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Abstract. Parent behaviors strongly predict child responses to acute pain; less studied are the factors shaping parent behaviors. Heart rate variability (HRV) is considered a physiological correlate of emotional responding. Resting or “trait” HRV is indicative of the capacity for emotion regulation, while momentary changes or “state” HRV is reflective of current emotion regulatory efforts. This study aimed to examine: (1) parent state HRV as a contributor to parent verbal behaviors before and during child pain and (2) parent trait HRV as a moderator between parent emotional states (anxiety, catastrophizing) and parent behaviors. Children 7–12 years of age completed the cold pressor task (CPT) in the presence of a primary caregiver. Parents rated their state anxiety and catastrophizing about child pain. Parent HRV was examined at 30-second epochs at rest (“trait HRV”), before (“state HRV-warm”), and during their child’s CPT (“state HRV-cold”). Parent behaviors were video recorded and coded as coping-promoting or distress-promoting. Thirty-one parents had complete cardiac, observational, and self-report data. A small to moderate negative correlation emerged between state HRV-cold and CP behaviors during CPT. Trait HRV moderated the association between parent state catastrophizing and distress-promoting behaviors. Parents experiencing state catastrophizing were more likely to engage in distress-promoting behavior if they had low trait HRV. This novel work suggests parents who generally have a low (vs. high) HRV, reflective of low capacity for emotion regulation, may be at risk of engaging in behaviors that increase child distress when catastrophizing about their child’s pain.

Attention, working memory, and executive control are commonly considered distinct cognitive functions with important reciprocal interactions. Yet, longstanding evidence from lesion studies demonstrated both overlap and dissociation in their behavioural expression and anatomical underpinnings, suggesting that a lower dimensional framework could be employed to further identify processes supporting goal-directed behaviour. Here, we describe the anatomical and functional correspondence between attention, working memory, and executive control by providing an overview of cognitive models as well as recent data from lesion studies and both invasive and noninvasive multimodal neuroimaging and brain stimulation. We emphasize the benefits of considering converging evidence from multiple methodologies centred on the identification of brain mechanisms supporting goal-driven behaviour. We propose that expanding on this approach should enable the construction of a comprehensive anatomo-functional framework with testable new hypotheses, and aid clinical neuroscience to understand and treat neuropathologies of executive functions.

Recycling reinjection of CO2 captured and purified from the produced gas of CO2 flooding can not only enhance oil recovery, but also realize the geological storage of CO2, so as to provide good social and economic benefit. With the operation and advancement of CO2 flooding development mode, one single CO2 capture and purification process can hardly deal with the yearly increase and large-scale variation of CO2 content in the produced gas. In order to provide support for the promotion of CO2-EOR technology oil and gas fields, to this end, this paper puts forward four schemes of multi-method CO2 capture and purification process. It includes two-stage hydramine method, one-stage membrane separation + one-stage hydramine method, two-stage membrane separation + one-stage hydramine method, one-stage membrane separation + two-stage hydramine method. And based on the working condition data of CO2 flooding in one certain oilfield, simulation was carried out by using HYSYS software. In addition, the enrichment degree of the CO2 captured and purified by means of different schemes and its energy consumption and economy were analyzed mainly. And the following research results were obtained. First, when the CO2 concentration of the produced gas is low, it is necessary to put the two-stage alcohol amine circulation process into production firstly to realize the deacidification of natural gas while purchasing some pure CO2 to mix at a certain proportion, so as to reach the required CO2 purity of reinjected gas. Second, as the CO2 concentration of the produced gas increases, it is better to use the membrane separation technology before the two-stage alcohol amine circulation process, so that the enriched and purified gas can reach the required CO2 purity of direction reinjection. In conclusion, the research results can provide engineering practical guidance for the formulation of the scheme to enrich and purify CO2 from the produced gas of CO2 flooding.

As mechanical simulations play an increasingly role in engineering projects, an appropriate integration of simulations into design-oriented product development processes is essential for efficient collaboration. To identify and overcome barriers between design and simulation departments, the BRIDGES approach was elaborated for barrier reduction in design engineering and simulation. This paper shows the industrial evaluation of the approach using a multi-method study of an online survey and focus group workshops. The experts' assessments were statistically analysed to build a connection matrix of barriers and recommendations. 59 participants from multiple industries with practical experience in the field contributed to the online survey, while 24 experts could be acquired for the focus group workshops. As a result of the workshops, both the data-based and the workshop-based part of the BRIDGES approach were assessed as beneficial to raise the efficiency of collaboration and practically applicable. This provides an empirically secured connection of barriers and suitable recommendations, allowing companies to identify and overcome collaboration barriers between design and simulation.

Our paper bridges psychological contract and recruitment literatures, examining the relationship between diversity messages on recruitment websites and internship outcomes, through the lens of anti...

