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Dementia often limits the agency of the person to such an extent that there is need for external support in making daily life decisions. This support is usually provided by family members who are sometimes legally empowered to engage in decision-making on behalf of the person for whom they care. However, such family carers receive little or no information on how to best provide support when there is a lack of capacity. This may have an impact on the agency of the person with dementia. This review explores the experience of agency in people living with dementia.
A systematic search was conducted on IBSS, MedLine, PsychINFO, EMBASE, and CINAHL. Two independent researchers screened the studies and conducted the quality appraisal. We used meta-ethnography for data analysis. As part of the synthesis, we identified behavioral mechanisms underlying the process of decision-making and looked at how the support of carers comes into play in making deliberate choices.
The meta-ethnography involved 20 studies. Three levels of third-order constructs were identified, each describing a decision-making pathway and reflecting the degree of autonomy of the person with dementia: autonomous decision-making, shared decision-making, and pseudo decision-making. Findings highlight those inter-relational processes that promote or negatively impact on the agency of people with dementia.
Our review will provide health and social care personnel with an understanding of the role of the carer in the decision-making process, and therefore which mechanisms need to be promoted or discouraged through training.
We have obtained near-IR, optical, and soft X-ray spectrophotometry for a number of bright quasars with 2 ≲ z ≲ 4. The observed ratios of Lyα/Hβ in this sample are smaller than Case B, and span a similar range to those seen at lower redshift. A correlation between the line width of Hβ and X-ray spectral index found for low-redshift PG quasars is also seen for the high-redshift objects.
Hyperspectral cathodoluminescence imaging provides spectrally and spatially resolved information on luminescent materials within a single dataset. Pushing the technique toward its ultimate nanoscale spatial limit, while at the same time spectrally dispersing the collected light before detection, increases the challenge of generating low-noise images. This article describes aspects of the instrumentation, and in particular data treatment methods, which address this problem. The methods are demonstrated by applying them to the analysis of nanoscale defect features and fabricated nanostructures in III-nitride-based materials.
Electroluminescence (EL) emission controlled by means of surface acoustic waves (SAWs) in planar light-emitting diodes (pLEDs) is demonstrated. Interdigital transducers (IDTs) for SAW generation were integrated onto pLEDs fabricated following a scheme compatible with SAW propagation . EL in presence of SAW was studied by time-correlated photon-counting techniques. We found intensity oscillation at the SAW frequency (˜1 GHz) demonstrating electron injection into the p-type region synchronous with the SAW wavefronts.
Using data from a survey of Pennsylvania food processors, we investigate what firm-level characteristics make a processor more or less likely to buy agricultural inputs and ingredients though contracts. We find that over 20 percent of Pennsylvania processors use contracts, and over 44 percent of agricultural inputs (based on value) are purchased under contract. We also analyze the two related questions of what firm attributes, attitudes, or other factors make a firm more likely to use contracts at all, and what factors lead a processor who does contract to use them more intensively.
This study examines several aspects of the Environmental Horticulture Industry (EHI) in the northeastern United States. First, the EHI is compared to other agricultural sectors in the region. The sector's growth is found to far outpace growth in traditionally important crops and commodities. The study then takes a closer look at the EHI in Pennsylvania, utilizing survey data and the IMPLAN input-output model to estimate the overall economic contributions of the industry to the state's economy. Results suggest that the EHI generates nearly $3.3 billion in value-added and more than 107,000 state jobs through direct, indirect, and induced effects. Finally, survey data are used to identify and discuss important issues that land grant universities throughout the Northeast can address as they seek to strengthen the sector.
The Wisconsin Economic Impact Modeling System, a conjoined input-output/econometric model of Wisconsin counties, is used to simulate the economic and fiscal impact of two alternative residential development patterns. Under the first scenario, the impact of migrating retirees on a small tri-county region in northern Wisconsin is examined. Under the second scenario, the impact of the migration of younger families with children is examined. A comparison-contrast between the two scenarios demonstrates that the characteristics of the migrating household can have a significant impact on the nature of the impacts.
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