London Experience Research Articles

Co-Production at the Strategic Level: Co-Designing an Integrated Care System with Lay Partners in North West London, England.

In North West London, health and social care leaders decided to design a system of integrated care with the aim of improving the quality of care and supporting people to maintain independence and participation in their community. Patients and carers, known as ‘lay partners,’ were to be equal partners in co-production of the system.Lay partners were recruited by sending a role profile to health, social care and voluntary organisations and requesting nominations. They formed a Lay Partners Advisory Group from which pairs were allocated to system design workstreams, such as which population to focus on, financial flow, information technology and governance. A larger and more diverse Lay Partners Forum provided feedback on the emerging plans.A key outcome of this approach was the development of an integration toolkit co-designed with lay partners. Lay partners provided challenge, encouraged innovation, improved communication, and held the actions of other partners to account to ensure the vision and aims of the emerging integrated care system were met.Key lessons from the North West London experience for effective co-production include: recruiting patients and carers with experience of strategic work; commitment to the vision; willingness to challenge and to listen; strong connections within the community being served; and enough time to do the work. Including lay partners in co-design from the start, and at every level, was important. Agreeing the principles of working together, providing support and continuously recruiting lay representatives to represent their communities are keys to effective co-production.

Charlotte Brontë in London

The author of this Address to the Brontë Society was a close colleague of George Smith, Charlotte Brontë’s publisher. In this mixture of reminiscence and analysis he chronicles Charlotte’s many visits to London. Parallels are drawn between her experiences in London, particularly during her stays at the home of George Smith and his mother, and incidents in Charlotte’s novel, Villette. The characters of Dr Graham Bretton and Mrs Bretton are closely modelled on Smith and his mother.Charlotte’s meeting with Thackeray is noted, aided by the memories of eyewitnesses, Lady Anne Richie, Thackeray’s daughter, and the artist Sir J. M. Millais. Note: The opening section of this address, which mainly relates to the speaker’s own attachment to the Brontë novels and other personal comments, is omitted here.

The Capital and the Romantic Sublime: The Case of Thomas De Quincey

This paper aims to explore the idea that the formulation of the modern discipline of economics involved a discourse on the romantic sublime. By using the example of Thomas De Quincey's Confessions of an English Opium-Eater (1821), it will address the issue of money and knowledge as two formative experiences in De Quincey's life. Unlike his literary model, William Wordsworth, who is eager to build up his ‘egotistical sublime’ (Keats's phrase), De Quincey is intent on registering his traumatic memories and resultant disorders and neuroses. Thus, he builds up a new type of romantic subjectivity where his personal accumulation of debt can be read as an encounter with the sublime, and it runs parallel to Britain's ever-increasing national debt. The sublime in De Quincey's Confessions carries an ideological burden as it affirms the subsistence of a middle-class individual and his right to participate in the discourse of the sublime. However, De Quincey falls from his middle-class position and becomes one of the poor where his access to the sublime experience is utterly denied. De Quincey's London experience is measured against Wordsworth's London experience in The Prelude (1805) and by experiencing the ‘negative sublime’ (Weiskel), he puts Wordsworthian ethics into practice. Thus, De Quincey's Confessions shows the tensions inherent in the romantic discourse of the sublime in a manner which connects romantic modes of subjectivity to the rising capitalist society.

Traffic management strategies for emissions reduction: recent experience in London

Traffic management strategies for emissions reduction: recent experience in London

Fixing Mobility in the Neoliberal City: Cycling Policy and Practice in London as a Mode of Political–Economic and Biopolitical Governance

