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...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.展开更多
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...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.展开更多
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 multidisciplin...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.展开更多
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 ...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.展开更多
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 unique...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.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Incarceration does not vitiate sexual desire. Therefore, sexual activit...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> 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. <b></b></span><b><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"></span></b> 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. <b><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"></span></b> 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 <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-size:10.0pt;font-family:;" "=""><span style="white-space:nowrap;"><span style="white-space:nowrap;">-</span></span></span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 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. <b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b> 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.</span></span></span>展开更多
In this paper,a composite numerical scheme is proposed to solve the threedimensional Darcy-Forchheimer miscible displacement problem with positive semi-definite assumptions.A mixed finite element is used for the fow e...In this paper,a composite numerical scheme is proposed to solve the threedimensional Darcy-Forchheimer miscible displacement problem with positive semi-definite assumptions.A mixed finite element is used for the fow equation.The velocity and pressure are computed simultaneously.The accuracy of velocity is improved one order.The concentration equation is solved by using mixed finite element,multi-step difference and upwind approximation.A multi-step method is used to approximate time derivative for improving the accuracy.The upwind approximation and an expanded mixed finite element are adopted to solve the convection and diffusion,respectively.The composite method could compute the diffusion flux and its gradient.It possibly becomes an eficient tool for solving convection-dominated diffusion problems.Firstly,the conservation of mass holds.Secondly,the multi-step method has high accuracy.Thirdly,the upwind approximation could avoid numerical dispersion.Using numerical analysis of a priori estimates and special techniques of differential equations,we give an error estimates for a positive definite problem.Numerical experiments illustrate its computational efficiency and feasibility of application.展开更多
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 t...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.展开更多
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 = ...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.展开更多
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.
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 equ...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.展开更多
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 stu...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.展开更多
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...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.展开更多
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 m...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.展开更多
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 an...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.展开更多
This study examines how generative artificial intelligence(AI)reshapes creative identity in design education.Drawing on post-humanist and network-based theories,it frames AI as a cognitive collaborator in ideation and...This study examines how generative artificial intelligence(AI)reshapes creative identity in design education.Drawing on post-humanist and network-based theories,it frames AI as a cognitive collaborator in ideation and authorship.Mixed-methods data reveal student anxiety and stylistic confusion,contrasted with designers’adaptive strategies.The AI–Cognition–Identity framework supports curricula that promote reflective,ethical,and epistemically informed AI-integrated pedagogy.展开更多
This mixed-methods study presents a needs analysis to investigate the workplace English language needs of medical students in China who are learning and using English as non-native speakers,the circumstances in which ...This mixed-methods study presents a needs analysis to investigate the workplace English language needs of medical students in China who are learning and using English as non-native speakers,the circumstances in which the various language skills are required,and stakeholders’perceived workplace preparedness in the light of language-related instructional provision during medical training.A leading university in China was chosen as the study case.Altogether,294 online questionnaires were collected from undergraduate medical students,graduate medical students and recent graduates working as physicians,and 33 semi-structured individual interviews were conducted with undergraduate medical students,graduate medical students,recent graduates working as physicians,medical teachers,English for Medical Purposes(EMP)teachers,program leaders and English-speaking patients.Results showed that in addition to physicians experiencing pressure to publish scientific articles internationally,participants attached greater importance to physicians’oral English communication ability,especially in undertaking clinical consultations in English,working with medical interpreters or acting as ad hoc interpreters.The participants also reported a lack of relevant EMP courses or trainings available at this university.Given these communicative events that physicians face in China,EMP courses need to include training in these specific areas.展开更多
