Search Results (2,096)

Introduction: With the emergence of the expert patient and the expansion of health literacy, the importance of planning and building health technologies aimed at teaching and training health professionals, especially nurses, due to their activities with patients in Primary Health Care, with the aim of meeting the real and constant demands of the expert patient, is evident. Methods: Methodological study with a quantitative approach. The course was constructed based on a scope review, scientific reference, and observational visits during the months of September 2021 and August 2022. For validation, an organized electronic form was used with general information about the research and items of the course constructed for later evaluation by the judges with the three-point Likert scale and with the application of the Delphi Technique between the months of September and October 2022; for the agreement of the judges, the Content Validation Coefficient > 0.8 was considered. Results: Based on the content selected in the scope review, the reference contribution, and the observational visits, the course was constructed. Nine judges participated in the validation stage in Delphi I with a total Content Validation Coefficient above 0.90 and with some suggestions for modifications and improvements pointed out by them. In Delphi II, six judges evaluated the course, resulting in a total Content Validation Coefficient of 0.99. Conclusions: The course developed was considered valid to support the training of Primary Health Care nurses in the formation of the expert patient, with a view to promoting patient autonomy in self-care management, optimizing Primary Health Care, and reducing unnecessary hospital admissions. Full article

Background: Midwifery’s Intangible Heritage was officially recognized by the United Nations Educational, Scientific and Cultural Organization on 6 December 2023, highlighting that elements of midwifery knowledge and practice, shaped over generations, constitute cultural heritage worth safeguarding. While previous studies have investigated midwives’ perceptions of professional identity, none have done so within the explicit framework of MIH. Objective: this study explored how midwives and student midwives in Cyprus perceive the intangible heritage of their profession and how it relates to their shared professional identity. Methods: A qualitative descriptive study was conducted between April and July 2023. Three focus groups were held, involving 22 participants: 15 registered midwives and 7 student midwives. A semi-structured interview guide consisting of 10 questions was used, developed by the lead author (M.P.) based on the literature and improvisation and finalized with the research team (E.H., S.V., N.M.) after expert input. Thematic analysis was performed inductively to identify recurrent themes. Results: Four major themes emerged: (1) key elements of Midwifery’s Intangible Heritage and their transmission across generations; (2) a sense of shared professional identity; (3) perceived threats to the midwifery profession; and (4) midwives’ expectations for the future of the profession. Conclusions: The findings reflect the historical background of midwifery in Cyprus and its contrast with contemporary practice, particularly within the context of the overmedicalization of birth and societal perceptions of midwifery in the socio-cultural setting. Safeguarding Midwifery’s Intangible Heritage requires both empowering women to seek midwifery-led care and enabling midwives to practice autonomously within their full professional scope. In addition, policymakers and educational bodies must support the preservation of midwives’ core skills through targeted educational curricula, structured mentorship, and continuous professional development. Full article

Background/Objectives: The COVID-19 pandemic caused pronounced disorder in healthcare delivery globally, including ophthalmology. Our study explores how ophthalmologists in Puerto Rico (PR) altered their practices during the pandemic, confronting obstacles such as resource shortages, evolving public health mandates, and unique socio-economic and geographic constraints. The study aims to enhance preparedness for future public health crises. Methods: We conducted descriptive analyses on four online surveys distributed at crucial time points of the pandemic (March 2020, May 2020, August 2020, August 2021) to all practicing ophthalmologists in PR (N ≈ 200), capturing data on closures, patient volume, personal protective equipment (PPE) access, telemedicine use, and financial relief. Results: Survey responses ranged from 41% (n = 81) to 56% (n = 111). By March 2020, 22% (24/111) of respondents closed their offices. By May 2020, 20% (19/93) of respondents maintained a closed office, while 89% (64/72) of open offices reported seeing less than 25% of their usual patient volume. Access to PPE was a challenge, with 59% (65/111) reporting difficulty obtaining N95 masks in March 2020. Telemedicine usage increased initially, peaking in May 2020 and declining in July 2020. By August 2021, all respondents were fully vaccinated and most practices returned to pre-pandemic levels. Overall, 86% (70/81) of respondents found the surveys to be useful for navigating practice changes during the pandemic. Conclusions: PR ophthalmologists showed adaptability during the COVID-19 pandemic to maintain care given limited resources. Guidelines from professional organizations and real time surveys play an important role in future crisis preparedness. Full article

