Remoteness, Rurality and Mental Health Problems (Findings paper no. 5)

Findings papers associated with ESRC-funded research project, 'Social Geographies of Rural Mental Health' (R000 23 8453)

Visibility, Gossip and Intimate Neighbourly Knowledges (Findings paper no. 7)

Findings papers associated with ESRC-funded research project, 'Social Geographies of Rural Mental Health' (R000 23 8453)

Highlands, Economy, Culture and Mental Health Problems (Findings paper no. 4)

Findings papers associated with ESRC-funded research project, 'Social Geographies of Rural Mental Health' (R000 23 8453)

Exclusionary Social Relations and Practices (Findings paper no. 3)

Findings papers associated with ESRC-funded research project, 'Social Geographies of Rural Mental Health' (R000 23 8453)

Shadow writing and participant observation : a study of criminal justice social work around sentencing

The study of decision-making by public officials in administrative settings has been a mainstay of law and society scholarship for decades. The methodological challenges posed by this research agenda are well understood: how can socio-legal researchers get inside the heads of legal decision-makers in order to understand the uses of official discretion? This article describes an ethnographic technique the authors developed to help them penetrate the decision-making practices of criminal justice social workers in writing pre-sentence reports for the courts. This technique, called `shadow writing', involved a particular form of participant observation whereby the researcher mimicked the process of report writing in parallel with the social workers. By comparing these `shadow reports' with the real reports in a training-like setting, the social workers revealed in detail the subtleties of their communicative strategies embedded in particular reports and their sensibilities about report writing more generally

Assisting and advising the sentencing decision process : the pursuit of 'quality' in pre-sentence reports

Pre-sentence reports are an increasingly prevalent feature of the sentencing process. Yet, although judges have been surveyed about their general views, we know relatively little about how such reports are read and interpreted by judges considering sentence in specific cases, and, in particular, how these judicial interpretations compare with the intentions of the writers of those same reports. This article summarizes some of the main findings of a four-year qualitative study in Scotland examining: how reports are constructed by report writers; what the writers aim to convey to the sentencing judge; and how those same reports are then interpreted and used in deciding sentence. Policy development has been predicated on the view that higher-quality reports will help to 'sell' community penalties to the principal consumers of such reports (judges). This research suggests that, in the daily use and interpretation of reports, this quality-led policy agenda is defeated by a discourse of judicial 'ownership' of sentencing

Role of serotonin in the regulation of aldosterone secretion from the rat adrenal gland

In 1959 Rosenkrantz et al., first described the effect of the indoleamine serotonin on aldosterone secretion from the adrenal gland. To date numerous studies have reported this steroidogenic effect, describing the second messenger system utilised and in some species the receptor type involved. However the full physiological and pathophysiological role of serotonin in the control of mineralocorticoid secretion still remains to be elucidated.Classically serotonin has always been thought to be the major indoleamine involved in the modulation of aldosterone secretion from the zona glomerulosa, a fact that has not been proven. To resolve this, numerous indoleamines, both naturally occurring and synthetic congeners, were studied in isolated rat zona glomerulosa cells for their ability to induce aldosterone secretion, as compared to serotonin. Of the compounds tested, 5-methoxytryptamine, tryptamine, N-methyltryptamine, 5-methyltryptamine, 6- methoxytryptamine and 5-hydroxytryptophan (5-HTP) stimulated, to various degrees aldosterone secretion, from the zona glomerulosa. Of those compounds tested that produced comparable stimulation of aldosterone as that produced by serotonin, cAMP output was also investigated and it was observed that all compounds stimulated cAMP output also, to varying degrees. The study allowed specific structural requirements, required for stimulation of aldosterone secretion, to be characterised, namely that the 5- hydroxyl grouping was not required for full agonist activity, but ring substitutions at other positions compromise agonist activity. The basicity of the terminal amine group is important also in receptor binding. This study will aid in the search for specific agonists and antagonists, required for the research into the serotonin receptor present within the zona glomerulosa.Unlike the cardiovascular and CNS, where specific receptors have been identified and categorised, specific receptors within the rat zona glomerulosa for serotonin have not yet been fully characterised. The second study of this thesis aimed at characterising the receptors found within rat zona glomerulosa by utilising an array of serotonin agonists and antagonists. The antagonists ketanserin and mesulergine were found to inhibit serotonin induced aldosterone secretion, and the agonists 5-methoxytryptamine and 5- carboxamidotryptamine, produced identical stimulation of aldosterone from rat zona glomerulosa, as that produced with serotonin. This effect was also found to be affected by sodium status. These results taken together with previous studies and preliminary studies with a 5-HT7 probe in sections of rat adrenal gland would suggest the presence of a 5-HT7 receptor in rat zona glomerulosa, although the presence of other serotonin receptors can not be ruled out.For serotonin to have a physiological role in aldosterone secretion, a local source of serotonin would be required. In consideration of this the role of the enzyme Laromatic amino acid decarboxylase (L-AAAD) in the local production of serotonin and dopamine was investigated in rat adrenal zona glomerulosa, in animals maintained on varying sodium diets. The presence of L-AAAD was located, via immunohistochemistry, in the zona glomerulosa, zona fasciculata and the medulla. Conversion of 5-HTP to serotonin and L-DOPA to dopamine was observed in capsular and medullary tissue preparations, and this was inhibited by carbidopa. 5-HTP significantly stimulated aldosterone secretion, from capsular tissue. This effect was more apparent in animals on a low salt diet and less apparent in high salt diet animals as compared to animals maintained on a normal salt diet. The opposite was true for studies with L-DOPA. The effect of sodium status would suggest that the enzyme is regulated by salt intake. No significant effect of L-DOPA and of 5-HTP on corticosterone secretion from tissue preparations was observed. The results from this study provide evidence for a role for L-AAAD in converting circulating L-DOPA and 5-HTP to dopamine and serotonin, to either inhibit or stimulate aldosterone secretion from the rat zona glomerulosa.The role of the serotonin transporter was studied within the rat adrenal gland. The transporter molecule was visualised throughout the rat adrenal medulla via immunohistochemistry. The serotonin uptake inhibitors citalopram and desmethylimipramine (DMI) were incubated with or without serotonin in isolated rat zona glomerulosa cells and the resulting aldosterone secretion was measured. Results varied and this was thought to be due to the harsh collagenase digestion process destroying the transporter, and so whole capsular tissue was studied in a superfusion system and aldosterone secretion measured. In all cases both reuptake inhibitors increased the aldosterone output from capsular tissue. The drug of abuse methylenedioxymethamphetamine (MDMA; 'Ecstasy') was also used in this system, and this compound also caused an increase in aldosterone secretion. In Vivo studies with MDMA produced interesting results with an increase in plasma aldosterone and PRA. From this study evidence has been found for the existence of the serotonin transporter molecule within the rat adrenal gland. MDMA may induce a rise in aldosterone concentration within the plasma by a direct action on the serotonin transporter within the adrenal gland.This thesis has provided strong evidence for a role of serotonin in the control of aldosterone secretion in the rat. Serotonin can be produced locally within the adrenal cortex and induce aldosterone secretion, and this action may be switched on in cases of low sodium status. Further studies are required to fully characterise the serotonin receptor, to elucidate a role for the transporter within the gland and to understand more fully the importance of serotonin and indeed dopamine, in the physiology and pathophysiology of the adrenal cortex

