Gloves, gowns and masks for reducing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in the hospital setting.

BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA; also known as methicillin-resistant S aureus) is a common hospital-acquired pathogen that increases morbidity, mortality, and healthcare costs. Its control continues to be an unresolved issue in many hospitals worldwide. The evidence base for the effects of the use of gloves, gowns or masks as control measures for MRSA is unclear. OBJECTIVES: To assess the effectiveness of wearing gloves, a gown or a mask when contact is anticipated with a hospitalised patient colonised or infected with MRSA, or with the patient's immediate environment. SEARCH METHODS: We searched the Specialised Registers of three Cochrane Groups (Wounds Group on 5 June 2015; Effective Practice and Organisation of Care (EPOC) Group on 9 July 2013; and Infectious Diseases Group on 5 January 2009); CENTRAL (The Cochrane Library 2015, Issue 6); DARE, HTA, NHS EED, and the Methodology Register (The Cochrane Library 2015, Issue 6); MEDLINE and MEDLINE In-Process & Other Non-Indexed Citations (1946 to June week 1 2015); EMBASE (1974 to 4 June 2015); Web of Science (WOS) Core Collection (from inception to 7 June 2015); CINAHL (1982 to 5 June 2015); British Nursing Index (1985 to 6 July 2010); and ProQuest Dissertations & Theses Database (1639 to 11 June 2015). We also searched three trials registers (on 6 June 2015), references list of articles, and conference proceedings. We finally contacted relevant individuals for additional studies. SELECTION CRITERIA: Studies assessing the effects on MRSA transmission of the use of gloves, gowns or masks by any person in the hospital setting when contact is anticipated with a hospitalised patient colonised or infected with MRSA, or with the patient's immediate environment. We did not assess adverse effects or economic issues associated with these interventions.We considered any comparator to be eligible. With regard to study design, only randomised controlled trials (clustered or not) and the following non-randomised experimental studies were eligible: quasi-randomised controlled trials (clustered or not), non-randomised controlled trials (clustered or not), controlled before-and-after studies, controlled cohort before-after studies, interrupted time series studies (controlled or not), and repeated measures studies. We did not exclude any study on the basis of language or date of publication. DATA COLLECTION AND ANALYSIS: Two review authors independently decided on eligibility of the studies. Had any study having been included, two review authors would have extracted data (at least for outcome data) and assessed the risk of bias independently. We would have followed the standard methodological procedures suggested by Cochrane and the Cochrane EPOC Group for assessing risk of bias and analysing the data. MAIN RESULTS: We identified no eligible studies for this review, either completed or ongoing. AUTHORS' CONCLUSIONS: We found no studies assessing the effects of wearing gloves, gowns or masks for contact with MRSA hospitalised patients, or with their immediate environment, on the transmission of MRSA to patients, hospital staff, patients' caregivers or visitors. This absence of evidence should not be interpreted as evidence of no effect for these interventions. The effects of gloves, gowns and masks in these circumstances have yet to be determined by rigorous experimental studies, such as cluster-randomised trials involving multiple wards or hospitals, or interrupted time series studies.

[Observational study of the adherence to the correct use of face masks by the general population in open public places during two periods of the COVID-19 pandemic in four Spanish cities.] / Estudio observacional de la adherencia al correcto uso de mascarillas por la población general en lugares públicos abiertos durante dos periodos de la pandemia por COVID-19 en 4 ciudades españolas.

OBJECTIVE: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation. METHODS: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearson's chi-squared test and multivariate logistic regression analysis. RESULTS: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of non-compliance was the incorrect placement of face masks (64%); 36% were without masks. The non-reusable face masks were most commonly worn (54.1%). We observed a significant increase in use of high-efficiency face masks in 2021 (27.1%) versus 2020 (13.7%). CONCLUSIONS: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage of high-efficiency masks. The main cause of non-compliance was incorrect placement.

