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Objective: We wanted to primarily examine the knowledge, attitudes and behaviour of parents and health workers (community nurses and paediatricians) regarding child injuries in order to understand the essence of the problem and to find out the most common misconceptions. Methods: Respondents were tested through an anonymous, self-administered questionnaire and all p values below 0.05 were considered significant. Results: Of all respondents, paediatricians answered accurately most of the questions considering knowledge than the other groups. More than 90% of respondents, in all groups, identified correct answers to 10 questions about attitudes towards child injury prevention and safety promotion. Conclusion: This study, which shows the current level of knowledge, attitudes and behaviour patterns of parents and health professionals in Croatia, could help in the preparation of appropriate prevention programmes.

This paper seeks to outline the challenges of tobacco consumption control in the transitional economy of Bulgaria. It focuses on issues of taxation, high unemployment, and smuggling while attempting to meet European Union (EU) requirements for tobacco control legislation that reduces smoking consumption. The issue of tobacco control is not a simple one and requires a multi-pronged approach. While Bulgaria has made some progress in adopting legislation, it needs to strengthen its efforts in terms of enforcement, stronger legislation and increased taxation of cigarettes.

Objective: As HIV/AIDS prevalence rises in Eastern Europe, assessment of local epidemics in the bordering Central European region, especially South Eastern Europe, is vital in order to meet treatment and prevention needs. Understanding current medical and social needs and barriers to care experienced by HIV-positive patients in these regions may provide insight into how to best respond to the local epidemics, increase patients' access to treatment, and reduce loss to follow-up. Design: This study assesses the patient characteristics, barriers to care, and current medical and social needs of HIV-positive patients in Albania. Semi-structured interviews were used in this cross-sectional study. Methods: We interviewed 79 of 85 patients (93% response rate) followed at the University Hospital Center of Tirana (UHCT) HIV/AIDS Ambulatory Clinic, which represented the majority of patients under HIV care in Albania during 2009. Results: The local HIV epidemic seems to be comprised mainly of heterosexual men who have spent an average of 3.6 years abroad. The vast majority of patients under care at UHCT HIV/AIDS Ambulatory Clinic had experienced barriers to care associated with social stigma (97.4%), lack of knowledge of HIV medical care (76.6%), and medical provider's lack of knowledge of HIV (70.9%). Social needs of the patients were also overwhelmingly unmet (90.0-95.7%). Conclusions: In addressing HIV/AIDS in Albania, it will be crucial to educate the healthcare sector in ways to identify and address barriers to care and current medical and social needs of HIV-positive patients.

Objectives: Health status is represented by people's subjective assessment of their sense of well-being and ability to perform social roles and has been well accepted as a health indicator of different populations. The aim of this study was to determine health-related quality of life in Slovenian population. Methods: We performed a cross-sectional postal survey in a random stratified sample of 1,000 adult Slovenian inhabitants. The questionnaire consisted of the respondents' demographic data (sex, age, education level, employment status, living environment), self-reported chronic conditions, self-reported use of health services and EQ-5D instrument for measuring quality of life. Results: The response rate was 41% (53.1% men, mean age 51.5 years). Respondents reported most problems in the pain dimension of EQ-5D (59.3%), following by mobility (30.4%), anxiety/depression (30.3%), daily activities (29.8%) and self-care (9.0%). At least one moderate problem was reported by 272 (66.3%) respondents. Independent factors, associated with problems in any EQ-5D dimension were primary and vocational education, older age, high blood pressure, rheumatic diseases, back problems, anxiety/depression, a visit to the emergency department in the past year, and a house visit from a family doctor in the past year. Conclusions: The present study showed that the health-related quality of life of the Slovenian inhabitants is lower than the one found in some other European countries. This finding is surprising and also worrying. Because we cannot find any perceptible reason for this observation, larger and prospective studies are needed to confirm those results and to determine the reasons for that.

