Sample records for autonomy promotive exercise
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The importance of supporting adolescents' autonomy in promoting physical-sport exercise.
Moreno-Murcia, Juan Antonio; Hernández, Elisa Huéscar
2013-01-01
This study was conducted toward the objective of analyzing certain factors that influence physical activity in Spanish adolescent students using self-determination theory (Deci & Ryan, 1985; 2000) as a framework. Participants included 698 physical education students whose perception of the autonomy support provided by their teachers was assessed in and out of the class context. Also assessed were social goals of responsibility and relationship with others, basic psychological needs, and intrinsic motivation, which is part of self-determination theory (SDT). Finally, the "intention" factor posited by the theory of planned behavior (TPB) and students' rate of exercise in the last twelve months were considered. The results of structural equations modeling suggest autonomy education, autonomy support, and social goals positively predicted certain psychological mediators, which in turn positively predicted students' intrinsic motivation, which was a positive predictor of intention, and that of rate of exercise. The results also highlight the benefit of promoting autonomy to enhance students' physical exercise practice.
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Directory of Open Access Journals (Sweden)
Jolly Kate
2009-06-01
Full Text Available Abstract Background The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT-based exercise referral consultation. Methods/Design Design: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT exercise on prescription intervention. Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7 or to the SDT-based intervention (n = 6. Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise. Discussion This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes via structural equation modelling. Trial registration The trial is registered as Current Controlled trials ISRCTN07682833.
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Chiang, Evelyn S; Padilla, Miguel A
2012-07-01
Self-determination theory has been widely applied to understanding individuals' health-related behaviors such as eating healthy foods and exercising. Different reasons for engagement are associated with varying levels of personal agency or autonomy. Authority figures in the environment can be supportive of autonomy or, in contrast, controlling. Although researchers have assessed individuals' perceptions of the autonomy-support in their environments, studies have not directly examined the authority figures' orientations to autonomy with respect to health contexts. A new scale, Parent Orientations to Health, was created to investigate parent orientation to autonomy and control with respect to healthy eating and exercise in children. One hundred and forty-three parents of elementary school-aged children responded to the scale. Scale validation and reliability results indicate that the scale successfully assessed parent orientation towards autonomy for children in health contexts. Furthermore, parent autonomy orientation varied according to child weight status and the healthiness of the child's diet. Parent orientation towards autonomy can be evaluated through the use of the Parent Orientations to Health scale. In addition, parent autonomy orientation is associated with both the healthiness of the child's diet (as perceived by the parent) and the child's body mass index. © 2012 The Authors. Applied Psychology: Health and Well-Being © 2012 The International Association of Applied Psychology.
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Directory of Open Access Journals (Sweden)
Morrison SA
2013-04-01
Full Text Available Shannon A Morrison, Carol J Dashiff, David E Vance School of Nursing, University of Alabama, Birmingham, AL, USA Abstract: Parental influence to promote autonomy and self-determination in their children as they grow up may also motivate them to exercise and eat healthily. Unfortunately, nutritious dietary consumption and physical activity frequency tend to decline during the adolescent years and reaches its lowest level as the adolescent nears adulthood. In this study of 132 freshman and sophomore college students, the influence of parental autonomy support on overall adolescents self-determination was examined to determine whether self-determination influences adolescents' motivation to engage in healthy diet and exercise behaviors. Utilizing hierarchical multiple regression analyses, parental autonomy support was not predictive of older adolescents' motivation for diet and exercise; however, study results did indicate that parental autonomy support remains highly influential in adolescent self-determination (F[2, 130] = 22.21; P = 0.001 during early college years and that in this sample, adolescent self-determination is predictive of motivation for diet (t = 2.21; P < 0.05, but not exercise. Findings suggest that parental autonomy support continues to influence adolescent internalization of attitudes and behaviors during latter adolescence, but may play a lessor role in motivation for specific health-related behaviors as the adolescent nears adulthood. A better understanding of health motivation antecedents of adolescents may facilitate nurses develop new approaches to health-promotion strategies. Keywords: parental autonomy support, self-determination, adolescent health behaviors, motivation
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Compulsory Autonomy-Promoting Education
Schinkel, Anders
2010-01-01
Today, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the development of autonomy in children, but also that this aim should…
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Maximing Learning Strategies to Promote Learner Autonomy
Directory of Open Access Journals (Sweden)
Junaidi Mistar
2001-01-01
Full Text Available Learning a new language is ultimately to be able to communicate with it. Encouraging a sense of responsibility on the part of the learners is crucial for training them to be proficient communicators. As such, understanding the strategies that they employ in acquiring the language skill is important to come to ideas of how to promote learner autonomy. Research recently conducted with three different groups of learners of English at the tertiary education level in Malang indicated that they used metacognitive and social startegies at a high frequency, while memory, cognitive, conpensation, and affective strategies were exercised at a medium frewuency. This finding implies that the learners have acquired some degrees of autonomy because metacognive strategies requires them to independently make plans for their learning activities as well as evaluate the progress, and social strategies requires them to independently enhance communicative interactions with other people. Further actions are then to be taken increase their learning autonomy, that is by intensifying the practice of use of the other four strategy categories, which are not yet applied intensively.
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The Exercise of Learner Autonomy in a Virtual EFL Course in Colombia
Directory of Open Access Journals (Sweden)
Paula Andrea Bedoya
2014-04-01
Full Text Available This case study explores how a group of graduate students manifest autonomy in an English as a Foreign Language virtual course at a Colombian university. Analysis of questionnaires, forums, and interviews showed that students manifested attitudes that led to autonomy such as motivation and commitment at the beginning of the course, but they also manifested high levels of dependence and lack of self-confidence. Later, they became more confident and performed more independently, two attitudes closely-related to autonomy. Furthermore, the results show that factors such as course design, the platform, and the teacher’s role influenced the students’ exercise of autonomy. Finally, the need for designing virtual English as a Foreign Language courses that promote autonomous learning and the teachers’ and the students’ roles in virtual environments are discussed.
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Compulsory autonomy-promoting education
A. Schinkel (Anders)
2010-01-01
textabstractToday, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the
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Autonomy and reason: treatment choice in breast cancer.
Twomey, Mary
2012-10-01
The practice of offering choice to those women with breast cancer for whom either breast conserving surgery or mastectomy would be equally beneficial has come to be seen as an important aspect of medical care. As well as improving satisfaction with treatment, this is seen as satisfying the ethical principle of respect for autonomy. A number of studies, however, show that women are not always comfortable with such choice, preferring to leave treatment decisions to their surgeons. A question then arises as to the extent that these women can be seen as autonomous or as exercising autonomy. This paper argues, however, that the understanding of autonomy which is applied in current approaches to breast cancer care does not adequately support the exercise of autonomy, and that the clinical context of care means that women are not able to engage in the kind of reasoning that might promote the exercise of autonomy. Where respect for autonomy is limited to informed consent and choice, there is a danger that women's interests are overlooked in those aspects of their care where choice is not appropriate, with very real, long-term consequences for some women. Promoting the exercise of autonomy, it is argued, needs to go beyond the conception of autonomy as rational individuals making their own decisions, and clinicians need to work with an understanding of autonomy as relational in order to better involve women in their care. © 2012 Blackwell Publishing Ltd.
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Documenting Different Domains of Promotion of Autonomy in Families
Manzi, Claudia; Regalia, Camillo; Pelucchi, Sara; Fincham, Frank D.
2012-01-01
Parental promotion of autonomy for offspring well-being has been widely recognized in developmental psychology. Recent studies, however, show that this association varies across cultures. Such variation may reflect inappropriate measurement of this dimension of parenting. Therefore, three existing measures of promotion of autonomy were used to…
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Puente, Rogelio; Anshel, Mark H
2010-02-01
The primary purpose of the present investigation was to test the hypothesis, derived from Self-Determination Theory (SDT), that an individual's perceived competence and autonomy mediate the relationship between the exercisers' perception of their instructor's interaction style and the exercisers' motivation to exercise. A secondary purpose was to identify the affective and behavioral outcomes derived from self-determined regulation. It was hypothesized that SDT would significantly explain and predict exercise behavior. Participants consisted of 238 college students, 103 males and 135 females (M age = 20.4 years, SD = 2.16), who volunteered to participate in the study. They were asked to complete a battery of questionnaires measuring instructor's interacting style, self-regulation to exercise, perceived autonomy and competence, enjoyment, positive and negative affect, and exercise frequency. Using structural equation modeling with observed variables, the results showed that perceived competence and autonomy mediated the relationship between perceived instructor's interacting style and self-determined regulation. It was also found that self-determined regulation was significantly related to exercise enjoyment, positive affect, and exercise frequency. It was concluded that understanding the motivational factors and emotional and behavioral consequences of physical activity will partially explain an individual's motives to engage regularly in exercise.
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Soenens, Bart; Vansteenkiste, Maarten; Lens, Willy; Luyckx, Koen; Goossens, Luc; Beyers, Wim; Ryan, Richard M.
2007-01-01
In current research on parenting, 2 ways of conceptualizing perceived parental autonomy support can be distinguished. Parental autonomy support can be defined in terms of promotion of independence (PI) or in terms of promotion of volitional functioning (PVF). This study aimed to establish the empirical distinctiveness of both conceptualizations…
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Issues of promoting learner autonomy in EFL context
Directory of Open Access Journals (Sweden)
Pichugova Inna L.
2016-01-01
Full Text Available The paper is focuded on investigating the phenomenon of learner autonomy, which has mostly been explored in Europe and the USA and is now attracting attention of researchers and academics in many other countries including Russia. Learner autonomy through a focus on learner reflection and taking responsibility for one’s own learning processes has become a central concern in the recent history of language teaching. However, many language teachers, who are committed to concepts of learnercentredness and autonomy, struggle with the ways to foster learner autonomy or at least to encourage the idea of learner autonomy in language classroom. The study aims at investigating what the most important issues which have a great impact on developing learner autonomy are. Having given special attention to conditions which can insure development of learner autonomy, a model covering seven issues relating to the subject matter has been designed. The authors state that such aspects as choice, goals and needs, support, emotional climate, learning strategies, learner attitude and motivation, and self-esteem should be considered as the goal to promote learner autonomy in EFL context.
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Are NHS foundation trusts able and willing to exercise autonomy? 'You can take a horse to water...'.
Exworthy, Mark; Frosini, Francesca; Jones, Lorelei
2011-10-01
Foundation trusts (FTs) have been a central part of the government's National Health Service (NHS) reforms in England since 2004. They illustrate the government's claim to decentralization, by granting greater autonomy to high performing organizations. The number of FTs has grown steadily, reaching 131 in September 2010, over 50% of eligible trusts. Despite this growth, and notwithstanding the fact that organizations which initially became FTs were previously high performing, doubts remain about the implementation of the FT policy. This article examines the implementation of FTs in the NHS and focuses on the nature and exercise of autonomy by FTs. It argues that the ability of FTs to exercise autonomy is in place, but the (relatively limited) extent of implementation may be explained by trusts' lack of willingness to exercise such autonomy. Such unwillingness may be because of continued centralization, unclear policy and financial regimes, fear of negative impacts on relations with other local organizations, and awareness of greater risk to the FT, among others. Addressing the tension between FTs' ability and willingness to exercise autonomy will largely explain the extent to which the government's provider side reforms will be implemented.
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Morrison SA; Dashiff CJ; Vance DE
2013-01-01
Shannon A Morrison, Carol J Dashiff, David E Vance School of Nursing, University of Alabama, Birmingham, AL, USA Abstract: Parental influence to promote autonomy and self-determination in their children as they grow up may also motivate them to exercise and eat healthily. Unfortunately, nutritious dietary consumption and physical activity frequency tend to decline during the adolescent years and reaches its lowest level as the adolescent nears adulthood. In this study of 132 freshman and sop...
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Institutional Financial Autonomy in Practice
DEFF Research Database (Denmark)
Szwebs, Witold
2016-01-01
The article reveals how university autonomy may in practice prove to be restrictive for units within the university. The need to implement and interpret external regulations and protect the institution may, argued in the paper, lead to a risk averse, conservative approach which is experienced...... by departments as bureaucratic and hampering effective research. Thus autonomy has produced new internal tensions between the central management/administration and the departments which it is argued is counter-productive and not beneficial for research and could be seen as a perverse aspect of greater autonomy....... Indeed because university policy and ‘interference’ is much closer to the researcher than in former less autonomous times and the university may now exercise other direct incentives through resource allocation, promotion and salary enhancement, the department and the individual may view autonomy...
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Education and Reproductive Autonomy: The Case of Married Nigerian Women.
Princewill, Chitu Womehoma; De Clercq, Eva; Riecher-Rössler, Anita; Jegede, Ayodele Samuel; Wangmo, Tenzin; Elger, Bernice Simone
2017-01-01
In this article, we examine the influence of education on the exercise of married women's reproductive autonomy. We carried out 34 in-depth interviews (IDIs) with purposively sampled married Ikwerre women in Rivers State, Nigeria. The participants were between the ages of 22 and 60, had different educational backgrounds, and were in monogamous and polygynous marriages. Data were analyzed using MAXQDA 11 software. We found that although formal education enhanced women's ability to exercise reproductive autonomy, the culture of demanding absolute respect for men remains a major barrier. Formal education provides women with the knowledge that they need in order to access adequate health services for themselves and their children. Participants also believed that educating men was critical for the exercise of women's reproductive autonomy. The cultural aspects that promote female subordination and patriarchy should be addressed more openly in Nigeria.
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2014-01-01
Background The National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the feasibility and impact of a Self Determination Theory-based (SDT) exercise referral consultation. Methods An exploratory cluster randomised controlled trial comparing standard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory. Individuals (N = 347) referred to an exercise referral scheme were recruited into the trial from 13 centres. Outcomes and processes of change measured at baseline, 3 and 6-months: Minutes of self-reported moderate or vigorous physical activity (PA) per week (primary outcome), health status, positive and negative indicators of emotional well-being, anxiety, depression, quality of life (QOL), vitality, and perceptions of autonomy support from the advisor, need satisfaction (3 and 6 months only), intentions to be active, and motivational regulations for exercise. Blood pressure and weight were assessed at baseline and 6 months. Results Perceptions of the autonomy support provided by the health and fitness advisor (HFA) did not differ by arm. Between group changes over the 6-months revealed significant differences for reported anxiety only. Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months, which were not seen in the standard exercise referral group. A process model depicting hypothesized relationships between advisor autonomy support, need satisfaction and more autonomous motivation, enhanced well being and PA engagement at follow up was supported. Conclusions Significant gains in physical activity and improvements in quality of life and well-being outcomes emerged
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Duda, Joan L; Williams, Geoffrey C; Ntoumanis, Nikos; Daley, Amanda; Eves, Frank F; Mutrie, Nanette; Rouse, Peter C; Lodhia, Rekha; Blamey, Ruth V; Jolly, Kate
2014-01-29
The National Institute for Health and Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the feasibility and impact of a Self Determination Theory-based (SDT) exercise referral consultation. An exploratory cluster randomised controlled trial comparing standard provision exercise referral with an exercise referral intervention grounded in Self Determination Theory. Individuals (N = 347) referred to an exercise referral scheme were recruited into the trial from 13 centres.Outcomes and processes of change measured at baseline, 3 and 6-months: Minutes of self-reported moderate or vigorous physical activity (PA) per week (primary outcome), health status, positive and negative indicators of emotional well-being, anxiety, depression, quality of life (QOL), vitality, and perceptions of autonomy support from the advisor, need satisfaction (3 and 6 months only), intentions to be active, and motivational regulations for exercise.Blood pressure and weight were assessed at baseline and 6 months. Perceptions of the autonomy support provided by the health and fitness advisor (HFA) did not differ by arm. Between group changes over the 6-months revealed significant differences for reported anxiety only. Within arm contrasts revealed significant improvements in anxiety and most of the Dartmouth CO-OP domains in the SDT arm at 6 months, which were not seen in the standard exercise referral group. A process model depicting hypothesized relationships between advisor autonomy support, need satisfaction and more autonomous motivation, enhanced well being and PA engagement at follow up was supported. Significant gains in physical activity and improvements in quality of life and well-being outcomes emerged in both the standard provision exercise
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Sanchez, Diana T; Himmelstein, Mary S; Young, Danielle M; Albuja, Analia F; Garcia, Julie A
2016-09-01
Few studies have considered confrontation in the context of coping with discriminatory experiences. These studies test for the first time whether confronting racial discrimination is associated with greater psychological well-being and physical health through the promotion of autonomy. In two separate samples of racial minorities who had experienced racial discrimination, confrontation was associated with greater psychological well-being, and this relationship was mediated by autonomy promotion. These findings did not extend to physical health symptoms. These studies provide preliminary evidence that confrontation may aid in the process of regaining autonomy after experiencing discrimination and therefore promote well-being. © The Author(s) 2015.
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The Role of Teachers in Promoting Learner Autonomy in Secondary Schools in Saudi Arabia
Alonazi, Saleema M.
2017-01-01
Today, learner autonomy is considered as a desirable goal in language education. The movement towards learner-centered approaches has resulted in more emphasis on the benefits of learner autonomy in the success of language education. The objective of the study was to investigate the roles of the teachers in promoting learner autonomy in Saudi EFL…
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Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy
DEFF Research Database (Denmark)
Rostbøll, Christian F.
2009-01-01
is understood as something we should presume everyone possesses, it provides a strong basis for equal respect among people from diverse cultures. A Kantian conception of autonomy can justify the right to freedom of expression while it at the same time requires that we in the exercise of freedom of expression......Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more...... complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disrespect for diversity only when it is understood as a character ideal that must be promoted as an end in itself. If it by contrast...
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"A Lesson in Love": The Right to Autonomy of the Disabled
Fernanda Holanda Fernandes
2016-01-01
The International Convention on the Rights of Persons with Disabilities aims to promote the autonomy of these individuals. In this context, it guarantees the right to sexuality, family pool, legal recognition, civil and political rights, etc. From this perspective, the goal is to understand autonomy as an element of human dignity and the theoretical foundations of exercise for people with disabilities. As an example, presents the movie "I Am Sam" in the history of a parent with mental retarda...
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Rouse, Peter C; Ntoumanis, Nikos; Duda, Joan L; Jolly, Kate; Williams, Geoffrey C
2011-06-01
Self-determination theory (Deci & Ryan, 2000, Intrinsic motivation and self-determination in human behaviour. New York: Plenum Publishing) highlights the impact autonomy supportive environments can have on exercise motivation and positive health outcomes. Yet little is known about whether differential effects occur as a function of which significant other is providing this support. Further, no research has examined the relationship between motivation and the social environment with participants' mental health and intentions to be physically active before entering an exercise intervention. Study participants were 347 British adults who were about to start an exercise referral scheme. Regression analyses revealed that the effects of autonomy support on mental health and physical activity intentions differed as a function of who provided the support (offspring, partner or physician), with the offspring having the weakest effects. A structural model was supported, indicating that autonomy support and more autonomous regulations led to more positive mental health outcomes and stronger intentions to be physically active. Knowledge of the social environmental and personal motivation of those about to commence an exercise programme can provide important insights for professionals supporting such efforts. © 2011 Taylor & Francis
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"A Lesson in Love": The Right to Autonomy of the Disabled
Directory of Open Access Journals (Sweden)
Fernanda Holanda Fernandes
2016-06-01
Full Text Available The International Convention on the Rights of Persons with Disabilities aims to promote the autonomy of these individuals. In this context, it guarantees the right to sexuality, family pool, legal recognition, civil and political rights, etc. From this perspective, the goal is to understand autonomy as an element of human dignity and the theoretical foundations of exercise for people with disabilities. As an example, presents the movie "I Am Sam" in the history of a parent with mental retardation and their legal battle for custody of their daughter.
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The effect of transformational leadership and job autonomy on promotive and prohibitive voice
DEFF Research Database (Denmark)
Svendsen, Mari; Unterrainer, Christine; Jønsson, Thomas Faurholt
2018-01-01
Although there is a vast amount of research on leadership and improvement-oriented voice behavior, the amount of cross-lagged research on leadership that also incorporates more challenging forms of voice is sparse. This paper reports on a two-wave study of white-collar workers in a Norwegian...... medical technology company, investigating the relationship among employees’ perceived transformational leadership behaviors, job autonomy, and promotive and prohibitive voice. Testing our results cross-lagged, we demonstrate that perceived transformational leadership is significantly related...... to prohibitive voice over time, whereas this effect worked in the opposite direction for promotive voice. We also explore the boundary conditions of transformational leadership, demonstrating that perceived job autonomy strengthens the effect of transformational leadership on prohibitive voice. Implications...
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Corpus-Based Websites to Promote Learner Autonomy in Correcting Writing Collocation Errors
Directory of Open Access Journals (Sweden)
Pham Thuy Dung
2016-12-01
Full Text Available The recent yet powerful emergence of E-learning and using online resources in learning EFL (English as a Foreign Language has helped promote learner autonomy in language acquisition including self-correcting their mistakes. This pilot study despite conducted on a modest sample of 25 second year students majoring in Business English at Hanoi Foreign Trade University is an initial attempt to investigate the feasibility of using corpus-based websites to promote learner autonomy in correcting collocation errors in EFL writing. The data is collected using a pre-questionnaire and a post-interview aiming to find out the participants’ change in belief and attitude toward learner autonomy in collocation errors in writing, the extent of their success in using the corpus-based websites to self-correct the errors and the change in their confidence in self-correcting the errors using the websites. The findings show that a significant majority of students have shifted their belief and attitude toward a more autonomous mode of learning, enjoyed a fair success of using the websites to self-correct the errors and become more confident. The study also yields an implication that a face-to-face training of how to use these online tools is vital to the later confidence and success of the learners
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Henry, Kimberly L.; Shtivelband, Annette; Comello, Maria Leonora G.; Slater, Michael D.
2011-01-01
This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40…
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Barriers to intensive care unit nurses' autonomy in Iran: A qualitative study.
AllahBakhshian, Maryam; Alimohammadi, Nasrollah; Taleghani, Fariba; Nik, Ahmadreza Yazdan; Abbasi, Saeed; Gholizadeh, Leila
The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using content analysis. Data analysis led to identification of two main themes and five subthemes: (a) the profession-related barriers with two associated subthemes of "lack of capacity to exercise autonomy" and "lack of strong professional bodies"; (b) organizational barriers with the associated subthemes of "role ambiguity," "a directive rather than supportive workplace," and "lack of motivation." ICU nurses in Iran may face many challenges in gaining professional autonomy. The identified inter- and intraprofessional barriers to the exercise of autonomy need to be addressed to promote critical thinking, job satisfaction, and motivation of ICU nurses, which can in turn lead to improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
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Pratt, Mercedes; Hoffmann, Debra; Taylor, Maija; Musher-Eizenman, Dara
2017-05-01
This study explored differences in mothers' and fathers' food parenting strategies, specifically coercive control, structure, and autonomy promotion, and whether parenting style and parental responsibility for food parenting related to the use of these strategies. Parents of children aged 2.5-7.5 years ( N = 497) reported about their parenting practices and food parenting strategies. Parenting style accounted for the majority of the variance in food parenting. Fathers were more authoritarian than mothers. Authoritarian and permissive parenting practices were related to more coercive strategies. Mothers reported more food parenting responsibility. Responsibility was related to less coercive practices and more autonomy promotion and structure.
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Henry, Kimberly L.; Shtivelband, Annette; Comello, Maria Leonora G.; Slater, Michael D.
2011-01-01
This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model. Autonomy was negatively correlated with intention to use alcohol and subsequent alcohol use at a later wave, and intention to use fully mediated the effect of autonomy on subsequent alcohol use. These results are consistent with the proposition that when personal autonomy is perceived as inconsistent with alcohol use among younger adolescents, students indicate a lower intention to use alcohol and use less alcohol during the following school year. PMID:23519434
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Henry, Kimberly L; Shtivelband, Annette; Comello, Maria Leonora G; Slater, Michael D
2011-08-01
This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model. Autonomy was negatively correlated with intention to use alcohol and subsequent alcohol use at a later wave, and intention to use fully mediated the effect of autonomy on subsequent alcohol use. These results are consistent with the proposition that when personal autonomy is perceived as inconsistent with alcohol use among younger adolescents, students indicate a lower intention to use alcohol and use less alcohol during the following school year.
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Sher-Censor, Efrat; Parke, Ross D.; Coltrane, Scott
2011-01-01
Mexican-American adolescents are at an elevated risk for adjustment difficulties. In an effort to identify parenting practices that can affect the adjustment of Mexican-American youth, the current study examined parents' promotion of psychological autonomy and parents' psychological control as perceived by Mexican-American early adolescents, and…
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Stammers, Trevor
2015-01-01
There can be little doubt, at least in the Western world, that autonomy is theruling principle in contemporary bioethics. In spite of its 'triumph' however,the dominance of the utilitarian concept of autonomy is being increasinglyquestioned. In this paper, I explore the nature of autonomy, how it came todisplace the Hippocratic tradition in medicine and how different conceptsof autonomy have evolved. I argue that the reduction of autonomy to'the exercise of personal choice' in medicine has led to a 'tyranny of autonomy' which can be inimical to ethical medical practice rather than conducive to it.I take the case of Kerrie Wooltorton as an illustration of how misplacedadherence to respect for patient autonomy can lead to tragic consequences.An analysis of autonomy based on the work of Rachel Haliburton isdescribed and applied to the role of autonomy in a recent bioethicaldebate--that arising from Savulescu's proposal that conscientious objection by health-care professionals should not be permitted in the NHS. Inconclusion, I suggest Kukla's concept of conscientious autonomy as onepromising pathway to circumvent both the limitations and adverse effectsof the dominance of current (mis)understandings of autonomy in biomedical ethics.
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Autonomy and Reproductive Rights of Married Ikwerre Women in Rivers State, Nigeria.
Princewill, Chitu Womehoma; Jegede, Ayodele Samuel; Wangmo, Tenzin; Riecher-Rössler, Anita; Elger, Bernice Simone
2017-06-01
A woman's lack of or limited reproductive autonomy could lead to adverse health effects, feeling of being inferior, and above all being unable to adequately care for her children. Little is known about the reproductive autonomy of married Ikwerre women of Rivers State, Nigeria. This study demonstrates how Ikwerre women understand the terms autonomy and reproductive rights and what affects the exercise of these rights. An exploratory research design was employed for this study. A semi-structured interview schedule was used to conduct thirty-four in-depth interviews and six focus group discussions with purposively sampled educated, semi-educated, and uneducated Ikwerre women in monogamous or polygynous marriages. The collected data was analysed qualitatively with MAXQDA 11 using open and axial coding. The interviews and focus group responses reveal a low level of awareness of autonomy and reproductive rights amongst the Ikwerre women in Nigeria. While some educated women were aware of their reproductive rights, cultural practices were reported to limit the exercise of these rights. Participants reported that Ikwerre culture is a patriarchal one where married women are expected to submit and obey their husbands in all matters; and a good married woman according to Ikwerre standard is one who complies with this culture. Women's refusal of sexual advances from their husbands is described as not being acceptable in this culture; and hence rape in marriage is not recognized in Ikwerre culture. Education and awareness creation on the importance of women's reproductive autonomy could improve their reproductive rights and autonomy in marital settings. Overcoming the patriarchal aspects of Ikwerre culture-for example, the greater value placed on male children than female children and treating women as incompetent individuals-is necessary to promote gender equality as well as help improve women's reproductive autonomy.
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Shimomura, Yoshiharu; Murakami, Taro; Nakai, Naoya; Nagasaki, Masaru; Harris, Robert A
2004-06-01
Branched-chain amino acids (BCAAs) are essential amino acids that can be oxidized in skeletal muscle. It is known that BCAA oxidation is promoted by exercise. The mechanism responsible for this phenomenon is attributed to activation of the branched-chain alpha-keto acid dehydrogenase (BCKDH) complex, which catalyzes the second-step reaction of the BCAA catabolic pathway and is the rate-limiting enzyme in the pathway. This enzyme complex is regulated by a phosphorylation-dephosphorylation cycle. The BCKDH kinase is responsible for inactivation of the complex by phosphorylation, and the activity of the kinase is inversely correlated with the activity state of the BCKDH complex, which suggests that the kinase is the primary regulator of the complex. We found recently that administration of ligands for peroxisome proliferator-activated receptor-alpha (PPARalpha) in rats caused activation of the hepatic BCKDH complex in association with a decrease in the kinase activity, which suggests that promotion of fatty acid oxidation upregulates the BCAA catabolism. Long-chain fatty acids are ligands for PPARalpha, and the fatty acid oxidation is promoted by several physiological conditions including exercise. These findings suggest that fatty acids may be one of the regulators of BCAA catabolism and that the BCAA requirement is increased by exercise. Furthermore, BCAA supplementation before and after exercise has beneficial effects for decreasing exercise-induced muscle damage and promoting muscle-protein synthesis; this suggests the possibility that BCAAs are a useful supplement in relation to exercise and sports.
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Promoting exercise behaviour in a secure mental health setting: Healthcare assistant perspectives.
Kinnafick, Florence-Emilie; Papathomas, Anthony; Regoczi, Dora
2018-05-30
Individuals with severe mental illness engage in significantly less amounts of physical activity than the general population. A secure mental health setting can exacerbate barriers to exercise, and facilitate physical inactivity and sedentary behaviour. Healthcare assistants are intimately involved in the daily lives of patients and, therefore, should be considered integral to exercise promotion in secure mental health settings. Our aim was to explore healthcare assistants' perceptions of exercise and their attitudes to exercise promotion for adult patients in a secure mental health hospital. Qualitative semi-structured interviews were conducted with 11 healthcare assistants from a large UK-based secure mental health hospital. Topics included healthcare assistants' personal experiences of exercise within a secure facility, their perceptions of exercise as an effective treatment tool for mental health, and their perceived roles and responsibilities for exercise promotion. Thematic analysis was used to analyse the data. Three main themes were identified: (i) exercise is multi-beneficial to patients, (ii) perceived barriers to effective exercise promotion, and (iii) strategies for effectives exercise promotion. Healthcare assistants considered exercise to hold patient benefits. However, core organizational and individual barriers limited healthcare assistants' exercise promotion efforts. An informal approach to exercise promotion was deemed most effective to some, whereas others committed to more formal strategies including compulsory sessions. With education and organizational support, we propose healthcare assistants are well placed to identify individual needs for exercise promotion. Their consultation could lead to more efficacious, person-sensitive interventions. © 2018 Australian College of Mental Health Nurses Inc.
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Epistemic Autonomy: A Criterion for Virtue?
Mudd, Sasha
2013-01-01
Catherine Elgin proposes a novel principle for identifying epistemic virtue. Based loosely on Kant's Categorical Imperative, it identifies autonomy as our fundamental epistemic responsibility, and defines the epistemic virtues as those traits of character needed to exercise epistemic autonomy. I argue that Elgin's principle fails as a…
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Nurses' autonomy in end-of-life situations in intensive care units.
Paganini, Maria Cristina; Bousso, Regina Szylit
2015-11-01
The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses' involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance of a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse's experience in exercising autonomy relating to end-of-life decision-making. Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude
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Personal financial incentives in health promotion: where do they fit in an ethic of autonomy?
Ashcroft, Richard E
2011-06-01
This paper reviews the ethical controversy concerning the use of monetary incentives in health promotion, focussing specifically on the arguments relating to the impact on personal autonomy of such incentives. Offering people small amounts of money in the context of health promotion and medical care has been attempted in a number of settings in recent years. This use of personal financial incentives has attracted a degree of ethical controversy. One form of criticism is that such schemes interfere with the autonomy of the patient or citizen in an illegitimate way. This paper presents a thematic analysis of the main arguments concerning personal autonomy and the use of monetary incentives in behaviour change. The main moral objections to the uses of incentives are that they may be in general or in specific instances paternalistic, coercive, involve bribery, or undermine the agency of the person. While incentive schemes may engage these problems on occasion, there is no good reason to think that they do so inherently and of necessity. We need better behavioural science evidence to understand how incentives work, in order to evaluate their moral effects in practice. © 2011 Blackwell Publishing Ltd.
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Promoting Postpartum Exercise: An Opportune Time for Change.
Ringdahl, Erika N.
2002-01-01
During the postpartum period clinicians can promote the importance of physical fitness, help patients incorporate exercise into lifestyle changes, and encourage them to overcome barriers to exercise. New responsibilities, physical changes, and time constraints may make exercise seem impossible. By emphasizing weight control, stress reduction, and…
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University Internationalization and University Autonomy
DEFF Research Database (Denmark)
Turcan, Romeo V.; Gulieva, Valeria
2016-01-01
Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability are d......, dissimilar, and sometimes conflicting dimensions of the financial, legal, organisational, staffing, and academic autonomy of the host country, are compromising key aspects of their own autonomy and core mission?......Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability...... are determined by the structure and exercise of university autonomy settings at home and in the host countries, and that the process itself cannot be successfully achieved and maintained without changes in the autonomy settings. The key question the authors ask is to what degree universities, in embracing new...
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Autonomy and autonomy competencies: a practical and relational approach.
Atkins, Kim
2006-10-01
This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals' formation of choices. In response to this problem, I will present a brief overview of Diana Meyers's account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical 'self-reading'. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills.
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High-intensity training versus traditional exercise interventions for promoting health
DEFF Research Database (Denmark)
Nybo, Lars; Sundstrup, Emil; Jakobsen, Markus D
2010-01-01
The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training.......The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training....
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THE IMPLEMENTATION OF ORAL PRESENTATION IN PROMOTING LEARNER AUTONOMY IN CLASS
Directory of Open Access Journals (Sweden)
Rahmatika Kayyis
2017-02-01
Full Text Available In class of Phonetic phonology, students having confusion about a huge differences of each symbol and its phoneme between Indonesia and English. Only by giving them a lecturer in each meeting would not satisfy their needs. As it simply cannot keep up with it, learners have to be able to process and investigate their curiosity on their own autonomously. Oral presentation is believed as one of implementations to promote learner autonomy in University environment. 32 students in the class divided into 10 groups presented several topics about phonetic and phonology. The data were collected through observation, interview, and questionaire. Then, they were analyzed using the steps in case study research method. The finding shows that oral presentation had given them “freedom”to discover and autonomy to do their own learning. They also given good response relating of what they had learnt dan investigated during teaching learning in Phonetic and Phonology Class.
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Importance of enjoyment when promoting physical exercise.
Hagberg, L A; Lindahl, B; Nyberg, L; Hellénius, M-L
2009-10-01
The purpose of this study was to investigate the importance of enjoyment of exercise in a health care-based intervention aimed at promoting physical exercise in primary health care patients. In a controlled study design, the intervention group was offered a wide range of group exercises over 3 months, followed by support in designing their own exercise program. The control group received usual care. Enjoyment of exercise and exercise level were measured. Associations between enjoyment and exercise level were analyzed using Spearman's rank correlation coefficients. Changes in enjoyment between and within study groups were analyzed by the independent and paired t-test. Associations were found between enjoyment and exercise level (r=0.36, Pexercise level (r=0.34, Pexercise was 25% higher in the intervention group than in the control group (Phealth care patients, enjoyment of exercise was associated with exercise level. Enjoyment of exercise seems to be a mediator of exercise level. Furthermore, health care-based interventions seem to be able to affect enjoyment of exercise. Enjoyment of exercise may be important for the long-term effectiveness, of health care-based interventions.
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A balanced intervention ladder: promoting autonomy through public health action.
Griffiths, P E; West, C
2015-08-01
The widely cited Nuffield Council on Bioethics 'Intervention Ladder' structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme 'negative liberty' view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided 'Balanced Intervention Ladder,' where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill's classic version of negative liberty puts some interventions on the positive side of the ladder. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.
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Respect for rational autonomy.
Walker, Rebecca L
2009-12-01
The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy.
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Importance of exercise immunology in health promotion.
Neto, J C Rosa; Lira, F S; de Mello, M T; Santos, Ronaldo Vagner T
2011-11-01
Chronic physical exercise with adequate intensity and volume associated with sufficient recovery promotes adaptations in several physiological systems. While intense and exhaustive exercise is considered an important immunosuppressor agent and increases the incidence of upper respiratory tract infections (URTI), moderate regular exercise has been associated with significant disease protection and is a complementary treatment of many chronic diseases. The effects of chronic exercise occur because physical training can induce several physiological, biochemical and psychological adaptations. More recently, the effect of acute exercise and training on the immunological system has been discussed, and many studies suggest the importance of the immune system in prevention and partial recovery in pathophysiological situations. Currently, there are two important hypotheses that may explain the effects of exercise and training on the immune system. These hypotheses including (1) the effect of exercise upon hormones and cytokines (2) because exercise can modulate glutamine concentration. In this review, we discuss the hypothesis that exercise may modulate immune functions and the importance of exercise immunology in respect to chronic illnesses, chronic heart failure, malnutrition and inflammation.
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How to make overweight children exercise and follow the recommendations.
Deforche, Benedicte; Haerens, Leen; de Bourdeaudhuij, Ilse
2011-09-01
As regular physical activity of high enough intensity is essential in the management of overweight, efforts should be made to increase physical activity adherence in overweight children. To make overweight children exercise and follow the recommendations, it is essential to have insight into determinants of exercise initiation and adherence. According to the Self-determination Theory, creating opportunities to satisfy the need for autonomy (i.e., having choices), competence (i.e., feeling effective) and relatedness (i.e., being socially connected) might increase autonomous motivation for physical activity in overweight children and promote a long-lasting active lifestyle. To increase feelings of autonomy in overweight children, exercise programs could be delivered in an autonomy-supportive manner by providing choices, supporting the child's initiatives, avoiding use of external rewards, offering relevant information and rationale for changing behaviour, making a decisional balance and using autonomy supportive language, while minimizing pressure and control. Perceived competence in physical activities could be increased by offering activities tailored to the capabilities of the overweight child, helping the children set realistic goals, learning the children self-management skills, providing the children with appropriate feedback and organizing separate exercise sessions for overweight children. Feelings of relatedness in overweight children might increase by adopting an empathic approach, showing interest in the child's well-being and problems, showing enjoyment and enthusiasm, knowing the names of the children, talking to the children as equals, offering group sessions and talks, encouraging club participation and having a sports partner and encouraging parental support.
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Italian Adaptation of the "Autonomy and Relatedness Coding System"
Directory of Open Access Journals (Sweden)
Sonia Ingoglia
2013-08-01
Full Text Available The study examined the applicability of the observational technique developed by Allen and colleagues (Allen, Hauser, Bell, & O’Connor, 1994; Allen, Hauser, et al., 2003 to investigate the issues of autonomy and relatedness in parent-adolescent relationship in the Italian context. Thirty-five mother-adolescent dyads participated to a task in which they discussed a family issue about which they disagree. Adolescents were also administered a self-report measure assessing their relationship with mothers. Mothers reported significantly higher levels of promoting and inhibiting autonomy, and promoting relatedness behaviors than their children. Results also suggested a partial behavioral reciprocity within the dyads, regarding promoting and inhibiting relatedness, and inhibiting autonomy. Finally, mothers’ inhibiting autonomy behaviors positively correlated to teens’ perception of their relationship as conflicting; adolescents’ inhibiting and promoting autonomy and inhibiting relatedness behaviors positively correlated to open confrontation, rejection and coolness, while promoting relatedness behaviors negatively correlated to open confrontation, rejection and coolness. The results suggest that, for Italian mothers, behaviors linked to autonomy seem to be associated with being involved in a more negative relationship with their children, even if not characterized by open hostility, while for Italian adolescents, behaviors linked to autonomy seem to be associated with threatening the closeness of the relationship. Globally, the findings suggest that the application of this observational procedure may help our understanding of youth autonomy and relatedness development in Italy, but they leave unanswered questions regarding its appropriate adaptation and the role played by cultural differences.
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Authenticity and autonomy in deep-brain stimulation.
Wardrope, Alistair
2014-08-01
Felicitas Kraemer draws on the experiences of patients undergoing deep-brain stimulation (DBS) to propose two distinct and potentially conflicting principles of respect: for an individual's autonomy (interpreted as mental competence), and for their authenticity. I argue instead that, according to commonly-invoked justifications of respect for autonomy, authenticity is itself in part constitutive of an analysis of autonomy worthy of respect; Kraemer's argument thus highlights the shortcomings of practical applications of respect for autonomy that emphasise competence while neglecting other important dimensions of autonomy such as authenticity, since it shows that competence alone cannot be interpreted as a reliable indicator of an individual's capacity for exercising autonomy. I draw from relational accounts to suggest how respect for a more expansive conception of autonomy might be interpreted for individuals undergoing DBS and in general. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Exercise Promotes Healthy Aging of Skeletal Muscle
DEFF Research Database (Denmark)
Cartee, Gregory D; Hepple, Russell T; Bamman, Marcas M
2016-01-01
caused by diseases and lifestyle factors. Secondary aging can exacerbate deficits in mitochondrial function and muscle mass, concomitant with the development of skeletal muscle insulin resistance. Exercise opposes deleterious effects of secondary aging by preventing the decline in mitochondrial...... respiration, mitigating aging-related loss of muscle mass and enhancing insulin sensitivity. This review focuses on mechanisms by which exercise promotes "healthy aging" by inducing modifications in skeletal muscle....
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Pernambuco, Carlos Soares; Borba-Pinheiro, Claudio Joaquim; Vale, Rodrigo Gomes de Souza; Di Masi, Fabrizio; Monteiro, Paola Karynne Pinheiro; Dantas, Estelio H M
2013-01-01
The aim of the present study was to evaluate the effects of an AAG on BMD, osteocalcin and functional autonomy in older women. The sample consisted of eighty-two post-menopausal women with low BMD, randomly divided into two groups: the Aquatic Aerobics Group [AAG; n=42; age: 66.8±4.2years], submitted to two weekly sessions over eight months, and the Control Group (GC; n=42; age: 66.9±3.2years), which did not participate in regular exercise. BMD was measured by Dual Energy X-ray Absorptiometry [DXA] of the lumbar and femur, and serum osteocalcin was measured using electrochemiluminescence. A functional autonomy assessment protocol (GDLAM, 2004) was also applied. Statistical analyses used were repeated measures ANOVA and Tukey's post hoc tests. The results showed a significant improvement in tests following the GDLAM protocol: 10 meters walk (10mw) -p=0.003; rising from a ventral decubitus position (RVDP) - Δ%=0.78, pAAG when compared to the CG. The AAG achieved the best results for BMD; however, no inter or intragroup statistical differences were recorded for total femur -p=0.975 and lumbar L(2)-L(4)p=0.597. For serum osteocalcin, intra and intergroup statistical differences of p=0.042 and p=0.027 were observed in the AAG, respectively. This demonstrates that an eight-month aquatic aerobic exercise program can improve functional autonomy and osteocalcin levels, although training did not improve lumbar and total femur BMD in the older women. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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Azétsop, Jacquineau; Rennie, Stuart
2010-01-18
Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.
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[Why and how to promote decision-making autonomy of cancer patients?
Mancini, Julien
2018-02-01
Involvement of patients in decision-making about their health has been promoted nationally and internationally since several years. Despite this, patient (and their relatives) participation remains insufficient and one of the objectives of the current French national cancer policy (Plan cancer 2014-2019) is to give everyone the possibility to play an active role in the management of their care. This overview focuses on decision-making autonomy of cancer patients through two main questions: why and how to promote it? After a brief review of the decision-making models described in the literature in the past decades insisting on the major role of the decisional context and the dynamic character of this context, this article presents a selection of published works which aimed to respond to those 2 questions. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
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Strategies to promote self-esteem, autonomy and self-care practices for people with chronic wounds
Directory of Open Access Journals (Sweden)
Liarine Fernandes Bedin
Full Text Available This is a qualitative study of an exploratory nature that aims to identify the strategies used by nurses in primary care, in situations involving nursing care, to promote self-esteem, autonomy and self-care practices for people with chronic wounds. The study included eight nurses. Data were collected by means of a focus group in July 2012. The thematic analysis technique was used to identify the following categories: Nursing care from the perspective of comprehensiveness; Recovering support networks: family and social movements; Multidisciplinary work; Autonomy and nurses. It was concluded that the presented strategies value, above all, the social environment of these individuals, the family, religion and the nurse's approximation to the realities of people with chronic wounds.
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Directory of Open Access Journals (Sweden)
Edgar Picón Jácome
2012-07-01
Full Text Available In this article I present some findings of an action research study intended to find out to what extent a teacher-student partnership in writing assessment could promote high school students’ autonomy. The study was conducted in a U.S. school. Two main action strategies in the assessment process were the use of symbols as the form of feedback and the design of a rubric containing criteria negotiated with the students as the scoring method. Results showed that the students developed some autonomy reflected in three dimensions: ownership of their learning process, metacognition, and critical thinking, which positively influenced an enhancement of their writing skills in both English and Spanish. Likewise, the role of the teacher was found to be paramount to set appropriate conditions for the students’ development of autonomy.
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Privacy, autonomy, and public policy: French and North American perspectives.
Merchant, Jennifer
2016-12-01
This article raises the question of whether in both the United States and in France, an individual's autonomy and private decision-making right(s) in matters of health care and access to reproductive technologies can be conciliated with the general interest, and more specifically, the role of the State. Can a full-fledged right to privacy, the ability to exercise one's autonomy, exist alongside the general interest, and depend neither on financial resources like in the United States nor on centralised government decisions or the medical hierarchy like in France? The contrast between these two modern democracies justify the importance of comparing them. I will demonstrate that overlaps do exist: the free exercise of religion and opinion, freedom of expression, the inherent value of each individual. What differs, however, are the institutions and how they provide, protect, promote, or frame access to and expressions of these democratic principles. The impact of the global economy, the exposure of people around the world to each other via the internet, and the mirror effects of social media, blogs, and other such forums, have created new perspectives that countries project onto one another. For example, does France now seem to tout 'autonomy' as a new and important value because it appears to be an 'American success story'? Does the United States now seem to value human rights and a social-democratic approach because of the 'French model'? There seems to be some truth behind these assertions, but as this article will demonstrate, the portrayals of what the 'right to privacy' is in the United States and what 'socialised medicine' is in France are not necessarily fully accurate.
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High-intensity training versus traditional exercise interventions for promoting health
DEFF Research Database (Denmark)
Nybo, Lars; Sundstrup, Emil; Jakobsen, Markus D
2010-01-01
The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training....
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Does company-sponsored egg freezing promote or confine women's reproductive autonomy?
Mertes, Heidi
2015-08-01
A critical ethical analysis of the initiative of several companies to cover the costs of oocyte cryopreservation for their healthy employees. The main research question is whether such policies promote or confine women's reproductive autonomy. A distinction needs to be made between the ethics of AGE banking in itself and the ethics of employers offering it to their employees. Although the utility of the former is expected to be low, there are few persuasive arguments to deny access to oocyte cryopreservation to women who are well informed about the procedure and the success rates. However, it does not automatically follow that it would be ethically unproblematic for employers to offer egg banking to their employees. For these policies to be truly 'liberating', a substantial number of conditions need to be fulfilled, which can be reduced to three categories: (1) women should understand the benefits, risks and limitations, (2) women should feel no pressure to take up the offer; (3) the offer should have no negative effect on other family-friendly policies and should in fact be accompanied by such policies. Fulfilling these conditions may turn out to be impossible. Thus, regardless of companies' possible good intentions, women's reproductive autonomy is not well served by offering them company-sponsored AGE banking.
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Boyd, A L
2000-07-01
The philosophical and ethical concept of autonomy is herein examined, ex post facto, using an existential lens to examine the process of a personal friend's dying. Anagogy, defined as interpretation of a word, passage, or text that finds beyond the literal, allegorical, and moral senses a fourth and ultimate spiritual or mystical sense, is intended to enlarge the understanding of the use of autonomy in this case. The idea of personhood linked inextricably to reason is, therefore, understood as empowering an individual to choose among various actions, to define and redefine life goals, and to give priority to selected values and moral tenants, which reveal a moral hermeneutic. Conditions and circumstances, existentially exposed, limit choice in unexpected ways, such that the predicted value of autonomy is vulnerable to misuse or misunderstanding. The intent to respect the dignity of every person is central to the philosophy of Respect for Persons ethics, and assumes that autonomy, as freedom of the moral agent, is a moral duty. Implicit reality of freedom is, in a practical sense, essential to being rational agents who can thereby exercise informed choice. The moral law, law of freedom, involves the autonomy of the will and an ultimate end to which all action is directed. Defined as the highest good, morality unites virtue and happiness by ascribing the ultimate end sought as God. The freedom to use rational will finds principles within its own rational nature. The ability to create maxims is autonomy of the will, which equates with the dignity of persons. My recent experience as a companion to a personal friend with a terminal illness inspired me to re-evaluate the concept of autonomy as it is too often interpreted in modern ethical discourse as a individualistic right of choice as opposed to the hermeneutic of dignity of person. This paper describes a shift of position in understanding the paradox of autonomy in this existential context.
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Heteronomous Citizenship: Civic Virtue and the Chains of Autonomy
Swaine, Lucas
2010-01-01
In this article, I distinguish personal autonomy from heteronomy, and consider whether autonomy provides a suitable basis for liberalism. I argue that liberal government should not promote autonomy in all its citizens, on the grounds that not all members of liberal democracies require autonomy for a good life. I then outline an alternative option…
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Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet
2016-08-01
Chronic pain is prevalent among older adults and is usually associated with high levels of functional disability. Social support for the promotion of functional autonomy and dependence has been associated with pain-related disability and self-reported physical functioning. Nevertheless, these relationships need further inquiry. Our aims were to investigate: (1) the relationship between perceived promotion of autonomy/dependence and pain-related disability and (2) the extent to which self-reported physical functioning mediated these relationships. 118 older adults (Mage = 81.0) with musculoskeletal chronic pain completed the Portuguese versions of the revised formal social support for Autonomy and Dependence in Pain Inventory, the pain severity and interference scales of the Brief Pain Inventory, and the physical functioning scale of the Medical Outcomes Study-Short-Form 36 v2. Higher levels of perceived promotion of autonomy were associated with lower pain-related disability; this relationship was partially mediated by self-reported physical functioning (B = -.767, p dependence was associated with higher pain-related disability; this effect was also partially accounted for by self-reported physical functioning (B = .889, p dependence for managing older adults' experience of chronic pain.
