Autonomy Index Research Articles

Motivation, accountability, and outcomes in a randomized controlled trial of internet weight-loss programs in primary care.

This study explored whether baseline autonomous motivation (AM), controlled motivation (CM), and relative autonomy index (RAI) scores predicted 12-month weight in a three-arm randomized controlled trial of internet weight loss programs in primary care. It also evaluated perceived accountability to a primary care provider for weight loss as a moderator and study engagement (operationalized as weeks logged into the study website) as a mediator of these relationships. Participants with complete data for all model variables (n = 428) were included. Multiple linear regression models controlling for baseline weight and covariates showed that one-unit increases in baseline CM and RAI scores predicted a 0.57 kg increase (p = 0.015; Cohen's f2 = 0.02) and 0.52 kg decrease (p = 0.019; Cohen's f2 = 0.02) in weight, respectively. AM was not associated with 12-month weight. No moderating or mediating effects were found. Findings suggest the need for greater attention to baseline CM in weight loss programs in primary care.

Self-Determined Motivation for Alcohol Use and Drinking Frequency, Intensity, and Consequences

Objective: Drinking motives predict drinking behaviors and outcomes among adults. Drinking motives are rarely studied using self-determination theory (SDT), which aligns with harm-reduction approaches to alcohol use, but SDT can offer a complementary theoretical framework to existing drinking motives frameworks that may help explain the observed heterogeneity in drinking motives and account for more variance in drinking outcomes. This study examined the associations between five SDT-based drinking motives with drinking frequency, intensity, and consequences. Method: A total number of 630 adults (M age = 21.5, 55% female, 88% undergraduates) rated drinking motives using the Comprehensive Relative Autonomy Index for Drinking (CRAI-Drinking) and the Drinking Motives Questionnaire (DMQ), typical alcohol consumption, and negative and positive drinking consequences. Results: Poisson regressions indicated that intrinsic (IRR = 1.13) and identified (IRR = 1.11) regulations were significantly associated with drinking frequency, identified (IRR = 0.94) and positive introjected (IRR = 1.07) regulations were significantly associated with drinking intensity, and amotivation (IRR = 1.16) and intrinsic regulation (IRR = 1.09) were associated with negative and positive consequences, respectively, after controlling for other CRAI-Drinking and DMQ scores, sex, and drinking intensity. After accounting for DMQ scores and sex, CRAI-Drinking scores accounted for 1.7%–9.9% additional deviance in drinking behaviors and consequences. Conclusions: Adults high in autonomous reasons for drinking reported low-risk, high-enjoyment drinking experiences. In contrast, adults with higher scores for amotivation for drinking reported more negative consequences, even after accounting for drinking intensity, suggesting that high amotivation for drinking may be a novel signal for future alcohol-related risks. These findings support the idea that SDT provides a useful framework for understanding drinking motives, behaviors, and consequences.

Abnormal functional lateralization and cooperation in bipolar disorder are associated with neurotransmitter and cellular profiles

BackgroundHemispheric lateralization and cooperation are essential for efficient brain function, and aberrations in both have been found in psychiatric disorders such as schizophrenia. This study investigated alterations in hemispheric lateralization and cooperation among patients with bipolar disorder (BD) and associations with neurotransmitter and cell-type density distributions to identify potential molecular and cellular pathomechanisms. MethodsSixty-seven BD patients and 127 healthy controls (HCs) were examined by resting-state functional MRI (rs-fMRI). Whole-brain maps of the autonomy index (AI) and connectivity between functionally homotopic voxels (CFH) were constructed to reveal BD-specific changes in brain functional lateralization and interhemispheric cooperation, respectively. Spatial associations of regional AI and CFH abnormalities with neurotransmitter and cell-type density distributions were examined by correlation analyses. ResultsBipolar disorder patients exhibited higher AI values in left superior parietal gyrus, cerebellar right Crus I, and cerebellar right Crus II, and these regional abnormalities were associated with the relative densities (proportions) of oligodendrocyte precursor cells and microglia. Patients also exhibited lower CFH values in right inferior parietal gyrus, bilateral middle occipital gyrus, left postcentral gyrus, and bilateral cerebellar crus II, and these regional abnormalities were associated with the densities of serotonin 1A and dopamine D2 receptors, oligodendrocyte precursor cells, astrocytes, and neurons. ConclusionsThese findings indicate that abnormal functional lateralization and cooperation in BD with potential molecular and cellular basis.

