Testing a mobile app for child abuse treatment: A mixed methods study

Objective:This study provides a preliminary evaluation of the usability and acceptability of a mobile application(sexual assault care algorithm,SACA).Methods:An explanatory sequential mixed methods research was used.A quantitative survey was followed up by a qualitative study.A convenience sample of participants(n=4)was recruited.The research was conducted on a one-on-one basis.In the quantitative phase,a random assignment technique was used to divide four participants into two groups of two participants each.Post-Study System Usability Questionnaire(PSSUQ)and Acceptability e-Scale were used to collect quantitative data.In the qualitative phase,interview,observation,and documentation were used to collect qualitative data.Data were analyzed both quantitative and qualitatively.The qualitative data were linked with the initial quantitative data to determine how the follow-up qualitative data helped explain the initial quantitative results.Results:The quantitative results suggested that SACA has high usability(5.05±1.83)and acceptability(3.81±1.22).The qualitative results further indicate that the participants thought SACA was easy to use and useful,and most of them would recommend it to others.Areas of improvement include adding features that would calculate and validate the elapsed time since the sexual assault,adding explanations to some buttons,and providing training.Conclusions:Our findings highlight the value of using a mixed methods research design to conduct a usability and acceptability test.Nurses are more likely to adopt a new technology for their evidencebased practice when the technology is easy to use and useful and requires less time to find the right piece of guideline evidence.Individualized training needs to be designed based on users'characteristics.

Study and promotion of safety culture using mixed methods research

Objective:With a positive safety culture,institutions offer the best quality and safe care to their patients.The objective of this study was to analyze patient safety culture from the perspective of the multidisciplinary team,to identify factors that influence patient safety culture,and to create/promote-jointly with the study participants-strategies for improving processes of change.Methods:The study design represented a mixed methods research approach,with a sequential explanatory design.A multidisciplinary team of workers at a general hospital was eligible for the study.To collect quantitative data,we administered the Safety Attitudes Questionnaire(SAQ).The qualitative phase was accomplished via focus groups(FGs),with participants from the first phase of the study using the principles of deliberative dialogue(DD)as a knowledge-translation strategy.The STROBE guideline was used to develop the study.Results:The overall SAQ score was positive(75.1±10.4).Negative scores were found in the fields of Safety Climate,Working Conditions,and Stress Recognition.Focus group discussions identified the aspects that create a negative impact on safety culture,such as ineffective communication,punitive approach in the event of errors,the lack of commitment and adherence to the protocols,and the non-recognition of the stress and the mistakes.Actions for the promotion of safety culture were developed and implemented during the study.Conclusions:The use of the principles of DD as a strategy for knowledge translation(KT)made it possible to identify and plan for joint actions to generate improvements in safety culture.

External application of Chinese medicine formula combined with analgesic drugs to treat lung squamous cell carcinoma pain： A case study with mixed methods

Objective： To investigate the effectiveness of the external application of Chinese medicine combined with analgesicdrugs to treat lung squamous cell carcinoma pain. Methods： A 54-year-old patient with upper lobe of the left lungsquamous cell carcinoma was studied, who suffered from severe cancer pain with the initial numeric rating scale （NRS）7 point when admitted. Exterior-use formula was applied to pain spot to relieve the pain. Mixed methods approachcomprising NRS, Short-form of McGill Pain Questionnaire, quality of life scale, times of breakout pain, records ofadverse reactions and semi-structured interviews were utilized to evaluate the effect. Results： With the combination useof the formula and analgesic drugs, the patient’s NRS score dropped from 7 to 3 point. Quality of life scale scoreimproved from 33 to 42 point. Times of breakout pain reduced from twice to none. The amount of oxycodone decreasedfrom 30 mg Bid to 10 mg Bid. No adverse effect appeared. The patient’s felt more energetic with good sleep and appetite.Conclusion： This formula is effective and safe for pain relief when combined with analgesic drugs, and may be a goodoption in dealing with local cancer pain. Future randomized, controlled studies are needed to better evaluate the efficacy.

