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This study explores the gendered nature of surgical practice in early modern London and the ways in which women participated in the provision of care within the city's surgical households. The juxtaposition of domestic and occupational space and the logistics of patient care within surgical households provided fertile experiential training ground for female practitioners and necessitated partnerships between surgeons and their wives. Despite the ambivalence engendered in attitudes toward women's affiliation with the Barber-Surgeons' Company, surgery's relatively broad practical scope, lack of clearly defined educational prerequisites and emphasis on cooperative practice facilitated the involvement of female practitioners. By challenging narrowly defined actors' categories, this study argues that inasmuch as women were not explicitly identified as surgeons by Barber-Surgeons' Company officials, they played vital and valued roles within London's medical landscape as the wives, widows and daughters of licensed surgeons. [ABSTRACT FROM PUBLISHER]

The United Kingdom implemented a containment strategy for pandemic (H1N1) 2009 through administering antiviral agents (AVs) to patients and their close contacts. This observational household cohort study describes the effect of AVs on household transmission. We followed 285 confirmed primary cases in 259 households with 761 contacts. At 2 weeks, the confirmed secondary attack rate (SAR) was 8.1% (62/761) and significantly higher in persons <16 years of age than in those >50 years of age (18.9% vs. 1.2%, p<0.001). Early (≤48 hours) treatment of primary case-patients reduced SAR (4.5% vs. 10.6%, p = 0.003). The SAR in child contacts was 33.3% (10/30) when the primary contact was a woman and 2.9% (1/34) when the primary contact was a man (p = 0.010). Of 53 confirmed secondary case-patients, 45 had not received AV prophylaxis. The effectiveness of AV prophylaxis in preventing infection was 92%. [ABSTRACT FROM AUTHOR]

Abstract: The United Kingdom has been at the forefront of an international movement to reform child welfare and protection systems both in terms of responding to children in difficulty and developing methods for organising such responses. More specifically, England and Wales have initiated a model of professional practice for vulnerable children and their families: the Framework for the Assessment of Children in Need and Their Families. This analytical and intervention framework has since been adopted in fifteen countries. This article reveals the results of a meta-evaluation of research that examines the implementation experiences and results of the framework in order to identify common and specific empirical elements related to its effectiveness. A content analysis of 50 documents reveals, in particular, the desirability of having organisational arrangements that, at the local level, foster leadership, inter-organisational collaboration, professional training, implementation planning, ownership of the target model, allowance of time for implementation and ownership of the target model, the use of information technology and communication, and reflexion. Promoting these elements reduces their observed counterparts such as confusion, cognitive biases, and faulty and uneven knowledge among the local partners. The results also indicate that professionals who use the framework ultimately make better assessments of the complex situations they face, have a more holistic and child-centered point of view, and consequently plan better interventions. The model increases inter-professional and inter-organisational collaboration. It also increases the participation of children and parents in the provision of services intended for them, yet slightly below expectations. The meta-evaluation also reveals that few evaluative studies address the impact of the model on the welfare of children. Finally, this article underscores the urgent need for incorporating measurements of child development into practice and evaluative research. [Copyright &y& Elsevier]

Please cite this paper as: bin-Reza et al. (2012) The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence. Influenza and Other Respiratory Viruses 6(4), 257-267. There are limited data on the use of masks and respirators to reduce transmission of influenza. A systematic review was undertaken to help inform pandemic influenza guidance in the United Kingdom. The initial review was performed in November 2009 and updated in June 2010 and January 2011. Inclusion criteria included randomised controlled trials and quasi-experimental and observational studies of humans published in English with an outcome of laboratory-confirmed or clinically-diagnosed influenza and other viral respiratory infections. There were 17 eligible studies. Six of eight randomised controlled trials found no significant differences between control and intervention groups (masks with or without hand hygiene; N95/P2 respirators). One household trial found that mask wearing coupled with hand sanitiser use reduced secondary transmission of upper respiratory infection/influenza-like illness/laboratory-confirmed influenza compared with education; hand sanitiser alone resulted in no reduction. One hospital-based trial found a lower rate of clinical respiratory illness associated with non-fit-tested N95 respirator use compared with medical masks. Eight of nine retrospective observational studies found that mask and/or respirator use was independently associated with a reduced risk of severe acute respiratory syndrome (SARS). Findings, however, may not be applicable to influenza and many studies were suboptimal. None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection. Some evidence suggests that mask use is best undertaken as part of a package of personal protection especially hand hygiene. The effectiveness of masks and respirators is likely linked to early, consistent and correct usage. [ABSTRACT FROM AUTHOR]