The human right to health:exploring disability, migration and health

Across the globe, an estimated one billion people are on the move today, of whom 244 million are international migrants. Not only have global horizons expanded in the realm of work and study; global conflict and exploitation have resulted in forced migration. Migration is a political issue, which raises questions of identity, citizenship, diversity and integration and is utilised to play upon the fear of the stranger, the ‘Other’ and difference in contemporary society. Disabled migrants are a hidden population whose experiences are often overlooked or subsumed within wider debates around disability and ethnicity. This article considers the intersection of disability and migration in contemporary society through the lens of healthcare access. Reflecting on the impact of citizenship rights on the realisation of human rights in the context of contemporary migration, using health as an example, the article considers the implications for disabled migrants, focusing primarily on the European Union

Access points and barriers to owner occupation for disabled people

Little research has been carried out on the housing circumstances and experiences of disabled people in the housing system, particularly in relation to the majority tenure in Britain, owner occupation. Adopting a 'social model' approach to disability, in which disability is seen as discrimination or oppression, the thesis explores disabled people's (i.e. those with a physical impairment) experiences of accessing home ownership. Utilising both quantitative and qualitative methods, the thesis addresses the question of what are the experiences of those with a physical impairment in the private sector of the housing system. Analysis of the Scottish House Condition Survey, 1996, and of a bespoke postal questionnaire, were used to examine the socio-economic and housing characteristics of disabled people at the national and local level. Semi-structured interviews with disabled people who had successfully accessed owner occupation or who were attempting to purchase were carried out in order to explore their experiences of the process of house buying and aspects of home ownership. Similarly, key informants from organisations routinely involved in the house buying process were also interviewed. The analysis identifies a number of barriers that occur throughout the house buying process. Often this process was disrupted, with choices and preferences being constrained by the need to find a mortgage and a suitable and usable property. The low socio-economic status of disabled people in general was identified as being a significant obstacle in accessing the tenure. Related to this, the source of income was problematic, with many disabled interviewees reliant upon benefits as the sole or significant source of income. This was problematic because lenders are often reluctant to acknowledge this as income. In relation to finding a property, interviewees encountered problems of access, design and affordability. Information around the house buying process was lacking, both for disabled people and lenders, developers and estate agents. There was a lack of information for all these groups regarding design issues, finance for disabled people and the needs of this group. The problems encountered by disabled people throughout the house buying process were compounded by the procedures of institutions and the attitudes and 'knowledge' implicit within such procedures. Underlying procedures, as they related to disabled people, were based on the dominant biological essentialist discourse around disability, which permeated organisations' knowledge and ability to deal with the needs of disabled people. In light of the analysis, the thesis concludes by offering policy recommendations and areas for future research. It is suggested that professionals in the housing system need to be more aware of the needs and rights of disabled people and, similar to disabled people, require improved information at each stage of the house buying process. A redefinition of disability is required at the legislative and policy level in order to engender real change in the broader circumstances of disabled people's lives. In order to gain a deeper understanding of the housing circumstances, needs and aspirations of disabled people, more research of a qualitative nature is required