Error Estimates of H^1-Galerkin Mixed Methods for the Viscoelasticity Wave Equation

H1-Galerkin mixed methods are proposed for viscoelasticity wave equation.Depending on the physical quantities of interest,two methods are discussed.The optimal error estimates and the proof of the existence and uniqueness of semidiscrete solutions are derived for problems in one space dimension.And the methods don＇t require the LBB condition.

Determinants of Risky Sexual Behaviour among Inmates in Katsina Correctional Service: A Mixed Methods Study

Background: Incarceration does not vitiate sexual desire. Therefore, sexual activities occur behind bars, regardless of the stringent rules in correctional institutions. However, little has been documented about risky sexual behaviors, determinants, and experiences among inmates of correctional institutions in Katsina State, Nigeria. The study determined the sexual practices, prevalence, and determinants of risky sexual behaviors among prison inmates in Katsina. Methodology: A descriptive cross-sectional design with concurrent mixed methods of data collection was used to interview 216 inmates using a semi-structured questionnaire supplemented with 22 in-depth interviews. Result: Most (94%) respondents were male, almost half (44.4%) had secondary education, more than half (55.1%) were engaged in business or trading before incarceration, and the majority (75.9%) were awaiting trial. Nearly all inmates (98.6%) reported having sexual desire. Drug use (80.1%) and unprotected sex (79.2%) were quite common but sexual violence was low (7.4%). The number of sexual partners of respondents remained a significant predictor of sexual activity. Inmates who had one (1) or no sexual partner were 64% less likely to engage in risky sexual activity within the confines of the prison (AOR = 0.36, 95% CI = 0.20 - 0.63, p = 0.01). Qualitative interviews revealed the denial of occurrence of sexual activity in prison despite sexual desire felt by inmates;loneliness, poverty, and curiosity as motives for sexual relations;denial of occurrence of sexual violence in prison;and drug use and use of unsterilized sharps as risky sexual behaviors. Conclusion: Despite the disciplinary action meted out on inmates, prisoners still engaged in a range of risky sexual behaviors. Conjugal visitations for married inmates could be considered to reduce sexually deviant and risky alternatives of relieving sexual desire among prisoners.

What incentives encourage local communities to collect and upload mosquito sound data by using smartphones?A mixed methods study in Tanzania

Background To detect and identify mosquitoes using their characteristic high-pitched sound,we have developed a smartphone application,known as the‘HumBug sensor’,that records the acoustic signature of this sound,along with the time and location.This data is then sent remotely to a server where algorithms identify the species according to their distinctive acoustic signature.Whilst this system works well,a key question that remains is what mechanisms will lead to effective uptake and use of this mosquito survey tool?We addressed this question by working with local communities in rural Tanzania and providing three alternative incentives:money only,short message service(SMS)reminders and money,and SMS reminders only.We also had a control group with no incentive.Methods A multi-site,quantitative empirical study was conducted in four villages in Tanzania from April to August 2021.Consenting participants(n=148)were recruited and placed into one of the three intervention arms:monetary incentives only;SMS reminders with monetary incentives;and SMS reminders only.There was also a control group(no intervention).To test effectiveness of the mechanisms,the number of audio uploads to the server of the four trial groups on their specific dates were compared.Qualitative focus group discussions and feedback surveys were also conducted to explore participants’perspectives on their participation in the study and to capture their experiences of using the HumBug sensor.Results Qualitative data analysis revealed that for many participants(37 out of 81),the main motivation expressed was to learn more about the types of mosquitoes present in their houses.Results from the quantitative empirical study indicate that the participants in the‘control’group switched on their HumBug sensors more over the 14-week period(8 out of 14 weeks)when compared to those belonging to the‘SMS reminders and monetary incentives’trial group.These findings are statistically significant(p<0.05 or p>0.95 under a two-sided z-test),revealing that the provision of monetary incentives and sending SMS reminders did not appear to encourage greater number of audio uploads when compared to the control.Conclusions Knowledge on the presence of harmful mosquitoes was the strongest motive for local communities to collect and upload mosquito sound data via the HumBug sensor in rural Tanzania.This finding suggests that most efforts should be made to improve flow of real-time information back to the communities on types and risks associated with mosquitoes present in their houses.

