Wednesday, December 13, 2023

 

The solar forest


A new Weizmann Institute study shows that building solar farms in arid regions is a far more effective way to tackle the climate crisis than planting forests


Peer-Reviewed Publication

WEIZMANN INSTITUTE OF SCIENCE




A verdant forest is one of the most iconic symbols of the power of nature, from the abundance of plant and animal life that shelters among its thick vegetation to the positive impact it has on Earth’s climate, thanks in part to photosynthesis, which removes carbon dioxide from the air, thereby mitigating the effects of global warming. Cutting down tropical evergreen forests has played a significant role in exacerbating the climate crisis, and many environmental initiatives focus on rehabilitating destroyed forests or planting new trees. The problem is that, even if we were to cover the entire surface of the planet with trees, the resultant massive photosynthetic force would still not suffice to absorb the huge surplus of carbon dioxide – the major greenhouse gas – that has been pumped into the atmosphere during the past 150 years of human activity.

There is another way of dealing with the climate crisis, which, unlike the forests, is neither natural nor green, at least not in the literal sense of the word. This artificial solution consists of erecting fields of dark-colored solar panels. Obviously, the production of electricity from solar power has a positive impact on climate balance, since it replaces power stations that use fossil fuels such as coal and gas, thereby reducing harmful emissions of greenhouse gases that accumulate at increasing concentrations in the atmosphere.

But both the green, natural forest and the artificial, dark “solar forest” produce other effects, some of which can be problematic from a climate perspective. They are both relatively dark, which means that they absorb a large proportion of the radiation from the Sun (making them “low albedo” surfaces in the professional jargon) and, as a result, they heat up. Some of this energy is used for photosynthesis in natural forests or to produce electricity in solar “forests” – but most returns to the atmosphere as fluxes of energy, heating it up. In contrast, the light-colored desert soil, for example, reflects a significant portion of the sunlight back into space, which does not add to the accumulated heat in the atmosphere. (Such soil is known as a surface with a “high albedo.”)

What, then, would be the most effective use of a certain plot of land in terms of the climate crisis: planting a forest, which is a natural means of absorbing carbon dioxide from the atmosphere, or erecting fields of solar panels, which reduce the emission of carbon dioxide into the atmosphere? This dilemma has long been debated by decision-makers around the world. 

Now, for the first time – based on findings from arid areas and on comprehensive measurements of the energy flow exchanged between the ground and the atmosphere – we may have an answer to this question, thanks to a new study led by Dr. Rafael Stern, Dr. Jonathan Muller and Dr. Eyal Rotenberg from Prof. Dan Yakir's lab at the Earth and Planetary Sciences Department of the Weizmann Institute of Science. The study, published today in PNAS Nexus, was coauthored by Madi Amer, also from Prof. Yakir’s lab, and Dr. Lior Segev of Weizmann’s Physics Core Facilities Department.

A century of photosynthesis

The first stage of the study involved comparing the impact of a forest situated on the border of an arid area to that of a field of solar panels, or a solar farm, in an arid environment. Arid areas are characterized by a large amount of sunlight and a relative paucity of plant diversity and biomass, which makes them especially suited for large solar farms. Such fields already exist in Israel in the Arava and the Negev, and the government has plans to erect more in Jordan through an international collaboration. Elsewhere in the world, huge solar projects are under way, for example, in the deserts of China, and the European Union has long discussed plans to build solar farms in the Sahara. The Weizmann researchers traveled down to the Arava in a truck carrying a mobile measuring station, specially designed by Yakir and Rotenberg. They began by placing this measuring station close to the solar panel field to measure the flux of energy between the ground and the atmosphere – as it occurs in an arid area without solar panels. Then they placed the station inside the solar panel field itself; this required overcoming operational and safety challenges stemming from the sensitivity of the panels, which had interfered with such measurements in the past. At both locations, the experiments were repeated during different seasons of the year. Finally, to compare their results to the similar process occurring in a forest, the scientists relied on data that Yakir and Rotenberg had collected over the past 20 years in Yatir Forest – the largest of the forests planted in Israel by the Jewish National Fund – on the northern edge of the arid Negev Desert.

