHIS (Development of Environment and Health Indicators for European Union Countries)., Methods: a group of experts (WG), identified 14 indicators after a review of the information collected at the EU level, each of them representing a specific aspect of the DPSEEA (Driving, Pressure, State, Exposure, Effect, Action) model applied and adapted to the road accidents. Each indicator was scored according to a list of 16 criteria chosen by the WG. Those found to have a high score were analysed to determine if they were compatible with EU legislation and then tested in the feasibility study., Results: 11 of the 14 indicators found to be relevant and compatible with the criteria of selection were proposed for the feasibility study. Mortality, injury, road accident rate, age of vehicle fleet, and distance travelled are the indicators recommended for immediate implementation., Conclusion: after overcoming the limitations that emerged (absence of a common definition of death by road accident and injury severity, underestimation of injuries, differences in information quality) this core set of indicators will allow Member States to carry out effective internal/external comparisons over time.

Objectives: To evaluate satisfaction with care for psoriatic inpatients. Identify areas in need of interventions and actions to improve the satisfaction with care., Methods: We analyzed 133 patients with psoriasis and 335 patients affected by other dermatological diseases in their first access at the hospital. Six determinants of satisfaction with care were investigated with a self administered questionnaire. Moreover the overall satisfaction was documented. Descriptive analysis and a multiple logistic regression analysis correcting for confounding factors were performed. Focus groups were conducted with patients to further investigate about specific aspects of relationships between patients and personnel., Results: Psoriatic inpatients were less satisfied than other dermatological inpatients regarding Coordination of care, Information and education, Emotional support. Emotional support was the determinant with the smallest percentage of satisfied patients. Focus groups confirmed what was identified with the questionnaire and suggested necessary interventions., Conclusions: It is necessary to improve the communication skills of health personnel. Information for patients need to be enhanced and the management of psoriatic patients has to be improved.

Measuring patient satisfaction is regarded as one of the principal methods for obtaining patients' evaluation of services they receive. During the last decades more interest has been devoted to inpatients' preferences and needs. Surveys on patient satisfaction may provide information to hospitals about areas where improvement is needed. In this survey, 648 questionnaires were completed by dermatological inpatients and were analyzed for overall satisfaction and seven satisfaction determinants. Background factors and clinical parameters were considered. Emotional support was recognized as a critical area. "Coordination of care" and "information and education" were identified as the most relevant determinants for overall patient satisfaction. The Hospital Management, taking into account the results, planned training in order to improve personnel's communication skills. This study confirms that patient satisfaction analysis is a useful instrument also among dermatological inpatients, and satisfaction is a valid measure of quality of health care.

Unlabelled: Our study aimed at both assessing the efficacy of the same training course in different contexts and training course repeated in the same context. We examined the most critical aspects, on which to develop further aimed course. In 1998 the Laboratory of Environmental Microbiology of the Institute of Hygiene (UCSC) has implemented 2 professional training courses both for food handlers of a refectory (course A) and of a hospital canteen (course B). Two years after a following course (C) in the hospital canteen. At the beginning and at the end of every course a questionnaire of 25 questions has been gathered in five areas. The data drawn by the questionnaires have been compared using the percentage of exact answers before and after the course. Correct answers beginning and end course: A 89% and 94%, B 68% and 77%, C 76% and 78%. The correct answers beginning course C and end course B are not significatively different (p = 0.1963). Critical areas of the C and B courses have been "microbiological risks" and "correct temperatures"; at the end of the training both the areas had sensitive improvements (C 40% to 59%, 60% to 78%-B 31% to 69%, 45% to 78%)., Conclusion: Food handlers professional training have been effective both in the same context and in a different context; the training should be based on both the operator's knowledge and difficulties met during the training; knowledge obtained by training is kept unchanged for some years, and it is supposed to repeat the course after one or two years; the analysis of the areas has confirmed the existence of critical problems, common causes of epidemics in collective catering services.