Autonomy In Everyday Life Research Articles

Reinvented acts of citizenship in Hong Kong: young people's pursuit of democracy through autonomy in everyday life

This article examines the political imaginaries of youth activists in Hong Kong in the period between the Umbrella Movement of 2014 and the mass protests that began in 2019. Drawing on interviews with young people involved in a range of political movements, it traces the emergence of what I call reinvented acts of citizenship, which emphasise autonomous everyday life practices in the community as a form of citizenship and democratic participation. These are driven by the reflexive practices that are applied in daily life, which tend to inspire a communitarian type of citizenship. Even before the repression of the democracy movement through the 2020 passage of the National Security Bill, young people engaged in this form of citizenship had decided that the pursuit of autonomy in everyday life was a preferable and realistic alternative to struggles which sought to change the structures of representative democracy and rule in Hong Kong. The article charts the emergence of these reinvented acts of citizenship, considers their relationship to other forms of mainstream and activist citizenship in Hong Kong, and speculates on their future prospects as state repression takes hold in contemporary Hong Kong after the imposition of the National Security Law.

Autonomy-supportive environments for people with dementia: an evidence-based review

Abstract Objective: As one of the core principles of person-centered care, supporting the autonomy of residents with dementia has received increasing attention worldwide. Supportive physical environments play an important role in promoting autonomy in the everyday life of residents in care facilities. However, there is no universal definition for autonomy in everyday life nor focused research on autonomy-supportive environments. Thus, this study aims to systematically review the existing evidence of autonomy-supportive design features based on a synthesized concept analysis of autonomy in everyday life. Methods: A synthesized concept analysis on autonomy was conducted based on related definitions of autonomy in design guidelines and environmental assessment tools of elderly care facilities. Using keywords from the concept analysis, multiple databases including PubMed, Web of Science, CINAHL, PsycINFO, and Dementia Design Info were used to carry out a systematic review of autonomy-supportive environmental design features for people with dementia. Additional guidelines and standards were manually searched. The design features supported by empirical studies and studies based on experts’ experience were extracted from the literature. The evidence intensity of each feature was assessed according to the quality and quantity of related studies. Results: Four domains of autonomy, freedom, independence, control, and choice emerged based on the concept analysis. Seventy-eight autonomy-supportive design features were extracted from the literature. Features are summarized into 8 categories: building layout, circulation space, living room, dining space, bathroom, bedroom, outdoor space, and details. Of design features, 60% in the category of building layout have been cross-validated by empirical studies, whereas only 25% of the overall design features have. Conclusions: The results of this review show that numerous design features of the physical environment can support the autonomy of people with dementia in the 4 domains. Features of building layout are well researched and the evidence intensity for the rest of design features still needs to be improved through future empirical studies.

An overview of innovative living arrangements within long-term care and their characteristics: a scoping review

BackgroundWithin long-term care, a culture change (e.g. focus on increasing autonomy in everyday life) is leading to the development of innovative living arrangements for older adults. Insight into characteristics of innovative living arrangements, which are described as an alternative to regular nursing homes, is lacking. This review aims to provide an overview of innovative living arrangements and to describe their defining characteristics.MethodsA scoping review was performed following the framework of Arksey and O’Malley. The preferred reporting items for systematic reviews and meta-analyses with extension, for scoping reviews (PRISMA-ScR) was also followed. The databases PubMed, PsycInfo, CINAHL, and Web of Science were searched. Articles, published between 2012 and 2023 were included when they presented an innovative living arrangement as an alternative to regular nursing homes. A thematic analysis was performed, describing the physical, social, and organizational environment of the innovative living arrangements.ResultsFifty-six articles were identified describing seven types of distinct innovative living arrangements: small-scale living, the green house model, shared housing arrangements, green care farms, dementia villages, group homes, intergenerational living, and an ‘other’ category. The themes included supporting autonomy and creating a small-scale and/or homelike environment, which were emphasized in most innovative living arrangements. Other themes, such as involvement of the community, focus on nature, integration of work tasks, and involvement of family members, were emphasized in a subsection of the described living arrangements. Twenty-eight articles reported on the effects of the innovative living environment on residents, family members, or staff members. Most articles (N = 22) studied resident-related outcomes, focusing mainly on quality of life and aspects of daily life.ConclusionMore insight into the mechanisms of the social and organizational environments is needed, which may lead to greater transparency and homogeneity regarding the description of living arrangements. This review shows that more knowledge is needed about the potential key elements of innovative living arrangements, especially related to their social and organizational environment. This may provide a better guide for developers within long-term care.