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Functional effectiveness of threat appeals in exercise promotion messages
Directory of Open Access Journals (Sweden)
Olivier Mairesse
2010-01-01
Full Text Available As more than 70% of individuals in Western societies can be categorized as sedentary and inactivity has been recognized to lead to a series of serious physical and psychological disorders, the importance of physical activity promotion is ever more emphasized. Many social marketing campaigns use threat (or fear appeals to promote healthy behaviors. Theoretical models, such as the Extended Parallel Process Model integrate concepts as 'perceived threat' and 'perceived efficacy' to explain how such messages operate and can cause diverse behavioral reactions. It is however still not entirely clear how these different aspects are valuated and combined to determine desired versus undesired response behaviors in individuals. In a functional integration task, threat-appeal based exercise promotion messages varying in psychological threat and efficacy content were shown to sedentary employees in order to assess how they affect their intention to engage in physical exercise. Our results show that individuals can be categorized in 4 different clusters depending on the way they valuate threat and efficacy appeals: i.e. individuals sensitive to both types of cues, those sensitive to either the threat or the efficacy component in the message and those insensitive to either one of them. As different segments of receivers of the message react differently to threat and efficacy combinations, it is concluded that different approaches to designing effective mass media campaigns may be required for effective exercise promotion.
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Borza, Liana Rada; Gavrilovici, Cristina; Stockman, René
2015-01-01
The present paper revisits the ethical models of patient--physician relationship from the perspective of patient autonomy and values. It seems that the four traditional models of physician--patient relationship proposed by Emanuel & Emanuel in 1992 closely link patient values and patient autonomy. On the other hand, their reinterpretation provided by Agarwal & Murinson twenty years later emphasizes the independent expression of values and autonomy in individual patients. Additionally, patient education has been assumed to join patient values and patient autonomy. Moreover, several authors have noted that, over the past few decades, patient autonomy has gradually replaced the paternalistic approach based on the premise that the physician knows what is best for the patient. Neither the paternalistic model of physician-patient relationship, nor the informative model is considered to be satisfactory, as the paternalistic model excludes patient values from decision making, while the informative model excludes physician values from decision making. However, the deliberative model of patient-physician interaction represents an adequate alternative to the two unsatisfactory approaches by promoting shared decision making between the physician and the patient. It has also been suggested that the deliberative model would be ideal for exercising patient autonomy in chronic care and that the ethical role of patient education would be to make the deliberative model applicable to chronic care. In this regard, studies have indicated that the use of decision support interventions might increase the deliberative capacity of chronic patients.
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Authenticity-Sensitive Preferentism and Educating for Well-Being and Autonomy
Haji, Ishtiyaque; Cuypers, Stefaan E.
2008-01-01
An overarching aim of education is the promotion of children's personal well-being. Liberal educationalists also support the promotion of children's personal autonomy as a central educational aim. On some views, such as John White's, these two goals--furthering well-being and cultivating autonomy--can come apart. Our primary aim in this paper is…
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Health equality, social justice and the poverty of autonomy.
Newdick, Christopher
2017-10-01
How does the concept of autonomy assist public responses to 'lifestyle' diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a 'nanny' state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.
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Drinking policies and exercise-associated hyponatraemia: is anyone still promoting overdrinking?
Beltrami, F G; Hew-Butler, T; Noakes, T D
2008-10-01
The purpose of this review is to describe the evolution of hydration research and advice on drinking during exercise from published scientific papers, books and non-scientific material (advertisements and magazine contents) and detail how erroneous advice is likely propagated throughout the global sports medicine community. Hydration advice from sports-linked entities, the scientific community, exercise physiology textbooks and non-scientific sources was analysed historically and compared with the most recent scientific evidence. Drinking policies during exercise have changed substantially throughout history. Since the mid-1990s, however, there has been an increase in the promotion of overdrinking by athletes. While the scientific community is slowly moving away from "blanket" hydration advice in which one form of advice fits all and towards more modest, individualised, hydration guidelines in which thirst is recognised as the best physiological indicator of each subject's fluid needs during exercise, marketing departments of the global sports drink industry continue to promote overdrinking.
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Exercise Promotes Healthy Aging of Skeletal Muscle.
Cartee, Gregory D; Hepple, Russell T; Bamman, Marcas M; Zierath, Juleen R
2016-06-14
Primary aging is the progressive and inevitable process of bodily deterioration during adulthood. In skeletal muscle, primary aging causes defective mitochondrial energetics and reduced muscle mass. Secondary aging refers to additional deleterious structural and functional age-related changes caused by diseases and lifestyle factors. Secondary aging can exacerbate deficits in mitochondrial function and muscle mass, concomitant with the development of skeletal muscle insulin resistance. Exercise opposes deleterious effects of secondary aging by preventing the decline in mitochondrial respiration, mitigating aging-related loss of muscle mass and enhancing insulin sensitivity. This review focuses on mechanisms by which exercise promotes "healthy aging" by inducing modifications in skeletal muscle. Copyright © 2016 Elsevier Inc. All rights reserved.
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Epistemic merit, autonomy, and testimony
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Jesús VEGA ENCABO
2008-01-01
Full Text Available In this paper, it is argued that both the informer and the hearer in a testimonial situation deserve epistemic merit insofar as they contribute to the collaborative achievement of sharing knowledge. The paper introduces a distinction between the ideals of self-sufficiency and epistemic autonomy. The autonomous exercise of our epistemic agency is very often carried out under strong conditions of epistemic dependence. Testimony exhibits a kind of social dependence that does not threaten the autonomy of the subjects that need to consider their own epistemic capacities. When involved in a testimonial situation, both speaker and hearer declare, at least implicitly, the standings they occupy in an epistemic space and are obliged to recognise certain epistemic requirements.
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The Development of Personal Autonomy throughout Cultures
Helwig, Charles C.
2006-01-01
It is argued here that autonomy entails universal psychological needs pertaining to agency and identity formation, expressed in different ways over different developmental periods. As children develop skills and abilities related to psychological needs for self-expression and competence, they will claim areas related to the exercise of these…
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The Exercise of Learner Autonomy in a Virtual EFL Course in Colombia
Bedoya, Paula Andrea
2014-01-01
This case study explores how a group of graduate students manifest autonomy in an English as a Foreign Language virtual course at a Colombian university. Analysis of questionnaires, forums, and interviews showed that students manifested attitudes that led to autonomy such as motivation and commitment at the beginning of the course, but they also…
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Analysis and implementation of health promotion through exercise in specialized higher education
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Veronica POPESCU
2017-03-01
Full Text Available Maintaining population health through exercise is a major responsibility of physical education teachers. Promoting regular exercising and transmitting basic sports culture elements are an important objective: they must be taught since early childhood and throughout the entire life– as lifelong education – for improving the quality of life. The purpose of this study is to contribute to changing people’s mindset and to raising awareness on the benefits brought by exercising; the ultimate goal is to make exercising a lifestyle. The issue of the study is that we can contribute to changing people’s attitude and mindset on exercising regularly, insofar as we present its benefits.The methods used for this study comprised meetings; more precisely, exchanges of educational experience between university teachers and weekend schools, where students took part. During these meetings, we discussed issues related to people’s perception of practicing sports activities for maintaining their health and we proposed new strategies to make people exercise.Findings. Following the meetings, we determined new research directions and methods for assessing people’s attitude toward practicing sports activities and methods to promote and raise awareness on the benefits of practicing sports activities.
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Exercising with Passion: Initial Validation of the Passion Scale in Exercise
Parastatidou, Irini S.; Doganis, Georgios; Theodorakis, Yannis; Vlachopoulos, Symeon P.
2012-01-01
The purpose of the researchers in the study was to psychometrically evaluate Passion Scale scores (Vallerand et al., 2003) in exercise. Self-report data were collected from two samples of Greek exercise participants. Sample 1 (n = 217) provided data on the Passion Scale and the self-determination theory variables of perceived autonomy support by…
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"Walking a Fine Line": Teachers' Perception of Curricular Autonomy in Estonia, Finland and Germany
Erss, Maria; Kalmus, Veronika; Autio, Tero Henrik
2016-01-01
The purpose of this paper is to comparatively investigate the professional autonomy of upper secondary school teachers in three European countries in interpreting and implementing curricula. The paper focuses on teachers' experiences, and their perceptions of their autonomy and the control exercised over them in the global era of neoliberal…
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Jozefien eDe Leersnyder
2015-05-01
Full Text Available The current research tested the idea that it is the cultural fit of emotions, rather than certain emotions per se, that predicts psychological well-being. We reasoned that emotional fit in the domains of life that afford the realization of central cultural mandates would be particularly important to psychological well-being. We tested this hypothesis with samples from three cultural contexts that are known to differ with respect to their main cultural mandates: a European American (N = 30, a Korean (N = 80, and a Belgian sample (N = 266. Cultural fit was measured by comparing an individual’s patterns of emotions to the average cultural pattern for the same type of situation on the Emotional Patterns Questionnaire (De Leersnyder, Mesquita, & Kim, 2011. Consistent with our hypothesis, we found evidence for universality without uniformity: In each sample, psychological well-being was associated with emotional fit in the domain that was key to the cultural mandate. However, cultures varied with regard to the particular domain involved. Psychological well-being was predicted by emotional fit a in autonomy-promoting situations at work in the U.S., b in relatedness-promoting situations at home in Korea, and c in both autonomy-promoting and relatedness-promoting situations in Belgium. These findings show that the experience of culturally appropriate patterns of emotions contributes to psychological well-being. One interpretation is that experiencing appropriate emotions is itself a realization of the cultural mandates.
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De Leersnyder, Jozefien; Kim, Heejung; Mesquita, Batja
2015-01-01
The current research tested the idea that it is the cultural fit of emotions, rather than certain emotions per se, that predicts psychological well-being. We reasoned that emotional fit in the domains of life that afford the realization of central cultural mandates would be particularly important to psychological well-being. We tested this hypothesis with samples from three cultural contexts that are known to differ with respect to their main cultural mandates: a European American (N = 30), a Korean (N = 80), and a Belgian sample (N = 266). Cultural fit was measured by comparing an individual's patterns of emotions to the average cultural pattern for the same type of situation on the Emotional Patterns Questionnaire (De Leersnyder et al., 2011). Consistent with our hypothesis, we found evidence for "universality without uniformity": in each sample, psychological well-being was associated with emotional fit in the domain that was key to the cultural mandate. However, cultures varied with regard to the particular domain involved. Psychological well-being was predicted by emotional fit (a) in autonomy-promoting situations at work in the U.S., (b) in relatedness-promoting situations at home in Korea, and (c) in both autonomy-promoting and relatedness-promoting situations in Belgium. These findings show that the experience of culturally appropriate patterns of emotions contributes to psychological well-being. One interpretation is that experiencing appropriate emotions is itself a realization of the cultural mandates.
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Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W
2017-08-01
There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.
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Learner Autonomy in Language Education : A Cross-Cultural Perspective
Kojima, Hideo
2006-01-01
In recent years, the importance of developing learner autonomy in language education hasbeen one of its more prominent themes in Japan as well as in the West. In spite of agreementconcerning its importance, there remains a good deal of uncertainty about its meaning inteaching and learning English as a foreign language (EFL). This paper aims to consider theconcept of learner autonomy amongst different cultures. Autonomy has a social as well as anindividual dimension. The promotion of learner a...
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Tai, S S; Gould, M; Iliffe, S
1997-01-01
The potential health benefits derived from sustained physical activity in older people are numerous; however, whether exercise promotion should take place in general practice is unsubstantiated. Exercise promotion should use existing research evidence of the advantages of exercise for various conditions, and target those inactive individuals who currently have no intention of changing their level of physical activity. Research has also raised methodological issues and questions about the feas...
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Collective autonomy and absenteeism within work teams: a team motivation approach.
Rousseau, Vincent; Aubé, Caroline
2013-01-01
This study investigates the role of collective autonomy in regard to team absenteeism by considering team potency as a motivational mediator and task routineness as a moderator. The sample consists of 90 work teams (327 members and 90 immediate superiors) drawn from a public safety organization. Results of structural equation modeling indicate that the relationships between collective autonomy and two indicators of team absenteeism (i.e., absence frequency and time lost) are mediated by team potency. Specifically, collective autonomy is positively related to team potency which in turn is negatively related to team absenteeism. Furthermore, results of hierarchical regression analyses show that task routineness moderates the relationships between collective autonomy and the two indicators of team absenteeism such that these relationships are stronger when the level of task routineness is low. On the whole, this study points out that collective autonomy may exercise a motivational effect on attendance at work within teams, but this effect is contingent on task routineness.
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Costa, Diogo Patricio Varandas da
2010-01-01
Degree of Master in Social and Organizational Psychology / PsycINFO Content Classification Code System: 3000 Social Psychology; 3660 Organizational Behavior Self-Determination Theory (SDT) argues that autonomy, competence and relatedness are three universally critical needs that, once satisfied, will promote self-determined types of motivation and more intrinscally motivated behaviours that yield positive effects on well-being. In contrast, researchers on cross-cultural differences argu...
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Interventions for promoting habitual exercise in people living with and beyond cancer.
Bourke, Liam; Homer, Kate E; Thaha, Mohamed A; Steed, Liz; Rosario, Derek J; Robb, Karen A; Saxton, John M; Taylor, Stephanie J C
2013-09-24
The beneficial effects of regular exercise for people living with or beyond cancer are becoming apparent. However, how to promote exercise behaviour in sedentary cancer cohorts is not as well understood. A large majority of people living with or recovering from cancer do not meet exercise recommendations. Hence, reviewing the evidence on how to promote and sustain exercise behaviour is important. To assess the effects of interventions to promote exercise behaviour in sedentary people living with and beyond cancer and to address the following questions: Which interventions are most effective in improving aerobic fitness and skeletal muscle strength and endurance? What adverse effects are attributed to different exercise interventions? Which interventions are most effective in improving exercise behaviour amongst patients with different cancers? Which interventions are most likely to promote long-term (12 months or longer) exercise behaviour? What frequency of contact with exercise professionals is associated with increased exercise behaviour? What theoretical basis is most often associated with increased exercise behaviour? What behaviour change techniques are most often associated with increased exercise behaviour? We searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 8, 2012), MEDLINE, EMBASE, AMED, CINAHL, PsycLIT/PsycINFO, SportDiscus and PEDro from inception to August 2012. We also searched the grey literature, wrote to leading experts in the field, wrote to charities and searched reference lists of other recent systematic reviews. We included only randomised controlled trials (RCTs) that compared an exercise intervention with a usual care approach in sedentary people over the age of 18 with a homogenous primary cancer diagnosis. Two review authors working independently (LB and KH) screened all titles and abstracts to identify studies that might meet the inclusion criteria, or that
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Does Promotion Orientation Help Explain Why Future-Orientated People Exercise and Eat Healthy?
Milfont, Taciano L; Vilar, Roosevelt; Araujo, Rafaella C R; Stanley, Robert
2017-01-01
A study with United States undergraduate students showed individuals high in concern with future consequences engage in exercise and healthy eating because they adopt a promotion orientation, which represents the extent to which individuals are inclined to pursue positive gains. The present article reports a cross-cultural replication of the mediation findings with undergraduate samples from Brazil and New Zealand. Promotion orientation mediated the association between concern with future consequences and exercise attitudes in both countries, but the associations for healthy eating were not replicated-which could be explained by distinct obesity prevalence and eating habits in these socio-cultural contexts. We discuss theoretical and practical implications of the findings for promoting health behavior.
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Does Promotion Orientation Help Explain Why Future-Orientated People Exercise and Eat Healthy?
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Taciano L. Milfont
2017-07-01
Full Text Available A study with United States undergraduate students showed individuals high in concern with future consequences engage in exercise and healthy eating because they adopt a promotion orientation, which represents the extent to which individuals are inclined to pursue positive gains. The present article reports a cross-cultural replication of the mediation findings with undergraduate samples from Brazil and New Zealand. Promotion orientation mediated the association between concern with future consequences and exercise attitudes in both countries, but the associations for healthy eating were not replicated—which could be explained by distinct obesity prevalence and eating habits in these socio-cultural contexts. We discuss theoretical and practical implications of the findings for promoting health behavior.
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Visual portrayals of obesity in health media: promoting exercise without perpetuating weight bias.
Pearl, R L; Dovidio, J F; Puhl, R M
2015-08-01
Health education campaigns for preventing and reducing obesity often contain weight-stigmatizing visual content, which may have unintended negative health consequences. The goal of the present research was to identify non-stigmatizing visual content for health education materials that can promote exercise among people of diverse weight statuses. An online sample of 483 US women viewed: (i) a woman with obesity portrayed stereotypically; (ii) a woman with obesity exercising; (iii) a woman with obesity portrayed neutrally; or (iv) a lean woman exercising. Race of the models pictured was randomized (White or Black). Participants completed measures of weight bias and exercise behavior and attitudes, and provided information about their weight status. Analysis of covariance revealed that responses to stereotypical and exercise images varied by participant weight status. Across participants, neutral obesity portrayals elicited lower expressions of weight-biased attitudes and higher reports of exercise liking/comfort. Among non-overweight participants, images portraying women with obesity stereotypically or counter-stereotypically produced greater endorsement of negative stereotypes than control, lean images. No effects of model race were found. These findings suggest that the public responds differently to visual portrayals of obesity depending on weight status, and neutral portrayals may be an effective route toward promoting exercise without perpetuating stigma. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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Berger, Zackary; Cahan, Rabbi Joshua
2016-10-01
In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices are sensitive to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge.
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Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness
Epstein, Ronald M.; Street, Richard L.
2011-01-01
In the context of serious illness, individuals usually rely on others to help them think and feel their way through difficult decisions. To help us to understand why, when, and how individuals involve trusted others in sharing information, deliberation, and decision making, we offer the concept of shared mind—ways in which new ideas and perspectives can emerge through the sharing of thoughts, feelings, perceptions, meanings, and intentions among 2 or more people. We consider how shared mind manifests in relationships and organizations in general, building on studies of collaborative cognition, attunement, and sensemaking. Then, we explore how shared mind might be promoted through communication, when appropriate, and the implications of shared mind for decision making and patient autonomy. Next, we consider a continuum of patient-centered approaches to patient-clinician interactions. At one end of the continuum, an interactional approach promotes knowing the patient as a person, tailoring information, constructing preferences, achieving consensus, and promoting relational autonomy. At the other end, a transactional approach focuses on knowledge about the patient, information-as-commodity, negotiation, consent, and individual autonomy. Finally, we propose that autonomy and decision making should consider not only the individual perspectives of patients, their families, and members of the health care team, but also the perspectives that emerge from the interactions among them. By drawing attention to shared mind, clinicians can observe in what ways they can promote it through bidirectional sharing of information and engaging in shared deliberation. PMID:21911765
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Patient autonomy and informed consent in critically lll
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Todorović Zoran M.
2017-01-01
Full Text Available Patient autonomy has been a cornerstone of contemporary clinical ethics since the Nuremberg trial, especially in American school of bioethics. Topic: Patient autonomy has been defined in the Nuremberg Code, and re-defined in the Declaration of Helsinki, Belmont Report and Barcelona Declaration. Founders and followers of the rights-oriented bioethics (for example, Hellegers, Beauchamp and Childers have established and promoted the patient autonomy as the main principle of bio(medical ethics since 1970s. However, there is a lot of controversy surrounding such a principle, especially in vulnerable patients. We aimed at evaluating the real meaning and value of patient autonomy in critical care settings regarding the communication between health workers and their patients and families. Conclusion: Protection of patients autonomy in critically ill is a complex issue. Careful benefit-risk assessment is needed in order to find the most appropriate way of obtaining the informed consent, proxy consent or to omit or delay it.
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Legault, Lisa; Weinstein, Netta; Mitchell, Jahlil; Inzlicht, Michael; Pyke, Kristen; Upal, Afzal
2017-10-01
Our experiences, attributes, and behaviors are diverse, inconsistent, and often negative. Consequently, our capacity to assimilate divergent experiences-particularly negative aspects-is important to the development of a unified self. Whereas this process of integration has received attention at the level of personal identity, it has not been assessed at the level of group identity. We examined the mechanisms involved in integrating positive and negative ingroup identities, as well as related outcomes. In three experiments, participants (N = 332) high and low in autonomy identified either positive or negative aspects of their ingroup and then indicated the extent to which they integrated the attribute. Those high in personal autonomy integrated both positive and negative identities, whereas those low in autonomy acknowledged only positive identities. Study 2 showed that, regardless of identity valence, those high in autonomy felt satisfied and close with their group. Conversely, those low in autonomy felt less close and more dissatisfied with their group after reflecting on negative identities. Finally, reflecting on a negative identity reduced prejudice, but only for those high in autonomy. Owning up to negative group traits is facilitated by autonomy and demonstrates benefits for ingroup and intergroup processes. © 2016 Wiley Periodicals, Inc.
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Autonomy, Competence and Non-interference.
Roberts, Joseph T F
2017-12-30
In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights to non-interference upon demonstration of competence. In this paper, I present a risk-sensitive account of competence as a means of grounding rights to non-interference. On a risk-sensitive account of competence individuals demonstrate their competence by exercising three capacities to the extent necessary to meet a threshold determined by the riskiness of the decision. These three capacities are the capacity to (i) acquire knowledge, (ii) use instrumental rationality, and (iii) form and revise a life plan.
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Tai Chi Chuan: an ancient wisdom on exercise and health promotion.
Lan, Ching; Lai, Jin-Shin; Chen, Ssu-Yuan
2002-01-01
Tai Chi Chuan (TCC) is a Chinese conditioning exercise and is well known for its slow and graceful movements. Recent investigations have found that TCC is beneficial to cardiorespiratory function, strength, balance, flexibility, microcirculation and psychological profile. The long-term practice of TCC can attenuate the age decline in physical function, and consequently it is a suitable exercise for the middle-aged and elderly individuals. TCC can be prescribed as an alternative exercise programme for selected patients with cardiovascular, orthopaedic, or neurological diseases, and can reduce the risk of falls in elderly individuals. The exercise intensity of TCC depends on training style, posture and duration. Participants can choose to perform a complete set of TCC or selected movements according to their needs. In conclusion, TCC has potential benefits in health promotion, and is appropriate for implementation in the community.
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"Women's autonomy and pregnancy care in rural India: a contextual analysis".
Mistry, Ritesh; Galal, Osman; Lu, Michael
2009-09-01
Studies in low-income countries have shown that women's autonomy (i.e. the freedom of women to exercise their judgment in order to act for their own interests) influences a number of reproductive and child health outcomes, including the use of pregnancy care services. However, studies have not examined the full spectrum of pregnancy care services needed for safe motherhood and have not accounted for community context. This study analyzed data on women and their villages from the cross-sectional population-based National Family Health Survey-2 (1998-1999) of rural India to investigate whether women's autonomy (measured in the 3 dimensions of decision-making autonomy, permission to go out, and financial autonomy) was associated with the use of adequate prenatal, delivery and postnatal care. The findings indicate women's autonomy was associated with greater use of pregnancy care services, particularly prenatal and postnatal care. The effect of women's autonomy on pregnancy care use varied according to the region of India examined (North, East and South) such that it was most consistently associated with pregnancy care use in south India, which also had the highest level of self-reported women's autonomy. The results regarding village level factors suggest that public investment in rural economic development, primary health care access, social cohesion and basic infrastructure such as electrification and paved roads were associated with pregnancy care use. Improvements in women's autonomy and these village factors may improve healthier child bearing in rural India.
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PEERS' INFLUENCE ON EXERCISE ENJOYMENT: A SELF-DETERMINATION THEORY APPROACH
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Juan Antonio Moreno Murcia
2008-03-01
Full Text Available The purpose of this research was to study the influence of motivational climate perceived in peers and basic psychological needs (competence, autonomy and relatedness on self-determined motivation and enjoyment in exercise. A sample comprised of 394 non- competitive physical exercisers, 156 women and 238 men aged between 16 and 54 (M = 21.64, SD = 7. 18, completed the Motivational Climate Perceived in Peers Scale, Scale of Motivational Mediators in Physical Activity, Behavioural Regulation in Exercise Questionnaire-2 and Physical Activity Enjoyment Scale. A correlation analysis between the variables studied, a confirmatory factor analysis (CFA and structural equation analysis were performed. The results showed that the task- involving peer motivational climate positively predicted the three basic psychological needs (competence, autonomy and relatedness. In turn, meeting the needs for competence and relatedness positively predicted self-determined motivation, which also positively predicted the enjoyment the exercisers had during the activity. There were no significant associations between the ego- involving peer motivational climate and psychological needs. A multisample analysis indicated that the model was invariant across age and degree of exercise involvement. This study reiterates the importance of increasing exercisers' self-determined motivation in order to obtain more enjoyment and to be more committed to the exercise. Therefore, it is essential to foster perceptions of competence, autonomy and relatedness by means of a task-involving climate. The findings provide evidence for the importance of peer motivational climate in sports motivation
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Patient autonomy in chronic care: solving a paradox
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Reach G
2013-12-01
Full Text Available Gérard Reach Department of Endocrinology, Diabetes, and Metabolic Diseases, Avicenne Hospital AP-HP, and EA 3412, CRNH-IdF, Paris 13 University, Sorbonne Paris Cité, Bobigny, France Abstract: The application of the principle of autonomy, which is considered a cornerstone of contemporary bioethics, is sometimes in obvious contradiction with the principle of beneficence. Indeed, it may happen in chronic care that the preferences of the health care provider (HCP, who is largely focused on the prevention of long term complications of diseases, differ from those, more present oriented, preferences of the patient. The aims of this narrative review are as follows: 1 to show that the exercise of autonomy by the patient is not always possible; 2 where the latter is not possible, to examine how, in the context of the autonomy principle, someone (a HCP can decide what is good (a treatment for someone else (a patient without falling into paternalism. Actually this analysis leads to a paradox: not only is the principle of beneficence sometimes conflicting with the principle of autonomy, but physician's beneficence may enter into conflict with the mere respect of the patient; and 3 to propose a solution to this paradox by revisiting the very concepts of the autonomous person, patient education, and trust in the patient–physician relationship: this article provides an ethical definition of patient education. Keywords: preference, autonomy, person, reflexivity, empathy, sympathy, patient education, trust, respect, care
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Autonomy and the principle of respect for autonomy.
Gillon, R
1985-06-15
Autonomy is defined as the capacity to think, decide, and act freely and independently on the basis of such thought and decisions. Three types of autonomy are distinguished: autonomy of thought, which embraces the wide range of human intellectual activities called "thinking for oneself"; autonomy of will, or the capacity to decide to do things on the basis of one's deliberations; and autonomy of action, the absence of which is illustrated by the situation of a patient whose voluntary muscles are paralyzed by curariform drugs and who thus cannot tell the surgeon that the anesthetist has forgotten the nitrous oxide. Autonomy is viewed as a prerequisite for all the virtues, rather than as a virtue in its own right. The arguments of Immanuel Kant and John Stuart Mill concerning the principle of respect for autonomy are summarized as exemplars respectively of the deontological and utilitarian philosophical approaches.
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Ing-Arahm, Rungsima; Suppuang, Arunya; Imjaijitt, Worarachanee
2010-11-01
Phramongkutklao College of Medicine is a military medical school and also a health promotion school. As a result, encouraging these medical students to have good attitude toward exercise is considered an important mission for the college. To study the attitudes of medical students at Phramongkutklao College of Medicine about exercise for health promotion. This survey research was carried out in 382 medical students in Academic Year 2008 using questionnaires including personal information, attitude testing and open-ended questions. Statistical analysis was conducted using descriptive analysis: percentage and mean and comparative analysis: t-test and F-test. The overall attitudes of medical students toward exercise were good. The attitudes of the medical cadets were better than those of the civilian medical students. The attitudes and also knowledge about exercise of the higher-year students were generally better than those of the lower-year ones. The attitudes of healthy medical students were higher than those of unhealthy ones. No significant difference in attitude was found between male and female students and between those with different Body Mass Indexes (BMI) and those with different in exercise duration and frequency. The overall medical students' attitudes toward exercise for health promotion in Phramongkutklao College of Medicine were good. The influencial factors were found to be status of medical students, stage of medical study and health status.
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Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa
2009-01-01
Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937
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Heráclito Mota Barreto Neto
2015-12-01
Full Text Available The following paper has as objective questioning the legitimacy of state's paternalistic interventions on individual autonomy by using institutional-criminal instruments. In this path, the paper aims to understand in which cases the State is allowed to interfere in private individual lives under the justification of being promoting a well or avoiding a harm and, as well, in which cases such interference is abusive of individuals self-determination. Into this analysis, the work will study the current concepts of paternalism, the theoretical classifications on paternalistic interventions which will be useful to demonstrate admissible and inadmissible species of paternalism and Joel Feinberg and Gerald Dworkin's anti- paternalistic theories. Following, this subject will be analyzed in association with the implications of juridical-criminal goods involved in conflicts between autonomy, human vulnerabilities and paternalism, specially regarding to the (unavailability of those goods. In the end, the work intends to define legitimation criteria for paternalistic interventions inserted in criminal laws, which superimpose themselves on the individual autonomy, in order to harmonize constitutional values of respect for autonomy, protection of vulnerable individuals and the Criminal Law functions of exclusive protection of juridical goods.
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Patient autonomy in home care: Nurses' relational practices of responsibility.
Jacobs, Gaby
2018-01-01
Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course ('learning circle') for home care nurses, including participant observations and focus groups. The theoretical notion of 'relational agency' and the moral concept of 'practices of responsibility' were used to conduct a narrative analysis on the nurses' stories about autonomy. Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients' strengths and collaboration with patients and informal caregivers. On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.
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Lovell, Geoff P; Gordon, James A R; Mueller, Marcus B; Mulgrew, Kate; Sharman, Rachael
2016-01-01
We compared mothers who exercised predominantly in group settings, those who exercised predominantly in individual settings, and those who exercised equally in group and individual contexts among the following: (a) satisfaction of basic psychological needs (autonomy, competence, and relatedness); (b) self-determined exercise motivation; and (c) psychological well-being. With clear implications for mothers' exercise interventions we found that exercising either predominantly in group contexts or in mixed group and individual settings was associated with mothers having significantly higher satisfaction of basic psychological needs and self-determined exercise motivation than those exercising predominantly alone.
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Vansteenkiste, Maarten; Simons, Joke; Lens, Willy; Sheldon, Kennon M; Deci, Edward L
2004-08-01
Three field experiments with high school and college students tested the self-determination theory hypotheses that intrinsic (vs. extrinsic) goals and autonomy-supportive (vs. controlling) learning climates would improve students' learning, performance, and persistence. The learning of text material or physical exercises was framed in terms of intrinsic (community, personal growth, health) versus extrinsic (money, image) goals, which were presented in an autonomy-supportive versus controlling manner. Analyses of variance confirmed that both experimentally manipulated variables yielded main effects on depth of processing, test performance, and persistence (all ps intrinsic goals and autonomy support were present. Effects were significantly mediated by autonomous motivation.
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Exercise Promotion in Geriatric Oncology.
Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M
2016-09-01
Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.
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Murray, Aileen; Hall, Amanda; Williams, Geoffrey C; McDonough, Suzanne M; Ntoumanis, Nikos; Taylor, Ian; Jackson, Ben; Copsey, Bethan; Hurley, Deirdre A; Matthews, James
2018-02-27
To assess the inter-rater reliability and concurrent validity of the Communication Evaluation in Rehabilitation Tool, which aims to externally assess physiotherapists competency in using Self-Determination Theory-based communication strategies in practice. Audio recordings of initial consultations between 24 physiotherapists and 24 patients with chronic low back pain in four hospitals in Ireland were obtained as part of a larger randomised controlled trial. Three raters, all of whom had Ph.Ds in psychology and expertise in motivation and physical activity, independently listened to the 24 audio recordings and completed the 18-item Communication Evaluation in Rehabilitation Tool. Inter-rater reliability between all three raters was assessed using intraclass correlation coefficients. Concurrent validity was assessed using Pearson's r correlations with a reference standard, the Health Care Climate Questionnaire. The total score for the Communication Evaluation in Rehabilitation Tool is an average of all 18 items. Total scores demonstrated good inter-rater reliability (Intraclass Correlation Coefficient (ICC) = 0.8) and concurrent validity with the Health Care Climate Questionnaire total score (range: r = 0.7-0.88). Item-level scores of the Communication Evaluation in Rehabilitation Tool identified five items that need improvement. Results provide preliminary evidence to support future use and testing of the Communication Evaluation in Rehabilitation Tool. Implications for Rehabilitation Promoting patient autonomy is a learned skill and while interventions exist to train clinicians in these skills there are no tools to assess how well clinicians use these skills when interacting with a patient. The lack of robust assessment has severe implications regarding both the fidelity of clinician training packages and resulting outcomes for promoting patient autonomy. This study has developed a novel measurement tool Communication Evaluation in Rehabilitation Tool and a
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van der Giessen, D.; Branje, S.T.J.; Meeus, W.H.J.
2014-01-01
According to the self-determination theory, experiencing autonomy support in close relationships is thought to promote adolescents' well-being. Perceptions of autonomy support from parents and from best friends have been associated with lower levels of adolescents' depressive symptoms. This
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van der Giessen, D.; Branje, S.; Meeus, W.
2014-01-01
According to the self-determination theory, experiencing autonomy support in close relationships is thought to promote adolescents' well-being. Perceptions of autonomy support from parents and from best friends have been associated with lower levels of adolescents' depressive symptoms. This
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Sleiman, Sama F; Henry, Jeffrey; Al-Haddad, Rami; El Hayek, Lauretta; Abou Haidar, Edwina; Stringer, Thomas; Ulja, Devyani; Karuppagounder, Saravanan S; Holson, Edward B; Ratan, Rajiv R; Ninan, Ipe; Chao, Moses V
2016-06-02
Exercise induces beneficial responses in the brain, which is accompanied by an increase in BDNF, a trophic factor associated with cognitive improvement and the alleviation of depression and anxiety. However, the exact mechanisms whereby physical exercise produces an induction in brain Bdnf gene expression are not well understood. While pharmacological doses of HDAC inhibitors exert positive effects on Bdnf gene transcription, the inhibitors represent small molecules that do not occur in vivo. Here, we report that an endogenous molecule released after exercise is capable of inducing key promoters of the Mus musculus Bdnf gene. The metabolite β-hydroxybutyrate, which increases after prolonged exercise, induces the activities of Bdnf promoters, particularly promoter I, which is activity-dependent. We have discovered that the action of β-hydroxybutyrate is specifically upon HDAC2 and HDAC3, which act upon selective Bdnf promoters. Moreover, the effects upon hippocampal Bdnf expression were observed after direct ventricular application of β-hydroxybutyrate. Electrophysiological measurements indicate that β-hydroxybutyrate causes an increase in neurotransmitter release, which is dependent upon the TrkB receptor. These results reveal an endogenous mechanism to explain how physical exercise leads to the induction of BDNF.
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Sylvester, Benjamin D; Standage, Martyn; Ark, Tavinder K; Sweet, Shane N; Crocker, Peter R; Zumbo, Bruno D; Beauchamp, Mark R
2014-10-01
In this study, we examined whether perceived variety in exercise prospectively predicts unique variance in exercise behavior when examined alongside satisfaction of the three basic psychological needs (for competence, relatedness, and autonomy) embedded within self-determination theory (Ryan & Deci, 2002), through the mediating role of autonomous and controlled motivation. A convenience sample of community adults (N = 363) completed online questionnaires twice over a 6-week period. The results of structural equation modeling showed perceived variety and satisfaction of the needs for competence and relatedness to be unique indirect positive predictors of exercise behavior (through autonomous motivation) 6 weeks later. In addition, satisfaction of the need for autonomy was found to negatively predict controlled motivation. Perceived variety in exercise complemented satisfaction of the needs for competence, relatedness, and autonomy in predicting motivation and (indirectly) exercise behavior, and may act as a salient mechanism in the prediction of autonomous motivation and behavior in exercise settings.
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The interaction between nutrition and exercise for promoting health and performance.
Witard, Oliver C; Ball, Derek
2018-02-01
The theme of The Nutrition Society Spring Conference 2017 was on the interaction between nutrition and exercise for promoting healthy ageing, maintaining cognitive function and improving the metabolic health of the population. The importance of this theme is highlighted by the public health issues surrounding obesity, diabetes and the age-related loss of skeletal muscle mass (sarcopenia). The opening symposium provided a historical perspective of both invasive and non-invasive methodologies for measuring exercise energetics and energy balance. Data derived from these techniques underpin current understanding regarding the metabolic response to nutrition and exercise. Further symposia examined the importance of skeletal muscle for healthy ageing in older men and postmenopausal women. From a nutritional perspective, the potential for animal- v. plant-based protein sources to offset the age-related decline in muscle mass was discussed. The day concluded by discussing the link(s) between nutrition, exercise and brain function. Day 2 commenced with examples of applied equine research illustrating the link between nutrition/exercise and insulin resistance to those of a human model. The final symposium examined the combined role of nutrition and exercise in reducing risk of type 2 diabetes and dyslipidaemia. The overall conclusion from the meeting was that the interaction between diet and physical activity confers greater benefits to human health and performance than either component alone.
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What does respect for the patient's autonomy require?
Cheng, Kam-Yuen
2013-11-01
Personal autonomy presupposes the notion of rationality. What is not so clear is whether, and how, a compromise of rationality to various degrees will diminish a person's autonomy. In bioethical literature, three major types of threat to the rationality of a patient's medical decision are identified: insufficient information, irrational beliefs/desires, and influence of different framing effects. To overcome the first problem, it is suggested that patients be provided with information about their diseases and treatment choices according to the objective standard. I shall explain how this should be finessed. Regarding the negative impact of irrational beliefs/desires, some philosophers have argued that holding irrational beliefs can still be an expression of autonomy. I reject this argument because the degree of autonomy of a decision depends on the degree of rationality of the beliefs or desires on which the decision is based. Hence, to promote patient autonomy, we need to eliminate irrational beliefs by the provision of evidence and good arguments. Finally, I argue that the way to smooth out the framing effects is to present the same information in different perspectives: it is too often assumed that medical information can always be given in a complete and unadorned manner. This article concludes with a cautionary note that the protection of patient autonomy requires much more time and effort than the current practice usually allows. © 2012 John Wiley & Sons Ltd.
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Quinteiro, Hugo; Buzin, Morgana; Conti, Filipe Fernandes; Dias, Danielle da Silva; Figueroa, Diego; Llesuy, Susana; Irigoyen, Maria-Cláudia; Sanches, Iris Callado; De Angelis, Kátia
2015-05-01
The aim of this study was to evaluate the effects of aerobic exercise training or resistance exercise training on cardiac morphometric, functional, and oxidative stress parameters in rats with ovarian hormone deprivation and diabetes. Female Wistar rats (200-220 g) were divided into a sham-operated group (euglycemic sham-operated sedentary [ES]; n = 8) and three ovariectomized (bilateral removal of ovaries) and diabetic (streptozotocin 50 mg/kg IV) groups as follows: diabetic ovariectomized sedentary (DOS; n = 8), diabetic ovariectomized undergoing aerobic exercise training (DOTA; n = 8), and diabetic ovariectomized undergoing resistance exercise training (DOTR; n = 8). After 8 weeks of resistance (ladder) or aerobic (treadmill) exercise training, left ventricle function and morphometry were evaluated by echocardiography, whereas oxidative stress was evaluated at the left ventricle. The DOS group presented with increased left ventricle cavity in diastole and relative wall thickness (RWT), and these changes were attenuated in both DOTA and DOTR groups. Systolic and diastolic function was impaired in the DOS group compared with the ES group, and only the DOTA group was able to reverse this dysfunction. Lipoperoxidation and glutathione redox balance were improved in both trained groups compared with the DOS group. Glutathione peroxidase and superoxide dismutase were higher in the DOTA group than in the other studied groups. Correlations were observed between lipoperoxidation and left ventricle cavity in diastole (r = 0.55), between redox balance and RWT (r = 0.62), and between lipoperoxidation and RWT (r = -0.60). Aerobic exercise training and resistance exercise training promote attenuation of cardiac morphometric dysfunction associated with a reduction in oxidative stress in an experimental model of diabetes and menopause. However, only dynamic aerobic exercise training is able to attenuate systolic and diastolic dysfunction under this condition.
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Fostering Autonomy through Syllabus Design: A Step-by-Step Guide for Success
Ramírez Espinosa, Alexánder
2016-01-01
Promoting learner autonomy is relevant in the field of applied linguistics due to the multiple benefits it brings to the process of learning a new language. However, despite the vast array of research on how to foster autonomy in the language classroom, it is difficult to find step-by-step processes to design syllabi and curricula focused on the…
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[School nutrition and autonomy - challenges and opportunities].
Barbosa, Najla Veloso Sampaio; Machado, Neila Maria Viçosa; Soares, Maria Cláudia Veiga; Pinto, Anelise Regina Royer
2013-04-01
This study seeks to emphasize school food as an important policy to promote student autonomy by means of food and nutrition education included in the curriculum, integrated with different actors and based on the standpoint of citizenship. It seeks to return to fundamental concepts in the context of school food reflecting on them through theoretical assumptions to identify possible strategies to promote citizenship and autonomy in school. The strategies involved food and nutrition education with the daily presence of quality and suitability in school meals, discussions on the various dimensions of food in the curriculum and integrating food in the pedagogical project extended to various areas of the education system. School food fosters the need for integration of actions, actors and the various social spaces interested in the food issue, such as ministries, education systems, departments and schools, so that they may tackle the demands of contemporary reality in an integrated, systematic, consistent and efficient manner.
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Respect and Autonomy in Children's Observation and Participation in Adults' Activities.
García, Fernando A
2015-01-01
This chapter examines Peruvian Quechua children's learning by observing and pitching in. The children concentrate attentively when they observe the activities of the adults and they exercise autonomy in the context of adults' encouragement of measured behaviors while always showing respectful silence in the presence of their elders. © 2015 Elsevier Inc. All rights reserved.
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Limits to relational autonomy--the Singaporean experience.
Krishna, Lalit Kumar Radha; Watkinson, Deborah S; Beng, Ng Lee
2015-05-01
Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered "content neutral" not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and "operationalize" the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. © The Author(s) 2014.
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Educating for Well-Being and Autonomy
Cuypers, Stefaan E.; Haji, Ishtiyaque
2008-01-01
Liberals champion the view that promoting autonomy--seeing to it that our children develop into individuals who are self-governing in the conduct of their lives--is a vital aim of education, though one generally accredited as being subsidiary to well-being. Our prime goal in this article is to provide a partial validation of this liberal ideal…
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Factor structure of the autonomy preference index in people with severe mental illness.
Bonfils, Kelsey A; Adams, Erin L; Mueser, Kim T; Wright-Berryman, Jennifer L; Salyers, Michelle P
2015-08-30
People vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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Capturing Requirements for Autonomous Spacecraft with Autonomy Requirements Engineering
Vassev, Emil; Hinchey, Mike
2014-08-01
The Autonomy Requirements Engineering (ARE) approach has been developed by Lero - the Irish Software Engineering Research Center within the mandate of a joint project with ESA, the European Space Agency. The approach is intended to help engineers develop missions for unmanned exploration, often with limited or no human control. Such robotics space missions rely on the most recent advances in automation and robotic technologies where autonomy and autonomic computing principles drive the design and implementation of unmanned spacecraft [1]. To tackle the integration and promotion of autonomy in software-intensive systems, ARE combines generic autonomy requirements (GAR) with goal-oriented requirements engineering (GORE). Using this approach, software engineers can determine what autonomic features to develop for a particular system (e.g., a space mission) as well as what artifacts that process might generate (e.g., goals models, requirements specification, etc.). The inputs required by this approach are the mission goals and the domain-specific GAR reflecting specifics of the mission class (e.g., interplanetary missions).
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Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.
Hendrick, C Emily; Marteleto, Leticia
2017-06-01
Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.
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Leaders promote attendance in sport and exercise sessions by fostering social identity.
Stevens, M; Rees, T; Coffee, P; Haslam, S A; Steffens, N K; Polman, R
2018-05-17
Sport and exercise participation exert a positive effect on numerous aspects of individuals' health. Although sport and exercise leaders have generally been observed to play a key role in shaping group members' behavior, our understanding of their impact on group members' attendance in sport and exercise sessions is limited. To address this, and building on promising findings in other domains, we examined the associations between perceptions of sport and exercise leaders' engagement in social identity leadership, group identification, and attendance. A sample of 583 participants from sports teams (n = 307) and exercise groups (n = 276) completed questionnaires measuring identity leadership, group identification, and attendance. Analyses demonstrated that perceptions of leader engagement in social identity leadership were positively associated with members' group identification, and that this in turn was positively associated with their attendance in either a sports group or an exercise group. Moreover, there was a significant indirect effect for perceptions of leader engagement in identity leadership on group members' attendance through their greater identification with these groups. Findings highlight the importance of considering the impact sport and exercise leaders have on group members' attendance and suggest that leaders who represent, advance, create, and embed a shared sense of identity (ie, a shared sense of "us") among attendees can promote participation in sport and exercise. © 2018 The Authors. Scandinavian Journal of Medicine & Science In Sports Published by John Wiley & Sons Ltd.
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Paul-Binyamin, Ilana; Gindi, Shahar
2017-01-01
This study investigated the tension that exists between promoting an educational agenda and practising an educational approach which emphasises autonomy within the framework of religious education. Our main thesis is that every educational deed contains a dialectical tension between endorsing an educational agenda and the promotion of autonomy.…
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Building up Autonomy Through Reading Strategies
Directory of Open Access Journals (Sweden)
Alexander Izquierdo Castillo
2014-10-01
Full Text Available This article reports on an action research project conducted with six ninth grade students in a rural public school in Colombia. The purpose of the study was to determine how the implementation of three reading strategies (skimming, scanning, and making predictions, when reading topics selected by learners, helps them to improve their reading comprehension and promotes their autonomy in the learning process. The results show that these learners developed some autonomous features such as making decisions for learning and doing assigned homework, increasing reading awareness and motivation. Additionally, the training on reading strategies allowed them to succeed in their reading comprehension. We conclude that these reading strategies are tools that take learners along the path of autonomy.
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Johnson, Stephanie B; Butow, Phyllis N; Kerridge, Ian; Tattersall, Martin H N
2018-02-01
Patients' are encouraged to participate in advance care planning (ACP) in order to enhance their autonomy. However, controversy exists as to what it means to be autonomous and there is limited understanding of how social and structural factors may influence cancer patients' ability to exercise their autonomy. The objective of this study is to explore oncologists' and palliative care physicians' understanding of patient autonomy, how this influences reported enactment of decision-making at the end of life (EOL), and the role of ACP in EOL care. Qualitative semi-structured interviews were conducted with consultant oncologists (n = 11) and palliative medicine doctors (n = 7) working in oncology centres and palliative care units across Australia. We found that doctors generally conceptualized autonomy in terms of freedom from interference but that there was a profound disconnect between this understanding of autonomy and clinical practice in EOL decision-making. The clinicians in our study privileged care, relationships and a 'good death' above patient autonomy, and in practice were reluctant to 'abandon' their patients to total non-interference in decision-making. Patient autonomy in healthcare is bounded, as while patients were generally encouraged to express their preferences for care, medical norms about the quality and 'reasonableness' of care, the availability of services and the patients' family relationships act to enhance or limit patients' capacity to realize their preferences. While for many, this disconnect between theory and practice did not diminish the rhetorical appeal of ACP; for others, this undermined the integrity of ACP, as well as its relevance to care. For some, ACP had little to do with patient autonomy and served numerous other ethical, practical and political functions. The ethical assumptions regarding patient autonomy embedded in academic literature and policy documents relating to ACP are disconnected from the realities of clinical care
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Quinn, Mary Ellen; Guion, W. Kent
2010-01-01
The health benefits of regular exercise are well documented, yet there has been limited success in the promotion of regular exercise in older African American women. Based on theoretical and evidence-based findings, the authors recommend a behavioral self-efficacy approach to guide exercise interventions in this high-risk population. Interventions…
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Challenging the bioethical application of the autonomy principle within multicultural societies.
Fagan, Andrew
2004-01-01
clear. The autonomy principle may be presently invalidly applied in certain circumstances because the conditions for the exercise of autonomy have not been fully or even adequately satisfied. This is a controversial claim. The precise terms of my argument, while addressing the specific application of the autonomy principle within bioethics, will resonate beyond this sphere and raises questions for attempts to establish a common moral discourse upon the ideal of personal autonomy within multicultural societies generally.
