Browsing by Issue Date, starting with "2025-05-01"
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- The wittmann-price theory of emancipated decision-making in women’s health care: an analysis based on McEwenPublication . Lopes, Marlene Isabel; Wittmann-Price, Ruth A.The use of theories in nursing reflects the discipline’s progression toward autonomy and delineates its scope, directly guiding practice, research, education, and administration. This paper analyzes and evaluates the theoretical model for nursing care of women involved in health care decisions—The Wittmann-Price Theory of Emancipated Decision-Making in Women’s Health Care—based on McEwen’s systematic theory 3-phase evaluation method. Developed through a rigorous process, this theory centers on the concept of emancipation and its associated subconcepts crucial to decision-making in women’s health. This included crafting explanatory propositions and incorporating them into a structured theoretical framework. Having been applied and refined in various clinical settings, the theory has improved in applicability and proven effective for guiding nursing care across diverse environments. Furthermore, fostering a flexible environment that enhances personal knowledge significantly contributes to emancipated decision-making, which is closely linked to decision satisfaction.
- Economic impact of healthcare cyber risksPublication . Brilhante, M. Fátima; Mendonça, Sandra; Pestana, Pedro; Rocha, M. Luísa; Santos, RuiPurpose: The healthcare sector is a primary target for cybercriminals, with health data breaches ranking among the most critical threats. Despite stringent penalties imposed by the U.S. Department of Health and Human Services Office for Civil Rights (OCR), vulnerabilities still persist due to slow detection and ineffective data protection measures. On the other hand, as organizations are often reluctant to disclose security breaches for fear of reputational and market share losses, penalties can serve as a useful proxy for quantifying losses and insurance claims. Methods: This study analyzes fines and settlements (2008–2024) using the traditional lognormal, general extreme value (GEV) and other heavy-tailed statistical models, including the geo-max-stable loglogistic law, and also the mixture models hyperexponential and hyperloglogistic. Results: Mixture models, either the hyperexponential or the hyperloglogistic, deliver the best fit for OCR penalties, and for yearly maxima, the best fit is achieved with the GEV distribution. Regarding Attorneys General fines, the hyperexponential model is optimal, with the GEV model excelling again for their yearly maxima. Hence, mixture models effectively capture the dual nature of penalty data, comprising clusters of moderate and extreme values. However, yearly maxima align better with the GEV model. Conclusions: The findings suggest that while Panjer’s theory for aggregate claims suffices for moderate claims, it must be supplemented with strategies to address extreme cybercrime scenarios, ensuring insurers and reinsurers can manage severe losses effectively.
- Nurse and midwife interventions to protect, promote and support breastfeeding: an umbrella reviewPublication . Couto, Cristina; Prata, Ana Paula; Souto, Sandra Patrícia; Machado, Joana; Viana, Clara RoqueteBackground Low breastfeeding rates continue to be a global concern among nurses and midwives, raising critical questions about knowledge and effectiveness in promoting breastfeeding. Summarising evidence on nursing and midwifery interventions to protect, promote, and support breastfeeding enables a deeper understanding of how these professionals can enhance breastfeeding practices, inform decision-makers, and improve care quality. Aim To synthesise nursing and midwifery interventions that protect, promote, and support breastfeeding. Methods The JBI methodology for umbrella reviews guided this study. Searches were conducted in databases aggregated by EBSCOhost, SCOPUS, and Web of Science, as well as relevant grey literature. Systematic reviews published in English, Portuguese, and Spanish from January 2018 to December 2023 were included. Two independent reviewers used a JBI critical appraisal tool and a specific data extraction instrument to synthesise findings. Findings A total of 29 studies met the inclusion criteria. Synthesised findings include: (1) the absence of nursing/midwifery interventions focused on breastfeeding protection; (2) five nursing/midwifery interventions aimed at breastfeeding promotion, with the primary intervention being prenatal education; and (3) twenty-four interventions of nurses/midwives on breastfeeding support, the most frequent being home visits, telephone technology and follow-up. Conclusion This umbrella review reveals limited involvement of nurses/midwives in breastfeeding protection, despite their expertise and potential influence on policy development to support breastfeeding. They are involved in breastfeeding promotion, but most of their intervention is focused on breastfeeding support. The diverse roles and settings of nursing and midwifery practice present challenges in evaluating intervention effectiveness. Further research specific to nursing and midwifery is needed to inform evidence-based practice and policymaking in breastfeeding care.