Background: The growing use of web-based patient portals offers patients valuable tools for accessing health information, communicating with healthcare providers, and engaging in self-management. However, the influenc...Background: The growing use of web-based patient portals offers patients valuable tools for accessing health information, communicating with healthcare providers, and engaging in self-management. However, the influence of educating patients on these portals’ functionality on clinical outcomes, such as all-cause readmission rates, remains underexplored. Objective: This research proposal tested the hypothesis that educating a subset of patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF), on how to effectively access and utilize the functionality of web-based patient portals can reduce all-cause readmission rates. Methods: We performed a prospective, quasi-experimental study at Bon Secours St. Mary’s Hospital in Richmond, Virginia, USA;dividing participants into an intervention group, receiving education about accessing and navigating “My Chart”, the Bon Secours Web based portal, and a control group, receiving standard care. We then compared 30-day readmission rates, patient engagement, and self-management behaviors between the groups. Data was analyzed using statistical tests to assess the intervention’s impact. Results: We projected that educated patients will exhibit lower readmission rates, improved engagement, and better self-management. The results of the study showed that there was a significant decrease in 30-day readmissions in the intervention group in comparison with the control group (22.7% and 40.9%, respectively). This reduction of 18. 2% of readmissions evaluated here for a trial of meaningful clinical effect is statistically insignificant (p = 0. 184). The practical significance of the intervention is considered small-to-moderate (Cramer V = 0. 20) suggesting that the observed difference has a potential clinical importance even though the difference was not statistically significant. Conclusion: These results imply that the proposed educational intervention might have a positive impact on readmissions;nonetheless, the patient’s characteristics that make him or her capable of readmission cannot be changed and are assessed by the RoR (Risk of Readmission) score. The potential impact of the intervention may be offset, in part, by these baseline risk factors. The study’s power may be limited by sample size, potentially affecting the detection of significant differences. Future studies with larger, multi-center samples and longer follow-up periods are recommended to confirm these findings.展开更多
Protected areas are necessary for the conservation and enhancement of biodiversity.Wildfires are major threats to forests and other natural areas,because they may cause irreversible damages.The aim of this study was t...Protected areas are necessary for the conservation and enhancement of biodiversity.Wildfires are major threats to forests and other natural areas,because they may cause irreversible damages.The aim of this study was to analyze the perspective of experts(N=284),from six countries of the Black Sea,on the current status and problems of protected areas and wildfires.Understanding their points of view could enhance future management on these issues in the region.Data collection was carried out for 9 months,using a web-based questionnaire.Wildfires were perceived as a serious problem in Turkey,Armenia and Greece but as a substantially less serious problem in Romania,Ukraine and Moldova.In Greece,Armenia,and especially Ukraine,the current designated protected areas are considered sufficient to maintain biodiversity,while in Romania,Turkey,and especially Moldova,more areas should be designated as protected.A major need in all countries(except for Turkey)is the increased use of information and communication technologies for both wildfire suppression and protected area management.Experts were divided on whether wildfire suppression and management of protected areas are interconnected.However,there is growing awareness of the adverse impacts of climate change in protected areas and the frequency of wildfires in the future.The most frequently suggested measures to alleviate these impacts were:changes in forest management and increasing public awareness for wildfire suppression,along with changes in forest management and increased staff training to enhance protected area conservation.展开更多
文摘Background: The growing use of web-based patient portals offers patients valuable tools for accessing health information, communicating with healthcare providers, and engaging in self-management. However, the influence of educating patients on these portals’ functionality on clinical outcomes, such as all-cause readmission rates, remains underexplored. Objective: This research proposal tested the hypothesis that educating a subset of patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF), on how to effectively access and utilize the functionality of web-based patient portals can reduce all-cause readmission rates. Methods: We performed a prospective, quasi-experimental study at Bon Secours St. Mary’s Hospital in Richmond, Virginia, USA;dividing participants into an intervention group, receiving education about accessing and navigating “My Chart”, the Bon Secours Web based portal, and a control group, receiving standard care. We then compared 30-day readmission rates, patient engagement, and self-management behaviors between the groups. Data was analyzed using statistical tests to assess the intervention’s impact. Results: We projected that educated patients will exhibit lower readmission rates, improved engagement, and better self-management. The results of the study showed that there was a significant decrease in 30-day readmissions in the intervention group in comparison with the control group (22.7% and 40.9%, respectively). This reduction of 18. 2% of readmissions evaluated here for a trial of meaningful clinical effect is statistically insignificant (p = 0. 184). The practical significance of the intervention is considered small-to-moderate (Cramer V = 0. 20) suggesting that the observed difference has a potential clinical importance even though the difference was not statistically significant. Conclusion: These results imply that the proposed educational intervention might have a positive impact on readmissions;nonetheless, the patient’s characteristics that make him or her capable of readmission cannot be changed and are assessed by the RoR (Risk of Readmission) score. The potential impact of the intervention may be offset, in part, by these baseline risk factors. The study’s power may be limited by sample size, potentially affecting the detection of significant differences. Future studies with larger, multi-center samples and longer follow-up periods are recommended to confirm these findings.
基金co-funded by the EU INTERREGⅣ"Black Sea Basin Joint Operational Programme 2007-2013"frameworkthe Black Sea Basin Programmethe financial assistance of the European Union
文摘Protected areas are necessary for the conservation and enhancement of biodiversity.Wildfires are major threats to forests and other natural areas,because they may cause irreversible damages.The aim of this study was to analyze the perspective of experts(N=284),from six countries of the Black Sea,on the current status and problems of protected areas and wildfires.Understanding their points of view could enhance future management on these issues in the region.Data collection was carried out for 9 months,using a web-based questionnaire.Wildfires were perceived as a serious problem in Turkey,Armenia and Greece but as a substantially less serious problem in Romania,Ukraine and Moldova.In Greece,Armenia,and especially Ukraine,the current designated protected areas are considered sufficient to maintain biodiversity,while in Romania,Turkey,and especially Moldova,more areas should be designated as protected.A major need in all countries(except for Turkey)is the increased use of information and communication technologies for both wildfire suppression and protected area management.Experts were divided on whether wildfire suppression and management of protected areas are interconnected.However,there is growing awareness of the adverse impacts of climate change in protected areas and the frequency of wildfires in the future.The most frequently suggested measures to alleviate these impacts were:changes in forest management and increasing public awareness for wildfire suppression,along with changes in forest management and increased staff training to enhance protected area conservation.
