Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened.

Abstractobjective Dengue fever is globally considered underestimated. This study provides expansion factors (EFs) for dengue endemic selected countries and highlights critical issues in the use of EFs. results Cohort studies differed in case definition, laboratory test used and surveillance methods. The information on SEARO, PAHO and WPRO websites differed in terms of dengue epidemiological variables, population denominators and completeness. The highest incidence was reported by PAHO countries followed by WPRO and SEARO countries. EFs may vary for the different variables and denominators used for calculation. EFs were the highest in SEARO countries and lowest in PAHO countries. A trend for lower local EFs was observed.conclusions The use of EFs for quantifying dengue underreporting may be problematic due to lack of uniformity in reporting dengue both active and passive surveillance data. Quality dengue surveillance data are urgently needed for a better estimate of dengue disease burden and to measure the impact of preventive intervention.

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Objective: Patients often do not eat/drink enough during hospitalization. To enable patients to meet their energy and nutritional requirements, food and catering service quality and staff support are therefore important. We assessed patients' satisfaction with hospital food and investigated aspects influencing it. Design: We conducted a cross-sectional study collecting patients' preferences using a slightly modified version of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Factor analysis was carried out to reduce the number of food-quality and staff-issue variables. Univariate and multivariate ordinal categorical regression models were used to assess the association between food quality, staff issues, patients' characteristics, hospital recovery aspects and overall foodservice satisfaction (OS). Setting: A university hospital in Florence, Italy, in the period NovemberDecember 2009. Subjects: Hospital patients aged 181 years (n 927). Results: Of the 1288 questionnaires distributed, 927 were returned completely or partially filled in by patients and 603 were considered eligible for analysis. Four factors (explained variance 64?3 %, Cronbach's alpha a C 5 0.856), i.e. food quality (FQ; a C 5 0?74), meal service quality (MSQ; a C 5 0?73), hunger and quantity (HQ; a C 5 0?74) and staff/service issues (SI; a C 5 0?65), were extracted from seventeen items. Items investigating staff/service issues were the most positively rated while certain items investigating food quality were the least positively rated. After ordinal multiple regression analysis, OS was only significantly associated with the four factors: FQ, MSQ, HQ and SI (OR 5 17?2, 6?16, 3?09 and 1?75, respectively, P , 0?001), and gender (OR 5 1?53, P 5 0?024). Conclusions: The most positively scored aspects of foodservice concerned staff/ service, whereas food quality was considered less positive. The aspects that most influenced patients' satisfaction were those related to food quality.

Background Since health-related quality of life (HRQL) measures are numerous, comparisons have been suggested. Aim To compare three HRQL measures: SF6D, HUI3 and EQ5D. Methods Three questionnaires (SF36, HUI3, EQ5D) were administered to 1,011 patients attending 16 general practices in two Italian cities. Information about patients' gender, age, education, marital status, smoking, body mass index (BMI) and chronic diseases (hypertension, diabetes, cardiovascular and musculoskeletal diseases) were also collected. Questionnaires scores were calculated using the appropriate algorithms; in particular SF6D scores were obtained from SF36 items. Agreement and correlation between questionnaires scores were investigated using Bland and Altman method and Spearman coefficient. The influence of sociodemographic and morbidity indicators on scores was analysed using the nonparametric quantile regression. Results The Spearman coefficient was about 0.6 for all questionnaires. The 95% limits of agreement of the scores were approximately from -0.5 to 0.3 except for SF6D and EQ5D when they were from -0.4 to 0.2. The measures were influenced by socio-demographic and clinical variables in a similar way, especially SF6D (the index obtained from SF36) and EQ5D, which appeared to be influenced by the same pattern of factors, including gender, chronic diseases, smoking and BMI. Conclusions Overall, the agreement between questionnaires scores was quite low, whilst the correlation level was good. Questionnaire scores were influenced by sociodemographic and clinical variables in a similar way, especially SF6D and EQ5D. Therefore, the descriptive capacity of SF6D and EQ5D was found to be similar.