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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]

Poland's accession to the European Union in May 2004 brought many new possibilities and opportunities for Polish migrants to the United Kingdom. However, the focus on individual migrants has underestimated the complex roles of families in migration strategies and decision making. This paper brings together data from two studies of Polish migrants in London. In 2006-2007, we carried out a qualitative study, Recent Polish Migrants in London. That research examined how families may be reconfigured in different ways through migration, for example, transnational networks and splits within families. While the study participants represented varied examples of family reunification, they also revealed the complex decision making processes about leaving, staying, rejoining and returning. In our most recent study, Polish Children in London Primary Schools, we interviewed parents, who had migrated with children, about their experiences and expectations of London schools. This study revealed that the age of children was usually a factor in family migration decision making. There was a common expectation that younger children could easily adapt to a new school and learn English quickly. Drawing on the findings of these two studies, this paper will explore firstly, the variety of family migration strategies and secondly, the factors that inform migrants' decisions to bring their families (especially children) or to leave them back home. Finally, the paper concludes by considering some of the policy implications of our findings. [ABSTRACT FROM AUTHOR]