MOTIVATION AND SELF-REGULATION OF LEARNING IN HOMESCHOOLED STUDENTS

In the context of education, motivation and self-regulation of learning are dominant issues. The degree of intrinsic and extrinsic motivation to learn is related to students’ academic achievement and literacy development. This study aimed to research the regulatory styles and motivation to learn among homeschooled students, with a particular focus on those who practice unschooling, a form of self-directed learning. A quantitative research strategy was employed, and data were collected using the standardised SQR-Academic questionnaire adapted for the homeschooling context. The questionnaire was completed by 143 homeschooled children (4th to 9th grade), of whom 10.88% reported engaging in unschooling or self-directed learning. The results indicated that identified regulation was prevalent among homeschooled students, who tended to exhibit intrinsic rather than extrinsic motivation. This contrasts with full-time attending students, who generally display a more external regulation style. Among unschoolers, identified regulation was equally prevalent, but the Relative Autonomy Index (RAI) values were higher, indicating a stronger inclination towards intrinsic motivation. Despite these differences in RAI between unschoolers and other homeschoolers, the differences were not statistically significant. The findings are consistent with relevant research from other countries. Future research should explore the factors that influence the degree of intrinsic and extrinsic motivation in homeschooled students. Keywords: homeschooled students, intrinsic motivation, lower secondary education students, primary education students, regulation of learning, unschooled students

Women’s autonomy, neonatal, infant and under-five mortality in the Upper East Region of Ghana

Child mortality remains a major health challenge in Sub-Saharan Africa. Child survival is greatly influenced by household circumstances and mother’s healthcare choices. Notwithstanding tremendous investment in women empowerment in Ghana, there is limited empirical evidence on whether women’s autonomy translates into better child mortality outcomes. To examine the association between women’s autonomy and neonatal, infant and under-five mortality in the Upper East Region of Ghana. Data were obtained from a randomized cluster household survey among 15–49 years old women in seven districts in the Upper East Region. Data analysis was restricted to 3,243 women who reported ever having given birth. Based on Principal Component Analysis (PCA), we constructed an autonomy index categorized into least, moderate, and high autonomy based on responses to six questions regarding household decision-making. Bivariate and multivariate logistic regressions were used to assess the association of women’s autonomy status and mortality outcomes. Attaining secondary education or higher was significantly associated with infant mortality (adjusted odds ratio (aOR) = 0.39, CI = 0.16, 0.94) and under-five mortality (aOR = 0.39, CI = 0.18–0.87). Also, maternal age was significantly associated with neonatal, infant, and under-five mortality, while living in rural setting was significantly associated with lower risk of neonatal (aOR = 0.38, CI = 0.19–0.75) and under-five (aOR = 0.63, CI = 0.48–0.83) mortality. However, we found that compared to women with least autonomy, infants of those with moderate autonomy (aOR = 1.76, CI 1.07–2.89) and high autonomy (aOR = 1.75; CI = 1.04–2.93) were significantly more likely to die. In this study setting, women’s autonomy was not predictive of child mortality. Interventions that aim to improve child mortality should pay attention to community and family level factors that promote increase utilization of essential early childhood interventions.

Utilizing Relative Autonomy Index Scores to Evaluate the Impact of Age on Motivation to Exercise in Black Women.