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Bérubé, Sarah; Mouillard, Florine; Amesse, Claudine; Sultan, Serge
2016-01-11
In pediatric hemophilia, caregivers are facing unique challenges to adherence and self-care in children and adolescents with hemophilia. Hemophilia treatment requires adequate prophylaxis and on-demand treatment, as well as a clear behavioral strategy to limit risk-taking in terms of physical exercise and diet. Medication adherence rates of hemophilia patients have been reported to decrease during late childhood and adolescence. In the developing child, moving safely from parent-care to self-care is one of the greatest challenges of integrative care within this domain. There is a clear need for initiatives designed to increase an individual's motivation for treatment and self-care activities. Among motivational approaches, the self-determination perspective offers a useful framework to explain how the transition to self-care can be facilitated. We discuss how motivation regarding hemophilia treatment may be increased through parental autonomy support and we offer examples of applied communication techniques to facilitate autonomy-supportive caregiving. Although it has not yet been tested in the context of hemophilia, these communication techniques could potentially help caregivers promote adherence and self-care in children. Confronted by unique challenges to adherence and self-care, caregivers of children with hemophilia should move from an exclusive focus on illness-management education to an integrative strategy, including motivation-enhancing communication. The self-determination perspective provides important proximal objectives (e.g. autonomy support) to maintain optimal adherence in adolescents as they move from parent-care to self-care. Future research initiatives should address the practice of these communication techniques and evaluate them in the context of hemophilia.
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Biases and Heuristics in Decision Making and Their Impact on Autonomy.
Blumenthal-Barby, J S
2016-05-01
Cognitive scientists have identified a wide range of biases and heuristics in human decision making over the past few decades. Only recently have bioethicists begun to think seriously about the implications of these findings for topics such as agency, autonomy, and consent. This article aims to provide an overview of biases and heuristics that have been identified and a framework in which to think comprehensively about the impact of them on the exercise of autonomous decision making. I analyze the impact that these biases and heuristics have on the following dimensions of autonomy: understanding, intentionality, absence of alienating or controlling influence, and match between formally autonomous preferences or decisions and actual choices or actions.
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Teaching ethics: when respect for autonomy and cultural sensitivity collide.
Minkoff, Howard
2014-04-01
Respect for autonomy is a key ethical principle. However, in some cultures other moral domains such as community (emphasizing the importance of family roles) and sanctity (emphasizing the sacred and the spiritual side of human nature) hold equal value. Thus, an American physician may sometimes perceive a conflict between the desire to practice ethically and the wish to be sensitive to the mores of other cultures. For example, a woman may appear to be making what the physician thinks is a bad clinical choice because her spouse is speaking on her behalf. That physician may find it difficult to reconcile the sense that the patient had not exercised freely her autonomy with the desire to be culturally sensitive. In this article, the means by which a physician can reconcile respect for other cultures with respect for autonomy is explored. The question of whether physicians must always defer to patients' requests solely because they are couched in the language of cultural sensitivity is also addressed. Copyright © 2014 Mosby, Inc. All rights reserved.
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Gracia, Diego
2012-02-01
What does autonomy mean from a moral point of view? Throughout Western history, autonomy has had no less than four different meanings. The first is political: the capacity of old cities and modern states to give themselves their own laws. The second is metaphysical, and was introduced by Kant in the second half of the 18th century. In this meaning, autonomy is understood as an intrinsic characteristic of all rational beings. Opposed to this is the legal meaning, in which actions are called autonomous when performed with due information and competency and without coercion. This last meaning, the most frequently used in bioethics, is primarily legal instead of moral. Is there a proper moral meaning of the word autonomy? If so, this would be a fourth meaning. Acts can only be called moral when they are postconventional (using the terminology coined by Lawrence Kohlberg), inner-directed (as expressed by David Riesman), and responsible (according to Hannah Arendt). Such acts are autonomous in this new, fourth, and to my mind, the only one proper, moral meaning. The goal of ethics cannot be other than forming human beings capable of making autonomous and responsible decisions, and doing so because they think this is their duty and not because of any other nonmoral motivation, like comfort, convenience, or satisfaction. The goal of ethics is to promote postconventional and mature human beings. This was what Socrates tried to do with the young people of Athens. And it is also the objective of every course of ethics and of any process of training.
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Edmunds, Jemma; Ntoumanis, Nikos; Duda, Joan L
2009-01-01
LEARNING OBJECTIVE: • This feature article emphasizes the need for physical activity and exercise interventions to be developed and delivered in accordance with psychological theory. Pulling from a contemporary theory of human motivation called Self-determination Theory, this article demonstrates how delivering an exercise message, consultation, or program in an autonomy-supportive, well-structured, and interpersonally involved way may benefit participants' attempts to become and stay more ac...
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The moral agency of institutions: effectively using expert nurses to support patient autonomy.
Charles, Sonya
2017-08-01
Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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Codes of Ethics and Teachers' Professional Autonomy
Schwimmer, Marina; Maxwell, Bruce
2017-01-01
This article considers the value of adopting a code of professional ethics for teachers. After having underlined how a code of ethics stands to benefits a community of educators--namely, by providing a mechanism for regulating autonomy and promoting a shared professional ethic--the article examines the principal arguments against codes of ethics.…
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African communal basis for autonomy and life choices.
Ikuenobe, Polycarp
2017-09-05
I argue that the metaphysical capacity of autonomy is not intrinsically valuable; it is valuable only when used in relation to a community's values and instrumentally for making the proper choices that will promote one's own and the community's well-being. I use the example of the choice to take one's life by suicide to illuminate this view. I articulate a plausible African conception of personhood as a basis for the idea of relational autonomy. I argue that this conception is better understood as a social-moral thesis, and not a metaphysical thesis. A metaphysical thesis gives an account of the abstract nature of an atomic individual, his agency, and rational choice. The social-moral thesis indicates that personhood and autonomy are positive and relational to the life plans, well-being, material conditions, and the best means for achieving them that are made available and possible by harmonious living in a community. This idea of autonomy is not just having the capacity of freewill; it also involves how such freewill is used, in terms of how an individual's choices are guided by internalized communal values. © 2017 John Wiley & Sons Ltd.
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Women's Autonomy and Its Correlates in Western Nepal: A Demographic Study.
Bhandari, Tulsi Ram; Kutty, V Raman; Ravindran, T K Sundari
2016-01-01
Despite various efforts for enhancing women's autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women's autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women's autonomy using a recently developed women's autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women's autonomy was 23.34 ± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple's education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women's education (OR = 8.14, CI = 3.77-17.57), husband's education (OR = 2.63, CI = 1.69-4.10) and economic status of household (OR = 1.42, CI = 1.01-2.03) on women's autonomy. When we adjusted women's education for husband's education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77-17.57) to (OR = 6.32, CI = 2.77-14.46)} and was a mediator effect. The economic status of household also had mediator effect on women's autonomy through their education. Education status of women is a key predictor of women's autonomy in Kapilvastu district. Husband's education and economic status of the household are other important predictors of women's autonomy which have a mediator effect on women's autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women's autonomy.
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Moreno Murcia, Juan A; Parra Rojas, Nicolás; González-Cutre Coll, David
2008-11-01
The purpose of this study was to analyze some factors that influence amotivation in physical education classes. A sample of 399 students, of ages 14 to 16 years, was used. They completed the Perceived Autonomy Support Scale in Exercise Settings (PASSES), the Social Goal Scale-Physical Education (SGS-PE), the factor of the Basic Psychological Needs in Exercise Scale (BPNES) adapted to physical education and the amotivation> factor of the Perceived Locus of Causality Scale (PLOC). The psychometric properties of the PASSES were analyzed, as this scale had not been validated to the Spanish context. In this analysis, the scale showed appropriate validity and reliability. The results of the structural equation model indicated that social responsibility and social relationship goals positively predicted perception of relatedness, whereas the context of autonomy support did not significantly predict it. In turn, perception of relatedness negatively predicted amotivation. The findings are discussed with regard to enhancing students' positive motivation.
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Clinical guidelines and the fate of medical autonomy in Ontario.
Rappolt, S G
1997-04-01
Conceptually, clinical guidelines and professional autonomy have a paradoxical relationship. Despite being the quintessence of medical knowledge at the corporate level, guidelines diminish the clinical autonomy of individual practitioners, and therefore threaten medicine's justification for its autonomy. Theorists have argued that professional autonomy will be retained through elite dominance of practitioners, while comparative research suggests that economic autonomy can be traded off to retain clinical autonomy. Under government pressure to regulate the growth of Ontario physicians' fee-for-service public expenditure, the profession's representative organization, the Ontario Medical Association (OMA), promoted voluntary clinical guidelines, hoping to both constrain costs and preserve professional control over the content of medical care. The OMA collaborated with the Ministry of Health in developing guidelines and establishing a provincial centre for health service research. Ontario's practitioners disregarded the OMA's exhortations to implement clinical guidelines, suggesting that in the absence of external constraints, practitioners can subvert elite dominance. However, practitioners' unchecked clinical and economic autonomy, combined with evidence of wide provincial variations in medical care, served to legitimize the government's increasingly unilateral control over the schedule of insured medical services, and, in 1993, their imposition of a global cap on physicians' fee-for-service income pool. When analysed in the context of ongoing Ministry-OMA relations, the failure of the OMA's guidelines strategy to constrain medical service costs has expedited an overall decline in medical autonomy in Ontario. The emergence and course of Ontario's clinical guidelines movement is consistent with the view that medical autonomy is contingent upon broad class forces, and the conceptualization of professional organizations as instruments for mediated occupational control.
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Whitehead, L C; Trip, H T; Hale, L A; Conder, J
2016-02-02
The basic human right of autonomy is underpinned by the ability to practice decision-making. The rights of people with disabilities to engage in autonomous decision-making are promoted as best practice and includes decisions around health and self-care. Little is known about autonomy in the field of long-term condition management. This paper explores how people with intellectual disabilities (ID) and their support workers experience and practice autonomy in relation to the management of diabetes. Semi-structured interviews were completed in residential and independent living settings with people living with an ID and type 1 (N = 8) or type 2 (N = 6) diabetes and their support workers (N = 17). The participant with ID's support worker was present as requested; however, the interviews were run separately with each participant rather than jointly. Thematic analysis was undertaken, and a constructivist lens informed both data collection and analysis. The analysis revealed a strong process of negotiated autonomy between people with ID and their support workers in relation to the daily management of diabetes. During times of transition, roles in relation to diabetes management were renegotiated, and the promotion of autonomy was prefaced within the context of risk and client safety. Goals to increase independence were drivers for negotiating greater autonomy. The successful negotiation of autonomy in relation to diabetes illustrates the potential for people with ID to play a key role in the management of long-term health conditions. The study highlights the primacy of developing decision-making skills among people with ID. Promoting opportunities for decision-making and an ethos of supported decision-making through person-centred planning are all vital in working towards enhancing autonomy. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
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Williams, Mary-Anne
This paper uses robot experience to explore key concepts of autonomy, life and being. Unfortunately, there are no widely accepted definitions of autonomy, life or being. Using a new cognitive agent architecture we argue that autonomy is a key ingredient for both life and being, and set about exploring autonomy as a concept and a capability. Some schools of thought regard autonomy as the key characteristic that distinguishes a system from an agent; agents are systems with autonomy, but rarely is a definition of autonomy provided. Living entities are autonomous systems, and autonomy is vital to life. Intelligence presupposes autonomy too; what would it mean for a system to be intelligent but not exhibit any form of genuine autonomy. Our philosophical, scientific and legal understanding of autonomy and its implications is immature and as a result progress towards designing, building, managing, exploiting and regulating autonomous systems is retarded. In response we put forward a framework for exploring autonomy as a concept and capability based on a new cognitive architecture. Using this architecture tools and benchmarks can be developed to analyze and study autonomy in its own right as a means to further our understanding of autonomous systems, life and being. This endeavor would lead to important practical benefits for autonomous systems design and help determine the legal status of autonomous systems. It is only with a new enabling understanding of autonomy that the dream of Artificial Intelligence and Artificial Life can be realized. We argue that designing systems with genuine autonomy capabilities can be achieved by focusing on agent experiences of being rather than attempting to encode human experiences as symbolic knowledge and know-how in the artificial agents we build.
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THE CHALLENGE OF AUTONOMY: AN EMPIRICAL STUDY OF THE VARIOUS DIMENSIONS OF AUTONOMY
Cristi IFTENE
2009-01-01
There are various dimensions of autonomy (policy, financial, structural, personnel, legal, institutional) as different scholars demonstrated (Christensen 2001, Verhoest et. al. 2004). In the present paper we will focus only on political and financial autonomy. As Yesilkagit and van Thiel demonstrated there is a difference between formal and de facto autonomy. They found that formal autonomy does not reinforce de facto autonomy and that organizations with less autonomy report higher levels of ...
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Van Assche, Jasper; van der Kaap-Deeder, Jolene; Audenaert, Elien; De Schryver, Maarten; Vansteenkiste, Maarten
2018-01-29
From a self-determination theory perspective, individuals are assumed to benefit and suffer from, respectively, the satisfaction and frustration of the psychological need for autonomy, even if they score low on autonomy strength. Yet, previous studies on need strength are scarce, operationalized need strength differently, and produced inconsistent findings. In two studies among 224 South African adults (M age = 24.13, SD = 4.25; 54.0% male) and 156 Belgian prisoners (M age = 38.60, SD = 11.68; 88.5% male), we investigated the moderating role of autonomy valuation and desire in the relations of autonomy satisfaction and frustration with a variety of well-being and ill-being indicators. Study 1 provided some evidence for the moderating role of mostly explicit autonomy desire (rather than explicit autonomy valuation). In Study 2, neither explicit nor implicit autonomy desire played a consistent moderating role. Overall, these findings are congruent with a moderate (albeit not with a strong) interpretation of the universality claim made within self-determination theory, provide initial evidence for a differentiation between deficit-based and growth-oriented interpersonal differences in need strength, and indicate that the potential moderating role of need strength deserves continued attention before any firm conclusions can be drawn. © 2018 Wiley Periodicals, Inc.
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da Silva de Vargas, Liane; Neves, Ben-Hur Souto das; Roehrs, Rafael; Izquierdo, Iván; Mello-Carpes, Pâmela
2017-06-30
Previously we showed the involvement of the hippocampal noradrenergic system in the consolidation and persistence of object recognition (OR) memory. Here we show that one-single physical exercise session performed immediately after learning promotes OR memory persistence and increases norepinephrine levels in the hippocampus. Additionally, effects of exercise on memory are avoided by an intra-hippocampal beta-adrenergic antagonist infusion. Taken together, these results suggest that exercise effects on memory can be related to noradrenergic mechanisms and acute physical exercise can be a non-pharmacological intervention to assist memory consolidation and persistence, with few or no side effects. Copyright © 2017 Elsevier B.V. All rights reserved.
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2013-01-01
Autonomy for Marine Robots provides a timely and insightful overview of intelligent autonomy in marine robots. A brief history of this emerging field is provided, along with a discussion of the challenges unique to the underwater environment and their impact on the level of intelligent autonomy required. Topics covered at length examine advanced frameworks, path-planning, fault tolerance, machine learning, and cooperation as relevant to marine robots that need intelligent autonomy. This book also: Discusses and offers solutions for the unique challenges presented by more complex missions and the dynamic underwater environment when operating autonomous marine robots Includes case studies that demonstrate intelligent autonomy in marine robots to perform underwater simultaneous localization and mapping Autonomy for Marine Robots is an ideal book for researchers and engineers interested in the field of marine robots.
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Directory of Open Access Journals (Sweden)
Meredith L. Ramsey
2016-04-01
Full Text Available This study sought to examine tenets of Self-Determination Theory by testing a mediation model of physical activity and personality via autonomy. A total of 290 adults were recruited to complete a one-time online survey of exercise habits and individual characteristics. Surveys assessed personality, autonomy, and physical activity. A measurement model specifying direct effects between personality dimensions and physical activity and indirect effects operating through autonomy provided an excellent fit to the data (Χ2 = 0.66, df = 3, p = 0.88, RMSEA(90% CI = 0.00 (0.00–0.05, CFI = 0.99, SRMR = 0.01. Results indicated significant (p < 0.05 effects of Extroversion (β = 0.42, Conscientiousness (β = 0.96, and Emotional Stability (β = 0.60 on autonomy, which in turn, was significantly associated with physical activity (β = 0.55. No significant effects were observed for Agreeableness or Intellect. None of the personality constructs were found to be directly associated with physical activity. This model accounted for 27% of the variance in physical activity. The results of this study suggest that autonomy is significantly associated with physical activity. Therefore, attempts to improve autonomy in individuals may be a useful intervention strategy in improving physical activity levels.
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University autonomy as sensemaking
DEFF Research Database (Denmark)
Lind, Jonas Krog
The formal autonomy of universities in Europe has generally increased over recent decades. However, new forms of accountability measures and more indirect state steering have accompanied this development, making it difficult to assess the actual autonomy. The article addresses this problem...... by applying the sensemaking approach to the study of organizational autonomy. Enacted autonomy is suggested as a new conceptualization that challenges the basic assumption in studies on formal autonomy that autonomy is only about external constraints on action. It does so by insisting on the active subjects...... in the enactment of the environment, thereby questioning the validity of a clear distinction between what is internal and what is external to an organization. By acknowledging the subjective dimension of autonomy, a set of stylized identities is developed as a tool for understanding the enactment of autonomy...
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Visual Portrayals of Obesity in Health Media: Promoting Exercise without Perpetuating Weight Bias
Pearl, R. L.; Dovidio, J. F.; Puhl, R. M.
2015-01-01
Health education campaigns for preventing and reducing obesity often contain weight-stigmatizing visual content, which may have unintended negative health consequences. The goal of the present research was to identify non-stigmatizing visual content for health education materials that can promote exercise among people of diverse weight statuses.…
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Aprile, A E
1998-02-01
Professional autonomy may represent the first step to implementing measures that will allow CRNAs to attain a level of independent practice consistent with their clinical and educational training. Autonomy is regarded as an essential ingredient of professionalism and confers independent function at the individual practitioner level. The principle of autonomy refers to the individual's capacity to make independent decisions based on the assumption that he or she possesses the cognitive, psychological, and emotional faculties to make rational decisions. Nursing practice meets the first two criteria of professionalism--competence and dedication to an important social good. The third criterion of professionalism, autonomy, has been a focal point for controversy since the late nineteenth century, in which obedience to supervisors and physicians remained a central focus of nursing ethics teaching until the advent of feminism in the 1970s. This article presents a thorough analysis of these concepts with some thoughts on how understanding the fundamental precepts and further research may not only help maintain the current level of CRNA professional autonomy but serve to guide us to become more autonomous in the future.
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Autonomy as Aesthetic Practice
Lütticken, S.
2014-01-01
This essay examines various conceptions of autonomy in relation to recent artistic practices. Starting from the apparent opposition between modernist notions of the autonomy of art and theorizations of political autonomy, the text problematizes the notion of the autonomy of art by using Jacques
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Anderson, Joel
2014-01-01
Like being able to drive a car, being autonomous is a socially attributed, claimed, and contested status. Normative debates about criteria for autonomy (and what autonomy entitles one to) are best understood, not as debates about what autonomy, at core, really is, but rather as debates about the
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Ayalon, Liat
2016-02-01
The study evaluated the concept of autonomy from the perspective of older adults and their adult children following a transition of the older adult to a continuing care retirement community (CCRC). Overall, 70 interviews (with older adults and their adult children; 34 dyads) were analyzed, using a line-by-line open coding, followed by dyadic analysis. Autonomy was not portrayed as a uniform, homogenous construct, but rather encompassed four different domains: (a) the focus of one's attention or concerns: on others, on self, or not at all; (b) the ability to exercise decisions and make independent choices; (c) the degree of physical functioning and ability of the older adult; and (d) the financial ability of the older adult. The duality in the relationships between older adults and their adult children is discussed in relation to the give and take of autonomy that occur following a transition to a CCRC. © The Author(s) 2015.
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Autonomy among physically frail older people in nursing home settings
DEFF Research Database (Denmark)
Andresen, Mette; Puggaard, Lis
2008-01-01
BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...... participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub......-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual...
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Developing a Danish version of the "Impact on Participation and Autonomy Questionnaire"
DEFF Research Database (Denmark)
Ghaziani, E.; Krogh, A.G.; Lund, Hans
2013-01-01
Objective: To translate the "Impact on Participation and Autonomy Questionnaire" into Danish (IPAQ-DK), and estimate its internal consistency and test-retest reliability in order to promote participation-based interventions and research. Design: Translation and two successive reliability assessme......Objective: To translate the "Impact on Participation and Autonomy Questionnaire" into Danish (IPAQ-DK), and estimate its internal consistency and test-retest reliability in order to promote participation-based interventions and research. Design: Translation and two successive reliability...... and cultural adaptation of the instrument. The revised version (IPAQ-DK) was subsequently subjected to a similar assessment demonstrating Chronbach's alpha values from 0.698 to 0.817. Weighted kappa ranged from 0.370 to 0.880; 78% of these values were higher than 0.600. The intraclass correlation coefficient...
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Qigong exercise with concentration predicts increased health.
Jouper, John; Hassmén, Peter; Johansson, Mattias
2006-01-01
Regular physical activity has many positive health effects. Despite this, approximately 50% of all adults are not exercising enough to enjoy better health and may, therefore, need an alternative to vigorous physical exercise. Qigong offers a gentle way to exercise the body. A questionnaire sample of 253 participants was collected and correlations with the variable health-now were analyzed. Results showed that health-now was positively correlated with number of completed qigong courses (p exercise thereby seems to offer a viable alternative to other more vigorous physical activities when wellness is the primary goal. When interpreted using self-determination theory, qigong seems to satisfy needs related to autonomy, competence and relatedness, thereby, primarily attracting individuals who are intrinsically motivated.
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Music use and exercise: A mixed methods study of activity, autonomy and adherence
Hallett, Rachel Justine
2015-01-01
Regular exercise improves both physical and mental health but many people struggle to adhere to exercise programmes. Music is widely used by exercisers, and may aid adherence, but no evidence has yet substantiated this.\\ud \\ud This thesis consists of four studies exploring exercise music’s potential to assist adherence. In Study 1 (N = 282), online survey responses indicated that women were more likely to use exercise music and to synchronise movement to the beat than men, that running perfor...
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Energy Technology Data Exchange (ETDEWEB)
Rocha, L.M.
1998-12-01
The study of adapting and evolving autonomous agents should be based on a complex systems-theoretic framework which requires both self-organizing and symbolic dimensions. An inclusive framework based on the notions of semiotics and situated action is advanced to build models capable of representing, as well as evolving in their environments.Such undertaking is pursued by discussing the ways in which symbol and self-organization are irreducibly intertwined in evolutionary systems. With this semiotic view of self-organization and symbols, the authors re-think the notion of autonomy of evolving systems, and show that evolutionary systems are characterized by a particular type of syntactic autonomy. Recent developments in emergent computation in cellular automata are discussed as examples of the emergence of syntactic autonomy in computational environments. New experiments emphasizing this syntactic autonomy in cellular automata are presented.
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International Nuclear Information System (INIS)
Emrich, D.; Schicha, H.; Baehre, M.
1986-01-01
The significance of autonomy in iodine-deficiency goiter for the development of hyperthyroidism was investigated. (1) In 171 of 426 consecutive patients high-resolution quantitative scintiscans showed signs suggestive of autonomy. With increasing 99mTc uptake by the thyroid their TT3 levels were found to rise progressively during suppression, while their pre-suppression TSH levels dropped progressively. This suggests global sup(99m)Tc uptake by the thyroid during suppression to be a useful indicator of the functional significance of autonomy. (2) Based on 326 patients with hyperthyroidism a system for differentiating between autonomy-related and immunogenic disease was developed and validated prospectively in another 162 patients with hyperthyroidism by assaying for thyroid stimulating antibodies (TSAb). TSAb was found to be present in 82% of the 77 patients diagnosed as having immunogenic hyperthyroidism and in only 8% of the 85 patients with autonomy-related hyperthyroidism. Our results support the assumption that autonomy in iodine-deficiency goiter plays a major role in the development of hyperthyroidism, while autoimmune processes appear to be of secondary importance. (Author)
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A biochemistry laboratory course designed to enhance students autonomy
Directory of Open Access Journals (Sweden)
T. Silva
2015-08-01
Full Text Available INTRODUCTION: Laboratory sessions are responsible for promoting instrumentation skills desirable in biochemistry and biochemistry related careers. They are traditionally based on experimental protocols that lead to the expected results, and students usually have not autonomy to plan and execute their experiments. GOALS: This work aimed to enhance a traditional biochemistry lab course, applying pre-lab quizzes on protein biochemistry and lab techniques in order to have students better prepared to plan, execute and interpret experiments. This approach also aims to bring the laboratory sessions into an inquiry-based environment capable to improve students’ independent capabilities in 2 autonomy domains: learning and communication. MATERIAL AND METHODS: Online quizzes are delivered one week before each laboratory session, containing questions regarding the experimental techniques and theoretical basis related to them. Laboratory activities are presented in an inquiry-based approach where the first class of each activity is dedicated to plan experiments in order to answer the research questions presented by instructors. Activities are also organized in order to enhance students’ autonomy. The first activity is the simplest and more instructor-controlled and the last one is the most complex and less driven, transferring gradually to students the responsibility for their decisions in laboratory, supporting students’ autonomy. RESULTS: Online quizzes allowed instructors to identify students’ difficulties and to timely intervene. Scientific reports presented by students at the end of each activity showed that they performed better on less driven activities in which autonomy support were more complex than in the instructor controlled activities. CONCLUSIONS: Scientific reports analysis reveals students capabilities related to different scopes of autonomy, such as: discuss different strategies; find multiple solutions to solve problems; make their
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Balancing self-management and standardization to improve learning, autonomy and wellbeing
DEFF Research Database (Denmark)
Hvid, Helge Søndergaard; Lund, Henrik Lambrecht; Holt, Helle
Back to Karasek’s construction of the Demand Control model learning and autonomy in work has been an important factor in conceptualization of health and wellbeing (Karasek 1979). To promote learning and autonomy in work it was suggested to create teamwork, job-enrichment, and influence at work...... potentials for increased control in work (the employees control over how and what to do), however, boundarylessness threaten the frontiers from where the employees could defend their interests, and by that boundarylessness reduce employees’ control of their work. The erosion of boundaries is studied in two...
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Education for Autonomy and Open-Mindedness in Diverse Societies
Taylor, Rebecca M.
2017-01-01
In recent years, democracies across the globe have seen an increase in the popularity and power of authoritarian, nationalist politicians, groups, and policies. In this climate, the proper role of education in liberal democratic society, and in particular its role in promoting characteristics like autonomy and open-mindedness, is contested. This…
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Long-term high-level exercise promotes muscle reinnervation with age.
Mosole, Simone; Carraro, Ugo; Kern, Helmut; Loefler, Stefan; Fruhmann, Hannah; Vogelauer, Michael; Burggraf, Samantha; Mayr, Winfried; Krenn, Matthias; Paternostro-Sluga, Tatjana; Hamar, Dusan; Cvecka, Jan; Sedliak, Milan; Tirpakova, Veronika; Sarabon, Nejc; Musarò, Antonio; Sandri, Marco; Protasi, Feliciano; Nori, Alessandra; Pond, Amber; Zampieri, Sandra
2014-04-01
The histologic features of aging muscle suggest that denervation contributes to atrophy, that immobility accelerates the process, and that routine exercise may protect against loss of motor units and muscle tissue. Here, we compared muscle biopsies from sedentary and physically active seniors and found that seniors with a long history of high-level recreational activity up to the time of muscle biopsy had 1) lower loss of muscle strength versus young men (32% loss in physically active vs 51% loss in sedentary seniors); 2) fewer small angulated (denervated) myofibers; 3) a higher percentage of fiber-type groups (reinnervated muscle fibers) that were almost exclusive of the slow type; and 4) sparse normal-size muscle fibers coexpressing fast and slow myosin heavy chains, which is not compatible with exercise-driven muscle-type transformation. The biopsies from the old physically active seniors varied from sparse fiber-type groupings to almost fully transformed muscle, suggesting that coexpressing fibers appear to fill gaps. Altogether, the data show that long-term physical activity promotes reinnervation of muscle fibers and suggest that decades of high-level exercise allow the body to adapt to age-related denervation by saving otherwise lost muscle fibers through selective recruitment to slow motor units. These effects on size and structure of myofibers may delay functional decline in late aging.
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Motivations and barriers to exercise in chronic kidney disease: a qualitative study.
Clarke, Amy L; Young, Hannah M L; Hull, Katherine L; Hudson, Nicky; Burton, James O; Smith, Alice C
2015-11-01
Exercise has the potential to modulate a number of complications associated with chronic kidney disease (CKD). However, typically, CKD patients lead very sedentary lifestyles, the reasons for which are not fully known. The aim of this qualitative study was to gain an understanding of the motivators, barriers and beliefs held by CKD patients regarding exercise. We conducted 3 focus groups and 22 semi-structured interviews. Data were collected from nephrology outpatient clinics in the United Kingdom. A total of 36 individuals with CKD stages 1-5 not requiring renal replacement therapy, aged 26-83 years participated in this study. This manuscript outlines the findings from patients with CKD stages 3-5. Focus groups and interviews were transcribed verbatim and analysed thematically. Positive attitudes to exercise reflected autonomous motivations including: exercising for health; enjoyment and social interaction. Family support and goal setting were seen as motivators for exercise and the accessibility of local facilities influenced activity levels. Barriers to exercise were poor health, fear of injury or aggravating their condition, a lack of guidance from healthcare professionals and a lack of facilities. These findings are an important first stage in the development of a CKD-specific exercise behaviour change intervention. Interventions should operate at multiple levels, with a focus on improving patient autonomy and exercise self-efficacy, support networks and the physical environment (e.g. the accessibility of local facilities). In addition, strategies are required to ensure that the healthcare system is actively promoting and routinely supporting exercise for all patients with CKD. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
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Jorge, Maria Salete Bessa; Pinto, Diego Muniz; Quinderé, Paulo Henrique Dias; Pinto, Antonio Germane Alves; Sousa, Fernando Sérgio Pereira de; Cavalcante, Cinthia Mendonça
2011-07-01
Healthcare relations serve as efficient devices for the promotion of mental health and the development of comprehensive practices. This study seeks to analyze the measures that make mental healthcare possible in the daily operations of a Psychosocial Healthcare Center (CAPS). It is qualitative research adopting a critical and reflexive approach conducted in CAPS in the municipality of Sobral in the State of Ceará. Complying with regulations, the study was submitted for analysis by the Committee for Ethics in Research adhering to norms for research involving human beings. For data gathering, conducted between May and July 2008, semi-structured and systematic observation interview techniques were used. The research subjects involved 20 people, distributed into three groups: group I (mental health workers-8); group II (users-7) and group III (relatives of users-5). The material was organized and analyzed using principles of critical hermeneutics. According to the results, in the daily operations of CAPS, the relations of care and its devices (reception, emotional involvement, co-responsibility and autonomy) make the transversal adaptation of psychosocial practices possible. The dialogues were derived from meetings of mental health workers, users and relatives in their quest for healthcare solutions.
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Exercise promotion: an integration of exercise self-identity, beliefs, intention, and behaviour
de Bruijn, G.-J.; van den Putte, B.
2012-01-01
We explored the role of exercise self-identity within the framework of the theory of planned behaviour (TPB). Participants were 538 undergraduate students who completed measures of exercise self-identity, exercise behaviour, TPB items, and behavioural and control beliefs. Regression analysis showed
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University Reform and Institutional Autonomy: A Framework for Analysing the Living Autonomy
Maassen, Peter; Gornitzka, Åse; Fumasoli, Tatiana
2017-01-01
In this article we discuss recent university reforms aimed at enhancing university autonomy, highlighting various tensions in the underlying reform ideologies. We examine how the traditional interpretation of university autonomy has been expanded in the reform rationales. An analytical framework for studying how autonomy is interpreted and used…
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(Re)Discovering University Autonomy
DEFF Research Database (Denmark)
Reilly, John; Turcan, Romeo V.; Bugaian, Larisa
2016-01-01
discussion of challenges. The other outcome is the extent to which academic colleagues in a wide-range of disciplines and not directly engaged with research on university autonomy may not perceive or engage with the wider autonomy outcomes of their work and as a result their own case studies may not fully...... identify the autonomy impact real or potential. Many academic staff take for granted university autonomy without questioning its sometimes contradictory assumptions and impacts....
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Bernardes, Sónia F; Matos, Marta; Goubert, Liesbet
2017-09-01
Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults' ability to engage in their daily activities. Assessing older adults' preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals' needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain ( M age = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors ( r = .56): (a) preferences for autonomy support ( α = .99) and (b) preferences for dependence support ( α = .98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence ( r = .33) and the lower the desire for independence ( r = -.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults' functional autonomy when in pain.
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2013-01-01
Background Although cardiovascular disease has decreased, there is still potential for prevention as obesity and diabetes increase. Exercise has a positive effect on many cardiovascular risk factors, and it can significantly reduce the components of metabolic syndrome. The main challenge with exercise in primary care is how to succeed in motivating the patients at risk to change and increase their exercise habits. The objective of this study is to modify the cardiovascular risk in middle-aged men, either through a health promotion intervention alone or combined with an exercise intervention. Methods/design During a two-year period we recruit 300 men aged from 35 to 45 years with elevated cardiovascular risk (> two traditional risk factors). The men are randomized into three arms: 1) a health promotion intervention alone, 2) both health promotion and exercise intervention, or 3) control with usual community care and delayed health promotion (these men receive the intervention after one year). The main outcome measures will be the existence of metabolic syndrome and physical activity frequency (times per week). The participants are assessed at baseline, and at 3, 6, and 12 months. The follow-up of the study will last 12 months. Discussion This pragmatic trial in primary health care aimed to assess the effect of a health promotion programme with or without exercise intervention on cardiovascular risk and physical activity in middle-aged men. The results of this study may help to plan the primary care interventions to further reduce cardiovascular mortality. The study was registered at the Controlled Trials ( http://www.controlled-trials.com). Trial number: ISRCTN80672011. The study received ethics approval from the Coordinating Ethics Committee at Helsinki University Hospital on 8 June 2009 (ref: 4/13/03/00/09). PMID:23398957
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The support of autonomy and the control of behavior.
Deci, E L; Ryan, R M
1987-12-01
In this article we suggest that events and contexts relevant to the initiation and regulation of intentional behavior can function either to support autonomy (i.e., to promote choice) or to control behavior (i.e., to pressure one toward specific outcomes). Research herein reviewed indicates that this distinction is relevant to specific external events and to general interpersonal contexts as well as to specific internal events and to general personality orientations. That is, the distinction is relevant whether one's analysis focuses on social psychological variables or on personality variables. The research review details those contextual and person factors that tend to promote autonomy and those that tend to control. Furthermore, it shows that autonomy support has generally been associated with more intrinsic motivation, greater interest, less pressure and tension, more creativity, more cognitive flexibility, better conceptual learning, a more positive emotional tone, higher self-esteem, more trust, greater persistence of behavior change, and better physical and psychological health than has control. Also, these results have converged across different assessment procedures, different research methods, and different subject populations. On the basis of these results, we present an organismic perspective in which we argue that the regulation of intentional behavior varies along a continuum from autonomous (i.e., self-determined) to controlled. The relation of this organismic perspective to historical developments in empirical psychology is discussed, with a particular emphasis on its implications for the study of social psychology and personality.
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[The autonomy of women: some reflections-statements on the goal].
De Koninck, M
1990-05-01
The author reflects on women's reproductive autonomy and raises questions on the true significance of advancements in feminism in recent years. Does today's context of social interaction between sexes not promote a biologistical femininity characterized by a negative perception of the feminine body and of its reproductive potential? Does women's "liberation" not imply the rejection of the feminine body and of its difference? In order to avoid the perverse effects of the search for autonomy, it is not more appropriate to redefine the feminine body with reference to women instead of with reference to the male universe, as it seems to be the case today?
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Law, autonomy and advance directives.
Willmott, Lindy; White, Ben; Mathews, Ben
2010-12-01
The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.
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Liu, Weiming; Devitt, Ann
2014-01-01
Peer teaching has been used as a mechanism for promoting learner autonomy in a range of language learning contexts. This article explores how absolute beginners in a Chinese class can engage in reciprocal peer teaching (RPT) from the start of their language learning experience and how this contributes to the development of their autonomy as…
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Iwane, M; Shibe, Y; Itoh, K; Kinoshita, F; Kanagawa, Y; Kobayashi, M; Mugitani, K; Ohta, M; Ohata, H; Yoshikawa, A; Ikuta, Z; Nakamura, Y; Mohara, O
2001-03-01
We investigated the prevalence and characteristics of ischemic heart disease especially silent myocardial ischemia (SMI) and arrhythmia in need of careful observation in the exercise stress tests in the Total Health Promotion Plan (THP), which was conducted between 1994-96 for the purpose of measuring cardiopulmonary function. All workers (n = 4,918, 4,426 males) aged 18-60 yr old in an occupational field were studied. Exercise tests with an ergometer were performed by the LOPS protocol, in which the maximal workload was set up as a presumed 70-80% maximal oxygen intake, or STEP (original multistage protocol). ECG changes were evaluated with a CC5 lead. Two hundred and fifteen people refused the study because of a common cold, lumbago and so on. Of 4,703 subjects, 17 with abnormal rest ECG and 19 with probable anginal pain were excluded from the exercise tests. Of 4,667 who underwent the exercise test, 37 (0.79%) had ischemic ECG change, and 155 (3.32%) had striking arrhythmia. These 228 subjects then did a treadmill exercise test with Bruce protocol. Twenty-two (0.47% of 4,703) showed positive ECG change, 9 (0.19%) of 22 had abnormal findings on a 201Tl scan. 8 (0.17%) were diagnosed as SMI (Cohn I), in which the prevalence of hypertension, hyperlipidemia, diabetes mellitus, smoker and positive familial history of ischemic heart disease was greater than that of all subjects. In a 15-30 month follow up, none has developed cardiac accidents. Exercise-induced arrhythmia was detected in 11 (0.23%) subjects. Four were non-sustained ventricular tachycardia without any organic disease, 4 were ventricular arrhythmia based on cardiomyopathy detected by echocardiography, 2 were atrial fibrillation and another was WPW syndrome. It is therefore likely that the ergometer exercise test in THP was effective in preventing sudden death caused by ischemic heart disease or striking arrhythmia.
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Entrepreneurial autonomy and its dynamics
van Gelderen, M.W.
2016-01-01
Founding and owning an independent business does not automatically provide the owner/founder with autonomy. Autonomy-motivated entrepreneurs must often make an effort to achieve and maintain autonomy. The aim of this research is to investigate the experience of autonomy, its variations over time,
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Autonomy, Independence, Inclusion
Directory of Open Access Journals (Sweden)
Filippo Angelucci
2015-04-01
Full Text Available The living environment must not only meet the primary needs of living, but also the expectations of improvement of life and social relations and people’s work. The need for a living environment that responds to the needs of users with their different abilities, outside of standardizations, is increasingly felt as autonomy, independence and well-being are the result of real usability and adaptability of the spaces. The project to improve the inclusivity of living space and to promote the rehabilitation of fragile users need to be characterized as an interdisciplinary process in which the integration of specialized contributions leads to adaptive customization of space solutions and technological that evolve with the changing needs, functional capacities and abilities of individuals.
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What motivates girls to take up exercise during adolescence? Learning from those who succeed.
Gillison, Fiona; Sebire, Simon; Standage, Martyn
2012-09-01
The present study explored factors that underpin increased internalization (i.e., perceived autonomy) in motivation towards exercise over a 1-year period in adolescent girls. A mixed methods prospective study. A total of 107 girls (mean age = 13.28 years) reported their exercise behaviour, exercise goals, and a multidimensional measure of motivation towards exercise on two occasions, 1 year apart. Ten girls reporting increased autonomous motivation were then interviewed. Two themes were extracted; growing up and seeking challenge. Most participants reported being more interested in exercising for their health as a result of growing up, through having greater understanding of the health-behaviour link and willingness to act now for future health gain. However, their motivation appeared to be only partially internalized, as health was still viewed primarily as a value promoted by respected others (parents, teachers, media). Furthermore, as many girls conflated being healthy with being thin, health for appearance-related weight control was experienced as an extrinsic (controlling) goal. The second theme was more suggestive of autonomous motivation; girls reported valuing exercise for the opportunity it provides to set and achieve personally meaningful challenges, facilitating a sense of competence and achievement. The findings may have a useful application in suggesting how exercise settings could be manipulated to increase enjoyment and participation during adolescence. In particular, the findings suggest that means of increasing the salience of the rewarding nature of setting and reaching personal challenges in an exercise setting are investigated. ©2011 The British Psychological Society.
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[Autonomy and dementia Part II: autonomy and representation: a possible combination?].
Rigaux, Natalie
2011-06-01
This paper, based on a critical review of the medico-social literature, questions the representation of patients with dementia in relation to the autonomy perspectives presented in a previous article. In the canonical perspective of autonomy (defined as a rational decision-making by a stand alone self), the surrogate is the spokeperson of the subject's wills when he was competent because he knows these wills through advance directives or assuming them via substituted judgment. Best patient's interest is then depreciated because it is focused on the present incompetent self. In the relational perspective, where autonomy is constructed through a dialogue with others, the surrogate is the present interlocutor, making the decisions with the patient and care-givers in a way varying with the disease process. He represents the subject with dementia as he was before the disease but also as he has become. Therefore, there is a continuum between autonomy and representation. Autonomy and well being are both the surrogate aims. The relational perspective allows care continuity of patients with dementia even when considered as incompetent. It offers a more balanced perspective on the patient autonomy since it is embedded in all others, and opens a richer view on what good life is, untill the end of dementia.
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Relationship of Autonomy Social Support to Quitting Motivation in Diverse Smokers.
Patten, Christi A; Clinic, Mayo; Goggin, Kathy; Harris, Kari Jo; Richter, Kimber; Williams, Karen; Decker, Paul A; Clinic, Mayo; Bradley-Ewing, Andrea; Catley, Delwyn
2016-01-01
Research examining relationships between social support and smoking cessation has paid little attention to non-treatment seeking smokers and not considered the role of autonomy support for fostering quitting motivation. This study examined if autonomy support received from family and friends was associated with quitting motivation and making a quit attempt among diverse smokers with varying levels of quitting motivation. Demographic characteristics associated with autonomy support were explored. Participants (N=312) responded to advertisements seeking smokers "not quite ready to quit," and were primarily Black, low-income, and unemployed. Most (255) enrolled in a clinical trial of smoking cessation induction strategies (treatment sample). An additional 57 not meeting the trial eligibility criteria of low quitting motivation enrolled for baseline assessments only. Participants completed baseline measures of autonomy support received from friends and autonomous quitting motivation. In the treatment sample, quit attempts were assessed at 6-months follow-up. Females reported higher levels than males of autonomy support from friends (p=0.003). Participants with a high school diploma/GED reported higher levels of support from family (pautonomy support scores were significantly, albeit weakly, associated with autonomous quitting motivation. Autonomy support was not associated with making a quit attempt. Support from family and friends may promote autonomous reasons to quit among diverse smokers. Research is needed to assess the role of social support in the pre-quitting phases among racial and socio-economically diverse populations.
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Richert, Jana; Lippke, Sonia; Ziegelmann, Jochen P
2011-01-01
Intervention-engagement has received little attention in sports medicine as well as research and promotion of physical exercise. The construct is important, however, in the understanding of why interventions work. This study aimed at shedding more light on the interplay of engagement and the subsequent effectiveness of physical exercise interventions. A three-stage model differentiating among nonintenders, intenders, and actors informed the intervention design in this study. In an Internet-based randomized controlled trial (RCT) with two measurement points, N = 326 participants received a stage-matched, stage-mismatched, or control treatment. Assessed variables were goal setting, planning, behavior, and intervention-engagement. It was found that regarding goal setting, nonintenders in the stage-matched intervention and those who engaged highly in the stage-matched intervention improved significantly over time. Regarding planning, intenders in the matched condition as well as all actors increased their levels over time. Regarding behavior, nonintenders and intenders having engaged highly in the intervention improved more than those having engaged little. In order to help nonintenders progress on their way toward goal behavior, it is necessary that they engage highly in a stage-matched intervention. Implications for exercise promotion are that interventions should also aim at increasing participants' intervention-engagement.
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Let it go: Relationship autonomy predicts pro-relationship responses to partner transgressions.
Hadden, Benjamin W; Baker, Zachary G; Knee, C Raymond
2017-11-24
The purpose of the present research is to better understand how relationship autonomy-having more self-determined reasons for being committed to a relationship-contributes to pro-relationship responses to transgressions in romantic relationships (e.g., forgiveness and accommodation). Study 1 employed a cross-sectional design (N = 350) and Study 2 used a weekly diary (N = 121) to test associations between relationship autonomy and pro-relationship responses to transgressions. Studies 3 and 4 utilized dyadic designs (Study 3: N = 200 couples, 400 individuals; Study 4: N = 275 couples, 550 individuals) to determine how both partners' relationship autonomy is associated with pro-relationship responses. Results revealed that relationship autonomy is robustly associated with pro-relationship responses to transgressions, both as general tendencies and as responses to idiosyncratic transgressions. Results of actor-partner interdependence model (APIM) analyses in Studies 3 and 4 provide evidence that one's partner's relationship autonomy is important for promoting pro-relationship responses as well. Study 4 also found that people perceive that partners respond better to transgressions if their partner is high in relationship autonomy. This research provides consistent and compelling evidence that the degree of self-determination underlying commitment is important for understanding how people respond to transgressions in their relationships, beyond their current levels of commitment. © 2017 Wiley Periodicals, Inc.
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From solidarity to autonomy: towards a redefinition of the parameters of the notion of autonomy.
Fainzang, Sylvie
2016-12-01
Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use.
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(Re)Discovering University Autonomy
DEFF Research Database (Denmark)
This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter......-relationships between stakeholders and policies which can reinforce and equally pull in opposite directions. The holistic view is expressed in a model of institutional university autonomy that brings together the traditional basic four pillars of autonomy, and five interfaces: government–university; university......–university staff; academic staff–students; university–business; and university–internationalisation. This model is explored through international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are complex, interactive and genuinely...
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Kuwano, Noriko; Fukuda, Hiromi; Murashima, Sachiyo
2016-11-01
The study aimed to analyze the professional autonomy of Japanese nurses when caring for non-Japanese patients and to identify its contributing factors. A descriptive cross-sectional design was used. Participants included 238 clinical nurses working at 27 hospitals in Japan. The Intercultural Sensitivity Scale (Chen and Starosta), and the Scale for Professional Autonomy in Nursing (Kikuchi and Harada) were used to measure intercultural sensitivity and professional autonomy. Stepwise multiple regression analysis was used to identify the most significant factors affecting professional autonomy. Professional autonomy of Japanese nurses caring for non-Japanese patients was significantly lower than when caring for Japanese patients (142.84 vs. 172.85; p autonomy of Japanese nurses by promoting intercultural sensitivity. © The Author(s) 2015.
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Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors.
Amini, Kourosh; Negarandeh, Reza; Ramezani-Badr, Farhad; Moosaeifard, Mahdi; Fallah, Ramezan
2015-02-01
This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy. © 2013 Wiley Publishing Asia Pty Ltd.
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van der Kaap-Deeder, Jolene; Vansteenkiste, Maarten; Soenens, Bart; Loeys, Tom; Mabbe, Elien; Gargurevich, Rafael
2015-11-01
Autonomy-supportive parenting yields manifold benefits. To gain more insight into the family-level dynamics involved in autonomy-supportive parenting, the present study addressed three issues. First, on the basis of self-determination theory, we examined whether mothers' satisfaction of the psychological needs for autonomy, competence, and relatedness related to autonomy-supportive parenting. Second, we investigated maternal autonomy support as an intervening variable in the mother-child similarity in psychological need satisfaction. Third, we examined associations between autonomy-supportive parenting and autonomy-supportive sibling interactions. Participants were 154 mothers (M age = 39.45, SD = 3.96) and their two elementary school-age children (M age = 8.54, SD = 0.89 and M age = 10.38, SD = 0.87). Although mothers' psychological need satisfaction related only to maternal autonomy support in the younger siblings, autonomy-supportive parenting related to psychological need satisfaction in both siblings and to an autonomy-supportive interaction style between siblings. We discuss the importance of maternal autonomy support for family-level dynamics. © 2015 by the Society for Personality and Social Psychology, Inc.
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Cell-derived microparticles promote coagulation after moderate exercise.
Sossdorf, Maik; Otto, Gordon P; Claus, Ralf A; Gabriel, Holger H W; Lösche, Wolfgang
2011-07-01
Cell-derived procoagulant microparticles (MP) might be able to contribute to exercise-induced changes in blood hemostasis. This study aimed to examine (i) the concentration and procoagulant activity of cell-derived MP after a moderate endurance exercise and (ii) the differences in the release, clearance, and activity of MP before and after exercise between trained and untrained individuals. All subjects performed a single bout of physical exercise on a bicycle ergometer for 90 min at 80% of their individual anaerobic threshold. MP were identified and quantified by flow cytometry measurements. Procoagulant activity of MP was measured by a prothrombinase activity assay as well as tissue factor-induced fibrin formation in MP-containing plasma. At baseline, no differences were observed for the absolute number and procoagulant activities of MP between trained and untrained subjects. However, trained individuals had a lower number of tissue factor-positive monocyte-derived MP compared with untrained individuals. In trained subjects, exercise induced a significant increase in the number of MP derived from platelets, monocytes, and endothelial cells, with maximum values at 45 min after exercise and returned to basal levels at 2 h after exercise. Untrained subjects revealed a similar increase in platelet-derived MP, but their level was still increased at 2 h after exercise, indicating a reduced clearance compared with trained individuals. Procoagulant activities of MP were increased immediately after exercise and remained elevated up to 2 h after exercise. We conclude that increased levels of MP were found in healthy individuals after an acute bout of exercise, that the amount of circulating MP contributes to an exercise-induced increase of hemostatic potential, and that there were differences in kinetic and dynamic characteristics between trained and untrained individuals.
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Evans, Miriam; Boucher, Alyssa R.
