T. Gunnar. Northcentral University.

The most sedentary members of the population are more likely to make and sustain smaller changes in lifestyle such as walking cheap diclofenac gel 20 gm amex arthritis diet stories, cycling and stair use rather than the more dramatic changes required by the uptake of rigorous exercise programmes purchase diclofenac gel 20 gm arthritis knee exercises 2009. This shifting perspective is illustrated by contemporary research on the benefits of exercise. Aspects of exercise have been defined in different ways according to intention, outcome and location. Some researchers have differentiated between different types of behaviours in terms of the individual’s intentions. Physical activity has been defined as ‘any bodily movement produced by skeletal muscles that results in energy expenditure’. This perspective emphasizes the physical and biological changes that happen both automatically and through intention. Exercise has been defined as ‘planned, structured and repetitive bodily movement done to improve or maintain one or more components of physical fitness’. This perspective emphasizes the physical and biological changes that happen as a result of intentional movements. This distinction illustrates a shift in emphasis from intensive exercise resulting in cardiovascular fitness to moderate exercise resulting in mild changes in health status. It also illustrates a shift towards using a definition of health that includes both biological and psychological changes. For example, Paffenbarger and Hale (1975) differentiated between occupational activity, which was performed as part of an individual’s daily work, and leisure activity, which was carried out in the individual’s leisure time. These definitions are not mutually exclusive and illustrate the different ways exercise has been conceptualized. The results of a survey, in which men and women were asked about their exercise behaviour, are shown in Figure 7. They suggest that the four most common forms of exercise are walking, swimming, snooker/pool/billiards and keep fit/yoga. Research has examined the possible physical and psychological benefits of exercise. They reported the results from a longitudinal study which suggested that individuals with a weekly energy expenditure of more than 2000 kcals on exercise reported as walking, stair climbing and sports, lived for two-and-a-half years longer on average than those with an energy expenditure of less than 500 kcal per week on these activities. The possible reasons for the effects of exercise on longevity are as follows: 1 Reduction in blood pressure: physical activity has an inverse relationship to both diastolic and systolic blood pressure. This effect is particularly apparent in those who have mild or moderately raised blood pressure. Exercise may help promote weight loss/maintenance (see Chapter 15 for details of exercise and obesity). Coronary heart disease The effects of exercise on coronary heart disease have been examined by assessing the consequences of both occupational activity and leisure activity. Regarding occupational activity, Paffenbarger and Hale (1975) followed up 3975 longshoremen for 22 years. The results showed that at the end of this period, 11 per cent had died from coronary heart disease and that those longshoremen who expended more than 8500 kcal per week had a significantly lower risk of coronary heart disease than those in jobs requiring less energy. This difference remained when other risk factors such as smoking and blood pressure were controlled. This relationship between occupational activity and coronary heart disease has also been shown in samples of both men and women (Salonen et al. Research has also evaluated the relationship between leisure-time activity and coronary heart disease. The results showed that those who attempted to keep fit showed less than half the incidence of coronary heart disease at follow-up compared with the other subjects. Exercise may influence coronary heart disease in the following ways: 1 Increased muscular activity may protect the cardiovascular system by stimulating the muscles that support the heart. The physical benefits of exercise have been summarized by Smith and Jacobson (1989) as: (1) improved cardiovascular function; (2) increased muscle size and strength and ligament strength for maintaining posture, preventing joint instability and decreasing back pain; (3) improved work effort; and (4) changing body composition. The psychological benefits of exercise Research also indicates that exercise may improve psychological well-being. These effects are outlined below: Depression Research using correlational designs suggests an association between the amount of exercise carried out by an individual and their level of depression. Much of the reviews into this association have stressed the correlational nature of the research and the inherent problems in determining causality (e. However, McDonald and Hodgdon (1991) carried out a meta-analysis of both the correlational and experimental research into the association between depression and exercise. They concluded that aerobic exercise was related to a decrease in depression and that this effect was greatest in those with higher levels of initial depressive symptoms.

