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A randomization test can be used to statistically test hypotheses in multiple baseline designs to complement the commonly used visual inspection analysis. A crossed factor simulation study was performed to investigate the power of a randomization test in an multiple baseline design. The results show that the degree of autocorrelation of the observations, the number of participants, the effect size, the overlap of possible start moments of the intervention between participants, the ratio of the number of measurements in the baseline- and intervention phase, a gradually emerging effect, and the number of measurements had strong main effects on the power. The two-way interactions between number of participants and effect size, and between the number of measurements and the number of start moments of the intervention also had a large effect. An online tool was developed to calculate the power of a multiple baseline design given several design characteristics.

The author's memoir recounting his wife Liz's death shortly after the birth of their daughter Madeline and how he and his daughter Maddy have built a life for themselves--grounded in large part in the life and marriage he shared with Liz.

Background Worldwide, children with cerebral palsy (CP) living in underserved communities face barriers to accessing motor therapy services. This study assessed the implementation and effectiveness of an 8-week, upper limb (UL) home-based intervention with a movement-tracking videogame (Bootle Blast) in Costa Rican children with CP. Methods Children established a weekly playtime goal and two UL activities of daily living (ADLs) that they would like to improve on. A multiple-baseline, single-case experimental design, was used with the Performance Quality Rating Scale (PQRS) as the repeated measure to track changes in performance of the selected ADLs between the baseline (usual care) and intervention (Bootle Blast) phases. The Canadian Occupational Performance Measure (COPM), the Box and Blocks Test (BBT) and the Children’s Hand-Use Experience Questionnaire (CHEQ) were collected before and after the intervention. Technical barriers were documented during weekly video calls with a monitoring therapist. Treatment effect size, slope changes and percentage of non-overlapping data were identified for the PQRS. Descriptive statistics summarized results for the BBT, CHEQ, videogame logs (e.g., playtime) and technical barriers. Results Fifteen children participated and 13 completed the intervention. Both participants who dropped out did so after completing baseline assessments, but before experiencing Bootle Blast. Children’s mean active playtime (i.e., mini-games targeting the UL) across the 8-weeks was 377 min, while mean total time spent engaging with Bootle Blast ( active  +  passive play time [e.g., time navigating menus, reviewing rewards]) was 728 min. In total, eight technical issues (from five children) were reported, and all but three were resolved within 48 h. Partial effectiveness was associated with the intervention. Specifically, 85% of participants improved on the PQRS and 69% achieved clinically important improvements ≥ 2 points in performance on the COPM. Children improved by 1.8 blocks on average on the BBT, while on the CHEQ, five children had a clinically important increase of 10% of the total number of UL activities performed with both hands. Conclusion Bootle Blast is a feasible and effective option to facilitate access and engage children with cerebral palsy in UL home rehabilitation. Trial registration Trial registration number: NCT05403567.

Purpose The growing discussion on blockchain and business models often falls short of demonstrating and evaluating systems consistently exposed to settings of dynamic complexity. Therefore, in practicing systems thinking, this study aims to provide a depiction of dynamic complexity in blockchain business models and develop policy-based scenarios to enhance blockchain-based systems behavior. Design/methodology/approach This study integrated the soft system dynamic (SD) methodology approach, which focuses on a situation analysis and SDs in policy design. This single case study chose a firm engaged in the content industry, where the adoption of blockchains is a solution to tackle the industry’s significant challenges. Data were collected using a qualitative approach and then adapted into a simulation model. Findings The study pinpointed key parameters significantly affecting the system through a sensitivity analysis. Then, this experimental study found that all improvement initiatives delivered better system performance. At the same time, the study also identified counterintuitive findings, where the interventions using multiple value subsystems had insignificant effects on the system compared to a single advent. Originality/value This study illuminates the growing field of blockchain and business models through system modeling and experimentation, using an integrative approach like soft system dynamics methodology. It also identifies and demonstrates value distribution and the dynamic complexity inherent in the blockchain business model.

This title was first published in 2000. This is a study which compares and contrasts how lone mothers' relationships to paid work and care-giving are constructed across 20 countries, and with what outcomes for lone mothers' levels of economic well-being. In doing so, the book explores from an international perspective, the implications of the re-orientation of lone mothers' citizenship within the UK policy field from that of care-giver to paid worker. The volume engages with feminist comparative social policy literature concerned with specifying a construction of citizenship appropriate to capturing international variations in women's social rights. By incorporating social rights attached to paid work and care, as well as those which enable lone mothers to move between sequential periods of paid work and care-giving across the child-rearing cycle, the study makes a significant contribution to the literature.

