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Emphasizes writing a dissertation in undergraduate geography study as a means of giving the student some control over subject matter. Offers criteria for selecting a topic including originality, topicality, feasibility, and likelihood of sustaining student interest. Warns that choices by academic supervisors may be made with regard to grant money rather than to interest. (DK)

To date, solicited diaries have been relatively neglected as a social science research method. This is particularly true within the field of health research. Yet, these narrative approaches can provide invaluable insights into the health behaviours of individuals and how these are played out across time and space. To illustrate this, we draw on recent research in the north west of England that investigated the potential benefits of communal gardening as opposed to other social activities in maintaining the health and emotional well-being of older people. As part of a wider study using largely qualitative techniques, our analysis revealed that, contrary to the findings of earlier studies, diaries can be used effectively over relatively long periods of time and are equally effective in exploring health issues amongst both older men and women. With the benefit of good researcher support, we argue that diary techniques can offer some unique insights into the ongoing health routines and coping strategies of older people and can prove invaluable in uncovering those, often hidden, aspects of their daily lives and routines that impact on their health histories. Through the gathering of chronologically organised data about daily activities, diaries can act as both a record and reflection of the health experiences, activities and life-worlds inhabited by older people. Keywords: Diaries; Older people; Health; Activities; Qualitative methods; UK

The interest of social scientists in complexity theory has developed rapidly in recent years. Here, I consider briefly the primary characteristics of complexity theory, with particular emphasis given to relations and networks, non-linearity, emergence, and hybrids. I assess the 'added value' compared with other, existing perspectives that emphasise relationality and connectedness. I also consider the philosophical underpinnings of complexity theory and its reliance on metaphor. As a vehicle for moving away from reductionist accounts, complexity theory potentially has much to say to those interested in research on health inequalities, spatial diffusion, emerging and resurgent infections, and risk. These and other applications in health geography that have invoked complexity theory are examined in the paper. Finally, I consider some of the missing elements in complexity theory and argue that while it is refreshing to see a fruitful line of theoretical debate in health geography, we need good empirical work to illuminate it. Keywords: Complexity theory; Geography; Networks; Inequalities; Spatial diffusion

While gardening is seen, essentially, as a leisure activity it has also been suggested that the cultivation of a garden plot offers a simple way of harnessing the healing power of nature (The therapeutic garden, Bantam Press. London, 2000). One implication of this is that gardens and gardening activity may offer a key site of comfort and a vital opportunity for an individual's emotional, physical and spiritual renewal. Understanding the extent to which this supposition may be grounded in evidence underpins this paper. In particular, we examine how communal gardening activity on allotments might contribute to the maintenance of health and well being amongst older people. Drawing on recently completed research in northern England, we examine firstly the importance of the wider landscape and the domestic garden in the lives of older people. We then turn our attention to gardening activity on allotments. Based on the findings of our study, we illustrate the sense of achievement, satisfaction and aesthetic pleasure that older people can gain from their gardening activity. However, while older people continue to enjoy the pursuit of gardening, the physical shortcomings attached to the aging process means they may increasingly require support to do so. Communal gardening on allotment sites, we maintain, creates inclusionary spaces in which older people benefit from gardening activity in a mutually supportive environment that combats social isolation and contributes to the development of their social networks. By enhancing the quality of life and emotional well being of older people, we maintain that communal gardening sites offer one practical way in which it may be possible to develop a 'therapeutic landscape'. Keywords: Gardening; Elderly; Therapeutic landscapes; Mental well being

In 1999-2000, a pilot study was conducted to assess the feasibility of using local historical archives and oral histories to map historical factors that may be important in understanding contemporary variations in health. Focusing on housing clearances in the 1950s, 1960s and 1970s, the pilot study drew on a wide range of materials (documentary and oral) to explore now changes to local housing impacted upon the local social and psychological landscape. This research note considers methodological issues relevant to the use of documentary and oral history resources and illustrates the value of the historical resources we identified, We suggest that, on the basis of this pilot research, future explorations of the link between places and inequalities in health should incorporate an historical analysis. KEY WORDS health inequalities / historical research methods / housing / social capital

This paper explores the links between lay knowledge, place and health related social action (or agency) at the individual and collective level. It is based on an analysis of in-depth interviews and neighbourhood survey data across four localities in two cities in the North West of England. The qualitative analysis has identified 'guidelines' that we argue provide socially shared understandings of the normative contours of 'proper places' which shape the way people respond to the everyday lived reality of places. The quantitative findings suggest that a substantial minority of people, particularly in disadvantaged areas, are exposed to significant dissonance between the normative dimensions and lived experience of place. The analysis points to potential interactions between individual and collective action which may affect the health of individuals and populations and 'ontological fit'--people's ability to (re) construct a positive identity despite living in what they and others perceive to be an 'improper' place. This is linked to their biographical connections with particular places and the extent to which they can localise problems and people in places at a distance from themselves. The paper contributes to understanding about the processes that generate inequalities in the health experience of people living in sharply contrasting socio-economic circumstances as well as finer-grained health inequalities between the 'poor' and the 'poorest'. Keywords: Health inequalities; Place; Normative guidelines; Ontological identity; Agency; Narratives; England