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Furthermore generic diclofenac gel 20 gm without prescription arthritis in back surgery, both the chronic and acute processes highlight the central role for stress induced changes in behaviour and changes in physiology buy discount diclofenac gel 20 gm line arthritis in knee massage. However, there are also studies exploring links between illnesses such as cancer, diabetes and recovery from surgery. These risk factors are strongly influenced by behaviour and reflect the behavioural pathway between stress and illness (Krantz et al. In line with this, some research has examined the effect of stress on specific health-related behaviours. Smoking Smoking has been consistently linked to a range of illnesses including lung cancer and coronary heart disease (see Chapter 5). Research suggests a link between stress and smoking behaviour in terms of smoking initiation, relapse and the amount smoked. Wills (1985) argued that smoking initiation in adolescents was related to the amount of stress in their lives. In addition, there has been some support for the prediction that children who experience the stressor of changing schools may be more likely to start smoking than those who stay at the same school throughout their secondary educa- tion (Santi et al. Research also indicates that increased smoking may be effective at reducing stress. The results showed that regardless of whether the smokers smoked or not, all subjects reported an increased desire to smoke in the stressful condition. However, this desire was less in those smokers who were actually allowed to smoke. In a more naturalistic study, smokers were asked to attend a stressful social situation and were instructed either to smoke or not to smoke. Those who could not smoke reported the occasion as more socially stressful than those who could smoke (Gilbert and Spielberger 1987). This association was also found in one large scale study of over 6000 Scottish men and women which showed that higher levels of perceived stress were linked to smoking more (Heslop et al. Alcohol High alcohol intake has been linked to illnesses such as coronary heart disease, cancer and liver disease (see Chapter 5). Research has also examined the relationship between stress and alcohol consumption. Many authors have suggested that work stress in par- ticular, may promote alcohol use (e. The tension reduction theory suggests that people drink alcohol for its tension- reducing properties (Cappell and Greeley 1987). Therefore according to this model, negative moods are the internal stressors, or the consequence of an external stressor, which cause alcohol consumption due to the expected outcome of the alcohol. For example, if an individual feels tense or anxious (their internal state) as a result of an exam (the external stressor) and believes that alcohol will reduce this tension (the expected outcome), they may drink alcohol to improve their mood. This theory has been supported by some evidence of the relationship between negative mood and drinking behaviour (Violanti et al. Further- more, it has been suggested that medical students’ lifestyle and the occurrence of problem drinking may be related to the stress they experience (Wolf and Kissling 1984). In one study, this theory was tested experimentally and the health-related behaviours of medical students were evaluated both before and during a stressful examination period. The results showed that the students reported a deterioration in mood in terms of anx- iety and depression and changes in their behaviour in terms of decreases in exercise and food intake (Ogden and Mtandabari 1997). The authors concluded that acute exposure to stress resulted in negative changes in those behaviours that had only a minimal influence on the students’ ability to perform satisfactorily. Obviously chronic stress may have more damaging effects on longer-term changes in behaviour. Eating Diet can influence health either through changes in body weight or via the over or under consumption of specific dietary components (see Chapter 6). Most research has focused on the individual difference model and has examined whether either naturally occurring stress or laboratory- induced stress causes changes in eating in specific individuals. Therefore, gender, weight and levels of dieting (see Chapter 6) seem to be important predictors of a link between stress and eating. Their results showed a direct associ- ation between increased daily hassles and increased snacking but showed no differences according to either gender or dieting. Such inconsistencies in the literature have been described by Stone and Brownell (1994) as the ‘stress eating paradox’ to describe how at times stress causes overeating and in others it causes undereating without any clear pattern emerging. Exercise Exercise has been linked to health in term of its impact on body weight and via its beneficial effects on coronary heart disease (see Chapter 7). Accidents Accidents are a very common and rarely studied cause of injury or mortality. Research has also examined the effects of stress on accidents and correlational research suggests that individuals who experience high levels of stress show a greater tendency to perform behaviours that increase their chances of becoming injured (Wiebe and McCallum 1986). Further, Johnson (1986) has also suggested that stress increases accidents at home, at work and in the car. If this is the case then the stress following illness also has implications for the health of individuals. Such stress may influence individuals’ behaviour in terms of their likelihood to seek help, their compliance with interventions and medical recommendations, and also adopting healthy lifestyles.

