A case-control study on risk factors of domestic accidents in an elderly population.

The aim of this study was to evaluate the combined influence of several lifestyle, health and housing factors in the occurrence of home injuries (HIs) among the elderly. The subjects were recruited from 10 hospitals in Rome, Italy. This study is a paired case-control study. Cases included subjects, aged 65-85 years, who visited the Emergency Department for an HI and were subsequently hospitalised (15 September 2004-30 June 2005). Controls were the subjects of the same gender, age (±3 years) and area of residence of cases. A conditional logistic regression model was used for analysing the variables obtained. In this study, we enrolled 107 hospitalised cases. It was found that the living room was the place where 33% of the accidents occurred. Eighty-seven per cent of the accidents were falls, and 33% of the accidents were the immediate consequence of sudden malaise. One-half of the cases reported one or more leg fractures. The variables that were independently associated with HI were poor household illumination, poor emotional status, regular physical activities and housekeeping activities. We conclude that this study shows the areas of intervention to target HI prevention activities.

Defining a common set of indicators to monitor road accidents in the European Union.

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.

[Feasibility of behavioural interventions for tobacco smoking cessation in routine general practice]. / Intervento motivazionale del medico di medicina generale nel processo di disassuefazione dal fumo di tabacco.

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.

Satisfaction with health care among dermatological inpatients.

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.