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Objectives: The aim of the present paper was, first, to analyze a four level biopsychosocial model to examine the interaction of various initial health behaviors and, second, their consequences with respect to the course of physical fitness (PF) and health of adults over the course of 18 years. Design: Longitudinal study based on medical examinations and self-ratings. Method: Path analysis along with latent growth curve analysis was based on the German study about the relationship of physical activity, fitness and health (1992–2010). Data were collected from 495 adults (243 women) with an average age of 45.03 years in 1992 (SD = 7.45). Participants were randomly selected from the official registers of local residents' registration offices in the community of Bad Schönborn. Results: For the mean PF and health levels in 1992, direct and indirect influences were shown on four levels including socioeconomic status and immigration on the first level, outcome expectations and stress coping strategies on the second level as well as eating patterns and physical activity on the third level; furthermore, the course of PF and the course of health (from 1992 until 2010) were affected by the initial behaviors (physical activity and eating patterns in 1992); finally PF and health were not related. Conclusions: Influences on four levels provided evidence for the complexity of PF and health (outcome level). Initial behaviors predicted current PF and health status, as well as their course. Thus, preventive measures should ensure that healthy behaviors are adopted early in adulthood. [Copyright &y& Elsevier]

Recognizing the ageing of populations and expected increase in prevalence of dementia, the necessity of research involving persons with dementia is widely agreed upon. Autonomy is key to nursing home residents' well-being and quality of life, but this phenomenon has not been thoroughly assessed from the residents' perspective. The aim of this cross-sectional study was to investigate perceived autonomy of nursing home residents. Data on 560 randomly selected residents in 40 nursing homes in two German federal states were generated by face-to-face interviews, psychological and physical assessments, analysis of nursing records, and acquisition of institutional parameters. This paper reports on a subsample ( n = 179) that met screening requirements, including subjects with and without mild cognitive impairment ( Mini Mental Status Examination score 30-18), who completed the Hertz Perceived Enactment of Autonomy Scale ( HPEAS). The mean score of HPEAS was 101.1 ± 14.5 (range 54-122). In our population, Cronbach's alpha was 0.89. Scores in HPEAS were not related to demographical factors but positively associated with increasing self-efficacy and absence of pain. The novel findings contribute to an understanding of autonomy from the residents' perspective. [ABSTRACT FROM AUTHOR]