Autonomy Of People Research Articles

GENDER DIFFERENCE IN INTERNAL EDUCATIONAL MIGRATION: DISTANCE ANALYSIS BETWEEN HOMETOWNS AND UNIVERSITIES OF ISTANBUL

University education is one of the primary incentives for internal migration and most educational migration in Turkey is directed toward the city of İstanbul. In addition to vocational and academic achievement, university education also provides autonomy for young people by allowing them to live in different and perhaps distant areas from their families. In this article, we analyze students who have moved to İstanbul with regard to characteristics of gender and migratory distance in order to determine whether there is a gender difference in the realization of distant resettlement for education. To accomplish this, we use a database of students in the 2017-2018 academic year who applied for accommodation to the General Directorate of Credit and Hostels (KYK), which is the largest public institution that provides housing opportunities for university students in Turkey. This dataset includes 27,643 students, 49% of whom are female while 51% are male. Controlling for the demographic, social, and economic characteristics of the students and their scores on the university entrance exam, we reveal that male students move greater distances to study in universities and they have more opportunities to migrate to İstanbul from settlements farther away than female students.

Supporting autonomy for people with dementia living in nursing homes: A rapid realist review

BackgroundFor people with dementia living in nursing homes, autonomy is important. However, they experience difficulty with being heard as an autonomous person, as well as with expressing their preferences and choices. The question is how to support their autonomy. ObjectiveDespite extensive efforts to support autonomy in daily care for people with dementia living in nursing homes, we do not know exactly what works for whom, in which context, how and why. The objective of this realist review is to explore what is known in literature on autonomy support interventions for people with dementia in nursing homes. DesignA rapid realist review of literature. Review methodsTo understand how autonomy is supported, a realist approach was applied that entailed identifying the research question, searching for information, performing a quality appraisal, extracting data, synthesizing the evidence and validating the findings with a panel of experts. Causal assumptions were derived from articles found in four bibliographic databases (PubMed, PsychInfo, Cochrane and CINAHL) leading to context (C)–mechanism (M)–outcome (O) configurations. ResultsData extraction from the included articles ultimately resulted in sixteen CMO configurations on four themes: a. preferences and choice: interventions for supporting autonomy in nursing homes and their results, b. personal characteristics of residents and family: people with dementia and their family being individuals who have their own character, habits and behaviors, c. competent nursing staff each having their own level of knowledge, competence and need for support, and d. interaction and relationships in care situations: the persons involved are interrelated, continuously interacting in different triangles composed of residents, family members and nursing staff. ConclusionThe findings showed that results from interventions on autonomy in daily-care situations are likely to be just as related not only with the characteristics and competences of the people involved, but also to how they interact. Autonomy support interventions appear to be successful when the right context factors are considered.

Man braucht zwei Augen, um dreidimensional gucken zu können

When the BVerfG had judged about the assisted suicide on Feb 26th, 2020 some emphasize the free autonomy of people who want to die, others want to do everything to inhibit assisted suicides and point out alternatives. Both are right. It is important to protect old, ill and weak persons and offer good and enough palliative care and hospices. Also important is: People, who have suffered for a long time and desire nothing but death and know what they ask for, must get assistance in dying.

Moving towards a continuum of safer supply options for people who use drugs: A qualitative study exploring national perspectives on safer supply among professional stakeholders in Canada

BackgroundNovel public health interventions are needed to address the toxic drug supply and meet the needs of people who use drugs amidst the overdose crisis. Safer supply – low-barrier distribution of pharmaceutical grade substances – has been implemented in some jurisdictions to provide safer alternatives to the unregulated drug supply, yet no studies to date have explored professional stakeholder perspectives on this approach.MethodsWe used purposive sampling to recruit professional stakeholders (n = 17) from four locations in British Columbia, Ontario, and Nova Scotia, including program managers, executive directors, political and health authority representatives, and healthcare providers involved in the design, implementation, and/or operation of safer supply programs in their communities. Semi-structured, one-to-one interviews were conducted, and interview data were coded and analyzed using thematic analyses.ResultsParticipants defined safer supply as low-barrier access to substances of known quality and quantity, offered on a continuum from prescribed to a legal, regulated supply, and focused on upholding autonomy and liberation of people who use drugs. Stakeholders expressed support for safer supply but explained that current iterations do not meet the needs of all people who use drugs and that implementation is limited by a lack of willing prescribers, stigma towards people who use drugs, and precarity of harm reduction programs to political ideology. Stakeholders expressed strong support for wider-reaching approaches such as decriminalization, legalization, and regulation of substances as a way to fully realize a continuum of safer supply, directly address the overdose crisis and toxic drug supply, and ensure equity of access nationally.ConclusionThe results of this study highlight the need for innovative strategies to address the overdose crisis and that safer supply has the potential to benefit certain people who use drugs. A one-size-fits-all approach is not sufficient and the perspectives of professional stakeholders should be considered alongside those of people who use drugs when designing and implementing future safer supply.

