Evaluation of Croatian model of polycentric health planning and decision making.

OBJECTIVE: To determine the progress in the development and implementation of health policies on a county level resulting from the learning-by-doing training provided through the County Public Health Capacity Building Program started in 2001 in Croatia. METHODS: Modular training using management tools, public health theory and practice, and SMDP's Healthy Plan-it tool, followed by the self-evaluation of the progress made by county teams in health needs assessment and health policy development, implementation, and assurance. Fifteen county teams consisting of politicians, executive officers, public health professionals, and community members. RESULTS: Twelve of 15 county teams completed the program. The teams made progress in the evaluated areas, although to a different extent, which did not depend on the amount of time they had or the governance experience. The differences in improvement depended on the differences in the strength of political, executive, and professional components of the teams. Teams with a strong political and/or executive component, but weak public health professional and community components made major improvements in policy development and/or assurance function, but performed less well in the health needs assessment and constituency building. The reversed was also true. CONCLUSION: Learning-by-doing training program improved public health practices on a county level in Croatia.

Causes of death of foreign tourists in the county of Istria during the summer holiday season from 2000 to 2004.

UNLABELLED: In this paper, the causes of death are presented of 322 foreign tourists that occured during summer holidays in County of Istria, Croatia, in the period from May to September, during 5 years (from 2000 to 2004). The aim of this study was to evaluate the frequency of the common causes of these deaths. Data about these cases were taken out of the archives of the Institute of Public Health of County of Istria in Pula. RESULTS: During this period of time there were 322 cases of deaths recorded. The rate was 3.2 deaths for 100 000 tourists. Heart attack occured in 126 cases (39%), and it was the leading cause of death. The highest number of deaths by the heart attack (n=31) was registered in 2002. The frequency of heart attack was six times higher in males than in females. The heart attack occurance was between 47% in 2000 to 30% in 2003. Drowning was the second leading cause of death with 10.5% of all cases of deaths recorded. Out of all victims (n=34), there were three times more males then females. Other causes of deaths were chronic ischaemic heart disease (8%), cardiac arrest (4%) and stroke (3.0%). CONCLUSION: Heart attack and drowning were the leading causes of death among foreign tourists in Istria.

Tobacco smoking in hotel workers and the necessity to promote non-smoking policy at the workplace.

This investigation aimed at evaluating the prevalence of active smokers in hotel workers to underline the need for a non-smoking campaign at the workplace. Data on smoking habit were collected in a questionnaire which included 398 subjects of whom 170 were men and 228 women aged in average 29 and 35 years, respectively. Seventy-six men and 134 women declared themselves regular tobacco smokers. In average, they started to smoke at the age of 17 and 18, respectively and had been smoking for 21 and 16 years, respectively. Although the number of smokers was high, it is encouraging that 29% of men and of 51% women tried and did not succeed in quitting smoking, whereas 30% of men and 12% of women did quit smoking. The authors advocate reducing tobacco use and controlling environmental tobacco smoke exposure at the workplace, which should include a non-smoking company policy, implementation of smoking cessation programmes, social support programmes, trade union support, as well as the assistance of health professionals during regular check-ups.