Black women are disproportionately affected by overweight and obesity. One theory that may have utility in increasing the amount of exercise among Black women is self-determination theory, a psychology-based theory commonly used to investigate motivation in the context of exercise. The objective of this study was to determine whether motivation towards exercise behavior differs between younger and older Black women. A cross-sectional study was conducted by administering a survey to Black women in the Midwestern United States to elicit factors which may impact their motivation to exercise. The survey consisted of questions to gather sociodemographic information as well as responses to the Behavioral Regulations in Exercise Questionnaire (BREQ-2). Responses on the BREQ-2 were utilized to derive the Relative Autonomy Index (RAI) which is a direct measure of self-determination that provides insight into the extent of an individual's motivation to exercise. Multiple linear regression was utilized to determine if age was predictive of relative RAI scores after adjusting for marital status and receipt of a memorable message regarding health. Mean RAI scores among respondents at least 40years old were significantly higher in comparison to the RAI among respondents younger than 40. When adjusting for marital status and receipt of a memorable message regarding health, women at least 40 had a mean RAI score approximately 4.2 points higher than those under age 40. Women at least 40years of age also had significantly higher scores on the identified regulation and intrinsic regulation subscales of the BREQ-2 questionnaire when compared to women younger than 40 after adjusting for marital status and recalling a memorable message related to health. These findings suggest that exercise motivations differ among age groups of Black women. Additionally, these results highlight the importance of understanding exercise motivations to further improve health outcomes.

Municipal Fiscal Performance

This research aims at verifying whether mayors’ and councilors’ Human Capital has influence on the fiscal performance of Brazilian municipalities. The existing literature attributes the fiscal results of municipal management to mayors. However, taking into consideration the Human Capital Theory, we sought to verify the influence of the legislative municipal power on this issue. The sample was comprised of Brazilian municipalities from 2013 to 2019. The quantitative descriptive methodology with longitudinal section and multiple linear regression was used to analyze the phenomena discussed in this research. The fiscal performance was measured based on the Fiscal Autonomy Index (IAF), general IFGF, IFGF autonomy, IFGF personnel, IFGF liquidity and IFGF investment. In order to measure the Human Capital, the following information was considered: one’s education level, age and occupation in public administration before inauguration. The results showed that mayors’ and councilors’ Human Capital has influence on fiscal performance in general terms.

Physical Activity and Exercise Motivation Differences Among College Students

ABSTRACT Health behaviors established during college years are typically carried on into adulthood; however, many college students are not meeting physical activity guidelines. In addition, sociodemographic and environmental factors impact exercise motivation and physical activity; yet, only limited research has compared motivations and behaviors between different student groups. Thus, the purpose of this study was to compare exercise motivation and physical activity among college students. In this quantitative cross-sectional survey study, a volunteer sample of 307 undergraduate students (75.2% White, 68.7% Female) enrolled in health and fitness courses at a Mid-Atlantic region United States University and Community College completed an online demographic questionnaire, International Physical Activity Questionnaire-Short Form (IPAQ-SF), and Behavioral Regulations in Exercise Questionnaire (BREQ-3). A series of independent samples t-tests were conducted to compare relative autonomy index (RAI) and subscale scores (obtained via the BREQ-3), as well as physical activity scores (MET-minutes/week obtained via the IPAQ-SF). Statistically significant differences in exercise motivation and physical activity were found based on student age, housing status, major/program of study, and gender identity. In an effort to reduce health disparities, university administrators and coordinators are advised to keep these considerations in mind when developing physical activity policies and programs for college students.