Meta-analysis of dimension of autonomy on the psychological well-being measurement in Indonesia

Since it was raised more than two decades ago, research on Psychological Well-Being (PWB) in Indonesia has invited many interested people to follow up. This situation is in line with the development of the overall orientation of Positive Psychology as a form of renewal from conventional psychological orientation. A large number of PWB studies carried out in Indonesia provides quite broad theoretical and practical implications. In general, the data obtained through these studies use group norms on respondents who are relatively small in size, so that their findings are not accurate in providing a description of PWB in the group of respondents studied. Among the six dimensions psychological well-being (self-acceptance, personal growth, positive relations with others, purpose in life, environmental mental mastery, and autonomy), dimensions autonomy often show findings with lower scores than other dimensions. The purpose of this study was to find a profile of the dimensions of autonomy. The research method used is a meta-analysis and confirmation analysis of approximately 100 results of existing research, with a respondent size of around 3,000 people. After getting the score standard autonomy from the meta-analysis study, it will be continued by distributing the PWB questionnaire to around 844 respondents emerging adulthood. This research moved from the basic assumption that Indonesian culture was different from a western culture where the initial research of this PWB was developed. These cultural differences will then form different behaviors in displaying dimensions autonomy in everyday life. Keywords: autonomy; meta-analysis; positive psychology; psychological well-being; emerging adulthood.

Living with global amnesia: self-established compensation strategies of a patient with severe memory impairment – a narrative report

ABSTRACT We report the case of C.H., a 48-year-old patient with global amnesia caused by herpes simplex encephalitis at the age of 20 and subsequent extensive bilateral temporal lobe lesions. Neuropsychological examinations performed at various intervals found persistent dense explicit memory impairment and limited vocabulary, yet intact procedural memory. Despite these limitations, C.H. self-developed and acquired a variety of effective strategies. As a result, C.H. achieved a high level of autonomy in everyday life. Her remarkable case is an encouraging and helpful example for successful implementation of creative methods and procedures to compensate and alleviate cognitive limitation, even if extensive.

Day and night changes in energy expenditure of patients on automated peritoneal dialysis

Automated peritoneal dialysis (APD) treatment for end-stage kidney disease affords patients a degree of autonomy in everyday life. Clinical investigations of their energy expenditure (EE) are usually based on resting EE, which could mask day and night variations in EE. The aim of this study, therefore, was to compare the components of EE in APD patients and healthy control (C) subjects. Patients treated with APD for more than 3 months were compared with C volunteers matched for age and lean body mass (LBM). Biochemical analyses were performed and body composition was determined by DEXA to adjust EE to LBM. Total EE, its different components and respiratory quotients (RQ) were measured by a gas exchange method in calorimetric chambers. Spontaneous total and activity-related EE (AEE) were also measured in free-living conditions over 4 days by a calibrated accelerometer and a heart rate monitor. APD (n=7) and C (n=7) patients did not differ in age and body composition. REE did not differ between the two groups. However, prandial increase in EE adjusted for dietary energy intake was higher in APD patients (+57.5±12.71kcal/h) than in C subjects (+33.8±10.5kcal/h, p=0.003) and nocturnal decrease in EE tended to be lower in APD patients undergoing dialysis sessions (- 4.53±8.37kcal/h) than in subjects (- 11.8±7.69kcal/h, p=0.059). Resting RQ (0.91±0.09 vs 0.81±0.04, p=0.032) and nocturnal RQ (0.91±0.09 vs 0.81±0.04, p=0.032) were significantly higher in APD patients, indicating a preferential use of glucose substrate potentially absorbed across the peritoneum. AEE was lower in APD patients (595.9±383.2kcal/d) than in C subjects (1205.2±370.5kcal/d, p=0.011). In contrast, energy intakes were not significantly different (1986±465 vs 2083±377kcal/d, p=0.677). Although the two groups had identical resting EE, APD patients had a higher prandial increase in EE, a lower activity-related EE and higher resting and nocturnal RQ than healthy subjects.