2015-01-01
Choice plays a critical role in promoting students' intrinsic motivation and deep engagement in learning. Across a range of academic outcomes and student populations, positive impacts have been seen when student autonomy is promoted through meaningful and personally relevant choice. This article presents a theoretical perspective on the…
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Providing Choice in Exercise Influences Food Intake at the Subsequent Meal.
Beer, Natalya J; Dimmock, James A; Jackson, Ben; Guelfi, Kym J
2017-10-01
The benefits of regular exercise for health are well established; however, certain behaviors after exercise, such as unhealthy or excessive food consumption, can counteract some of these benefits. To investigate the effect of autonomy support (through the provision of choice) in exercise-relative to a no-choice condition with matched energy expenditure-on appetite and subsequent energy intake. Fifty-eight men and women (body mass index, 22.9 ± 2.3 kg·m; peak oxygen consumption, 52.7 ± 6.4 mL·kg·min) completed one familiarization session and one experimental trial, in which they were randomized to either a choice or no-choice exercise condition using a between-subjects yoked design. Ad libitum energy intake from a laboratory test meal was assessed after exercise, together with perceptions of mood, perceived choice, enjoyment, and value. Despite similar ratings of perceived appetite across conditions (P > 0.05), energy intake was significantly higher after exercise performed under the no-choice condition (2456 ± 1410 kJ) compared with the choice condition (1668 ± 1215 kJ; P = 0.026; d = 0.60). In particular, the proportion of energy intake from unhealthy foods was significantly greater after exercise in the no-choice condition (1412 ± 1304 kJ) compared with the choice condition (790 ± 861 kJ; P = 0.037, d = 0.56). Participants in the choice condition also reported higher perceptions of choice (P 0.05). A lack of choice in exercise is associated with greater energy intake from "unhealthy" foods in recovery. This finding highlights the importance of facilitating an autonomy supportive environment during exercise prescription and instruction.
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Better Nurse Autonomy Decreases the Odds of 30-Day Mortality and Failure to Rescue
Rao, Aditi D.; Kumar, Aparna; McHugh, Matthew
2017-01-01
Research Purpose Autonomy is essential to professional nursing practice and is a core component of good nurse work environments. The primary objective of this study was to examine the relationship between nurse autonomy and 30-day mortality and failure to rescue (FTR) in a hospitalized surgical population. Study Design This study was a secondary analysis of cross-sectional data. It included data from three sources: patient discharge data from state administrative databases, a survey of nurses from four states, and the American Hospital Association annual survey from 2006–2007. Methods Survey responses from 20,684 staff nurses across 570 hospitals were aggregated to the hospital level to assess autonomy measured by a standardized scale. Logistic regression models were used to estimate the relationship between nurse autonomy and 30-day mortality and FTR. Patient comorbidities, surgery type, and other hospital characteristics were included as controls. Findings Greater nurse autonomy at the hospital level was significantly associated with lower odds of 30-day mortality and FTR for surgical patients even after accounting for patient risk and structural hospital characteristics. Each additional point on the nurse autonomy scale was associated with approximately 19% lower odds of 30-day mortality (p autonomy place their surgical patients at an increased risk for mortality and FTR. Clinical Relevance Patients receiving care within institutions that promote high levels of nurse autonomy have a lower risk for death within 30 days and complications leading to death within 30 days. Hospitals can actively take steps to encourage nurse autonomy to positively influence patient outcomes. PMID:28094907
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Exercise, physical activity, and self-determination theory: A systematic review
2012-01-01
Background Motivation is a critical factor in supporting sustained exercise, which in turn is associated with important health outcomes. Accordingly, research on exercise motivation from the perspective of self-determination theory (SDT) has grown considerably in recent years. Previous reviews have been mostly narrative and theoretical. Aiming at a more comprehensive review of empirical data, this article examines the empirical literature on the relations between key SDT-based constructs and exercise and physical activity behavioral outcomes. Methods This systematic review includes 66 empirical studies published up to June 2011, including experimental, cross-sectional, and prospective studies that have measured exercise causality orientations, autonomy/need support and need satisfaction, exercise motives (or goal contents), and exercise self-regulations and motivation. We also studied SDT-based interventions aimed at increasing exercise behavior. In all studies, actual or self-reported exercise/physical activity, including attendance, was analyzed as the dependent variable. Findings are summarized based on quantitative analysis of the evidence. Results The results show consistent support for a positive relation between more autonomous forms of motivation and exercise, with a trend towards identified regulation predicting initial/short-term adoption more strongly than intrinsic motivation, and intrinsic motivation being more predictive of long-term exercise adherence. The literature is also consistent in that competence satisfaction and more intrinsic motives positively predict exercise participation across a range of samples and settings. Mixed evidence was found concerning the role of other types of motives (e.g., health/fitness and body-related), and also the specific nature and consequences of introjected regulation. The majority of studies have employed descriptive (i.e., non-experimental) designs but similar results are found across cross
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Exercise, physical activity, and self-determination theory: A systematic review
Directory of Open Access Journals (Sweden)
Teixeira Pedro J
2012-06-01
Full Text Available Abstract Background Motivation is a critical factor in supporting sustained exercise, which in turn is associated with important health outcomes. Accordingly, research on exercise motivation from the perspective of self-determination theory (SDT has grown considerably in recent years. Previous reviews have been mostly narrative and theoretical. Aiming at a more comprehensive review of empirical data, this article examines the empirical literature on the relations between key SDT-based constructs and exercise and physical activity behavioral outcomes. Methods This systematic review includes 66 empirical studies published up to June 2011, including experimental, cross-sectional, and prospective studies that have measured exercise causality orientations, autonomy/need support and need satisfaction, exercise motives (or goal contents, and exercise self-regulations and motivation. We also studied SDT-based interventions aimed at increasing exercise behavior. In all studies, actual or self-reported exercise/physical activity, including attendance, was analyzed as the dependent variable. Findings are summarized based on quantitative analysis of the evidence. Results The results show consistent support for a positive relation between more autonomous forms of motivation and exercise, with a trend towards identified regulation predicting initial/short-term adoption more strongly than intrinsic motivation, and intrinsic motivation being more predictive of long-term exercise adherence. The literature is also consistent in that competence satisfaction and more intrinsic motives positively predict exercise participation across a range of samples and settings. Mixed evidence was found concerning the role of other types of motives (e.g., health/fitness and body-related, and also the specific nature and consequences of introjected regulation. The majority of studies have employed descriptive (i.e., non-experimental designs but similar results are found across
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Patient autonomy preferences among hypertensive outpatients in a primary care setting in Japan.
Nomura, Kyoko; Ohno, Maiko; Fujinuma, Yasuki; Ishikawa, Hirono
2007-01-01
To investigate autonomy preferences and the factors to promote active patient participation in a primary care setting in Japan. Ninety-two hypertensive outpatients who consecutively visited a Japanese hospital between January and May of 2005 in Tokyo, Japan. This cross-sectional study was conducted by using a self-administered questionnaire. The main outcome measures were patient preferences for autonomy (i.e., decision-making and information-seeking preferences), measured by the Autonomy Preference Index (API). The variables studied were patient sociodemographic characteristics, physician characteristics based on patient preference (i.e., ability to communicate, extent of clinical experience, qualifications, educational background, gender, and age), and the Multidimensional Health Locus of Control. On the API scale from 0 to 100, the patients had an intermediate desire for decision-making (median: 51) and a greater desire for information (median: 95). A multivariate regression model indicated that decision-making preference increased when patients were woman and decreased as physician age increased, and information-seeking preference was positively associated with good communication skills, more extensive clinical experience, physicians of middle age, and patient beliefs that they were responsible for their own health, and was negatively associated with a preference for man physicians. Physicians may need to understand that patient autonomy preferences pertain to physician age and gender, physician communication ability and extent of clinical experience, and patient beliefs about self-responsibility toward health, and could use the information to promote reliable patient-physician relationships.
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Gillison, Fiona B; Standage, Martyn; Skevington, Suzanne M
2011-01-01
A prospective study was conducted to explore the relative contributions of weight-related self-perceptions and exercise-related motivation variables in predicting change in leisure-time exercise within a sample of adolescents in the United Kingdom. A cohort of 310 adolescents (51% male, Mean age = 14.08 ± .32 years at baseline) was classified into four groups on the basis of reported change in leisure-time exercise over 10-months: those who maintain, drop out from exercise, take up exercise, and those who were continually inactive. Discriminant function analyses were conducted to predict group membership from adolescents' profiles of motivational and weight-related perceptions at baseline. For boys, the first discriminant function (DF1) revealed that exercise maintainers reported higher identified regulation, introjected regulation, competence, relatedness, and body satisfaction than all other groups (between-group R(2) = .45). DF2 was more indicative of current exercise levels than change, indicating higher intrinsic motivation and lower amotivation for both active groups at baseline (between-group R(2) = .40). In girls, DF1 showed that exercise maintainers reported higher intrinsic motivation, identified regulation, autonomy, competence, relatedness, and lower external regulation than all other groups (between-group R(2) = .58). DF2 indicated that higher body mass index, and perceiving greater pressure to lose weight positively predicted drop out, and negatively predicted exercise uptake (between-group R(2) = .26). Fostering autonomous (self-determined) motivation seems a key determinant to maintaining leisure-time exercise for both boys and girls. Additionally, reducing perceptions of pressure to lose weight and promoting positive interactions with others during exercise may be particularly useful to prevent dropout in girls. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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DEFF Research Database (Denmark)
Hansen, Morten Balle; Niklasson, Birgitta; Roness, Paul
agencies in four Nordic countries: Denmark, Finland, Norway and Sweden. By using survey data from more than 500 state agencies in the four countries, the article analyses whether there is indeed a Scandinavian style of autonomy and result control and assesses which structural, cultural, and environmental......NPM-doctrines states that ideal-type agencies should have a high level of managerial autonomy, while being controlled through result-based control instruments, like performance contracts. In this article, the authors present a first preliminary attempt to comparatively analyze the autonomy of state...... variables might explain similarities and differences in the autonomy of agencies....
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Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness.
Rutten, Elisabeth A P; Bachrach, Nathan; van Balkom, Anton J L M; Braeken, Johan; Ouwens, Machteld A; Bekker, Marrie H J
2016-12-01
Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness. © 2015 The British Psychological Society.
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Directory of Open Access Journals (Sweden)
Mania Nosratinia
2015-05-01
Full Text Available Based on the findings of previous studies which highlight the role of vocabulary knowledge in English as a Foreign Language/English as a Second Language (EFL/ESL learners’ learning process, this study investigated the relationship among EFL learners’ Critical Thinking (CT, Autonomy (AU, and choice of Vocabulary Learning Strategies (VLS. To fulfill the purpose of this study, 100 male and female undergraduate EFL learners, between the ages of 18 and 25 (Mage = 21 were randomly selected. These participants, who were receiving formal instruction by means of English as the main language along with learners’ first language, were asked to complete three questionnaires, estimating their CT, AU, and VLS. Analyzing the collected data by Pearson’s product-moment correlation coefficient revealed significant relationships between participants' AU and CT, CT and VLS, and AU and VLS. Furthermore, a linear regression through the stepwise method revealed that between CT and AU, AU is the best predictor of VLS. The findings of this provide EFL teachers, EFL learners, and syllabus designers with insights into the nature of VLS and the way it can be promoted through other internal factors.
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Iwasaki, Yoshie; Honda, Sumihisa; Kaneko, Shuji; Kurishima, Kazuhiro; Honda, Ayumi; Kakinuma, Ayumu; Jahng, Doosub
2017-03-01
Physical activity (PA) is ranked as a leading health indicator and the workplace is a key setting to promote PA. The purpose of this study was to examine how goal-setting and exercise self-efficacy (SE) during a health promotion program influenced PA level among Japanese workers. Using a cross-sectional study design, we surveyed 281 employees. The short version of the International Physical Activity Questionnaire was used to assess PA level. Exercise SE was assessed using a partially modified version of Oka's exercise SE scale. Personal goals were assessed as the total numbers of "yes" responses to five items regarding "details of personal goals to perform PA". A mediational model was used to examine whether exercise SE mediates between the number of personal goals and PA level. The mean age of the participants was 46.3 years, 76.2% were men, and the most common occupational category was software engineer (30.6%). The average PA level per week exceeded the recommended level in 127 participants (45.2%). One hundred and eighty-four participants (65.5%) set some form of concrete personal goal to perform PA. The relationship between the number of personal goals and PA level was mediated by exercise SE. Our study showed that exercise SE mediates goal-setting and increases PA. The results suggest that the components of PA promotion programs should be tailored to enhance participants' confidence in performing PA.
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Joussemet, Mireille; Koestner, Richard; Lekes, Natasha; Houlfort, Nathalie
2004-02-01
Two experiments compared rewards and autonomy support as methods to promote children's self-regulation for an uninteresting vigilance task. Dependent measures were ratings of positive affect, perception of the task's value, and free-choice engagement. ANOVA results revealed some positive effects associated with autonomy support, whereas no effect for rewards was found in either study. The outcomes of most interest were correlations between free-choice behavior and self-reported measures of affect and value, reflecting the level of integration in self-regulation. As predicted by self-determination theory (Deci & Ryan, 1985, 1991, 2000), rewards were associated with behaviors incongruent from affect and value, whereas autonomy support led to integrated self-regulation. This finding was first detected in Study 1 and later replicated in Study 2. Together, these results point to autonomy support as a beneficial alternative to the common use of rewards.
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LEARNER AUTONOMY IN THE INDONESIAN EFL SETTINGS
Directory of Open Access Journals (Sweden)
Nenden Sri Lengkanawati
2017-01-01
Full Text Available Learner autonomy in Indonesian educational institutions has not commonly been listed as a teaching-learning objective, and most teachers seem to be hardly acquainted with learner autonomy (LA. Therefore, it is very essential to conduct a study of LA as perceived and experienced by school teachers and to find out the importance of LA training for professional development. A questionnaire was used to collect the data about English teachers’ perceptions regarding LA and LA-based practices. In addition, an LA training was conducted to see its significance for professional development. After the data were qualitatively and quantitatively analyzed, it was found that the participating teachers tended to maintain that autonomy should be inculcated among learners, and that the LA concept should not be misinterpreted as learning without a teacher. Concerning choices and decisions by the learners, it was believed that learners’ making choices about how they learned and what activities they did, and involving them to decide what and how to learn could promote autonomy among learners. As regards LA-based teaching-learning practices, it was revealed that most teachers desired to implement LA principles in their teaching-learning contexts, although they identified that many of the LA principles were not that feasible to apply in their situation. It was also found that LA training could improve the teachers’ perceptions regarding LA concepts and principles. There were some constraints which could make learner autonomy difficult to develop among Indonesian learners in general: limited time allotted for the implementation of the curriculum, learners’ lack of autonomous learning experience, too much focus on national examinations, and insufficient proficiency of English. LA-based teaching-learning practices were most desired; however, many were considered as having insufficient feasibility. In this respect, commitment is certainly the key to
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Yoshie Iwasaki; Sumihisa Honda; Shuji Kaneko; Kazuhiro Kurishima; Ayumi Honda; Ayumu Kakinuma; Doosub Jahng
2017-01-01
Background: Physical activity (PA) is ranked as a leading health indicator and the workplace is a key setting to promote PA. The purpose of this study was to examine how goal-setting and exercise self-efficacy (SE) during a health promotion program influenced PA level among Japanese workers. Methods: Using a cross-sectional study design, we surveyed 281 employees. The short version of the International Physical Activity Questionnaire was used to assess PA level. Exercise SE was assessed us...
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Is exercise effective in promoting mental well-being in older age? A systematic review.
Windle, Gill; Hughes, Dyfrig; Linck, Pat; Russell, Ian; Woods, Bob
2010-08-01
Promoting the mental well-being of older people has been neglected. To examine the clinical and cost-effectiveness of exercise and physical activity interventions on mental well-being in people aged 65+. Systematic review, meta-analysis, economic model. Reports published in English, identified by searching 25 databases, 11 websites and references lists of systematic reviews. Eligible studies were those with a comparison or control group or offering qualitative evidence; exercise and physical activity interventions for people aged 65 and above living at home, in the community, in supported housing or in residential care homes; including outcome measures of mental well-being, not simply measures of depression or anxiety. Low-quality studies were excluded from the data synthesis. An overall effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14-0.40). The included interventions were designed for older people, targeted those who are sedentary and delivered in a community setting, primarily through a group-based approach led by trained leaders. As a minimum, the evidence would suggest two exercise sessions per week, each of 45 min duration. There is some indication that exercise can also improve the mental well-being of frail elders. Economic evidence indicated incremental cost-effectiveness ratios (compared with minimal intervention) of pound 7300 and pound 12,100 per quality adjusted life year gained for community-based walking and exercise programmes, respectively. Mental well-being in later life is modifiable through exercise and physical activity. To generalise the findings, there is a need for more evidence of effectiveness from older people in the UK.
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Public Health Autonomy: A Critical Reappraisal.
Zimmerman, Frederick J
2017-11-01
The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.
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Zhang, Jing; Slesnick, Natasha
2017-03-01
Parents' and children's autonomy and relatedness behaviors are associated with a wide range of child outcomes. Yet, little is known about how parents and children's autonomy and relatedness behaviors jointly influence child outcomes. The current study captured this joint influence by exploring the longitudinal trajectory of mother-child discrepancies in autonomy and relatedness behaviors and its association with child problem behaviors. The effects of a family systems intervention on the trajectory of mother-child discrepancies were also examined. The sample included 183 substance using mothers and their children (M age = 11.54 years, SD = 2.55, range 8-16; 48 % females). Both the mother and child completed an assessment at baseline, 6- and 18-month post-baseline. A person-centered analysis identified subgroups varying in mother-child discrepancy patterns in their autonomy and relatedness behaviors. The results also showed that participation in the family systems therapy was associated with decreased mother-child discrepancies, and also a synchronous increase in mother's and child's autonomy and relatedness. Additionally, increased mother-child discrepancies and mother-child dyads showing no change in autonomy and relatedness was associated with higher levels of children's problem behaviors. The findings reveal a dynamic process of mother-child discrepancies in autonomy and relatedness behaviors related to child outcomes. The findings also support the effectiveness of the family systems therapy, and highlight the importance of understanding the complexities in family interactions when explaining children's problem behaviors.
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Intention, autonomy, and brain events.
Gillett, Grant
2009-07-01
Informed consent is the practical expression of the doctrine of autonomy. But the very idea of autonomy and conscious free choice is undercut by the view that human beings react as their unconscious brain centres dictate, depending on factors that may or may not be under rational control and reflection. This worry is, however, based on a faulty model of human autonomy and consciousness and needs close neurophilosophical scrutiny. A critique of the ethics implied by the model takes us towards a 'care of the self' view of autonomy and the subject's attunement to the truth as the crux of reasoning rather than the inner mental/neural state views of autonomy and human choice on offer at present.
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The health promotion lifestyle of metabolic syndrome individuals with a diet and exercise programme.
Lin, Yu-Hua; Chu, Li-Ling
2014-04-01
The purpose of this study was to explore a health promotion lifestyle (HPL) with a diet and exercise programme (DEP) in metabolic syndrome adults. The study consisted of 207 individuals who followed a DEP and 185 who did not. The subjects were rural community adults. Their HPL was evaluated using the Chinese version of the Health Promotion Lifestyle Profile Short Form (HPLP-S). The average HPLP-S score was significantly higher in the DEP group (3.28 ± 0.36) than in the group without the DEP (2.05 ± 0.65). Stepwise regression analysis revealed that group, gender, smoking, alcohol use, marital status, religion and chronic disease were predictors of an HPL and accounted for 67.0% of the variance in the HPLP-S score. This study demonstrates that a DEP has positive effects on a health promotion lifestyle. The community-based DEP targeting health promotion behaviours should be presented as a strategy for metabolic syndrome in adults. © 2013 Wiley Publishing Asia Pty Ltd.
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An intercultural nursing perspective on autonomy.
Hanssen, Ingrid
2004-01-01
This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients' possibly harmful choices is discussed, the focus is on 'forced' autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively participate neither in the treatment offered nor in making choices regarding that treatment. Nurses' demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person's autonomy is also respect for the person, one's respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second-order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why.
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Individual autonomy in work teams : the role of team autonomy, self-efficacy, and social support
Mierlo, van H.; Rutte, C.G.; Vermunt, J.K.; Kompier, M.A.J.; Doorewaard, J.A.C.M.
2006-01-01
Task autonomy is long recognized as a means to improve functioning of individuals and teams. Taking a multilevel approach, we unravelled the constructs of team and individual autonomy and studied the interplay between team autonomy, self-efficacy, and social support in determining individual
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Downie, Michelle; Chua, Sook Ning; Koestner, Richard; Barrios, Maria-Fernanda; Rip, Blanka; M'Birkou, Sawsan
2007-07-01
Previous research has demonstrated that autonomy support is one particularly effective means of promoting internalization and fostering well-being. The present study sought to determine if this would also be the case with regards to culture by testing the relation of perceived parental autonomy support to the cultural internalization and well-being of multicultural students. In Study 1, 105 multicultural participants living in Canada were more likely to have fully internalized their host and heritage cultures and to have higher self-reported well-being when they reported that their parents were autonomy supportive. In Study 2, 125 Chinese-Malaysians sojourners were also more likely to have fully internalized their heritage culture and indicated higher well-being when they perceived their parents as autonomy supportive. In both studies, heritage cultural internalization was also associated with higher well-being. Copyright 2007 APA
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Mumtaz, Zubia; Salway, Sarah
2009-04-01
Recent research and policy discourse commonly view the limited autonomy of women in developing countries as a key barrier to improvements in their reproductive health. Rarely, however, is the notion of women's autonomy interrogated for its conceptual adequacy or usefulness for understanding the determinants of women's reproductive health, effective policy formulation or program design. Using ethnographic data from 2001, including social mapping exercises, observation of daily life, interviews, case studies and focus group discussions, this paper draws attention to the incongruities between the concept of women's autonomy and the gendered social, cultural, economic and political realities of women's lives in rural Punjab, Pakistan. These inadequacies include: the concept's undue emphasis on women's independent, autonomous action; a lack of attention to men and masculinities; a disregard for the multi-sited constitution of gender relations and gender inequality; an erroneous assumption that uptake of reproductive health services is an indicator of autonomy; and a failure to explore the interplay of other axes of disadvantage such as caste, class or socio-economic position. This paper calls for alternative, more nuanced, theoretical approaches for conceptualizing gender inequalities in order to enhance our understanding of women's reproductive wellbeing in Pakistan. The extent to which our arguments may be relevant to the wider South Asian context, and women's lives in other parts of the world, is also discussed.
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Autonomy and intimacy in the family as risk factors for sexual abuse
Directory of Open Access Journals (Sweden)
Tanja Repič
2006-08-01
Full Text Available The study examined the level of two risk factors (autonomy and intimacy for healthy functional family among sexually abused and sexually non-abused individuals. Autonomy and intimacy were measured with Family-of-Origin Scale (FOS; Hovestadt, Anderson, Piercy, Cochran, & Fine, 1985. 261 participants (194 girls and 67 boys completed the FOS, average age was 25 years (SD = 7. Among all participants 18% were sexually abused (N = 46, approximately every fifth (5.7 girl and every seventh (6.7 boy. There were 78% girls and 22% boys among sexually abused participants. Families of sexually abused participants in comparison with the families of sexually non-abused showed many statistically significant differences in elements of autonomy (clarity of expressing emotions, responsibility, respect for others, openness to others, and acceptance of separation and loss and intimacy (encouraging expression of a range of feelings, creating a warm atmosphere in the home, dealing with conflict resolution without undue stress, promoting empathy among family members, trust and developing trust. In general the sexually abused group had a statistically significantly lower level of autonomy and intimacy in comparison with sexually non-abused group.
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Standage, Martyn; Gillison, Fiona B; Ntoumanis, Nikos; Treasure, Darren C
2012-02-01
A three-wave prospective design was used to assess a model of motivation guided by self-determination theory (Ryan & Deci, 2008) spanning the contexts of school physical education (PE) and exercise. The outcome variables examined were health-related quality of life (HRQoL), physical self-concept (PSC), and 4 days of objectively assessed estimates of activity. Secondary school students (n = 494) completed questionnaires at three separate time points and were familiarized with how to use a sealed pedometer. Results of structural equation modeling supported a model in which perceptions of autonomy support from a PE teacher positively predicted PE-related need satisfaction (autonomy, competence, and relatedness). Competence predicted PSC, whereas relatedness predicted HRQoL. Autonomy and competence positively predicted autonomous motivation toward PE, which in turn positively predicted autonomous motivation toward exercise (i.e., 4-day pedometer step count). Autonomous motivation toward exercise positively predicted step count, HRQoL, and PSC. Results of multisample structural equation modeling supported gender invariance. Suggestions for future work are discussed.
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Ruzek, Erik A.; Hafen, Christopher A.; Allen, Joseph P.; Gregory, Anne; Mikami, Amori Yee; Pianta, Robert C.
2017-01-01
Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11–17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools. PMID:28190936
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Ruzek, Erik A; Hafen, Christopher A; Allen, Joseph P; Gregory, Anne; Mikami, Amori Yee; Pianta, Robert C
2016-04-01
Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11-17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools.
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The Challenge of University Autonomy
DEFF Research Database (Denmark)
Reilly, John; Turcan, Romeo V.; Bugaian, Larisa
2016-01-01
The authors introduce the reader to the book, providing a historical perspective and a current understanding of university autonomy. While appreciating the central role of the four dimensions of university autonomy – organisational, financial, human resource, and academic – the authors conjecture...... that a fuller understanding of university autonomy can only be obtained through a holistic view of the complex inter-relationships between stakeholders and policies which can reinforce and, equally, pull in opposite directions. This holistic view is represented in a model of institutional university autonomy......, which is discussed at length in the chapter. The authors conclude by presenting international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are genuinely global....
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Estimation of Exercise Intensity in “Exercise and Physical Activity Reference for Health Promotion”
Ohkubo, Tomoyuki; Kurihara, Yosuke; Kobayashi, Kazuyuki; Watanabe, Kajiro
To maintain or promote the health condition of elderly citizens is quite important for Japan. Given the circumstances, the Ministry of Health, Labour and Welfare has established the standards for the activities and exercises for promoting the health, and quantitatively determined the exercise intensity on 107 items of activities. This exercise intensity, however, requires recording the type and the duration of the activity to be calculated. In this paper, the exercise intensities are estimated using 3D accelerometer for 25 daily activities. As the result, the exercise intensities were estimated to be within the root mean square error of 0.83 METs for all 25 activities.
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Nightingale, Tom E; Metcalfe, Richard S; Vollaard, Niels B; Bilzon, James L
2017-08-01
Spinal cord injury (SCI) is a life-changing event that, as a result of paralysis, negatively influences habitual levels of physical activity and hence cardiometabolic health. Performing regular structured exercise therefore appears extremely important in persons with SCI. However, exercise options are mainly limited to the upper body, which involves a smaller activated muscle mass compared with the mainly leg-based activities commonly performed by nondisabled individuals. Current exercise guidelines for SCI focus predominantly on relative short durations of moderate-intensity aerobic upper-body exercise, yet contemporary evidence suggests this is not sufficient to induce meaningful improvements in risk factors for the prevention of cardiometabolic disease in this population. As such, these guidelines and their physiological basis require reappraisal. In this special communication, we propose that high-intensity interval training (HIIT) may be a viable alternative exercise strategy to promote vigorous-intensity exercise and prevent cardiometabolic disease in persons with SCI. Supplementing the limited data from SCI cohorts with consistent findings from studies in nondisabled populations, we present strong evidence to suggest that HIIT is superior to moderate-intensity aerobic exercise for improving cardiorespiratory fitness, insulin sensitivity, and vascular function. The potential application and safety of HIIT in this population is also discussed. We conclude that increasing exercise intensity could offer a simple, readily available, time-efficient solution to improve cardiometabolic health in persons with SCI. We call for high-quality randomized controlled trials to examine the efficacy and safety of HIIT in this population. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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Patient’s autonomy from a biethical perspective.
Directory of Open Access Journals (Sweden)
Adriana Ribeiro-Alves
2012-12-01
Full Text Available Even though the conflicts arising in the field of Bioethics are generated by biomedical advances, these problems are meta-medical, that is they are transverse to all disciplines with scope in the human health. In this context, the application of bioethical principles such as the principle of autonomy, is considered a starting point, crucial to decision making referring to the exercise of medical and dental practice. In this sense, it is necessary to increase efforts through health policies and formation at the highest level for professionals in health disciplines in order to guide them to reduce violations of bioethical principles, as indeed happens in the day by day practice, in health services, both public and private, clinics or hospitals in order to get a health system with a more humanistic commitment. Thus, bioethics must be the base on which lay the foundations of a necessary dialogue that tends to resolve the observed conflicts, seeking to have the human being, and dignity of life as essential issues of their actions. The aim of this review is not to propose a definition of the Principle of Autonomy, that everyone already handle, but invite to a reflexion which contributes to size it and apply it in the field of dental practice in a bioethical context linked to the human person.
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The economic value of autonomy
Boot, A.W.A.; Thakor, A.V.
2003-01-01
We develop an economic theory of "autonomy", which we interpret as the discretion or ability to make a decision that others disagree with. We show that autonomy is essentially an option for the decisionmaker, and can be valued as such. The value of the autonomy option is decreasing in the extent to
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Controlled Autonomy: Novice Principals' Schema for District Control and School Autonomy
Weiner, Jennie M.; Woulfin, Sarah L.
2017-01-01
Purpose: The purpose of this paper is to gain insights into how a group of novice principals, all in schools that deployed principles of autonomy as mechanisms for improvement, conceptualized what the authors label "controlled autonomy"--a condition in which school leaders are expected to both make site-based decisions and be accountable…
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Autonomy and Acceptance of Long-Term Care
Hsu, Hui-Chuan; Ting, Yu-Shan; Jiang, Ting-Wen; Chien, Ming-Chih; Chien, Chih-Hsin
2009-01-01
This study explored the relationship between four types of autonomy (health autonomy, informational autonomy, living autonomy, and financial autonomy) and the acceptance of five types of long-term care (adult day care, respite care, assisted living, unit care, and group home) for the elderly in Taiwan. Data were collected from 167 middle-aged and…
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Roque, Fernanda R.; Soci, Ursula Paula Renó; De Angelis, Katia; Coelho, Marcele A.; Furstenau, Cristina R.; Vassallo, Dalton V.; Irigoyen, Maria Claudia; Oliveira, Edilamar M.
2011-01-01
OBJECTIVES: Aerobic exercise training prevents cardiovascular risks. Regular exercise promotes functional and structural adaptations that are associated with several cardiovascular benefits. The aim of this study is to investigate the effects of swimming training on coronary blood flow, adenosine production and cardiac capillaries in normotensive rats. METHODS: Wistar rats were randomly divided into two groups: control (C) and trained (T). An exercise protocol was performed for 10 weeks and 60 min/day with a tail overload of 5% bodyweight. Coronary blood flow was quantified with a color microsphere technique, and cardiac capillaries were quantified using light microscopy. Adenine nucleotide hydrolysis was evaluated by enzymatic activity, and protein expression was evaluated by western blot. The results are presented as the means ± SEMs (p<0.05). RESULTS: Exercise training increased the coronary blood flow and the myocardial capillary-to-fiber ratio. Moreover, the circulating and cardiac extracellular adenine nucleotide hydrolysis was higher in the trained rats than in the sedentary rats due to the increased activity and protein expression of enzymes, such as E-NTPDase and 5′-nucleotidase. CONCLUSIONS: Swimming training increases coronary blood flow, number of cardiac capillaries, and adenine nucleotide hydrolysis. Increased adenosine production may be an important contributor to the enhanced coronary blood flow and angiogenesis that were observed in the exercise-trained rats; collectively, these results suggest improved myocardial perfusion. PMID:22189737
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Directory of Open Access Journals (Sweden)
Fernanda R. Roque
2011-01-01
Full Text Available OBJECTIVES: Aerobic exercise training prevents cardiovascular risks. Regular exercise promotes functional and structural adaptations that are associated with several cardiovascular benefits. The aim of this study is to investigate the effects of swimming training on coronary blood flow, adenosine production and cardiac capillaries in normotensive rats. METHODS: Wistar rats were randomly divided into two groups: control (C and trained (T. An exercise protocol was performed for 10 weeks and 60 min/day with a tail overload of 5% bodyweight. Coronary blood flow was quantified with a color microsphere technique, and cardiac capillaries were quantified using light microscopy. Adenine nucleotide hydrolysis was evaluated by enzymatic activity, and protein expression was evaluated by western blot. The results are presented as the means ± SEMs (p<0.05. RESULTS: Exercise training increased the coronary blood flow and the myocardial capillary-to-fiber ratio. Moreover, the circulating and cardiac extracellular adenine nucleotide hydrolysis was higher in the trained rats than in the sedentary rats due to the increased activity and protein expression of enzymes, such as E-NTPDase and 59- nucleotidase. CONCLUSIONS: Swimming training increases coronary blood flow, number of cardiac capillaries, and adenine nucleotide hydrolysis. Increased adenosine production may be an important contributor to the enhanced coronary blood flow and angiogenesis that were observed in the exercise-trained rats; collectively, these results suggest improved myocardial perfusion.
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ONE SIZE FITS ALL? ON PATIENT AUTONOMY, MEDICAL DECISION-MAKING, AND THE IMPACT OF CULTURE.
Gilbar, Roy; Miola, José
2015-01-01
While both medical law and medical ethics have developed in a way that has sought to prioritise patient autonomy, it is less clear whether it has done so in a way that enhances the self-determination of patients from non-western backgrounds. In this article, we consider the desire of some patients from non-western backgrounds for family involvement in decision-making and argue that this desire is not catered for effectively in either medical law or medical ethics. We examine an alternative approach based on relational autonomy that might serve both to allow such patients to exercise their self-determination while still allowing them to include family members in the decision-making process. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Davis, Charles
2014-01-01
State officials responsible for the regulation of hydraulic fracturing (fracking) operations used in the production of oil and gas resources will inevitably confront a key policy issue; that is, to what extent can statewide regulations be developed without reducing land use autonomy typically exercised by local officials? Most state regulators have historically recognized the economic importance of industry jobs and favor the adoption of uniform regulatory requirements even if these rules preempt local policymaking authority. Conversely, many local officials seek to preserve land use autonomy to provide a greater measure of protection for public health and environmental quality goals. This paper examines how public officials in three states-Colorado, Pennsylvania, and Texas-address the question of state control versus local autonomy through their efforts to shape fracking policy decisions. While local officials within Texas have succeeded in developing fracking ordinances with relatively little interference from state regulators, Colorado and Pennsylvania have adopted a tougher policy stance favoring the retention of preemptive oil and gas statutes. Key factors that account for between state differences in fracking policy decisions include the strength of home rule provisions, gubernatorial involvement, and the degree of local experience with industrial economic activities.
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Shared decision-making and patient autonomy.
Sandman, Lars; Munthe, Christian
2009-01-01
In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.
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Liu, Dong; Fu, Ping-ping
2011-01-01
This study examined the roles of 3 multilevel motivational predictors in proteges' personal learning in teams: an autonomy-supportive team climate, mentors' autonomy support, and proteges' autonomy orientation. The authors followed 305 proteges in 58 teams for 12 weeks and found that all 3 predictors were positively related to the proteges'…
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From Autonomy to Quality Management: NPM Impacts on School Governance in Switzerland
Hangartner, Judith; Svaton, Carla Jana
2013-01-01
This article reviews the impact of discourses on "New Public Management" (NPM) on compulsory schooling in Switzerland during the last two decades and traces its implementation in the Canton of Bern. The analysis suggests that while NPM reformers initially promoted increased school autonomy, the introduction of market elements and school…
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Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia
2014-11-01
The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies.
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Senegal : School Autonomy and Accountability
World Bank
2012-01-01
Senegal has accelerated the decentralization of education since 1996. Budgetary autonomy is latent. Autonomy over the management of operational budgets has been delegated to the communes, but salaries for teachers are managed at the central level. Autonomy in personnel management is latent. Both school directors and teachers are appointed at the central level. The role of the school counci...
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Edwards, Christian; Tod, David; Molnar, Gyozo; Markland, David
2016-03-01
We examined if there were both direct and indirect relationships (via the drive for muscularity) between the perceived pressure to be muscular and internalization of the mesomorphic ideal, and if autonomy moderates these relationships in physically active men. A sample of 330 men, who were undergraduate students studying sport, completed the Behavioral Regulation in Exercise Questionnaire-2, the Mesomorphic Ideal Internalization subscale of the revised male version Sociocultural Attitudes Toward Appearance Questionnaire, the Perceived Sociocultural Pressure Scale-Modified, and the Drive for Muscularity Scale Attitudes subscale. Perceived pressure predicted internalization directly, and indirectly through the drive for muscularity. The direct relationship between pressure and internalization was weaker under higher levels of autonomy. The indirect path, via drive for muscularity, was stronger under higher levels of autonomy. These results provide insights into why men vary in the degree to which they internalize pressure to develop a mesomorphic ideal, supporting further examination of autonomy. Copyright © 2015 Elsevier Ltd. All rights reserved.
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The origins and consequences of patient autonomy: a 25-year retrospective.
Rothman, D J
2001-01-01
This essay explores the evolution of the tension between the principles of autonomy and beneficence in American health care over the past several decades. In retrospect it is clear that the social movements of the 1960s and 70s set the tone and the goals for the emergence of a new emphasis on patient autonomy. Indeed, the impact of civil liberties-minded lawyers on the promotion of a commitment to autonomy is far more vital than the term "bioethics" commonly suggests. Tracing the impact of this principle on clinical encounters over the past 25 years makes apparent that consumers have extended their influence over a wide range of treatment decisions. This influence is now being reinforced by an extraordinary information revolution, which includes the computer, the web, the dot.coms, the search engines, and such novel practices as Direct-to-Consumer advertising by pharmaceutical companies. The impact of these developments may be seen in such diverse issues as physician-assisted suicide and the failure of national health insurance initiatives.
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Physicians' perceptions of autonomy across practice types: Is autonomy in solo practice a myth?
Lin, Katherine Y
2014-01-01
Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians' autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked "spell" data constructed from the Community Tracking Study (CTS) Physician Survey (1996-2005) (n = 16,519) I examine how physicians' perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. Copyright © 2013
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Physicians’ Perceptions of Autonomy across Practice Types: Is Autonomy in Solo Practice a Myth?
Lin, Katherine Y.
2013-01-01
Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians’ autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked “spell” data constructed from the Community Tracking Study (CTS) Physician Survey (1996–2005) (n=16,519) I examine how physicians’ perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. PMID:24444835
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Understanding nurse practitioner autonomy.
Weiland, Sandra A
2015-02-01
This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.
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Autonomy and Foreign Policy in Latin America: an Open Debate, an Uncertain Future.
Directory of Open Access Journals (Sweden)
Juan Gabriel Tokatlian
1995-01-01
Full Text Available After the disappearance of the East-West confrontation, the persistence of the traditional inequality in the North-South divide justifies a revision of the current state of the debate with respect to autonomy in the foreign policy of a peripheral country such as Colombia. In analysing the different viewpoints of the realist and interdependentist theoretical schools and of the international political economy, a basic coincidence can be found in consideringautonomy as something possible, desirable, beneficial and practical for the State. A synthetic analysis of the recent treatment of the theme of autonomy by the most prestigious theorists in latinamerican matters, from O’Donnell, Link and Jaguaribe through to Cepeda or Escudé, via Puig or Drekonja or the present author, Tokatlian together with Pardo, brings to light the persistence of many holes and questions among which one could highlight: - the unit of basic analysis when evaluating the question of autonomy still seems to be the State, without paying attention to the phenomenon of a gradual erosion of the modern system of State-nation and the correlative increase of non-State forces - this state slant permits the notion that absolute sovereignty and political isolation are still viable- the autonomic “dream”, which has a partial explanation in thesecular structural symmetry which has motivated the attempt to overcome it, and the historical experience, which demonstrates that the autonomy of the opposing parties serves the interests and long term needs of the most powerful actors, point out that the relativeautonomy still makes sense while a change is taking place towards a postmodern system Force and wealth aside, as fundamental materials for the exercise of the potential of autonomy on behalf of the peripheral countries, it is in the field of ideas where a crucialsource of power in Latin America remains to be explored.
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Directory of Open Access Journals (Sweden)
Klain Ingi Petitemberte
2015-06-01
Full Text Available This research aimed to analyze the validity of the relations hypothesized by the theory of self-determination in predicting adherence to physical exercise in fitness academy users and subjects following personal training. A total of 588 persons from Pelotas / RS / Brazil (405 gym users and 183 subjects following personal training completed the Portuguese version of the three questionnaires, i.e. the Perceived Autonomy Support Climate Exercise Questionnaire, Basic Psychological Needs in the Exercise Scale and Behavioral Regulation in the Exercise Questionnaire −2. The results support the factorial structure of the questionnaires used in this sample. There was a significant multivariate effect of context on self-determination for physical exercise training [Wilks’ λ = 0.934, F (10, 576.000 = 4.03, p < 0.001, η2 = 0.01]. The hypothesized structural equation model, which considered the self-determination theory, showed a good fit to the data (S-B χ2 = 234.703; p= .001; df = 52; χ2/df = 4.514; SRMS = .049; NNFI = .906; CFI = .926; RMSEA = .077; RMSEA 90% CI = .067 − .088. However, in the comparative analysis, the perception of autonomy support, relatedness and competence were significantly higher in the context of personal training, while the amotivation and external regulation were significantly higher in the context of fitness academies.
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Euthanasia--he illusion of autonomy.
Hartling, O J
2006-03-01
The paper deals with some of the more common arguments used for the legalisation of voluntary euthanasia. It looks at these arguments from an ethical and philosophical point of view. First, the argument that to offer a person the possibility of euthanasia is to respect that person's autonomy is questionable. Can a person's decision on euthanasia be really autonomous? If euthanasia were legal everybody would be conscious of this option: the patient, the doctor, the family and the nursing staff. Thus, there could be indirect pressure on the patient to make a decision. The choice is meant to be free but the patient is not free not to make the choice. Secondly, a choice that seeks to alleviate suffering and thus improve life by annihilating it is irrational. Thirdly, autonomy as to one's own death is hardly exercised freely. Even an otherwise competent person may not be competent in deciding on his own death on account of despair, hopelessness, fear or maybe a feeling of being weak, superfluous and unwanted. This is a very uncertain base for decision-making, especially in the irrevocable decision of euthanasia. Finally, a competent person usually makes any choice in a responsible way and after due consideration; a 'good' decision should consider and respect the wishes and feelings of others. This will be no less the case in making a decision on the so-called free choice of euthanasia. Thus 'normal' behaviour in decision making will only add to the tendency of the already depressed person to feel a burden on his family, the staff and even on society.
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Froiland, John Mark; Davison, Mark L.; Worrell, Frank C.
2016-01-01
Among 110 Native Hawaiians and Pacific Islanders, teacher autonomy support in 9th grade significantly predicted intrinsic motivation for math in 9th grade as well as math course-taking over the next 2 years, both of which in turn significantly predicted math achievement by 11th grade. In a second model, teacher autonomy support was positively…
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Women, 'madness' and exercise.
Hardes, Jennifer Jane
2018-03-21
The positive relationship between exercise and mental health is often taken for granted in today's society, despite the lack of academic literature evidencing this symbiosis. Gender is considered a significant determinant in a number of mental health diagnoses. Indeed, women are considered twice as likely as men to experience the most pervasive mental health condition, depression. Exercise for women's mental health is promoted through various macrolevel charity, as well as microlevel, campaigns that influence government healthcare policy and National Health Service guidelines. Indeed, 'exercise prescriptions' in the treatment of depression is not uncommon. Yet, this link between exercise as a treatment for women's mental health has not always been so pervasive. In fact, an examination of asylum reports and medical journals from the late 19th century highlights a significant shift in attitude towards the role of exercise in the treatment of women's emotional states and mental health. This paper specifically examines how this treatment of women's mental health through exercise has moved from what might be regarded as a focus on exercise as a 'cause' of women's mental ailments to exercise promoted as a 'cure'. Unpacking the changing medical attitudes towards exercise for women in line with larger sociopolitical and historic contexts reveals that while this shift towards exercise promotion might prima facie appear as a less essentialist view of women and their mental and physical states, it inevitably remains tied to larger policy and governance agendas. New modes of exercise 'treatment' for women's mental health are not politically neutral and, thus, what appear to emerge as forms of liberation are, in actuality, subtler forms of regulation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Respect for autonomy and technological risks
Asveld, L.
2008-01-01
Technological developments can undermine the autonomy of the individual. Autonomy is one's ability to make and act upon decisions according to one's own moral framework. Respect for autonomy dictates that risks should not be imposed on the individual without her consent. Technological developments
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(Re)Discovering University Autonomy
DEFF Research Database (Denmark)
This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter-re...
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[Is autonomy ground of human dignity?].
Gordillo Alvarez-Valdés, Lourdes
2008-01-01
This paper considers the conditions of autonomy if this is to be the foundation of human dignity. Since Kant Modernity has dissociated nature from morality and has tried to support autonomy in its purely formal aspect. To forget nature has voluntarist consequences that affect the way in which autonomy is understand. But autonomy does not consist of not having links, but of knowing how to assume one's own links freely and to be conscious of one's own limits. Autonomy and liberty are the very thing of the rational being, capable of discerning good and bad, and this must direct our actions. Reason directs as and distances us from reality to recognize the advisable thing in the human being.
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Müller, Andre Matthias; Khoo, Selina; Morris, Tony
2016-01-07
Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones. The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants' exercise frequency and the effects of the intervention on secondary outcomes. The Malaysian Physical Activity for Health Study (myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity-related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24. In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study
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Ethical issues in exercise psychology.
Pauline, Jeffrey S; Pauline, Gina A; Johnson, Scott R; Gamble, Kelly M
2006-01-01
Exercise psychology encompasses the disciplines of psychiatry, clinical and counseling psychology, health promotion, and the movement sciences. This emerging field involves diverse mental health issues, theories, and general information related to physical activity and exercise. Numerous research investigations across the past 20 years have shown both physical and psychological benefits from physical activity and exercise. Exercise psychology offers many opportunities for growth while positively influencing the mental and physical health of individuals, communities, and society. However, the exercise psychology literature has not addressed ethical issues or dilemmas faced by mental health professionals providing exercise psychology services. This initial discussion of ethical issues in exercise psychology is an important step in continuing to move the field forward. Specifically, this article will address the emergence of exercise psychology and current health behaviors and offer an overview of ethics and ethical issues, education/training and professional competency, cultural and ethnic diversity, multiple-role relationships and conflicts of interest, dependency issues, confidentiality and recording keeping, and advertisement and self-promotion.
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Models, controls, and levels of semiotic autonomy
Energy Technology Data Exchange (ETDEWEB)
Joslyn, C.
1998-12-01
In this paper the authors consider forms of autonomy, forms of semiotic systems, and any necessary relations among them. Levels of autonomy are identified as levels of system identity, from adiabatic closure to disintegration. Forms of autonomy or closure in systems are also recognized, including physical, dynamical, functional, and semiotic. Models and controls are canonical linear and circular (closed) semiotic relations respectively. They conclude that only at higher levels of autonomy do semiotic properties become necessary. In particular, all control systems display at least a minimal degree of semiotic autonomy; and all systems with sufficiently interesting functional autonomy are semiotically related to their environments.
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Changing professional autonomy?
DEFF Research Database (Denmark)
Jespersen, Peter Kragh
The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway......The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway...
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Brazilian Eratosthenes Project: autonomy of teachers in experimental activities of Astronomy
Directory of Open Access Journals (Sweden)
Rodolfo Langhi
2017-05-01
Full Text Available Research results point to the use of experimental activities in Science Education as one of the most efficient strategies to arouse interest and dedication of the students. One of the important considerations about the experimental activities is that there is no effective contribution to the use of kits with ready scripts, closed procedures and measurement of expected experimental results. This limits the autonomy of the teachers and students in the teaching-learning process. Specifically on Astronomy Education, the researches show the importance of considering the observational component and practice of this science. Then, our research question was structured: which elements subsidize the construction of teacher autonomy in the development and implementation of experimental activities in order to effectively contribute to the teaching of Astronomy? We developed this research in the context of Brazilian Eratosthenes Project, through a discourse analysis of a group of teachers participating in this project since 2010. Our results reveal the predominance of a training model cast in an approach extremely focused on the content and under the technical rationality, with few elements contributing to the construction the autonomy of teaching. On the other hand, a historical analysis of Eratosthenes Project and the activities developed by some of the participants indicate potential regarding the development of elements that can enable these professionals to exercise independently their profession, to develop and implement experimental activities unstructured in the interdisciplinary teaching of Astronomy.
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Subsidiary Autonomy and Knowledge Transfer
DEFF Research Database (Denmark)
Søberg, Peder Veng; Wæhrens, Brian Vejrum
2015-01-01
Purpose: This paper explores the effect of subsidiary autonomy on knowledge transfers during captive R&D offshoring to emerging markets. Design/methodology/approach: A framework to this end is developed and illustrated in relation to four cases of captive R&D offshoring to emerging markets....... Findings: Subsidiary autonomy has a mainly negative effect on primary knowledge transfer and a mainly positive effect on reverse knowledge transfer. Newly established R&D subsidiaries in emerging markets need primary knowledge transfer in order to build up their competence before they can add...... to the knowledge level of the MNE. Originality: A dual role of subsidiary autonomy is identified. Gradual increase in R&D subsidiary autonomy is beneficial for subsidiary innovation performance....
