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2 Accounting for health

Until relatively recently most of the information available to us about how people think about health and illness was concerned with non-Western societies. There was a time when a search in a good anthropological library in Britain would reveal more about the everyday health beliefs of the peoples of, say, African, Asian or South American countries than could be discovered about the everyday health beliefs of the people of the British Isles. Good (1994), in his book Medicine, Rationality a
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Introduction

The unit begins by exploring the notion implied in the title that health pervades all parts of our public and private lives. It will become clear that although health is everywhere, it takes different forms and has different meanings for different people and in different contexts. We all have our own versions of health and you will be able to check yours against a range of other views, including the views of the team who were responsible for producing this unit. We think this is important bec
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Activity 5

Adapting participatory methods

0 hours 45 minutes

This activity is an opportunity to reflect on how you might adapt and use the ideas introduced in Activity 4. Imagine you are running a summer holiday
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Introduction

The aim of this learning guide is to help you develop a critical understanding of the values, skills and methods associated with children’s participation. You will be encouraged to reflect upon and creatively apply the experiences of children and practitioners to new participatory contexts.

There are six activities in this unit:

  • Activity 1: Introductory reading on children’s participation (allow 6 hours)
  • Activity 2: Share
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1.6.2 Treating alcohol-related liver disorders

Although considerable progress has been made in the treatment of many other chronic medical conditions, scant progress has been made in the treatment of cirrhosis. In over 8000 people admitted to hospitals in the Oxford region of the UK with liver cirrhosis during a 30-year observation period, 34 per cent had died one year after their admission and this death rate remained more or less constant (Roberts et al., 2005).

The largely pessimistic view of the failure of treatment of liver dam
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7.4.1 Employers and employees

As a student on a professional social work qualification programme, you would need to sign up to the codes of practice as part of registration with your nation's care council. Codes of practice have been devised for all the nations of the UK. In principle they have much in common, providing a clear guide for all those who work in social care, social work or social services generally. They set out the standards of practice that both workers and their employers should meet. While there is much
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3.3 Case study 1

For much of the last century, many children who would today be regarded as being in need were caught up in the long-running child migration scheme. This scheme had been running throughout the 19th century and into the 20th century and its role was to export children to the outposts of the Empire. In all, it is estimated that 150,000 children were exported in this way (Bean and Melville, 1989). The scheme continued to run throughout the post-war years, which saw a rapid expansion of children's
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Introduction

Ever wondered what social workers do? This brief introduction gives you some insight into social work practice and the theory which informs the practice. This unit is made up of a series of six extracts. You are introduced to the four components to good practice and will look at the importance of the following approaches to social work practice:

  • Biography

  • The social context of social work

  • Responding to children’s needs
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1.4 Type

The ACSM recommends exercise that employs large muscle groups, is rhythmic or dynamic, can be maintained continuously and is aerobic in nature (ACSM, 2006; Pollock et al., 1998). This type of exercise results in larger increases in VO2max. Activities that would fit into this category include walking, running, swimming and cycling.


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1.1.3 Time

The recommended duration of an aerobic exercise session is dependent on several factors, such as the participant’s goals and fitness levels, and the intensity of exercise. Obviously, the higher the intensity of the exercise, the shorter will be its duration. As a general guide the ACSM recommends between twenty and sixty minutes of aerobic exercise, which can be undertaken either continuously – i.e. all at once – or intermittently – i.e. in shorter bouts accumulated during the day (AC
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Introduction

Some elite athletes in the United Kingdom are provided with financial support to allow them to train and prepare for competition. Where does the money come from to finance this? This unit will examine this question by looking at the funding of elite sport in the UK.

This unit is an adapted extract from the Open University course Introduction to sport, fitness and management (E112)
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2.3 Community care, fear and the ‘high-risk’ service user

So far in this unit you have seen how the concept of risk has come to suggest danger. This section explores in greater depth how the changes that have led to this situation have impacted on mental health policies and practice. The next activity involves reading an article to help you consider risk in the context of mental health services.


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3.6 Ethical practice and accountability: the role and function of professional bodies

The UK's medical profession is regulated by the General Medical Council (GMC). One of the main ways in which the GMC, and other regulatory bodies, influences its members is through its code of ethics. This sets out broad principles, rather than detailed guidance, for how practitioners should behave in specific circumstances. This is necessary because a practitioner retains individual accountability and ultimate responsibility for decisions taken during professional practice. Not all br
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3.5 The principles underlying ethical practice

Box 3 describes four principles that are central to an understanding of acting ethically.

Box 3 The principles of acting ethically

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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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2.12.1 Integration

One factor which is already influencing the nature of the therapeutic relationship is the move towards greater integration with orthodox medicine. Whether or not CAM practitioners welcome this development, it is inevitable. The impetus for this is partly about providing health care that gives patient satisfaction, and also stemming the tide of the spiralling costs of hi-tech, orthodox medicine and medical litigation. Stacey (1988) points out that, when the state funds parts of the nati
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2.12 The future of the therapeutic relationship

As discussed earlier in this extract, therapeutic relationships are subject to constant review and reinterpretation. As the culture changed, the predominant shift in health care was away from paternalistic forms of relationships based on professional expertise towards partnership models in which the patient has more rights but also more responsibilities. This final section looks to the future and considers some of the factors that can impact on therapeutic relationships in CAM.


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2.5 The therapeutic relationship as a placebo

Mitchell and Cormack propose that the relationship aspect of a therapeutic encounter can be as important as the technical dimensions of healing (Mitchell and Cormack, 1998). CAM practitioners argue that the therapeutic relationship itself may be an important tool in healing. Critics of CAM turn this argument on its head, suggesting that CAM is, in fact, no more than a powerful form of placebo. What they generally mean is that it is not the specific treatments used that evoke a healing respons
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2.3.3 CAM and the ‘tyranny of health’

Some commentators criticise the very idea of the ‘therapy culture’. The issue for them is not how to get people more involved with their health and the therapeutic relationship, but the unhealthy attitude many people have towards seeking perfect health in the first place. How healthy is it for people to constantly turn to professionals or therapists for advice on health care and lifestyle? Should people believe that being in the best of health is the main concern in their lives? The cultu
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2.3.2 Responsibility for the causes of ill health

Doyal and Pennell (1979) write from the perspective of political economy and argue that there is a continual state of conflict hidden within health experiences and health care relationships. Society produces ill health through an unrelenting drive towards profit and a failure to put the health and wellbeing of individuals first. Work and everyday social life are bound up with taking risks. Many workers experience stress and some occupations involve the risk of physical injury. Social class gr
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