Academic interest in utility cycling has burgeoned in recent years with significant literature relating to the health and environmental benefits of cycling, the efficacy of cycle-specific infrastructure, and the embodied experiences of cycling. Yet with few exceptions, none of these accounts conceptualizes cycling as a mode of neoliberal governance through which circulation and quality of labor are improved. This article seeks to address this absence, positioning cycling in relation to broader biopolitical and political–economic governance in two ways: Focusing on the recent experiences of London (UK) it argues first that cycle promotion is a principally biopolitical “mobility” fix that seeks to operate through shaping individuals as entrepreneurs of the self who will move more efficiently. Second, and in relation to this biopolitics of cycling, it suggests that the minimal spatial fixing embodied in cycle-specific infrastructure represents a metaphorical fix resulting from tensions created between the enterprise of cycling, the realities of practicing it in hostile urban environments, and the temporary networks of actors that produce it as such. In doing so, the article contends that what is being materialized is a narrow productivist framing of cycling both materially and discursively in the shape of commuter-focused infrastructure and promotion that effectively marginalizes subaltern and alternative performances. The article concludes by arguing that theorizing the promotion and practice of cycling as part of broader processes of neoliberalization should help to direct future research agendas for cycling and critical mobilities scholarship more broadly.

Urban Road Pricing: A Comparative Study on the Experiences of London, Stockholm and Milan

Urban road pricing schemes have been designed in order to reduce externalities generated by traffic. Main impacts regard: time loss due to congestion, local pollution, noise; contribution to climate change caused by emissions of GHGs, pavement costs and road damages, increase in accidents risks, extra-fuel consumption, decrease in quality of life. Moreover road pricing schemes generate public revenues.The paper performs a comparative evaluation of the three main experiences of urban road pricing in Europe: London (in operations since 2003), Stockholm (in operations since 2007, after a period of trial in 2006) and Milan (in operations since 2008, with a shift from pollution to congestion charge in 2012). Since their launch, the schemes have been adjusted in terms of amount of charge, area of application and other features.The schemes have been able to reduce negative externalities generated by traffic, such as accidents, congestion and emissions, up to different levels. A comparative analysis of the three schemes is provided. Determinants of differences in the effectiveness of the schemes are evaluated with a particular focus on elasticity of use of private vehicles to charge.The results can be useful to design well targeted congestion charge schemes and to assess their efficacy.

Mental health problems in people living with HIV: changes in the last two decades: the London experience 1990–2014

ABSTRACTMental health problems continue to be a significant comorbidity for people with HIV infection, even in the era of effective antiretroviral therapy. Here, we report on the changes in the mental health diagnoses based on clinical case reports amongst people with HIV referred to a specialist psychological medicine department over a 24-year period, which include the relative increase in depressive and anxiety disorders, often of a chronic nature, together with a decline in acute mental health syndromes, mania, and organic brain disorders. In addition, new challenges, like the presence of HIV and Hepatitis C co-infection, and the new problems created by recreational drugs, confirm the need for mental health services to be closely involved with the general medical services. A substantial proportion of people with HIV referred to specialist services suffer complex difficulties, which often require the collaboration of both psychiatrists and psychologists to deal effectively with their difficulties.

Urban Road Pricing: A Comparative Study on the Experiences of London, Stockholm and Milan

Urban road pricing schemes have been designed in order to reduce externalities generated by traffic. Main impacts regard: time loss due to congestion, local pollution, noise, contribution to climate change caused by emissions of GHGs, pavement costs and road damages, increase in accidents risks, extra-fuel consumption, decrease in quality of life. Moreover road pricing schemes generate public revenues.The paper performs a comparative evaluation of the three main experiences of urban road pricing in Europe: London (in operations since 2003), Stockholm (in operations since 2007, after a period of trial in 2006) and Milan (in operations since 2008, with a shift from pollution to congestion charge in 2012). Since their launch, the schemes have been adjusted in terms of amount of charge, area of application and other features.The schemes have been able to reduce negative externalities generated by traffic, such as accidents, congestion and emissions, up to different levels. A comparative analysis of the three schemes is provided. Determinants of differences in the effectiveness of the schemes are evaluated with a particular focus on elasticity of use of private vehicles to charge.The results can be useful to design well targeted congestion charge schemes and to assess their efficacy.

Emergency department procedural sedation: the London experience.

