Search

Background: Trigeminal neuralgia (TN) is a relatively rare condition which has a profound impact not only on the patient but also on those around them. There is no cure for TN, and the management of the condition is complex. The most effective forms of treatment are either through medication, neurosurgery, or combination of the two. Each option has risks and implications for the patient. As with all clinical decisions, it is important for patients to understand and be fully informed of the treatments available to them. A London UK unit adopted a joint-consultation clinic approach where the patient meets with both physician and neurosurgeon at the same time to discuss treatment options. The purpose of this evaluation is to understand patients' level of satisfaction with the joint-consultation clinic and evaluate utilisation of a clinical decision-making tool. Method: Patients who had attended the joint-consultation clinic over a period of 12 months were invited to participate in a telephone or paper survey (N = 55). Responses were analysed using descriptive statistics and thematic analysis. Results: Forty-one patients (77% response rate) participated in the survey, and the results were overwhelmingly positive for the joint-consultation clinic regarding satisfaction. The benefits were broad ranging including increased understanding, collaboration and confidence in decision-making. Conclusions: A joint-consultation clinic comprising a neurosurgeon and a physician for the treatment of TN is valued by patients who become better informed and able to make decisions about their care. Positive application of clinical decision-making aids in this situation offers potential across specialities. [ABSTRACT FROM AUTHOR]

Contemporary cities are thick with infrastructure. In recognition of this fact a great deal of recent work within urban studies and urban geography has focused on transformations in the governance and ownership of infrastructural elements within cities. Less attention has been paid to the practices through which urban infrastructures are inhabited by urban dwellers. Yet in all sorts of ways infrastructures are realised through their use and inhabitation. This paper argues for the importance of attending to the ways that infrastructures are reinterpreted through use. Focusing on a case study of commuter cyclists in London, it explores the ways in which cyclists accommodate themselves to (and are in turn accommodated by) the infrastructural orderings of London's streets. Confronted by the obduracy of a road infrastructure designed primarily for motorised traffic, cyclists show a diverse range of approaches to negotiating movement through the city on bikes. The paper describes how this negotiation can be understood in terms of the more or less skilful processes of navigation, rule following, rule making, and rule bending. This involves a polymorphous mix of practices, some common to driving, others to walking, and yet others unique to cycling. In conclusion, the paper suggests that transformations of infrastructures found within cities need to be understood as much through emergent changes between their elements, and that close attention to how infrastructures come to be inhabited offers productive avenues for thinking about ways to improve them. [ABSTRACT FROM AUTHOR]

This paper focuses on the spatial imprint and social impacts of the emerging geographies of concentrated overseas investment into London’s high-end real estate market, particularly the boroughs of Westminster and Kensington and Chelsea. Framed by literatures on the 1% and the super-rich, and based on a mixed methodological approach of qualitative interviews with intermediaries and a quantitative mapping of overseas investors using 2011 census data, the results speak to the pervasive nature of “safe-haven” seeking in London real estate and its attendant transnational provenance set within a laissez-faire regulatory framework. In so doing, it makes an important contribution to the geographies of the super-rich, the class geographies of London, and the broader sense that overseas investors are producing what we call “pied-à-terre” urbanism which builds on a conventional gentrification framework (exclusionary displacement and a more affluent incoming group) but also exceeds it in several ways, leading to an increasingly socially attenuated landscape. This exceeding relates to: a different kind of rent gap, in that it is not speculative but safe-haven seeking, a guaranteed return on investment, and occurs without previous disinvestment; the agents are not traditional gentrifiers; the transnational nature of the process, with no attachment to particular places like in the traditional gentrification model; and a process focused on super-prime areas and completely independent of the existing gentrification process in London. [ABSTRACT FROM AUTHOR]

In this paper we argue that postgraduate education forms an important, but hitherto neglected, element in the distinctive institutional landscape of the City of London. In particular, and drawing on research into early-career financial and legal elites in the City, we show how postgraduate education tailored to the demands of employers within London plays an important role in indoctrinating early-career elites into situated, Cityspecific, working practices and, in so doing, helps to sustain the City's cultures and norms of financial practice. Specifying the role of postgraduate education in reproducing these situated City practices is significant because, although geographical variegation in working practices between international financial centres has been widely reported, less attention has been paid to how such institutionally embedded differences are created and sustained. By identifying education as one mechanism of creation and sustenance, our analysis enhances understanding of how the institutional landscapes that underlie financial centres might be maintained or, when necessary, challenged; challenge being significant in relation to attempts to reform practices and cultures in international financial centres in the wake of the 2007-08 crisis. [ABSTRACT FROM AUTHOR]