There has been limited research into the individual, social, and environmental factors for infection risk among patients in the home healthcare (HHC) setting, where the infection is a leading cause of hospitalisation. The aims of this study were to (1) explore nurse perceptions of individual, social, and environmental factors for infection risk among HHC patients; and (2) identify the frequency of environmental barriers to infection prevention and control in HHC. Data were collected in 2017-2018 and included qualitative interviews with HHC nurses (n = 50) and structured observations of nurse visits to patients' homes (n = 400). Thematic analyses of interviews with nurses suggested they perceived infection risk among patients as being influenced by knowledge of and attitudes towards infection prevention and engagement in hygiene practices, receipt of support from informal caregivers and nurse interventions aimed at cultivating infection control knowledge and practices, and the home environment. Statistical analyses of observation checklists revealed nurses encountered an average of 1.7 environmental barriers upon each home visit. Frequent environmental barriers observed during visits to HHC patients included clutter (39.5%), poor lighting (38.8%), dirtiness (28.5%), and pets (17.2%). Additional research is needed to clarify inter-relationships among these factors and identify strategies for addressing each as part of a comprehensive infection control program in HHC.

Low information exchange in global production networks results in long response time to disruption and negative performance impact. Digitalization enables a more intensive information exchange. This paper analyses the performance of order management, quality problem resolution and engineering change management in production networks with respect to different disruptions and information flows. Cause-effect relationships are revealed based on a multi-method simulation model and statistical experiments. Using surrogate modelling and robust optimization, a target picture for information exchange is determined. The benefits of the approach are demonstrated using a case study for the production of metal-plastic parts for the automotive supplier industry.

Audiences’ TV series entertainment experiences are increasingly shaped not only by the events on the ‘first screen’ but also by discussions on social media. While an extensive body of research has examined practices of ‘second screening,’ especially on Twitter, online discussions before and after the live broadcast and on other platforms have received less attention. On Reddit—one of the most important platforms for Social TV—discussions often take place in temporally structured threads that allow users to discuss an episode before (pre-premiere thread), during (live premiere thread), and after (post-premiere thread) it airs. In this project, we examine whether these spaces mainly indicate temporal preferences among users or are associated with different usage practices and motives. To do so, we conducted two case studies of the Reddit community r/gameofthrones: a survey about usage motives (n = 417) and an automated content analysis of approximately 1.2 million comments left on the episode discussion threads in which we examined thread use over time, interactions between users, and discussion content. The results revealed differing usage motives and practices for the three thread types, illustrating the distinct function that these communication spaces fulfil for users.

An informal caregiver (ICG) is an individual who provides care (unpaid) to a person with a disability or disease. ICGs report the extreme time spent as an ICG lowers their availability to participa...

Background Telemedicine and telephone-triage may compromise patient safety, particularly if urgency is underestimated. We aimed to explore the level of safety of a pediatric telemedicine service, with particular reference to the appropriateness of the medical diagnoses made by the online physicians and the reasonableness of their decisions. Methods This retrospective multi-method study investigated the decision-making process of physicians in a pediatric tele-triage service provided in Israel. The first section of the study investigates several measures relating to patient safety in the telemedicine setting. Two physicians reviewed a random sample of 339 parent-physician consultations conducted via a pediatric telemedicine service provided by a healthcare organization during 2014–2017. The consultations were analyzed for factors that may have affected the online physicians’ decisions, with an emphasis on the appropriateness of the diagnoses and the reasonableness of the decisions. The online physicians’ decisions were also compared to the subsequent outcomes (i.e., parental compliance with the recommendations and medical follow-ups within the healthcare system) after each consultation. The second section of the study (using a qualitative approach) consisted of interviews with 15 physicians who work in the pediatric telemedicine service, in order to explore their subjective experiences and efforts for assuring patient safety. The physicians were asked about factors that may have affected their reaching an appropriate diagnosis and a reasonable decision while maintaining patient safety. Results The first section of the study demonstrates high levels of diagnosis appropriateness (98.5%) and decision reasonableness (92%), as well as low levels of false-positive (2.65%) and false-negative (5.3%), good sensitivity (82.85%), and high specificity (96.15%). A high association between the online decisions and the subsequent outcomes was also observed. The second section of the study presents physicians’ means for ensuring high patient safety – by implementing a range of factors that helped them reach appropriate diagnoses and reasonable decisions. Conclusions The results show overall high patient safety in the pediatric tele-triage service that was examined. However, decision makers must strive to implement additional means for further enhancing the clinicians’ ability to reach accurate diagnoses and provide optimal treatments within the tele-triage settings – with the aim of ensuring patient safety.