Background: The aim of this study was to compare socioeconomic characteristics of the Roma population living in Roma settlements with the majority population. Moreover, it was aimed to assess socioeconomic differences in health and health-related behaviour within the population living in Roma settlements. Methods: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Roma in selected settlements were recruited by local Roma community workers. Respondents from the major population were randomly selected from a list of patients from general practitioners. Data were collected via questionnaire, anthropometric measures and analysed blood samples. Differences in socioeconomic characteristics between the population living in Roma settlements and the majority population were tested using the chi-square test. The contribution of selected socioeconomic characteristics on health and health-related behaviour of the population living in Roma settlements was assessed by logistic regression models adjusted for age and gender. Results: The population living in Roma settlements is characterised by significantly lower socioeconomic standards, and the living conditions are significantly worse compared with the majority. With few exceptions, the study did not confirm any significant association between socioeconomic indicators and health and health-related behaviour within the population living in Roma settlements. Conclusions: The deteriorating effect of living in Roma settlement on health and health-related behaviour seems to be immense regardless differences in socioeconomic characteristics or living condition within the settlement population.

Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health policy. Methods: Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. Results: No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers, a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

The study analysed occupational diseases in the Czech Republic from the viewpoint of occupational medicine and medical geography. It used a dataset consisting of 32,646 cases of occupational diseases reported during the period of 1994-2013. The descriptive part of the study analysed occupational diseases according to their spatial distribution, occurrence in different branches of economic activities, employees' gender, and according to chapters of the List of occupational diseases. The incidence of occupational diseases showed an overall decreasing trend, which can be related to several factors - transformation of the national economy (shift from heavy industry to manufacturing industry and services), an improvement in access to occupational healthcare services, increased responsibility of employers for safe working conditions, but also a concealment of health problems by employees for fear of losing job. An exception to the decreasing trend is the automotive industry, in which the upward trend in occupational diseases occurrence was noted. The analytical part of the study focused on the relation between unemployment and occupational diseases incidence rates in different regions of the Czech Republic. In most regions, a statistically significant inverse association was shown between the rate of unemployment and occupational disease incidence. The situation is described in more detail for the Moravia-Silesia and Ústí nad Labem Regions and the Capital City of Prague, wherein a statistically significant inverse association was shown between the rate of unemployment and occupational disease incidence. The theory of marginal utility can explain the phenomenon. To certain degree of health problems, employees tend to prefer employment stability, especially if the unemployment is on rise in their region. On the other hand, if losing their job, they often try to claim benefits connected with occupational diseases.

Background: Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare. Methods: The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests. Results: A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p=0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%). Conclusion: Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is necessary.

Background: We aimed to evaluate the computer usage patterns of adolescents and to determine the effects of family life and parental attitude on these patterns. Methods: This was a descriptive, cross-sectional, population-based survey that included 935 children between 11 and 16 years of age who were students in the second level of primary school and their parents as well. The following instruments were used in the survey: student and parent questionnaires on computer usage patterns and the Parental Attitude Research Instrument (PARI) to assess parental attitudes towards child-rearing and family life. Results: Of the study population, the majority of the students had a computer in their homes and spent a lot of time on the Internet. Parental control over the amount of time spent on the Internet and the websites that were visited had sometimes limited and contradictory effects on computer usage among the students. A democratic parental attitude was the best approach. Using the computer as a reward or punishment had a negative impact on the children's computer usage patterns. Conclusions: Although parents are confused concerning the benefits and harms of the Internet for their children and not certain how to manage their children's use of the computer and safe navigation of the Internet, a democratic parental attitude appears to be the best approach for reaching the most beneficial computer usage patterns for students.

The 21st-century health landscape is shaped by growing global, regional and local interdependence and an increasingly complex array of interlinking factors that influence health and well-being. Most of today's major public health challenges, including noncommunicable diseases, antimicrobial resistance, health inequalities and the health effects of austerity measures in some countries, cannot be addressed effectively without intersectoral and coordinated action at supranational, national and local levels. The 53 countries of the WHO European Region developed and adopted a European policy framework and strategy for the 21st century (Health 2020) as a common, evidence-informed policy framework to support and encourage coordinated action by policy-makers at all levels and in all sectors to improve population health and well-being. This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, we describe what is needed to successfully implement Health 2020 in countries and how can WHO provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework.

The first objective is to project obesity trends to 2030 based on the current data from Poland. The second objective is to test the effect of a 1% or 5% decrease in population BMI upon future incidence and prevalence of related non-communicable diseases. A two-stage modelling design projecting overweight and obesity trends and related diseases in a microsimulation model was developed. Epidemiological data for entry into a microsimulation model were gathered from Poland. This study used population level data from Poland creating a virtual population within a microsimulation model. Obesity and overweight in Poland was found to increase to very high levels in men while trends remained unchanged in women. In a country that currently has about 38 million inhabitants, it is anticipated that by 2030, there might be more than 9 million new cancer cases; 10 million CHD and stroke cases, and 7 million new cases of type 2 diabetes. These findings have policy implications highlighting the need for action to curb trends and to reduce increases in the rates of diet-related non-communicable disease.