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The Metamorphic Technique is not a therapy or a treatment diclofenac gel 20 gm amex arthritis joint protection handout, since it is not concerned mesmerism The technique of “animal magnet- with addressing specific symptoms or problems 20gm diclofenac gel with visa is arthritis in the knee curable. It can be used alone or complement conventional or alternative medicine therapies. Metamorphic Technique An approach to self- No special training, abilities, or background are healing and personal development through elimi- needed in order to become a practitioner. Clients nating limited beliefs about one’s potential and who wish to transform their behavioral and emo- patterns both physical and emotional that cause tional patterns often seek the Metamorphic Tech- these beliefs. The recip- technique acts as a catalyst to this energy (also ient removes shoes and socks and may either sit or known as the life force), gently helping to trans- lie down. The practitioner uses a light touch on the form the negative patterns into positive ones. The Metamorphic Technique originated in the Metamorphic Technique practitioners work in a work of Robert St. John, a British naturopath and detached way: nonjudgmental, nonmanipulative, reflexologist. He then abilities, as well as in schools for children with developed the spinal reflexes approach in combi- learning difficulties, in hospitals, in prisons, and nation with the concept of innate self-healing abil- in practices that help people overcome addic- ity and eventually called the entire process tions, eating disorders, and stress-related condi- Metamporphosis, particularly because the changes tions. It is also used by pregnant women and experienced by clients appeared to be enduring. John during the 1970s, further devel- The Metamorphic Association offers these oped St. In 1979 he set up the Metamorphic Association, which was then registered as a charity • A unique tool for personal transformation. While other approaches often focus on particularly by syphilis, a venereal disease that removing energy blockages, the Metamorphic eventually destroys all the bodily systems. It does not consider people to be “blocked” or “broken” and in need of being mind-body connection The relationship between “fixed. The energy that was fatigue, exposure to environmental factors, and involved in creating the old patterns is released other general emotional conditions are manifested and can be used to create new patterns. Any changes that occur originate at the National Institute of Mental Health, Candace entirely from within the recipient. The practitioner simply acts as a catalyst in tides, encouraged research on neuropeptides. Alternative nor diagnosis, nor any need to discuss personal and integrative medicine modalities have embraced problems or medical history. It func- tions as a network of people who support each molecular nutrition The application of biochemi- other in learning, sharing, exploring, practicing, cal and physiological approaches to the understand- promoting and teaching the Metamorphic Tech- ing of nutrient function and metabolism in systems nique. As members of the association, they have a ranging from the whole animal to the molecular common goal: “to promote good health and well- level. Nutrition is a natural science that has a funda- being through awareness, understanding and use of mental biological basis. To study such processes and pathways miasm In homeopathic medicine, an underlying requires a critical knowledge of biochemistry and pattern of dysfunction that creates and maintains physiology combined with a fundamental back- chronic disease processes and their recurrences. The headquarters of The The three miasms formulated by Samuel Hahne- International Society for Molecular Nutrition and mann are psora, sycosis, and syphilis. A sycotic miasm refers to Cardiology, Philipps University of Marburg, Karl- gonorrhea and other disorders involving mucous von-Frisch-Str. Once on the other side of the tun- and disease and organizing scientific meetings in the nel, or after they have risen into the heavens, area of molecular nutrition, including nutrition the dying meet people who glow with an related to cancer, cardiovascular diseases, immune inner light. Often they find that friends and disorders, neurosciences, nutritional abnormalities, relatives who have already died are there to and vitamins and trace elements. The being of light presents the the near-death experience and is a proponent of dying with a panoramic review of everything the concept of an afterlife, particularly as it pertains they have ever done. His best-selling every act they have ever done to other people book, Life after Life, first focused public attention in and come away feeling that love is the most 1975 on the near-death experience and what it is important thing in life. The being of light sometimes and compared the experiences of 150 persons who tells the dying that they must return to life. His Other times, they are given a choice of stay- research describes the results of decades of inquiry ing or returning. The people who choose to elements that generally occur during the near- return do so only because of loved ones they death experience: do not wish to leave behind. While people are dying, writer, and lecturer who lives in New England they may be in intense pain, but as soon as with his wife and two children. He has published they leave the body the pain vanishes and many articles in the areas of archetypal and Jun- they experience peace.