Background:Disaster mental health outcomes of individuals may be affected by the families they inhabit,with effects rippling through the entire family system.Existing research on the experience of children in disaster...Background:Disaster mental health outcomes of individuals may be affected by the families they inhabit,with effects rippling through the entire family system.Existing research on the experience of children in disasters has typically been limited to examining single individuals or,at most,family dyads.Research is needed to explore interactions within families as a whole,including interactions among multiple family members,as well as with community entities in a broad systems approach with dynamic analysis of family systems over time.The purpose of this study was to combine quantitative and qualitative data using structured diagnostic interviews and accompanying open-ended narratives of family members(spouses and children)of survivors of the 9/11 attacks.Methods:This study examined 60 members in 25 families of employees affected by the 9/11 attacks on New York City’s World Trade Center,using a mixed methods approach,collecting quantitative data using full assessments of psychiatric disorders and qualitative data from detailed personal disaster narratives.The employees were a highly 9/11 trauma-exposed group,with about one-fourth developing posttraumatic stress disorder(PTSD).The employees’exposures and PTSD did not regularly appear to propagate straightforwardly to psychopathology in their spouses or children.Based on the impact of disaster experience,4 illustrative families were selected for narrative and family systems analyses.Results:Qualitative analysis of their narratives suggested distinct family system patterns or archetypes that may reflect different ways that families cope with disaster.Conclusion:Findings suggest that family systems and family dynamics may influence not only disaster trauma-exposed members but also other family members in supporting one another and coping with the disaster,with interactions with outside community influences adding further complexity.This information may help guide disaster response efforts to provide psychosocial support targeted to specific family patterns.展开更多
Purpose'. To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods processevaluation to determine satisfaction with intervention components and interpret...Purpose'. To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods processevaluation to determine satisfaction with intervention components and interpret a*dolescents experiences of the intervention process in order toprovide insights for future intervention design.Methods'. Participants (n = 1542;13.2 土 0.4 years, mean 土 SD) provided questionnaire data at baseline (shyness, activity level) and post-intervention(intervention acceptability, satisfaction with components). Between-group differences (boys vs. girls and shy/inactive vs. others) weretested with linear regression models, accounting for school clustering. Data from 16 individual interviews (shy/inactive) and 11 focus groupswith 48 participants (mean = 4;range 2—7) were thematically coded. Qualitative and quantitative data were merged in an integrative mixedmethods convergence matrix, which denoted convergence and dissonance across datasets.Results'. Effect sizes for quantitative results were small and may not represent substantial between-group differences. Boys (vs. girls) preferredclass-based sessions (0 = 0.2, 95% confidence interval (CI): 0.1—0.3);qualitative data suggested that this was because boys preferred competition,which was supported quantitatively (0 = 0.2, 95%CI: 0.1-0.3). Shy/inactive students did not enjoy the competition (0 = -0.3, 95%CI:—0.5 to —0.1). Boys enjoyed trying new activities more (0 = 0.1, 95%CI: 0.1 -0.2);qualitative data indicated a desire to try new activities acrossall subgroups but identified barriers to choosing unfamiliar activities with self-imposed choice restriction leading to boredom. Qualitative datahighlighted critique of mentorship;adolescents liked the idea, but older mentors did not meet expectations.Conclusion. We interpreted adolescent perspectives of intervention components and implementation to provide insights into future complexinterventions aimed at increasing young people's physical activity in school-based settings. The intervention component mentorship was liked inprinciple, but implementation issues undesirably impacted satisfaction;competition was disliked by girls and shy/inactive students. The resultshighlight the importance of considering gender differences in preference of competition and extensive mentorship training.展开更多
The operator splitting method is used to deal with the Navier-Stokes equation, in which the physical process described by the equation is decomposed into two processes： a diffusion process and a convection process; a...The operator splitting method is used to deal with the Navier-Stokes equation, in which the physical process described by the equation is decomposed into two processes： a diffusion process and a convection process; and the finite element equation is established. The velocity field in the element is described by the shape function of the isoparametric element with nine nodes and the pressure field is described by the interpolation function of the four nodes at the vertex of the isoparametric element with nine nodes. The subroutine of the element and the integrated finite element code are generated by the Finite Element Program Generator （FEPG） successfully. The numerical simulation about the incompressible viscous liquid flowing over a cylinder is carded out. The solution agrees with the experimental results very well.展开更多
基金The development of the application for SACA was partially supported by funding from the Upstate Foundation,a 501(c)3 nonfor-profit corporation (upstatefoundation.org)
文摘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.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences:Design and Application of Mixed Method Research in Traditional Chinese Medicine(No.CI2021B003)Special Project of China Center for Evidence Based Traditional Chinese Medicine:Integrated Innovation and Application of Traditional Trial and Real-World Study of Chinese Medicine in Integrated Chinese and Western Medicine Setting(No.2020YJSZX-3)the Fundamental Research Funds for the Central Public Welfare Research Institutes:the Optimal Subject Setting and Design of Evidence-Based Research Implementation in the Area of Brain Diseases of Traditional Chinese Medicine(No.ZZ13-024-3)
文摘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.