The aim of this study was to assess the risk factors in the origin of lethal or surgically corrected isolated atrial septal defect secundum. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities (conducted between 1980 and 1996) comprised 472 atrial septal defect secundum cases, 678 matched controls and 38,151 available controls without any defects; in addition, 21,022 malformed controls with other isolated defects. Medically recorded chronic disorders in the prenatal maternity logbook were evaluated, while acute maternal diseases, drug treatments and pregnancy supplements were analyzed on the basis of both prospective medically recorded data and retrospective maternal information. Acute pelvic inflammatory disease, paroxysmal supraventricular tachycardia and phenolphthalein treatment due to severe constipation of mothers were shown to contribute to the development of atrial septal defect secundum of their children. High doses of folic acid in early pregnancy had positively influenced a minor part of isolated atrial septal defect secundum in foetuses. In conclusion, the obvious genetic predisposition for atrial septal defect secundum is connected with maternal paroxysmal supraventricular tachycardia and triggered by acute pelvic inflammatory diseases and phenolphthalein treatment, while the manifestation of atrial septal defect secundum can be reduced by high doses of folic acid supplementation in early pregnancy.

The sand core making process is performed manually in West Bengal involving a large number of workers of lowest economic strata. The core making workers most often work for a prolonged period of time and they are forced to handle various amounts of heavy load during the entire period of work. In this study an attempt was made to identify the work related musculoskeletal disorders among the sand core-making workers. Fifty male workers engaged in carbon dioxide and chemical core making work at an unorganized sector at Baruipur, Calcutta were randomly selected for this study. A detailed modified Nordic questionnaire study on discomfort feeling was performed among the core making workers. REBA method was applied to analyze the working posture. Finally, discomfort level and risk level of the individual working postures were calculated by the use of risk level and discomfort level scale. From the questionnaire study it was revealed that most of the core making workers grind often in awkward postures. The workers were affected by musculoskeletal disorders like pain at low back (100%), hand (40%), shoulder (30%), wrist (20%) and neck (20%). It has been also found that there is a significant (p<0.05) correlation between discomfort level and risk level of the individual working postures of the workers. It was concluded from the study that health of the core-making workers was highly affected by different awkward postures and that they suffer from posture-related musculoskeletal disorders primarily affecting the low back region.

A neighborhood environment allows defining typical features for physically active or inactive lifestyle. An accelerated pace of life and higher availability of an unhealthy lifestyle increase obesity rates. An analysis of body composition can be used as a predictor for assessment of current somatic conditions. The aim of the study was to determine the dependence of selected body composition parameters on neighborhood walkability in 167 women aged 20-60 years attending weight-loss programme called STOB-courses. A multifrequency bioimpedance analysis InBody 720 was used to determine the body composition of respondents. Further, ANEWS questionnaire was used to determine the level of neighborhood walkability. We divided the sample into two age groups (<40 years; ≥40 years) and into partial subgroups according to the neighborhood "level of walkability" (lower and higher level). Based on the assessment of body composition, it can be assumed more walkable neighborhood opportunities positively affect body composition. Body composition in older women is positively influenced if they lived in high walkable areas. In younger women we found only one indicator of body composition (body fat mass) influenced by neighborhood walkability. The relationship between health indicators of body composition and residential infrastructure might be useful in strategies aimed at maintaining and developing a healthy lifestyle within the community.

Background: Throughout Europe, differences in satisfaction with HIV-care of people living with HIV (PLHIV) persist, despite a tendency towards harmonisation of policy and management. Methods: A European sample of 1,549 PLHIV responded to an anonymous questionnaire assessing demographic background, general health, mental health, sexual health, and HIV-service provision. We compared the results across 3 regions: Western, Southern and Central/Eastern Europe. Results: PLHIV differed in several socio-demographic variables (gender, migrant status, sexual orientation, and financial situation) as well as specific psychosocial aspects (HIV-related discrimination, satisfaction with sexual and reproductive health (SRH) services in HIV-care settings, and complaints about service provision). Using multivariate analysis, a predictive model for satisfaction with SRH services in HIV clinics was developed, resulting into region of residence, and participants' satisfaction with their own health status as significant predictors. Conclusions: Better integration of SRH services in HIV-care should be encouraged. Service providers should be trained and encouraged to discuss SRH issues with their patients to create a supportive environment, free of discrimination. More time should be allocated to discuss SRH issues with individual patients.