Spatiotemporal patterns of sensorimotor fMRI activity influence hand motor recovery in subacute stroke: A longitudinal task-related fMRI study

Motor hand deficits impact autonomy in everyday life, and neuroplasticity processes of motor recovery can be explored using functional MRI (fMRI). However, few studies have used fMRI to explore the mechanisms underlying hand recovery following stroke. Based on the dual visuomotor model positing that two segregated dorsomedial and dorsolateral cerebral networks control reach and grasp movements, we explored the relationship between motor task-related activity in the sensorimotor network and hand recovery following stroke.Behavioral recovery was explored with a handgrip force task assessing simple grasp, and a visuomotor reaching and precise grasping task, the Purdue Pegboard Test (PPT). We used a passive wrist flexion-extension task to measure fMRI activity in 36 sensorimotor brain areas. Behavioral and fMRI measurements were performed in 27 patients (53.2 ± 9.5 years) 1-month following stroke, and then 6-month and 24-month later. The effects of sensorimotor activity on hand recovery were analyzed using correlations and linear mixed models (LMMs).PPT and handgrip force correlated with fMRI activity measures in the sensorimotor and parietal areas. PPT recovery was modeled by fMRI measures in the ipsilesional primary motor cortex (MI-4p), superior parietal lobule (SPL-7M) and parietal operculum OP1, and lesion side. Handgrip force was modeled by ipsilesional MI-4a, OP1, and contralesional inferior parietal lobule (IPL-PFt). Moreover, the relationship between fMRI activity and hand recovery was time-dependent, occurring in the early recovery period in SPL-BA-7M, and later in MI.These results suggest that areas of both dorsolateral and dorsomedial networks participate to visuomotor reach and grasp tasks (PPT), while dorsolateral network areas may control recovery of simple grasp (handgrip force), suggesting that the type of movement modulates network recruitment. We also found functional dissociations between MI-4p related to PPT that required independent finger movements and MI-4a related to simple grasp without independent finger movements. These findings need to be replicated in further studies.

Drug treatment of Alzheimer's dementia : Status quo and perspectives

Alzheimer's disease (AD) is aneurodegenerative disease of the central nervous system. AD is characterized by progressive impairments of memory as well as other cognitive functions and an increasing loss of autonomy in everyday life. This review article provides an overview of the current state-of-the-art (symptomatic) pharmacological treatment of Alzheimer's disease, specifics in the context of concomitant neuropsychiatric symptoms in multimorbid patients, and drugs currently under development that have apotentially causal (disease modifying) effect are also mentioned.

Return to work predicts perceived participation and autonomy by individuals with stroke

