'Therapeutic landscapes' and the importance of nostalgia, solastalgia, salvage and abandonment for psychiatric hospital design.

We examine emotional reactions to changes to medical spaces of care, linked with past experiences. In this paper we draw on findings from a qualitative study of the transfer of psychiatric inpatient care from an old to a newly built facility. We show how the meanings attributed to 'therapeutic landscapes' from one׳s past can evoke emotions and memories, manifesting in ideas about nostalgia, solastalgia, salvage and abandonment, which can impinge on one׳s present therapeutic experience.

Spaces for smoking in a psychiatric hospital: social capital, resistance to control, and significance for 'therapeutic landscapes'.

This paper reports on research framed by theories of therapeutic landscapes and the ways that the social, physical and symbolic dimensions of landscapes relate to wellbeing and healing. We focus especially on the question of how attributes of therapeutic landscapes are constructed in different ways according to the variable perspectives of individuals and groups. Through an ethnographic case study in a psychiatric hospital in the North of England we explore the perceived significance for wellbeing of 'smoking spaces' (where tobacco smoking is practiced in ways that may, or may not be officially sanctioned).

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards.

This paper contributes to the international literature examining design of inpatient settings for mental health care. Theoretically, it elaborates the connections between conceptual frameworks from different strands of literature relating to therapeutic landscapes, social control and the social construction of risk. It does so through a discussion of the substantive example of research to evaluate the design of a purpose built inpatient psychiatric health care facility, opened in 2010 as part of the National Health Service (NHS) in England.

Creating 'therapeutic landscapes' for mental health carers in inpatient settings: a dynamic perspective on permeability and inclusivity.

Although there has been a shift toward treatment in the home and the community, in the UK, inpatient facilities are still important in modern mental health care. 'Informal carers', including family members, often play an essential role, not only in providing care in the community but also in care of patients during periods of hospitalisation. UK National Health Service policies increasingly consider the position of these carers as 'partners' in the care process, but relatively little attention has been paid to their position within the hospital settings where treatment is provided for inpatients.

New spaces of inpatient care for people with mental illness: a complex 'rebirth' of the clinic?

This paper examines the implications for design of inpatient settings of community-based models of care and treatment of mental illness. The study draws on ideas from relational geographies and expands interpretations based on Foucault's writing. We analyse material from a case study which explored the views of patients, consultants, and other staff from a new Psychiatric Inpatient Unit in a deprived area of East London, UK.

Mingling, observing, and lingering: everyday public spaces and their implications for well-being and social relations.

The rejuvenation of public spaces is a key policy concern in the UK. Drawing on a wide literature and on qualitative research located in a multi-ethnic area of East London, this paper explores their relationship to well-being and social relations. It demonstrates that ordinary spaces are a significant resource for both individuals and communities.

African American beliefs about diabetes.

In this presentation, a diabetes explanatory model of rural, African American adults at high risk for diabetes is described. Kleinman's explanatory model of illness was used as the organizing framework. African American men and women (N=42), between the ages of 18 and 51, participated.

I'm not a doctor but I play one on TV: E.R. and the place of contemporary health care in fixing crisis.

This paper is an examination of the popular TV drama E.R. What is notable for health geographers about E.

Diabetes beliefs among low-income, white residents of a rural North Carolina community.

Context: Every social group shares beliefs about health and illness. Knowledge and understanding of these health beliefs are essential for education programs to address health promotion and illness prevention.

Purpose: This analysis describes the diabetes Explanatory Models of Illness (EMs) of low-income, rural, white Southerners who have not been diagnosed with diabetes.

Children's health and workers' productivity: an examination of family interference with work in rural America.

This article examines the association of children's health with their parents' performance in the workplace using data from a random survey sample of adults living in rural western North Carolina (N=206). Guided by the effort-recovery model, the authors hypothesized that parents whose children are more ill have poorer performance in the workplace because their parenting requires greater effort and they have less opportunity for physical and psychological recovery. Child health was unassociated with parents cutting back at work because of physical health.

A suite of methods for representing activity space in a healthcare accessibility study.

Background: "Activity space" has been used to examine how people's habitual movements interact with their environment, and can be used to examine accessibility to healthcare opportunities. Traditionally, the standard deviational ellipse (SDE), a Euclidean measure, has been used to represent activity space. We describe the construction and application of the SDE at one and two standard deviations, and three additional network-based measures of activity space using common tools in GIS: the road network buffer (RNB), the 30-minute standard travel time polygon (STT), and the relative travel time polygon (RTT).

Identifying diabetes knowledge network nodes as sites for a diabetes prevention program.