Fileless malware is a type of malware that does not rely on executable files to persist or propagate. Unlike traditional file-based malware, fileless malware is more difficult to detect and remove, posing a significant threat to organizations. This paper introduces a novel hybrid analysis model that combines static and dynamic analysis techniques to identify fileless malware. Applied to four real-world and two custom-created fileless malware samples, the proposed model demonstrated its qualitative effectiveness in uncovering complex behaviors and evasion tactics, such as obfuscated macros, process injection, registry persistence, and covert network communications, which often bypass single-method analyses. While the analysis reveals the potential for significant damage to organizational reputation, resources, and operations, the paper also outlines a set of mitigation measures that cybersecurity professionals and researchers can adopt to protect users and organizations against threats posed by fileless malware. Overall, this research offers valuable insights and a novel analysis model to better address and understand fileless malware threats. Full article

Employee turnover remains a critical challenge for organizations, prompting an examination of how leadership approaches influence employees’ intentions to leave. This study investigates the impact of transformational leadership on turnover intention, focusing on emotional exhaustion and creativity as potential mediators. The study employs a quantitative design grounded in leadership and organizational psychology theory and surveys 182 professionals working in the information technology sector across Bosnia and Herzegovina, Croatia, Serbia, and Montenegro. Structural equation modeling reveals that transformational leadership reduces turnover intention by alleviating emotional exhaustion, highlighting the importance of psychological well-being in employee retention. While transformational leadership enhances employee creativity, creativity did not significantly mediate turnover intention in this context. These findings suggest that strategies that foster engagement and reduce burnout in knowledge-intensive industries can strengthen organizational commitment and improve retention. This study contributes to the understanding of behavioral mechanisms linking leadership to employee outcomes and offers actionable insights for modern organizations aiming to address turnover through supportive, empowering leadership practices. Additional mediators and contextual variables should be explored in further research. Full article

This study explores the role of solidarity finance in promoting local development and the empowerment of marginalized communities through financial inclusion and access to community credits. It focuses on how solidarity-based financial mechanisms provide accessible credit with fewer barriers, fostering productive activities and economic resilience. This study employed a quantitative and exploratory design, analyzing data from 51 community funds in Ecuador out of a total of 220 through a self-administered online survey, validated by auditing professionals and answered by community representatives. The 25-item questionnaire gathered data on organizational dynamics, financial practices, and perceptions of sustainability. Descriptive analysis was complemented with an analysis of variance to test hypotheses concerning associativity, self-management, and organizational performance. The results show that while associativity, self-management, and organizational management are perceived as institutional strengths, aspects such as autonomy and solidarity received lower evaluations, suggesting critical areas for strategic improvement. Notably, significant differences emerged between self-management–organization and solidarity–organization groups, emphasizing the importance of associativity (collaboration) in enhancing the sustainability of solidarity finance, which proves to be a vital mechanism for community empowerment and local development; however, its long-term sustainability depends on strengthening internal dimensions, particularly autonomy and solidarity, and reinforcing associativity as a core driver of organizational resilience. Full article

As organizations continue to embrace digital transformation, the need for robust cybersecurity strategies has never been more critical. This paper explores the Zero Trust Architecture (ZTA) as a contemporary cybersecurity framework that addresses the challenges posed by increasingly interconnected systems. Zero Trust (ZT) operates under the principle of “never trust, always verify,” ensuring that every access request is thoroughly authenticated, regardless of the requester’s location within or outside the network. However, implementing ZT is a challenging task, requiring an adequate roadmap to prioritize the different initiatives in agreement with company culture, exposure and cyber posture. We apply multi-criteria decision analysis (MCDA) to evaluate the relative importance of various components within a ZT framework, using the Incomplete Analytic Hierarchy Process (IAHP). Expert opinions from professionals in cybersecurity and IT governance were gathered through structured questionnaires, leading to a prioritized ranking of the eight key ZT pillars, as defined by the Cybersecurity and Infrastructure Security Agency (CISA), Washington, DC, USA, along with a prioritization of the sub-elements within each pillar. The study provides actionable insights into the implementation of ZTA, helping organizations prioritize security efforts to mitigate risks effectively and build a resilient digital infrastructure. The evaluation results were used to create a prioritized framework, integrated into the ZEUS platform, developed with Teleconsys S.p.A., to enable detailed assessments of a firm’s cyber partner regarding ZT and identify improvement areas. The paper concludes by offering recommendations for future research and practical guidance for organizations transitioning to a ZT model. Full article