The aim of this study was to develop a procedural sedation guideline and an audit tool to identify the medications chosen, the incidence of predefined adverse events and the factors associated with their occurrence. We performed a prospective observational study using a standardized proforma. We obtained data on patient demographics, the procedure performed, the drugs used and the dosages and predefined adverse events. Our target population was adult patients attending three urban UK teaching hospital Emergency Departments (EDs) over a 12-month period. We included all patients who were to undergo procedural sedation in the ED. Data were obtained on 414 patients. The majority of procedures were reductions of fractures and dislocations (89%). Midazolam was the sedative agent used most commonly (45%), and morphine was the most frequently used analgesic agent (36%). Overall 10% of sedations involved predefined complications (95% confidence interval: 7.1-12.9). There were no cases of airway obstruction requiring intervention; no patients showed clinical evidence of aspiration and no patient required intubation. Procedural success was 96%. Propofol was associated with fewer adverse events (95% confidence interval: 0.024-0.572), as well as higher procedural success. Procedural sedation and analgesia can be safely and effectively performed in the ED by appropriately trained emergency physicians.

Use of serious games for creating awareness about social enterprises

India has 3.17 million registered not-for-profit social enterprises with an estimated 83.3 million people engaged with them as employees or volunteers. In the absence of a widespread formal education system for social enterprises, learning by experience has been the main knowledge driver. In recent years, the social sector has drawn more people towards it. The present authors have designed a board game to create awareness about social enterprises. A pilot run, with 48 participants in the age group of 15–74 years, conducted in India, indicates that the challenge before the social sector in India is to create awareness and image building of the sector, to conduct training and workshops, attract more people and organizations to participate in their activities, and possibly make it an integral part of the education system. The board game version can be adopted in electronic format for a wider reach. In a vast country like India, the latter game version can also overcome the traditional barriers of education, language, cost and time to spread awareness on social issues. The social entrepreneurship board game shows the effectiveness of serious games for awareness creation and its potential to impact the thought process. It is an effective method of learning for topics and subjects, in which people normally would not invest in terms of time, efforts and money. This is corroborated by the FloodSim experience in London which used a serious game for a similar objective. Serious games could be designed to address specific social issues like civic discipline, sanitation, health, hygiene, water, power, and environmental protection.

Circus maximus: the economic gamble behind hosting the Olympics and the World Cup

The numbers are staggering: China spent $40 billion to host the 2008 Summer Olympic Games in Beijing and Russia spent $50 billion for the 2014 Sochi Winter Games. Brazil's total expenditures are thought to have been as much as $20 billion for the World Cup this summer and Qatar, which will be the site of the 2022 World Cup, is estimating that it will spend $200 billion. How did we get here? And is it worth it? Those are among the questions noted sports economist Andrew Zimbalist answers in Circus Maximus: The Economic Gamble Behind Hosting the Olympics and the World Cup . Both the Olympics and the World Cup are touted as major economic boons for the countries that host them, and the competition is fierce to win hosting rights. Developing countries especially see the events as a chance to stand in the world's spotlight. Circus Maximus traces the path of the Olympic Games and the World Cup from noble sporting events to exhibits of excess. It exposes the hollowness of the claims made by their private industry boosters and government supporters, all illustrated through a series of case studies ripping open the experiences of Barcelona, Sochi, Rio, and London. Zimbalist finds no net economic gains for the countries that have played host to the Olympics or the World Cup. While the wealthy may profit, those in the middle and lower income brackets do not, and Zimbalist predicts more outbursts of political anger like that seen in Brazil surrounding the 2014 World Cup.

“Group-cum-Brutalism”?