Using both quantitative and qualitative research techniques, we investigate the effect of leaders' style and personality on foreign policy. The study examines six Turkish leaders, Suleyman Demirel, Bulent Ecevit, Necmettin Erbakan, Recep Tayyip Erdogan, Abdullah Gul, and Turgut ozal, and 18 foreign policy cases to answer the following questions: do Turkish leaders differ from each other in terms of their personality traits and styles?; how did their styles affect their foreign policy choices?; and how did they react to various domestic and international constraints they encountered in cases of foreign policy? Our findings suggest that: (a) in terms of their personality traits, Turkish leaders do not collectively fit in one category; (b) there are some stark differences among our six leaders, although some leaders are more similar to each other than others in terms of their personality traits and styles; (c) these differences were observable in the foreign policy decisions they made.

This chapter reflects on the lessons learnt from applying multi-methods in a study to determine community librarians' disaster management beliefs and practices in a rural context. A case study design that used a questionnaire, interviews, and document analysis was employed. The study sought to generate new knowledge about disaster management practices of community libraries in the North West Province of South Africa. The researcher collected quantitative data as the primary data collection strategy, and qualitative data supplemented it. The rationale for triangulating the two types of data was that neither quantitative nor qualitative methods were sufficient to capture the perceptions and identify practices amongst the participants. The triangulation of data facilitated the understanding of the subjective meanings, developing a description of disaster management practices and localising participants' statements within social patterns of interaction.

A cost-efficient approach to long-term monitoring is to focus on one species or group of organisms as indicators of ecological condition. Through the use of autonomous monitoring technologies, monitoring programs can efficiently expand the biological community surveyed and inferences made. Amphibians have been monitored in Yellowstone and Grand Teton national parks by the Greater Yellowstone Inventory and Monitoring Network (GRYN) since 2006, yet other taxa dependent on wetlands have not been systematically studied. Our main aim was to explore what additional insights we could gain about wetland biodiversity by combining GRYN’s amphibian surveys with multiple autonomous technologies. We deployed wildlife cameras and acoustic recorders (for audible and ultrasonic sounds) at 4 permanent wetlands in Grand Teton National Park, WY during early and late summer 2017 and used descriptive metrics to summarize our findings. During GRYN’s surveys, 3 of 4 native amphibians were detected. With autonomous monitoring tools, we also documented avian and mammalian communities and detected changes in the degree of activity over the summer. Combining multiple, complementary technologies with field-based surveys provides a more comprehensive picture of wetland biodiversity and enhances insights about ecological condition and change.

Smart monitoring plays a principal role in the intelligent automation of manufacturing systems. Advanced data collection technologies, like sensors, have been widely used to facilitate real-time data collection. Computationally efficient analysis of the operating systems, however, remains relatively underdeveloped and requires more attention. Inspired by the capabilities of signal analysis and information visualization, this study proposes a multi-method framework for the smart monitoring of manufacturing systems and intelligent decision-making. The proposed framework uses the machine signals collected by noninvasive sensors for processing. For this purpose, the signals are filtered and classified to facilitate the realization of the operational status and performance measures to advise the appropriate course of managerial actions considering the detected anomalies. Numerical experiments based on real data are used to show the practicability of the developed monitoring framework. Results are supportive of the accuracy of the method. Applications of the developed approach are worthwhile research topics to research in other manufacturing environments.

Test smells are poor design and implementation choices that can affect the test code’s understanding and maintainability. Recent studies show the industry is not aware of the test smells concept, while software engineers commonly encounter obstacles to maintain test code. This study investigated test creation and maintenance strategies through developers’ perception of eight test smells types. We surveyed 87 software testers and interviewed eight to understand their view on test smells in practice. Our results show that most participants use manual strategies for creating and maintaining test cases. Based on data captured from software testers’ perspectives, this study contributes with possible directions and treatments to analyze test smells, seeking to understand how the test affects and potential solutions for test smells.