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Characteristics of Law-Autonomy Foreign Subsidiaries
DEFF Research Database (Denmark)
Gammelgaard, Jens; McDonald, Frank; Stephan, Andreas
2012-01-01
This paper examines several characteristics of foreign subsidiaries with low autonomy. Data derived from a survey of 381 MNC subsidiaries located in Denmark, Germany and the UK demonstrate that low-autonomy subsidiaries are highly embedded in their respective MNC networks and that they establish ...... relationship between lower autonomy and the production activities carried out by the subsidiary. In fact, low-autonomy subsidiaries appear to be specialized in that they focus on a few value-chain activities and they typically serve as marketing outlets....
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Directory of Open Access Journals (Sweden)
Jerome N. Rachele, Timo Jaakkola, Tracy L. Washington, Thomas F. Cuddihy, Steven M. McPhail
2015-09-01
Full Text Available The provision of autonomy supportive environments that promote physical activity engagement have become popular in contemporary youth settings. However, questions remain about whether adolescent perceptions of their autonomy have implications for physical activity. The purpose of this investigation was to examine the association between adolescents’ self-reported physical activity and their perceived autonomy. Participants (n = 384 adolescents aged between 12 and 15 years were recruited from six secondary schools in metropolitan Brisbane, Australia. Self-reported measures of physical activity and autonomy were obtained. Logistic regression with inverse probability weights were used to examine the association between autonomy and the odds of meeting youth physical activity guidelines. Autonomy (OR 0.61, 95% CI 0.49-0.76 and gender (OR 0.62, 95% CI 0.46-0.83 were negatively associated with meeting physical activity guidelines. However, the model explained only a small amount of the variation in whether youth in this sample met physical activity guidelines (R2 = 0.023. For every 1 unit decrease in autonomy (on an index from 1 to 5, participants were 1.64 times more likely to meet physical activity guidelines. The findings, which are at odds with several previous studies, suggest that interventions designed to facilitate youth physical activity should limit opportunities for youth to make independent decisions about their engagement. However, the small amount of variation explained by the predictors in the model is a caveat, and should be considered prior to applying such suggestions in practical settings. Future research should continue to examine a larger age range, longitudinal observational or intervention studies to examine assertions of causality, as well as objective measurement of physical activity.
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Schüz, Benjamin; Westland, Josh N; Wurm, Susanne; Tesch-Römer, Clemens; Wolff, Julia K; Warner, Lisa M; Schwarzer, Ralf
2016-03-01
Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy. (c) 2016 APA, all rights reserved).
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Neuroscience of exercise: from neurobiology mechanisms to mental health.
Matta Mello Portugal, Eduardo; Cevada, Thais; Sobral Monteiro-Junior, Renato; Teixeira Guimarães, Thiago; da Cruz Rubini, Ercole; Lattari, Eduardo; Blois, Charlene; Camaz Deslandes, Andrea
2013-01-01
The neuroscience of exercise is a growing research area that is dedicated to furthering our understanding of the effects that exercise has on mental health and athletic performance. The present study examined three specific topics: (1) the relationship between exercise and mental disorders (e.g. major depressive disorder, dementia and Parkinson's disease), (2) the effects of exercise on the mood and mental health of athletes, and (3) the possible neurobiological mechanisms that mediate the effects of exercise. Positive responses to regular physical exercise, such as enhanced functional capacity, increased autonomy and improved self-esteem, are frequently described in the recent literature, and these responses are all good reasons for recommending regular exercise. In addition, physical exercise may improve both mood and adherence to an exercise program in healthy individuals and might modulate both the performance and mental health of athletes. Exercise is associated with the increased synthesis and release of both neurotransmitters and neurotrophic factors, and these increases may be associated with neurogenesis, angiogenesis and neuroplasticity. This review is a call-to-action that urges researchers to consider the importance of understanding the neuroscience of physical exercise and its contributions to sports science. Copyright © 2013 S. Karger AG, Basel.
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Relations Between Student Procrastination and Teaching Styles: Autonomy-Supportive and Controlling.
Codina, Nuria; Valenzuela, Rafael; Pestana, Jose V; Gonzalez-Conde, Joan
2018-01-01
Procrastination is a complex problem that can be defined as delaying an intended course of action (despite anticipating adverse consequences). Even when some students have equivalent motivation and skill levels, they tend to procrastinate more frequently than others. Approaches that analyze whether contextual influences may prevent or promote dysregulation processes associated with procrastination are scarce. According to Self-Determination Theory, contextual influences can facilitate self-regulated motivation (e.g., autonomous pursuit of interests or personal goals), if teaching style is autonomy-supportive and guarantees the satisfaction of students' basic psychological needs for perceived competence, autonomy, and relatedness. Contrariwise, school context can also impede the development of autonomous motivation if teachers frustrate the satisfaction of their students' psychological needs by recurring to controlling teaching behaviors, such as controlling use of rewards, negative conditional regard, excessive personal control, or intimidation. The goal of the present study was to assess the relations between controlling and autonomy-supportive teaching behaviors, psychological needs satisfaction (of the needs for competence, autonomy, and relatedness), and four distinct measures of procrastination: general procrastination, decisional procrastination, procrastination linked to task avoidance, and pure procrastination. Data based on public university undergraduate students ( N = 672) shows that controlling teaching behaviors are associated negatively with psychological needs satisfaction and positively with procrastination. Contrariwise, autonomy-supportive teaching behaviors are positively associated with psychological needs satisfaction and negatively with procrastination. The data obtained is useful for suggesting new lines of research to study the link between contextual influences and the prevention of academic procrastination in view of Self
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School Autonomy: perspectives and practices in the development of political projects
Directory of Open Access Journals (Sweden)
Nora Gluz
2008-03-01
Full Text Available State programs promoting school autonomy have been developed within the neo-liberal project and its state reform policies characterized by decentralization and privatization of social services. These programs were fostered as strategies to improve educational quality and equity, in the midst of the redefinition of the role of the state as guarantor of education as a social right. Disputing the neo-liberal view which led to the dismantlement of the welfare state, social movements arising from marginal sectors of society have implemented their own education projects, often working in collaboration with academia. In these projects, school autonomy is seen as a strategy to challenge existing social relations. In this paper, we compare and contrast the meanings attached to the notion of “school autonomy” and the characteristics of the social practices fostered by the educational programs promoted by two different agents, i.e. the state and social movements. Thus, we analyze in the case of Argentina a nation-wide program implemented by the National Ministry of Education (Programa Nueva Escuela Argentina para el Siglo XXI as well as an educational program developed by a social movement (the Movimiento Nacional de Empresas Recuperadas.
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Bronson, Sevilla
2016-09-01
In the U.S., enrollment and graduation rates of baccalaureate nursing programs are slowly increasing. Rigorous program requirements can be overwhelming for students who may have difficulty adjusting to curriculum demands. Faculty who help students to adjust may also build a supportive learning environment that promotes autonomous motivation, improves engagement, and strengthens academic performance. Students may also experience well-being and autonomy when they feel supported and when their needs are met. The aim of this study was to investigate nursing students' autonomy support environments and autonomous motivation (measured as spirituality), and the influence on engagement and academic performance. A cross-sectional correlational design using a convenience sample of 150 nursing students in the last year of a baccalaureate nursing program was used. Participants were recruited from four universities in Florida and data collection occurred over three months. All participants were enrolled in the last year of their baccalaureate nursing program with an average Grade Point Average (GPA) of 3.36. The learning climate alone was moderately supportive of student motivation (M=70.60, SD=18.99). No significant relationship between the autonomy support environment and autonomous motivation (r=.034, p=.676) was found. Correlations and regression analysis of autonomous motivation and work engagement were significant (F (2, 147)=28.28, p=.000). Comparison of participant groups from each university independently revealed supportive learning environments. Strategies to promote autonomy must be developed and implemented as a means of ensuring a favorable learning environment. Future research may include the investigation of spirituality and autonomous motivation as two separate variables. Copyright © 2016 Elsevier Ltd. All rights reserved.
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DEFF Research Database (Denmark)
Barten, Ulrike
2008-01-01
on the content of the syllabus. When autonomy is understood in the literal sense, of giving oneself one's own laws, then there is a clear connection. Autonomy is usually connected to politics and a geographically limited territory. Special political rights of minorities - e.g. is the Danish minority party SSW...
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Autonomy, Social Interactions and Culture
Marini, Annalisa; Navarra, Pietro
2016-01-01
The present paper, using a social interactions model, studies the impact of culture on autonomy of immigrants. The results suggest that: (i) immigrants' autonomy is largely influenced by the autonomy of individuals living in a host country; (ii) some immigrants are better off in countries and regions with better institutional environments. The results are robust to sensitivity checks. The contributions of the paper are as follows. First, we estimate a social interactions model that models bot...
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Promoting Healthful Exercise for Visually Impaired Persons with Diabetes.
Weitzman, D. M.
1993-01-01
This article discusses the importance of exercise for many people with visual impairments and diabetes. It lists precautions for the person with visual impairments and diabetes and specifies who should not exercise, explains "diabetes-specific" benefits of exercise, suggests a format for a safe workout, and includes an example of a successful…
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Steinberg, Matthew P.; Cox, Amanda Barrett
2017-01-01
A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…
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U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization?
Bustamante, Arturo Vargas
2016-01-01
For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form) is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form) is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization. PMID:27694684
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Advance directives as autonomy enhancers: reality or myth?
Navarro Michel, Mónica
2015-01-01
In the last few decades there has been a wealth of literature and legislation on advance directives. As you all know, it is an instrument by which a person can express their wishes as regards what treatment they should be given or, more to the point, not to be given, when he is in a situation when he can not do so himself. Regulations in the western world seem to promote advance directives as a way to enhance patient¿s autonomy in the context of human rights, and the media has presen...
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Valencia, Jorge Andrick Parra; Dallos, Adriana Rocío Lizcano; Ballesteros, Eliécer Pineda
2017-01-01
This study presents a mechanism which explains the effect of synchronous communication on students' perception of the training process in virtual learning methodology used in a postgraduate programme at the University of Santander. We use System Dynamics to design a mechanism that integrates motivation, confidence, trust, and autonomy in students.…
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Enzo, Aya; Okita, Taketoshi; Asai, Atsushi
2018-05-29
The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.
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Gregg, Vanessa H; Ferguson, James E
2017-10-01
Routine exercise should be recommended to healthy pregnant women after consultation with an obstetric provider. Even pregnant women who have not been exercising regularly can gradually increase their exercise during pregnancy. Regular exercise during pregnancy promotes overall wellness and helps maintain appropriate gestational weight gain and appropriate fetal weight gain. Exercise in pregnancy may also reduce hypertensive disorders of pregnancy and gestational diabetes, and may be associated with shorter first stage of labor and decreased risk for cesarean section. Exercise in pregnancy is safe for pregnant women and their fetuses and can have multiple health benefits. Copyright © 2017 Elsevier Inc. All rights reserved.
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The Role of Unconditional Parental Regard in Autonomy-Supportive Parenting.
Roth, Guy; Kanat-Maymon, Yaniv; Assor, Avi
2016-12-01
Two studies explored the role of parents' unconditional positive regard (UCPR) as perceived by adolescents and young adults in promoting the effectiveness of specific parenting practices that may support offspring's academic autonomous motivation. Study 1 tested the hypothesis that UCPR predicts rationale-giving and choice-provision practices and, at the same time, moderates their relations with adolescents' autonomous motivation. Study 2 replicated the association between UCPR and the parental practices, and further explored the role of parents' authenticity as an antecedent of UCPR and parental autonomy support. Study 1 included 125 adolescents and Study 2 considered 128 college-students and their mothers. The offspring reported on their perceptions of their mothers and on their autonomous motivation, and the mothers reported on their sense of authenticity. Both studies found consistent associations between UCPR and parenting practices that may support autonomous motivation. Moreover, Study 1 demonstrated that the rationale giving and choice provision were more strongly related to adolescents' autonomous motivation when adolescents perceived mothers as high on UCPR. Finally, Study 2 demonstrated that mothers' authenticity predicted UCPR, which in turn was related to autonomy-supportive parenting. Findings support the assumption that parents' autonomy-supportive practices are more effective when accompanied by UCPR. © 2015 Wiley Periodicals, Inc.
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Beauchamp, Tom L; Wobber, Victoria
2014-04-01
Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach.
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Directory of Open Access Journals (Sweden)
Manuel Portugal Ferreira
2013-11-01
Full Text Available The management of multinational corporations (MNCs is complicated by the dispersion of subsidiaries in different locations, and the need to organize the best solutions for control, coordination and independence of each subsidiary to leverage their contribution to the EMN. In this article, based on the case study of a U.S. MNC with a subsidiary in Portugal, we analyze the relationship between autonomy and control headquarters the Portuguese subsidiary. The study identifies the main reasons that determine the amount of control exercised over the subsidiary. We conclude that the centralization, formalization of processes and integration rules are essential to the maintenance of coordination and cooperation between headquarters and subsidiary. However, it is the performance of the subsidiary and its role, particularly as contributory network of subsidiaries, which seems to confine the relations of control-autonomy.
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The Connotations of Language Teacher Autonomy
Han, Ligang
2017-01-01
With the research on the development of learner autonomy in foreign language education, teacher autonomy has become a hot topic in the research of foreign language teacher education. However, it is the most difficult question to define language teacher autonomy and any answer to it is likely to be subjective. On the basis of expounding upon the…
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Autonomy and Firefighting: Perceived Competence and Stress.
Chiang, Evelyn S; Baley, John; Ponder, Joy; Padilla, Miguel A
2016-12-01
In workplace settings, autonomy is implicated in employee motivation as well as supervisor autonomy support. As a profession of risk, firefighters may experience greater levels of stress. A self-determination paradigm was applied to the firefighter workplace. Of particular interest were perceived competence (to perform job duties) and the experience of stress. Firefighters' levels of autonomous and controlled regulation were surveyed, along with their perceptions of the autonomy support of their immediate supervisor. Autonomous regulation was positively related to perceived competence, whereas controlled regulation was negatively related. Higher levels of controlled regulation were also connected with greater stress. In contrast, greater perceived autonomy support was associated with decreased stress. Both perceived competence and stress are related to firefighter motivation and autonomy support. Recommendations are offered to increase autonomy support by chief officers.
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Indications for treatment of thyroid autonomy
International Nuclear Information System (INIS)
Emrich, D.
1989-01-01
Based on pathophysiological findings and considerations it is attempted to review critically the present state of indications and therapeutic modalities in cases of thyroid autonomy. If hyperthyroidism occurs or has occurred in autonomy, definitive treatment with radioiodine or surgery is indicated. In cases of autonomy with euthyroidism, treatment planning and indication of definite therapy are difficult still today, because the risk to develop hyperthyroidism cannot as yet be sufficiently estimated. A useful indicator in such cases seems to be the percentage of global thyreoidal uptake of 99m-technetium under supression. If autonomy is severe surgical treatment today is superior to radio-iodine therapy, but is associated with a higher rate of manifest hypothyroidism. Further research into both the risk of hyperthyroidism in thyroid autonomy and the optimization of radio-iodine therapy are needed. (orig./MG) [de
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Li, Liman Man Wai
2018-04-26
Depression is one of the leading causes of work disability. Thus, it is important to explore possible ways to reduce its impact on employees. The current research examined whether promoting job autonomy would attenuate the detrimental effect of depression on employees' well-being. Study 1 included the data from 5974 full-time employees from China. Full-time employees living in India, a collectivistic culture, and the United States, an individualistic culture, were recruited online in Study 2. Study 1 revealed that job autonomy moderated the influence of depression on job strain and perceived control mediated this interaction effect. Specifically, job autonomy weakened the detrimental effect of depression on job strain via weakening the association between depression and perceived control. The data from the 258 full-time employees in Study 2 replicated the findings and found that job autonomy had a stronger attenuating effect on the influence of depression in India than it had in the United States. Job autonomy was found to be an effective way to reduce the negative impact of depression on employees' well-being, a finding that should be considered when organizations develop their work policies.
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Exercise promotes collateral artery growth mediated by monocytic nitric oxide.
Schirmer, Stephan H; Millenaar, Dominic N; Werner, Christian; Schuh, Lisa; Degen, Achim; Bettink, Stephanie I; Lipp, Peter; van Rooijen, Nico; Meyer, Tim; Böhm, Michael; Laufs, Ulrich
2015-08-01
Collateral artery growth (arteriogenesis) is an important adaptive response to hampered arterial perfusion. It is unknown whether preventive physical exercise before limb ischemia can improve arteriogenesis and modulate mononuclear cell function. This study aimed at investigating the effects of endurance exercise before arterial occlusion on MNC function and collateral artery growth. After 3 weeks of voluntary treadmill exercise, ligation of the right femoral artery was performed in mice. Hindlimb perfusion immediately after surgery did not differ from sedentary mice. However, previous exercise improved perfusion restoration ≤7 days after femoral artery ligation, also when exercise was stopped at ligation. This was accompanied by an accumulation of peri-collateral macrophages and increased expression of endothelial nitric oxide synthase and inducible nitric oxide synthase (iNOS) in hindlimb collateral and in MNC of blood and spleen. Systemic monocyte and macrophage depletion by liposomal clodronate but not splenectomy attenuated exercise-induced perfusion restoration, collateral artery growth, peri-collateral macrophage accumulation, and upregulation of iNOS. iNOS-deficient mice did not show exercise-induced perfusion restoration. Transplantation of bone marrow-derived MNC from iNOS-deficient mice into wild-type animals inhibited exercise-induced collateral artery growth. In contrast to sedentary controls, thrice weekly aerobic exercise training for 6 months in humans increased peripheral blood MNC iNOS expression. Circulating mononuclear cell-derived inducible nitric oxide is an important mediator of exercise-induced collateral artery growth. © 2015 American Heart Association, Inc.
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Gallagher, Kristel M
2016-01-01
The benefits of exercise gained by older adults during physical therapy are often not maintained once the program is over. This lack of sustained benefits is thought to be partially the result of poor adherence to the prescribed home exercise program to be continued once therapy is completed. Most of what is known about older adults' adherence to physical therapy and home exercise comes from research seeking to identify and understand predictors of adherence, rather than trying to enhance adherence explicitly. The purpose of this study was to test a theoretically grounded approach to promoting adherence to home exercise programs in older adults. Sixty older adults (M age = 69.3 (6.87) years) in a program of physical therapy received 1 of 2 print messages and magnets promoting adherence to home exercise. The content of the messages was informed by the goal-specific tenets of socioemotional selectivity theory-one message described the emotional and meaningful benefits of home exercise, such as time with loved ones and independence, and one message described facts and information about physiological benefits, such as balance and strength. Adherence to home exercise was measured 2 weeks after participants were discharged from physical therapy by calculating the percentage of the prescribed exercises participants reported completing at home. An analysis of covariance indicated that there was no statistically significant difference in adherence rates between participants receiving either message. However, a 2×2 analysis of covariance did reveal a significant interaction between the type of message participants received and the time at which they received that message. Post hoc analyses separately examined the rates of adherence in participants who received the intervention message with time remaining in their therapy program and participants who received the intervention message on the day of discharge. In the subset of participants who received their intervention
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Relations Between Student Procrastination and Teaching Styles: Autonomy-Supportive and Controlling
Directory of Open Access Journals (Sweden)
Nuria Codina
2018-05-01
Full Text Available Procrastination is a complex problem that can be defined as delaying an intended course of action (despite anticipating adverse consequences. Even when some students have equivalent motivation and skill levels, they tend to procrastinate more frequently than others. Approaches that analyze whether contextual influences may prevent or promote dysregulation processes associated with procrastination are scarce. According to Self-Determination Theory, contextual influences can facilitate self-regulated motivation (e.g., autonomous pursuit of interests or personal goals, if teaching style is autonomy-supportive and guarantees the satisfaction of students’ basic psychological needs for perceived competence, autonomy, and relatedness. Contrariwise, school context can also impede the development of autonomous motivation if teachers frustrate the satisfaction of their students’ psychological needs by recurring to controlling teaching behaviors, such as controlling use of rewards, negative conditional regard, excessive personal control, or intimidation. The goal of the present study was to assess the relations between controlling and autonomy-supportive teaching behaviors, psychological needs satisfaction (of the needs for competence, autonomy, and relatedness, and four distinct measures of procrastination: general procrastination, decisional procrastination, procrastination linked to task avoidance, and pure procrastination. Data based on public university undergraduate students (N = 672 shows that controlling teaching behaviors are associated negatively with psychological needs satisfaction and positively with procrastination. Contrariwise, autonomy-supportive teaching behaviors are positively associated with psychological needs satisfaction and negatively with procrastination. The data obtained is useful for suggesting new lines of research to study the link between contextual influences and the prevention of academic procrastination in view of
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Autonomy and the Sources of Political Normativity
DEFF Research Database (Denmark)
Rostbøll, Christian F.
Contemporary political liberals argue for extending the scope of reasonable disagreement to include also the principle of autonomy that was central in classical liberal theory. I take outset in Charles Larmore, The Autonomy of Morality (2008), which argues that liberal theory can dispense...... with the commitment to autonomy that one finds in Locke, Kant, and Mill, because "the essential convictions of liberal thought lie at a more fundamental level," namely in the principle of respect for persons. The main question I address is whether we can see the commitment to respect for persons as separable from...... the commitment to autonomy. My focus is the Kantian conception of autonomy, and I argue for understanding this conception practically and politically, rather than metaphysically and theoretically. In this way we can separate the principle of respect for persons from the metaphysical idea of autonomy as self...
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Promoting Exercise in Young Cancer Survivors
In children and adolescent cancer survivors, an online game helped them get regular exercise, as this NCI Cancer Currents post explains. A NCI-funded trial is testing the approach for acute lymphoblastic leukemia (ALL) survivors.
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Neff, Kristin D; Brabeck, Kalina M; Kearney, Lisa K
2006-10-01
The author examined relationship styles of self-focused autonomy (SFA), other-focused connection (OFC), and mutuality among 415 European and Mexican American young adults in 2 U.S. colleges. Mutuality was the most commonly reported style for both ethnic groups, although Mexican American men were more likely than the others to indicate that they had the SFA style. Mexican American participants perceived their fathers' styles as SFA more often than did the others regarding either of their parents' styles. Mutuality was associated with the best mental-health outcomes regardless of gender or ethnicity. The present results indicate that the cultural influences on autonomy and connection are complex and that collectivistic cultural contexts may sometimes promote autonomy concerns in men.
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Immediate increase in food intake following exercise messages.
Albarracin, Dolores; Wang, Wei; Leeper, Joshua
2009-07-01
Communications to stimulate weight loss include exercise-promotion messages that often produce unsatisfactory results due to compensatory behavioral and metabolic mechanisms triggered by physical activity. This research investigated potential automatic facilitation of eating immediately after exercise messages in the absence of actual exercise. Two controlled experiments demonstrated greater than control food intake following exposure to print messages typical of exercise campaigns as well as subliminal presentation of action words associated with exercise (e.g., "active"). These inadvertent effects may explain the limited efficacy of exercise-promotion programs for weight loss, particularly when systematic dietary guidelines are absent.
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Adolescents, Graduated Autonomy, and Genetic Testing
Directory of Open Access Journals (Sweden)
Susan Fox
2012-01-01
Full Text Available Autonomy takes many shapes. The concept of “graduated autonomy” is conceived as comprising several unique features: (1 it is incremental, (2 it is proportional, and (3 it is related to the telos of the life stage during which it occurs. This paper focuses on graduated autonomy in the context of genetic testing during adolescence. Questions can be raised about other life stages as well, and some of these questions will be addressed by discussing a possible fourth characteristic of graduated autonomy, that is, its elasticity. Further scholarship and analysis is needed to refine the concept of graduated autonomy and examine its applications.
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Autonomy support for autonomous motivation in medical education.
Kusurkar, Rashmi A; Croiset, Gerda
2015-01-01
Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.
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Motivational and evolutionary aspects of a physical exercise training program: a longitudinal study.
Directory of Open Access Journals (Sweden)
João Paulo Pereira Rosa
2015-05-01
Full Text Available Several studies have indicated that motivational level and prior expectations are relevant aspects to increase commitment to physical activity. Moreover, these aspects are not properly described in terms of proximal (Self Determination Theory and distal (evolutionary explanations in the literature. This paper aims to verify if level of motivation (BREQ-2 and expectations regarding regular physical exercise (IMPRAF-54 before starting a one-year exercise program could determine likelihood of completion. Ninety-four volunteers (53 women included a completed protocol group (CPG n=21 and drop-out group (DG n=73. The IMPRAF-54 scale was used to assess six different expectations associated with physical activity, and the BREQ-2 inventory was used to assess the level of motivation in five steps (from amotivation to intrinsic motivation. Both questionnaires were assessed before the regular exercise program. The CPG group presented higher sociability and lower pleasure scores according to IMPRAF-54 domains. A logistic regression showed that a one-point increment on sociability score increased the chance of completing the program by 10%, and the same one-point increment on pleasure score reduced the chance of completing the protocol by 16%. ROC curves were also calculated to establish IMPRAF-54 cutoffs for adherence (Sociability - 18.5 points – 81% sensibility/50% specificity and dropout (Pleasure – 25.5 points – 86% sensibility/20% specificity of the exercise protocol. Our results indicate that an expectation of social interaction was a positive factor in predicting adherence to exercise. Grounded in SDT and its innate needs (competence, autonomy, relatedness, physical exercise is not an end; it is a means to achieve autonomy and self-cohesion. The association of physical activity with social practices, like in hunter-gathering groups, can engage people to be physically active and can provide better results in adherence exercise programs for the
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Standby-battery autonomy versus power quality
Bitterlin, Ian F.
Batteries are used in a wide variety of applications as an energy store to bridge gaps in the primary source of supplied power for a given period of time. In some cases this bridging time, the battery's "autonomy", is fixed by local legislation but it is also often set by historically common practices. However, even if common practice dictates a long autonomy time, we are entering a new era of "cost and benefit realism" underpinned by environmentally friendly policies and we should challenge these historical practices at every opportunity if it can lead to resource and cost savings. In some cases the application engineer has no choice in the design autonomy; either follow a piece of local legislation (e.g. 4 h autonomy for a "life safety" application), or actually work out what is needed! An example of the latter would be for a remote site, off-grid, using integrated wind/solar power (without emergency generator back-up) where you may have to design-in several days' battery autonomy. This short paper proposes that a battery's autonomy should be related to the time expected for the system to be without the primary power source, balanced by the capital costs and commercial risk of power failure. To discuss this we shall consider the factors in selecting the autonomy time and other related aspects for high voltage battery systems used in facility-wide uninterruptible power supply (UPS) systems.
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Integrated System Health Management (ISHM) and Autonomy
Figueroa, Fernando; Walker, Mark G.
2018-01-01
Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.
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Autonomy and independence in language learning
Benson, Phil
2014-01-01
The topics of autonomy and independence play an increasingly important role in language education. They raise issues such as learners' responsibility for their own learning, and their right to determine the direction of their own learning, the skills which can be learned and applied in self-directed learning and capacity for independent learning and the extents to which this can be suppressed by institutional education. This volume offers new insights into the principles of autonomy and independence and the practices associated with them focusing on the area of EFL teaching. The editors' introduction provides the context and outlines the main issues involved in autonomy and independence. Later chapters discuss the social and political implications of autonomy and independence and their effects on educational structures. The consequences for the design of learner-centred materials and methods is discussed, together with an exploration of the practical ways of implementing autonomy and independence in language ...
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Petner-Arrey, Jami; Copeland, Susan R.
2015-01-01
This study from the south-western United States investigated the perceptions of persons with intellectual disability receiving support and of persons providing support regarding the autonomy of people with intellectual disability. The participants included 10 people with intellectual disability and 10 support workers. Through interviews, this…
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Autonomy support for autonomous motivation in medical education
Directory of Open Access Journals (Sweden)
Rashmi A. Kusurkar
2015-05-01
Full Text Available Background: Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion: Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion: Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.
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The Principalship, Autonomy, and After
Eacott, Scott
2015-01-01
Contemporary discourses in educational administration have exponentially grown the number of adjectival leaderships, challenged traditional organisational structures, and offered autonomy as a solution to performance issues. In this theoretical paper, I ask "what does the principalship look like after autonomy?" Despite the range of…
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Matos, Marta; Bernardes, Sónia F; Goubert, Liesbet; Beyers, Wim
2017-12-01
This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults' pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults' healthy ageing process, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Protecting autonomy as authenticity using Ulysses contracts.
van Willigenburg, Theo; Delaere, Patrick
2005-08-01
Pre-commitment directives or Ulysses contracts are often defended as instruments that may strengthen the autonomous self-control of episodically disordered psychiatric patients. Autonomy is understood in this context in terms of sovereignty ("governing" or "managing" oneself). After critically analyzing this idea of autonomy in the context of various forms of self-commitment and pre-commitment, we argue that what is at stake in using Ulysses contracts in psychiatry is not autonomy as sovereignty, but autonomy as authenticity. Pre-commitment directives do not function to protect autonomous self-control. They serve in upholding the guidance that is provided by one's deepest identity conferring concerns. We elucidate this concept of autonomy as authenticity, by showing how Ulysses contracts protect the possibility of being "a self."
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Markets & Myths: Autonomy in Public & Private Schools
Directory of Open Access Journals (Sweden)
Sandra Rubin Glass
1997-01-01
Full Text Available
School choice is the most controversial education policy issue of the 1990s. John Chubb and Terry Moe's Politics, Markets and America's Schools stimulated this investigation. They concluded that teacher and administrator autonomy was the most important influence on student achievement. They assumed that the organization of private schools offered greater autonomy resulting in higher student achievement and that the bureaucracy of public schools stifles autonomy limiting student achievement. The research undertaken here elaborates, elucidates, and fills in the framework of teacher and principal autonomy in public and private secondary schools. Interviews of more than thirty teachers and administrators in six high schools, observations, field notes, and analysis of documents collected in the field form the empirical base of this work. The sites included three private, independent, nondenominational secondary schools which are college preparatory and three public secondary schools noted for high graduation rates and offering numerous advanced placement courses.
The feelings expressed by both public and private school participants in this study testify to equally high degrees of autonomy. Issues that emerged from data analysis in this study which mitigate and shape autonomy include the following: conflicting and contradictory demands, shared beliefs, layers of protection, a system of laws, funding constraints and matters of size of the institution. These issues challenge oversimplified assertions that differences of any importance exist between the autonomy experienced by professionals in public and private high schools. This study reveals the complexity of the concept of autonomy and challenges the myth that teachers and principals in private schools enjoy autonomy and freedom from democratic bureaucracy that their public school counterparts do not.
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Autonomy, Vulnerability, Recognition, and Justice
Anderson, J.H.; Honneth, A.
2005-01-01
One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life,
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Núñez, Juan L; León, Jaime
2016-07-18
Self-determination theory has shown that autonomy support in the classroom is associated with an increase of students' intrinsic motivation. Moreover, intrinsic motivation is related with positive outcomes. This study examines the relationships between autonomy support, intrinsic motivation to learn and two motivational consequences, deep learning and vitality. Specifically, the hypotheses were that autonomy support predicts the two types of consequences, and that autonomy support directly and indirectly predicts the vitality and the deep learning through intrinsic motivation to learn. Participants were 276 undergraduate students. The mean age was 21.80 years (SD = 2.94). Structural equation modeling was used to test the relationships between variables and delta method was used to analyze the mediating effect of intrinsic motivation to learn. Results indicated that student perception of autonomy support had a positive effect on deep learning and vitality (p motivation to learn. These findings suggest that teachers are key elements in generating of autonomy support environment to promote intrinsic motivation, deep learning, and vitality in classroom. Educational implications are discussed.
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Radioiodine therapy of thyroid autonomy
Energy Technology Data Exchange (ETDEWEB)
Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)
2002-08-01
Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. {sup 131}I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)
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Radioiodine therapy of thyroid autonomy
International Nuclear Information System (INIS)
Reiners, Christoph; Schneider, Peter
2002-01-01
Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131 I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)
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The ADEPT Framework for Intelligent Autonomy
National Research Council Canada - National Science Library
Ricard, Michael; Kolitz, Stephan
2003-01-01
...) architecture for intelligent autonomy. Intelligent autonomy is the ability to plan and execute complex activities in a manner that provides rapid, effective response to stochastic and dynamic mission events...
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Rawls: The Problem of Autonomy and Coherentism
Directory of Open Access Journals (Sweden)
Elnora Gondim
2010-12-01
Full Text Available The transformation of the idea of autonomy into that of justice as equality modifies the work of Rawls taken as a whole. Thus, while in the Theory of Justice, a Kantian- type of autonomy is adopted, in Political Liberalism, autonomy is extended to the sphere of the political.
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Student Perceptions of Their Autonomy at University
Henri, D. C.; Morrell, L. J.; Scott, G. W.
2018-01-01
Learner autonomy is a primary learning outcome of Higher Education in many countries. However, empirical evaluation of how student autonomy progresses during undergraduate degrees is limited. We surveyed a total of 636 students' self-perceived autonomy during a period of two academic years using the Autonomous Learning Scale. Our analysis suggests…
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Progress in medicine: autonomy, oughtonomy and nudging.
Devisch, Ignaas
2011-10-01
In this article, I argue that we need a new perspective in the debate on autonomy in medicine, to understand many of the problems we face today - dilemmas that are situated at the intersection of autonomy and heteronomy, such as why well informed and autonomous people make unhealthy lifestyle choices. If people do not choose what they want, this is not simply caused by their lack of character or capability, but also by the fact that absolute autonomy is impossible; autonomous individuals are 'contaminated' by heteronymous aspects, by influences from 'outside'. Consequently, there are many good reasons to question the widely accepted hierarchical opposition of autonomy (progress) versus heteronomy (paternalism) in medicine. In an earlier article an analysis is made of the neologism 'oughtonomy' to support the thesis that when it comes down to human existence, autonomy and heteronomy are intertwined, rather than being merely opposites. In this article, I reflect upon how social conditions might improve our 'choice architecture', what Thaler & Sunstein have called 'nudging': how to change individual health choices without being paternalistic? I explore the extent to which both oughtonomy and nudging are able to challenge the question of autonomy in today's medicine. Autonomy may and should be a shared target in today's medicine, but we should never forget that it is always intertwined with heteronomy. Starting from this perspective, progress in medicine demands far more than the increase of autonomy. © 2011 Blackwell Publishing Ltd.
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Jones, Paul R; Brooks, John H M; Wylie, Ann
2013-11-01
Physicians are increasingly being called upon to promote physical activity (PA) among patients. However, a paucity of exercise medicine teaching in the UK undergraduate medical curricula prevents students from acquiring the necessary knowledge and skills to do so. To address this issue, King's College London School of Medicine introduced an exercise medicine strand of teaching. This study evaluated the acceptability of exercise promotion behaviour change lectures and explored the knowledge and attitudes of the students who received it. Students were invited to complete a 6-item online questionnaire prior to and after exercise medicine lectures. The questionnaire assessed beliefs regarding the importance of PA in disease prevention and management, in addition to their confidence in advising patients on PA recommendations. A focus group (n=7) explored students' attitudes towards and knowledge of PA promotion and exercise prescribing. In total, 121 (15%) first-year and second-year MBBS students completed the questionnaire. Students' beliefs regarding the importance of PA in managing disease and their confidence in PA promotion among patients increased after the teaching (pexercise medicine teaching, strongly supportive of its continued inclusion in the curriculum and advocated its importance for patients and themselves as future doctors. Behaviour change teaching successfully improved students' knowledge of and confidence regarding PA promotion. These improvements are a step forward and may increase the rates and success of physician PA counselling in the future.
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Kudomi, Yoshiyuki; Hosogane, Tsuneo; Inui, Akio
1999-01-01
Identifies three directions in the field of education reform in Japan that are in mutual opposition: (1) State Bureaucratic Control, (2) De-regulation and Marketization, and (3) Participation and (Local or School) Autonomy. Analyzes the process and mechanism of the opposition and compromise among these directions through three case studies. (CMK)
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Autonomy, nudging and post-truth politics.
Keeling, Geoff
2017-11-16
In his excellent essay, 'Nudges in a post-truth world', Neil Levy argues that 'nudges to reason', or nudges which aim to make us more receptive to evidence, are morally permissible. A strong argument against the moral permissibility of nudging is that nudges fail to respect the autonomy of the individuals affected by them. Levy argues that nudges to reason do respect individual autonomy, such that the standard autonomy objection fails against nudges to reason. In this paper, I argue that Levy fails to show that nudges to reason respect individual autonomy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Decision-Making Autonomy and Subsidiary Innovation
DEFF Research Database (Denmark)
Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt
2013-01-01
This paper investigates how decision-making autonomy affects the possibility and intensity of innovation in subsidiaries of multinational enterprises (MNEs). Subsidiaries are increasingly identified as sources of innovation and as vehicles for cross-border transfer of new competences. The question...... of how much decision-making autonomy subsidiaries should have is a core issue in the management of headquarters-subsidiary relationships. Using two complementary theoretical perspectives, we hypothesize a non-linear relationship between subsidiary’s decision-making autonomy and innovation. We test our...... hypothesis in a multi-country and multiindustry database based on survey evidence of 134 subsidiaries located in five Central and Eastern European countries from 23 home countries. The empirical results provide support for a non-linear U shaped relationship between subsidiary decision-making autonomy...
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Directory of Open Access Journals (Sweden)
Zhang Y
2016-12-01
Full Text Available Ying Zhang,1,* Richard Y Cao,2,* Xinling Jia,3,* Qing Li,1 Lei Qiao,1 Guofeng Yan,4 Jian Yang1 1Department of Rehabilitation, 2Laboratory of Immunology, Shanghai Xuhui Central Hospital, Shanghai Clinical Research Center, Chinese Academy of Sciences, 3School of Life sciences, Shanghai University, 4School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Stroke is one of the major causes of morbidity and mortality worldwide, which is associated with serious physical deficits that affect daily living and quality of life and produces immense public health and economic burdens. Both clinical and experimental data suggest that early physical training after ischemic brain injury may reduce the extent of motor dysfunction. However, the exact mechanisms have not been fully elucidated. The aim of this study was to investigate the effects of aerobic exercise on neuroprotection and understand the underlying mechanisms.Materials and methods: Middle cerebral artery occlusion (MCAO was conducted to establish a rat model of cerebral ischemia–reperfusion injury to mimic ischemic stroke. Experimental animals were divided into the following three groups: sham (n=34, MCAO (n=39, and MCAO plus treadmill exercise (n=28. The effects of aerobic exercise intervention on ischemic brain injury were evaluated using functional scoring, histological analysis, and Bio-Plex Protein Assays.Results: Early aerobic exercise intervention was found to improve motor function, prevent death of neuronal cells, and suppress the activation of microglial cells and astrocytes. Furthermore, it was observed that aerobic exercise downregulated the expression of the cytokine interleukin-1β and the chemokine monocyte chemotactic protein-1 after transient MCAO in experimental rats.Conclusion: This study demonstrates that treadmill exercise rehabilitation promotes neuroprotection against cerebral
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Psychological determinants of exercise behavior of nursing students.
Chan, Joanne Chung-Yan
2014-01-01
Though expected to be role models in health promotion, research has shown that nursing students often have suboptimal exercise behavior. This study explored the psychological factors associated with the exercise behavior of nursing students. A total of 195 first-year undergraduate nursing students completed a cross-sectional quantitative survey questionnaire, which included measures of their exercise behavior, the Physical Exercise Self-efficacy Scale, and the Exercise Barriers/Benefits Scale. The results showed that male students spent more time exercising and had higher exercise self-efficacy compared with female students, but there were no gender differences in the perceived barriers to or benefits of exercise. Fatigue brought on by exercising was the greatest perceived barrier to exercise, whereas increasing physical fitness and mental health were the greatest perceived benefits of exercise. Multiple linear regression showed that gender, exercise self-efficacy, perceived barriers to exercise, and perceived benefits of exercise were independent predictors of exercise behavior. Nurse educators can endeavor to promote exercise behavior among nursing students by highlighting the specific benefits of exercise, empowering students to overcome their perceived barriers to exercise, and enhancing students' exercise self-efficacy.
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School Autonomy, Leadership and Learning: A Reconceptualisation
Cheng, Yin Cheong; Ko, James; Lee, Theodore Tai Hoi
2016-01-01
Purpose: The purpose of this paper is to develop a framework for reconceptualising research on school autonomy to redress the limitations of traditional research, strengthen the conceptual links between school autonomy and learning outcomes and offer a range of new strategies for studying the interplay of school autonomy, leadership and learning.…
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Freedom of Expression, Deliberation, Autonomy, and Respect
DEFF Research Database (Denmark)
Rostbøll, Christian Fogh
for freedom of expression in terms of its relationship to different dimensions of autonomy. In response to the objection that Enlightenment theories pose a threat to cultures that reject autonomy, it is argued that autonomy-based democracy is not only compatible with but necessary for respect for cultural......The strongest versions of the democracy argument for freedom of expression rely on the deliberative conception of democracy. Deliberative democracy entails both an ideal of political autonomy and of autonomous preference formation. This paper elaborates the deliberative democracy argument...... diversity. On the basis of an intersubjective epistemology, I argue that citizens cannot know how to live on mutually respectful terms without engaging in public deliberation. Moreover, to be successful deliberation must foster some degree of personal autonomy, at least the ability to distinguish what...
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Buddhism and Autonomy-Facilitating Education
Morgan, Jeffrey
2013-01-01
This article argues that Buddhists can consistently support autonomy as an educational ideal. The article defines autonomy as a matter of thinking and acting according to principles that one has oneself endorsed, showing the relationship between this ideal and the possession of an enduring self. Three central Buddhist doctrines of conditioned…
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Perceptions of health promoters about health promotion ...
African Journals Online (AJOL)
2013-02-11
Feb 11, 2013 ... regarding a health promotion programme for families with ... to contribute to high rates of not going to school (ibid. ... sector in order, amongst other objectives, to prevent health ... exercise and mental health promotion must be incorporated ..... (2009:141) identified ignorance and misconception about the.
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Energy Technology Data Exchange (ETDEWEB)
Hayden, Nancy Kay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kleban, Stephen D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
2017-05-01
Sandia has identified autonomy as a strategic initiative and an important area for providing national leadership. A key question is, “How might autonomy change how we think about the national security challenges we address and the kinds of solutions we deliver?” Three workshops at Sandia early in 2017 brought together internal stakeholders and potential academic partners in autonomy to address this question. The first focused on programmatic applications and needs. The second explored existing internal capabilities and research and development needs. This report summarizes the outcome of the third workshop, held March 3, 2017 in Albuquerque, NM, which engaged Academic Alliance partners in autonomy efforts at Sandia by discussing research needs and synergistic areas of interest within the complex systems and system modeling domains, and identifying opportunities for partnering on laboratory directed and other joint research opportunities.
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Acute exercise remodels promoter methylation in human skeletal muscle
DEFF Research Database (Denmark)
Barrès, Romain; Yan, Jie; Egan, Brendan
2012-01-01
DNA methylation is a covalent biochemical modification controlling chromatin structure and gene expression. Exercise elicits gene expression changes that trigger structural and metabolic adaptations in skeletal muscle. We determined whether DNA methylation plays a role in exercise-induced gene ex...
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Directory of Open Access Journals (Sweden)
Yoshie Iwasaki
2017-03-01
Conclusion: Our study showed that exercise SE mediates goal-setting and increases PA. The results suggest that the components of PA promotion programs should be tailored to enhance participants' confidence in performing PA.
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Benefits of Exercise Training in Multiple Sclerosis.
Motl, Robert W; Sandroff, Brian M
2015-09-01
Exercise training represents a behavioral approach for safely managing many of the functional, symptomatic, and quality of life consequences of multiple sclerosis (MS). This topical review paper summarizes evidence from literature reviews and meta-analyses, supplemented by recent individual studies, indicating that exercise training can yield small but important improvements in walking, balance, cognition, fatigue, depression, and quality of life in MS. The paper highlights limitations of research on exercise training and its consequences and future research directions and provides an overview for promotion of exercise training in MS based on recent prescriptive guidelines. Collectively, the evidence for the benefits of exercise training in MS suggests that the time is ripe for the promotion of exercise by healthcare providers, particularly neurologists as a central part of the clinical care and management of MS patients.
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Viswan, Saritha P; Ravindran, T K Sundari; Kandala, Ngianga-Bakwin; Petzold, Max G; Fonn, Sharon
2017-01-01
The persistent low contraceptive use and high fertility in Nigeria despite improvements in educational achievements calls for an examination of the role of factors, which may moderate the use of modern contraception. This article explores the influence of sexual autonomy on the use of modern contraceptive methods among women and its relative importance compared with other, more traditional, indicators of women's autonomy such as education and occupation. Data from two Demographic and Health Surveys (DHS), 2008 and 2013, were used in this study. An index of sexual autonomy was constructed by combining related DHS variables, and its association with current use of modern contraception was examined at each time point as well as over time using multivariate regression analysis. The observed prevalence for use of modern contraception was 2.8 and 2.6 times higher among women who had high sexual autonomy in 2008 and 2013, respectively. The corresponding figures for women with secondary or higher education were 8.2 and 11.8 times higher, respectively, compared with women with no education. But after controlling for wealth index, religion, place of residence, autonomy and experience of intimate partner violence (IPV), the likelihood of use of modern contraception was lowered to about 2.5 (from 8.2) and 2.8 (from 11.8) times during 2008 and 2013, respectively, among women with secondary or higher education. The likelihood of use of modern contraception lowered only to 1.6 (from 2.8) and 1.8 (from 2.6) times among women with high sexual autonomy after controlling for other covariates, respectively, during the same period. Sexual autonomy seems to play an important role in women's use of modern contraceptive methods independent of education and a number of other factors related to women's status. Sexual autonomy needs to be simultaneously promoted alongside increasing educational opportunities to enhance women's ability to use modern contraception.
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Factors Contributing to the Uptake and Maintenance of Regular Exercise Behaviour in Emerging Adults
Langdon, Jody; Johnson, Chad; Melton, Bridget
2017-01-01
Objective: To identify the influence of parental autonomy support, basic need satisfaction and motivation on emerging adults' physical activity level and exercise behaviours. Design: Cross-sectional survey. Setting: This study convenience-sampled approximately 435 college students identified as emerging adults--aged 18-25 years, who did not have a…
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Motivational and evolutionary aspects of a physical exercise training program: a longitudinal study
Rosa, João P. P.; de Souza, Altay A. L.; de Lima, Giscard H. O.; Rodrigues, Dayane F.; de Aquino Lemos, Valdir; da Silva Alves, Eduardo; Tufik, Sergio; de Mello, Marco T.
2015-01-01
Several studies have indicated that motivational level and prior expectations influence one’s commitment to physical activity. Moreover, these aspects are not properly described in terms of proximal (SDT, Self Determination Theory) and distal (evolutionary) explanations in the literature. This paper aims to verify if level of motivation (BREQ-2, Behavioral Regulation in Exercise Questionnaire-2) and expectations regarding regular physical exercise (IMPRAF-54) before starting a 1-year exercise program could determine likelihood of completion. Ninety-four volunteers (53 women) included a completed protocol group (CPG; n = 21) and drop-out group (n = 73). The IMPRAF-54 scale was used to assess six different expectations associated with physical activity, and the BREQ-2 inventory was used to assess the level of motivation in five steps (from amotivation to intrinsic motivation). Both questionnaires were assessed before starting a regular exercise program. The CPG group presented higher sociability and lower pleasure scores according to IMPRAF-54 domains. A logistic regression analysis showed that a one-point increment on sociability score increased the chance of completing the program by 10%, and the same one-point increment on pleasure score reduced the chance of completing the protocol by 16%. ROC curves were also calculated to establish IMPRAF-54 cutoffs for adherence (Sociability – 18.5 points – 81% sensibility/50% specificity) and dropout (Pleasure – 25.5 points – 86% sensibility/20% specificity) of the exercise protocol. Our results indicate that an expectation of social interaction was a positive factor in predicting adherence to exercise. Grounded in SDT and its innate needs (competence, autonomy, relatedness), physical exercise is not an end; it is a means to achieve autonomy and self-cohesion. The association of physical activity with social practices, as occurs in hunter-gathering groups, can engage people to be physically active and can provide
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Perceived autonomy in the first semester of mathematics studies
Liebendörfer, Michael; Hochmuth, Reinhard
2015-01-01
International audience; We focus on the perceived autonomy of mathematics students in their first semester at university. According to self-determination theory by Deci and Ryan (1985), students have to satisfy their need for autonomy in order to develop intrinsic motivation. Using two facets of autonomy, we analyse interview data to explore which situations foster or hinder the students' perceived autonomy. The main factors affecting students' autonomy are briefly discussed.