The continuous advancement of fire protection technologies has necessitated the development of comprehensive safety standards, leading to an increasingly diversified and specialized regulatory landscape. This has made it difficult for fire protection professionals to quickly and accurately locate the required fire safety standard information. In addition, the lack of effective integration and knowledge organization concerning fire safety standard entities has led to the severe fragmentation of fire safety standard information and the absence of a comprehensive “one map”. To address this challenge, we introduce FT-FLAT, an innovative CNN–Transformer fusion architecture designed specifically for fire safety standard entity extraction. Unlike traditional methods that rely on rules or single-modality deep learning, our approach integrates TextCNN for local feature extraction and combines it with the Flat-Lattice Transformer for global dependency modeling. The key innovations include the following. (1) Relative Position Embedding (RPE) dynamically encodes the positional relationships between spans in fire safety texts, addressing the limitations of absolute positional encoding in hierarchical structures. (2) The Multi-Branch Prediction Head (MBPH) aggregates the outputs of TextCNN and the Transformer using Einstein summation, enhancing the feature learning capabilities and improving the robustness for domain-specific terminology. (3) Experiments conducted on the newly annotated Fire Safety Standard Entity Recognition Dataset (FSSERD) demonstrate state-of-the-art performance (94.24% accuracy, 83.20% precision). This work provides a scalable solution for constructing fire safety knowledge graphs and supports intelligent information retrieval in emergency situations. Full article

Background/Objectives: Collaboration in mental health care is essential for implementing a model oriented towards the psychosocial rehabilitation of people based on multifaceted interventions involving different actors and sectors of society to respond to demands. Despite the benefits presented by the scientific evidence, there are still many barriers to collaborative care, and professionals continue to struggle in reorienting their conduct. The current situation demands organization and the framing of well-founded action plans to overcome challenges, which in turn requires a detailed understanding of collaborative practices in mental health care and their conceptual boundaries. A concept analysis was undertaken to propose a working definition of collaborative practices in mental health care (CPMHC). Methods: This paper used the Walker and Avant concept analysis method. This includes identifying the defining concept attributes, antecedents, consequences, and empirical referents. A literature search was carried out from November 2024 to February 2025 in three databases (Medline, CINAHL, and LILACS), considering studies published between 2010 and 2024. Results: The final sample of literature investigated consisted of 30 studies. The key attributes were effective communication, building bonds, co-responsibility for care, hierarchical flexibility, articulation between services, providers and community, monitoring and evaluating of care processes, and attention to the plurality of sociocultural contexts. Conclusions: This comprehensive analysis contributes to guiding future research and policy development of collaborative practices in mental health, considering the individual, relational, institutional, and social levels. Further research is possible to deepen the understanding of the production of collaborative practices in mental health in the face of the complexity of social relations and structural inequities. Full article

Data visualization is a key activity in data-driven decision making and is gaining momentum in many organizational contexts. However, the role and contribution of both end-user development (EUD) and artificial intelligence (AI) technologies for data visualization and analytics are still not clear or systematically studied. This work investigates how effectively AI-supported EUD tools may assist visual analytics tasks in organizations. An exploratory case study with eight interviews with key informants allowed a deep understanding of data analysis and visualization practices in a large Italian company. It aimed at identifying the various professional roles and competencies necessary in the business context, understanding the data sources and data formats exploited in daily activities, and formulating suitable hypotheses to guide the design of AI-supported EUD tools for data analysis and visualization. In particular, the results of interviews with key informants yielded the development of a prototype of an LLM-based EUD environment, which was then used with selected target users to collect their opinions and expectations about this type of intervention in their work practice and organization. All the data collected during the exploratory case study finally led to defining a set of design guidelines for AI-supported EUD for data visualization. Full article

The global elimination of hepatitis C virus (HCV) has been prioritized by the World Health Organization (WHO) as a key public health target, with a deadline set for 2030. This initiative aims to significantly reduce both new infection rates and HCV-associated mortality. A major breakthrough in achieving this goal has been the development of direct-acting antiviral agents (DAAs), which offer cure rates exceeding 95%, along with excellent safety and tolerability. Nevertheless, transmission via parenteral routes continues to be the dominant pathway, particularly among high-risk groups, such as individuals who inject drugs, incarcerated populations, those exposed to unsafe medical practices, and healthcare professionals. Identifying, monitoring, and delivering tailored interventions to these groups is crucial to interrupt ongoing transmission and to reduce the burden of chronic liver disease. On a global scale, several nations have demonstrated measurable progress toward HCV elimination, with some nearing the targets set by WHO. These achievements have largely resulted from context-adapted policies that enhanced diagnostic and therapeutic access while emphasizing outreach to vulnerable communities. This review synthesizes current advancements in HCV prevention and control and proposes strategic frameworks to expedite global elimination efforts. Full article