BackgroundCOVID-19 changed access to healthcare, including vaccinations, in the United Kingdom (UK). This study explored UK women’s experiences of accessing pertussis vaccination during pregnancy and infant vaccinations during COVID-19.MethodsAn online cross-sectional survey was completed, between 3rd August-11 th October 2020, by 1404 women aged 16+ years who were pregnant at some point after the first UK lockdown from March 23rd, 2020. Ten follow-up semi-structured interviews were conducted.ResultsMost women surveyed were pregnant (65.7%) and a third postnatal (34.3%). Almost all women (95.6%) were aware that pertussis vaccination is recommended in pregnancy. Most pregnant (72.1%) and postnatal women (84.0%) had received pertussis vaccination; however, access issues were reported.Over a third (39.6%) of women had a pregnancy vaccination appointment changed. COVID-19 made it physically difficult to access pregnancy vaccinations for one fifth (21.5%) of women and physically difficult to access infant vaccinations for almost half of women (45.8%). Nearly half of women (45.2%) reported feeling less safe attending pregnancy vaccinations and over three quarters (76.3%) less safe attending infant vaccinations due to COVID-19. The majority (94.2%) felt it was important to get their baby vaccinated during COVID-19.Pregnant women from ethnic-minorities and lower-income households were less likely to have been vaccinated. Minority-ethnicity women were more likely to report access problems and feeling less safe attending vaccinations for both themselves and their babies.Qualitative analysis found women experienced difficulties accessing antenatal care and relied on knowledge from previous pregnancies to access vaccines in pregnancy.ConclusionDuring the ongoing and future pandemics, healthcare services should prioritise equitable access to routine vaccinations, including tailoring services for ethnic-minority families who experience greater barriers to vaccination.HighlightsAccess to pregnancy vaccines in the United Kingdom was disrupted by the COVID-19 pandemic.UK women reported difficulties in physically accessing vaccine appointments and feeling less safe accessing vaccine appointments for themselves when pregnant and for their babies during COVID-19, with women from ethnic minorities in the UK were more likely to report difficulties.Vaccine services must ensure equitable access to vaccine appointments during the ongoing COVID-19 pandemic including tailoring services for lower income and ethnic minority families.

This paper examines grid interfaces which are currently used in many musical devices and instruments. This type of interface concept has been rooted in the NIME community since the early 2000s. We provide an overview of research projects and commercial products and conducted an expert interview as well as an online survey. In summary this work shares: (1) an overview on grid controller research, (2) a set of three usability issues deduced by a multi method approach, and (3) an evaluation of user perceptions regarding persistent usability issues and common reasons for the use of grid interfaces.

Integrating sustainability in humanitarian operations has been seen as a promising approach toward effective and long-term solutions. During disaster emergency management, the evacuation determines the risk of loss in a disaster. To better understand the effectiveness of the evacuation plan while considering the sustainability standpoint, this paper develops a multi-method simulation (MMS) approach to evaluate evacuation time, load balance of the shelters, and CO2 emission. The MMS integrating Agent-Based Modeling (ABM) and Discrete-Event Simulation (DES) incorporates evacuation decision-making and evacuation processes. Comparative analysis shows that the MMS outperforms the use of ABM solely. The simulation results indicate over-utilization and imbalanced load among the shelters, implying a need to expand shelters’ capacity and to revisit the evacuation plan concerning the location of the assembly points and the shelters and the resource allocation. Evacuation behavior heading to the nearest assembly point instead of the designated assembly point based on the evacuation plan worsens the imbalanced load among the shelters and results in higher CO2 emissions by 8%. The results demonstrate the necessity to include evacuation decision-making (social dimension) on top of the technical dimension and to adopt sustainable performance indicators in planning the evacuation sustainably. Avenues for future research are also discussed.

Trauma exposure is highly prevalent among children globally, and is associated with elevated rates of PTSD. The goal of this study was to systematically evaluate the effects of multiple informants and multiple screening measures on the identification of specific PTSD symptoms and rates of PTSD diagnoses. Participants in this study included 350 maltreated children from two cohorts, one recruited from Connecticut (N=130), and the other from Vermont (N=220). Both cohorts completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED) before a PTSD self-report measure. The KSADS psychiatric interview was also completed with the Connecticut cohort, with best-estimate ratings generated using parent and child interview, child self-report, and teacher questionnaire data. In addition to the SCARED and PTSD self-report scale, parents of the Vermont cohort completed the Child Behavioral Checklist. Significant differences emerged between parent and child report of sleep, nightmares, concentration, and irritability problems, suggesting the need for multiple informants in PTSD screening. Children also under-reported nightmares when asked in the context of a trauma-specific screening tool. As child trauma is associated with a broad range of psychiatric sequelae, comprehensive assessment using both general symptomatology and trauma-specific measures is recommended, since children often shut down when completing trauma measures.

Background: Dispensing of antibiotics without a prescription (DAwP) has been widely practised among community pharmacies in Saudi Arabia despite being illegal. However, in May 2018, the law and regulations were enforced alongside fines. Consequently, we wanted to evaluate the impact of these changes. Methods: A study was conducted among 116 community pharmacies in two phases. A pre-law enforcement phase between December 2017 and March 2018 and a post-law enforcement phase one year later. Each phase consisted of a cross-sectional questionnaire-based survey and a simulated client method (SCM) approach. In the SCM, clients presented with either pharyngitis or urinary tract infections (UTI). In SCM, for each phase, all 116 pharmacies were visited with one of the scenarios. Results: Before the law enforcement, 70.7% of community pharmacists reported that DAwP was common with 96.6% and 87.7% of participating pharmacies dispensed antibiotics without a prescription for pharyngitis and UTI respectively. After the law enforcement, only 12.9% reported that DAwP is still a common practice, with only 12.1% and 5.2% dispensing antibiotics without prescriptions for pharyngitis and UTI respectively. Conclusion: law enforcement was effective. However, there is still further scope for improvement. This could include further educational activities with pharmacists, physicians and the public.