Pathways to Need-Supportive Teaching: Teaching Mindsets and Motivation to Teach

AbstractTeachers differ in the extent to which they support their students’ basic psychological needs. To better understand these differences, we investigated how mindsets and motivation to teach English relate to their need-supportive teaching practices. Data was gathered from 348 EFL instructors (261 female, 87 male; Mage = 38.47, SD = 9.22) working at state and private universities in Turkey through the following self-report questionnaires: the Implicit Theories of Intelligence Scale (ITIS; Dweck et al., 1995), the Comprehensive Relative Autonomy Index (C-RAI; Sheldon et al., 2017), and the Teacher as a Social Context Questionnaire (TASC-Q; Belmont et al., 1988). Results of structural equation modeling revealed that language instructors’ fixed teaching mindset beliefs had both direct and indirect relationships with their need-supportive teaching through quality of teaching motivation. The direct relationships suggest that instructors who believe their teaching ability is a fixed trait are less likely to teach for autonomous reasons, such as personal interest and values, and more inclined to teach out of external reasons, such as pressure from supervisors. The indirect relationships suggest that autonomous teaching motivation mediates the negative relationships between fixed teaching mindset and provision of involvement and structure. These findings highlight the important role of teaching mindsets and motivation in promoting need-supportive learning environments.

Sociodemographic profile, index of functional autonomy and physical activity level of elderly women

To analyze the sociodemographic profile, functional autonomy index and level of physical activity of elderly women participating in an exercise program. 372 elderly women participating in the MASTERFITTS program and completed questionnaires regarding medical history and the adapted Baecke questionnaire to assess the level of physical activity in elderly. Tests from the GDLAM protocol were performed to evaluate functional autonomy. 51.61% were physically active ( = 2.68±0.49; ∆% = 1.09), and the majority achieved a good classification in the tests and overall functional autonomy index. A significant difference was found in the W10m test (p= 0.041; ∆% = -0.89), RSP (p= 0.024; ∆% = -1.90), and RVDP (p= 0.032; ∆% = -1.20) between the active and sedentary groups. An increase in the level of physical activity will also lead to a decrease in the completion times of the functional autonomy assessment tests, contributing to improved health.

Brain functional specialization and cooperation in Alzheimer's disease.

Cerebral specialization and interhemispheric cooperation are two vital features of the human brain. Their dysfunction may be associated with disease progression in patients with Alzheimer's disease (AD), which is featured as progressive cognitive degeneration and asymmetric neuropathology. This study aimed to examine and define two inherent properties of hemispheric function in patients with AD by utilizing resting-state functional magnetic resonance imaging (rs-fMRI). Sixty-four clinically diagnosed AD patients and 52 age- and sex-matched cognitively normal subjects were recruited and underwent MRI and clinical evaluation. We calculated and compared brain specialization (autonomy index, AI) and interhemispheric cooperation (connectivity between functionally homotopic voxels, CFH). In comparison to healthy controls, patients with AD exhibited enhanced AI in the left middle occipital gyrus. This increase in specialization can be attributed to reduced functional connectivity in the contralateral region, such as the right temporal lobe. The CFH of the bilateral precuneus and prefrontal areas was significantly decreased in AD patients compared to controls. Imaging-cognitive correlation analysis indicated that the CFH of the right prefrontal cortex was marginally positively related to the Montreal Cognitive Assessment score in patients and the Auditory Verbal Learning Test score. Moreover, taking abnormal AI and CFH values as features, support vector machine-based classification achieved good accuracy, sensitivity, specificity, and area under the curve by leave-one-out cross-validation. This study suggests that individuals with AD have abnormal cerebral specialization and interhemispheric cooperation. This provides new insights for further elucidation of the pathological mechanisms of AD.

Porezna autonomija lokalne samouprave

The paper measures the total (two-tier) local tax autonomy (cities/municipalities and counties combined) in Croatia applying the OECD methodology in terms of the definition and scope of taxes and their classification according to taxing power and autonomy. First, it follows the methodology of previous studies for Croatia, which considered only nominal taxes. This results in a relatively small share of autonomous taxes in local tax revenues. The change from a formal recording of taxes to an effective one based on the OECD definition of taxes leads to more than a doubling of local autonomous taxes. However, compared to other OECD unitary countries (countries with only the local level), Croatia still lags significantly behind the OECD average and also behind the average of EU member countries that are also OECD member countries. The weighting of different categories, despite the risk of arbitrariness, and the resulting tax autonomy index show an additional improvement of the Croatian situation. Further calculation of the tax autonomy index and, in particular, the composite indicator of tax autonomy (share of autonomous local taxes in total general government taxes), as well as the composite tax autonomy index (local tax autonomy index divided by total general government taxes), lead to a further improvement of the Croatian position. Although the country is still below the OECD average, it has improved to an almost median position. The indicators suggest that the taxing powers of local governments need to be further strengthened.