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Energy Technology Data Exchange (ETDEWEB)
Hillenhinrichs, H.; Emrich, D. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin
1998-05-01
Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global {sup 99m}Tc thyroid uptake of {>=}3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [Deutsch] Analyse der funktionellen Autonomie in der euthyreoten Phase. Methoden: Es wurden 163 klinisch euthyreote Patienten mit Jodmangelstruma ohne und 179 mit funktioneller Autonomie anhand von Geschlechtsverhaeltnis, Lebensalter, Beschwerden, Symptomen, sonographischem Befund, qualitativer und quantitativer Szintigraphie ohne und mit Suppression, TRH-Test, Hormonkonzentrationen und Jodausscheidung im Urin verglichen. Ergebnisse: Lebensalter, Beschwerden und Symptome, Schilddruesenvolumen und Echomuster lieferten keinen ausreichend sicheren Beitrag zur Diagnose. Die quantitative Szintigraphie war dem TRH-Test ueberlegen. Erhoehte Hormonkonzentrationen ergaben sich bei 15% der Patienten mit funktioneller Autonomie. Als Grenzwert fuer ein erhoehtes spontanes Hyperthyreoserisiko wurde eine globale thyreoidale {sup 99m}Tc-Aufnahme unter Suppression von {>=}3% ermittelt, die in 20% der Patienten mit funktioneller
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Learner autonomy development through digital gameplay
Directory of Open Access Journals (Sweden)
Alice Chik
2011-04-01
Full Text Available Playing digital games is undeniably a popular leisure activity, and digital gaming is also gaining academic attention and recognition for enhancing digital literacies and learning motivation. One tricky issue when exploring digital gaming in Asian contexts is the popularity of English and Japanese games. Though Chinese and Korean online games are readily available, many of the more popular commercial off-the-shelf (COTS digital games are in English and Japanese. Students in Hong Kong are required to take English as a foreign language, which resulted in a huge range of proficiency, but Japanese is not offered at public schools. So, most Hong Kong gamers are playing foreign language games. Yet language barriers do not diminish the market demand for foreign language digital games. This paper explores the phenomenon of digital gaming in foreign languages. Based on findings from an on-going research project with ten undergraduate video gamers (F=4, M=6, this paper argues that gamers exercise learner autonomy by managing their gaming both as leisure and learning experiences.
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The Path Forward: School Autonomy and Its Implications for the Future of Boston's Public Schools
French, Dan; Miles, Karen Hawley; Nathan, Linda
2014-01-01
This study explores the question of how Boston Public Schools (BPS) can strengthen and support autonomy and accountability across its portfolio to promote innovation and expand access to equity and high performance. Some of the specific questions guiding this work are: (1) Should all schools within BPS operate within autonomous structures? (2) Is…
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Freedom of Expression, Deliberation, Autonomy and Respect
DEFF Research Database (Denmark)
Rostbøll, Christian F.
2011-01-01
This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy...... is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms without engaging in public deliberation and develop some degree of personal autonomy. While freedom...... of expression is indispensable for deliberation and autonomy, this does not mean that people have no obligations regarding how they speak to each other. The moral insights provided by deliberation depend on the participants in the process treating one another with respect. The argument is related to the Danish...
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The Autonomy Activity Status of Multinational Subsidiaries
DEFF Research Database (Denmark)
Dzikowska, Marlena; Gammelgaard, Jens; Jindra, Björn
Research concerning the autonomy of subsidiaries has been concentrated on the possession of decision-making rights. Building on the definitional and empirical argumentation, we claim that so understood autonomy has a prospective character, is not equal to the implementation of actual actions (or...... lack of thereof) and neglects the issue of the scope of potential actions. This paper aims to fill in the current literature gap by offering a holistic stance in which we assert that subsidiaries can be meaningfully differentiated according to their levels of autonomy and corresponding actions. We base...... this argumentation on the findings of real option theory and competitive dynamics perspective, develop a typology specific to a subsidiary’s autonomy activity status (the position of a subsidiary in terms of its autonomy level confronted with the extent of actions taken in a corresponding area). We evaluate...
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Concept analysis: patient autonomy in a caring context.
Lindberg, Catharina; Fagerström, Cecilia; Sivberg, Bengt; Willman, Ania
2014-10-01
This paper is a report of an analysis of the concept of patient autonomy Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Concept analysis. Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context. © 2014 John Wiley & Sons Ltd.
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Validation of the Basic Psychological Needs in Exercise Scale in a Portuguese sample.
Moutão, João Miguel Raimundo Peres; Serra, Luis Filipe Cid; Alves, José Augusto Marinho; Leitão, José Carlos; Vlachopoulos, Symeon P
2012-03-01
In line with self-determination theory (SDT: Deci & Ryan, 1985, 2002) the satisfaction of the basic psychological needs for autonomy, competence, and relatedness has been identified as an important predictor of behavior and optimal functioning in various contexts including exercise. The lack of a valid and reliable instrument to assess the extent to which these needs are fulfilled among Portuguese exercise participants limits the evaluation of causal links proposed by SDT in the Portuguese exercise context. The aim of the present study was to translate into Portuguese and validate the Basic Psychological Needs in Exercise Scale (BPNES: Vlachopoulos & Michailidou, 2006). Using data from 522 exercise participants the findings provided evidence of strong internal consistency of the translated BPNES subscales while confirmatory factor analysis supported a good fit of the correlated 3-factor model to the data. The present findings support the use of the translated into Portuguese BPNES to assess the extent of basic psychological need fulfilment among Portuguese exercise participants.
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Personal Autonomy and Rational Suicide.
Webber, May A.; Shulman, Ernest
That certain suicides (which can be designated as rational) ought not to be interfered with is closely tied to the notion of the "right to autonomy." Specifically it is because the individual in question has this right that interference is prohibited. A proper understanding of the right to autonomy, while essential to understanding why…
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Teacher Autonomy: Power or Control?
Lawson, Tony
2004-01-01
The article explores the issue of teacher autonomy in relation to its potential for freedom or control. It examines the concept of empowerment as applied to education, arguing that, although it is traditionally cast as a means of achieving autonomy, an alternative approach sees empowerment as part of the disciplinary apparatus of late modern…
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Cutrona, Carolyn E; Russell, Daniel W
2017-02-01
Adult attachment theory provides guidance for providing optimal social support in intimate relationships. According to attachment theory, facilitating autonomy (secure base support) sometimes is more important than providing nurturance (safe haven support). In addition, it is important that couples celebrate one another's triumphs and successes (another form of secure base support). A key construct that explains the development of attachment is responsiveness to the individual's needs. Support that is delivered in a responsive manner (i.e., that leads the individual to feel understood, validated, and cared for) is more likely to enhance the relationship and less likely to damage self-esteem than assistance that is not responsive. A responsive exchange is more likely if emotion dysregulation can be prevented. Attachment theory offers explanations for why people vary in their effectiveness at emotion regulation. Appropriate emotion regulation is more likely if disclosures of current difficulties can be made in a way that is not defensive or accusatory, an ability that varies as a function of attachment orientation. Attachment theory also offers guidance regarding the optimal forms of social support for specific individuals. All these insights from adult attachment theory can be integrated into interventions to help couples become more effective support providers. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Garcia, A W; Broda, M A; Frenn, M; Coviak, C; Pender, N J; Ronis, D L
1995-08-01
This study examined gender and developmental differences in exercise-related beliefs and exercise behaviors of 286 racially diverse youth and explored factors predictive of exercise. Compared to males, females reported less prior and current exercise, lower self-esteem, poorer health status, and lower exercise self-schema. Adolescents, in contrast to pre-adolescents, reported less social support for exercise and fewer exercise role models. In a path model, gender, the benefits/barriers differential, and access to exercise facilities and programs directly predicted exercise. Effects of grade, perceived health status, exercise self-efficacy, social support for exercise, and social norms for exercise on exercise behavior, were mediated through the benefits/barriers differential. Effect of race on exercise was mediated by access to exercise facilities and programs. Continued exploration of gender and developmental differences in variables influencing physical activity can yield valuable information for tailoring exercise promotion interventions to the unique needs of youth.
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Oppression, Autonomy and the Impossibility of the Inner Citadel
Nelsen, Peter
2010-01-01
This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account…
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Matos, Marta; Bernardes, Sónia F
2013-09-01
Development and preliminary validation of a Portuguese measure of perceived Formal Social Support for Autonomy and Dependence in Pain (FSSADI_PAIN). One hundred and fifty-one older adults (88.1% women), between 56 and 94 years of age (M = 75.41; SD = 9.11), who attended one of the following institutions--day care centre (33.1%), nursing home (36.4%) and senior university (30.5%)--were recruited for this study. Along with the FSSADI_PAIN, participants filled out the Portuguese versions of the Brief Pain Inventory (Azevedo et al., 2007, Dor, 15, 6) and the Social Support Scale of Medical Outcomes Survey (Pais-Ribeiro & Ponte, 2009, Psicologia, Saúde & Doença, 10, 163). The factorial structure reflected the functions of perceived promotion of (1) dependence and (2) autonomy, showing good internal consistency (α > .70) and sensitivity indices. The FSSADI_PAIN showed good content, discriminant and criterion validity; it differentiated the perceptions of promotion of dependence/autonomy according to individual's pain severity and disability, as well as the type of institution. These preliminary findings suggest that the FSSADI_PAIN is an innovative and promising measure of perceived formal social support adapted to pain-related contexts. © 2012 The British Psychological Society.
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Kachanoff, Frank J; Taylor, Donald M; Caouette, Julie; Khullar, Thomas H; Wohl, Michael J A
2018-01-11
Four studies assessed the potentially detrimental effects that restrictions to collective autonomy (i.e., a group's freedom to determine and practice its own identity) may have for the personal autonomy and psychological well-being of group members. In Study 1, using 3 distinct samples (NSample1a = 123, NSample1b = 129, NSample1c = 370), correlational and cross-cultural evidence indicates that perceived restrictions to the collective autonomy of one's group is directly associated with reduced personal autonomy, and indirectly associated with diminished well-being through personal autonomy. In Study 2 (N = 411), a longitudinal assessment of group members over 3 time-points during a 4-month period found that group members who perceived greater collective autonomy restriction also experienced reduced personal autonomy, and in turn, reduced psychological well-being over time. In Study 3 (N = 255), group members described a time during which their ingroup had (or did not have) its collective autonomy unduly restricted by other groups. Participants who were primed to think that their group lacked collective autonomy reported reduced feelings of personal autonomy, and reduced psychological well-being (compared with those primed to think their group had collective autonomy). In Study 4 (N = 389), collective autonomy was manipulated within the context of an intensive laboratory simulation. Collective autonomy-restricted group members experienced less personal autonomy than those who did not have their collective autonomy restricted. Together these findings suggest that restrictions to a group's collective autonomy may have detrimental consequences for the personal autonomy and psychological well-being of group members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Van Dalsem, William; Krishnakumar, Kalmanje Srinivas
2016-01-01
This is a powerpoint presentation that highlights autonomy across the 15 NASA technology roadmaps, including specific examples of projects (past and present) at NASA Ames Research Center. The NASA technology roadmaps are located here: http:www.nasa.govofficesocthomeroadmapsindex.html
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Aerobic vs anaerobic exercise training effects on the cardiovascular system
Patel, Harsh; Alkhawam, Hassan; Madanieh, Raef; Shah, Niel; Kosmas, Constantine E; Vittorio, Timothy J
2017-01-01
Physical exercise is one of the most effective methods to help prevent cardiovascular (CV) disease and to promote CV health. Aerobic and anaerobic exercises are two types of exercise that differ based on the intensity, interval and types of muscle fibers incorporated. In this article, we aim to further elaborate on these two categories of physical exercise and to help decipher which provides the most effective means of promoting CV health.
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Katz, Idit; Shahar, Bat-Hen
2015-01-01
Findings from several studies suggest that teachers who embrace an autonomy-supportive style vis-à-vis their students promote student motivation. However, the question of what makes teachers adopt this supportive style remains unanswered. Using Self-Determination Theory as a framework, we suggest that teachers' own motivation and their beliefs…
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Background Choice promotes the experience of autonomy, which enhances intrinsic motivation. Providing a greater choice of traditional active toys may increase children’s activity time. Mastery also increases intrinsic motivation and is designed into exergames, which may increase play time of a singl...
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Promoting Dignity: The Ethical Dimension of Health.
Buchanan, David R
2016-01-01
The article examines the limitations of a strict scientific account of the causes of unhealthy behaviors, based on the standards promoted in evidence-based medicine, where randomized controlled trials are seen to provide the gold standard for establishing the validity of different explanations. The article critiques this account based on its disputed assumption that human free will does not exist, and thus, human autonomy and moral responsibility are an illusion. By denying human autonomy, the naturalistic paradigm also denies the possibility of human dignity. In contrast, the article describes and explains a humanistic account of human agency where human beings are characterized by the capacity to choose how to live their lives based on values that matter. Based on this humanistic framework, the article explains why dignity is an essential dimension of human health and well-being and describes key research challenges in moving the field of health promotion in a more humanistic direction. The article concludes with the recommendation to expand the goal of health promotion beyond physical fitness and to reorient the methods of research toward articulating values that matter and promoting human dignity. © The Author(s) 2016.
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Autonomy, recognition and education
Directory of Open Access Journals (Sweden)
Angelo Vitório Cenci
2015-01-01
Full Text Available This paper addresses Honneth’s concept of autonomy from two dimensions of his work, distinct, though inseparable. The first one is suggested through the subject’s positive practical self-relation linked to the patterns of reciprocal recognition of love, right and social esteem; the second is formulated as non-centered autonomy opposed to the present-day criticism of the modern autonomous subject encompassing three levels, namely: the capacity of linguistic articulation, the narrative coherence of life and the complementation of being guided by principles with some criteria of moral sensitivity to the context. We defend the position that, by metaphysically anchoring the concept of autonomy onto the intersubjective assumptions of his/her theory of the subject, and exploring it linked to the subject’s positive practical self-relation and to a non-centered meaning, Honneth has managed to renew it, which allows drawing important consequences of such effort to the field of education.
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Gallagher, Kristel M; Updegraff, John A
2011-07-01
A unique aspect of exercise is that people may choose to engage in it to achieve a variety of outcomes, ranging from extrinsic (appearance, health) to intrinsic (satisfaction, enjoyment). We examined how the impact of gain- vs. loss-framed messages depends on the type of outcome emphasised. Drawing from regulatory focus theory (Higgins, E.T. (1997). Beyond pleasure and pain. American Psychologist, 52, 1280-1300; Higgins, E.T. (2000). Making a good decision: Value from fit. American Psychologist, 55, 1217-1230), we predicted that gain-framed messages would 'fit' with intrinsic outcomes and loss-framed messages would 'fit' with extrinsic outcomes, but the effect of such fit on physical activity would depend on the participants' need for cognition (NC). We tested these hypotheses with a sample of 176 sedentary young adults who read an exercise message with randomly assigned frame (gain/loss) and outcome (intrinsic/extrinsic). Participants provided daily reports of exercise over the following week. The predicted interaction between frame, outcome and NC was found (p=0.001) such that a 'fit' message promoted somewhat, but not significantly, greater exercise for those with high NC, but a 'non-fit' message promoted significantly greater exercise for those with low NC. Furthermore, differences in physical activity were partially mediated by attitudes towards exercise. Findings shed light on how the outcomes and motivations associated with physical activity shape people's behavioural responses to framed health communications. © 2011 Taylor & Francis
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ROS and myokines promote muscle adaptation to exercise
DEFF Research Database (Denmark)
Scheele, Camilla; Nielsen, Søren; Pedersen, Bente K
2009-01-01
in skeletal muscle. In fact, it seems that exercise-induced ROS are able to stimulate cytokine production from skeletal muscle. Despite the initial view that ROS were potentially cell damaging, it now seems possible that these substances have important roles in the regulation of cell signaling. Muscle......-derived cytokines, so-called 'myokines', are distinguished from inflammation and instead possess important anti-inflammatory and metabolic properties. In this opinion piece, we suggest that both ROS and myokines are important players in muscle adaptation to exercise....
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Volitional Trust, Autonomy Satisfaction, and Engagement at Work.
Heyns, Marita; Rothmann, Sebastiaan
2018-02-01
This study tested a structural model that identifies the nature of relationships between trust, autonomy satisfaction, and personal engagement at work. A cross-sectional survey design with a convenience sample ( n = 252) was used. The Behavioral Trust Inventory, Work-Related Basic Need Satisfaction Scale, and Work Engagement Scale were administered. While reliance-based trust did not have a significant influence on engagement, disclosure-based trust in a focal leader was found to predict satisfaction of autonomy needs and employee engagement. Mediation analyses revealed that satisfaction of the need for autonomy facilitates the influence of trust on work outcomes. More specifically, disclosure (a dimension of trust) impacted engagement via autonomy satisfaction. Overall, the model explained 44% of total variance in engagement, to which the variables proportionately contributed as follows: autonomy satisfaction = 79.58%, disclosure = 18.22%, and reliance = 2.20%. The findings provide possible directions for how leaders can leverage trust to facilitate autonomy support and higher levels of engagement.
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Teacher Autonomy Perceptions of Iranian and Turkish EFL Teachers
Directory of Open Access Journals (Sweden)
Ebrahim KHEZERLOU
2013-07-01
Full Text Available The study aimed at examining Iranian (N= 218 and Turkish (N=142 high school EFL teachers’ opinions about teacher autonomy over (a the choice of appropriate teaching methods, strategies and techniques and implementation of the established curriculum (b teacher involvement in decision making processes and (c teachers’ use of personal initiative in solving their work problems. An 11-item questionnaire (α= .758 was used to measure autonomy perceptions of the participants. The results revealed that Turkish teachers’ autonomy perceptions were greater than that of Iranian teachers in the three teacher autonomy dimensions. Moreover, it was observed that male and master- holder teachers perceive less autonomy than female and bachelor-holder ones; whereas, no significant relationship were observed for the age and marital status variables with any teacher autonomy dimensions. Lastly, decision making dimension was the strongest predictor of teacher autonomy among both Iranian and Turkish teachers.
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Durand, Guillaume
What does patient autonomy mean? If an autonomous choice is defined as an objective and rational choice, is the doctor's prescription not always the best route? Our contemporary democracies are marked by moral and religious pluralism which obliges society to respect a multiplicity of choices of existence. Three levels are important in terms of autonomy: a range of intellectual capacities, freedom with regard to constraints (external and internal), the capacity to be in control of one's existence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
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Emotional autonomy and depression among Chinese adolescents.
Chou, K L
2000-06-01
Depression is quite common among young people in Hong Kong Chinese society. This study examined the association between emotional autonomy and depressive symptomatology among Chinese young people in Hong Kong. The respondents were 512 young people between 16 and 18 years of age from a cross-sectional study in Hong Kong. Significant bivariate relationships were found between depressive symptomatology and three dimensions of emotional autonomy (individuation, nondependency on parents, and deidealization of parents). Using multiple regression models, the author found that depressive symptomatology was associated with two aspects of emotional autonomy: individuation and deidealization of parents. Results indicate that the relationships between depressive symptomatology and these three aspects of emotional autonomy are similar in both individualistic and collectivistic societies.
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Resident Autonomy in the Operating Room: Expectations Versus Reality.
Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M
2017-09-01
There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application. A separate "expected autonomy" survey elicited faculty and resident perceptions of how much autonomy a resident should have for six common operations: decortication, wedge resection, thoracoscopic lobectomy, coronary artery bypass grafting, aortic valve replacement, and mitral valve repair. Thirty-three trainees from 7 institutions submitted evaluations of 596 cases over 18 months (March 2015 to September 2016). Thirty attendings subsequently provided their evaluation of 476 of those cases (79.9% response rate). Expected autonomy surveys were completed by 21 attendings and 19 trainees from 5 institutions. The six operations included in the survey constituted 47% (226 of 476) of the cases evaluated. Trainee and attending expectations did not differ significantly for senior trainees. Both groups expected significantly higher levels of autonomy than observed in the operating room for all six types of cases. Although faculty and trainees both expect similar levels of autonomy in the operating room, real-time measurements of autonomy show a gap between expectations and reality. Decreasing this gap will require a concerted effort by both faculty and residents to focus on the development of independent operative skills. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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Chen, Yi-Ching; Ho, Ching-Wen; Tsai, Hsing-Hua; Wang, Jong-Shyan
2015-04-01
Acute hypoxic exposure increases vascular thrombotic risk. The release of procoagulant-rich microparticles from neutrophils accelerates the pathogenesis of inflammatory thrombosis. The present study explicates the manner in which interval and continuous exercise regimens affect neutrophil-derived microparticle (NDMP) formation and neutrophil/NDMP-mediated thrombin generation (TG) under hypoxic condition. A total of 60 sedentary males were randomized to perform either aerobic interval training [AIT; 3-min intervals at 40% and 80% V̇O2max (maximal O2 consumption)] or moderate continuous training (MCT; sustained 60% V̇O2max) for 30 min/day, 5 days/week for 5 weeks, or to a control (CTL) group who did not receive any form of training. At rest and immediately after hypoxic exercise test (HE, 100 W under 12% O2 for 30 min), the NDMP characteristics and dynamic TG were measured by flow cytometry and thrombinography respectively. Before the intervention, HE (i) elevated coagulant factor VIII/fibrinogen concentrations and shortened activated partial thromboplastin time (aPTT), (ii) increased total and tissue factor (TF)-rich/phosphatidylserine (PS)-exposed NDMP counts and (iii) enhanced the peak height and rate of TG promoted by neutrophils/NDMPs. Following the 5-week intervention, AIT exhibited higher enhancement of V̇O2max than did MCT. Notably, both MCT and AIT attenuated the extents of HE-induced coagulant factor VIII/fibrinogen elevations and aPTT shortening. Furthermore, the two exercise regimens significantly decreased TF-rich/PS-exposed NDMP formation and depressed neutrophil/NDMP-mediated dynamic TG at rest and following HE. Hence, we conclude that AIT is superior to MCT for enhancing aerobic capacity. Moreover, either AIT or MCT effectively ameliorates neutrophil/NDMP-promoted TG by down-regulating expression of procoagulant factors during HE, which may reduce thrombotic risk evoked by hypoxia. Moreover, either AIT or MCT effectively ameliorates neutrophil/NDMP-promoted
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Radioiodine-treatment (RIT) of functional thyroidal autonomy
International Nuclear Information System (INIS)
Meller, J.; Sahlmann, C.O.; Becker, W.
2002-01-01
Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)
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Netherlands: Steady decline in job autonomy
Muller, J.; Hooftmann, W.; Houtman, I.L.D.
2015-01-01
Research shows that job autonomy has predominantly positive effects, such as the prevention of stress, burnout and cardiovascular disease. Employees with a good deal of autonomy generally report better well-being, are more productive, more creative, have more self-esteem and have higher work
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Advancing Learner Autonomy in TEFL via Collaborative Learning
Jacobs, George M.; Shan, Tan Hui
2015-01-01
The present paper begins by situating learner autonomy and collaborative learning as part of a larger paradigm shift towards student-centred learning. Next are brief discussions of learner autonomy and how learner autonomy links with collaborative learning. In the main part of the paper, four central principles of collaborative learning are…
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A Reconfigurable Testbed Environment for Spacecraft Autonomy
Biesiadecki, Jeffrey; Jain, Abhinandan
1996-01-01
A key goal of NASA's New Millennium Program is the development of technology for increased spacecraft on-board autonomy. Achievement of this objective requires the development of a new class of ground-based automony testbeds that can enable the low-cost and rapid design, test, and integration of the spacecraft autonomy software. This paper describes the development of an Autonomy Testbed Environment (ATBE) for the NMP Deep Space I comet/asteroid rendezvous mission.
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Klain, Ingi Petitemberte; de Matos, Dihogo Gama; Leitão, José Carlos; Cid, Luís; Moutão, João
2015-01-01
This research aimed to analyze the validity of the relations hypothesized by the theory of self-determination in predicting adherence to physical exercise in fitness academy users and subjects following personal training. A total of 588 persons from Pelotas / RS / Brazil (405 gym users and 183 subjects following personal training) completed the Portuguese version of the three questionnaires, i.e. the Perceived Autonomy Support Climate Exercise Questionnaire, Basic Psychological Needs in the Exercise Scale and Behavioral Regulation in the Exercise Questionnaire −2. The results support the factorial structure of the questionnaires used in this sample. There was a significant multivariate effect of context on self-determination for physical exercise training [Wilks’ λ = 0.934, F (10, 576.000) = 4.03, p amotivation and external regulation were significantly higher in the context of fitness academies. PMID:26240667
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Chan, Shu-Ya; Kuo, Chang-Chih; Chen, Kuei-Min; Tseng, Wei-Shyuan; Huang, Hsin-Ting; Li, Chun-Huw
2016-06-01
Studies indicate that the incidence of disease, the mortality rate, and medical costs are significantly higher in people aged 65 years and over who do not engage in physical activities than in their peers who do engage in these activities. Therefore, promoting appropriate physical activity among older adults in the community is essential to delaying the health implications of aging. This pilot test was developed to assess the effectiveness of a newly developed Senior Elastic Band (SEB) exercise program on the health of older adults in community care stations. A quasiexperimental design was used. A convenience sample of 20 participants from a community care station was recruited. The SEB intervention included three phases (warm-up, aerobic motion, and static stretching) and was conducted three times per week, 40 minutes per session for 1 month. Twelve health indicators in three categories (functional fitness, self-perceived health status, and sleep quality) were examined before and immediately after 1 month of SEB exercises. Participants showed improved performance at the end of the 1-month study for the following indicators: lung capacity, cardiopulmonary fitness, upper and lower body flexibilities, upper limb muscle power, lower limb muscle endurance, and self-perceived physical health status (all ps exercise program shows preliminary and promising effects on improving the health of older adults in a community care station. Healthcare professionals who work with older adults living in the community may consider the SEB exercise program as a health promotion modality to recommend and implement with this population. However, we recommend further testing the long-term effects of this program on a larger population.
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Dizziness, Physical Exercise, Falls, and Depression in Adults and the Elderly
Directory of Open Access Journals (Sweden)
Teixeira, Adriane Ribeiro
2015-11-01
Full Text Available Introduction Dizziness is a symptom that can lead to falls, which, in turn, undermine onés independence and autonomy, leading to several comorbidities. The practice of physical exercise, however, can help prevent falls. Objective The objective of this study is to confirm the association between physical exercise, dizziness, probability of falling, and depressive symptoms in a group of middle-aged adults and seniors. Methods The authors evaluated subjects based on history, the Geriatric Depression Scale, and functional reach test. Results The sample consisted of 90 individuals with a mean age of 69.3 ± 6.8 years. The authors found that 37.8% had been practicing exercise, 33.7% had depressive symptoms, and their probability of falling was above average in the functional reach test. Conclusion The results of this study indicated an association between dizziness, exercise practice and depressive symptoms, indicating that physical activity is a beneficial factor for the aging population.
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Taylor, Ian M; Lonsdale, Chris
2010-10-01
Using basic psychological needs theory (BPNT; Ryan & Deci, 2000) as our guiding framework, we explored cultural differences in the relationships among physical education students' perceptions of teacher autonomy support, psychological need satisfaction, subjective vitality and effort in class. Seven hundred and fifteen students (age range from 13 to 15 years) from the U.K. and Hong Kong, China, completed a multisection inventory during a timetabled physical education class. Multilevel analyses revealed that the relationships among autonomy support, subjective vitality and effort were mediated by students' perceptions of psychological need satisfaction. The relationship between autonomy support and perceptions of competence was stronger in the Chinese sample, compared with the U.K. sample. In addition, the relationship between perceptions of relatedness and effort was not significant in the Chinese students. The findings generally support the pan-cultural utility of BPNT and imply that a teacher-created autonomy supportive environment may promote positive student experiences in both cultures.
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Directory of Open Access Journals (Sweden)
Ricardo Marquisio Aguirre
2017-10-01
Full Text Available Some elements of the ideal of moral autonomy are discussed in this paper. Such ideal is a key assumption in social practices focused on normative imputation, particularly morality and law. First, a constructivist conception of normativity is introduced, taking reasons as an essential and non-reducible element, and focused on the conceptual features of moral reasons within the normative domain. Then, an idea of moral autonomy based on the self-constitution is developed including three key features: the possibility of responding to reasons based on shared social expectations; the responsibility for certain scope of actions, according to a set of reasons available to the individual and to their maximum extent of expansion; and the need to preserve autonomy as a purpose unifying the set of autonomous actions of moral agents.
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How important is Autonomy to Professional Workers?
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Arne Mastekaasa
2011-11-01
Full Text Available A common assumption is that autonomy is crucial to professional workers. I examine this using survey data on a sample of public sector welfare professionals, viz. medical doctors, nurses, teachers, social workers. Comparisons are made with general population data from the International Social Survey Programme. Two methods of assessing the importance of work autonomy are employed; respondents’ direct ratings and statistical associations between work autonomy (and other job characteristics on the one hand and job satisfaction and organizational commitment on the other. Findings: Autonomy is not rated as more important among the professionals than in the general population, and neither is it more strongly related to job satisfaction. Interesting work and workplace social support appear to be more central.
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Exercise Video Games and Exercise Self-Efficacy in Children.
Dos Santos, Hildemar; Bredehoft, Margaret Dinhluu; Gonzalez, Frecia M; Montgomery, Susanne
2016-01-01
The aim of this article was to investigate the use of exergaming in promoting exercise behavior among children and to examine the impact of the intervention on participants' exercise self-efficacy, in addition to assessing physiological changes. A sample of 55 children enrolled in the Family Fit program, where participants were categorized into 2 groups: healthy weight and overweight. Measures were taken at baseline, after the 7-week program, at the 12-week follow-up, and at the 24-month follow-up. Positive changes in exercise self-efficacy were significant for the overweight group, while the healthy weight group maintained their exercise self-efficacy. At the 24-month follow-up, 97% children reported being interested in participating in a future fitness program, and 96% children who did not play sports before the intervention started practicing sports. Exercise self-efficacy is a predictor of physical activity, and incorporating exergaming in a structured program may lead to increased self-efficacy in participants.
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Exercise Video Games and Exercise Self-Efficacy in Children
Directory of Open Access Journals (Sweden)
Hildemar Dos Santos MD, DrPH
2016-04-01
Full Text Available The aim of this article was to investigate the use of exergaming in promoting exercise behavior among children and to examine the impact of the intervention on participants’ exercise self-efficacy, in addition to assessing physiological changes. A sample of 55 children enrolled in the Family Fit program, where participants were categorized into 2 groups: healthy weight and overweight. Measures were taken at baseline, after the 7-week program, at the 12-week follow-up, and at the 24-month follow-up. Positive changes in exercise self-efficacy were significant for the overweight group, while the healthy weight group maintained their exercise self-efficacy. At the 24-month follow-up, 97% children reported being interested in participating in a future fitness program, and 96% children who did not play sports before the intervention started practicing sports. Exercise self-efficacy is a predictor of physical activity, and incorporating exergaming in a structured program may lead to increased self-efficacy in participants.
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Relational autonomy or undue pressure? Family's role in medical decision-making.
Ho, Anita
2008-03-01
The intertwining ideas of self-determination and well-being have received tremendous support in western bioethics. They have been used to reject medical paternalism and to justify patients' rights to give informed consent (or refusal) and execute advanced directives. It is frequently argued that everyone is thoroughly unique, and as patients are most knowledgeable of and invested in their own interests, they should be the ones to make voluntary decisions regarding their care. Two results of the strong focus on autonomy are the rejection of the image of patients as passive care recipients and the suspicion against paternalistic influence anyone may have on patients' decision-making process. Although the initial focus in western bioethics was on minimizing professional coercion, there has been a steady concern of family's involvement in adult patients' medical decision-making. Many worry that family members may have divergent values and priorities from those of the patients, such that their involvement could counter patients' autonomy. Those who are heavily involved in competent patients' decision-making are often met with suspicion. Patients who defer to their families are sometimes presumed to be acting out of undue pressure. This essay argues for a re-examination of the notions of autonomy and undue pressure in the contexts of patienthood and relational identity. In particular, it examines the characteristics of families and their role in adult patients' decision-making. Building on the feminist conception of the relational self and examining the context of contemporary institutional medicine, this paper argues that family involvement and consideration of family interests can be integral in promoting patients' overall agency. It argues that, in the absence of abuse and neglect, respect for autonomy and agency requires clinicians to abide by patients' expressed wishes.
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Freedom of Expression, Deliberation, Autonomy and Respect
Rostbøll, Christian F.
2011-01-01
This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms w...
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Singh, Kavita; Haney, Erica; Olorunsaiye, Comfort
2013-07-01
Globally 2.5 million children under-five die from vaccine preventable diseases, and in Nigeria only 23 % of children ages 12-23 months are fully immunized. The international community is promoting gender equality as a means to improve the health and well-being of women and their children. This paper looks at whether measures of gender equality, autonomy and individual attitudes towards gender norms, are associated with a child being fully immunized in Nigeria. Data from currently married women with a child 12-23 months from the 2008 Nigeria demographic and health survey were used to study the influence of autonomy and gender attitudes on whether or not a child is fully immunized. Multivariate logistic regression was used and several key socioeconomic variables were controlled for including wealth and education, which are considered key inputs into gender equality. Findings indicated that household decision-making and attitudes towards wife beating were significantly associated with a child being fully immunized after controlling for socioeconomic variables. Ethnicity, wealth and education were also significant factors. Programmatic and policy implications indicate the potential for the promotion of gender equality as a means to improve child health. Gender equality can be seen as a means to enable women to access life-saving services for their children.
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Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy
Rostbøll, Christian F.
2009-01-01
Udgivelsesdato: 2009 Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disre...
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Margalit, Daniella; Ben-Ari, Amichai
2014-01-01
Background: Adolescents participate in decision-making processes involving risky behaviors. Management of these important decisions may be promoted by enhancing adolescents' self-efficacy beliefs and cognitive autonomy. Objective: In order to elucidate the value of wilderness therapy to the successful management of decision making processes among…
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Autonomy and informed consent: a mistaken association?
Kristinsson, Sigurdur
2007-09-01
For decades, the greater part of efforts to improve regulatory frameworks for research ethics has focused on informed consent procedures; their design, codification and regulation. Why is informed consent thought to be so important? Since the publication of the Belmont Report in 1979, the standard response has been that obtaining informed consent is a way of treating individuals as autonomous agents. Despite its political success, the philosophical validity of this Belmont view cannot be taken for granted. If the Belmont view is to be based on a conception of autonomy that generates moral justification, it will either have to be reinterpreted along Kantian lines or coupled with a something like Mill's conception of individuality. The Kantian interpretation would be a radical reinterpretation of the Belmont view, while the Millian justification is incompatible with the liberal requirement that justification for public policy should be neutral between controversial conceptions of the good. This consequence might be avoided by replacing Mill's conception of individuality with a procedural conception of autonomy, but I argue that the resulting view would in fact fail to support a non-Kantian, autonomy-based justification of informed consent. These difficulties suggest that insofar as informed consent is justified by respect for persons and considerations of autonomy, as the Belmont report maintained, the justification should be along the lines of Kantian autonomy and not individual autonomy.
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Carroll, Jennifer K; Fiscella, Kevin; Epstein, Ronald M; Sanders, Mechelle R; Winters, Paul C; Moorhead, S Anne; van Osch, Liesbeth; Williams, Geoffrey C
2013-09-01
To assess the effect of a pilot intervention to promote clinician-patient communication about physical activity on patient ratings of their perceived competence for physical activity and their clinicians' autonomy-supportiveness. Family medicine clinicians (n=13) at two urban community health centers were randomized to early or delayed (8 months later) communication training groups. The goal of the training was to teach the 5As (Ask, Advise, Agree, Assist, Arrange) for physical activity counseling. Outcome measures were changes in patient perceptions of autonomy support (modified Health Care Climate Questionnaire, mHCCQ) and perceived competence (Perceived Competence Scale for physical activity, PCS) completed via surveys at baseline, post-intervention and six-month follow-up. Patients (n=326) were mostly female (70%) and low income. Using a generalized estimating equations model (GEE) with patients nested within clinician, patient perceived autonomy support increased at post-intervention compared to baseline (mean HCCQ scores 3.68-4.06, p=0.03). There was no significant change in patient perceived competence for physical activity. A clinician-directed intervention increased patient perceptions of clinician autonomy support but not patient perceived competence for physical activity. Clinicians working with underserved populations can be taught to improve their autonomy supportiveness, according to patient assessments of their clinicians. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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Are there limits to respect for autonomy in bioethics?
de Roubaix, Malcolm
2008-06-01
I discuss the significance of respect for personal autonomy in bioethics with reference to its practical expression: rational informed patient choice. The question is whether, given the apparent practical limitations to this notion, bioethical autonomy should be seen as an absolute. After a historical review of informed consent and its development, I discuss the requirements for informed consent. Some inherent tensions are evaluated, as is the applicability of the notion that in order to be legitimate, autonomy should do some ethical work. Limits to the notion of informed consent are explored with reference to six examples: the right of women to reproductive autonomy; the autonomy of legally minor Jehovah's Witnesses; autonomy in cosmetic surgery; inappropriate treatment; autonomy and human medical research, and euthanasia and other end-of-life options. The discussion is within a South African framework with reference to other jurisdictions and decisions where appropriate. I conclude that whilst some unusual instances of limitation of bioethical informed consent might be ethically justifiable, the arguments presented point to the opposite: the unfounded limitation of informed consent.
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Directory of Open Access Journals (Sweden)
Nicholas de Genova
2017-06-01
Full Text Available As ostensibly unwanted or undesirable non-citizens, the utter disposability of deportees appears to be finally and conclusively verified by deportation as a sovereign state power’s perfunctory and mundane act of 'taking out the trash.' Hence, it is no accident that, etymologically, the origins of the very word 'deportation' would indicate a carrying away, a removal, a disposal. The eradication of deportees’ individual lives — their personal identities and life trajectories — emerges as a frightfully routine and prosaic fact of deportation. In spite of the sheer violence of the ruptures inflicted though deportation, however, those who have been rendered the objects of this power persistently reassert their own subjectivity. Ethnographic insights into the lived struggles of the deported (as well as their loved ones and communities elucidates the enduring subjectivity of those who have been made the objects of such sovereign acts of state power and subjected to deportation's techniques of eradication, and illustrates the stubborn incorrigibility of human life against the myriad forces that would seek to enforce its precarity and disposability. In the post-deportation condition, we confront anew the elementary and elemental human freedom of movement, and the incorrigibility of the autonomy and subjectivity of migration. Much as the autonomy of migration instigates a contest in which state power never has the first word, what we may now conceive as the autonomy of deportation — an autonomy and subjectivity of the deported within and against their predicaments of deportation — similarly ensures that state power never has the last word, either.
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[Lumbar stabilization exercises].
Vásquez-Ríos, Jorge Rodrigo; Nava-Bringas, Tania Inés
2014-01-01
Exercise is the intervention with the highest level of evidence on efficacy for treatment of chronic low back pain, with a higher benefit in terms of pain and function compared to any other intervention. A wide variety of exercises programs have been designed; however, "lumbar stabilization exercises" have become increasingly popular among clinicians who are in contact with spine diseases. However, there is controversy regarding the adequate prescription and there are multiple protocols. The aim of this literature review is to analyze the information about these exercises to promote better decision-making among clinicians and design the best program for each patient. We found the program an essential tool in the treatment of low back pain in both therapeutic and preventive phases.
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Autonomy and Interests: The Social Life of a Curriculum.
Reddiford, Gordon
1993-01-01
Examines the arguments that students should determine their own curriculum. Reviews the case for student autonomy based on philosophical anarchism and Immanuel Kant's views on autonomy. Argues that curriculum should be a result of the shared autonomy of students and teachers. (CFR)
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PROMOTING AUTONOMOUS LEARNING IN READING CLASS
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Agus Sholeh
2015-11-01
Full Text Available To have good acquisition and awareness in reading, the learners need a long and continuous process, and therefore, they are required to have autonomy in learning reading. This study aims to promote learner autonomy in reading class by combining learner-centered reading teaching and extensive reading teaching. Learner-centered reading teaching was carried out through group discussion, presentation, and language awareness activities. Meanwhile, extensive reading teaching was done to review the learners‘ materials in presentation and reinforce their acquisition. Those two different approaches were applied due to differences on learner's characteristics and needs. The result showed some success in the practice of autonomy, indicated by changes on learners' attitude. However, many learners showed that they focused more on obtaining score than on developing their language acquisition. By implementing the approach, the teacher can assist learners to be aware of their ability to learn independently and equip them with the skill needed for long-life learning.
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Euthyroid goitre with and without functional autonomy: A comparison
International Nuclear Information System (INIS)
Hillenhinrichs, H.; Emrich, D.
1998-01-01
Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global 99m Tc thyroid uptake of ≥3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [de
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Autonomy and Housing Accessibility Among Powered Mobility Device Users
Brandt, Åse; Lexell, Eva Månsson; Iwarsson, Susanne
2015-01-01
OBJECTIVE. To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users’ autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy. METHOD. This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used. RESULTS. More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors. CONCLUSION. To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems. PMID:26356666
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Effective means of planning for and implementing autonomy
DEFF Research Database (Denmark)
Rehof, Lars Adam
1991-01-01
Autonomy, self-government, indigenous people, human rights, minority protection, minority rights......Autonomy, self-government, indigenous people, human rights, minority protection, minority rights...
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Does Sport-Drink Use During Exercise Promote an Acute Positive Energy Balance?
Dragusin, Iulian B; Horswill, Craig A
2016-10-01
Sports drinks have been implicated in contributing to obesity and chronic diseases by providing surplus calories and excess sugars. Using existing literature we compared energy intake from sports drinks consumed during exercise with the exercise-induced calorie expenditure to determine whether sports drink use might eliminate the energy deficit and jeopardize conditions for improved metabolic fitness. We identified 11 published studies that compared sport drink consumption to placebo during exercise with a primary focused on the effect of sport drinks or total carbohydrate content on enhancing physical performance. Energy expenditure (EE) was calculated using VO 2 , RER, and exercise duration for the exercise protocol. Energy ingestion (EI) was determined using the carbohydrate dosing regimen administered before and during the exercise protocol. A two-tailed t test was used to test whether the energy balance (EI-EE) was different from zero (alpha level = 0.05). Sport drink consumption during aerobic exercise of sufficient duration (≥ 60 min) did not abolish the energy deficit (p sports drinks to enhance performance did not abolish the caloric deficit of aerobic exercise. Sports drinks can be used in accordance with research protocols that typically provide 30-60 g of carbohydrate per hour when exercising at adequate durations for moderate to high intensity and still maintain a substantive caloric deficit.
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Reflective and Non-conscious Responses to Exercise Images.
Cope, Kathryn; Vandelanotte, Corneel; Short, Camille E; Conroy, David E; Rhodes, Ryan E; Jackson, Ben; Dimmock, James A; Rebar, Amanda L
2017-01-01
Images portraying exercise are commonly used to promote exercise behavior and to measure automatic associations of exercise (e.g., via implicit association tests). The effectiveness of these promotion efforts and the validity of measurement techniques partially rely on the untested assumption that the images being used are perceived by the general public as portrayals of exercise that is pleasant and motivating. The aim of this study was to investigate how content of images impacted people's automatic and reflective evaluations of exercise images. Participants ( N = 90) completed a response time categorization task (similar to the implicit association test) to capture how automatically people perceived each image as relevant to Exercise or Not exercise . Participants also self-reported their evaluations of the images using visual analog scales with the anchors: Exercise / Not exercise, Does not motivate me to exercise / Motivates me to exercise, Pleasant / Unpleasant , and Energizing/Deactivating . People tended to more strongly automatically associate images with exercise if the images were of an outdoor setting, presented sport (as opposed to active labor or gym-based) activities, and included young (as opposed to middle-aged) adults. People tended to reflectively find images of young adults more motivating and relevant to exercise than images of older adults. The content of exercise images is an often overlooked source of systematic variability that may impact measurement validity and intervention effectiveness.
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Reflective and Non-conscious Responses to Exercise Images
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Kathryn Cope
2018-01-01
Full Text Available Images portraying exercise are commonly used to promote exercise behavior and to measure automatic associations of exercise (e.g., via implicit association tests. The effectiveness of these promotion efforts and the validity of measurement techniques partially rely on the untested assumption that the images being used are perceived by the general public as portrayals of exercise that is pleasant and motivating. The aim of this study was to investigate how content of images impacted people's automatic and reflective evaluations of exercise images. Participants (N = 90 completed a response time categorization task (similar to the implicit association test to capture how automatically people perceived each image as relevant to Exercise or Not exercise. Participants also self-reported their evaluations of the images using visual analog scales with the anchors: Exercise/Not exercise, Does not motivate me to exercise/Motivates me to exercise, Pleasant/Unpleasant, and Energizing/Deactivating. People tended to more strongly automatically associate images with exercise if the images were of an outdoor setting, presented sport (as opposed to active labor or gym-based activities, and included young (as opposed to middle-aged adults. People tended to reflectively find images of young adults more motivating and relevant to exercise than images of older adults. The content of exercise images is an often overlooked source of systematic variability that may impact measurement validity and intervention effectiveness.
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Directory of Open Access Journals (Sweden)
Roberto Aquilani
2014-01-01
Full Text Available Exercise intolerance remains problematic in subjects with chronic heart failure (CHF and/or chronic obstructive pulmonary disease (COPD. Recent studies show that supplemented essential amino acids (EAAs may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1–3 months of EAA supplementation (8 g/d. In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test, and 12% to 22% (meters in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25% and improved tissue insulin sensitivity by 16% (HOMA index. COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population. These mechanisms could be accounted for by EAA’s intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD.
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Understanding critical care nurses' autonomy in Jordan.
Maharmeh, Mahmoud
2017-10-02
Purpose The aim of this study was to describe Jordanian critical care nurses' experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse's autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses' job satisfaction. Therefore, improving nurses' clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.
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Experienced job autonomy among maternity care professionals in The Netherlands.
Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G; Verhoeven, Corine J
2017-11-01
High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care system and whether they expect a new system of integrated maternity care to affect their experienced job autonomy. A cross-sectional survey. The Leiden Quality of Work Life Questionnaire was used to assess experienced job autonomy among maternity care professionals. Data were collected in the Netherlands in 2015. 799 professionals participated of whom 362 were primary care midwives, 240 obstetricians, 93 clinical midwives and 104 obstetric nurses. The mean score for experienced job autonomy was highest for primary care midwives, followed by obstetricians, clinical midwives and obstetric nurses. Primary care midwives scored highest in expecting to lose their job autonomy in an integrated care system. There are significant differences in experienced job autonomy between maternity care professionals. When changing the maternity care system it will be a challenge to maintain a high level of experienced job autonomy for professionals. A decrease in job autonomy could lead to a reduction in job related wellbeing and in satisfaction with care among pregnant women. Copyright © 2017. Published by Elsevier Ltd.
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Autonomy, Competence and Non-interference
Roberts, Joseph T.F.
2017-01-01
In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights ...
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The Changing Scope of Professional Autonomy
DEFF Research Database (Denmark)
Jespersen, Peter Kragh; Wrede, Sirpa
2009-01-01
Kapitlet undersøger hvordan lægeprofessionens autonomi ændres i relation til ledelse i sygehuse i Danmark, Norge, Sverige og Finland i tiden fra 1970 og fremefter.......Kapitlet undersøger hvordan lægeprofessionens autonomi ændres i relation til ledelse i sygehuse i Danmark, Norge, Sverige og Finland i tiden fra 1970 og fremefter....
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Shively, Jay
2017-01-01
A significant level of debate and confusion has surrounded the meaning of the terms autonomy and automation. Automation is a multi-dimensional concept, and we propose that Remotely Piloted Aircraft Systems (RPAS) automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present definitions of automation, pilot in the loop, pilot on the loop and pilot out of the loop. We further propose that in future, the International Civil Aviation Organization (ICAO) RPAS Panel avoids the use of the terms autonomy and autonomous when referring to automated systems on board RPA. Work Group 7 proposes to develop, in consultation with other workgroups, a taxonomy of Levels of Automation for RPAS.
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Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.
Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang
2016-09-01
Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.
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Artists’ Autonomy and Professionalization in a New Cultural Policy Landscape
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Marita Flisbäck
2015-08-01
Full Text Available Using literature on the professions, the article explores how a new political model for funding and steering may affect professional autonomy. Professional groups’ efforts to independently practice their profession during times of political change are elaborated. The professional group in questions is artists, the context is Sweden, and the new model is called the Collaborative Cultural Model. This model entails a shift in the funding and realization of cultural policy from the national to the regional level. From a situation in which civil servants with specific culture knowledge were involved, politicians, representatives of civil society, civil servants and artists are now to work together to create a regional culture plan. In the article, two different outcomes of the new model are discussed as possible. It can lead to de-professionalization process, particularly if the policy on keeping outside influences at “arm’s length” weakens. On the other hand, negotiations between different actors could result in artists’ knowledge becoming more prominent and receiving more recognition than previously. This, in turn, could promote professional artists’ status.Keywords: Cultural policy, public funding, autonomy, artistic (deprofessionalization, dominated and dominating
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Preferences for autonomy in end-of-life decision making in modern Korean society.
Kim, Su Hyun
2015-03-01
The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making in Korean people. This study was a cross-sectional correlational study using a survey. Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. The study was approved by the hospitals' directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Results of this study suggested the necessity for development of alternatives to a dominant traditional "family-centered" approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Healthcare providers need to examine not only patients' preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. © The Author(s) 2014.
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[Psychiatric advance directives and the role of autonomy].
Ambrosini, Daniel L; Crocker, Anne G
2009-01-01
Although psychiatric advance directives (PADs) are grounded in the ethics of autonomy, the relationship between the two is unclear. PADs are legal documents that allow individuals with mental illness to record their treatment preferences should they become incompetent in the future. The relationship between autonomy and PADs has been discussed in ethical, legal, and philosophical terms, but has not been clearly operationalized for clinical purposes. Autonomy is a fundamental ethical value that includes having the independence from outside controlling influences and the mental capacity to direct one's personal actions. Individuals with mental illness sometimes require assistance to understand their ethical and legal rights with respect to autonomous choice, and professional stakeholders need education regarding the importance of autonomy for clinical practice. Competency to consent to treatment is the mental prerequisite that ensures individuals with mental illness are able to complete PADs with insight, whereas autonomy is the value that empowers individuals to work towards their recovery.