In a previously published report, our researcher–practitioner partnership demonstrated the effectiveness of a coursework plus higher-dosage coaching professional development intervention (Expanding...

To fabricate highly complex structures, sacrificial support material is usually needed. However, traditional petroleum-based support materials are un-sustainable, non-recyclable, and difficult to be completely removed from the target structure after 3D processing. Instead, cellulose nanocrystals (CNC) gel could serves as an interesting 3D printing support material due to its sustainability, renewability, and potential recyclability. Since CNCs are highly dispersible in water as nanoparticles and are also not UV sensitive, it has less absorption or bondability with other UV curable polymer matrices. This allows them to be completely washed out by water, which offers a green and efficient method to remove the CNC support material during post processing. In addition, with increasing needs for more intricate structures, combining different 3D printing strategies into a hybrid 3D printing platform can be highly beneficial. In this work, a multi-materials-multi-methods (M4) printer with dual direct-ink-write (DIW) and DIW-inkjet printing capability was used to fabricate various complex structures while using CNC as support material. After 3D printing, water was used to remove the CNC support structure. Even in a highly confined environment, such as the inside of a balloon structure, CNC support material was still easily removed. The potential of using sustainable CNC support material and M4 hybrid 3D printing strategies to fabricate different complex structures was demonstrated. Since CNC gel is derived from forestry products and is entirely water based, the 3D printing process was also made more environmentally friendly, sustainable, and potentially recyclable.

Contamination fear and washing compulsions are among the most common symptoms of obsessive compulsive disorder (OCD). Though these symptoms have traditionally been viewed as being driven by a desire to avoid harm, recent research has highlighted the importance of feelings of incompleteness (INC) or not-just right experiences (NJREs) in this symptom dimension. However, no study to date has examined the extent to which INC/NJREs may be associated with treatment response for contamination symptoms. The current study used a multi-method approach to examine the role of INC/NJREs in treatment of contamination symptoms. Participants (n = 88) with elevated contamination symptoms, half of whom met for an OCD diagnosis, engaged in three sessions of exposure and response prevention (ERP) targeting contamination fears, and completed self-report and in vivo measures of INC/NJRES and contamination symptoms. ERP was associated with significant reductions in INC/NJREs. Further, changes in INC were associated with changes in contamination symptoms, independent of changes in harm avoidance. Greater discomfort in response to an in vivo NJRE task at pre-treatment predicted poor treatment response, though a self-report measure of INC did not predict response. These findings provide novel evidence for the importance of INC/NJREs in contamination-based OCD and its treatment.

As cross-border e-commerce becomes more popular among global consumers and more important to global trade, there is a growing need for e-commerce research that explores the factors contributing to the success of global electronic markets. Yet, most extant literature on cross-border e-commerce is carried out from a buyer’s perspective. In this study, we contribute by arguing that the success of cross-border e-commerce is also determined by the behavior of sellers and their decision on which platforms to participate. To accomplish our research, we apply a sequential multimethod approach and draw on the information system success model and valence framework to conceptualize our work. We carried out interviews in a qualitative study of Chinese cross-border e-commerce sellers to uncover the key factors about which these sellers may be concerned, and the reasons why they engage in cross-border e-commerce. Our work then develops new operational definitions for concepts of system quality, service quality, perceived benefit and perceived cost relevant to the context of cross-border e-commerce. Next, we develop and test a research model to identify the most salient factors using data collected from a sample of 198 sellers in a Chinese cross-border e-commerce platform. Our quantitative results explain over 67% of seller intentions to participate in cross-border platforms, with trust and perceived benefits most important to that decision process. While other factors such as service quality were also found important, perceived costs had no direct effect. The theoretical contributions of the work and the practical implications for cross-border platforms are presented.

Background COVID-19 vaccines are advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine uptake among pregnant women is inadequate. Methods An online survey and semi-structured interviews were used to investigate pregnant women’s views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. One thousand one hundred eighty-one women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August–11th October 2020. Ten women were interviewed. Results The majority of women surveyed (81.2%) reported that they would ‘definitely’ or were ‘leaning towards’ accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p p Conclusion Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed.