Applicability of a supramaximal high-intensity interval training program for older adults previously not engaged in regular exercise; analyses of secondary outcomes from the Umeå HIT Study

This analysis of secondary outcomes investigated the applicability of supramaximal high-intensity interval training (HIT) with individually prescribed external intensity performed on stationary bicycles. Sixty-eight participants with a median (min; max) age of 69 (66; 79), at the time not engaged in regular exercise were randomized to 25 twice-weekly sessions of supramaximal HIT (20-min session with 10 × 6-s intervals) or moderate-intensity training (MIT, 40-min session with 3 × 8-min intervals).The primary aim was outcomes on applicability regarding; adherence to prescribed external interval intensity, participant reported positive and negative events, ratings of perceived exertion (RPE 6–20), and affective state (Feeling Scale, FS -5–5). A secondary aim was to investigate change in exercise-related self-efficacy (Exercise Self-Efficacy Scale) and motivation (Behavioural Regulations in Exercise Questionnaire-2).Total adherence to the prescribed external interval intensity was [median (min; max)] 89 % (56; 100 %) in supramaximal HIT, and 100 % (95; 100 %) in MIT. The supramaximal HIT group reported 60 % of the positive (112 of 186) and 36 % of the negative (52 of 146) events. At the end of the training period, the median (min; max) session RPE was 15 (12; 17) for supramaximal HIT and 14 (9; 15) for MIT. As for FS, the median last within-session rating was 3 (−1; 5) for supramaximal HIT and 3 (1; 5) for MIT. Exercise-related motivation increased (mean difference in Relative Autonomy Index score = 1.54, 95 % CI [0.69; 2.40]), while self-efficacy did not change (mean difference = 0.55, 95 % CI [-0.75; 1.82]), regardless of group.This study provide support for supramaximal HIT in supervised group settings for older adults.

The role of self-efficacy in women’s autonomy for health and nutrition decision-making in rural Bangladesh

BackgroundAgency – including the sub-domains of intrinsic agency, instrumental agency, and collective agency – is a critical component of the women’s empowerment process. Self-efficacy (a component of intrinsic agency) may operate as a motivational influence for women to make choices according to their own preferences or goals, such that higher self-efficacy would be associated with more autonomous decision-making (a key component of instrumental agency).MethodsWe examine these relationships using mixed methods. We developed a series of decision-making autonomy indices, which captured alignment between the woman’s reported and preferred roles in health and nutrition decisions. Using ordinal logistic regression, we assessed the relationship between generalized self-efficacy and decision-making autonomy.ResultsThere was a consistently positive association across all categories of decision-making, controlling for a number of individual and household-level covariates. In a sub-sample of joint decision-makers (i.e., women who reported making decisions with at least one other household member), we compared the association between generalized self-efficacy (i.e., one’s overall belief in their ability to succeed) and decision-making autonomy to that of domain-specific self-efficacy (i.e., one’s belief in their ability to achieve a specific goal) and decision-making autonomy. Across all decision-making categories, domain-specific self-efficacy was more strongly associated with decision-making autonomy than generalized self-efficacy. In-depth interviews provided additional context for interpretation of the regression analyses.ConclusionsThe results indicate the importance of the role of self-efficacy in the women’s empowerment process, even in the traditionally female-controlled areas of health and nutrition decision-making. The development of the decision-making autonomy index is an important contribution to the literature in that it directly recognizes and captures the role of women’s preferences regarding participation in decision-making.

