Background: Numerous studies have investigated mortality during a heatwave, while few have quantified heat associated morbidity. Our aim was to investigate the relationship between hospital admissions and intensity, duration and timing of heatwave across the summer months.

Background and Purpose-Measuring the impact of stroke through population-based stroke registers is complex and costly. The aim of the present study is to assess the validity of hospital discharge diagnoses (all ages) and to estimate the total number of hospitalized stroke events in the Veneto region (Northeastern Italy, 4 500 000 inhabitants). Methods-All discharges covering a 1-year period (1999) sharply decreased in the other diagnostic levels. Code 342 also showed a high PPV. The probability of suspected events meeting the stroke definition increased with age and was highest for patients admitted to neurological wards and for fatal events. Overall 9400 strokes (first-ever and recurrent) were estimated to be hospitalized in 1999, with an attack rate of 208 per 100 000. Conclusions-Our data indicate that once validation studies are undertaken on a sample of all hospitalized events, hospital discharge records can provide a valuable source of information on the actual burden of strokes on hospital services.

Objective: To assess the effect of a demerit points system, introduced in Italy in July 2003, on the prevalence of seat belt use (intermediate outcome) and the number of road traffic deaths and injuries (health outcomes). Design: Pre-and post-intervention regional observational study for seat belt investigation (April 2003, October 2004; national time-series analysis of road traffic deaths and injuries between 1999 and 2004 for health outcomes. Setting: Veneto region, Italy. Participants: 19 551 drivers, 19 057 front passengers and 8123 rear passengers estimated to be aged over 11 years were included in the investigation into seat belt use. 38 154 fatalities and 1 938 550 injured subjects were examined for the time-series analysis. Interventions: Demerit points system. Main outcome measures: The proportions of drivers and front and rear passengers observed to be using seat belts before and after the intervention; estimates of lives and injuries saved through the implementation of a penalty points system. Results: The demerit points system was followed by an increase in observed seat belt use of 51.8% (95% confidence interval 48.7% to 54.9%) among drivers, of 42.3% (95% confidence interval 39.2% to 45.5%) among front passengers and of 120.7% (95% confidence interval 99.4% to 144.3%) among rear passengers. It is estimated that 1545 (95% confidence interval 1387 to 1703; p,0.0001) deaths and 91 772 (95% confidence interval 67 762 to 115 783; p,0.0001) injuries were prevented in the 18 months after the introduction of the legislation, i.e. an 18% reduction (1545/8570) in fatalities and a 19% reduction (91 772/473 048) in injuries. Conclusions: The demerit points system is effective both in encouraging drivers and passengers to adhere to the law and in terms of health outcomes, substantially contributing to road safety.

A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.

Objective: Diabetes mellitus is a growing public health problem, for which efficient and timely surveillance is a key policy. Administrative databases offer relevant opportunities for this purpose. We aim to monitor the incidence of diabetes and its major complications using administrative data. Study design and methods:We study a population of about 850000 inhabitants in the Veneto Region (Italy) from the end of year 2001 to the end of year 2004. We use four administrative databases with record linkage. Databases of drug prescriptions and of exemptions from medical charge were linked to identify diabetic subjects; hospital discharge records and mortality data were used for the assessment of macrovascular and renal complications and vital status. Results:We identified 30230 and 34620 diabetic subjects at the start and at the end of the study respectively. The row prevalence increased from 38.3/1000 (95% CI 37.2 -39.5) to 43.2/1000 (95% CI 42.3 -44) for males and from 34.7/1000 (95% CI 33.9 -35.5) to 38.1/1000 (95% CI 37.4 -39) for females. The mean row incidence is 5.3/1000 (95% CI 5 -5.6) person years for males and 4.8/ 1000 (95% CI 4.4 -5.2) person years for females. The rate of hospitalisations for cardiovascular or kidney diseases is greatly increased in diabetic people with respect to non diabetics for both genders. The mortality relative risk is particularly important in younger age classes: diabetic males and females aged 45-64 years present relative risk for death of 1.7 (95% CI 1.58 -1.88) and 2.6 (95% CI 2.29 -2.97) respectively. Conclusion:This study provides a feasible and efficient method to determine and monitor the incidence and prevalence of diabetes and the occurrence of its complications along with indexes of morbidity and mortality.