The role of serotonin (51M) in the physiological regulation of AVP secretion is controversial. Neuroanatomical studies, largely in rats but also in human brains, have suggested that 5HT may have a direct modulatory effect on magnocellular vasopressin (AVP) secretion. Pharmacological and neurophysiological studies in animals have provided further evidence to support this and suggest that increase in 5HT neurotransmission leads to a rise in plasma AVP and that 5HT may be important in osmoregulated AVP secretion Studies investigating the importance of 511T as a modulator of AVP release in humans have not be undertaken. Indirect evidence of a putative role derives from the occurrence of hyponatraemia, and possible inappropriate AVP secretion,associated with the clinical use of drugs, particularly antidepressants, which have effects on 5HT neurotransmission. In addition there has been some suggestion that AVP secretion may be abnormal in depression where there is a putative abnormality of the 5HT nervous system. This research has approached the study of anatomical and physiological relationships between 5HT and AVP in 3 ways. Firstly through studies in normal man, secondly by studies in depressed patients, as a putative disease model of 5HT neurotransmission, and thirdly to more extensively explore the effect of pharmacological manipulation of 5HT neurotransmission using an animal model of osmoregulation. Studies in man found no evidence that 7 days treatment with a 5HT reuptake inhibitor (Fluoxetine) had a significant effect on osmoregulated AVP secretion. Studies in elderly depressed patients showed that there was an apparent deficiency of osmoregulated AVP secretion with normal ageing but found no evidence that either moderate depressive il lness, or treatment of the depression with Fluoxetine, had significant effect on water balance. Studies in the rat model of osmoregulation showed that acute 5HT reuptake inhibition stimulated basal AVP secretion and increased the osmotic sensitivity of AVP secretion but had no effect on the osmotic threshold of secretion. Chronic treatment (21 days) with the reuptake inhibitor had no significant effect on basal AVP secretion or on the osmotic threshold but significantly decreased the osmotic sensitivity of AVP secretion. Studies with the 5HT2/5HTIc antagonist, Ritanserin, and the 5HT2 agonist, DOI, suggested that this modulatory effect was not mediated through these receptor subtypes. Autoradiographic studies identified a low density of 5HT2 and 5HTIa receptors in the vicinity of the magnocellular neurons of the rat hypothalamus. The results suggested that 5HT modulates AVP secretion indirectly, possibly by inhibition of inhibitory afferent stimuli. This is of little physiological consequencien the normal rat and probably in healthy man where there is rapid accommodation and autoregulation. In situations where there is a dysfunction of the normal adaptive mechanisms such as in depression,the role of 5HT may be more important and occasionally may lead to severe hyponatraemia.

No description available.

This thesis addresses the growing number of inmates with a mental illness in correctional facilities in Canada which continues to attract public attention and concern. Several explanations have been put forward to explain the rise in the number of inmates with a mental illness. These include: the deinstitutionalization of the mentally ill that began in the 1970’s, lack of treatment availability for those released into the community, and criminalization of persons with a mental illness by the justice system. The increasing numbers of persons with a mental illness in the correctional system has led to serious concerns about the capacity of this system to manage, treat, and rehabilitate individuals with a mental illness. Lack of proper treatment, management, rehabilitation and monitored discharge means that inmates with serious mental illness are more likely to come into contact with the criminal justice system more frequently. This thesis examines the incidence seriously mentally ill offenders and their propensity to recontact. Three hundred and ninety eight face-to-face assessments were conducted using the Resident Assessment Instrument-Mental Health 2.0 (RAI-MH) and from total scores from the Level of Service Inventory Ontario Revision (LSI-OR). These assessments were conducted in 14 Ontario Provincial Correctional facilities during the years 2005-2008. Bivariate and multivariate regression analysis was conducted to assess recontact rates for serious mentally disordered and non-mentally disordered offenders. With regards to recontact, no differences were revealed between the seriously mentally ill offender and non-mentally ill offender. This null finding on recontact is very surprising given the current literature on the seriously mentally ill. An additional finding revealed that for offenders with or without a serious mental illness, having a higher score on the scale of criminogenic tendencies (LSI-OR) increased rates for recontact. Another surprising finding is that seriously mentally ill offenders were more likely to commit minor crimes upon release, rather than violent crimes as current literature suggests. A more accurate research tool, as well as a larger sample size, will be required to assess the validity of these results. The implications of the negative outcome with respect to recontact and issues of identifiable risk factors for recidivism for both seriously mentally ill and non-mentally ill inmate populations are discussed in relation to outcomes in terms of both improvements to Corrections policy and theories of criminology. It is important to continue research in this area, to determine the true gravity of the incidence and recontact rates of mentally ill offenders.