Objectives: The aim of the study is to describe attitudes which underlie Pole's declarations of support for a smoking ban in public places. Methods: The qualitative study using semi-structured individual in-depth interviews was conducted. The 30 IDI-s (in depth interviews) being a part of a larger research project entitled 'Lay meanings of health and life orientation of Polish society versus prevention and health promotion attitudes' were realized between 2007-2009. People belonging to all key socio-demographic categories identified by variables such as sex, age, education, and place of domicile were interviewed. The resulting material was subjected to content analysis. In the study the structural concept of 'attitude' was adopted. In order to identify the attitudes towards smoking bans in public places statements related to all three components of attitudes were analysed, but the typology of attitudes was constructed mainly on the basis of the emotional-evaluative component. Results: The study identified as many as four attitudes behind the declared support for a smoking ban in public places. Those attitudes were labelled 'supportive', 'accepting', 'conditionally accepting', and 'ambivalent'. They differ as regards degree of acceptance for the ban, conviction about harmfulness of passive smoking, setting great store by other regulators of smoking like cultural norms or healthy consciousness, and propensity to observe and execute the smoking ban. The 'supportive' attitude can be characterized not only by total support for the smoking ban in public places but also by insistence on the need for its extension. The 'accepting' attitude means approval for the smoking ban, and the 'conditionally accepting' attitude is distinguished from the others by the stress put on the right of smokers to have an access to places where smoking is permitted. The 'ambivalent' attitude can be typified by underlining other than legal ways of influencing smoking in public places. Conclusions: The study suggests that the attitudes underlying the Pole's declarations of support for a smoking ban in public places can be differentiated. However, because of the low number of participants in the study the results should be verified thus the further research is needed. Therefore, there is a need not only to study people's declaration of support or objection for the smoking ban in public places but also to examine their attitudes including cognitive and behavioural components using both qualitative and quantitative methods of social research.

Occupational safety and health (OSH) is an area concerned with protecting the safety, health and welfare of people engaged in work or employment. Successful and productive companies around the world look after the safety and health of their workers and follow certain principles of good practice for the prevention of occupational accidents and diseases. Massey University of New Zealand hosted in February 2013 interdisciplinary conference "Understanding small enterprises" (USE Conference). Conference had a dual aim of improving both well-being of the worker (healthy working lives) and equally of the business (healthy business). This contribution represents commentary on the Second Global Interdisciplinary Conference "Understanding small enterprises" in Nelson, New Zealand, 19-22 February 2013.

Child survival is the focus of the fourth Millenium Developmental Goal (MDG4). This paper describes levels, trends, and differentials in Under-Five Mortality Rate (U5MR) and also summarizes state programmes in Turkey between 1988 and 2010. Turkey is among only a few countries that have already surpassed MDG4 and have reduced their under-five mortality rate by more than two-thirds. In 2010, 13 out of every 1,000 children died before their fifth birthday. Low birth weight, high-birth order, short birth intervals, rural residence, low level of maternal education and lowest wealth quintile have affected negatively children's chances of survival. Expanding the scope of free vaccination programmes for children, improving screening and disease prevention schemes aimed at children, encouraging breastfeeding, implementing an emergency obstetric care programme, improving the services provided to newborns (a newborn intensive care programme) have brought about a significant decrease in the rate of infant and under-five mortality. The implementation of state and region specific action plans should be necessary to increase the chance of an access to the Continuum of Care for each mother and infant and to surpass MDG4.