Purpose: Participation in activities of everyday life is seen as main goal of rehabilitation after a stroke and return to work is an important factor to consider for the substantial number of persons having a stroke at working age. The current study aims to investigate whether returning to work would predict self-perceived participation and autonomy in everyday life after a stroke, from a long-term perspective.Materials and methods: Persons with first-ever stroke at age 18–63 years in 2009–2010, Gothenburg, were included. As 5-year follow-up, the Impact on Participation and Autonomy questionnaire was sent out, investigating self-perceived participation/autonomy in five levels, and work status was investigated from national sick-absence registers. Prediction of work on participation/autonomy was investigated with logistic regression.Results: A total of 109 participants (49%) responded to the questionnaire. The majority (69–94%) perceived very good participation/autonomy in all domains and 59% were working 5 years after stroke. Working was a significant predictor of high participation/autonomy in all domains of the questionnaire.Conclusions: Being able to return to work after a stroke seems to be important for self-perceived participation/autonomy. This emphasizes the importance of work-oriented information and rehabilitation after a stroke at working age.Implications for rehabilitationThe current study shows that the majority report high self-perceived participation and autonomy in everyday life and 59% are working 5 years after a stroke in working age.To work 5 years after a stroke was a significant predictor for self-perceived participation and autonomy in everyday life.Since stroke is becoming more common among working age persons and work seem important for perceived participation and autonomy, to optimize the return to work by for instance work-oriented information and vocational rehabilitation is important.

Making and repairing places for making and repairing

Collective DIY (do-it-yourself) is a phenomenon that is increasingly connected with struggles for autonomy. Autonomy here is seen as creating shared resources and the means of continuously steering the activities of the collective. Therefore, this article explores contemporary, collective DIY initiatives, and the relation of design and autonomy in such initiatives, based on three cases from Finland and Germany. The first case is a sewing cafe located close to Ulm that has operated as a living lab for research on sustainable consumption since 2016. The second case is a cultural lab in Helsinki, which was open for all to participate in and ran on an internal currency for one year until its closure, in 2017. Finally, the third case is a cultural lab in Berlin, which has provided a space for a variety of DIY activities since 2010. The paper conceptualizes the initiatives with the notion of infrastructure in order to better understand how these initiatives create conditions for different ways of being and acting from a design perspective. I complement this concept with a practice-theoretical approach in order to see if these different ways of acting hold any potential for autonomy in everyday life. Empirical evidence, including evidence from interviews with the organizers and participant observation, indicates that DIY collectives organize around ideals of creativity, democratic and mutually supportive relations, and sets of commons. Whilst evidence on the broader impacts of the initiatives is scarce, skills, common resources, and alternative spaces outside the market logic have potential for autonomy in everyday life. Keywords: DIY, DIT, autonomy, infrastructuring, practice theory.

Depleting fragile bodies: the political economy of sexual and reproductive health in crisis situations

AbstractIn a crisis-prone world, the number of internally displaced persons (IDPs) uprooted by both armed conflicts and environmental disasters has drastically increased and displacement risks have intensified. Despite the growing attention within global security and development agendas to sexual and reproductive health and rights (SRHR), there remain striking gaps in addressing SRHR in crisis situations, particularly among IDP women and girls. This article examines the continuum between social reproduction in times of crisis and the material and ideological conditions that restrict women’s bodily autonomy in everyday life. Using the case of the Philippines where millions of people are routinely affected by conflict and disaster-induced displacements, it argues that the failure to recognise the centrality of women’s health and bodily autonomy not only hinders the sustainable provision of care and domestic labour during and after crisis, but also fundamentally constrains how security is enacted within these spaces. Thus, the article highlights an urgent need to rethink the gendered political economy of crisis responses as a building block for stemming gendered violence and depletion of social reproductive labour at the household, state, and global levels.

Malnutrition According to Mini Nutritional Assessment Is Associated With Severe Functional Impairment in Geriatric Patients Before and up to 6 Months After Hip Fracture