基金This study was approved by the ethics committee of the Regional University of the Northwest of the State of Rio Grande do Sul(UNIJUÍ)(IRB approval number:2,355,933).
文摘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.
文摘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.
基金Supported by NNSF(10601022,11061021)Supported by NSF of Inner Mongolia Au-tonomous Region(200607010106)Supported by SRP of Higher Schools of Inner Mongolia(NJ10006)
文摘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.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> 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. <b></b></span><b><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"></span></b> 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. <b><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"></span></b> 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 <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-size:10.0pt;font-family:;" "=""><span style="white-space:nowrap;"><span style="white-space:nowrap;">-</span></span></span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 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. <b></b></span><b><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"></span></b> 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.</span></span></span>
基金supported by the Natural Science Foundation of Shandong Province(ZR2021MA019)the National Natural Science Foundation of China(11871312)。
文摘In this paper,a composite numerical scheme is proposed to solve the threedimensional Darcy-Forchheimer miscible displacement problem with positive semi-definite assumptions.A mixed finite element is used for the fow equation.The velocity and pressure are computed simultaneously.The accuracy of velocity is improved one order.The concentration equation is solved by using mixed finite element,multi-step difference and upwind approximation.A multi-step method is used to approximate time derivative for improving the accuracy.The upwind approximation and an expanded mixed finite element are adopted to solve the convection and diffusion,respectively.The composite method could compute the diffusion flux and its gradient.It possibly becomes an eficient tool for solving convection-dominated diffusion problems.Firstly,the conservation of mass holds.Secondly,the multi-step method has high accuracy.Thirdly,the upwind approximation could avoid numerical dispersion.Using numerical analysis of a priori estimates and special techniques of differential equations,we give an error estimates for a positive definite problem.Numerical experiments illustrate its computational efficiency and feasibility of application.
文摘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.
文摘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.
基金Project supported by the National Natural Science Foundation of China (Nos.10471100 and 40437017)
文摘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.
文摘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.
文摘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.
基金Project supported by the National Natural Science Foundation of China (Nos.10471100 and 40437017)the Science and Technology Foundation of Beijing Jiaotong University
文摘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.
文摘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.
文摘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.
文摘This study examines how generative artificial intelligence(AI)reshapes creative identity in design education.Drawing on post-humanist and network-based theories,it frames AI as a cognitive collaborator in ideation and authorship.Mixed-methods data reveal student anxiety and stylistic confusion,contrasted with designers’adaptive strategies.The AI–Cognition–Identity framework supports curricula that promote reflective,ethical,and epistemically informed AI-integrated pedagogy.
文摘This mixed-methods study presents a needs analysis to investigate the workplace English language needs of medical students in China who are learning and using English as non-native speakers,the circumstances in which the various language skills are required,and stakeholders’perceived workplace preparedness in the light of language-related instructional provision during medical training.A leading university in China was chosen as the study case.Altogether,294 online questionnaires were collected from undergraduate medical students,graduate medical students and recent graduates working as physicians,and 33 semi-structured individual interviews were conducted with undergraduate medical students,graduate medical students,recent graduates working as physicians,medical teachers,English for Medical Purposes(EMP)teachers,program leaders and English-speaking patients.Results showed that in addition to physicians experiencing pressure to publish scientific articles internationally,participants attached greater importance to physicians’oral English communication ability,especially in undertaking clinical consultations in English,working with medical interpreters or acting as ad hoc interpreters.The participants also reported a lack of relevant EMP courses or trainings available at this university.Given these communicative events that physicians face in China,EMP courses need to include training in these specific areas.
基金supported by National Institute of Mental Health(NIMH)Grant MH68853the National Memorial Institute for the Prevention of Terrorism(MIPT)and Office of State and Local Government Coordination and Preparedness,US Department of Homeland Security MIPT106-113-2000-020.
