Aims and objectives:This study aims to provide insight into healthcare professionals' lived experiences of digital health competence with the objective of improving the knowledge of how digital health competence is perceived by healthcare professionals.Background: Healthcare professionals need to adjust to the digital era to provide quality and ethical care. Previous research has rarely adopted a healthcare professional's standpoint to describe their perceptions of digital health competence, even though their perspective in how new care practices are designed and implemented is vital.Design: A qualitative descriptive study.Methods: Healthcare professionals (nurses and allied health professionals) from versatile healthcare settings were recruited for individual semi-structured interviews in Sweden (n = 5) and Finland (n = 15) (spring 2019-summer 2020). Purposive and convenience sampling was used. Participants' backgrounds were in the public and private sectors. The interviews were transcribed for inductive content analysis. The SRQR guideline guided the study process.Results: Healthcare professionals' perceptions of digital health competence are connected to competence to provide patient-centric care through digital channels, using technology and digital health systems, interacting with the patient through digital means, evaluating what digital health is and combining digital and traditional methods.Professionals' perceptions of their own digital health competence were divided, with the participants either reporting sufficient competence or perceiving a lack of skills in some specific areas.Conclusions: Healthcare professionals' perceptions of digital health competence focus on the ability to provide patient-centric care by evaluating the need and possibilities for using digital health services jointly with more traditional methods. This study provides a sound basis for digital health research, but future studies should focus on elucidating factors which affect digital health competence and competence development.
Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucault's discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics : (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly person's death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.KEY WORDS -older people, death and dying, nursing home, staff, focus-group discussions, discourse analysis.
-A criticism of Evolutionary Algorithms (EAs) might be the lack of efficient and robust generic methods to handle constraints. The most widespread approach for constrained search problems is to use penalty methods. EAs have received increased interest during the last decade due to the ease of handling multiple objectives., A constrained Optimization problem or a n unconstrained multiobjective problem may in principle be two different ways to pose the same underlying I problem. In this paper an alternative approach for the constrained optimization problem is presented. The method is a variant of a multiobjective real coded Genetic Algorithm (CA) inspired by the penalty approach. It is evaluated on six different constrained single objective problems found in the literature. The results show that the proposed method performs well in terms of efficiency, and that it is rohust for a majority of the test problems.
Design optimization is becoming and increasingly important tool for design. In order to have an impact on the product development process it must permeate all levels of the design in such a way that a holistic view is maintained through all stages of the design. One important area is in the case of optimization based on simulation, which generally requires non-gradient methods and as a consequence direct-search methods is a natural choice. The idea in this paper is to use the design optimization approach in the optimization algorithm itself in order to produce an efficient and robust optimization algorithm. The result is a single performance index to measure the effectiveness of an optimization algorithm, and the COMPLEX-RF optimization algorithm, with optimized parameters.
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