ObjectivesHip fractures (HFs) in old age frequently cause severe functional impairment and deteriorating autonomy in everyday life. Many older patients with HFs are malnourished or at risk of malnutrition. In this study, we examined the relationship between nutritional status of geriatric patients before HF and their functional and clinical course up to 6 months after hospital discharge. DesignObservational study with follow-up after 6 months. SettingFour wards of the department of trauma and orthopedic surgery of a large urban maximum care hospital (Klinikum Nürnberg, Nuremberg, Germany). ParticipantsGeriatric patients aged ≥75 years with surgically repaired proximal femoral fracture. MeasurementsPrefracture nutritional status was determined by Mini Nutritional Assessment (MNA). Comorbidities and complications during hospital stay were obtained from medical documentation. Functional status before HF, postoperatively, at hospital discharge, and 6 months later was assessed by Barthel Index for activities of daily living (ADL) and patients' mobility level and related to MNA categories. Associations were evaluated using χ2, Fisher exact, Kruskal-Wallis, Mann-Whitney-U, Jonckheere-Terpstra, and Cochrane-Armitage tests as appropriate, as well as analysis of covariance with repeated measures. ResultsOf 97 included patients, 17% were malnourished and 38% at risk of malnutrition before HF. Participants with (risk of) malnutrition were equally mobile but more dependent in ADL prior to HF than well-nourished patients (P < .001). Independent of nutritional status, after 6 months 68% of participants had not regained their prefracture level of independence in ADL. According to analysis of covariance, the ADL development over time until follow-up 6 months after hospital discharge did not depend on nutritional status. However, at follow-up malnourished patients more often suffered from remaining losses in ADL ≥25% of initial Barthel Index points (P = .033) and less often had regained their prefracture mobility level (P = .020) than well-nourished patients. Clinical course did not differ significantly between the groups with different nutritional status. ConclusionsIn this study with geriatric HF patients from all functional and cognitive levels, worse prefracture nutritional status was associated with worse functional status and more frequent remaining functional loss, whereas the trajectory of ADL recovery and clinical course did not differ significantly. Further studies with sufficient statistical power are needed to substantiate these inconclusive results. In order to clarify the association of nutritional status with functional and clinical course in geriatric patients after HF, they should preferably focus on the role of nutritional management during the hospital stay.

The influence of institutionalization on the perception of autonomy and quality of life in old people.

To evaluate the influence exercised by institutionalization on the autonomy and perception of quality of life among the institutionalized elderly. The study is quasi-experimental (interrupted time series) and longitudinal. The sample is composed for 104 elderly people who went into a three nursing home in Santander, Spain. To assess the quality of life and dependence two scales were used: the Barthel Index and Lawton Index. There was an important relationship between autonomy and independence and their deterioration due to their institutionalisation, such as the physical and social aspects. It´s important to point out that the dependence of the elderly is a complex phenomenon, which admits many types of intervention, including the customary ones referring to more classic welfare actions which tend to supplant the absence of autonomy in everyday life by facilitating services and attention to make up for this need, without having to resort to institutionalization.

Elderly People's Perceptions of a Telehealthcare System: Relative Advantage, Compatibility, Complexity and Observability

The use of telehealthcare systems to promote independent living for elderly people is growing. The results presented in this article, derived from an initial user lab test of a telecare system—GiraffPlus—indicate that the crucial factor for adoption of telehealthcare systems is not usability but the system's ability to support autonomy in everyday life. Eleven users tested the usability and reported what they perceived as possible benefits of having such a system at home. To support autonomy, customization is crucial for the system to be perceived as meaningful for the individual. Our analysis confirms previous research.

Multiple system atrophy with early cognitive deficits: A case report

We present the case of a patient with multiple system atrophy with predominant cerebellar ataxia (MSA-C) in the early stage of the disease, who was assessed using a comprehensive neuropsychological test battery. Many studies have found cognitive deficits in MSA patients assessed after 2–3 years, but not in the first stages of the disease. The aim of this paper is to stress the importance of a complete neuropsychological assessment, even at the initial stage of the disease, when instrumental examinations are not able to show cortical involvement and daily life activities have not been affected. The neuropsychological tests examined general cognition, verbal and visual memory, visuospatial and constructional ability, language, executive function, depression and functional autonomy. Results showed cognitive deficits in executive functions, above all in the control and inhibition of automatic response, planning and reasoning abilities, memory and visuoconstructional functions. However, these problems did not affect the patient’s autonomy in everyday life. MRI scan showed the involvement of the cerebellum and the fibers of the pons and raphe, with normal cerebral ventricles and sulci. The cognitive deficits in our patient could be explained by a disruption in cerebrocerebellum connections between the frontal areas and the cerebellar structures. These results show that a more comprehensive cognitive evaluation is necessary to detect early the onset of neuropsychological deficits, also in order to begin in time adequate rehabilitation programs.