For example diclofenac gel 20gm on line arthritis hip, Breckler (1994) defined it as ‘a conflict aroused by competing evaluative predispositions’ and Emmons (1996) defined it as ‘an approach – avoidance conflict – wanting but at the same time not wanting the same goal object’ buy diclofenac gel 20gm with mastercard arthritis degenerative. A total of 325 volunteers completed a questionnaire including a measure of ambivalence assessed in terms of the mean of both positive and negative evaluations (e. This computation provides a score which reflects the balance between positive and negative feelings. The results showed that the relationship between attitude and intention was weaker in those participants with higher ambivalence. This implies that holding both positive and negative attitudes to a food makes it less likely that the overall attitude will be translated into an intention to eat it. Predicting behaviour: exploring the intention–behaviour gap Sutton (1998a) argued that although structured models are ineffective at predict- ing behavioural intentions they are even less effective at predicting actual behaviour. In fact, he suggested that studies using these models only predict 19–38 per cent of the variance in behaviour. Some of this failure to predict behaviour may be due to the behaviour being beyond the control of the individual concerned. For example, ‘I intend to study at university’ may not be translated into ‘I am studying at university’ due to economic or educational factors. Further, ‘I intend to eat healthily’ may not be trans- lated into ‘I am eating healthily’ due to the absence of healthy food. In such instances, the correlation between intentions and behaviour would be zero. However, for most behaviours the correlation between intentions and behaviour is not zero but small, suggesting that the individual does have some control over the behaviour. Psychologists have addressed the problem of predicting actual behaviour in three ways: (1) the con- cept of behavioural intentions has been expanded; (2) past behaviour has been used as a direct predictor of behaviour; and (3) variables that bridge the intention–behaviour gap have been studied. Expanding behavioural intentions Much of the research that uses models to predict health behaviours focuses on behavioural intentions as the best predictor of actual behaviour. However, recent researchers have called for additional variables to be added which expand behavioural intentions. They suggested that such self-predictions are more likely to reflect the individual’s consideration of those factors that may help or hinder the behaviour itself. To date, some research supports the usefulness of this new variable (Sheppard et al. Paisley and Sparks (1998) argued that it is the perception by an individual that they need to change their behaviour which is critical. For example, an intention ‘I intend to stop smoking’ may be less influential than a perceived need to stop smoking ‘I need to stop smoking’. They examined the role of perceived need in predicting expectations of reducing dietary fat and argued for the use of this variable in future research. Therefore, by expanding behavioural intentions to include self-predictions, behavioural willingness and/or perceived need it is argued that the models will be become better predictors of actual behaviour. The role of past behaviour Most research assumes cognitions predict behavioural intentions, which in turn predict behaviour. This is in line with the shift from ‘I think, therefore I intend to do, therefore I do’. It is possible, however, that behaviour is not predicted by cognitions but by behaviour. From this perspective, individuals are more likely to eat healthily tomorrow if they ate healthily today. They are also more likely to go to the doctor for a cervical smear if they have done so in the past. In terms of past behaviour, research suggests that it predicts behaviours such as cycle helmet use (Quine et al. In addition, past behaviour may itself predict cognitions that then predict behaviour (Gerrard et al. In terms of habit, research indicates a role in explaining condom use (Trafimow 2000) and that habit reduces people’s use of information (Aarts et al. In particular, some research has highlighted the role of plans for action, health goals commitment and trying as a means to tap into the kinds of cognitions that may be responsible for the translation of intentions into behaviour (Bagozzi and Warshaw 1990; Schwarzer 1992; Bagozzi 1993; Luszczynska and Schwarzer 2003). Most research, however, has focused on Gollwitzer’s (1993) notion of implementation intentions. According to Gollwitzer, carrying out an intention involves the development of specific plans as to what an individual will do given a specific set of environmental factors. Therefore, implementation intentions describe the ‘what’ and the ‘when’ of a particular behaviour. For example, the intention ‘I intend to stop smoking’ will be more likely to be translated into ‘I have stopped smoking’ if the individual makes the implementation intention ‘I intend to stop smoking tomorrow at 12. Further, ‘I intend to eat healthily’ is more likely to be translated into ‘I am eating healthily’ if the implementation intention ‘I will start to eat healthily by having an apple tomorrow lunchtime’ is made.

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