Efficacy of facemasks in preventing transmission of COVID-19 in non-healthcare settings: A scoping review.

Background: During the COVID-19 pandemic, an abundance of literature relating to the efficacy of face masks on reducing transmission of COVID-19 in non-healthcare settings emerged. Aim/objective: The aim of this scoping review was to allow the identification of: types of evidence conducted in this area; knowledge gaps and common concepts relating to mask efficacy in non-healthcare settings. Methods: A comprehensive literature search was conducted in PubMed, CINAHL, MEDLINE, Embase and the Irish Management Institute bibliographic database on December 15th, 2021. All types of face masks were included. Of 722 records, 16 were included after full text screening. Findings/results: Themes from an adapted model of Howard et al. framework were used to group results and identify common concepts. The grouped thematic results were then applied to the socio-ecological model. This illustrated the multifactorial elements determining the efficacy of masks themselves while also illustrating how other factors such as individual behaviours, social interactions, settings and national policy can influence the degree of the protective effect. Discussion: The findings from this scoping review indicate that an abundance of experimental literature is available indicating that masks are effective at preventing COVID-19 transmission but their degree of efficacy is impacted by external factors. This review highlights that the quality of the evidence available is low.

Better noncommunicable disease outcomes: challenges and opportunities for health systems: Croatia country assessment: focus on cardiovascular diseases and diabetes

In Croatia, noncommunicable diseases (NCDs) account for 93% of all deaths. They aff ect mainly the populationof working age, with an 18% probability of premature mortality from four leading NCDs. This has signifi cantsocioeconomic consequences on the development of the country, indicating that immediate action must betaken to strengthen the capacity of the health system to respond. Much progress has been made, with politicalcommitment to health reform; however, NCDs were targeted only recently. The assessment reported here,conducted by the WHO Regional Offi ce for Europe in collaboration with the Ministry of Health, will form thebasis for integrated approaches to addressing the burden of cardiovascular diseases and diabetes in Croatia. Theauthors analysed the current capacity of the health system to prevent and control these NCDs and identifi edmajor health system challenges; the document also reports good practice in using information technology forintegrating patient information. On the basis of the assessment, recommendations are made for further policiesand action.

A national study of the retention of Irish opiate users in methadone substitution treatment.

BACKGROUND: Retention in treatment is a key indicator of methadone treatment success. The study aims to identify factors that are associated with retention. OBJECTIVES: To determine retention in treatment at 12 months for Irish opiate users in methadone substitution treatment and to indicate factors that increase the likelihood of retention. METHODS: National cohort study of randomly selected opiate users commencing methadone treatment in 1999, 2001, and 2003 (n = 1269). RESULTS: Sixty-one percent of patients attending methadone treatment remained in continuous treatment for more than 1 year. Retention in treatment at 12 months was associated with age, gender, facility type, and methadone dose. Age and gender were no longer significant when adjusted for other variables in the model. Those who attended a specialist site were twice as likely to leave methadone treatment within 12 months compared with those who attended a primary care physician. The most important predictor of retention in treatment was methadone dose. Those who received <60 mg of methadone were three times more likely to leave treatment. CONCLUSION: Retention in methadone treatment is high in Ireland in a variety of settings. The main factors influencing retention in methadone treatment was an adequate methadone dose and access to a range of treatment settings including from primary care physicians. SCIENTIFIC SIGNIFICANCE: Providing an adequate dose of methadone during treatment will increase the likelihood of treatment retention. Methadone treatment by the primary care physician is a successful method of retaining opioid users in treatment.

Factors predicting completion in a cohort of opiate users entering a detoxification programme.

AIM: To determine the outcome and factors influencing outcome among a cohort of drug users commencing detoxification from opiate use. METHODS: National cohort study of randomly selected opiate users commencing methadone detoxification treatment in 1999, 2001 and 2003 (n = 327). RESULTS: One quarter 62 (25.6%) of opiate users had a successful detoxification within the 3-month study criteria. Receiving some inpatient treatment as part of detoxification programme resulted in completion by 56.3% drug users compared to outpatient only treatment (21%). The factors independently influencing detoxification are as follows: having some inpatient treatment AOR 5.9 (2.63-13.64) and never having injected AOR 2.25 (1.20-4.25). An additional 31 (9%) opiate users had a detoxification between 3 months and 1 year and 27 (8%) moved into methadone maintenance. CONCLUSIONS: This study finds that having some inpatient treatment increases the likelihood of a detoxification within 3 months. Offering a detoxification early in a drug using career pre-injecting drug use should be considered for suitable and motivated patients.