Purpose: Exercise is recommended for survivors of breast cancer to alleviate adverse reactions and reduce the psychological burden. In recent years, however, environmental factors (e.g., pandemics and climate change) have made it difficult to exercise outdoors. Therefore, this study focused on the COVID-19 pandemic in Japan and evaluated the relationship between changes in physical activity (PA) and mental and physical health in breast cancer survivors. Methods: A questionnaire survey was conducted among 345 outpatient female breast cancer survivors aged between 29 and 69 years. The questionnaire was based on the International Physical Activity Questionnaire, the Patient Health Questionnaire-9, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, and the Fear of COVID-19 Scale and included patient characteristics, changes in PA during pandemic restrictions, and needs for exercise support. The analysis categorized PA changes into two groups according to activity levels. The relationship between changes in PA and physical and mental health was evaluated using logistic regression analysis. Results: Patients with decreased PA accounted for 65.5% of the study population. Regardless of their activity level, these patients were aware of an increased susceptibility to COVID-19, showed a fear of the disease and a tendency for depression, and reported low life satisfaction and declined physical function. Of the patients who stopped exercising, 82.9% reported a decline in PA. Compared with those who had never exercised, those who stopped exercising saw their risk of depression increase by 15.6%. There was a high demand for personalized exercise support from healthcare professionals. Conclusions: Regardless of their activity level, decreasing PA during the pandemic decreased mental health and physical function in breast cancer survivors. There was a higher risk of depression among patients who stopped exercising. Because it is possible that similar situations may occur in the future, interventions by healthcare professionals must be considered in order to continue exercise. Full article

Background/Objectives: It is essential to explore and disseminate positive deviance strategies that promote resilience, mindfulness, and well-being beyond stress and burnout reduction strategies for residents and physicians who experience high levels of occupational stress. This scoping review maps studies that investigate positive deviance strategies to enhance the well-being of residents and physicians. Methods: A scoping review was conducted by PRISMA guidelines to identify English-language studies on strategies for physician well-being. PubMed, MEDLINE, Embase, and ERIC were searched using terms related to well-being, coping, and medical education. Results: Among the 38 studies included, 17 (44.7%) targeted physicians in graduate medical education (GME), while 19 (50%) focused on continuing medical education (CME). Positive deviance strategies were identified in 26 studies and were most frequently implemented at the microsystem level, such as small group interventions (e.g., coaching, mentoring, and workshops). These strategies addressed individual and organisational factors that contribute to physician well-being and were associated with improvements in life satisfaction, resilience, professional identity, and psychological safety. The review found that positive deviance strategies were often proactive, values-driven, and disseminated organically over time, emphasising the importance of longitudinal engagement and sustained institutional support. Conclusions: This scoping review highlights the growing use of positive deviance strategies, especially at the microsystem level, to promote physician well-being. These approaches emphasise sustainable, values-driven practices and may offer effective, context-sensitive solutions within healthcare systems. Full article

Introduction: Poorly designed safety job descriptions may have a negative impact on occupational safety and health (OSH) performance. Firstly, they limit the chances of hiring highly qualified safety professionals who are vital to the success of OSH management systems in organizations. Secondly, the relationship between the presence of qualified safety professionals and the safety culture (and performance) in an organization is reciprocal. Thirdly, the low quality of job descriptions limits exploring the proper competencies needed by safety professionals before they are hired. The safety professional is thus uncertain of what level of education or training and which skills they should attain. Objectives: The main goal of the study is to integrate the analytic hierarchy process (AHP) and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) with importance–performance analysis (IPA) to evaluate job descriptions in multiple sectors. Results: The results of the study indicate that it is vital to clearly define job levels, the overall mission, key responsibilities, time-consuming tasks, required education/certifications, and necessary personal abilities in safety job descriptions. This clarity enhances recruitment, fairness, performance management, and succession planning. The organization can then attract and retain top talent, improve performance, foster a strong safety culture, create realistic job expectations, increase employee satisfaction and productivity, and ensure that competent individuals are hired, ultimately leading to a safer and more productive workplace. Conclusion: The outcomes of this study provide a robust framework that can and should be used as a guideline to professionalize job description development and enhance talent acquisition strategies. Full article

Background/Objectives: Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. Methods: This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women’s autonomy and satisfaction with care. Results: Important conclusions emphasize that improving women’s experiences and minimizing needless interventions require active decision-making participation, a positive provider–patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women’s experiences of consent can be more effectively understood through the use of instruments such as the Mothers’ Respect (MOR) Index and the Mothers’ Autonomy in Decision Making (MADM) Scale. Conclusions: To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice. Full article