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Concept: London borough


Cumulative impact zones (CIZs) are a discretionary policy lever available to local government, used to restrict the availability of alcohol in areas deemed already saturated. Despite little evidence of their effect, over 200 such zones have been introduced. This study explores the impact of three CIZs on the licensing of venues in the London Borough of Southwark.

Concepts: London, Local government, City of London, London borough, London Borough of Croydon, London Borough of Southwark


Yancy Jensen has a tough job. In her new role as a healthy weight specialist nurse in the inner London borough of Southwark, Ms Jensen focuses on the area’s most overweight primary school children and their families, offering to educate and support them into a healthier lifestyle.

Concepts: Nutrition, Nursing, School, London, London borough, London Borough of Southwark, London Borough of Lambeth, London Borough of Lewisham


Adolescence is a vulnerable period for the development of mental health problems. The DISCOVER intervention aims to provide accessible, acceptable and cost-effective psychological support for stressed adolescents in inner-city secondary schools. The intervention uses age-appropriate cognitive-behavioural therapy (CBT) methods and materials, delivered in an interactive 1-day workshop with additional telephone support. An open-access entry route allows students to self-refer. This protocol describes a feasibility cluster randomised controlled trial (RCT) comparing DISCOVER with a waitlist control condition. The study will run across 10 clusters (secondary schools) in the inner London Boroughs of Southwark and Lambeth. Participants are students aged over 16years who are seeking help with anxiety and/or depressive symptoms. Key feasibility parameters relate to the proportion of students willing to participate in the research following publicity events; the proportion of students who complete the intervention; and response rates for outcome measures. Outcome variance estimates and intra-cluster correlations will be obtained for future power calculations. Qualitative methods will be used to explore the acceptability of the intervention and research procedures for students and school staff. The feasibility of an economic evaluation will also be examined. The results will (i) determine the appropriateness of proceeding to a definitive full-scale trial; and (ii) inform the development of an optimised version of the DISCOVER intervention that can be tested within feasible parameters.

Concepts: Psychology, Randomized controlled trial, Qualitative research, Adolescence, High school, Cognitive behavioral therapy, College, London borough


To explore the factors predicting preventive behaviours among NHS dentists in Camden, Islington and Haringey in London, using constructs from the Theory of Planned Behaviour.

Concepts: Prediction, Behavior, Dentistry, London, London borough, Inner London, London Borough of Camden


Routine HIV testing in areas of high HIV prevalence has been shown to be both cost effective and to avert downstream morbidity and mortality from ‘late’ HIV diagnosis (defined as CD4 cell count <350 cells/ml). In the London borough of Waltham Forest in 2010, late HIV diagnoses were resulting in high morbidity with associated lengthy and costly hospital admissions.

Concepts: Greater London, London borough, Leytonstone, London boroughs, London Borough of Waltham Forest, Walthamstow, Epping Forest, Leyton Orient F.C.


The London Borough of Newham has the highest rates of tuberculosis (TB) within Europe (116 per 100,000). There is a lack of guidance in lymph node (LN) TB on how to best obtain a positive culture, which is the gold standard in the face of increasing mycobacterial resistance.

Concepts: Tuberculosis, Face, County borough, Greater London, London borough, London Borough of Newham, Municipal Borough of Barking, London boroughs


Angiostrongylus vasorum is a parasitic nematode that can cause serious and potentially fatal disease in dogs and other canids. The aim of this study was to determine the intermediate slug species infected in nature by sampling sites in Greater London and Hertfordshire located within a known hyperendemic region. Overall, A. vasorum larvae were recovered from 6/381 slugs (1.6 %) by tissue digestion, and their identity was confirmed by PCR. Infected slugs originated from three different sites in the Greater London area: one in Waltham Forest and two in Bromley. Slugs parasitised by A. vasorum were identified by a combination of external morphological characteristics and molecular techniques and belonged to three different families: the Arionidae, the Milacidae and the Limacidae. This includes two new host records for the parasite: Arion distinctus and Tandonia sowerbyi. This is the first record of A. vasorum in the family Milacidae, indicating that the parasite has a broader intermediate host range than previously recognised.

Concepts: Nematodes, Dog, Host, Angiostrongylus vasorum, Greater London, London borough, London Government Act 1963, Tandonia


Pre-school children placed in local authority care show elevated rates of mental health disorders when compared to the general population. This study investigated risk factors for mental health disorders relating to the period prior to entering care and while in care. A representative sample of 43 children in care aged 0-72 months in an inner London borough underwent comprehensive multidimensional assessments. Presence of emotional, behavioural, attachment and adaptive disorders was ascertained. Exposure to two pre-placement risk factors and six placement risk factors was compared between children with and without a disorder. A total of 26 children (60.5%) had at least one mental health disorder. The two pre-placement risk factors, multiple types of maltreatment and entry into care after the age of 6 months, were both significantly associated with mental health disorders. The three placement risk factors of sudden placement moves, multiple placement moves and child-carer alienation showed a significant association with mental health disorders. There was a strong correlation between the number of risk factors and the number of co-morbid mental health disorders per child (r = .67, p < .001). In conclusion, this study identified five modifiable risk factors related to the quality of safeguarding and fostering services which showed a significant association with pre-school mental health.

Concepts: Psychology, Foster care, Mental disorder, Attachment theory, Fosterage, London borough


Few geographically-linked datasets of people with Multiple Sclerosis (MS) exist in the UK. The development of these datasets enriched with clinical information would aid in testing etiological hypotheses, comparing disease progression between treatment regimes, and recruiting clinical trial participants. The population in East London (defined here as The City, Hackney, Tower Hamlets, and Newham) is of particular interest because of its ethnic mix, which is reflected by its population with MS.

Concepts: Epidemiology, Clinical trial, Multiple sclerosis, United Kingdom, London, City of London, London borough, London Borough of Tower Hamlets


In the UK, there are growing concerns about the impact of ‘out-of-area treatments’ (OATs) on mental health service users, both clinically and financially. In addition to being costly to the National Health Service (NHS) and local social care authorities, service users placed out of area have been socially dislocated and in some cases over supported. Prompted by these concerns, a project was set up in one inner London Borough, to review and where appropriate repatriate mental health service users they had placed outside the local area. This study explored the experiences and impact of these relocations from service users' perspectives. Increased autonomy was the most commonly reported positive outcome, which was welcomed by all; however, many service users also reported feeling lonely in their new local placements. Five out of seven were pleased with their increased contact with family and most concluded that generally, relocation enhanced their quality of life. A number of NHS Trusts are considering the implementation of similar approaches to review their ‘OATs’ clients; hence the favourable outcomes reported here and elsewhere are likely to encourage this. However, it is essential that these be considered alongside the support required for service users to reconnect positively with their families, in addition to adjusting to more independent living.

Concepts: Health care, Public health, National Health Service, Outcome, Perspective, London borough, Relocation