Background: The proportion of occupational infectious diseases (ID) in the total number of occupational diseases reported in the Slovak Republic (SR) and the Czech Republic (CR) was decreasing from 1973 to 2010. Our study presents a longitudinal analysis of the occurrence of occupational infectious diseases in the Slovak Republic and the Czech Republic in the period from 1973-2010 with special focus on viral hepatitis. Methods: The sources of data were national health statistics of Czechoslovakia, the Czech Republic and the Slovak Republic. Descriptive statistical methods were used for data analysis. Incidence rate of reported diseases was calculated per 100,000 general population or per 100,000 people insured. Results: During the studied period, a total of 2,931 and 8,318 cases of occupational viral hepatitis (VH) were reported in the Slovak Republic and the Czech Republic, respectively. The incidence culminated in the late 1970s when hepatitis represented almost 50% of all reported occupational infectious diseases. Most cases of occupational hepatitis occurred in health and social services. Since the early 1980s, a steep decrease in the incidence of hepatitis has been observed due to the gradual implementation of mandatory vaccination against hepatitis A and B in risk groups. In SR in 1973, the incidence rate of occupational infectious diseases and that of occupational viral hepatitis was 10.85/100,000 and 1.86/100,000, respectively. In 2010, these rates decreased to 0.74/100,000 and 0.20/100,000, respectively. In CR, the incidence rates of occupational infectious diseases and that of occupational viral hepatitis reported in 1973 were 11.75/100,000 and 3.69/100,000. In 2010, reported incidence rates were 1.71/100,000 and 0.10/100,000, respectively. Conclusion: Although the incidence of occupational viral hepatitis has dramatically decreased in the Slovak and the Czech Republic as well as in other Visegrad group countries during the studied period, we emphasize the necessity of continuing epidemiological surveillance of hepatitis, especially with regard to the recent incidence increase of viral hepatitis C.

This article investigates elements of tobacco control issues in Romania. Using European Union requirements for tobacco control legislation as a backdrop, it examines the key issues of smuggling, taxation, and unemployment in a transitional economy. Romania has made some progress by adding text and pictorial warnings to cigarette packages and offering comprehensive help to quit smoking. Using empirical examples, it is argued that more progress in tobacco control is needed in the area of increased taxation, enforcement of non-smoking bans, and new legislation requiring advertising bans at point of sale, kiosks, and billboards. This article draws wider public attention to the problems that smuggling and taxation present for tobacco control, helps identify other countries confronting similar issues, and stimulates effective interventions.

Objective: We examined the effect of a 6-month combined aerobic and resistance training programme on cardiometabolic risk factors in non-diabetic subjects and compared its effectiveness when executed under strict professional supervision or without direct supervision. Methods: Eighty-five sedentary, non-diabetic subjects (27 men and 58 women), mean age 47.5±0.6 years, mean body mass index (BMI, 33.8±0.6 kg/m²) participated in a combined exercise programme assigned to supervised (S, n=31), non-supervised (NS, n=24) or control group (C, n=30). Cardiometabolic risk parameters were assessed at baseline and after the 6-month training. Results: In both the S and NS group there was a significant decrease in BMI (-1.6±0.3, p<0.001 and -1.0±0.3 kg/m², p=0.004), waist circumference (-10.1±1.1 cm, p<0.001 and -7.8±0.8 cm, p<0.001), fat mass (-1.8±0.4%, p<0.001 and -2.1±0.6%, p=0.003), and a significant increase in fat-free mass (+1.7±0.4%, p<0.001 and +2.0±0.7%, p=0.008), and aerobic capacity (+6.9±1.1, p<0.001 and +6.9±0.8 ml/kg per min, p=0.008). Fasting glucose did not change in S and NS, but increased in C (p=0.048). In the S group a significant decrease in fasting insulin (p<0.001), homeostasis model assessment of insulin resistance (p<0.001), highly sensitive C-reactive protein (p=0.004), leucocytes count (p=0.04), systolic high (p<0.001) and diastolic (p=0.009) blood pressure was found. Comparable significant decreases in total and low-density lipoprotein cholesterol were observed in all study groups. Conclusions: A 6-month combined exercise programme led to substantial improvement of various cardiometabolic risk factors. This programme was effective even when executed without direct supervision, although the effects were more pronounced in the supervised group. Our findings suggest that non-supervised exercise programmes may be a valuable, cost-effective tool to translate the current physical activity guidelines in a real-life setting.