Medizinische und kommunale Herausforderungen einer alternden Gesellschaft im ländlichen Bereich

The aim of this survey is the assessment of health and social situation of elderly persons in rural regions as well as their requests and needs concerning accommodation and medical care in the old age. In a cross-sectional survey, inhabitants of the rural commune Markt Heiligenstadt, Upper Franconia, aged over 50 years were interviewed. Sixty-eight questions were asked regarding wishes and needs concerning accommodation and living in the old age. 513 (39%) inhabitants participated. Their mean age was 66 years (± 11 years) and 53% were female. 49% are suffering from hypertension and 17% from diabetes mellitus. Reduced autonomy in everyday life is predominantly caused by diseases of the musculoskeletal system. 40% of the respondents aged over 70 years reported hearing and visual impairments. Most of the participants are living in their privately owned home (81%) despite their comparatively low income and express their wish to live and be cared for in their own home in old age (90%). 75% of the respondents are married or living in a partnership. 90% have children and in 55% the children are living in the same house or in the commune. There are 2 local family doctors' practices, but no specialists' practices and no hospitals in the commune. Almost all the respondents (98%) have a regular family doctor. 17% of the participants would relocate if there was no family doctor nearby, 6% if there was no specialist and 4% if there was no hospital nearby. Health problems and functional limitations among the inhabitants of Markt Heiligenstadt are similar to those reported in German nationwide surveys. Medical care is strongly depending on general practitioners. The strong social networks of the participants and the predominant presence of residential property are important resources needed to accomplish the preference for home care in old age. This implies increasing challenges for the primary care providers. In future, the general practitioner will be a central coordinator of medical care and professional nursing together with the care by family members.

Add-on of aripiprazole improves outcome in clozapine-resistant schizophrenia

Although clozapine proved effective in treating 30-50% of the cases of resistant schizophrenia, its clinical use is hampered by significant side effects. To overcome this problem, augmentation with other atypical antipsychotics has been attempted, with conflicting results. A clozapine-aripiprazole combination showed interesting properties, due to the favourable complementary pharmacodynamic receptor profile and to the negligible metabolic interactions. In this retrospective case series, we investigated the change in BPRS scores and metabolic features like BMI, fasting glucose, total and LDL cholesterol, triglycerides, functional outcome HoNOS Rome and PSP scores after aripiprazole augmentation in 16 persons with treatment-resistant schizophrenia who were already treated with clozapine. The results demonstrated a statistically significant improvement in metabolic indices, psychopathology and functional outcome measures from baseline to endpoint (6weeks) after augmentation with aripiprazole. Statistically significant correlations were observed between psychopathological and behavioural measures at baseline and at endpoint. Linear regression analysis defined a tripartite model, in which item HoNOS Rome 11, measuring autonomy in everyday life, explained nearly half of functional outcome PSP score predictive variance, together with BPRS total psychopathology score and HoNOS Rome total social functioning score. Adequately conducted randomised double-blind studies should provide further specific data highlighting the role of a clozapine-aripiprazole combination in improving functional outcome of persons with treatment-resistant schizophrenia.