OBJETIVO: Dentro de las medidas adoptadas para mitigar la pandemia por SARS-CoV-2 se encuentra el uso de mascarillas en la población general. Para que esta medida sea efectiva las mascarillas deben cubrir la nariz y la boca. Nos propusimos conocer su uso correcto por la población general en espacios públicos abiertos mediante observación directa. METODOS: Estudio prospectivo observacional del correcto uso de mascarillas en la población general en espacios abiertos en Bilbao, Santander, Oviedo y Zaragoza, del 16 al 26/07/2020 y del 23/01 al 02/03/2021. Se realizó un muestreo por conveniencia evaluando el cumplimiento del uso de mascarilla cuando los adultos la llevaban cubriendo completamente nariz y boca. Se registró el tipo e inadecuación de su uso mediante formulario estandarizado. Se realizó distribución de frecuencias, comparaciones con χ2 de Pearson y regresión logística multivariable. RESULTADOS: Se realizaron 5.464 observaciones. El cumplimiento global fue del 89,5%; 10,9 puntos mayor en 2021 (94,7%) que en 2020 (83,8%) (p<0,001). La principal causa de incumplimiento fue la colocación incorrecta (64%) frente no llevar nada (36%). Respecto al tipo de mascarillas, las más utilizadas fueron las no reutilizables (54,1%), aumentando en 2021 el uso de las de alta eficacia (13,7% versus 27,6%) de forma significativa. CONCLUSIONES: En todas las ciudades estudiadas se observa un aumento del uso correcto de la mascarilla desde que se hizo obligatorio en espacios públicos, así como aumento de las mascarillas de alta eficacia. La principal causa de incumplimiento es llevar la mascarilla mal colocada.

[Breast cancer mortality trend in Spain and its autonomous communities during the period 1980-2005]. / Mortalidad por cáncer de mama: evolución en España y sus comunidades autónomas durante el período 1980-2005.

BACKGROUND: Breast cancer is the most common cancer in women. The aim of this study is to describe the development of breast cancer mortality and its relation with the implementation of population screening programs in Spain and its Autonomous Communities (AC) from 1980 to 2005. METHODS: A breast cancer mortality trends analysis was done. We used the data from mortality of Ministry of Health and Social Policies. We calculated crude, standardized, specific and truncated mortality rates per 100,000 women. Trend analysis was done using a Joinpoint Regression Model to compute the Annual Percentage Change (APC). RESULTS: 131746 people died from breast cancer in Spain between 1980 and 2005. In Spain, mortality rates increased until 1992, when there was a change in the trend (APC = -0.1, -0.9, -0.8 for standard, specific and truncated rates respectively), CONCLUSIONS: Mortality from breast cancer in women in Spain indicates a general downward trend from 1992 to 2005 that was different among the different age groups. This downward trend was also observed in all the AC with some variability in the year that change occurs.

Estudio observacional de la adherencia al correcto uso de mascarillas por la población general en lugares públicos abiertos durante dos periodos de la pandemia por COVID-19 en 4 ciudades españolas / Evaluation of the effectiveness of a school-based alcohol and cannabis prevention programme among adolescents