Thesis (PhD)--University of South Australia, 2000

Research Doctorate - Doctor of Philosophy / Preschool children frequently experience illness and consequently are significant users of health services. Despite children’s rights, children’s understandings of illness are rarely given due consideration in health care. Nursing practice tends to rely on adult accounts of the child’s illness. Children’s limited language ability is seen as a barrier to understanding their views. Thus this thesis is a search for what it means to preschool children to be ill. Careful analysis of the behavioural and cognitive literature on preschool children’s understandings of illness reveals a dependence upon abstract adult models of illness as a point of comparison. Despite being marginalized in the literature children’s kinaesthetic, intersubjective, situational, and spatial understandings of illness are uncovered. Existing research methodologies present barriers to understanding the world as children do. Drawing on the writings of Maurice Merleau-Ponty, Eugene Gendlin and other phenomenological scholars a new ethnographic phenomenological methodology is detailed. This methodology reveals a relational edge from which adults can begin to understand the world as children do. The methodology was used to identify how preschool children experience being ill from short-term illnesses and how they communicate those experiences to others. Field data was collected from 49 close observations with 10 children and eight parental interviews. Using field data and contemporary research, I explicate my thesis that preschool children understand illness inside-out, unimpeded by others. I examine how children, initially devoid of boundaries between inner and outer, and in advance of what they can say, articulate their meaning (‘inside’ experience/body sense) of the illness through movement and gesticulation (out) as expression. This inside-out expression of the illness experience is unimpeded by others. Adults in intimate situations with ill children can begin to understand children’s experience of illness by focusing on their own body-sense, which is related to the child’s body sense, because there is an incomplete differentiation between self and other. Knowing that children understand illness inside-out helps to understand the nature of preschool children’s experience of illness. Such understandings should influence adult interactions with sick children.

Doctor of Philosophy(PhD) / Policy makers, service agencies and people with mental illness themselves view employment for people with mental illness as a major concern. This is due to the low rate of employment of people with mental illness, the difficulties many experience in finding and keeping satisfactory jobs, and the perception of paid employment as highly desirable for people with mental illness. The most extensive research on employment for people with mental illness has focused on establishing statistical relationships between various hypothesised predictors of employment success and vocational outcomes. While some attention has been paid to how individuals with mental illness view being employed, this has primarily focused on specific areas such as the benefits of employment, difficulties encountered and coping techniques used. My aim in this research was to develop a theoretical formulation which explains the processes that people with mental illness engage in with regard to employment. Data was gathered by way of in-depth interviews with users of psychiatric services. Some of these participants were employed, others were seeking employment, while others were not engaged in employment-related activities. At the centre of the theoretical formulation is a process I have called negotiating an appropriate vocational place. Using this process, people with mental illness make decisions about actions to take in relation to employment and these may or may not include trying to get and keep a job. Decisions are made by weighing up the benefits and drawbacks of employment and the advantages and risks of different vocational strategies. In doing so, people with mental illness are influenced by the Australian societal context, their individual social networks, their individual characteristics and circumstances (including their mental illness), and their employment options. This process of negotiating an appropriate vocational place is cyclical, ongoing and dynamic, as individuals' views and circumstances change. Knowing that people with mental illness strive toward an appropriate vocational place rather than taking for granted that they are working towards getting a job presents a challenge to policy and practice in which a successful outcome is defined as obtaining and maintaining a paid position in the workforce. Detailing and elaborating the process by which people with mental illness go about negotiating an appropriate vocational place provides a framework for practitioners, policy makers and researchers to understand the decisions made by people with mental illness and their actions in relation to employment. The understanding provided by the findings from this study will assist those working with people with mental illness and those responsible for employment policies to tailor their work more closely to individuals' desired goals. Immediate and longer term research opportunities are identified to apply the theoretical formulation derived from this study to vocational service practice with people with mental illness.

Research Doctorate - Doctor of Philosophy / Preschool children frequently experience illness and consequently are significant users of health services. Despite children’s rights, children’s understandings of illness are rarely given due consideration in health care. Nursing practice tends to rely on adult accounts of the child’s illness. Children’s limited language ability is seen as a barrier to understanding their views. Thus this thesis is a search for what it means to preschool children to be ill. Careful analysis of the behavioural and cognitive literature on preschool children’s understandings of illness reveals a dependence upon abstract adult models of illness as a point of comparison. Despite being marginalized in the literature children’s kinaesthetic, intersubjective, situational, and spatial understandings of illness are uncovered. Existing research methodologies present barriers to understanding the world as children do. Drawing on the writings of Maurice Merleau-Ponty, Eugene Gendlin and other phenomenological scholars a new ethnographic phenomenological methodology is detailed. This methodology reveals a relational edge from which adults can begin to understand the world as children do. The methodology was used to identify how preschool children experience being ill from short-term illnesses and how they communicate those experiences to others. Field data was collected from 49 close observations with 10 children and eight parental interviews. Using field data and contemporary research, I explicate my thesis that preschool children understand illness inside-out, unimpeded by others. I examine how children, initially devoid of boundaries between inner and outer, and in advance of what they can say, articulate their meaning (‘inside’ experience/body sense) of the illness through movement and gesticulation (out) as expression. This inside-out expression of the illness experience is unimpeded by others. Adults in intimate situations with ill children can begin to understand children’s experience of illness by focusing on their own body-sense, which is related to the child’s body sense, because there is an incomplete differentiation between self and other. Knowing that children understand illness inside-out helps to understand the nature of preschool children’s experience of illness. Such understandings should influence adult interactions with sick children.

Thesis (M. P. H.)--University of Hong Kong, 2006. / Also available in print.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2001. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of New South Wales, 2001. / Also available online.