Highgate Spinney (1964–66), designed by Howard & Rotherham, is a five-storey block of thirty flats in the north London suburb of Crouch End. It is one of many buildings published in Zodiac 18 (1968) – a substantial issue of the Italian magazine, dedicated to recent and contemporary British architecture in general and to New Brutalism in particular. Though published alongside canonical buildings of British New Brutalism, Highgate Spinney has largely been erased from the historical record.To revisit and expand upon the inclusion of Highgate Spinney in Zodiac 18, this article explores the partnership of Howard & Rotherham and the design of their building. Both architects brought a range of experiences to bear on the design. The article focuses on those of Bruce Rotherham, because he has an established reputation in New Zealand, and because comparatively little is known of the life and other architectural work of John Howard, who died at a young age, shortly after the completion of Highgate Spinney.The article considers Rotherham's formative years with the Group Construction Company and Group Architects in Auckland, his early work experiences in London and the impact of his two years of study at the Architectural Association School of Architecture. It also reveals interactions between Rotherham and James Gowan. These provide grounds for considering buildings by Stirling & Gowan, particularly the Flats at Ham Common and Preston Housing, as points of reference and comparison for the design of Highgate Spinney. The article shows that Highgate Spinney demonstrates synchronicities with the Stirling & Gowan precedents, while also being an independent and considered design in its own right.

Breaking down barriers: Clinical psychology and psychiatry in a mental health service for homeless people

Psychologists have only recently begun to work directly with homeless people. This paper describes one such experience in South London with a well-established mental health outreach team for homeless people.

Other-Hegemony in de Martino: The Figure of the Gramscian Fieldworker between Lucania and London

Abstract This paper reflects on the role of fieldwork in folklore studies and anthropology. By speculating on the fieldwork experience of Ernesto de Martino in Lucania, we consider the figure of the Gramscian Fieldworker commenting on Stephen Olbrys Gencarella’s proposal for a critical folklore studies. An imaginary de Martino, one that never existed, is seen as the precursor for such a figure, built around the scenario of the "end" as depicted by Heidegger and embodying the Gramscian proposition of the Organic Intellectual. The second part of the article grounds such a figure in the author’s ethnographic experience of London, offering an examination of the current state of British multiculturalism through the case of an East London singer-songwriter. A practical example of how to interpret the fieldwork tactic pioneered by an imaginary de Martino in Lucania is presented as a way for social sciences and the humanities to overcome the predilection for text analysis of deconstructionism.

The lived experience of London 2012 Olympic and Paralympic Games volunteers: a serious leisure perspective

Along with other sporting mega-events, the Olympic Games, in all its versions, makes extensive use of volunteers. The 70,000 London 2012 Olympic and Paralympic volunteers, for example, played a vital role in the delivery of the event. Stebbins’ theoretical perspective of serious leisure includes consideration of volunteering and there are calls for its further empirical evaluation. This study, therefore, uses a qualitative study of the lived experience of London 2012 volunteers to test the relevance of the serious leisure framework to Olympic volunteering. The data are drawn from the reflective diaries of 20 participants who volunteered in a variety of roles during London 2012. It is concluded that all of the qualities of serious leisure are identifiable to various extents within the experiences of the London 2012 volunteers. This finding will help Olympic and other sporting mega-event managers to understand and improve the experiences of their volunteers. Recommendations are also made, in the light of the findings, for the further refinement of the serious leisure perspective. Particular attention is paid to highlighting how the findings might contribute to recent debates around whether sporting mega-event volunteering is best explained by the serious leisure quality of career volunteering, or by the serious leisure associated concept of project-based leisure, or alternatively by the competing term of episodic volunteering.

A London experience 1995-2012: demographic, dietary and biochemical characteristics of a large adult cohort of patients with renal stone disease.