Fundamentos: Dentro de las medidas adoptadas para mitigar la pandemia por SARS-CoV-2 se encuentra el uso de mascarillas en la población general. Para que esta medida sea efectiva las mascarillas deben cubrir la nariz y la boca. Nos propusimos conocer su uso correcto por la población general en espacios públicos abiertos mediante observación directa. Métodos: Estudio prospectivo observacional del correcto uso de mascarillas en la población general en espacios abiertos en Bilbao, Santander, Oviedo y Zaragoza, del 16 al 26/07/2020 y del 23/01 al 02/03/2021. Se realizó un muestreo por conveniencia evaluando el cumplimiento del uso de mascarilla cuando los adultos la llevaban cubriendo completamente nariz y boca. Se registró el tipo e inadecuación de su uso mediante formulario estandarizado. Se realizó distribución de frecuencias, comparacionescon χ2 de Pearson y regresión logística multivariable. Resultados: Se realizaron 5.464 observaciones. El cumplimiento global fue del 89,5%; 10,9 puntos mayor en 2021 (94,7%) que en 2020 (83,8%) (p<0,001). La principal causa de incumplimiento fue la colocación incorrecta (64%) frente no llevar nada (36%). Respecto al tipo de mascarillas, las más utilizadas fueron las no reutilizables (54,1%), aumentando en 2021 el uso de las de alta eficacia (13,7% versus 27,6%) de forma significativa. Conclusiones: En todas las ciudades estudiadas se observa un aumento del uso correcto de la mascarilla desde que se hizo obligatorio en espacios públicos, así como aumento de las mascarillas de alta eficacia. La principal causa de incumplimiento es llevar la mascarilla mal colocada.(AU)

Background: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation. Methods: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearson’s chisquared testand multivariate logistic regression analysis. Results: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of noncompliance was the incorrect placement of face masks (64%); 36% were without masks. The nonreusable face masks were most commonly worn (54.1%). We observed a significant increase in use of highefficiency face masks in 2021 (27.1%) versus 2020 (13.7%). Conclusions: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage ofhighefficiency masks. The main cause of non-compliance was incorrect placement.(AU)

Mortalidad por cáncer de mama: evolución en España y sus comunidades autónomas durante el período 1980-2005 / Breast cancer mortality trend in Spain and its autonomous communities during the period 1980-2005

Fundamentos: El cáncer de mama es el tumor más frecuente enmujeres. El objetivo de este estudio es describir el comportamientode la mortalidad por cáncer de mama en España y en las ComunidadesAutónomas (CCAA) desde 1980 a 2005 y estudiar la relacióncon la implantación de los programas de cribado poblacionales.Métodos: Se ha realizado un análisis de tendencia de la mortalidadpor cáncer de mama a partir de los datos de mortalidad delMinisterio de Sanidad y Política Social. Se calcularon las tasas demortalidad cruda, estandarizada, específica y truncada por 100.000mujeres. El análisis de tendencia se realizó mediante un modelo deregresión joinpoint y se obtuvo el porcentaje de cambio anual (PCA).Resultados: Entre 1980 y 2005 en España se produjeron131.746 defunciones por cáncer de mama. En España las tasas bruta,estandarizada, y truncada, presentaron un comportamiento crecientehasta 1992, año en el que se produjo un cambio de tendencia (PCA=-0,1; -0,9; -0,8 respectivamente).Conclusión: La mortalidad por cáncer de mama en las mujeresen España presenta un cambio de tendencia descendente a partir de1992 que persistió hasta 2005 y que no fue homogénea en todos losgrupos de edad.Esta reducción en la tasa de mortalidad también seobservó en las CCAA con cierta variabilidad en el año donde se produceel cambio(AU)

Background: Breast cancer is the most common cancer inwomen. The aim of this study is to describe the development of breastcancer mortality and its relation with the implementation of populationscreening programs in Spain and its Autonomous Communities(AC) from 1980 to 2005.Methods: A breast cancer mortality trends analysis was done.We used the data from mortality of Ministry of Health and SocialPolicies. We calculated crude, standardized, specific and truncatedmortality rates per 100,000 women. Trend analysis was done using aJoinpoint Regression Model to compute the Annual PercentageChange (APC).Results: 131746 people died from breast cancer in Spain between1980 and 2005. In Spain, mortality rates increased until 1992,when there was a change in the trend (APC = -0.1, -0.9, -0.8 for standard,specific and truncated rates respectively),Conclusions: Mortality from breast cancer in women in Spainindicates a general downward trend from 1992 to 2005 that was differentamong the different age groups. This downward trend was alsoobserved in all the AC with some variability in the year that changeoccurs(AU)