A Posteriori Error Estimate of Two Grid Mixed Finite Element Methods for Semilinear Elliptic Equations

In this paper, we present the a posteriori error estimate of two-grid mixed finite element methods by averaging techniques for semilinear elliptic equations. We first propose the two-grid algorithms to linearize the mixed method equations. Then, the averaging technique is used to construct the a posteriori error estimates of the two-grid mixed finite element method and theoretical analysis are given for the error estimators. Finally, we give some numerical examples to verify the reliability and efficiency of the a posteriori error estimator.

Critical care nurses and their clinical reasoning for customizing monitor alarms:a mixed-method study

Objective:To explore the clinical rationale of critical care nurses for personalizing monitor alarms.One of the most crucial jobs assigned to critical care nurses is monitoring patients'physiological indicators and carrying out the necessary associated interventions.Successful use of equipment in the nursing practice environment will be improved by a thorough understanding of the nurse's approach to alarm configuration.Methods:A mixed-method design integrating quantitative and qualitative components was used.The sample of this study recruited a convenience sample of 60 nurses who have worked in critical care areas.This study took place at Lebanese American University Medical Center Rizk Hospital,utilizing a semi-structured interview with participants.Results:The study demonstrated the high incidence of nuisance alarms and the desensitization of critical care nurses to vital ones.According to the nurses,frequent false alarms and a shortage of staff are the 2 main causes of alarm desensitization.Age was significantly associated with the perception of Smart alarms,according to the data(P=0.03).Four interconnected themes and subcategories that reflect the clinical reasoning process for alarm customization were developed as a result of the study's qualitative component:(1)unit alarm environment;(2)nursing style;(3)motivation to customize;and(4)clinical and technological customization.Conclusions:According to this study,nurses believe that alarms are valuable.However,a qualitative analysis of the experiences revealed that customization has been severely limited since the healthcare team depends on nurses to complete these tasks independently.Additionally,a staffing shortage and lack of technical training at the start of placement have also hindered customization.

Mixed methods research in complementary and alternative medicine:a scoping review

OBJECTIVE:To update the current characteristics about the scope and quality of mixed methods research(MMR)in complementary and alternative medicine(CAM)after nearly 10 years.METHODS:A 5-stage approach for conducting a scoping review was adopted.Articles published on the top 10 journals in CAM with the highest impact factor in 2020 were screened for MMR.Information of included articles were extracted,and then synthesized to illustrate the current state.Methodological quality was evaluated according to the Mixed Method Appraisal Tool(MMAT)2018 version.RESULTS:A total of 55(55/2991,2%)articles using mixed methods were retrieved,including 17 medical studies and 38 ethnobotanical studies.We performed an in-depth analysis on the 17 medical studies,which studied cancer,stress,pain,fatigue,exercises,mindfulness intervention,herbal medicine use,art and acupuncture.Thirteen pilot studies applied MMR to evaluate the feasibility of interventions or programs(13/17,76%);phenomenology was inferred as the most common philosophical assumptions(13/17,76%);the most applied type of MMR was convergent design(16/17,94%);integration often took place at integration(12/17,71%).Among the 16 eligible studies for quality appraisal,majority were rated as good(14/16,88%),whereas two studies were rated as poorly described.Primarily,a poor rating was due to incomplete reporting of data analysis and citations in qualitative components;lack of confounder controlling and the sampling strategy in quantitative components;poor description of integration and justification for mixed methods.Comparing with the previous review,fewer MMR were published in 2020 in CAM,but the proportion of studies that clearly reported MMR has increased by 4 times(4%→15%).CONCLUSION:CAM researchers need to realize the benefits that MMR can have on conducting further health care research.Our findings highlight that applying MMR will be helpful to understand the complex dynamics and interdisciplinary nature of complex intervention.In addition,addressing a standardized reporting criteria for MMR is recommended.