Autonomy of people with psychological suffering from the perspective of work: Perceptions of users and their families

ObjectiveTo present the results of a study with a psychosocial approach that aimed to examine the autonomy of people with mental suffering cared for at psychosocial care centres from the perspective of work, based on the perceptions of the users and their families, and using the psychosocial rehabilitation framework and Agnes Heller’s theory of everyday life. MethodsFour psychosocial care centres were selected, and 40 people collaborated with the research through semi-structured interviews analysed with the Collective Subject Discourse technique. ResultsAlthough the users wanted to have a job, they showed no initiative, as there are impediments to carrying out work activities due to the side effects of the medication and the obstacles posed by third parties concerned about the loss of social benefits. Prejudice was seen as a mechanism that negatively interferes with social relations and empowerment for autonomy. Expectations of resuming studies and participation in voluntary activities, especially religious ones, were frequent in the users’ discourse. ConclusionsThere is an urgent need to expand territorial spaces so that the users of mental health services can be protagonists of their own autonomy and carry out their occupations in the area of productivity with greater ownership.

Concerted Model of Healthcare for Awá Indigenous of Nariño, Colombia.

Indigenous communities in Colombia are facing a critical health situation; alternative health care models based on the vision of the communities themselves are needed. The objective of this research was to create a health care model that decreases health inequities for the Indigenous Awá population of Nariño, Colombia. This study was guided by the paradigm of community-based participatory action research; the process was carried out in 2015 and 2016. The proposed Intercultural Health Care Model is essentially based on health promotion, disease prevention, community empowerment, social participation in health, decentralized health care and coordination between the two medicines (traditional and allopathic). Strategies such as those reported herein, with concerted efforts rather than imposition, maintain human rights and respect for the sovereignty and autonomy of Indigenous people.

The impact of individualised funding on the wellbeing of mothers raising an autistic child in Aotearoa New Zealand

INTRODUCTION: How best to support the wellbeing of mothers raising autistic children is an emerging issue of importance due to the growth in autism diagnoses. While the move to individualised funding has been seen to promote autonomy for disabled people and their family to make decisions about services to meet their needs, it has also received criticisms, leading to inequitable processes and outcomes. The purpose of this research was to explore how individualised funding has impacted on mothers raising autistic children and their wellbeing. METHODS: A qualitative approach, combining semi-structured interviews and the theoretical underpinning of social constructionism, was used to interview seven mothers in 2020 to discuss their experiences of raising an autistic children and how individualised funding has impacted on them. Thematic analysis was used to analyse the data collected. FINDINGS: Key findings indicated that caring for an autistic child has an ongoing negative impact on mothers’ overall wellbeing and the individualised funding did not seem to ease the stresses of caring. CONCLUSION: Mothers raising an autistic child in Aotearoa New Zealand face complex funding systems, which are difficult to navigate. Individualisation of disability funding frameworks continues to create barriers and negatively impact the wellbeing of mothers. Wellbeing requires the funding support to see the family as a unit of care instead of the individualisation of a child’s needs. Results of this study urge practitioners and policymakers to support parents raising an autistic child in a more flexible and holistic way to meet the unique circumstances of a family.

The Benefit of Sport for People with Disabilities

Starting points: People with disabilities face daily obstacles that do not allow them to integrate adequately into society. Health disadvantage itself is a complex and multidimensional phenomenon, which carries with it several specificities. Social inclusion is a phenomenon that is still present in the academic world than in society itself. A specific part of inclusion is precisely the participation of people with disabilities in sporting activities. Although sport can be understood as the most beautiful means of inclusion of people with disabilities, it is here that we can observe shortcomings in participation in sport. Very little attention is paid to the management of sport of persons with disabilities and their support from society is at a minimum. We chose this issue precisely because of the increase in the interest of people with disabilities in sports activities. Methods: The study analyzes sport as a means of inclusion of people with disabilities in society. We carried out the research in qualitative design and as a method of data collection we chose a semi-structured interview, which we conducted with 9 informants between October 2021 and March 2022. We analyzed the results of our research was to find out what sport brings to the lives of people with disabilities and to find out in what areas sport has enriched the lives of people with disabilities. Results & conclusions: Based on our findings, we can conclude that people with disabilities reflect the changes that occurred in their lives after they started active sports. Through sport, they managed to improve not only their physical condition, but also brought positive changes to them by sport in the fields of mental and social. Our research also confirmed the positive impact of sport on the autonomy of people with health disadvantages.