The researchers discovered that the albedo effect of both of these “forests” was similar, but the absorption or prevention of carbon emissions was very different, favoring the solar forest. To complete the comparison, they calculated the equilibrium points at which the opposing effects on the Earth’s climate – heating from both forests’ dark color and cooling from reduced atmospheric carbon dioxide – balance out one another, ultimately lowering the concentration of greenhouse gases in the atmosphere as a result of the natural forest’s photosynthesis or the solar forest’s reduced electricity-production emissions. It turns out that it takes two and a half years for the heat emitted by solar farms to be offset by the carbon emissions that are averted thanks to the energy they generate. This even takes into account the carbon emissions from the manufacture, transportation and operation of the panels, as well as of batteries used for electricity storage. In the case of a forest of similar size, it would take more than 100 years of photosynthesis to offset its heating effect.

The researchers also wanted to establish how the heating and cooling ratio changed in other climates. Using data from similar measurements collected from satellites and databases, they found that in more humid environments such as the tropics or in temperate grassland regions like Europe, the heating effect of planting large numbers of trees is smaller. This is because the ground there is darker to begin with, which means that the albedo-related effect is smaller, and the carbon capture rate by trees is higher, so the break-even point is reached within 15 to 18 years. With that, they note, it must be kept in mind that less open space is available in these areas for planting new forests.

Stern and Muller explain: “Our study unequivocally shows that in arid environments, where most of the open land reserves exist, building solar farms is far more effective than planting forests when it comes to dealing with the climate crisis. In this environment, erecting solar panels on areas that are far smaller than forests (up to one hundredth of the size) will offset exactly the same quantity of carbon emissions. Having said that, forests currently absorb close to one-third of humanity’s annual carbon emissions, so it’s of paramount importance to safeguard this capability and prevent the kind of widescale deforestation that takes place in tropical regions. Moreover, forests play a vital role in the global rain cycle, in maintaining biodiversity and in many other environmental and social contexts. Therefore, the conclusion from our study is that we must protect the Earth’s forests, and that the most appropriate solution to the climate crisis is to combine the planting and rehabilitation of forests in humid regions with erecting fields of solar panels in arid regions.”

Prof. Dan Yakir's research is supported by the Helen Kimmel Center for Planetary Science and the Schwartz Reisman Collaborative Science Program. 

Prof. Yakir is the incumbent of the Hilda and Cecil Lewis Professorial Chair.

 

 

Extracting uranium from seawater as another source of nuclear fuel


Peer-Reviewed Publication

AMERICAN CHEMICAL SOCIETY

Extracting uranium from seawater as another source of nuclear fuel 

IMAGE: 

THIS NEW COATED CLOTH EFFECTIVELY ACCUMULATED URANIUM (IN YELLOW) ON ITS SURFACE FROM URANIUM-SPIKED SEAWATER.

view more 

CREDIT: ADAPTED FROM ACS CENTRAL SCIENCE, 2023, DOI: 10.1021/ACSCENTSCI.3C01291




Oceans cover most of Earth’s surface and support a staggering number of lifeforms, but they’re also home to a dilute population of uranium ions. And — if we can get these particular ions out of the water — they could be a sustainable fuel source to generate nuclear power. Researchers publishing in ACS Central Science have now developed a material to use with electrochemical extraction that attracts hard-to-get uranium ions from seawater more efficiently than existing methods.

Nuclear power reactors release the energy naturally stored inside of an atom and turn it into heat and electricity by literally breaking the atom apart — a process known as fission. Uranium has become the favored element for this process as all its forms are unstable and radioactive, making it easy to split. Currently, this metal is extracted from rocks, but uranium ore deposits are finite. Yet, the Nuclear Energy Agency estimates that 4.5 billion tons of uranium are floating around in our oceans as dissolved uranyl ions. This reserve is over 1,000 times more than what’s on land. Extracting these ions has proven to be challenging, though, as the materials for doing so don’t have enough surface area to trap ions effectively. So, Rui Zhao, Guangshan Zhu and colleagues wanted to develop an electrode material with lots of microscopic nooks and crannies that could be used in the electrochemical capture of uranium ions from seawater.

To create their electrodes, the team began with flexible cloth woven from carbon fibers. They coated the cloth with two specialized monomers that were then polymerized. Next, they treated the cloth with hydroxylamine hydrochloride to add amidoxime groups to the polymers. The natural, porous structure of the cloth created many tiny pockets for the amidoxime to nestle in and easily trap the uranyl ions. In experiments, the researchers placed the coated cloth as a cathode in either naturally sourced or uranium-spiked seawater, added a graphite anode and ran a cyclic current between the electrodes. Over time, bright yellow, uranium-based precipitates accumulated on the cathode cloth.

