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In 2001 each primary care trust in England was required to undertake a needs assessment in preparation for the development of a mental health promotion strategy. In Greenwich, it was decided to include the physical environment as one of the themes. This paper describes the findings of a literature review undertaken of health, social sciences and architectural research and the preliminary conceptual model subsequently developed to pull together all aspects of the interface between the urban and physical environment and mental well‐being. The literature review identified five key domains that impacted on this relationship: control over the internal housing environment, quality of housing design and maintenance, presence of valued ‘escape facilities’, crime and fear of crime, and social participation. That these domains can be confounded by socio‐economic and demographic factors and also interact with cultural factors and housing type suggests the importance of a public health approach, which focuses on causal systems rather than simply on individual causal factors.

Medical uncertainty is recognized as a critical issue in the sociology of diagnosis and medical sociology more generally, but a neglected focus of this concern is the question of patient decision making. Using a mixed methods approach that draws upon autoethnographic accounts and third-party interviews, we aim to illuminate the dilemmas of patient decision making in the face of uncertainty. How do patients and supportive caregivers go about navigating this state of affairs? What types of patient–doctor/healthcare professional relationships hinder or enhance effective patient decision making? These are the themes we explore in this study by following patients through the sequence of experiencing symptoms, seeking a diagnosis, evaluating treatment protocols, and receiving treatments. In general, three genres of culturally available narratives are revealed in the data: strategic, technoluxe, and unbearable health narratives.

Learning disability nurses are in a prime position to help protect clients from abuse. But current training programmes are not preparing nurses adequately to fulfill this role. This article argues that a shift in organisational culture is required in order to ensure new knowledge is properly integrated with nurses' experience and training needs.