The use of high resolution 3D point clouds and digital terrain models (DTM) from laserscanning or photogrammetry becomes more and more state of the art in landslide studies. Based on a multi-temporal terrestrial laserscanning (TLS) dataset of the deep-seated compound rockslide Laatsch, South Tyrol, we present a multi-method approach to characterize processes such as sliding, falling, toppling, and flows. Sliding is the predominant process of the Laatsch rockslide, accompanied by secondary processes such as rockfall, debris flows and erosion. The presented methods are applicable to all kind of 3D point clouds and not limited to TLS data. For remote sensing-based landslide analyses a distinction between two classes of surface processes is necessary: i) processes where the original surface is destroyed and no correlations between the shape and texture of the pre- and post-failure surfaces can be found (falls, rapid flows, rapid slides) and ii) processes where the surface is displaced without major surface changes (slow slides, slow flows and toppling). For processes where the original surface is destroyed, the distance between the pre- and post-failure terrain surface is measured with the aim to delineate the scarp and depositional area, and to quantify the failure volume as well as the scarp thickness. With DTMs of differences (DoD), the distance is measured along the plumb line. DoDs can be used to quickly and reliably assess the volume and extent of fall processes on flat to moderate slopes. For steep or even overhanging terrain, a 3D distance measurement approach must be used, where the distance is measured along the local surface normal. After 3D distance measurement, the volume of steep scarp areas can be calculated by first rotating, the point cloud into the horizontal plane (by making use of the average surface normal) and by interpolating the rotated 3D distance measurement values into a grid. Summing up the distances and multiplying with the cell area of the grid yields the scrap rupture volume. Remote sensing-based analyses of sliding and toppling processes are more complex compared to fall processes because the displaced surface patch must be detected in both surveys. Displacement analyses based on image correlation of ambient occlusion shaded relief images, together with DTMs of both epochs, are used to analyse the displacement of the entire rockslide area. The result is a map with displacement vectors. Disadvantages of image correlation are the coarse spatial resolution and the inability, as it is a 2.5D approach, to deal with steep slope parts. To analyse the displacement and toppling of steep rock walls a combination of the 3D distance measurement approach and an iterative closest point (ICP) based approach is applied. The 3D distance measurement values are clustered and used for a segmentation of the point cloud. In a next step, the ICP is applied on each of the resulting segments. This approach can deal with 3D displacements. The results are still sensitive towards the geometric contrast within the segments and not fully automated yet.

Background In the absence of a cure for the majority of rare diseases, the disease management aims to provide optimal supportive care. The goal of this study was to assess supportive care needs in patients with chronic rare diseases. Methods Cross-sectional mixed-method study was conducted using validated self-report scales and open-ended questions to assess supportive care needs. Participants affected by rare diseases across Germany were contacted via patient organizations and centers for rare diseases. N = 304 participants with 81 different rare diseases completed the study, 81.6% were female, mean age was 44.2 years (SD = 12.8, range 16–74). The quantitative results regarding supportive care needs were compared to a reference population of patients affected by cancer (N = 888). Main outcomes were unmet supportive care needs of patients with rare diseases, as assessed by the Supportive Care Needs Survey (SNCS-SF34) and an open-ended question on support wishes. Results Patients with rare diseases did not feel sufficiently supported with regard to psychological support, health system and information, physical and daily living, patient care and support, and sexuality needs. The unmet supportive care needs were significantly higher in the patient sample with rare diseases compared to the SCNS-SF34 reference sample of patients with cancer. 60% of patients with rare diseases did not feel sufficiently socially supported. Conclusions Patients affected by rare diseases have high unmet support needs in all areas studied. Multidisciplinary care, including psychological support and the provision of information regarding the healthcare system, treatment options, disease course and sexuality, might help address these needs.

Code obfuscation is a kind of powerful protection technique for software code. At present, research on obfuscation techniques is mainly focused on analyzing the effect of single obfuscation method, leaving few discussions on cooperative obfuscation of multiple methods. This paper firstly presented a brief introduction of the concept and methods of code obfuscation, then designed and implemented an obfuscator with multiple obfuscation methods. Then, a collaborative obfuscation strategy suitable for multiple obfuscation methods is proposed in detail. Finally, we verified that the obfuscation strategy indeed improves the performance of obfuscation through experiments.

After a person experiences an acquired brain injury (ABI), there can be grieving for what has been lost. Little is known about the loss felt by relatives of people with ABI. This study investigates concepts of loss among individuals with ABI and their families. Forty participants, recruited from a brain injury charity client pool, took part in a semi-structured interview. Of the participants, 17 were in dyadic relationships (53% spouses, 41% parent/child and 6% sibling relationships). They also completed the Brain Injury Grief Inventory (BIGI; Coetzer, B. R., Vaughan, F. L., & Ruddle, J. A. (2003). The Brain Injury Grief Inventory. Unpublished Manuscript. North Wales Brain Injury Service, Conwy & Denbighshire NHS Trust) as a quantitative measure of loss after ABI. Five main themes emerged from the interviews: loss of person; loss of relationships; loss of activity/ability; loss of future; unclear loss. There were distinct differences qualitatively between individuals and relatives and only two dyads experienced similar loss, but there were no significant differences in loss as measured quantitatively by the BIGI. The differences between relatives’ loss and individuals with ABIs’ loss are discussed. This research suggests that it is important when supporting families to consider individual experiences, because even though the loss originates from the same injury, the loss as experienced may substantially differ among those affected by it.