Assistive Robots for Patients With Amyotrophic Lateral Sclerosis: Exploratory Task-Based Evaluation Study With an Early-Stage Demonstrator.

BackgroundAlthough robotic manipulators have great potential in promoting motor independence of people with motor impairments, only few systems are currently commercially available. In addition to technical, economic, and normative barriers, a key challenge for their distribution is the current lack of evidence regarding their usefulness, acceptance, and user-specific requirements.ObjectiveAgainst this background, a semiautonomous robot system was developed in the research and development project, robot-assisted services for individual and resource-oriented intensive and palliative care of people with amyotrophic lateral sclerosis (ROBINA), to support people with amyotrophic lateral sclerosis (ALS) in various everyday activities.MethodsThe developed early-stage demonstrator was evaluated in a task-based laboratory study of 11 patients with ALS. On the basis of a multimethod design consisting of standardized questionnaires, open-ended questions, and observation protocols, participants were asked about its relevance to everyday life, usability, and design requirements.ResultsMost participants considered the system to provide relevant support within the test scenarios and for their everyday life. On the basis of the System Usability Scale, the overall usability of the robot-assisted services for individual and resource-oriented intensive and palliative care of people with ALS system was rated as excellent, with a median of 90 (IQR 75-95) points. Moreover, 3 central areas of requirements for the development of semiautonomous robotic manipulators were identified and discussed: requirements for semiautonomous human-robot collaboration, requirements for user interfaces, and requirements for the adaptation of robotic capabilities regarding everyday life.ConclusionsRobotic manipulators can contribute to increase the autonomy of people with ALS. A key issue for future studies is how the existing ability level and the required robotic capabilities can be balanced to ensure both high user satisfaction and effective and efficient task performance.

Tata Memorial Hospital: a Peerless Icon.

Few institutes last long and fewer maintain their pre-eminent position throughout their life. They are called temples of their silo. Tata Memorial Hospital and Centre (TMC) is one such temple of healing. The contribution of TMC in patient care, education and research is unique and reasons for its success are varied. It is probably the best expression of Tata culture, Government's commitment, dedication and autonomy of people who ran it. A glimpse into the journey with its changing vision towards a pointed mission of conquest of cancer in India is captured in words.

Effects of Rehabilitation on Long-COVID-19 Patient's Autonomy, Symptoms and Nutritional Observance.

Background: Despite significant improvements in COVID-19 therapy, many patients still present with persistent symptoms and quality-of-life alterations. The aim of this study was to simultaneously investigate the long-term evolution of autonomy, malnutrition and long-lasting symptoms in people infected with COVID-19 and hospitalized in the ICU. Method: Patients’ clinical characteristics; extent of their loss of autonomy based on “Autonomie Gérontologie Groupes Iso-Ressources” (AG-GIR) classification; nutritional status while following the French and Global Leadership Initiative on Malnutrition (GLIM) recommendations; and symptom evolutions before infection, during hospitalization and rehabilitation, and up to 6 months after returning home were determined in thirty-seven patients. Results: Prior to a COVID-19 infection, all patients were autonomous, but upon admission to the rehabilitation center (CRM), 39% of them became highly dependent. After discharge from the center and 6 months after returning home, only 6 and 3%, respectively, still required considerable assistance. Of these thirty-seven patients, 11% were moderately malnourished and 81% presented with severe malnutrition, with a significant correlation being observed between malnutrition and autonomy (p < 0.05). Except for fatigue, which persisted in 70% of the patients 6 months after discharge from rehabilitation, all other symptoms decreased significantly. Conclusions: This study shows a striking decrease in autonomy associated with malnutrition after hospitalization for a COVID-19 infection and a clear beneficial effect from personalized rehabilitation. However, although almost all patients regained autonomy 6 months after returning home, they often still suffer from fatigue. Patient compliance with their nutritional recommendations deserves further improvement, preferably through personalized and persistent follow-up with the patient.

Design and development of a social assistive robot for music and game activities: a case study in a residential facility for disabled people.