Self-determined motivation and physical activity in patients with rheumatoid arthritis: a cross-sectional study

Objective To identify factors associated with two self-reported measures of physical activity (PA) in patients with rheumatoid arthritis (RA). Method Hospital outpatients with RA from central Norway filled in questionnaires about symptoms, psychological factors, and PA. Outcomes were two alternative self-reported measures of PA: (i) fulfilling the aerobic PA recommendations of ≥ 150 min/week at moderate intensity or ≥ 75 min/week at vigorous intensity; or (ii) being in the PA maintenance stage of the Stages of Exercise Behaviour Change framework. Logistic regression was applied to identify factors associated with PA. Step 1 included the independent variables sex, age, and smoking habits. Step 2a added self-reported function, joint pain during the past 6 months, and fatigue to Step 1. Step 2b added Exercise Self-Efficacy and the Relative Autonomy Index (RAI), calculated from the Behavioural Regulation in Exercise Questionnaire-2, to Step 1. Step 3 included all the mentioned independent variables. Steps 1–3 were analysed for each PA measure. Results In total, 227 patients participated. The RAI had a statistically significant positive association with being physically active according to both PA definitions. Joint pain had a significant negative association with meeting the aerobic PA recommendations but was not associated with being in the PA maintenance stage. Conclusion The degree of self-determined motivation was the most consistent variable associated with self-reported PA behaviour. Joint pain was associated with one of the two PA measures. Motivation and joint pain may be useful targets for intervention in clinical practice to improve PA engagement among patients with RA.

Test-retest reliability of Latin American Group for Maturity (GDLAM) protocol in older women.

Functional autonomy (FA) is a critical factor in determining the quality of life of older adults (OA), especially in the case of older women (OW), as they face a decline in FA in their later years of life. FA should be assessed early, using valid, reliable, and low-cost tests. This study evaluated the test-retest reliability of GDLAM and GDLAM autonomy index (GI) in OW. Thirty-nine OW (71.2 ± 6.50 years) participated in the study. A repeated measures design was used to compare the interday test-retest reliability of the five GDLAM tests (seconds) and the GI (points). The five tests represent activities of daily living, such as dressing or wandering around the house, while the GI provides a weighting of the results of the five tests. The analysis consisted of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). A CV ≤ 10% and an ICC ≥ 0.80 were considered acceptable reliability, whereas a CV ≤ 5% and an ICC ≥ 0.90 were considered high reliability. The outcome of the five tests, represented by the GI, showed high interday test-retest reliability (CV = 6.00% and ICC = 0.91). The results of this study demonstrate that the five tests of the GDLAM protocol and the GI have high interday test-retest reliability and good interday reproducibility. From a practical point of view, the GDLAM protocol allows the assessment of FA of community-dwelling OW, providing background for early diagnosis and, with it, the possibility of developing an individualized physical exercise prescription.

Assessing self-determined motivation for drinking alcohol via the Comprehensive Relative Autonomy Index for Drinking.

Self-Determination Theory (SDT) examines human motivation in multiple domains; however, the only existing measure assessing SDT-informed behavioral regulations for drinking focuses on responsible drinker behaviors, rather than drinking per se, which is important given the alignment between SDT and harm reduction approaches to alcohol use. The aim of this study was to test the structural validity of the SDT-informed Comprehensive Relative Autonomy Index for Drinking (CRAI-Drinking) among college students. Participants included two convenience samples with a total of 630 adult drinkers (Mage = 21.5, 55% female, 88% undergraduates). Participants rated drinking behavioral regulations on the 24 original CRAI-Drinking items on a 5-point Likert Scale. Multi-dimensional scaling analyses and factor analyses were used to investigate the underlying autonomy continuum and factor structure of the CRAI-Drinking. In Sample 1 (n = 274), multi-dimensional scaling analyses confirmed that CRAI-Drinking item and subscale order aligned with SDT's autonomy continuum. Confirmatory factor analyses supported a five factor, 19-item model of the CRAI-Drinking with factors for intrinsic, identified, positive introjected, external, and amotivation regulations (Cronbach's α: 0.68-0.85). In Sample 2 (n = 356), a confirmatory factor analysis confirmed that the 19-item model fit was comparable to Sample 1. This study provides evidence for the structural validity of CRAI-Drinking scores for assessing SDT-based behavioral regulations for drinking in adults.