Kidney stone disease has an estimated prevalence of around 10%. Genetic as well as environmental factors are thought to play an important role in the pathogenesis of renal stones. The aim of our study was to analyse and report the main characteristics of patients with kidney stones attending a large UK metabolic stone clinic in London between 1995 and 2012. A cross-sectional study. Analysis of data from stone formers attending the University College and Royal Free Hospitals' metabolic stone clinic from 1995 to 2012. Demographic, clinical, dietary and biochemical characteristics have been summarized and analysed for men and women separately; trends over time have also been analysed. Of the 2861 patients included in the analysis, 2016 (70%) were men with an average age of 47 years (range 18-87 years) and median duration of disease of 6 years (range 0-60 years). The prevalence of low urine volume, hypercalciuria, hyperoxaluria, hyperuricosuria and hypocitraturia was 5.6%, 38%, 7.9%, 18% and 23%, respectively. The prevalence of several risk factors for stones increased over time. The majority of stones were mixed, with around 90% composed of calcium salts in varying proportion. Our findings in a large cohort of patients attending a London-based stone clinic over the past 20 years show differences in distributions of risk factors for stones for men and women, as well as metabolic profiles and stone composition. The impact of most risk factors for stones appeared to change over time.

Destination images of non-visitors

This article provides much needed understanding of destination images held by non-visitors. Recognizing the characteristics of non-visitor images and their formation is important in order to understand images more widely. This qualitative study assesses images of London. The views of three hundred people in the Czech Republic who have never visited London were obtained via an innovative open-ended research instrument. The study showed that non-visitors imagine destinations through comparisons with their own experiences of places. Findings indicate that images can be very persistent and that the first images formed of a destination endure over time. Although the research is based on people with no direct experience of London, the research highlights that a range of secondary ‘experiences’ influence image formation.

Migrant Drifters: Samuel Beckett's Murphy and Sam Selvon's The Lonely Londoners in a Postcolonial Comparative Context

Samuel Beckett’s third work of prose fiction, the novel Murphy, has not heretofore received substantial critical consideration as a novel of Irish migratory experience in 1930s London.1 Reception of Samuel Beckett’s Murphy to date is far less concerned with its migrant-themed or even broadly postcolonial implications than with foregrounding the novel’s philosophical or comic aspects. The novel’s reception contrasts markedly with that of a text with an established postcolonial reception, Sam Selvon’s second novel, The Lonely Londoners.2 Selvon’s novel has, since its first publication, been reviewed and discussed extensively as a novel principally concerning Anglophone Caribbean arrival and attempts at settlement in the London of the 1950s. The purpose of this paper is to re-evaluate Murphy from a postcolonial perspective, using the canonical postcolonial model of The Lonely Londoners to compare just how strikingly and considerably the two novels parallel one another in terms of their treatment of narrative forms and themes specific to the topic of migration and its vicissitudes. The Lonely Londoners is very arguably to date the canonical epitome of the innovative migrant Caribbean British novel of the 1950s and 1960s. The novel’s reception as a prime text of Anglophone Caribbean migrant-themed significance is evident from observation of discussions, since the start of this century, by Susheila Nasta, Roydon Salick and Alison Donnell. Nasta regards The Lonely Londoners as a seminal text of ‘Black British’ and ‘migrant writing’, going on to describe the novel as groundbreaking and important ‘both in terms of its strategic reinvention of London as a black city of words and for its innovative experimentations with language and literary form’.3 Donnell and Salick argue that The Lonely Londoners is now so established in Caribbean studies that the

What's mental health got to do with integrated diabetes care? The North West London Experience

What's mental health got to do with integrated diabetes care? The North West London Experience

Pound e l'economia: gli inizi

Pound’s economics is largely based on his poetic notion of “usura” surfacing for the first time in the war sections of Hugh Selwyn Mauberley and based on C. H. Douglas’s unorthodox underconsumptionist theory of Social Credit . Since Pound is not an economist but a poet, in order to understand the way in which economics permeates his poetry and essays one should bear in mind that Pound’s utopian crusade against financiers is closely tied to his avant-garde efforts to create a new poetic language. In this essay I will briefly survey four stages decisively shaping his early economic ‘education’: first, his London experiences in the radical magazine The New Age with its strong Ruskinian allegiances; secondly, his own American agrarian background which consciously or unconsciously and in various hues, stayed with him his whole life; thirdly, his editing Eliot’s The Waste Land along with the idea of art as handicraft; finally I will examine one of the Hell Cantos where the financiers’ corrupting economics merges with the corruption of language.