Cognitive disability strongly reduces people's autonomy in performing desired as well as daily activities. The use of Social Assistive Robots (SARs) for cognitive rehabilitation therapy for disabled people could be a valuable gateway for the residential facility of the future. In this work, we design and develop a SAR that can be used for cognitive therapy proposing music and game activities. The results confirm that participants were positively engaged during the proposed activities and satisfied by the robot, despite the low perception of its usability. Professional caregivers noticed and confirmed the high level of engagement and the positive acceptance of the robot within the session, suggesting future tasks for SAR. Clinical Relevance- The results suggest the potential use of SAR also with disabled people proposing cognitive games as a part of the cognitive rehabilitation program.

Https://biomedpharmajournal.org/vol15no2/regular-physical-exercise-increase-of-growth-hormone-gh-and-insulin-like-growth-factor-1-igf-1-activity-in-elderly-improve-the-aging-process-and-quality-of-life-a-mini-review/

By doing regular physical exercise, it is expected to improve the quality of life through increasing levels of the hormones GH and IGF-1. Many studies have been conducted to prove the effect of exercise on GH and IGF-1 levels, but still show inconsistent results. This review aims to find out whether regular physical exercise increase GH and IGF-1 levels in the elderly, and will improve the aging process and quality of life. This literature review inquiry was obtained from various PubMed and Google Scholar data bases by entering keywords, namely: It can be concluded that physical exercises may influence the secretion of hormones in the elderly and the hormonal impact of physical exercise can aid in determining the efficacy of training regimens for maintaining or improving IGF-1 and GH levels, as well as the possible impacts of various types of exercise on this hormone. This could increase elderly people's functional autonomy and quality of life.

Respect for Autonomy and Dementia Care in Nursing Homes: Revising Beauchamp and Childress’s Account of Autonomous Decision-Making

Specifying the moral demands of respect for the autonomy of people with dementia (PWD) in nursing homes (NHs) remains a challenging conceptual task. These challenges arise primarily because received notions of autonomous decision-making and informed consent do not straightforwardly apply to PWD in NHs. In this paper, I investigate whether, and to what extent, the influential account of autonomous decision-making and informed consent proposed by Beauchamp and Childress has applicability and relevance to PWD in NHs. Despite its otherwise practical orientation and suitability for acute care settings, I identify three problems with this account when applied to PWD in NHs. These problems include (1) intentionality as an all-or-nothing condition of autonomous decision-making, (2) construing consent as one-off authorization, and (3) unresolved ambiguities around the primacy of precedent autonomy over best interest considerations. To address these problems, I propose and defend a number of revisions to Beauchamp and Childress’s account. First, I suggest that we consider intentionality as a non-binary criterion of autonomous decision-making. Second, I argue for a model of process consent to overcome the moral inadequacy of construing consent as one-off authorization in NHs. And, to overcome the third problem, I suggest accounting for both precedent and extant autonomy of PWD, considering mandates of precedent autonomy not as prescriptive but as informative, and drawing a less rigid distinction between autonomy considerations and best interest judgements. I conclude that this revised version of Beauchamp and Childress’s account fares better than the original version in capturing relevant autonomy considerations to care for PWD in NHs.

Directives anticipées en psychiatrie périnatale : une aide à la parentalité pour les femmes ayant un trouble bipolaire ?

Advance directives in psychiatry (ADP) allow patients to anticipate their requests for care. Their purpose is to promote the acceptation of care, prevent relapses and maintain the autonomy of people with severe and persistent disorders such as bipolar disorder (BD). The risk of relapse is particularly high during the perinatal period. ADPs could be a tool to facilitate care pathway and so maintain mood stability for women with BD during the perinatal period and provide good conditions for child development.

Design, Development, and Control of a Hand/Wrist Exoskeleton for Rehabilitation and Training

Robotic devices for rehabilitation and training is a promising and challenging research topic with a potentially huge social impact. The availability of tools for autonomously performing physiotherapy exercises increases their efficiency, provides supplementary information about results and progress, reduces physiotherapists&#x2019; efforts and the need of their physical presence during exercise sessions, and encourages autonomy and independence in people with disabilities. Nevertheless, supportive technologies developed without the inputs and feedback of the end-user throughout the design process are less likely to be adopted for their intended purpose and use case. In this article, we propose a modular hand/wrist exoskeleton that actuates the wrist flexion/extension and adduction/abduction motions and hand fingers flexion/extension motions. It is designed to be wearable and easy to control and manage and can be used by the patient in collaboration with the physiotherapist or autonomously. A user-centered design perspective has been employed in all the design and development phases. This article introduces the main features of the device and presents some tests conducted with a user having limited hand and wrist mobility.