文摘Background:Disaster mental health outcomes of individuals may be affected by the families they inhabit,with effects rippling through the entire family system.Existing research on the experience of children in disasters has typically been limited to examining single individuals or,at most,family dyads.Research is needed to explore interactions within families as a whole,including interactions among multiple family members,as well as with community entities in a broad systems approach with dynamic analysis of family systems over time.The purpose of this study was to combine quantitative and qualitative data using structured diagnostic interviews and accompanying open-ended narratives of family members(spouses and children)of survivors of the 9/11 attacks.Methods:This study examined 60 members in 25 families of employees affected by the 9/11 attacks on New York City’s World Trade Center,using a mixed methods approach,collecting quantitative data using full assessments of psychiatric disorders and qualitative data from detailed personal disaster narratives.The employees were a highly 9/11 trauma-exposed group,with about one-fourth developing posttraumatic stress disorder(PTSD).The employees’exposures and PTSD did not regularly appear to propagate straightforwardly to psychopathology in their spouses or children.Based on the impact of disaster experience,4 illustrative families were selected for narrative and family systems analyses.Results:Qualitative analysis of their narratives suggested distinct family system patterns or archetypes that may reflect different ways that families cope with disaster.Conclusion:Findings suggest that family systems and family dynamics may influence not only disaster trauma-exposed members but also other family members in supporting one another and coping with the disaster,with interactions with outside community influences adding further complexity.This information may help guide disaster response efforts to provide psychosocial support targeted to specific family patterns.
基金funded by the National Institute for Health Research (NIHR) Public Health Research Programme (13/90/18)supported by the Medical Research Council (Unit Program number MC_UU_12015/7)and was undertaken under the auspices of the Centre for Diet and Activity Research (CEDAR),a UKCRC Public Health Research Centre of Excellence+2 种基金Funding from the British Heart Foundation, Cancer Research UK,Economic and Social Research Council, Medical Research Council,National Institute for Health Research,and Wellcome Trust,under the auspices of the UK Clinical Research Collaboration,is gratefully acknowledged(087636/Z/08/ZES/G007462/1MR/K023187/1)
文摘Purpose'. To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods processevaluation to determine satisfaction with intervention components and interpret a*dolescents experiences of the intervention process in order toprovide insights for future intervention design.Methods'. Participants (n = 1542;13.2 土 0.4 years, mean 土 SD) provided questionnaire data at baseline (shyness, activity level) and post-intervention(intervention acceptability, satisfaction with components). Between-group differences (boys vs. girls and shy/inactive vs. others) weretested with linear regression models, accounting for school clustering. Data from 16 individual interviews (shy/inactive) and 11 focus groupswith 48 participants (mean = 4;range 2—7) were thematically coded. Qualitative and quantitative data were merged in an integrative mixedmethods convergence matrix, which denoted convergence and dissonance across datasets.Results'. Effect sizes for quantitative results were small and may not represent substantial between-group differences. Boys (vs. girls) preferredclass-based sessions (0 = 0.2, 95% confidence interval (CI): 0.1—0.3);qualitative data suggested that this was because boys preferred competition,which was supported quantitatively (0 = 0.2, 95%CI: 0.1-0.3). Shy/inactive students did not enjoy the competition (0 = -0.3, 95%CI:—0.5 to —0.1). Boys enjoyed trying new activities more (0 = 0.1, 95%CI: 0.1 -0.2);qualitative data indicated a desire to try new activities acrossall subgroups but identified barriers to choosing unfamiliar activities with self-imposed choice restriction leading to boredom. Qualitative datahighlighted critique of mentorship;adolescents liked the idea, but older mentors did not meet expectations.Conclusion. We interpreted adolescent perspectives of intervention components and implementation to provide insights into future complexinterventions aimed at increasing young people's physical activity in school-based settings. The intervention component mentorship was liked inprinciple, but implementation issues undesirably impacted satisfaction;competition was disliked by girls and shy/inactive students. The resultshighlight the importance of considering gender differences in preference of competition and extensive mentorship training.
文摘The operator splitting method is used to deal with the Navier-Stokes equation, in which the physical process described by the equation is decomposed into two processes： a diffusion process and a convection process; and the finite element equation is established. The velocity field in the element is described by the shape function of the isoparametric element with nine nodes and the pressure field is described by the interpolation function of the four nodes at the vertex of the isoparametric element with nine nodes. The subroutine of the element and the integrated finite element code are generated by the Finite Element Program Generator （FEPG） successfully. The numerical simulation about the incompressible viscous liquid flowing over a cylinder is carded out. The solution agrees with the experimental results very well.