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Liu-Ambrose, Teresa; Eng, Janice J
2015-01-01
Background Stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. Both exercise and recreational activities are promising strategies. We assessed the effect of a six-month exercise and recreation program on executive functions in adults with chronic stroke. Methods A six-month ancillary study within a multi-centre randomized trial. Twenty-eight chronic stroke survivors (i.e., ≥ 12 months since an index stroke) were randomized to one of two experimental groups: intervention (INT; n=12) or delayed intervention (D-INT; n=16). Participants of the INT group received a six-month community-based structured program that included two sessions of exercise training and one session of recreation and leisure activities per week. Participants of the D-INT group received usual care. The primary outcome measure was the Stroop Test, a cognitive test of selective attention and conflict resolution. Secondary cognitive measures included set shifting and working memory. Mood, functional capacity, and general balance and mobility were additional secondary outcome measures. Results Compared with the D-INT group, the INT group significantly improved selective attention and conflict resolution (p=0.02), working memory (p=0.04), and functional capacity (p=0.02) at the end of the six-month intervention period. Improved selective attention and conflict resolution was significantly associated with functional capacity at six months (r=0.39; p=0.04). Conclusions This is the first randomized study to demonstrate that an exercise and recreation program can significantly benefit executive functions in community-dwelling chronic stroke survivors who are mildly cognitively impaired – a population at high-risk for dementia and functional decline. Thus, clinicians should consider prescribing exercise and recreational activities in the cognitive rehabilitation of chronic stroke survivors. Clinical Trial Registration http
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Stirring the motivational soup: within-person latent profiles of motivation in exercise.
Lindwall, Magnus; Ivarsson, Andreas; Weman-Josefsson, Karin; Jonsson, Linus; Ntoumanis, Nikos; Patrick, Heather; Thøgersen-Ntoumani, Cecilie; Markland, David; Teixeira, Pedro
2017-01-14
The purpose of the present study was to use a person-oriented analytical approach to identify latent motivational profiles, based on the different behavioural regulations for exercise, and to examine differences in satisfaction of basic psychological needs (competence, autonomy and relatedness) and exercise behaviour across these motivational profiles. Two samples, consisting of 1084 and 511 adults respectively, completed exercise-related measures of behavioural regulation and psychological need satisfaction as well as exercise behaviour. Latent profile analyses were used to identify motivational profiles. Six profiles, representing different combinations of regulations for exercise, were found to best represent data in both samples. Some profiles were found in both samples (e.g., low motivation profile, self-determined motivation profile and self-determined with high introjected regulation profile), whereas others were unique to each sample. In line with the Self-Determination Theory, individuals belonging to more self-determined profiles demonstrated higher scores on need satisfaction. The results support the notions of motivation being a multidimensional construct and that people have different, sometimes competing, reasons for engaging in exercise. The benefits of using person-oriented analyses to examine within-person interactions of motivation and different regulations are discussed.
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Liao, Gen-Yih; Chien, Yu-Tai; Chen, Yu-Jen; Hsiung, Hsiao-Fang; Chen, Hsiao-Jung; Hsieh, Meng-Hua; Wu, Wen-Jie
2017-05-25
Physical activity is important for middle-agers to maintain health both in middle age and in old age. Although thousands of exercise-promotion mobile phone apps are available for download, current literature offers little understanding regarding which design features can enhance middle-aged adults' quality perception toward exercise-promotion apps and which factor may influence such perception. The aims of this study were to understand (1) which design features of exercise-promotion apps can enhance quality perception of middle-agers, (2) whether their needs are matched by current functions offered in app stores, and (3) whether physical activity (PA) and mobile phone self-efficacy (MPSE) influence quality perception. A total of 105 middle-agers participated and filled out three scales: the International Physical Activity Questionnaire (IPAQ), the MPSE scale, and the need for design features questionnaire. The design features were developed based on the Coventry, Aberdeen, and London-Refined (CALO-RE) taxonomy. Following the Kano quality model, the need for design features questionnaire asked participants to classify design features into five categories: attractive, one-dimensional, must-be, indifferent, and reverse. The quality categorization was conducted based on a voting approach and the categorization results were compared with the findings of a prevalence study to realize whether needs match current availability. In total, 52 multinomial logistic regression models were analyzed to evaluate the effects of PA level and MPSE on quality perception of design features. The Kano analysis on the total sample revealed that visual demonstration of exercise instructions is the only attractive design feature, whereas the other 51 design features were perceived with indifference. Although examining quality perception by PA level, 21 features are recommended to low level, 6 features to medium level, but none to high-level PA. In contrast, high-level MPSE is recommended
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EFFECTS OF A MULTICOMPONENT EXERCISE PROGRAM ON THE FUNCTIONAL FITNESS IN ELDERLY WOMEN
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Frank Shiguemitsu Suzuki
Full Text Available ABSTRACT Introduction: Aging is inevitable and irreversible, but with the advancement of technology, life expectancy is increasing every year, bringing proposals for various interventions to improve the quality of life. One such intervention is physical exercise programs. Objectives: To investigate the impact of multicomponent training in circuits on functional autonomy parameters in elderly women. Methods: Elderly were recruited and distributed in two groups: trained (N = 16 and non-trained (N = 15. Those in the trained group performed 75-minute training sessions twice a week over a 56-week period. The resistance training included upper and lower limbs with a relative intensity of 70% of 1RM, exercises using body weight, stretching and specific tasks for agility, performed in a circuit form and totaling three passages. Participants underwent functional autonomy (FA assessment by the protocol of the Latin American Developmental Group for Maturity, the 6-minute walk test (T6M, and the sit-and-reach (SR test. Results: The trained group had a significant decrease in body weight (p=0.02 and body mass index (p=0.015. Significant improvements (p=0,009 were also observed in FA, SR, and T6M after the intervention Compared with the untrained group, the trained group also obtained significant differences in all functional parameters analyzed. Conclusion: A long-term multicomponent training program conducted on a circuit and applied twice a week was enough to improve multiple components of the functional autonomy of elderly women. Level of Evidence II; Prognostic studies - Investigating the effect of a patient characteristic on the outcome of disease.
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Nys, Thomas
2016-02-01
This article seeks to explore and analyze the relationship between autonomy and trust, and to show how these findings could be relevant to medical ethics. First, I will argue that the way in which so-called "relational autonomy theories" tie the notions of autonomy and trust together is not entirely satisfying Then, I will introduce the so-called Encapsulated Interest Account as developed by Russell Hardin. This will bring out the importance of the reasons for trust. What good reasons do we have for trusting someone? I will criticize Hardin's business model as insufficiently robust, especially in the context of health care, and then turn to another source of trust, namely, love. It may seem that trust-through-love is much better suited for the vulnerability that is often involved in health care, but I will also show that it has its own deficiencies. Good health care should therefore pay attention to both models of trust, and I will offer some tentative remarks on how to do this. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Emotional autonomy and problem behavior among Chinese adolescents.
Chou, Kee-Lee
2003-12-01
The author examined the association between emotional autonomy and problem behavior among Chinese adolescents living in Hong Kong. The respondents were 512 adolescents, 16 to 18 years of age, who were interviewed for a cross-sectional study. Three dimensions of emotional autonomy including individuation, nondependency on parents, and de-idealization of parents were significantly and positively correlated with the amount of problem behavior the participants engaged in during the past 6 months. Using a simple linear multiple regression model, the author found that problem behavior was associated with only one aspect of emotional autonomy-individuation. Results indicated that the relationship between problem behavior and three aspects of emotional autonomy was similar in both individualistic and collectivistic societies.
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Demographic and Socio-Economic Determinants of Local Financial Autonomy in Romania
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Dănuţ Vasile JEMNA
2013-06-01
Full Text Available Local autonomy is a rarely explored concept in the literature, still holding an increasing importance in the current context of Romania’s development in the European Union. In this paper we attempt to provide an overall survey on the financial dimension of local autonomy, assuming that local autonomy cannot be implemented, unless local authorities have adequate financial resources. In this study we also analyze the possibility to measure the local revenue autonomy and to identify the variables which represent the determinants of the local revenue autonomy. Using empirical evidence from Romanian counties, we analyze the regional distributions for own revenues and for the significant determinants of local revenue autonomy. By means of econometric modeling we will highlight the variables which are statistically significant and explain the variation of the local revenues of Romanian counties, as well as the order of importance of the determinants of local financial autonomy. The empirical results show us that, although, theoretically, the counties have a great administrative and financial autonomy, practically this autonomy is very reduced (an average of under 40% for local revenue. The modeling results show that the degree of local financial autonomy can be increased by increasing economic development, urbanization, the average living area per person and fertility. Unemployment and a high level of demographic dependency contribute to the decrease of local financial autonomy.
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Effects of exercise intensity and creatine loading on post-resistance exercise hypotension
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Moreno Rodrigues Moreno
2009-09-01
Full Text Available Postexercise hypotension plays an important role in the non-pharmacological treat-ment of hypertension and is characterized by a decrease in blood pressure after a single exercise bout in relation to pre-exercise levels. This study investigated the effects of exercise intensity and creatine monohydrate supplementation on postexercise hypotension, as well as the possible role of blood lactate in this response. Ten normotensive subjects underwent resistance exercise sessions before (BC and after (AC creatine supplementation: 1 muscle endurance (ME consisting of 30 repetitions at 30% of one-repetition maximum; 2 hypertrophy (HP consisting of 8 repetitions at 75% of one-repetition maximum. Blood pressure was measured before and after the exercise bout. Blood lactate was measured after the exercise bout. The HP and ME sessions promoted a decrease in systolic blood pressure (∆ -19 ± 1.0 mmHg; ∆ -15 ± 0.9 mmHg, respectively, P 0.05. In conclusion, resistance exercise intensity did not influence postexercise hypotension. Creatine supplementation attenuated the decrease in blood pressure after resistance exercise. The results suggest the involvement of blood lactate in post-resistance exercise hypotension.
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Effects of exercise intensity and creatine loading on post-resistance exercise hypotension
Directory of Open Access Journals (Sweden)
Moreno Rodrigues Moreno
2009-01-01
Postexercise hypotension plays an important role in the non-pharmacological treat-ment of hypertension and is characterized by a decrease in blood pressure after a single exercise bout in relation to pre-exercise levels. This study investigated the effects of exercise intensity and creatine monohydrate supplementation on postexercise hypotension, as well as the possible role of blood lactate in this response. Ten normotensive subjects underwent resistance exercise sessions before (BC and after (AC creatine supplementation: 1 muscle endurance (ME consisting of 30 repetitions at 30% of one-repetition maximum; 2 hypertrophy (HP consisting of 8 repetitions at 75% of one-repetition maximum. Blood pressure was measured before and after the exercise bout. Blood lactate was measured after the exercise bout. The HP and ME sessions promoted a decrease in systolic blood pressure (∆ -19 ± 1.0 mmHg; ∆ -15 ± 0.9 mmHg, respectively, P 0.05. In conclusion, resistance exercise intensity did not influence postexercise hypotension. Creatine supplementation attenuated the decrease in blood pressure after resistance exercise. The results suggest the involvement of blood lactate in post-resistance exercise hypotension.
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Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education
Directory of Open Access Journals (Sweden)
Yu-Kai Chang, Senlin Chen, Kun-Wei Tu, Li-Kang Chi
2016-09-01
Full Text Available Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61 or the control group (n = 65 for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation.
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Students' autonomy and teacher's interpersonal style in self-determination theory
Directory of Open Access Journals (Sweden)
Lalić-Vučetić Nataša
2009-01-01
Full Text Available Starting from psychological needs that are considered basic within self-determination theory (autonomy, competence and relatedness, the importance of encouraging students' autonomy in school context is particularly emphasised. Appreciation of students' autonomy has a stimulating effect on school achievement, conceptual understanding, creativity development, strengthening of self-esteem, and students adapt better to school system and demonstrate a larger degree of internalisation of school rules and intrinsic motivation. Teachers' behavioural style largely determines the degree of students' autonomy in school life and work. Self-determination theory implies the necessity of agreement between the developmental need for autonomy in children and the level of adult control and distinguishes between two styles of interpersonal behavior of teachers: (a those who offer support to students' autonomy by their behavior and (b those that are predominantly inclined to control students' behavior. This paper also points out to different strategies that can be applied by teachers in working with students in school, which also contribute to the development of students' autonomy. What is especially encouraging is the fact that it is possible to learn and to develop 'appreciation of students' autonomy' as teacher's interpersonal style.
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A longitudinal research on the development of emotional autonomy during adolescence.
Parra, Agueda; Oliva, Alfredo
2009-05-01
The purpose of the present paper was to study the development of emotional autonomy through adolescence analysing its association with family relationships. The development of emotional autonomy involves an increase in adolescents' subjective sense of his or her independence, especially in relation to parents. From some scholars emotional autonomy is a normative manifestation of the detachment process from parents, however, others point out that detachment from parental ties is not the norm, so high level of adolescent emotional autonomy is the consequence of negative family relationships. In our study a sample of 101 adolescents were followed for 5 years, from early to middle adolescence, and completed questionnaires to measure their emotional autonomy and the quality of their family relationships. Our results showed that over the course of adolescence some dimensions of emotional autonomy increase, meanwhile others decrease, so the global level of emotional autonomy global level remains stable. On the other hand, emotional autonomy is associated with negative family relationships, so emotional autonomy, more than a necessary process to become adult, could be indicating an insecure attachment to parents.
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Highlighting relatedness promotes prosocial motives and behavior.
Pavey, Louisa; Greitemeyer, Tobias; Sparks, Paul
2011-07-01
According to self-determination theory, people have three basic psychological needs: relatedness, competence, and autonomy. Of these, the authors reasoned that relatedness need satisfaction is particularly important for promoting prosocial behavior because of the increased sense of connectedness to others that this engenders. In Experiment 1, the authors manipulated relatedness, autonomy, competence, or gave participants a neutral task, and found that highlighting relatedness led to higher interest in volunteering and intentions to volunteer relative to the other conditions. Experiment 2 found that writing about relatedness experiences promoted feelings of connectedness to others, which in turn predicted greater prosocial intentions. Experiment 3 found that relatedness manipulation participants donated significantly more money to charity than did participants given a neutral task. The results suggest that highlighting relatedness increases engagement in prosocial activities and are discussed in relation to the conflict and compatibility between individual and social outcomes. © 2011 by the Society for Personality and Social Psychology, Inc
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Autophagy Is a Promoter for Aerobic Exercise Performance during High Altitude Training
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Ying Zhang
2018-01-01
Full Text Available High altitude training is one of the effective strategies for improving aerobic exercise performance at sea level via altitude acclimatization, thereby improving oxygen transport and/or utilization. But its underlying molecular mechanisms on physiological functions and exercise performance of athletes are still vague. More recent evidence suggests that the recycling of cellular components by autophagy is an important process of the body involved in the adaptive responses to exercise. Whether high altitude training can activate autophagy or whether high altitude training can improve exercise performance through exercise-induced autophagy is still unclear. In this narrative review article, we will summarize current research advances in the improvement of exercise performance through high altitude training and its reasonable molecular mechanisms associated with autophagy, which will provide a new field to explore the molecular mechanisms of adaptive response to high altitude training.
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On the Compatibility of Autonomy and Relatedness.
Hodgins, Holley S.; And Others
1996-01-01
Investigates the relation of autonomy to naturally occurring social interactions in two studies: the first investigated college students' interactions with parents, and the second examined interactions across all relationships. Autonomy was significantly related to more positive and naturally occurring interaction, whereas control related more to…
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40 CFR 73.86 - State regulatory autonomy.
2010-07-01
... 40 Protection of Environment 16 2010-07-01 2010-07-01 false State regulatory autonomy. 73.86 Section 73.86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... regulatory autonomy. Nothing in this subpart shall preclude a State or State regulatory authority from...
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Dietary antioxidants and exercise.
Powers, Scott K; DeRuisseau, Keith C; Quindry, John; Hamilton, Karyn L
2004-01-01
Muscular exercise promotes the production of radicals and other reactive oxygen species in the working muscle. Growing evidence indicates that reactive oxygen species are responsible for exercise-induced protein oxidation and contribute to muscle fatigue. To protect against exercise-induced oxidative injury, muscle cells contain complex endogenous cellular defence mechanisms (enzymatic and non-enzymatic antioxidants) to eliminate reactive oxygen species. Furthermore, exogenous dietary antioxidants interact with endogenous antioxidants to form a cooperative network of cellular antioxidants. Knowledge that exercise-induced oxidant formation can contribute to muscle fatigue has resulted in numerous investigations examining the effects of antioxidant supplementation on human exercise performance. To date, there is limited evidence that dietary supplementation with antioxidants will improve human performance. Furthermore, it is currently unclear whether regular vigorous exercise increases the need for dietary intake of antioxidants. Clearly, additional research that analyses the antioxidant requirements of individual athletes is needed.
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Preenen, P.T.Y.; Howaldt, J.; Oeij, P.R.A.; Dhondt, S.; Kraan, K.O.; Jansen, E.
2016-01-01
Although the positive impact of job autonomy has been widely shown for individual-level employee outcomes, research on job autonomy and company-level outcomes has been surprisingly scarce. Therefore, among 3,311 companies in the Netherlands, we investigate the relationship between employees' job
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Acute exercise and motor memory consolidation: Does exercise type play a role?
DEFF Research Database (Denmark)
Thomas, Richard; Flindtgaard, Mads; Skriver, Kasper Christen
2017-01-01
d. The results demonstrate that high-intensity, acute exercise can lead to a decrease in motor performance assessed shortly after motor skill practice (R1h), but enhances offline effects promoting long-term retention (R1d). Given that different exercise modalities produced similar positive off...... following visuomotor skill acquisition on the retention of motor memory in 40 young (25.3 ±3.6 years), able-bodied male participants randomly assigned to one of four groups either performing strength training (STR), circuit training (CT), indoor hockey (HOC) or rest (CON). Retention tests of the motor skill......-line effects on motor memory, we conclude that exercise-induced effects beneficial to consolidation appear to depend primarily on the physiological stimulus rather than type of exercise and movements employed....
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Diana, Restrepo B; Carlos, Cardeño C; Marle, Duque G; Santiago, Jaramillo
2012-06-01
Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. To determine the psychiatrist's role in evaluating these patients. The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
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Matthews, James; Hall, Amanda M; Hernon, Marian; Murray, Aileen; Jackson, Ben; Taylor, Ian; Toner, John; Guerin, Suzanne; Lonsdale, Chris; Hurley, Deirdre A
2015-07-05
Clinical practice guidelines for the treatment of low back pain suggest the inclusion of a biopsychosocial approach in which patient self-management is prioritized. While many physiotherapists recognise the importance of evidence-based practice, there is an evidence practice gap that may in part be due to the fact that promoting self-management necessitates change in clinical behaviours. Evidence suggests that a patient's motivation and maintenance of self-management behaviours can be positively influenced by the clinician's use of an autonomy supportive communication style. Therefore, the aim of this study was to develop and pilot-test the feasibility of a theoretically derived implementation intervention to support physiotherapists in using an evidence-based autonomy supportive communication style in practice for promoting patient self-management in clinical practice. A systematic process was used to develop the intervention and pilot-test its feasibility in primary care physiotherapy. The development steps included focus groups to identify barriers and enablers for implementation, the theoretical domains framework to classify determinants of change, a behaviour change technique taxonomy to select appropriate intervention components, and forming a testable theoretical model. Face validity and acceptability of the intervention was pilot-tested with two physiotherapists and monitoring their communication with patients over a three-month timeframe. Using the process described above, eight barriers and enablers for implementation were identified. To address these barriers and enablers, a number of intervention components were selected ranging from behaviour change techniques such as, goal-setting, self-monitoring and feedback to appropriate modes of intervention delivery (i.e. continued education meetings and audit and feedback focused coaching). Initial pilot-testing revealed the acceptability of the intervention to recipients and highlighted key areas for
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Hunter, Jayden R; Gordon, Brett A; Lythgo, Noel; Bird, Stephen R; Benson, Amanda C
2018-04-01
Physical activity and exercise participation is limited by a perceived lack of time, poor access to facilities and low motivation. The aim was to assess whether providing an exercise program to be completed at the workplace with or without direct supervision was effective for promoting health-related physical fitness and exercise participation. Fifty university employees aged (Mean ± SD) 42.5 ± 11.1 years were prescribed a moderate- to vigorous-intensity aerobic and resistance exercise program to be completed at an onsite facility for 8 weeks. Participants were randomly allocated to receive direct exercise supervision or not. Cardiorespiratory fitness (V̇O 2max ) and maximal muscular strength were assessed at baseline and 8 weeks. Self-report physical activity was assessed at baseline, 8 weeks and 15 months post-intervention. Attendance or exercise session volume were not different between groups. Cardiorespiratory fitness (Mean ± 95% CI); +1.9 ± 0.7 mL·kg·min -1 ; P exercise facility to complete an individually-prescribed 8-week exercise program is sufficient to improve health-related physical fitness in the short-term independent to the level of supervision provided, but does not influence long-term participation. SO WHAT?: Lower cost onsite exercise facility supervision is as effective at improving physical health and fitness as directly supervised exercise, however ongoing support may be required for sustained physical activity behaviour change. © 2017 Australian Health Promotion Association.
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Sailer, Pascal; Wieber, Frank; Pröpster, Karl; Stoewer, Steffen; Nischk, Daniel; Volk, Franz; Odenwald, Michael
2015-09-03
Regular exercise can have positive effects on both the physical and mental health of individuals with schizophrenia. However, deficits in cognition, perception, affect, and volition make it especially difficult for people with schizophrenia to plan and follow through with their exercising intentions, as indicated by poor attendance and high drop-out rates in prior studies. Mental Contrasting and Implementation Intentions (MCII) is a well-established strategy to support the enactment of intended actions. This pilot study tests whether MCII helps people with schizophrenia in highly structured or autonomy-focused clinical hospital settings to translate their exercising intentions into action. Thirty-six inpatients (eleven women) with a mean age of 30.89 years (SD = 11.41) diagnosed with schizophrenia spectrum disorders from specialized highly structured or autonomy-focused wards were randomly assigned to two intervention groups. In the equal contact goal intention control condition, patients read an informative text about physical activity; they then set and wrote down the goal to attend jogging sessions. In the MCII experimental condition, patients read the same informative text and then worked through the MCII strategy. We hypothesized that MCII would increase attendance and persistence relative to the control condition over the course of four weeks and this will be especially be the case when applied in an autonomy-focused setting compared to when applied in a highly structured setting. When applied in autonomy-focused settings, MCII increased attendance and persistence in jogging group sessions relative to the control condition. In the highly structured setting, no differences between conditions were found, most likely due to a ceiling effect. These results remained even when adjusting for group differences in the pre-intervention scores for the control variables depression (BDI), physical activity (IPAQ), weight (BMI), age, and education. Whereas commitment and
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Keegan, John P.; Chan, Fong; Ditchman, Nicole; Chiu, Chung-Yi
2012-01-01
The main objective of this study was to validate Pender's Health Promotion Model (HPM) as a motivational model for exercise/physical activity self-management for people with spinal cord injuries (SCIs). Quantitative descriptive research design using hierarchical regression analysis (HRA) was used. A total of 126 individuals with SCI were recruited…
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Shang, Zhe; Tao, Tuoxin; Wang, Lei
2016-01-01
Choice effect is a robust phenomenon in which even “mere choice” that does not include actual choosing actions could result in more preference for the self-chosen objects over other-chosen objects. In the current research, we proposed that autonomy would impact the mere choice effect. We conducted two studies to examine the hypothesis. The results showed that the mere choice effect measured by Implicit Association Test (IAT) significantly decreased for participants with lower levels of trait autonomy (Study 1) and when participants were primed to experience autonomy deprivation (Study 2). The theoretical and practical implications are discussed. PMID:27148132
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[The medical autonomy of elderly in Taiwan].
Chen, Kai-Li; Chen, Ching-Huey
2014-10-01
The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.
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Patient autonomy: a view from the kitchen.
Struhkamp, Rita M
2005-01-01
In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the concrete activities of day-to-day health care, in the material and technological context of care, in arrangements of health care institutions, in the physical training of people with disabilities, as well as in the concrete activities of care-giving. This move from conversations in the consultation room to other sites and situations in the practice of care takes seriously the empirical reality of medical care and intends to show that patient autonomy is practically realised in a much richer and more creative way than most ethical theory seems to assume.
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[Autonomy: to what extent is the concept relevant in psychiatry?].
de Wit, F A
2012-01-01
Autonomy is an important concept in psychiatry, but because it is a somewhat abstract and ambiguous notion, it is not applicable in its entirety in a psychiatric context. This becomes obvious in situations where patients are receiving long term care and treatment. To modify the concept of autonomy in such a way that it acquires an extra dimension that renders it applicable to daily psychiatric practice. The literature was reviewed in order to find articles that reveal the tensions that arise between autonomy and dependence in psychiatry and that reflect the human characteristics that are concealed behind the modern concepts of autonomy, freedom and respect for autonomy. Concepts such as person, identity, acknowledgement, dialogical ethics and life histories are used as an addition to the concepts of autonomy of Kant and Mill. A phenomenological and a context sensitive conception of autonomy is needed within the perspective of dialogical ethics. A dialogical perspective requires from psychiatric professionals a susceptibility for what the patient as a human being really has to say. On the basis of a dialogue where there is space and attention for life histories, backgrounds and the potentials of patients, a new perspective can be developed that is shared by the persons involved. In psychiatry, statements about real autonomy and genuine respect for autonomy are only truly meaningful within the context of doctors, nurses and patients. A hermeneutic approach to patients which involves dialogue creates new opportunities in the field of staff-patient relations.
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"It's My Life": Autonomy and People with Intellectual Disabilities
Björnsdóttir, Kristín; Stefánsdóttir, Guðrún V; Stefánsdóttir, Ástríður
2015-01-01
This article discusses autonomy in the lives of adults with intellectual disabilities. The article draws on inclusive research in Iceland with 25 women and 16 men and employs ideas of relational autonomy from the perspectives of the Nordic relational approach to disability. In this article, we examine autonomy in relation to private life, that is,…
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Charter School Autonomy: The Mismatch between Theory and Practice
Finnigan, Kara S.
2007-01-01
In theory, the charter school concept is based on a trade-off or exchange: greater autonomy for increased accountability. Although charter schools have been operating for more than 10 years, little is known about charter school autonomy in practice. This mixed-methods study used survey and case study data to examine the degree of autonomy of…
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The Need for Authenticity-Based Autonomy in Medical Ethics.
White, Lucie
2017-08-11
The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of "authenticity", the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical ethics, and too stringent for use in practical contexts. I argue, however, that the very condition of authenticity that forms a focus in theoretical philosophy is also essential to autonomy and competence in medical ethics. After tracing the contours of contemporary authenticity-based theories of autonomy, I consider and respond to objections against the incorporation of a notion of authenticity into accounts of autonomy designed for use in medical contexts. By looking at the typical problems that arise when making judgments concerning autonomy or competence in a medical setting, I reveal the need for a condition of authenticity-as a means of protecting choices, particularly high-stakes choices, from being restricted or overridden on the basis of intersubjective disagreement. I then turn to the treatment of false and contestable beliefs, arguing that it is only through reference to authenticity that we can make important distinctions in this domain. Finally, I consider a potential problem with my proposed approach; its ability to deal with anorexic and depressive desires.
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Midtgaard, Julie
2013-02-01
Sedentary behaviour and reduced exercise capacity are potential persisting effects of anti-cancer therapy that may predispose to serious health conditions. It is well-established that physical exercise may prevent some of these problems. However, the extent to which cancer survivors are able to adopt long-term physical activity habits depends largely on their motivation. This theoretical paper aims to outline how researchers and practitioners can draw from Antonovsky's salutogenetic theory and White & Epston's Narrative Therapy to develop and implement intervention efforts centered on promotion of long-term physical activity behaviour, while at the same time increasing the individual cancer survivor's sense of meaning and personal health resources. The Copenhagen PACT (Physical Activity after Cancer Treatment) Study targeting adoption and maintenance of regular physical activity in post-therapy cancer survivors is briefly presented including a brief review of the theoretical rationale behind the psychological component of the intervention, i.e. a narrative-based exercise counselling programme. Subsequently, particular attention is given to the core principles, different components and structure of the counselling manual including sample questions and examples of written documents that have emanated from the individual counselling sessions. The discussion includes consideration of some methodological challenges that arise when attempting to evaluate narrative-based interventions in the context of physical activity promotion in cancer rehabilitation and survivorship care.
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Changing Light Bulbs: Practice, Motivation, and Autonomy
Carter, Jean A.
2011-01-01
The comment on the Ryan, Lynch, Vansteenkiste, and Deci (2011) article on motivation and autonomy in psychotherapy considers motivation and its role as prerequisite, process variable, or appropriate outcome, speculating that all are appropriate ways to conceptualize motivation in the behavior change process. Autonomy, as a useful addition, refers…
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Measuring local autonomy: A decision-making approach
Fleurke, F.; Willemse, R.
2006-01-01
In studies on central-local relations it is common to assess local autonomy in a deductive way. The extent of local autonomy is determined by measuring the central legal and financial competence, after which the remaining room for local decision-making is determined. The outcome of this indirect
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Stories of Human Autonomy, Law, and Technology
Tranter, Kieran
2010-01-01
Considering the relationship between human autonomy, law and technology has deep origins. Both technology studies and legal theory tell origin stories about human autonomy as the prize from either a foundational technological or jurisprudential event. In these narratives either law is considered a second order consequence of technology or…
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Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education
Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang
2016-01-01
Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation. Key points The SDT is a relevant theoretical framework for elementary school physical education. Using the quasi-experimental research design, this study is one of the earlies studies supporting that elementary school PE teachers can manipulate the instructional context using the SDT to increase students’ perceived autonomy and intrinsic motivation. Increasing students’ perceived autonomy may not lead to significant changes in other SDT constructs (i.e., amotivation, external regulation, introjected regulation, and identified regulation). PMID:27803624
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Dialysis Exercise Team: The Way to Sustain Exercise Programs in Hemodialysis Patients
Directory of Open Access Journals (Sweden)
Alessandro Capitanini
2014-07-01
Full Text Available Patients affected by end-stage renal disease (ESRD show quite lower physical activity and exercise capacity when compared to healthy individuals. In addition, a sedentary lifestyle is favoured by lack of a specific counseling on exercise implementation in the nephrology care setting. Increasing physical activity level should represent a goal for every dialysis patient care management. Three crucial elements of clinical care may contribute to sustain a hemodialysis exercise program: a involvement of exercise professionals, b real commitment of nephrologists and dialysis professionals, c individual patient adaptation of the exercise program. Dialysis staff have a crucial role to encourage and assist patients during intra-dialysis exercise, but other professionals should be included in the ideal “exercise team” for dialysis patients. Evaluation of general condition, comorbidities (especially cardiovascular, nutritional status and physical exercise capacity are mandatory to propose an exercise program, in either extra-dialysis or intra-dialysis setting. To this aim, nephrologist should lead a team of specialists and professionals including cardiologist, physiotherapist, exercise physiologist, renal dietician and nurse. In this scenario, dialysis nurses play a pivotal role since they guarantee a constant and direct approach. Unfortunately dialysis staff may often lack of information and formation about exercise management while they take care patients during the dialysis session. Building an effective exercise team, promoting the culture of exercise and increasing physical activity levels lead to a more complete and modern clinical care management of ESRD patients.
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Broten, Gregory S.; Monckton, Simon P.; Collier, Jack; Giesbrecht, Jared
2006-05-01
In 2002 Defence R&D Canada changed research direction from pure tele-operated land vehicles to general autonomy for land, air, and sea craft. The unique constraints of the military environment coupled with the complexity of autonomous systems drove DRDC to carefully plan a research and development infrastructure that would provide state of the art tools without restricting research scope. DRDC's long term objectives for its autonomy program address disparate unmanned ground vehicle (UGV), unattended ground sensor (UGS), air (UAV), and subsea and surface (UUV and USV) vehicles operating together with minimal human oversight. Individually, these systems will range in complexity from simple reconnaissance mini-UAVs streaming video to sophisticated autonomous combat UGVs exploiting embedded and remote sensing. Together, these systems can provide low risk, long endurance, battlefield services assuming they can communicate and cooperate with manned and unmanned systems. A key enabling technology for this new research is a software architecture capable of meeting both DRDC's current and future requirements. DRDC built upon recent advances in the computing science field while developing its software architecture know as the Architecture for Autonomy (AFA). Although a well established practice in computing science, frameworks have only recently entered common use by unmanned vehicles. For industry and government, the complexity, cost, and time to re-implement stable systems often exceeds the perceived benefits of adopting a modern software infrastructure. Thus, most persevere with legacy software, adapting and modifying software when and wherever possible or necessary -- adopting strategic software frameworks only when no justifiable legacy exists. Conversely, academic programs with short one or two year projects frequently exploit strategic software frameworks but with little enduring impact. The open-source movement radically changes this picture. Academic frameworks
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Directory of Open Access Journals (Sweden)
Miki Tadaishi
Full Text Available Maximal oxygen uptake (VO(2max predicts mortality and is associated with endurance performance. Trained subjects have a high VO(2max due to a high cardiac output and high metabolic capacity of skeletal muscles. Peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α, a nuclear receptor coactivator, promotes mitochondrial biogenesis, a fiber-type switch to oxidative fibers, and angiogenesis in skeletal muscle. Because exercise training increases PGC-1α in skeletal muscle, PGC-1α-mediated changes may contribute to the improvement of exercise capacity and VO(2max. There are three isoforms of PGC-1α mRNA. PGC-1α-b protein, whose amino terminus is different from PGC-1α-a protein, is a predominant PGC-1α isoform in response to exercise. We investigated whether alterations of skeletal muscle metabolism by overexpression of PGC-1α-b in skeletal muscle, but not heart, would increase VO(2max and exercise capacity.Transgenic mice showed overexpression of PGC-1α-b protein in skeletal muscle but not in heart. Overexpression of PGC-1α-b promoted mitochondrial biogenesis 4-fold, increased the expression of fatty acid transporters, enhanced angiogenesis in skeletal muscle 1.4 to 2.7-fold, and promoted exercise capacity (expressed by maximum speed by 35% and peak oxygen uptake by 20%. Across a broad range of either the absolute exercise intensity, or the same relative exercise intensities, lipid oxidation was always higher in the transgenic mice than wild-type littermates, suggesting that lipid is the predominant fuel source for exercise in the transgenic mice. However, muscle glycogen usage during exercise was absent in the transgenic mice.Increased mitochondrial biogenesis, capillaries, and fatty acid transporters in skeletal muscles may contribute to improved exercise capacity via an increase in fatty acid utilization. Increases in PGC-1α-b protein or function might be a useful strategy for sedentary subjects to perform exercise
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Threats to Autonomy in Consumer Societies and Their Implications for Education
Schinkel, Anders; de Ruyter, Doret; Steutel, Jan
2010-01-01
The development of autonomy in children is a central concern of liberal philosophers of education. We endorse the liberal intuition that autonomy matters and that it is an appropriate aim of education. However, we divert from autonomy liberals, who defend a rather limited and demanding conception of autonomy that is closely connected with skills…
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[Autonomy, Trust and Medical Ethics in Onora O'Neill's Work].
Jaramillo, Carlos Alberto López; Lew, Jorge Carlos Holguín
2013-03-01
Autonomy has become a key concept in bioethics. Onora O'neill is perhaps the most representative author and researcher in the philosophical and bioethical fields regrding the concept of autonomy. To review the concept of autonomy in Onora O'Neill's work so as to understand its relevance in current bioethics. The concept of bioethics is reviewed in relation to three fundamental quesions: 1) Which are the main limitations of the individualistic conception of autonomy? 2) How to understand the relations between trust and autonomy together with their implications? and 3) Which are the implications of principled autonomy for aspects such as doctor-patient relationship and informed consent. The main works by O'Neill are reviewed, specifically regarding medical bioethics. O'neill's approach is original and relates Kantian autonomy to her own conceptions about trust, and both the individual and social levels of bioethics. The author has developed a Kantian non indvidualistic view of autonomy. Her conceptulization of trust and the crises this concept is currently undergoing complement and strengthen the concept of principled autonomy. The implications of O'Neill's concepts go beyond theoretical discussions and in her work she uses examples and analyzes circumstances which demonstrate the applicability of her proposals. O'Neill's work contributes to dealing with the challenges posed by the socio-political context of cost-efficiency oriented health systems and of the so-called defensive medicine. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
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Perceived Autonomy Support in the NIMH RAISE Early Treatment Program.
Browne, Julia; Penn, David L; Bauer, Daniel J; Meyer-Kalos, Piper; Mueser, Kim T; Robinson, Delbert G; Addington, Jean; Schooler, Nina R; Glynn, Shirley M; Gingerich, Susan; Marcy, Patricia; Kane, John M
2017-09-01
This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.
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Direct-to-consumer genomics on the scales of autonomy
Vayena, Effy
2015-01-01
Direct-to-consumer (DTC) genetic services have generated enormous controversy from their first emergence. A dramatic recent manifestation of this is the Food and Drug Administration's (FDA) cease and desist order against 23andMe, the leading provider in the market. Critics have argued for the restrictive regulation of such services, and even their prohibition, on the grounds of the harm they pose to consumers. Their advocates, by contrast, defend them as a means of enhancing the autonomy of those same consumers. Autonomy emerges as a key battle-field in this debate, because many of the ‘harm’ arguments can be interpreted as identifying threats to autonomy. This paper assesses whether DTC genomic services are a threat to, or instead, an enhancement of, personal autonomy. It deploys Joseph Raz's account of personal autonomy, with its emphasis on choice from a range of valuable options. It then seeks to counter claims that DTC genomics threatens autonomy because it involves manipulation in contravention of consumers’ independence or because it does not generate valuable options which can be meaningfully engaged with by consumers. It is stressed that the value of the options generated by DTC genomics should not be judged exclusively from the perspective of medical actionability, but should take into consideration plural utilities. Finally, the paper ends by broaching policy recommendations, suggesting that there is a strong autonomy-based argument for permitting DTC genomic services, and that the key question is the nature of the regulatory conditions under which they should be permitted. The discussion of autonomy in this paper helps illuminate some of these conditions. PMID:24797610
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Women's decision-making autonomy and children's schooling in rural Mozambique.
Luz, Luciana; Agadjanian, Victor
2015-03-24
Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.
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Scaffolding Learner Autonomy in Online University Courses
Ribbe, Elisa; Bezanilla, María José
2013-01-01
This paper deals with the question in what ways teachers and course designers can support the development and exertion of learner autonomy among online university students. It advocates that a greater attention to learner autonomy could help more students to complete their course successfully and thus contribute the decrease of the high dropout…
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Chou, Eileen Y; Halevy, Nir; Galinsky, Adam D; Murnighan, J Keith
2017-09-01
Contracts are commonly used to regulate a wide range of interactions and relationships. Yet relying on contracts as a mechanism of control often comes at a cost to motivation. Integrating theoretical perspectives from psychology, economics, and organizational theory, we explore this control-motivation dilemma inherent in contracts and present the Contract-Autonomy-Motivation-Performance-Structure (CAMPS) model, which highlights the synergistic benefits of combining structure and autonomy. The model proposes that subtle reductions in the specificity of a contract's language can boost autonomy, which increases intrinsic motivation and improves a range of desirable behaviors. Nine field and laboratory experiments found that less specific contracts increased task persistence, creativity, and cooperation, both immediately and longitudinally, because they boosted autonomy and intrinsic motivation. These positive effects, however, only occurred when contracts provided sufficient structure. Furthermore, the effects were limited to control-oriented clauses (i.e., legal clauses), and did not extend to coordination-oriented clauses (i.e., technical clauses). That is, there were synergistic benefits when a contract served as a scaffold that combined structure with general clauses. Overall, the current model and experiments identify a low-cost solution to the common problem of regulating social relationships: finding the right amount of contract specificity promotes desirable outcomes, including behaviors that are notoriously difficult to contract. The CAMPS model and the current set of empirical findings explain why, when, and how contracts can be used as an effective motivational tool. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Relativní autonomie kultury v Alexanderově kulturní sociologii
Skovajsa, Marek
2012-01-01
This article offers a critical discussion of the concept of the ‘relative autonomy of culture’ that is central to Jeffrey C. Alexander’s cultural sociology. It shows that, in Alexander’s work, the relative autonomy of culture is conceptualised in two different ways: first, as an analytical autonomy that is part of a multidimensional model of social action, and second, as the formal autonomy of a semiotic system that dominates in the more culturalist strand of Alexander’s work. The author clai...
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The Effect of Gender on Resident Autonomy in the Operating room.
Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M
Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application. Differences in autonomy given to male and female residents were elucidated using chi-square analysis and ordered logistic regression. Seven academic medical centers with thoracic surgery training programs. Volunteer thoracic surgery residents in both integrated and traditional training pathways and their affiliated cardiothoracic faculty. Residents (n = 33, female 18%) submitted a total of 596 evaluations to faculty (n = 48, female 12%). Faculty gave less autonomy to female residents with only 56 of 184 evaluations (30.3%) showing meaningful autonomy (passive help or supervision only) compared to 107 of 292 evaluations (36.7%) at those levels for male residents (p = 0.02). Resident perceptions of autonomy showed even more pronounced differences with female residents receiving only 38 of 197 evaluations (19.3%) with meaningful autonomy compared to 133 of 399 evaluations (33.3%) for male residents (p autonomy granted to residents. Evaluations of operative autonomy reveal a significant bias against female residents. Faculty education is needed to encourage allowing female residents more operative autonomy. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Sebire, Simon J; Standage, Martyn; Gillison, Fiona B; Vansteenkiste, Maarten
2013-06-01
Goals are central to exercise motivation, although not all goals (e.g., health vs. appearance goals) are equally psychologically or behaviorally adaptive. Within goal content theory (Vansteenkiste, Niemiec, & Soenens, 2010), goals are adaptive to the extent to which they satisfy psychological needs for autonomy, competence, and relatedness. However, little is known about what exercisers pursuing different goals are feeling, doing, thinking, and paying attention to that may help to explain the association between goal contents and need satisfaction. Using semistructured interviews and interpretative phenomenological analysis, we explored experiences of exercise among 11 adult exercisers who reported pursuing either predominantly intrinsic or extrinsic goals. Four themes emerged: (a) observation of others and resulting emotions, (b) goal expectations and time perspective, (c) markers of progress and (d) reactions to (lack of) goal achievement. Intrinsic and extrinsic goal pursuers reported divergent experiences within these four domains. The findings illuminate potential mechanisms by which different goals may influence psychological and behavioral outcomes in the exercise context.
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Hypotensive response magnitude and duration in hypertensives: continuous and interval exercise.
Carvalho, Raphael Santos Teodoro de; Pires, Cássio Mascarenhas Robert; Junqueira, Gustavo Cardoso; Freitas, Dayana; Marchi-Alves, Leila Maria
2015-03-01
Although exercise training is known to promote post-exercise hypotension, there is currently no consistent argument about the effects of manipulating its various components (intensity, duration, rest periods, types of exercise, training methods) on the magnitude and duration of hypotensive response. To compare the effect of continuous and interval exercises on hypotensive response magnitude and duration in hypertensive patients by using ambulatory blood pressure monitoring (ABPM). The sample consisted of 20 elderly hypertensives. Each participant underwent three ABPM sessions: one control ABPM, without exercise; one ABPM after continuous exercise; and one ABPM after interval exercise. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and double product (DP) were monitored to check post-exercise hypotension and for comparison between each ABPM. ABPM after continuous exercise and after interval exercise showed post-exercise hypotension and a significant reduction (p ABPM. Comparing ABPM after continuous and ABPM after interval exercise, a significant reduction (p < 0.05) in SBP, DBP, MAP and DP was observed in the latter. Continuous and interval exercise trainings promote post-exercise hypotension with reduction in SBP, DBP, MAP and DP in the 20 hours following exercise. Interval exercise training causes greater post-exercise hypotension and lower cardiovascular overload as compared with continuous exercise.
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Balaguer, Isabel; Castillo, Isabel; Cuevas, Ricardo; Atienza, Francisco
2018-01-01
Drawing on the self-determination framework, the study examined the effect of coaches' autonomy support on the leisure experience of young male football players. Specifically, a model was tested analyzing the long-term predictive power of the players' perceptions of the coaches' autonomy support at the beginning of the season on the subjective vitality of young football players at the end of the season, through needs satisfaction and intrinsic motivation (IM). Moreover, we tested whether the effects of coaches' autonomy support on the aforementioned variables (needs satisfaction, IM, and subjective vitality) at the end of the season remained at the beginning of the following season. Because the coach in the second season was not the same one as in the first season, the perception of coaches' autonomy support at the beginning of the second season was used as a control variable. Three hundred and sixty football players ( M age = 12.60 years; SD = 0.52) completed a questionnaire on the variables of interest at the beginning of the first season (T1), at the end of the first season (T2), and at the beginning of the second season (T3). The results of the path analyses showed that players' perceptions of coaches' autonomy support at the beginning of the season (T1) positively predicted needs satisfaction at the end of the first season (T2), which in turn predicted IM at the end of the first season (T2). Additionally, IM significantly and positively predicted subjective vitality at the end of the first season (T2). Finally, needs satisfaction, IM, and subjective vitality at the end of the second season (T2) positively predicted these same variables at the beginning of the second season (T3). Results emphasized the importance of the autonomy support offered by the coach in promoting the quality of young people's leisure experience playing football and its benefits for their well-being.
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González-Cutre, David; Sicilia, Álvaro; Fernández, Alberto
2010-11-01
The purpose of this study was to validate the Behavioural Regulation in Exercise Questionnaire in the Spanish context, including items to measure integrated regulation. Participants were 524 exercisers, mean age 29.59 years. The results revealed acceptable fit indices in the confirmatory factor analysis and good internal consistency (with a Cronbach alpha of .87 for integrated regulation). The diverse subscales also conformed to a simplex pattern and the factor structure was invariant across gender and age. Integrated regulation reflected high temporal stability over a 4-week period (ICC=.90). The criterion validity analysis of integrated regulation indicated that this variable was positively predicted by satisfaction of the needs for competence and autonomy. The results regarding the importance of measuring integrated regulation in exercise are discussed.
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SOCIOTROPY AND AUTONOMY IN EATING DISORDERS
Radziwiłłowicz, Wioletta; Czarniak, Katarzyna
2014-01-01
Objectives: Studies of development psychopathology and psychia try have shown that personality variables are greatly associated with eating disorders. Sociotropy and autonomy may be features that facilitate the occurrence and persistence of the eating disturbances. Theoretical framework for own research was mainly the A. Beck’s concept of autonomy and sociotropy. The aim of the study was to answer the research question whether a person suffering from an eating disorder is characterized by ...
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The Cascading Development of Autonomy and Relatedness From Adolescence to Adulthood
Oudekerk, Barbara A.; Allen, Joseph P.; Hessel, Elenda T.; Molloy, Lauren E.
2014-01-01
We tested a developmental cascade model of autonomy and relatedness in the progression from parent to friend to romantic relationships across ages 13, 18, and 21. Participants included 184 adolescents (53% female, 58% Caucasian, 29% African American) recruited from a public middle school in Virginia. Parental psychological control at age 13 undermined the development of autonomy and relatedness, predicting relative decreases in autonomy and relatedness with friends between ages 13 and 18 and lower levels of autonomy and relatedness with partners at age 18. These cascade effects extended into adult friendships and romantic relationships, with autonomy and relatedness with romantic partners at age 18 being a strong predictor of autonomy and relatedness with both friends and partners at age 21. PMID:25345623
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Relational autonomy: moving beyond the limits of isolated individualism.
Walter, Jennifer K; Ross, Lainie Friedman
2014-02-01
Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.
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Exercise and sleep in aging: emphasis on serotonin.
Melancon, M O; Lorrain, D; Dionne, I J
2014-10-01
Reductions in central serotonin activity with aging might be involved in sleep-related disorders in later life. Although the beneficial effects of aerobic exercise on sleep are not new, sleep represents a complex recurring state of unconsciousness involving many lines of transmitters which remains only partly clear despite intense ongoing research. It is known that serotonin released into diencephalon and cerebrum might play a key inhibitory role to help promote sleep, likely through an active inhibition of supraspinal neural networks. Several lines of evidence support the stimulatory effects of exercise on higher serotonergic pathways. Hence, exercise has proved to elicit acute elevations in forebrain serotonin concentrations, an effect that waned upon cessation of exercise. While adequate exercise training might lead to adaptations in higher serotonergic networks (desensitization of forebrain receptors), excessive training has been linked to serious brain serotonergic maladaptations accompanied by insomnia. Dietary supplementation of tryptophan (the only serotonin precursor) is known to stimulate serotonergic activity and promote sleep, whereas acute tryptophan depletion causes deleterious effects on sleep. Regarding sleep-wake regulation, exercise has proved to accelerate resynchronization of the biological clock to new light-dark cycles following imposition of phase shifts in laboratory animals. Noteworthy, the effect of increased serotonergic transmission on wake state appears to be biphasic, i.e. promote wake and thereafter drowsiness. Therefore, it might be possible that acute aerobic exercise would act on sleep by increasing activity of ascending brain serotonergic projections, though additional work is warranted to better understand the implication of serotonin in the exercise-sleep axis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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Wado, Yohannes Dibaba; Afework, Mesganaw Fantahun; Hindin, Michelle J
2014-01-01
Vaccination can reduce child mortality significantly and is a cost effective way to improve child health.Worldwide, more than 22 million children do not receive the basic recommended vaccinations.Vaccination coverage in Ethiopia remains low. Research on child health has focused on socio-economic factors such as maternal education and access to health care, but little attention has been given to demographic factors and women's autonomy within the household. The purpose of this study was to examine the influences of demographic factors and women's autonomy on the completion of childhood vaccination in rural Ethiopia. A cross-sectional community-based study was conducted in a Health and Demographic Survelliance System (HDSS) in southwestern Ethiopia. Data were drawn from a random sample of women with children aged 12-24 months (n = 889). Information on maternal socio-demographic characteristics and household variables were collected using an interviewer-administered structured questionnaire. Vaccination data were obtained from vaccination cards or mother's recall. Multivariate logistic regression was used to assess the association of independent variables with completion of childhood vaccination. Of 889 children aged 12-24 months, 690 (78%) had received at least one vaccination. Only 37% (95% CI, 33.5-39.9) were fully vaccinated. Women's decision making autonomy, number of under-five children in the household, mother's education, use of antenatal care services and proximity to health facility were the main factors associated with full vaccination status. Completion of basic vaccination series is very low in the study area. Initiatives that enhance women's autonomy within the household and that promote healthy timing and spacing of pregnancies may help in improving child health through vaccination.