This paper reports on the methods used and results of a study that identified specific places within a community that have the potential to be sites for a diabetes prevention program. These sites, termed diabetes knowledge network nodes (DKNNs), are based on the concept of socio-spatial knowledge networks (SSKNs), the web of social relationships within which people obtain knowledge about type 2 diabetes. The target population for the study was working poor African Americans, Latinos, and European Americans of both sexes in a small rural southern town who had not been diagnosed with diabetes.

Access to transportation and health care utilization in a rural region.

Context: Access to transportation to transverse the large distances between residences and health services in rural settings is a necessity. However, little research has examined directly access to transportation in analyses of rural health care utilization.

Purpose: This analysis addresses the association of transportation and health care utilization in a rural region.

The effects of geography and spatial behavior on health care utilization among the residents of a rural region.

Objective: This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors.

Data Sources: A survey of 1,059 adults in 12 rural Appalachian North Carolina counties.

Study Design: This cross-sectional study used a three-stage sampling design stratified by county and ethnicity.

Diabetes meanings among those without diabetes: explanatory models of immigrant Latinos in rural North Carolina.

The prevalence of type 2 diabetes is increasing in the United States, particularly among minority individuals. Primary prevention programs for diabetes must be designed to address the beliefs of the populations they target. Little research has investigated the beliefs of those who do not have diabetes.

Updated feasibility trial experience with the Viaderm percutaneous access device.

The percutaneous access device (PAD) is used to connect an external drive unit to the Kantrowitz CardioVad (KCV), a cardiac assist device for the treatment of chronic heart failure. The PAD conveys pneumatic power from a drive unit to the implanted blood pump and an electrocardiogram signal from the myocardium to the drive unit. The device-tissue interface of the PAD is precoated with autologous fibroblasts cultured from a skin sample of the intended recipient.

Therapy by design: evaluating the UK hospital building program.

A renewed interest in hospital design in the UK, prompted by the Private Finance Initiative, provides an opportunity to consider hospitals as 'therapeutic environments'. Noting that the therapeutic value of hospitals is related to their physical, social and symbolic design, this paper argues that 'expert' knowledges have encouraged the development of hospitals that all-too-rarely provide benign settings for promoting patient recovery and healing. The recent programme of hospital building in the UK, however, has been accompanied by a vigorous debate over what constitutes good hospital design, with four significant ideas emerging: hospitals should be clinically efficient, be integrated within the community, be accessible to consumers and the public, and encourage patient and staff well-being.

An introduction to three studies of rural elderly people: effects of religion and culture on health.

The paper introduces three empirical studies which relate the religious beliefs and practices or rural older adults from different ethnic groups to their health behaviors. It briefly describes the rationale for the studies and their main components, including their aims, study sites, study populations, methods used, and their principal findings. Then it discusses two primary themes which run through all the papers, namely rurality and cross-cultural comparisons.

Determinants of health care use by children in rural western North Carolina: results from the Mountain Accessibility Project.

Objective: To assess determinants of health care visits among children in a 12-county region of western North Carolina representative of rural areas in the United States.

Methods: Households were randomly selected for surveys of household characteristics, health status, and health care use. Surveys were conducted June 1999 to January 2000 and were stratified for children younger than 5 years and 5 years and older.

A spatial analysis of county-level variation in hospitalization rates for low back problems in North Carolina.

Hospitalization rates for low back problems vary widely. In previous non-spatial analyses, population-level socioeconomic and health resource characteristics have explained little of the variation in rates. This study examines geographic variation in hospitalization rates for low back problems while controlling for spatial dependence in the data.

Sociospatial knowledge networks: appraising community as place.

This article introduces a new theory of geographical analysis, sociospatial knowledge networks, for examining and understanding the spatial aspects of health knowledge (i.e., exactly where health beliefs and knowledge coincide with other support in the community).

Developing socio-spatial knowledge networks: a qualitative methodology for chronic disease prevention.

Chronic disease is a significant and costly social problem. The burden is even more pronounced in communities with high rates of a particular chronic disease. Assessment of health belief systems and the local geographies of health beliefs can assist community health planners to create cost-effective strategic intervention programs where populations are at high risk for chronic diseases.

Hans Castorp's journey-to-knowledge of disease and health in Thomas Mann's The Magic Mountain.

The paper examines Thomas Mann's novel, The Magic Mountain, to show how imaginative literature can enhance our understanding of health in place. The story centers on the experiences of Hans Castorp, a young bourgeois German, at a tuberculosis sanatorium in the Swiss Alps. Three themes are examined: (1) how knowledge about illness and health, death and life, is gained; (2) how knowledge is arrived at through a dialectical process which reconciles seeming opposites; and(3) how new knowledge is gained through making transitions.