Deaf-Blindness through the Voices and Experiences of Parents and Educators.

This qualitative study used the experiences of parents and educators to explore the developmental processes and behaviors of deafblind people of different ages and with different etiologies. It also explored which strategies of intervention and care employed by parents and educators best promote and stimulate the abilities and the autonomy of deafblind people. Eligible parents and educators were identified and recruited from the New York Parents Association for Deafblind and the Helen Keller National Center on Long Island using purposeful sampling. Seven mothers, one father, and two educators were interviewed using a narrative method. Data analysis was performed using Heideggerian hermeneutic phenomenology. The themes that emerged concern communication, expression of emotions, sense of self and external reality, autonomy, and the sphere of educational intervention. This research goes beyond existing knowledge on the syndromes/disabilities related to deafblindness, focusing instead on the combinations of varying degrees of hearing and sight deprivation.

Care relationships and the autonomy of people with physical disabilities.

As a form of functional diversity, spinal cord injury expressed by tetraplegia is one of the most serious events that can impact people, affecting their family and socioeconomic life. The type of care relationship established in these cases will be essential for preserving autonomy. The objective of this study was to understand how care relationships influence the autonomy of people with tetraplegia and the dynamics that trigger practices of autonomy violation, maintenance and promotion.This research is inspired by problematization as a methodology using the Arch of Maguerez as an analytical approach strategy that enables an engagement between empirical and theoretical data. Some models of care relationships identified in this study either promote or violate autonomy: the protectionist model, based on the biomedical interpretation model of disability and the bodily impediments caused by spinal cord injury; the participatory model, involving the patient's interest in adapting to their new condition of family and community life, seeking to understand the practical aspects of daily life; the sharing model, in which the complicity and understanding of new forms of bodily expression allow the caregiver to be almost an extension of the tetraplegic person's body; the delegate model, which occurs in relationships with professional caregivers; and the emancipatory model, which seeks to empower the patient, highlight potentialities, and encourage autonomy. The key components of these conceptual care models guided the elaboration of hypotheses for intervention with the objective of maintaining and promoting the autonomy of people with tetraplegia through supported care.

Be autonomous or stay away! Providing evidence for autonomy beliefs as legitimizing myths for the stigma of schizophrenia (¡Sé autónomo o mantente al margen! Ofreciendo evidencias para las creencias en la autonomía consideradas como mitos legitimizantes para el estigma de la esquizofrenia)

ABSTRACT Authors suggest that in liberal contexts, groups considered as lacking autonomy, such as people with schizophrenia, can face stigma. Following Social Dominance theory, we hypothesized that perceived autonomy of people with schizophrenia mediates the relation between SDO and stigmatizing attitudes. Participants from the general population (N = 255; 76.5% women, Mage = 25.33, SD = 12.3) responded to our questionnaire assessing one’s SDO, perceived autonomy and stigmatizing attitudes towards schizophrenia (i.e., dangerousness and desired social distance). Analysis of direct paths from SDO to perceived autonomy (b = −.45, p < .001) and from the latter to perceived dangerousness (b = −.33, p < .001) and to social distance (b = −.46, p < .001), as well as analysis of indirect paths (b = .15, p < .01) for perceived dangerousness (b = .25, p < .001 for social distance), confirmed our hypotheses, and our model showed a good data fit. Our results provide evidence for the stigmatizing role of the autonomy ideal for people with disabilities and invite further development regarding anti-stigma efforts.

The Effectiveness of Assistive Technologies for Older Adults and the Influence of Frailty: Systematic Literature Review of Randomized Controlled Trials.

BackgroundThe use of assistive technologies (ATs) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties.ObjectiveWe aimed to evaluate the effectiveness of ATs on relevant outcomes with a focus on frail older adults.MethodsA systematic literature review of randomized controlled trials evaluating ATs was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Ovid Medline, PsycINFO, SocIndex, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and IEEEXplore databases were searched from January 1, 2009, to March 15, 2019. ATs were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ≥65 years. Trials performed within a laboratory setting were excluded. Studies were retrospectively categorized according to the physical frailty status of participants.ResultsA total of 19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective, with four out of five studies showing significant improvement of disease-related outcomes. Frailty could only be assessed for seven trials. Studies including participants with significant or severe impairment showed no effectiveness.ConclusionsDifferent ATs show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated ATs might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of ATs and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives.Trial RegistrationPROSPERO CRD42019130249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130249