Enabled by technological advancements, a contemporary form of technology use that particularly became popular are online multiplayer video games, which are played with others in real time. Besides various positive impacts on the user experience (e.g., fun, additional social exchange) adverse consequences have occurred as well (e.g., stress, anger). Most recently, a sincere problem gaining increased attention is toxic behavior (i.e., a behavior spreading negative effects and bad mood during play). With our study, we propose a way to handle toxic behavior on a level of video game design by using a multi-method approach. First, we will consult the online disinhibition effect and its antecedents to identify design related relationships. Afterwards, we will conduct a qualitative workshop engaging video game designers and players to reshape in-game experiences by incentivizing players to buffer toxicity.

Background People with dementia are not routinely offered rehabilitation services despite experiencing disability associated with the condition and accumulating evidence for therapies such as exercise, occupational therapy, and cognitive or physical rehabilitation. It is important to understand the needs and preferences of people with dementia regarding rehabilitation services. The aim of this study was to explore thoughts and beliefs about rehabilitation amongst people with dementia and their families. Methods Interviews with people with dementia and family members regarding their experience of care following diagnosis and their attitudes and beliefs about rehabilitation for dementia. Surveys with older people with cognitive impairment and/or a diagnosis of dementia to determine preferences for services and understanding of rehabilitation programs. Results Interviews with 13 participants (n = 6 people living with dementia with mean age 60 and n = 7 care partners) revealed gaps in care post diagnosis. People reported having to seek out services and frequently sought out services which were rehabilitative in nature. Survey data (n = 91 participants, average age 82) showed that most people had heard of rehabilitation (92%) or had experience of rehabilitation (49%) at some point. There was a wide range of services identified as being beneficial. Rehabilitative interventions including case management, exercise and memory strategies were considered desirable. Conclusions People with dementia report having a wide variety of needs. There are gaps following diagnosis where people with dementia report having to seek out their own services. Some interview participants (who tended to be younger) clearly articulated the need for tailored interventions which maximised independence and quality of life. Survey participants, who were on average older, reported that they would participate in individually applicable rehabilitative therapies if they were available.

BackgroundRelatively poor UK cancer outcomes are blamed upon late diagnosis. Despite most cancer patients presenting to their GP with symptoms, diagnostic delay remains a common theme, with many clinical and non-clinical factors responsible. Early diagnosis is key to improving outcomes and survival. This paper reports the multi-method process to design a complex intervention to improve the timely diagnosis of symptomatic cancer.MethodsA review of reviews, survey, discrete choice experiment, qualitative interviews and focus groups, all informed a realist evidence synthesis. This in turn informed the design of a complex intervention, guided by the Behaviour Change Wheel framework using a multi-step process.ResultsKey themes from the realist evidence synthesis included effective safety netting at practitioner and practice system level, increased vigilance and lowering referral thresholds. Qualitative findings explored the tensions, barriers and facilitators affecting suspected cancer referral. The Think Cancer! intervention is an educational and quality improvement workshop directed at the whole primary care team. Bespoke cancer safety netting plans and appointment of cancer champions are key components.ConclusionsThink Cancer! is a novel primary care early cancer diagnosis intervention, requiring evaluation through a cluster randomised control trial.

The proportion of older adults (OAs) is increasing throughout the globe. One of the most important needs of this age group is to maintain active social engagement, which can be achieved through smartphone applications offering active social engagement facilities. But OAs are often reluctant to use these apps, which leads to lower uptake over time. The underlying problem is pitfalls in guidance to develop smartphone applications for older adults. This leads to a lack of usage of the guidance by practitioners and hence the reflection of these guidelines on apps for older adults is limited. We have researched this problem space by undertaking a mixed-methods empirical study with 235 OAs. We elicited requirements that can be used in the design and development of smartphone applications for older adults. The contribution of this study is an evaluated classification of the derived recommendations, called ReDEAP (Recommendations for DEveloping smartphone applications for an aging Population). ReDEAP serves as a starting point for researchers and practitioners designing smartphone applications for older adults.