Local autonomy around the world: the updated and extended Local Autonomy Index (LAI 2.0)

ABSTRACT This paper presents an extension and update of the Local Autonomy Index (LAI) under the name LAI 2.0. It applies the comprehensive methodology of the LAI 1.0 to 57 countries over 30 years (1990–2020), including almost all EU, CoE and OECD member states. Looking at the overall results, over thirty years, the LAI has increased around 7–8%, albeit less important in the most recent period of 2015–2020. The biggest increase is to be found in the Central and Eastern European countries. Conversely, some countries (e.g. Hungary and Belarus) have seen a decrease in local autonomy. The highest ranking countries include the Nordic countries and Switzerland, whereas South-Eastern European countries generally score the lowest. We view the LAI as a springboard to academics and policymakers for a more comprehensive and empirically based understanding of local autonomy over time.

Effect of rehabilitation motivation on improving activities of daily living in subacute stroke patients

ObjectivesTo determine the effect of rehabilitation motivation on activities of daily living improvement in subacute stroke patients starting intensive rehabilitation. Materials and methodsThis was a single-center cohort study involving patients with a subacute stroke who were admitted to or discharged from a Recovery Rehabilitation Unit between February 2021 and August 2022. Improvement in Activity of Daily Living was evaluated using the Functional Independence Measure. We calculated the corrected motor Functional Independence Measure effectiveness using its motor-related items at admission and discharge. The Behavioral Regulation in Exercise Questionnaire 2 was used to evaluate admission rehabilitation motivation, and the Relative Autonomy index was calculated. Hierarchical multiple regression analysis was used to examine the relationship between the corrected motor Functional Independence Measure effectiveness and the Relative Autonomy Index. ResultsEighty-six of the 231 patients (37.2 %) were included in the analysis. Hierarchical multiple regression analysis adjusted for demographic and clinical variables demonstrated that age, comorbidities, and Relative Autonomy Index were significantly associated with corrected motor Functional Independence Measure effectiveness (R2 = 0.423, p ≺ .001). ConclusionMotivation at intensive rehabilitation initiation in patients with a subacute stroke influences Activities of Daily Living improvement. These results may help develop rehabilitation programs aimed at improving Activities of Daily Living in patients with subacute strokes.

Abnormal hemispheric specialization and inter-hemispheric functional cooperation in generalized anxiety disorder

Abnormal hemispheric specialization and inter-hemispheric interactions may contribute to the pathogenesis of general anxiety disorder (GAD). The current study investigated these abnormalities in GAD patients based on the two analytic approaches and examined whether such abnormalities are correlated with anxiety symptom severity. Seventy-three patients with GAD and 60 matched healthy controls were recruited. All participants completed anxiety symptoms assessment and resting-state functional magnetic resonance imaging (rs-fMRI). The autonomy index (AI) and Connectivity between Functionally Homotopic voxels (CFH) were applied to measure and compared between groups. Compared to controls, patients showed stronger AI in the right middle temporal gyrus (MTG). Seed-based analysis revealed stronger functional connectivity (FC) of the right MTG with both right precuneus and right dorsolateral prefrontal cortex (dlPFC) in patients. Patients also exhibited greater CFH in right anterior cingulate cortex (ACC) but decreased CFH in bilateral postcentral gyrus (PCG) and superior occipital gyrus (SOG). Further there were significant correlations between these regional CFH and anxiety symptoms severity. GAD patients demonstrate right hemispheric specialization and aberrant inter-hemispheric functional cooperation, and abnormal inter-hemispheric coordination is associated with anxiety symptom severity. These findings provide a clue to understanding the neuropathological mechanisms of GAD.