This paper addresses the issues surrounding an individual's exposure to potential environmental risk factors, which can be implicated in the aetiology of a disease. We hope to further elucidate the 'lag' or latency period between the initial exposure to potential pathogens and the physical emergence of the disease, with specific reference to the rare neurological condition, motor neurone disease (MND), using a dataset obtained from the Finnish Death Certificate registry, for MND deaths between the period 1985-1995. A space-time approach is adopted, whereby patterns in both time and space are considered. No prior assumptions about the aetiology of MND are adopted. By using methods for the analysis of point processes, which preserve the continuous nature of the data, we resolve some of the problems of analysis that are often based on arbitrary areal units, such as postcode boundaries, or political boundaries. We use kernel estimation to model space-time patterns. Raised relative risk is assessed by adopting appropriate adjustments for the underlying population at risk, with the use of controls. Significance of the results is assessed using Monte Carlo simulation, and comparisons are made with results obtained from Openshaw's geographical analysis machine (GAM). Our results demonstrate the utility of kernel estimation as a visualisation tool. Small areas of elevated risk are identified, which need to be more closely examined before any firm conclusions can be drawn. We highlight a number of issues concerning the inadequacies of the data, and possibly of the techniques themselves.

This study investigates variations in survival following surgery for colo-rectal cancer in the Wessex region (part of southern England), using 5147 cases diagnosed between 1 September 1991 and 31 August 1995. Survival curve estimation by life tables and Cox's proportional hazards model were used to examine geographical variation in cancer survival, with a specific focus on distance between place of residence and treatment centre, and district of treatment. We also consider whether area deprivation has an impact on survival. In seeking to answer these questions we control for possible confounders, including: age, gender, site of tumour, stage of disease at operation, hospital size and surgery type (whether elective or non-elective). District of treatment, distance and deprivation all show a relationship to outcome using survival curves, but when adjusting for other covariates using the Cox model, and considering deaths from all causes, only district of treatment was a very significant covariate (p < 0.0001). Distance, deprivation, and gender were only weakly significant (p < 0.10). Considering only deaths related to operation (within 30 days) district of treatment remained significant, but while distance had some effect on outcome, deprivation and gender ceased to be significant covariates. There is some evidence that those who live furthest from centres of treatment have the worst outcomes but the 'geography of survival' manifests itself more through where patients are treated than through area (deprivation) effects or relative location. The results have important policy implications, as they show variations among treatment centres having controlled for potentially confounding factors.

We seek to determine whether variability in deprivation at small area level, and population stability, influence standardised morbidity ratios in England and Wales. A regression analysis was conducted with data from the 1991 British Census, in order to explain variation in morbidity. Both an area deprivation score (for electoral wards) and the within-area variability of deprivation scores were examined as possible determinants of morbidity (self-reported, limiting, long-term illness). Particular attention was focused on a spatially-sensitive measure of the variability of deprivation scores within a wider 'locality'. There was a significant, positive relationship between age-standardised limiting, long-term illness and deprivation. The variation in area deprivation scores within the small areas themselves was also significant and positive. However, the variation in deprivation scores calculated for both an electoral ward and its contiguous neighbours (the locality) was slightly more significant. Areas with higher relative levels of in-migration also had significantly lower standardised morbidity ratios. Multivariate models showed that the deprivation score, the variation in deprivation scores for the broader locality, and the measure of migration, were all significant in combination. Residual analysis showed that many areas in London had lower levels of morbidity than expected, while electoral wards in the coal mining valleys of South Wales had higher levels than expected. We conclude that, for small areas (wards) in England and Wales, morbidity is related to deprivation, variation in deprivation within and surrounding each area, and the proportion of the population that are migrants. Variations in deprivation influence standardised morbidity rates, and policies which widen inequalities will influence health outcomes. Resource allocation based simply on measures of deprivation, which ignore population change within the area and variations in deprivation in the locality, may be inefficient. Keywords: Limiting long-term illness; Area deprivation; Health variations; Population migration; England and Wales

A previous study showed that variations in deprivation within small localities in England and Wales influenced the rates of self-reported limiting long-term illness, controlling for overall levels of deprivation. These results suggest that while morbidity is related to overall levels of material deprivation, the distribution of resources within small areas have a significant effect on health outcomes. However, it is possible that these area effects become redundant once individual-level characteristics are accounted for. This analysis examines whether area-level deprivation and variations in deprivation are significant indicators of individual-level limiting long-term illness, once individual characteristics have been accounted for. Keywords: Limiting long-term illness; Health variations; England and Wales; Logit models; Material deprivation