In the tests using seawater collected from the Bohai Sea, the electrodes extracted 12.6 milligrams of uranium per gram of water over 24 days. The coated material’s capacity was higher than most of the other uranium-extracting materials tested by the team. Additionally, using electrochemistry to trap the ions was around three times faster than simply allowing them to naturally accumulate on the cloths. The researchers say that this work offers an effective method to capture uranium from seawater, which could open up the oceans as new suppliers of nuclear fuel.

The authors acknowledge funding from the National Key R&D Program of China, the National Natural Science Foundation of China, the Project of Education Department of Jilin Province, the Natural Science Foundation of Department of Science and Technology of Jilin Province, the Fundamental Research Funds for the Central Universities, and the “111” project.

The paper’s abstract will be available on Dec. 13 at 8 a.m. Eastern time here: http://pubs.acs.org/doi/abs/10.1021/acscentsci.3c01291

###

The American Chemical Society (ACS) is a nonprofit organization chartered by the U.S. Congress. ACS’ mission is to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and all its people. The Society is a global leader in promoting excellence in science education and providing access to chemistry-related information and research through its multiple research solutions, peer-reviewed journals, scientific conferences, eBooks and weekly news periodical Chemical & Engineering News. ACS journals are among the most cited, most trusted and most read within the scientific literature; however, ACS itself does not conduct chemical research. As a leader in scientific information solutions, its CAS division partners with global innovators to accelerate breakthroughs by curating, connecting and analyzing the world’s scientific knowledge. ACS’ main offices are in Washington, D.C., and Columbus, Ohio.

To automatically receive news releases from the American Chemical Society, contact newsroom@acs.org.

Note: ACS does not conduct research, but publishes and publicizes peer-reviewed scientific studies.

Follow us: Twitter | Facebook | LinkedIn | Instagram

 

 

Medicare doesn’t cover obesity drugs, but 76% of older adults think it should


Poll of people aged 50 to 80 finds 63% of those who say they are overweight are interested in taking a prescription medication for weight management


Reports and Proceedings

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN




The vast majority of older adults – 83% -- think health insurers should cover medications that can help people with obesity manage their weight, a new poll of people age 50 to 80 finds.

Nearly as many -- 76% -- believe Medicare should cover these drugs, which it cannot currently do under law, according to the new results from the University of Michigan National Poll on Healthy Aging.

A law passed in 2003 prohibits Medicare from covering weight loss medications, though it can cover drugs to help people with Type 2 diabetes manage their weight. Medicaid covers obesity medications for adults with low incomes in 15 states. Most private plans and the Veterans Health Administration cover them, but with restrictions due to high monthly costs for the new generation of medications.

The poll gauged the interest of older adults in taking prescription medications for weight management. Among the 27% of people age 50 to 80 who say they are overweight, 63% are interested in taking such medications. So are 45% of those with diabetes, regardless of weight. Among adults who had ever taken a weight-loss medication before, 83% said they’d do so again.

“Our data show the strong awareness and interest in these medications, and in access to them through insurance, alongside coverage for other weight-focused care including nutrition counseling, exercise programs and bariatric surgery,” said Lauren Oshman, M.D., M.P.H., an obesity medicine specialist and associate professor in the U-M Department of Family Medicine who worked on the poll.

“We hope these findings will help inform policymakers and benefit plan designers who are grappling with the tradeoffs of cost and long-term benefit when it comes to these medications,” she added. In 2022, Oshman helped lead an analysis that informed the Michigan Medicaid program’s decision to cover obesity medications.

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, the University of Michigan’s academic medical center.

The poll team asked a national sample of adults aged 50 to 80 about their awareness of, and attitudes toward, weight-management medications and other weight-related care.

High awareness

The new findings come at a time when injectable GLP-1 medications such as Ozempic, Wegovy, Mounjaro and Zepbound have gotten a lot of attention in the news and on social media – overshadowing a previous generation of oral medications also approved for obesity and for weight management in type 2 diabetes.

The poll finds that 61% of people age 50 to 80 had heard of Ozempic. That drug, which has U.S. Food & Drug Administration approval only for use in people with diabetes but has been used off-label for weight loss, contains the same active ingredient as Wegovy, which is approved for use in obesity, and which 18% of older adults had heard of.

Next most familiar was the older drug phentermine, which 13% had heard of. In addition to being prescribed alone, it is also available as part of the combination medication sold as Qsymia, which 3% of older adults had heard of. Similarly, 3% had heard of Saxenda or Contrave. Zepbound, the obesity-specific form of the GLP-1 drug Mounjaro approved for diabetes, received FDA approval for weight management after the poll was taken.

The poll shows most older adults had heard about the medications from the news, but far fewer had heard about them from a health care provider.