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Supported teaching autonomy support. [Enseñanza apoyada en el soporte de autonomía].
Directory of Open Access Journals (Sweden)
Juan Antonio Moreno-Murcia
2016-01-01
Full Text Available The findings obtained from the study and research into the consequences of applying determined teaching styles has led to a growing interest in this area among the scientific community. The student-centered and constructivist learning environments which enable students to gain a significant understanding through their own efforts has grown in importance compared with the traditional learning environment based on the transfer of learning by teachers (Oguz, 2013. In the context of the constructivist approach, students create their own knowledge by actively participating in the learning process (Wang, 2011, and by giving importance to the learners’ autonomy. In these environments of interaction, the teacher becomes the learning facilitator, planning tasks and supporting responsibility for learning (Koç, 2006, providing students with options, helping them make their own decisions and solve problems for themselves. Consequently, this new focus provides students with opportunities to ask their own questions, and create their own learning concepts and strategies based on existing knowledge. The teacher has to accept students’ autonomy and their enterprising spirit, and support them in this sense. In the context of this constructivist focus, one of the the main objectives of education is to promote students’ autonomy (Öztürk, 2011.
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Autonomy-based arguments against physician-assisted suicide and euthanasia: a critique.
Sjöstrand, Manne; Helgesson, Gert; Eriksson, Stefan; Juth, Niklas
2013-05-01
Respect for autonomy is typically considered a key reason for allowing physician assisted suicide and euthanasia. However, several recent papers have claimed this to be grounded in a misconception of the normative relevance of autonomy. It has been argued that autonomy is properly conceived of as a value, and that this makes assisted suicide as well as euthanasia wrong, since they destroy the autonomy of the patient. This paper evaluates this line of reasoning by investigating the conception of valuable autonomy. Starting off from the current debate in end-of-life care, two different interpretations of how autonomy is valuable is discussed. According to one interpretation, autonomy is a personal prudential value, which may provide a reason why euthanasia and assisted suicide might be against a patient's best interests. According to a second interpretation, inspired by Kantian ethics, being autonomous is unconditionally valuable, which may imply a duty to preserve autonomy. We argue that both lines of reasoning have limitations when it comes to situations relevant for end-of life care. It is concluded that neither way of reasoning can be used to show that assisted suicide or euthanasia always is impermissible.
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Desire for autonomy in health care decisions: a general population survey.
Cullati, Stéphane; Courvoisier, Delphine S; Charvet-Bérard, Agathe I; Perneger, Thomas V
2011-04-01
To examine factors associated with desire for autonomy in health care decisions in the general population. Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Soma, Yuki; Tsunoda, Kenji; Kitano, Naruki; Jindo, Takashi; Okura, Tomohiro
2015-01-01
The present study examines factors affecting individuals' awareness of certain types of preventive care exercises, particularly the distance from their home to an exercise facility and their social networks. Participants were 3206 men (age, 73.0±6.2 years) and 3395 women (age, 73.2±6.4 years) aged ≥65 years who had not been certified as persons with care needs and who had responded to an inventory survey conducted in Kasama City, Japan, in 2013. We performed multiple logistic regression analysis to assess the characteristics associated with participants' awareness of two types of exercises for preventive care: "silver rehabili taisou" (SRT) and "square-stepping exercise" (SSE). Independent variables were distance from home to the exercise facility, social networks, transportation availability, physical function, cognitive function, and neighborhood population density. Older adults who were aware of the exercises lived significantly closer to an exercise facility (SRT, aware: 1,148.5±961.3 m vs. unaware: 1,284.2±1,027.4 m; SSE, aware: 1,415.9±1104.1 m vs. unaware: 1,615.7±1,172.2 m). Multiple logistic regression analysis showed that participation in community activities (men, SRT-odds ratio [OR]=2.54 and SSE-OR=2.19; women, SRT-OR=4.14 and SSE-OR=3.34] and visiting friends (men, SRT-OR=1.45 and SSE-OR=1.49; women SRT-OR=1.44 and SSE-OR=1.73) were promoting factors for awareness of both types of exercises. In men and women, low physical function (SRT-OR=0.73 and SSE-OR=0.56) and dependence on another person to drive them to the destination (SRT-OR=0.79 and SSE-OR=0.78) were inhibiting factors, respectively. A distance of >500 m between their home and the facility tended to be an inhibiting factor. A shorter distance from home to an exercise facility and better social networks increased awareness of preventive care exercises in both sexes and for both types of exercise. Establishing exercise centers and devising effective methods of imparting information to
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Measuring the e-Learning Autonomy of Distance Education Students
Directory of Open Access Journals (Sweden)
Mehmet Firat
2016-08-01
Full Text Available Previous studies have provided evidence that learner autonomy is an important factor in academic achievement. However, few studies have investigated the autonomy of distance education students in e-learning environments. The purpose of this study is to evaluate the e-learning autonomy of distance education students who are responsible for their own learning. For this purpose, as the first step of the study, an e-learning autonomy scale was developed. Analyses of the validity and reliability of the scale were carried out with the participation of 1,152 distance education students from Anadolu University, Open Education System. The scale has an internal consistency coefficient of α = 0.952 and a single factorial model that explains 66.58% of the total variance. The scale was implemented with 3,293 students from 42 different programs. According to the findings, student autonomy in e-learning environments is directly proportional to level of ICT use but not affected by program or gender.
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Becoming Autonomous: Nonideal Theory and Educational Autonomy
Wilson, Terri S.; Ryg, Matthew A.
2015-01-01
Autonomy operates as a key term in debates about the rights of families to choose distinct approaches to education. Yet, what autonomy means is often complicated by the actual circumstances and contexts of schools, families, and children. In this essay, Terri S. Wilson and Matthew A. Ryg focus on the challenges involved in translating an ideal of…
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Fathers' Autonomy Support and Social Competence of Sons and Daughters
Corwyn, Robert F.; Bradley, Robert H.
2016-01-01
Relations between paternal autonomy support and four aspects of adolescent social competence and responsibility at age 16 were examined using data from the NICHD Study of Early Child Care and Youth Development. With controls on maternal autonomy support, significant relations were observed between paternal autonomy support and three of the four…
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A relational perspective on autonomy for older adults residing in nursing homes.
Sherwin, Susan; Winsby, Meghan
2011-06-01
To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.
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Falzon, Charlène; Radel, Rémi; Cantor, Ambre; d'Arripe-Longueville, Fabienne
2015-03-01
Research in health communication has shown that narratives contribute more positively to changing health behaviors than informational messages. The main purposes of this study were to examine and to compare the effects of two messages promoting physical activity, one narrative and the other informational, on the perceptions and behavioral intentions of cancer patients. A total of 158 women with breast cancer, undergoing chemotherapy and sedentary, were assigned to read the testimony of a breast cancer survivor who had been physically active during and after treatment (TE group), a content-equivalent message composed of expert recommendations about physical activity in breast cancer patients (RE group), or no message (control group). Source trust was higher in TE group than RE group (p Exercise self-efficacy and exercise intention were higher in TE group than RE and control groups (p exercise benefits (p exercise risks (p exercise self-efficacy, and beliefs about exercise benefits and risks mediated the relationship between the message and exercise intention. The results suggest that narratives may be more effective in improving perceived physical abilities and involvement in physical activity, whereas informational messages seem to be more appropriate to convey the benefits and the absence of risks related to physical activity.
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The cascading development of autonomy and relatedness from adolescence to adulthood.
Oudekerk, Barbara A; Allen, Joseph P; Hessel, Elenda T; Molloy, Lauren E
2015-01-01
A developmental cascade model of autonomy and relatedness in the progression from parent to friend to romantic relationships across ages 13, 18, and 21 was examined among 184 adolescents (53% female, 58% Caucasian, 29% African American) recruited from a public middle school in Virginia. Parental psychological control at age 13 undermined the development of autonomy and relatedness, predicting relative decreases in autonomy and relatedness with friends between ages 13 and 18 and lower levels of autonomy and relatedness with partners at age 18. These cascade effects extended into adult friendships and romantic relationships, with autonomy and relatedness with romantic partners at age 18 being a strong predictor of autonomy and relatedness with both friends and partners at age 21. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.
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The impact of financial constraints and incentives on professional autonomy.
Lewis, Jenny M; Marjoribanks, Tim
2003-01-01
General practice has been the subject of extensive reforms over the 1990s in Australia as elsewhere. Reforms have attempted to improve quality and contain the overall cost of health care, and have often been seen as reducing the autonomy of medical professionals. This paper examines the impact of financial constraints and incentives introduced during the 1990s on Australian GPs' perceptions of autonomy. An existing seven component definition of autonomy and six themes that emerged from reviewing publications were used to construct focus group questions. A total of 25 GPs participated in four focus groups. Those who participated believe that their financial autonomy has been diminished by policy changes and consumer expectations. They also perceive that their ability to control clinical decisions, which they regard as the most important aspect of professional autonomy, has been reduced along with financial autonomy. Organized medicine in Australia sees financial accountability and clinical decision making as polar opposites, and has continued to argue that fee-for-service payment is the only appropriate method of remuneration, despite increasing evidence that this does not guarantee clinical autonomy. Major changes to the financing of general practice in Australia are required to address the concerns of GPs, governments and patients.
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Stephen, Kate; Cumming, Grant P
2012-09-01
This paper describes the investigation, categorization/characterization and viewing of pelvic floor muscle exercises (PFME) on YouTube from the perspective of the 'wisdom of the crowd'. The aim of the research was to increase awareness of the type of clips that individuals are likely to come across when searching YouTube and to describe trends and popularity. This awareness will be useful for the design of continence promotion services, especially for hard-to-reach individuals. Web-based videos relating to PFE were identified by searching YouTube using the snowball technique. Main outcome measures Number of views; the approach taken (health, fitness, sexual and pregnancy); product promotion; and the use of music, visual cues and elements designed to encourage exercise. The number of views of each video was recorded at three points over a seven-month period. Twenty-two videos were identified. Overall these videos had been viewed over 430,000 times during the study period. One video was viewed over 100,000 times and overall the median increase in views was 59.4%. YouTube is increasingly used to access information about pelvic floor exercises. Different approaches are used to communicate PFME information but there are no formal structures for quality control. Further research is required to identify which elements of the video clips are effective in communicating information and in motivating exercise and to establish appropriate protocols. Kitemarking is recommended in order that women obtain correct advice.
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Exercise, fitness, and the gut.
Cronin, Owen; Molloy, Michael G; Shanahan, Fergus
2016-03-01
Exercise and gut symptomatology have long been connected. The possibility that regular exercise fosters intestinal health and function has been somewhat overlooked in the scientific literature. In this review, we summarize current knowledge and discuss a selection of recent, relevant, and innovative studies, hypotheses and reviews that elucidate a complex topic. The multiorgan benefits of regular exercise are extensive. When taken in moderation, these benefits transcend improved cardio-respiratory fitness and likely reach the gut in a metabolic, immunological, neural, and microbial manner. This is applicable in both health and disease. However, further work is required to provide safe, effective recommendations on physical activity in specific gastrointestinal conditions. Challenging methodology investigating the relationship between exercise and gut health should not deter from exploring exercise in the promotion of gastrointestinal health.
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Wang, Qian; Chan, Hoi-Wing; Lin, Li
2012-11-01
Despite ample evidence for the benefits of parental autonomy support and the harms of parental psychological control to Chinese adolescents' well-being, little is known about what foreshadows these parenting behaviors among Chinese parents. The current research addressed this gap in the literature. It tested the hypothesis that parents' endorsement of self-development socialization goals (i.e., regarding a positive sense of self in terms of holding optimistic attitudes toward oneself, feeling autonomous in one's actions, and establishing one's independence from others, as important for adolescents to develop) and adolescents' school performance may interact to predict parental autonomy support and psychological control in urban China. Three hundred and forty-one Chinese seventh graders (mean age = 13.30 years, 58 % female) and their parents (186 mothers and 155 fathers) participated. Parents reported on their own and their spouses' endorsement of self-development socialization goals; adolescents reported on parental autonomy support and psychological control; and adolescents' grades were obtained from school records. Significant interactions were found between parents' socialization goals and adolescents' grades in predicting parenting behaviors. When adolescents were doing well at school, the stronger parents' endorsement of self-development socialization goals, the greater their autonomy support and the lesser their psychological control; when adolescents were doing poorly at school, regardless of parents' socialization goals, their autonomy support was relatively low and their psychological control was relatively high. These findings highlight a tension between parental concerns over adolescents' self-development and academic success, which needs to be resolved to promote autonomy support and prevent psychological control among urban Chinese parents.
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Calogiuri, Giovanna; Elliott, Lewis R
2017-04-04
Exercise in natural environments ("green exercise") confers numerous health benefits, but little is known about why people engage in green exercise. This study examined the importance of nature experiences as a motive for physical activity and the motivational profile of people who engage in green exercise compared to gym- and sports-based exercise. Physical activity motives and typical times spent in different domains of physical activity were reported by 2168 Norwegian adults in a survey. Experiencing nature was generally rated as the second-most important physical activity motive, exceeded only by convenience motives, and it was especially important for older adults and those who engage in greater amounts of instrumental physical activity. Green exercisers reported stronger motives concerning convenience and experiencing nature, whereas gym- or sports-based exercisers reported stronger motives for physical health and sociability. The motives associated with different leisure-time exercise domains may assist in understanding optimal promotion of green exercise.
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How Sex Selection Undermines Reproductive Autonomy.
Browne, Tamara Kayali
2017-06-01
Non-medical sex selection is premised on the notion that the sexes are not interchangeable. Studies of individuals who undergo sex selection for non-medical reasons, or who have a preference for a son or daughter, show that they assume their child will conform to the stereotypical roles and norms associated with their sex. However, the evidence currently available has not succeeded in showing that the gender traits and inclinations sought are caused by a "male brain" or a "female brain". Therefore, as far as we know, there is no biological reason why parents cannot have the kind of parenting experience they seek with a child of any sex. Yet gender essentialism, a set of unfounded assumptions about the sexes which pervade society and underpin sexism, prevents parents from realising this freedom. In other words, unfounded assumptions about gender constrain not only a child's autonomy, but also the parent's. To date, reproductive autonomy in relation to sex selection has predominantly been regarded merely as the freedom to choose the sex of one's child. This paper points to at least two interpretations of reproductive autonomy and argues that sex selection, by being premised on gender essentialism and/or the social pressure on parents to ensure their children conform to gender norms, undermines reproductive autonomy on both accounts.
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Effect of aerobic exercise intervention on DDT degradation and oxidative stress in rats.
Li, Kefeng; Zhu, Xiaohua; Wang, Yuzhan; Zheng, Shuqian; Dong, Guijun
2017-03-01
Dichlorodiphenyltrichloroethane (DDT) reportedly causes extensively acute or chronic effects to human health. Exercise can generate positive stress. We evaluated the effect of aerobic exercise on DDT degradation and oxidative stress. Male Wistar rats were randomly assigned into control (C), DDT without exercise training (D), and DDT plus exercise training (DE) groups. The rats were treated as follows: DDT exposure to D and DE groups at the first 2 weeks; aerobic exercise treatment only to the DE group from the 1st day until the rats are killed. DDT levels in excrements, muscle, liver, serum, and hearts were analyzed. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels were determined. Aerobic exercise accelerated the degradation of DDT primarily to DDE due to better oxygen availability and aerobic condition and promoted the degradation of DDT. Cumulative oxidative damage of DDT and exercise led to significant decrease of SOD level. Exercise resulted in consistent increase in SOD activity. Aerobic exercise enhanced activities of CAT and GSH-Px and promoted MDA scavenging. Results suggested that exercise can accelerate adaptive responses to oxidative stress and activate antioxidant enzymes activities. Exercise can also facilitate the reduction of DDT-induced oxidative damage and promoted DDT degradation. This study strongly implicated the positive effect of exercise training on DDT-induced liver oxidative stress.
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Religious Belonging, Religious Agency, and Women’s Autonomy in Mozambique
Agadjanian, Victor; Yabiku, Scott T.
2016-01-01
Women’s autonomy has frequently been linked with women’s opportunities and investments, such as education, employment, and reproductive control. The association between women’s autonomy and religion in the developing world, however, has received less attention, and the few existing studies make comparisons across major religious traditions. In this study, we focus on variations in levels of female decision-making autonomy within a single religious tradition—Christianity. Using unique survey data from a predominantly Christian area in Mozambique, we devise an autonomy scale and apply it to compare women affiliated to different Christian denominations as well as unaffiliated women. In addition to affiliation, we examine the relationship between autonomy and women’s religious agency both within and outside their churches. Multivariate analyses show that women belonging to more liberal religious traditions (such as Catholicism and mainline Protestantism) and tend to have higher autonomy levels, regardless of other factors. These results are situated within the cross-national scholarship on religion and women’s empowerment and are interpreted in the context of gendered religious dynamics in Mozambique and similar developing settings. PMID:26973353
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Perceived benefits and barriers to physical exercise participation of ...
African Journals Online (AJOL)
Regular participation in exercise is associated with disease prevention and provides many benefits. Physical exercise plays a key role in the promotion of good health. However, very few young people participate in physical exercise. The purpose of this study was to identify the perceived benefits and barriers to participation ...
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The Fiction of Respect Individual Autonomy as a Kind Of Clínical Research Human Subject Explotation
Directory of Open Access Journals (Sweden)
Natalia Petersen Nascimento Santos
2015-12-01
Full Text Available This article promotes a discussion of western legal concept which sees individuals as subjects of rights, discussing the advisability of such a formulation in the context of clinical trials in humans, since the commonly borderline situation of vulnerability in which they are volunteers who submit to such procedures. For this purpose, it was used as a theoretical framework to work "Critical Introduction to Law" Michel Mialle, in which the author states in a forceful way that the construction of the legal institute of the "subject of law" and the imposition of unrestricted recognition of individual autonomy constitute a construction of the bourgeois state to facilitate the domination of vulnerable, so that this, although not legally obliged to practice certain behaviors, see forced by circumstances to act in line with the interests of that institution. It is argued, therefore, that autonomy to consent to participation in scientific trials must be assessed in each case, with special attention to circumstances which might vulnerabilizar voluntary research and mitigate their individual autonomy in the face of the experiments, under penalty to be subjecting the individual to harmful procedures to their lives and health for the benefit of capital society's interests.
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School nurses' perceptions of empowerment and autonomy.
DeSisto, Marie C; DeSisto, Thomas Patrick
2004-08-01
The purpose of this study was to explore Kanter's Theory of Structural Power in Organizations, using school nurses and to answer the research question of whether there is a relationship between empowerment and autonomy in school nurses. This study found a positive relationship between the nurses' perceptions of empowerment and autonomy. The school nurses surveyed perceived themselves to have a high degree of autonomy and a moderate degree of empowerment, and they reported that their access to informal power structures was higher than their access to formal power structures in their school systems. School nurses can benefit by understanding factors that can increase their empowerment in the workplace. They need to understand the organizational structure of their workplace to increase their effectiveness and job satisfaction.
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Attachment, Autonomy, and Emotional Reliance: A Multilevel Model
Lynch, Martin F.
2013-01-01
This article reports a test of a multilevel model investigating how attachment security and autonomy contribute to emotional reliance, or the willingness to seek interpersonal support. Participants ("N" = 247) completed online measures of attachment, autonomy, emotional reliance, and vitality with respect to several everyday…
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Autonomy and exclusion among Danish prisoners in education
DEFF Research Database (Denmark)
Riis, Anita Holm
2018-01-01
A prison sentence necessarily means that the person receiving the sentence is in essential ways excluded from the surrounding society. This exclusion means fewer choices and, in the long run, this may affect the person’s ability to actively make choices – therefore, autonomy is an important theme...... choices as well as a high degree of autonomy on the part of the individual inmate. This article focuses on the interplay between exclusion and autonomy in relation to Danish prison inmates who are in education. Alongside this, a more general insight into the educational life of Danish prisoners...
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Changing Professional autonomy in the Context of Institutional Change
DEFF Research Database (Denmark)
Jespersen, Peter Kragh; Houlberg Salomonsen, Heidi
The Changing autonomy of doctors and civil servants in Denmark in different institutional contexts......The Changing autonomy of doctors and civil servants in Denmark in different institutional contexts...
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Rebranding exercise: closing the gap between values and behavior
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Eccles Jacquelynne S
2011-08-01
Full Text Available Abstract Background Behavior can only be understood by identifying the goals to which it is attached. Superordinate-level goals are linked to individuals' values, and may offer insights into how to connect exercise with their core values and increase participation in sustainable ways. Methods A random sample of healthy midlife women (aged 40-60y was selected to participate in a year-long mixed-method study (n = 226. Superordinate goals were measured inductively and analyzed using grounded theory analysis. Attainment Value and Exercise Participation were quantitatively measured. An ANOVA and pairwise comparisons were conducted to investigate the differences between superordinate exercise goals in attainment value. This study fit a Linear Mixed Model to the data to investigate the fixed effects of superordinate goals on exercise participation, controlling for BMI and social support. Results Participants mainly exercised to achieve Healthy-Aging, Quality-of-Life, Current-Health, and Appearance/Weight superordinate goals. Despite equally valuing Healthy-Aging, Quality-of-Life, and Current-Health goals, participants with Quality-of-Life goals reported participating in more exercise than those with Current-Health (p Conclusions Superordinate exercise goals related to health and healthy aging are associated with less exercise than those related to enhancing daily quality of life, despite being equally valued. While important, pursuing distant benefits from exercise such as health promotion, disease prevention, and longevity might not be as compelling to busy individuals compared to their other daily priorities and responsibilities. By shifting our paradigm from medicine to marketing, we can glean insights into how we can better market and "sell" exercise. Because immediate payoffs motivate behavior better than distant goals, a more effective "hook" for promoting sustainable participation might be to rebrand exercise as a primary way individuals can
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Lessons for Hospital Autonomy : Implementation in Vietnam from International Experience
Vietnam Ministry of Health; Health Strategy and Policy Institute; World Bank; World Health Organization
2011-01-01
The Government of Vietnam sees hospital autonomy policy as important and consistent with current development trends in Vietnam. It is based on government policies as laid out in government Decree on financial autonomy of revenue-generating public service entities; and to 2006, it is replaced by decree on professional, organizational, human resource management and financial autonomy of reve...
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Development and Validation of the Adolescent Psychological Need Support in Exercise Questionnaire.
Emm-Collison, Lydia G; Standage, Martyn; Gillison, Fiona B
2016-10-01
Grounded within self-determination theory (SDT; Deci & Ryan, 2000; Ryan & Deci, in press), three studies were conducted to develop and psychometrically test a measure of adolescents' perceptions of psychological need support for exercise (viz., for autonomy, competence, and relatedness): the Adolescent Psychological Need Support in Exercise Questionnaire (APNSEQ). In Study 1, 34 items were developed in collaboration with an expert panel. Through categorical confirmatory factor analysis and item response theory, responses from 433 adolescents were used to identify the best fitting and performing items in Study 2. Here, a three-factor nine-item measure showed good fit to the data. In Study 3, responses from an independent sample of 373 adolescents provided further evidence for the nine-item solution as well as for internal consistency, criterion validity, and invariance across gender and social agent (friends, family, and physical education teacher). The APNSEQ was supported as a measure of adolescents' perceptions of psychological need support within the context of exercise.
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Autonomy and Accountability in Standards-Based Reform
Directory of Open Access Journals (Sweden)
Susan Watson
2001-08-01
Full Text Available In this article we discuss the effects of one urban school district's efforts to increase the autonomy and accountability of schools and teams of teachers through a standards-based reform known as team- based schooling. Team-based schooling is designed to devolve decision-making authority down to the school level by increasing teachers' autonomy to make decisions. Increased accountability is enacted in the form of a state-level standards-based initiative. Based on our evaluation over a two-year period involving extensive fieldwork and quantitative analysis, we describe the ways that teachers, teams and school administrators responded to the implementation of team-based schooling. What are the effects of increasing school-level autonomy and accountability in the context of standards- based reform? Our analysis highlights several issues: the "lived reality" of teaming as it interacts with the existing culture within schools, the ways that teachers respond to the pressures created by increased internal and external accountability, and the effects of resource constraints on the effectiveness of implementation. We conclude by using our findings to consider more broadly the trade-off between increased autonomy and accountability on which standards-based reforms like team-based schooling are based.
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Ny styring af lærernes autonomi?
DEFF Research Database (Denmark)
Holm, Claus
2015-01-01
Kapitlet ”Ny styring af lærernes autonom?” i bogen Folkeskolen - efter reformen fokuserer på, hvordan en realisering af den vedtagne skolereform og forventningen om en kommende brug af nye forenklede Fælles Mål ud fra en målstyringstænkning ændrer lærernes autonomi til at udøve dømmekraft i...... klasseværelset. Dermed er kapitlets tese, at man ikke – i hvert fald ikke kun – kan tale om et tab af autonomi, men en ændret opfattelse og indhold heraf. Opgaven er derfor at indkredse, hvordan danske læreres autonomi til at udøve professionel dømmekraft forandrer sig, hvis man realiserer idéen om en...... læringsmålstyret undervisning, konkret i form af forenklede Fælles Mål. Og netop spørgsmålet om lærerens autonomi til at udøve professionel dømmekraft bliver i sammenhæng med styring heraf et centralt emne og problematik at afklare. Ikke kun i dansk sammenhæng, men også internationalt....
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Mental health as rational autonomy.
Edwards, R B
1981-08-01
Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real.
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Toward a framework for levels of robot autonomy in human-robot interaction.
Beer, Jenay M; Fisk, Arthur D; Rogers, Wendy A
2014-07-01
A critical construct related to human-robot interaction (HRI) is autonomy, which varies widely across robot platforms. Levels of robot autonomy (LORA), ranging from teleoperation to fully autonomous systems, influence the way in which humans and robots may interact with one another. Thus, there is a need to understand HRI by identifying variables that influence - and are influenced by - robot autonomy. Our overarching goal is to develop a framework for levels of robot autonomy in HRI. To reach this goal, the framework draws links between HRI and human-automation interaction, a field with a long history of studying and understanding human-related variables. The construct of autonomy is reviewed and redefined within the context of HRI. Additionally, the framework proposes a process for determining a robot's autonomy level, by categorizing autonomy along a 10-point taxonomy. The framework is intended to be treated as guidelines to determine autonomy, categorize the LORA along a qualitative taxonomy, and consider which HRI variables (e.g., acceptance, situation awareness, reliability) may be influenced by the LORA.
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Autonomy and social functioning of recently admitted nursing home residents.
Paque, Kristel; Goossens, Katrien; Elseviers, Monique; Van Bogaert, Peter; Dilles, Tinne
2017-09-01
This paper examines recently admitted nursing home residents' practical autonomy, their remaining social environment and their social functioning. In a cross-sectional design, 391 newly admitted residents of 67 nursing homes participated. All respondents were ≥65 years old, had mini-mental state examination ≥18 and were living in the nursing home for at least 1 month. Data were collected using a structured questionnaire and validated measuring tools. The mean age was 84, 64% were female, 23% had a partner, 80% children, 75% grandchildren and 59% siblings. The mean social functioning score was 3/9 (or 33%) and the autonomy and importance of autonomy score 6/9 (or 67%). More autonomy was observed when residents could perform activities of daily living more independently, and cognitive functioning, quality of life and social functioning were high. Residents with depressive feelings scored lower on autonomy and social functioning compared to those without depressive feelings. Having siblings and the frequency of visits positively correlated with social functioning. In turn, social functioning correlated positively with quality of life. Moreover, a higher score on social functioning lowered the probability of depression. Autonomy or self-determination and maintaining remaining social relationships were considered to be important by the new residents. The remaining social environment, social functioning, quality of life, autonomy and depressive feelings influenced each other, but the cause--effect relation was not clear.
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THE CORRELATION BETWEEN THE AUTONOMY RATIO AND THE RETURN ON EQUITY
Directory of Open Access Journals (Sweden)
Daniel BRÎNDESCU – OLARIU
2014-11-01
Considering the relationship between the autonomy ratio and the bankruptcy risk as well as the relationship between the autonomy ratio and the return on equity, it is concluded that the optimum value of the autonomy ratio is placed within the interval [50%; 100%].
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Demographic and Socio-Economic Determinants of Local Financial Autonomy in Romania
Dănuţ Vasile JEMNA; Mihaela ONOFREI; Elena CIGU
2013-01-01
Local autonomy is a rarely explored concept in the literature, still holding an increasing importance in the current context of Romania’s development in the European Union. In this paper we attempt to provide an overall survey on the financial dimension of local autonomy, assuming that local autonomy cannot be implemented, unless local authorities have adequate financial resources. In this study we also analyze the possibility to measure the local revenue autonomy and to identify the variable...
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Eccentric or Concentric Exercises for the Treatment of Tendinopathies?
DEFF Research Database (Denmark)
Couppé, Christian; Svensson, René B; Silbernagel, Karin Grävare
2015-01-01
with respect to parameters like load magnitude, speed of movement, and recovery period between exercise sessions. Future studies should control for these loading parameters, evaluate various exercise dosages, and also think beyond isolated eccentric exercises to arrive at firm recommendations regarding...... exercise has been promoted. In this review we cover the relevant evidence for different exercise regimes in tendinopathy rehabilitation with particular focus on the applied loads that are experienced by the tendon and how the exercise regime may affect these applied loads. There is no convincing clinical...
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Shogren, Karrie A.; Wehmeyer, Michael L.; Lassmann, Heather; Forber-Pratt, Anjali J.
2017-01-01
Supported decision making (SDM) has begun to receive significant attention as means to enable people to exercise autonomy and self-determination over decisions about their life. Practice frameworks that can be used to promote the provision of supports for decision making are needed. This paper integrates the literature across intellectual and…
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Chiou, Wen-Bin
2006-01-01
In a culture or society with high collectivism, contingent orientation and constrained autonomy are the prominent characteristics of adolescents' self-construal. This article examined whether Taiwanese adolescents' contingency and autonomy were associated with their prevalent preferences for buffet consumption. Findings in a panel survey indicated that contingency was positively correlated with adolescents' buffet preference, whereas autonomy was negatively correlated. Moreover, the results showed that adolescents' contingent orientation and perceived autonomy could predict their subsequent buffet preference over a half-year period. A laboratory experiment showed that adolescents who perceived lower autonomy exhibited greater preferences for buffet over the other diet consumption. In general, the results suggest that collectivist adolescents' contingency and autonomy were related to their trait-like preferences for buffet, and the state-like preferences for buffet were affected by their perceived levels of autonomy. Findings provide further insights into the impact of adolescents' self-construal on their diet consumption.
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Physical exercise, inflammatory process and adaptive condition: an overview
Silva, Fernando Oliveira Catanho da; Macedo, Denise Vaz
2011-01-01
Physical exercise induces inflammation, a physiological response that is part of immune system activity and promotes tissue remodeling after exercise overload. The activation of the inflammatory process is local and systemic and is mediated by different cells and secreted compounds. The objective is to reestablish organ homeostasis after a single bout of exercise or after several exercise sessions. The acute-phase response involves the combined actions of activated leukocytes, cytokines, acut...
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De Geyndt, Willy
2017-04-01
Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier
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Food compensation: do exercise ads change food intake?
Kleef, van E.; Shimizu, M.; Wansink, B.
2011-01-01
Background: Past research has shown that promotional messages such as food advertising influence food consumption. However, what has gone largely unexplored is the effect of exercise advertising on food intake. This study experimentally tested the effects of exposure to exercise commercials on food
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Directory of Open Access Journals (Sweden)
Estélio Herinque Martin Dantas
2012-09-01
Full Text Available The present study aimed to determine the effects of a physical activity program on the functional autonomy of elderly women. The sample was divided into an experimental group (EG; n = 20; 68.51 ± 5.02 years; BMI = 27.01 ± 4.35 submitted to a physical activity program, and a control group (CG; n = 20; 67.01 ± 3.51 years; BMI = 26.71 ± 5.74. Functional autonomy was assessed using tests from the GDLAM autonomy protocol: 10 meter walk test (10MW, rising from a sitting position (RSP, rising from a ventral decubitus position (RVDP, rising from a chair and moving around the house (RCMH and putting on and taking off a t-shirt (PTT, after which the autonomy index (AI was calculated. In the EG, ANOVA showed significant reductions in execution times for the RSP (∆ = -3.92 s; p = 0.0001, RCMH (∆ = -9.61 s; p = 0.0001, 10MW (∆ = -0.94 s; p = 0.038 and RVDP (∆ = -1.15 s; p = 0.036 tests, as well as the AI (∆ = -6.27; p = 0.0001. This was not observed in the CG. Intergroup comparisons demonstrated that execution times for the RSP (∆% = -36.63; p = 0.0001, RCMH (∆% = -20.27; p = 0.0001, 10mW (∆% = -12.54; p = 0.002 and RVDP (∆% = -25.10; p = 0.005 tests and the AI (∆% = -21.37; p = 0.0001 of the EG were shorter than those of the CG. These results indicate that elderly subjects in the EG showed improved performance in activities of daily living after engaging in physical exercise.
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Consumer Behavior Classroom Exercises that Really Work.
Kimmel, Allan J.
1999-01-01
Describes five in-class exercises for use in consumer behavior classes that encourage student involvement in group and class discussions, promote student interest in course material, and stimulate critical thinking. Explains that the exercises can be adapted for other related courses and are equally successful with students of varying abilities.…
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Meta-synthesis on nurse practitioner autonomy and roles in ambulatory care.
Wang-Romjue, Pauline
2018-04-01
Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments. © 2017 Wiley Periodicals, Inc.
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Autonomy of nurse practitioners in primary care: An integrative review.
Choi, Min; De Gagne, Jennie C
2016-03-01
This integrative review of the existing literature was conducted to identify dimensions related to nurse practitioner (NP) autonomy and to recommend future areas of research related to the important topic of NP autonomy in this era of cost-conscious healthcare reform. Articles were identified from the following databases: CINAHL, MEDLINE, PubMed, Ovid, Scopus, Google Scholar, and EBSCO. Over 24 articles were found; 12 peer-reviewed articles met the inclusion criteria of research conducted with NPs, physicians, and patients. The results revealed three categories of association with regard to NP autonomy: job satisfaction, patient satisfaction, and physician-NP collaboration. This review was undertaken to advance understanding of autonomy among NPs and the dynamics involved in their delivery of care. Further research into the associations between NP autonomy and its dimensions are necessary to indicate a future direction to the NP role. ©2015 American Association of Nurse Practitioners.
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First- and second-born adolescents' decision-making autonomy throughout adolescence.
Campione-Barr, Nicole; Lindell, Anna K; Short, Stephen D; Greer, Kelly Bassett; Drotar, Scott D
2015-12-01
First- and second-born adolescents' and their parents' perceptions of adolescents' decision-making autonomy were compared from ages 12 to 19 in a longitudinal sample of 145 predominantly White, middle class families. Utilizing a multivariate, multilevel modeling approach, differences in perceptions of adolescents' autonomy between parents and each adolescent, as well as by social-cognitive domain were examined. The present study found that when comparing parents' perceptions of their children at the same age, second-borns were granted more autonomy regarding conventional issues than first-borns during early adolescence, but by later adolescence first-borns were granted more autonomy regarding prudential issues than second-borns. However, comparisons between adolescents' and siblings' perceptions showed no differences. Potential reasons for, and implications of, differences in perceptions of adolescent autonomy are discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-conceptualization
Naik, Aanand D.; Dyer, Carmel B.; Kunik, Mark E.; McCullough, Laurence B.
2010-01-01
The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. PMID:19180389
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Hypotensive Response Magnitude and Duration in Hypertensives: Continuous and Interval Exercise
Directory of Open Access Journals (Sweden)
Raphael Santos Teodoro de Carvalho
2015-03-01
Full Text Available Background: Although exercise training is known to promote post-exercise hypotension, there is currently no consistent argument about the effects of manipulating its various components (intensity, duration, rest periods, types of exercise, training methods on the magnitude and duration of hypotensive response. Objective: To compare the effect of continuous and interval exercises on hypotensive response magnitude and duration in hypertensive patients by using ambulatory blood pressure monitoring (ABPM. Methods: The sample consisted of 20 elderly hypertensives. Each participant underwent three ABPM sessions: one control ABPM, without exercise; one ABPM after continuous exercise; and one ABPM after interval exercise. Systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, heart rate (HR and double product (DP were monitored to check post-exercise hypotension and for comparison between each ABPM. Results: ABPM after continuous exercise and after interval exercise showed post-exercise hypotension and a significant reduction (p < 0.05 in SBP, DBP, MAP and DP for 20 hours as compared with control ABPM. Comparing ABPM after continuous and ABPM after interval exercise, a significant reduction (p < 0.05 in SBP, DBP, MAP and DP was observed in the latter. Conclusion: Continuous and interval exercise trainings promote post-exercise hypotension with reduction in SBP, DBP, MAP and DP in the 20 hours following exercise. Interval exercise training causes greater post-exercise hypotension and lower cardiovascular overload as compared with continuous exercise.
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Autonomy support, basic psychological needs and well-being in Mexican athletes.
López-Walle, Jeanette; Balaguer, Isabel; Castillo, Isabel; Tristán, José
2012-11-01
Based on Basic Needs Theory, one of the mini-theories of Self-determination Theory (Ryan & Deci, 2002), the present study had two objectives: (a) to test a model in the Mexican sport context based on the following sequence: perceived coach autonomy support, basic psychological needs satisfaction, and psychological well-being, and b) to analyze the mediational effect of the satisfaction of perceived coach autonomy support on indicators of psychological well-being (satisfaction with life and subjective vitality). Six hundred and sixty-nine young Mexican athletes (Boys = 339; Girls = 330; M(age) = 13.95) filled out a questionnaire assessing the study variables. Structural equations analyses revealed that perceived coach autonomy support predicted satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Furthermore, basic need satisfaction predicted subjective vitality and satisfaction with life. Autonomy, competence and relatedness partially mediated the path from perceived coach autonomy support to psychological well-being in young Mexican athletes.
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Students' autonomy and teacher's interpersonal style in self-determination theory
Lalić-Vučetić Nataša; Đerić Ivana; Đević Rajka
2009-01-01
Starting from psychological needs that are considered basic within self-determination theory (autonomy, competence and relatedness), the importance of encouraging students' autonomy in school context is particularly emphasised. Appreciation of students' autonomy has a stimulating effect on school achievement, conceptual understanding, creativity development, strengthening of self-esteem, and students adapt better to school system and demonstrate a larger degree of internalisation of school ru...
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[Autonomy for financial management in public and private healthcare facilities in Brazil].
Santos, Maria Angelica Borges dos; Madeira, Fátima Carvalho; Passos, Sonia Regina Lambert; Bakr, Felipe; Oliveira, Klivia Brayner de; Andreazzi, Marco Antonio Ratzsch de
2014-01-01
Autonomy in financial management is an advantage in public administration. A 2009 National Healthcare Facility Survey showed that 3.9% of Brazil's 52,055 public healthcare facilities had some degree of financial autonomy. Such autonomy was more common in inpatient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for resources in specific areas, relating to small outlays, consumables and capital goods, and outsourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facilities appears to be linked to local political decisions and not necessarily to the facility's specific legal and administrative status. However, legal status displays distinct scopes of autonomy - those under direct government administration tend to be less autonomous, and those under private businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.
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Directory of Open Access Journals (Sweden)
Betania Allen-Leigh
2008-01-01
Full Text Available This study aims to describe the ways in which Mexican adolescents and adults with intellectual disability exercise autonomy. Two focus groups were carried out with family members who are the legal guardians of people with intellectual disability who have received independent living training at the Center for Integral Training and Development (CADI, per its abbreviation in Spansh. Focus group transcripts were analyzed with codes defined a priori, based on an existing theoretical framework on autonomy and quality of life among intellectually disabled persons. Autonomy is exercised by the intellectually disabled in the personal, social, sexual and economic spheres of life. Empowered autonomy implies that the person is taught the necessary skills and then allowed to act upon his or her own interests. Negotiated autonomy includes guidance, explanation and negotiation; it constitutes a learning process. Interpreted autonomy is the most limited type described, and implies protection, interpretation and may involve decision-making by others. These types of autonomy constitute a complex phenomenon and the divisions between them are indistinct.Este estudio busca describir las maneras en que jóvenes y adultos mexicanos con discapacidad intelectual ejercen la autonomía. Dos grupos focales se llevaron a cabo con familiares de personas con discapacidad intelectual quienes han recibido capacitación para la vida independiente en el Centro de Capacitación y Desarrollo Integral, CADI. Se analizaron las transcripciones con códigos definidos a priori, basados en un marco teórico preexistente sobre autonomía y calidad de vida entre personas con discapacidad intelectual. Las personas con discapacidad intelectual ejercen autonomía en diversos ámbitos: personal, social, sexual y económico. La autonomía empoderada se da cuando se le enseña a la persona las habilidades necesarias y luego se le permite actuar con base en sus propios intereses. La autonom
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France, Christopher R; France, Janis L; Carlson, Bruce W; Frye, Victoria; Duffy, Louisa; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H
2017-02-01
The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one's behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation. Copyright © 2016 Elsevier Inc. All rights reserved.
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Physical exercise and psychological wellness in health club ...
African Journals Online (AJOL)
This paper constitutes a comparative and longitudinal investigation of physical exercise and psychological wellness in a sample of health club members in Zululand, South Africa. The research was contextualized within a public health and community psychological model of mental health promotion. Physical exercise was ...
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WOMEN’S AUTONOMY AND THE FAMILY IN RECENT ROMANIAN POLICY-MAKING
Directory of Open Access Journals (Sweden)
ALICE IANCU
2011-04-01
Full Text Available In my paper I aim to provide an analysis of the relation between women’s autonomy and the family in Romanian recent policy-making. I will focus primarily on policies developed by the Romanian state after Romania’s integration in the European Union with regards to the family and family-related policy domains. My analysis will focus on several variables: 1. the theoretical instruments available for analyzing women’s autonomy in relation to state policies 2. the understanding of the family in Romanian policy-making 3. the interplay between women’s autonomy and the family and how policy-making influences the relation between the two. The analysis will take into consideration the specific Romanian socio-political context in terms of economic conditions, ideological influences and gender relations. Political theory is no stranger to the issue of individual autonomy. In my paper I will focus on recent feminist political theories on gendered accounts of autonomy. These accounts modify the understanding of autonomy and focus on conditions and aspects of autonomy relevant to women’s lives and experiences. The current financial crisis and recent developments in Romanian policy-making will be analyzed in terms of how they affect women’s autonomy. Since much of Romanian policy-making still avoids including gender and gender relations into its explicit justifications, provisions and evaluation, referring to the family as a basic social unit, the gendered consequences for women’s autonomy of such an approach need to be understood and acknowledged. In my analysis I will use both Romanian and European recent policy papers, as well as recent data obtained through social research.
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DEFF Research Database (Denmark)
Midtgaard, Julie
2013-01-01
are able to adopt long-term physical activity habits depends largely on their motivation. AIM: This theoretical paper aims to outline how researchers and practitioners can draw from Antonovsky's salutogenetic theory and White & Epston's Narrative Therapy to develop and implement intervention efforts......BACKGROUND: Sedentary behaviour and reduced exercise capacity are potential persisting effects of anti-cancer therapy that may predispose to serious health conditions. It is well-established that physical exercise may prevent some of these problems. However, the extent to which cancer survivors...... centered on promotion of long-term physical activity behaviour, while at the same time increasing the individual cancer survivor's sense of meaning and personal health resources. MATERIAL AND METHODS: The Copenhagen PACT (Physical Activity after Cancer Treatment) Study targeting adoption and maintenance...
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Evidence-Responsiveness and the Ongoing Autonomy of Treatment Preferences.
Weimer, Steven
2017-06-14
To be an autonomous agent is to determine one's own path in life. However, this cannot plausibly be seen as a one-off affair. An autonomous agent does not merely set herself on a particular course and then lock the steering wheel in place, so to speak, but must maintain some form of ongoing control over her direction in life-must keep her eyes on the road and her hands on the wheel. Circumstances often change in important and unexpected ways, after all, and it is reasonable to think that a crucial part of autonomy consists of the ability and disposition to recognize and properly respond to such changes. This implies, I contend, that a patient whose initial decision to undergo a given treatment satisfied plausible requirements of autonomy, but who is now unable to recognize that available evidence indicates the need to reconsider her medical situation and options has come to lack autonomy with respect to her desire to continue that treatment. However, and despite its importance with respect to both theoretical understandings of autonomy and applications of the concept to clinical ethics, this ongoing aspect of autonomy has received little attention. This paper aims to go some way toward remedying that. I first critically review two of the few theories of autonomy that do address "evidence-responsiveness" so as to identify and elaborate what I take to be the most promising way in which to account for this aspect of autonomy. After considering and responding to a possible objection to the evidence-responsiveness condition I propose, I conclude by discussing its clinical implications. That condition, I argue, is not merely theoretically sound, but can and should be applied to clinical practice.
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Directory of Open Access Journals (Sweden)
Lee C
2012-07-01
Full Text Available Abstract Background Prostate cancer is the most commonly diagnosed non-melanoma cancer among men. Androgen deprivation therapy (ADT has been the core therapy for men with advanced prostate cancer. It is only in recent years that clinicians began to recognize the cognitive-psychosocial side effects from ADT, which significantly compromise the quality of life of prostate cancer survivors. The objectives of the study are to determine the efficacy of a simple and accessible home-based, walking exercise program in promoting cognitive and psychosocial functions of men with prostate cancer receiving ADT. Methods A 6-month prospective, single-blinded, randomized controlled trial will be conducted to compare the Exercise Group with the Control Group. Twenty men with prostate cancer starting ADT will be recruited and randomly assigned to one of the two groups: the Exercise Group will receive instructions in setting up an individualized 6-month home-based, walking exercise program, while the Control Group will receive standard medical advice from the attending physician. The primary outcomes will be psychosocial and cognitive functions. Cognitive functions including memory, attention, working memory, and executive function will be assessed using a battery of neurocognitive tests at baseline and 6 months. Psychosocial functions including depression, anxiety and self-esteem will be assessed at baseline, 3 and 6 months using the Center for Epidemiological Studies Depression Scale, Spielberger State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale. Discussion The significance of the cognitive-psychosocial side effects of ADT in men with prostate cancer has only been recently recognized, and the management remains unclear. This study addresses this issue by designing a simple and accessible home-based, exercise program that may potentially have significant impact on reducing the cognitive and psychosocial side effects of ADT, and ultimately
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Enhancing autonomy in paid surrogacy.
Damelio, Jennifer; Sorensen, Kelly
2008-06-01
The gestational surrogate--and her economic and educational vulnerability in particular--is the focus of many of the most persistent worries about paid surrogacy. Those who employ her, and those who broker and organize her services, usually have an advantage over her in resources and information. That asymmetry exposes her to the possibility of exploitation and abuse. Accordingly, some argue for banning paid surrogacy. Others defend legal permission on grounds of surrogate autonomy, but often retain concerns about the surrogate. In response to the dilemma of a ban versus bald permission, we propose a 'soft law' approach: states should require several hours of education of surrogates--education aimed at informing and enhancing surrogate autonomy.
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Imayama, Ikuyo; Alfano, Catherine M; Mason, Caitlin E; Wang, Chiachi; Xiao, Liren; Duggan, Catherine; Campbell, Kristin L; Foster-Schubert, Karen E; Wang, Ching-Yun; McTiernan, Anne
2013-07-01
Regular exercise increases exercise self-efficacy and health-related quality of life (HRQOL); however, the mechanisms are unknown. We examined the associations of exercise adherence and physiological improvements with changes in exercise self-efficacy and HRQOL. Middle-aged adults (N = 202) were randomized to 12 months aerobic exercise (360 minutes/week) or control. Weight, waist circumference, percent body fat, cardiopulmonary fitness, HRQOL (SF-36), and exercise self-efficacy were assessed at baseline and 12 months. Adherence was measured in minutes/day from activity logs. Exercise adherence was associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (P(trend) ≤ 0.05). Increased fitness was associated with improved physical functioning, bodily pain and general health scores (P(trend) ≤ 0.04). Reduced weight and percent body fat were associated with improved physical functioning, general health, and bodily pain scores (P(trend) exercise adherence, increased cardiopulmonary fitness and reduced weight, waist circumference and percent body fat were associated with increased exercise self-efficacy (P(trend) exercise programs to induce changes in cardiopulmonary fitness and body composition may lead to greater improvements in HRQOL and self-efficacy that could promote exercise maintenance.
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Free to Lead: Autonomy in Highly Successful Charter Schools. Issue Brief
Ableidinger, Joe; Hassel, Bryan C.
2010-01-01
Autonomy is a key component of the charter school concept. By allowing charter schools to have autonomy over decisions concerning finance, personnel, scheduling, curriculum and instruction, states have enabled many of these schools to produce stellar results for their students. This issue brief explores autonomy at five excellent charter schools…