Multi-level determinants of failure to receive timely and complete measles vaccinations in Southwest China:a mixed methods study

Background Measles outbreaks re-emerged in 2013–2014 in Guangxi Zhuang Autonomous Region of China,where measles immunisation coverage is high.The discrepancy between the vaccination coverage and outbreaks indicates that timeliness is crucial,yet there is limited knowledge on the health system barriers to timely vaccination.Using integrated evidence at the household,village clinic,and township hospital levels,this study aimed to identify the determinants of failure in receiving timely measles vaccinations among children in rural Guangxi.Methods A multi-stage stratified cluster sampling survey with a nested qualitative study was conducted among children aged 18–54 months in Longan,Zhaoping,Wuxuan,and Longlin counties of Guangxi from June to August 2015.The status of timely vaccinations for the first dose of measles-containing vaccine(MCV1)and the second dose of measles-containing vaccine(MCV2)was verified via vaccination certificates.Data on household-level factors were collected using structured questionnaires,whereas data on village and township-level factors were obtained through in-depth interviews and focus group discussions.Determinants of untimely measles vaccinations were identified using multilevel logistic regression models.Results A total of 1216 target children at the household level,120 villages,and 20 township hospitals were sampled.Children were more likely to have untimely vaccination when their primary guardian had poor vaccination knowledge[MCV1,odds ratio(OR)=1.72;MCV2,OR=1.51],had weak confidence in vaccines(MCV1,OR=1.28–4.58;MCV2,OR=1.42–3.12),had few practices towards vaccination(MCV1,OR=12.5;MCV2,OR=3.70),or had low satisfaction with vaccination service(MCV1,OR=2.04;MCV2,OR=2.08).This trend was also observed in children whose village doctor was not involved in routine vaccination service(MCV1,OR=1.85;MCV2,OR=2.11)or whose township hospital did not provide vaccination notices(MCV1,OR=1.64;MCV2,OR=2.05),vaccination appointment services(MCV1,OR=2.96;MCV2,OR=2.74),sufficient and uniformly distributed sessions for routine vaccination(MCV1,OR=1.28;MCV2,OR=1.17;MCV1,OR=2.08),or vaccination service on local market days(MCV1,OR=2.48).Conclusions Guardians with poor knowledge,weak beliefs,and little practice towards vaccination;non-involvement of village doctors in routine vaccinations;and inconvenient vaccination services in township hospitals may affect timely measles vaccinations among children in rural China.

Superconvergence and L^(∞)-Error Estimates of RT1Mixed Methods for Semilinear Elliptic Control Problems with an Integral Constraint

In this paper,we investigate the superconvergence property and the L∞-error estimates of mixed finite element methods for a semilinear elliptic control problem with an integral constraint.The state and co-state are approximated by the order one Raviart-Thomas mixed finite element space and the control variable is approximated by piecewise constant functions or piecewise linear functions.We derive some superconvergence results for the control variable and the state variables when the control is approximated by piecewise constant functions.Moreover,we derive L∞-error estimates for both the control variable and the state variables when the control is discretized by piecewise linear functions.Finally,some numerical examples are given to demonstrate the theoretical results.

Error Estimates and Superconvergence of RT0Mixed Methods for a Class of Semilinear Elliptic Optimal Control Problems

In this paper,we will investigate the error estimates and the superconvergence property of mixed finite element methods for a semilinear elliptic control problem with an integral constraint on control.The state and co-state are approximated by the lowest order Raviart-Thomas mixed finite element and the control variable is approximated by piecewise constant functions.We derive some superconvergence properties for the control variable and the state variables.Moreover,we derive L∞-and H−1-error estimates both for the control variable and the state variables.Finally,a numerical example is given to demonstrate the theoretical results.

IMPLEMENTATION OF MIXED METHODS AS FINITE DIFFERENCE METHODS AND APPLICATIONS TO NONISOTHERMAL MULTIPHASE FLOW IN POROUS MEDIA

In this paper we consider mixed finite element methods for second order elliptic problems. In the case of the lowest order Brezzi-Douglas-Marini elements （if d = 2） or Brezzi- Douglas-Duran-Fortin elements （if d = 3） on rectangular parallelepipeds, we show that the mixed method system, by incorporating certain quadrature rules, can be written as a simple, cell-centered finite difference method. This leads to the solution of a sparse, positive semidefinite linear system for the scalar unknown. For a diagonal tensor coefficient, the sparsity pattern for the scalar unknown is a five point stencil if d = 2, and seven if d = 3. For a general tensor coefficient, it is a nine point stencil, and nineteen, respectively. Applications of the mixed method implementation as finite differences to nonisothermal multiphase, multicomponent flow in porous media are presented.

