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4.2 People knowledge

Stacey (1994) has made a passionate plea to understand the ‘power of lay knowledge’ which she prefers to call ‘people knowledge’. Stacey claims that two fundamental assumptions underline the importance of listening to lay voices. One is that all people are of equal worth and so their views should be heard. The other is that people are health producers as much as they are health consumers. She maintains that patients do a great deal of hard work, whether it is direct as with labouring
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3.4 Health and children

So far, all the studies we have discussed have been based on adults. Health viewed through children's eyes is receiving attention, mainly in order to be able to target health promotion messages. Bendelow and Pridmore (1998) interviewed 100 nine and 10-year-olds in three primary schools in urban and rural areas of south-west England. As well as having discussions with the children, they asked the children to draw pictures to convey their views. Their results are quoted in Box 2.


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3.1 Health and low income

Health is a very personal matter, but people's health is very much situated in their life experiences and so their perceptions of health are likely to reflect their social situation.

Bostock (1998), a health researcher, interviewed mothers who were managing on low incomes to find out about their perceptions of their health. She was struck by the difference between her respondents' self-assessed health status compared to that found by the British Household Panel Survey (BHPS) which relat
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3.1 Frequency

Frequency refers to how often or how frequently someone should exercise. To improve aerobic fitness, the American College of Sports Medicine (ACSM) recommends an exercise frequency of three days per week of vigorous exercise or five days of moderate exercise for healthy adults (Garber et al., 2011). The terms ‘vigorous’ and ‘moderate’ will be defined in the next section.

A frequency of 3–5 days per week using a combination of moderate and vigorous exercise is also recommended.
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2 Principles of training

When designing training sessions or programmes, it is important to consider the principles of training which include the principles of overload, progression, specificity, individual response and reversibility. These principles apply to all components of fitness, not just aerobic fitness,

Overload

In order to increase our fitness, we need to ‘overload’ our body systems. For examp
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Learning outcomes

After studying this course, you should be able to:

  • apply the principles of training to aerobic fitness development

  • consider the appropriate frequency, intensity, time/duration and type of exercise to develop aerobic fitness.


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3.3.1 A conflict of interest

One of the difficulties of the involvement of drug companies in the mental health field is that it produces a conflict of interest. To put it crudely, drug companies rely on a continuing supply of patients to keep them in business. This is not always congruent with people's best interests, as you will see below. Although mental health services are intended to help people experiencing mental distress, they also have other driving forces. The market economy model of provision has encouraged the
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1.1 Introduction

This extract looks at what we are calling ‘boundaries of explanation’. It tackles key issues such as:

  • What are mental health and distress – and who decides?

  • What are the views of people who have acquired a label of ‘mental illness’?

  • What are the views of those who determine – and patrol – the boundary between mental distress and ‘normality’?

The extract looks at language and terminology an
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3.20 Key ethical issues for CAM practitioners: an effective complaints mechanism

Effective relationships require strong communication skills. A good therapeutic relationship allows users the space and security to air their dissatisfaction without recourse to an external body. However, not all users enjoy such open relationships with their practitioners and may prefer to end the relationship than voice a complaint. This is why it is crucial for professional bodies to have accessible and user-centred complaints mechanisms in place. Complaints panels must include a significa
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3.19 Key ethical issues for CAM practitioners: professional etiquette and whistleblowing

In the past, professional bodies cautioned their members against disparaging other members of the same profession in front of a user. In the UK many codes of ethics still discuss professional etiquette from the perspective of safeguarding the interests of the practitioner rather than the user. Sensitivity is required when treating a user who is dissatisfied with a previous practitioner, but this should not prevent a practitioner being critical of someone else's obviously unacceptable treatmen
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3.11 Key ethical issues for CAM practitioners

Although CAM practitioners’ duties may vary in nature from other health professionals’ duties, the types of ethical concern remain broadly similar. The rest of this extract considers the key ethical areas underpinning standards of best practice in CAM. Although CAM practice varies dramatically in scope, all the issues listed in Author(s): The Open University

3.4.3 Respecting autonomy is the foremost ethical principle in health care

Some commentators believe the pendulum has swung so far in favour of respecting autonomy that it leaves little scope for users to be passive recipients of healing. The desire to make each user an active participant in their own healing process can make it hard, or even impossible, for a user to refuse to engage in active decision making, and leave the decision to the benevolent practitioner. In this case, the user may waive his or her rights, by choosing not to be kept informed about changes
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3.4.2 CAM practitioners are more ethical than conventional doctors

Proponents of CAM argue that because it is safer and has fewer side effects than conventional medicine, CAM practitioners must be inherently more ethical than doctors. This is a false argument in several respects. While CAM is generally very safe compared with some powerful conventional remedies (a point acknowledged in para. 4.21 of the House of Lords Report, 2000), all therapies can cause harm in unskilled hands. Some side effects of CAM are potentially serious, particularly if there is a c
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2.9 The failure of CAM therapeutic relationships: creating dependency to satisfy practitioners' emot

Although a failed therapeutic relationship is often assumed to involve a patient not returning, the case of a patient who attends repeatedly can also be highly problematic. This phenomenon can be seen as a breach of boundaries in that an inappropriately extended therapeutic relationship changes from being a healing encounter into a dependency relationship or friendship. Unlike the timescale contracts that may be negotiated in counselling and psychotherapy, there are no fixed timescales for mo
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1.6 Valuing diversity

Social workers need to recognise diversity: valuing and respecting service users – irrespective of, for example, their ethnicity, gender or age – is central to good practice. It is also about working in a way that counters the unfair or unequal treatment of individuals or groups on the basis of their race, gender, class, age, culture, religion, sexuality or ability. There is a growing body of law that seeks to prohibit and punish a range of discriminatory behaviours in various kinds of so
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1.5 Accountability

Social workers have to act within the law and can be called upon to justify their actions to courts and managers as well as to service users. The law can define a worker's accountability in some detail. Furthermore, service users have a right to complain. Social workers are also employees and thus can be called upon to justify their actions to their line management and agency; this will be outlined by their agency requirements.

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1.4 Rights

Rights is a word that is used in different ways. Lawyers use it to indicate that a person is entitled to something, for example not to be dismissed unfairly from their job or to sue for damages if they have been sold faulty goods. Others sometimes talk of rights when they are making a moral claim, for example that they ought to be allowed to demonstrate or that a particular law is unjust or unfair. In this course we use rights primarily in the first sense, i.e. when we are talking about the a
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3.6 Summary

This section has described how fossil fuels provide the majority of the world's energy requirements, with bioenergy, nuclear energy and hydropower also making major contributions. The other 'renewable' energy sources currently supply only a small fraction of world demand, although the contribution of these 'renewables' seems likely to grow rapidly in coming decades, as we shall see in the following section.


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4.1 When climate changes

We have seen that human-induced climate change poses a challenge for people who live on islands. Such changing patterns and extremes of climate also put pressure on the other living things that are part of the make-up of island territories. However, long before human beings became aware that they could transform the flows that constitute climate, they and other species were already taking advantage of these same flows to help create the very territories that are now under threat. But have the
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Acknowledgements

Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence

Grateful acknowledgement is made to the following sources for permission to reproduce materi
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