Background: Dental caries as an infectious disease is still a major oral public health issue. As documented in some recent studies, it has been recognized as the most common chronic childhood disease. Aim: The aim of this study was to evaluate caries prevalence, DMFT and dmft scores, as opposed to caries free children at the age of 6 years from a well developed western region of Primorsko-Goranska county. The purpose was also to evaluate a Significant Caries Index (SiC) and a Restoration Index (RI) in the same study sample of 6 year olds. Methods: Data for a sample of 1,825 (868 girls and 957 boys) children was collected and analyzed by using Chi-square and Mann-Whitney U Tests. Results: Results showed that the mean dmft was 4.68±4.19, and the mean DMFT was 0.22±0.69. D/d component constituted a major part of caries score (DMFT/dmft) in both primary and permanent dentitions in the population of 6 years old children. Caries prevalence was 74.5 in primary dentition and 11.9 in permanent dentition. Significant Caries Index value (SiC) was 0.66 for permanent and 9.6 for primary teeth, respectively. The Restoration Index (RI) was 20.1 for primary and 39.5 for permanent dentition. Conclusion: The results obtained in this study revealed that dental caries still appears to be quite a significant problem among 6 year olds. However, collected data, particularly considering the SiC Index, can be used for further planning of preventive and restorative dental treatments as well as setting up future goals for the prevention of dental caries in Croatian school children of Primorsko-Goranska county.

Background: The purpose of the current study was to describe tuberculosis (TB) knowledge, beliefs, and experience with TB services among injecting drug users. Methods: Participants for this anonymous, cross-sectional study were recruited from a community based syringe exchange programme in Tallinn, Estonia. A structured questionnaire was completed and included information on socio-demographics, health history, drug use, and knowledge about TB and HIV. Results: The study included 407 people (79% male, mean age 27.9 years, mean injection drug use 9.4 years). 32.9% of participants reported HIV infection and 1.7% lifetime history of TB. 26.4% participants (n=106) reported symptoms suggestive of TB. 93% of participants recognized correctly that TB is air-borne infection and 91% that HIV is a risk factor for TB. Only 40% of the participants knew that TB diagnostics and treatment in Estonia are free of charge for everybody and 58% reported they knew where to get health care services in case they suspected that they had TB. TB transmission and treatment adherence knowledge was better among those in contact with either health care or harm reduction services, e.g the community based syringe exchange programme. Conclusion: Similar to HIV services, TB prevention and education should be integrated into harm reduction and drug treatment programmes to facilitate early diagnosis and treatment of TB among injecting drug users.

Objectives: Organizations engaged in drug addiction treatment started their activities only recently in Hungary. This paper examines the organisational environment in drug outpatient treatment using the example of Blue Point Foundation (BPF), a non-governmental organization (NGO). The authors describe BPF's organizational structure and functioning related to its effectiveness. Methods: BPF staff members anonymously completed a 59-item questionnaire about its organizational characteristics and functioning. The questionnaire covered demographic data, 50 items of the Quality Control questionnaire and a SWOT (Strengths, Weakness, Opportunities, Threats) analysis. Results: Policy and strategy were considered BPF's best feature, while the management of funds received the lowest rating. The assessment of the staff and that of the organization as a whole was closer to the midpoint of the scale. Discussion: High risk of staff burnout and unstable organizational environment are the most important threats on the NGOs working in addictology in Hungary.

Objective: To examine the association of age and other factors with Self-rated Health (SRH) in the population aged 65 years or more in the context of action for health promotion in older adults. Material and Methods: The data used come from the household and adults questionnaires of the National Health Survey of Spain for 2006. SRH was categorized as positive (very positive or positive) and negative (fair, poor or very poor). Odds ratios for positive SRH compared to negative SRH were calculated using logistic regression models for complex samples. The determinants of the Positive SRH were obtained for the elderly population. Results: Among the population aged 65 years and older 39.7% report positive SRH. In this age group, those of 83 or more years have a better SRH. Other factors specific to this age group that improve the SRH are living alone, not having any functional dependence and high monthly family income. Conclusions: The association between several factors (particularly age) and positive SRH in people aged 65 and older differs from the one found in the rest of the population. Understanding the factors positively associated with the positive SRH in this population is of great importance for the design of specific programmes aimed at improving the health of older people.

Q fever, which is caused by Coxiella burnetii, is a worldwide zoonotic infectious disease and ruminants are the main reservoir for human infec-tions. Humans become infected primarily by inhaling aerosols that are contaminated with C. burnetii. Ingestion (particularly drinking raw milk) and person-to-person transmission are minor routes. Animals shed the bacterium in urine and faeces, and in very high concentrations in birth by-products. The bacterium persists in the environment in a resistant spore-like form which may become airborne and transported long distances by the wind. Q fever is considered primarily an occupational disease of workers in close contact with farm animals or processing their products, however, it may occur also in persons without direct contact. To prevent the introduction and spread of Q fever infection, preventive measures should be implemented including immunisation with currently available vaccines of domestic animals and humans at risk.