Superconvergence and L^(∞)-Error Estimates of the Lowest Order Mixed Methods for Distributed Optimal Control Problems Governed by Semilinear Elliptic Equations

In this paper, we investigate the superconvergence property and the L∞-errorestimates of mixed finite element methods for a semilinear elliptic control problem. Thestate and co-state are approximated by the lowest order Raviart-Thomas mixed finite element spaces and the control variable is approximated by piecewise constant functions.We derive some superconvergence results for the control variable. Moreover, we derive L^(∞)-error estimates both for the control variable and the state variables. Finally, anumerical example is given to demonstrate the theoretical results.

NONLINEAR GALERKIN MIXED ELEMENT METHODS FOR STATIONARY INCOMPRESSIBLE MAGNETOHYDRODYNAMICS

A nonlinear Galerkin mixed element （NGME） method for the stationary incompressible magnetohydrodynamics equations is presented. And the existence and error estimates of the NGME solution are derived.

MIXED FINITE ELEMENT METHODS FOR THE SHALLOW WATER EQUATIONS INCLUDING CURRENT AND SILT SEDIMENTATION (Ⅱ)——THE DISCRETE-TIME CASE ALONG CHARACTERISTICS

The mixed finite element(MFE) methods for a shallow water equation system consisting of water dynamics equations,silt transport equation,and the equation of bottom topography change were derived.A fully discrete MFE scheme for the discrete_time along characteristics is presented and error estimates are established.The existence and convergence of MFE solution of the discrete current velocity,elevation of the bottom topography,thickness of fluid column,and mass rate of sediment is demonstrated.

IMPLICIT-EXPLICIT MULTISTEP FINITE ELEMENT-MIXED FINITE ELEMENT METHODS FOR THE TRANSIENT BEHAVIOR OF A SEMICONDUCTOR DEVICE

The transient behavior of a semiconductor device consists of a Poisson equation for the electric potential and of two nonlinear parabolic equations for the electron density and hole density. The electric potential equation is discretized by a mixed finite element method. The electron and hole density equations are treated by implicit-explicit multistep finite element methods. The schemes are very efficient. The optimal order error estimates both in time and space are derived.

MIXED FINITE ELEMENT METHODS FOR THE SHALLOW WATER EQUATIONS INCLUDING CURRENT AND SILT SEDIMENTA-TION (Ⅰ)-THE CONTINUOUS-TIME CASE

An initial-boundary value problem for shallow equation system consisting of water dynamics equations,silt transport equation, the equation of bottom topography change,and of some boundary and initial conditions is studied, the existence of its generalized solution and semidiscrete mixed finite element(MFE) solution was discussed, and the error estimates of the semidiscrete MFE solution was derived.The error estimates are optimal.

Discrete formulation of mixed finite element methods for vapor deposition chemical reaction equations

The vapor deposition chemical reaction processes, which are of extremely extensive applications, can be classified as a mathematical model by the following governing nonlinear partial differential equations containing velocity vector, temperature field, pressure field, and gas mass field. The mixed finite element （MFE） method is employed to study the system of equations for the vapor deposition chemical reaction processes. The semidiscrete and fully discrete MFE formulations are derived. And the existence and convergence （error estimate） of the semidiscrete and fully discrete MFE solutions are demonstrated. By employing MFE method to treat the system of equations for the vapor deposition chemical reaction processes, the numerical solutions of the velocity vector, the temperature field, the pressure field, and the gas mass field can be found out simultaneously. Thus, these researches are not only of important theoretical means, but also of extremely extensive applied vistas.

A Posteriori Error Estimates of Mixed Methods for Quadratic Optimal Control Problems Governed by Parabolic Equations

In this paper,we discuss the a posteriori error estimates of the mixed finite element method for quadratic optimal control problems governed by linear parabolic equations.The state and the co-state are discretized by the high order Raviart-Thomas mixed finite element spaces and the control is approximated by piecewise constant functions.We derive a posteriori error estimates for both the state and the control approximation.Such estimates,which are apparently not available in the literature,are an important step towards developing reliable adaptive mixed finite element approximation schemes for the control problem.