Purpose The aim of this study was to implement a novel reinforcement strategy into traditional dysphagia therapy with a school-age child diagnosed with a rare genetic syndrome, anxiety, and a hypersensitive gag reflex response. This clinical focus article evaluated the impact of a computer-based straw-drinking game on total liquid volume intake and the relationship between motivation and its role in feeding therapy. Method A longitudinal pilot study was used and required the development and implementation of a computer-based straw-drinking game as a novel reinforcement strategy. The gaming system was implemented to supplement ongoing dysphagia treatment in a single-subject case study design utilizing a client with pediatric dysphagia. Results The participant exhibited a trend of increased endurance during therapy sessions, allowing for increased volume per sip, increased trials per session, and decreased time between sequential trials. Average daily volume of oral intake remained less than 30 ml. Conclusions The gaming system maximized opportunities for orosensory desensitization of tactile input, resulting in increased comfort and endurance during therapy sessions, leading to more opportunities to practice the swallow. A novelty effect was observed as motivation and interest in the gaming system appeared greatest at the onset of the study. Generalized fatigue and anxiety continue to serve as barriers to more significant progress.

Aims and objective To test a spaced retrieval intervention using spaced retrieval to alleviate mealtime difficulties in older people with dementia. Design A single‐case study design. Setting Nursing Homes in North Central England, United Kingdom. Participants Older people with Alzheimer’s disease. Methods A single‐case study using an ABA design was used. Data were collected using the Edinburgh Feeding Evaluation in Dementia scale, Mini Nutritional Assessment, and Body Mass Index before intervention, postintervention and following 3 months of postintervention. Realist evaluation was used to identify for which participants the intervention was effective, and an economic evaluation was also carried out. Finding Of 15 participants who entered the study, eight completed all phases of the study. A mean 104.4 h were needed to deliver the intervention. The number of sessions required ranged from 90–222. The length of time each participant retained information (for all sessions) ranged from 13–28 min. Participants had most difficulty with: “putting food into mouth and chewing it”; “realizing it was mealtime”; and “eating a whole meal continuously.” A reduction in the difficulty with mealtimes occurred between phase A1–A2 for most participants. Six participants maintained this in phase A3. Similar patterns were evident for nutritional scores. For most participants, the effect size of the intervention was moderate or large. Conclusions Spaced retrieval is useful in reducing mealtime difficulties in older participants with dementia. While the results of this study are promising, further large and multicentre trials are needed to explore the effectiveness of the intervention in diverse populations.

The Single Transferable Vote, or STV, is often seen in very positive terms by electoral reformers, yet relatively little is known about its actual workings beyond one or two specific settings. This book gathers leading experts on STV from around the world to discuss the examples they know best, and represents the first systematic cross-national study of STV. Furthermore, the contributors collectively build an understanding of electoral systems as institutions embedded within a wider social and political context, and begins to explain the gap between analytical models and the actual practice of elections in Australia, Ireland, and Malta. Rather than seeing electoral institutions in purely mechanical terms, the collection of essays in this volume shows that the effects of electoral system may be contingent rather than automatic. On the basis of solid empirical evidence, the volume argues that the same political system can, in fact, have quite different effects under different conditions. Contributors to the volume are Shaun Bowler, David Farrell, Michael Gallagher, Bernard Grofman, Wolfgang Hirczy, Colin Hughes, J. Paul Johnston, Michael Laver, Malcom Mackerras, Michael Maley, Michael Marsh, Ian McAllister, and Ben Reilly. Shaun Bowler is Professor of Political Science, University of California, Riverside. Bernard Grofman is Professor of Political Science, University of California, Irvine.

Women on Their Ownincludes eleven original essays that embrace a broad definition of singleness-women who never married, those who cohabit but are legally denied the right to marry, divorcees, and widows. Writers describe women who defiantly voted, single mothers who rejected dependency on public assistance, women who ran businesses, and others who found fulfillment in charitable work. Collectively, the self-reliance, creativity, and power to redefine difficult situations that these women-from a variety of cultures and countries-demonstrate make a powerful statement about the success of women on their own.