Clinical problems and everyday abilities of a group of Italian adolescent and young adults with Cornelia de Lange syndrome

Cornelia de Lange syndrome (CdLS) is a multiple congenital anomaly/mental retardation syndrome, characterized by distinctive facial features, generalized hirsutism, growth and cognitive dysfunction, microcephaly and limb abnormalities. Currently mutations of three different genes, NIPBL, SMC1A, and SMC3, are known to be related to the CdLS phenotype with an overall detection rate of about 50%. Few data are available regarding the level of autonomy in everyday life of CdLS patients. Due to the collaboration of the Italian parents' support group, we collected information regarding clinical and behavioral problems and everyday abilities of 45 CdLS patients between 13 and 39 years, using a specific multi-item questionnaire. To better analyze clinical information we divided our patients into three groups according to age: 13-20, 21-29, and over 30 years. Data from clinical, malformative and behavioral problems were not significantly different from those described for CdLS patients. Regarding personal autonomies this study showed the significant limitations of these individuals. It is interesting to observe that patients between 21 and 29 years, showed the best performance, while those over 30 had more severe difficulties. We suggest that these data be interpreted as a minimum level of autonomy achievable for CdLS adolescent/young adults, as the level of care, rehabilitation and stimulation of these patients has increased in the last 30 years.

Influence of age and movement complexity on kinematic hand movement parameters in childhood and adolescence

Development of fine motor functions, especially drawing and handwriting, are crucial for performance in school, autonomy in everyday life and the general human development. A variety of neurological and psychiatric conditions in childhood and adolescence stunt the normal development of fine motor skills. We sought to define the normal development of the kinematic parameters of fine motor movement and determine the influence of gender, laterality of handedness and extracurricular training on fine motor skills.One hundred and eighty-seven children and adolescents (mean age: 11.6 years (±S.D.: 3.58), range: 6–18 years) were included in the study. Participants performed drawing and handwriting tasks on a digitizing graphic tablet. Movement and pressure data were transferred to a computer using a sensor-equipped pen and post-processed using CSWIN. Movements were segmented into strokes and several kinematic parameters were calculated. The kinematic parameters that were analyzed represented speed (frequency and stroke peak velocity), automation (number of direction changes of velocity per stroke), variability (variation coefficient of stroke peak velocity) and pressure.Progression of kinematic parameters for each movement domain of the handwriting and circle drawing tasks correlated significantly with age (Pearson's correlation, p<0.003). Speed, automation and pressure increased with age, whereas variability decreased. Nonlinear regressions revealed maturation of hand movements at a certain age. Age of completed maturation depended on the task complexity (drawing circles vs. handwriting) and kinematic parameters. In the speed and automation domains, handwriting movements finish maturing later than circle drawing. Male subjects drew circles at significantly higher speeds than female subjects. Fine motor practice and laterality of handedness did not influence kinematic parameters. A repeated measure ANOVA confirmed the significant interdependency between age and complexity level for speed and automation (p<0.001).The digitizing graphic tablet is an extremely valuable tool in determining the normal development of hand movement skills of children and adolescents by measuring relevant daily tasks like handwriting and drawing. In our study, we showed that future analyses of impaired movement in children and adolescents need to take age and gender into consideration. Furthermore, differences were observed in the maturation of different task complexities, the complex fine motor function reaching maturity later than basic and repetitive movement patterns.

The oldest old: Autonomy in the face of frailty

Autonomy, a core American value, is routinely invoked as a goal in gerontological discussions of the aging process, yet frailty, another commonly used term in gerontology, suggests that functional losses may interfere with individuals' ability to maintain autonomy in everyday life. Older persons who are impaired are seldom asked how they view themselves with respect to autonomy and frailty, or what autonomy means. The meanings older persons attach to autonomy and decreases in physical abilities are explored through in-depth interviews with 28 persons age 80 or older. While autonomy encompassed a wide range of self-descriptions, respondents never used the word, frail, to describe themselves. I explore the potential of the construct of the lived body for a holistic approach to aging that values embodied knowledge and experiences of those who are old. I conclude that gerontological views of autonomy promote a cultural ideal that does not reflect elders' perspectives, and that the notion of frailty has the potential to stereotype elders, with negative effects on well being.