Objective Eating disorders (EDs) are characterized by dysregulated responses to palatable food. Using a multi-method approach, this study examined responses to palatable food exposure and subsequent ad libitum eating in women with binge-eating disorder (BED: n = 64), anorexia nervosa (AN: n = 16), and bulimia nervosa (BN: n = 35) and 26 healthy controls (HCs). Method Participants were exposed to palatable food followed by an ad libitum eating opportunity. Affective and psychophysiological responses were measured before and during the task. Results Participants with EDs reported greater negative affect, particularly fear, following the food cue exposure, whereas HCs reported no change. BN and BED groups reported greater urge to binge after the food cue exposure, whereas AN and HC groups reported no change. Respiratory sinus arrhythmia levels, skin conductance and tonic skin conductance levels increased during food exposure for all groups. Across baseline and during the food exposure, the BED group had lower respiratory sinus arrhythmia levels relative to the BN and HC groups. The BED group consumed significantly more palatable food than the AN group. Conclusions 'Palatable' food stimuli elicited more negative affect, particularly fear, in individuals with EDs; and this, rather than psychophysiological responses, distinguishes individuals with EDs from those without.

IntroductionPartial driving automation is not always reliable and requires that drivers maintain readiness to take over control and manually operate the vehicle. Little is known about differences in drivers’ arousal and cognitive demands under partial automation and how it may make it difficult for drivers to transition from automated to manual modes. This research examined whether there are differences in drivers’ arousal and cognitive demands during manual versus partial automation driving.MethodWe compared arousal (using heart rate) and cognitive demands (using the root mean square of successive differences in normal heartbeats; RMSSD, and Detection Response Task; DRT) while 39 younger (M= 28.82 years) and 32 late-middle-aged (M= 52.72 years) participants drove four partially automated vehicles (Cadillac, Nissan Rogue, Tesla, and Volvo) on interstate highways. If compared to manual driving, drivers’ arousal and cognitive demands were different under partial automation, then corresponding differences in heart rate, RMSSD, and DRT would be expected. Alternatively, if drivers’ arousal and cognitive demands were similar in manual and partially automated driving, no difference in the two driving modes would be expected.ResultsResults suggest no significant differences in heart rate, RMSSD, or DRT reaction time performance between manual and partially automated modes of driving for either younger or late-middle-aged adults across the four test vehicles. A Bayes Factor analysis suggested that heart rate, RMSSD, and DRT data showed extreme evidence in favor of the null hypothesis.ConclusionThis novel study conducted on real roads with a representative sample provides important evidence of no difference in arousal and cognitive demands. Younger and late-middle-aged motorists who are new to partial automation are able to maintain arousal and cognitive demands comparable to manual driving while using the partially automated technology. Drivers who are more experienced with partially automated technology may respond differently than those with limited prior experience.

This paper investigates the feasibility and viability of providing power to Ada County, Idaho, using a distributed network of rooftop solar photovoltaic panels. Using a multi-disciplinary and multi-method modeling approach, a detailed simulation is performed where existing structures are retro-fitted with grid-tied solar photovoltaic systems using currently available technology. Feasibility is determined using simulated supply and demand per building, while viability is determined through standard financial metrics used in the energy sector. A major critique of solar energy comes from the vast amounts of space required to efficiently capture solar power, along with the inefficiencies created by transmission loss and intermittency. Under a system where structures become both producers and consumers of energy, with PV panels deployed in unused rooftop space, this paper mitigates those critiques and analyzes the results. Four case scenarios are discussed based on the perspectives of differing energy stakeholders; consumers, private firms, public utilities, and national governments.

Community-based strategies for preventing non-communicable diseases, particularly cardiovascular diseases, are of great importance.This study aimed to formulate a policy brief to identify and prioritize community-based strategies to prevent cardiovascular disease in Iran.This multi-method study was conducted over three phases. In the first phase, rapid review, community-based strategies which mentioned to people's participation had been identified. PubMed and Scopus had been searched. In the second phase, a focus group discussion (FGD) was held by the participation of 15 experts from different disciplines to have been summarized and finalized the community-based strategies to prevent cardiovascular disease as policy options. Content analysis method was used. In the third phase, policy options were prioritized. In addition, the points of interest and the appropriate budget were suggested for each policy option by using the Delphi method with the participation of 15 experts.Community-based approach includes six strategies: engagement of non-governmental and charitable organizations, use of health marketing strategies, activating the role of community health workers, implementing of mobile health programs, social prescribing, and peripheral medicine.‌‌‌ Utilizing Community health workers, using mobile health and engaging NGOs and charities were ported in higher levels. In all policy options, public-private partnership as the best investment as well as the Ministry of Health as the best focal point were proposed.Implementing multiple prevention strategies in the form of public engagement, incorporating prevention programs delivered by community health workers and increasing public-private partnership financial support may be effective in reducing cardiovascular disease.