Potential impacts

“As these medications grow in awareness and use, and insurers make decisions about coverage, it’s crucial for patients who have obesity or diabetes, or who are overweight with other health problems, to talk with their health care providers about their options,” said poll director Jeffrey Kullgren, M.D., M.P.H., M.S., a primary care physician at the VA Ann Arbor Healthcare System and associate professor of internal medicine at U-M.

“This is an important conversation in the face of a growing realization over the past decade that obesity is a chronic condition with multiple contributing factors that raises downstream risks of health problems, and that a combination of lifestyle change and medical or surgical intervention is often needed to address it,” he added.

The newer medications can cost more than $12,000 a year for people who pay out of their own pockets and must be taken long-term to maintain weight loss. But current data suggest that medications are nearly as effective as bariatric surgery in helping people with obesity lose 10% or more of their body weight, far more than people with obesity can typically achieve or sustain through diet and exercise.

Recent findings suggest a large reduction in the risk of heart-related issues in people with a history of both obesity and heart conditions who took a GLP-1 medication. The strong demand for these medications, including for off-label purposes by people willing to pay full price, has created major shortages of them.

Oshman notes that in the new poll, nearly all older adults said they had tried to lose weight in the past, including large percentages who said they had exercised or changed their diet.

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone  in July and August 2023 among 2,657 adults aged 50 to 80. The sample was subsequently weighted to reflect the U.S. population. Read past National Poll on Healthy Aging reports and about the poll methodology.

Study: digital leisure reading does little to improve reading comprehension for students


Peer-Reviewed Publication

AMERICAN EDUCATIONAL RESEARCH ASSOCIATION




Washington, December 13, 2023—For years, research showed that print reading, whether for leisure or school, improved developing readers’ ability to comprehend text. However, the explosive use of digital reading devices, constant access to these devices, and new types of reading materials have introduced new reading habits. Now, a new comprehensive review of research on digital leisure reading habits finds a virtually nonexistent relationship between digital reading and improvement in reading comprehension among students.

The study was published in Review of Educational Research, a peer-reviewed journal of the American Educational Research Association, and was conducted by Lidia Altamura, Cristina Vargas, and Ladislao Salmerón, all at the University of Valencia.

Video: Co-author Lidia Altamura discusses findings and implications of the study

“In sum, for developing readers, leisure digital reading does not seem to pay off in terms of reading comprehension, at least not as much as traditional print reading does,” said study co-author Lidia Altamura, a PhD student at the University of Valencia. “Our findings are particularly surprising when you compare them to what we already know about the well-established positive association between reading frequency in print and text comprehension.”

Extrapolating from what is known from previous studies, the authors estimate that if a student spends 10 hours reading in print in their free time, their ability to comprehend will likely be six to eight times higher than if they read on digital devices for the same amount of time.

“We expected that digital leisure reading for informational purposes, such as visiting Wikipedia or other educational webpages, or reading the news, would be much more positively linked to comprehension,” said Altamura. “But even that was not the case.”

The study is the first meta-analysis of research that has focused on the specific links between leisure reading habits on digital devices and reading comprehension. The authors found that at early stages (primary and middle school), there were small negative relationships between leisure digital reading and comprehension, while at later stages (high school and university), the relationship turned slightly positive. Overall, regardless of education stage, digital reading habits had a smaller relationship with reading comprehension, compared to print reading results from previous research.

The findings are based on the authors’ synthesis of 25 studies, published between 2000 and 2022, involving around 470,000 participants from at least three dozen countries.

Altamura and colleagues suggested two reasons why digital reading may not pay off for developing readers compared to print reading. First, digital reading devices can serve many purposes other than reading, which distracts readers. Second, the internet has brought new types of reading, with features such as short- and fast-paced stimuli, lower quality content, and less sophisticated vocabulary.

The authors emphasized that educators and parents should encourage students, especially younger ones, to read in print more often than on digital devices.

“Based on our results, we cannot just assume that all leisure reading will be beneficial for developing readers,” said Altamura. “The medium used matters.”

Study citation: Altamura, L., Vargas, C., & Salmerón, L. (2023). Do new forms of reading pay off? A meta-analysis on the relationship between leisure digital reading habits and text comprehension. Review of Educational Research. Prepublished December 13, 2023. https://doi.org/10.3102/00346543231216463

###

About AERA
The American Educational Research Association (AERA) is the largest national interdisciplinary research association devoted to the scientific study of education and learning. Founded in 1916, AERA advances knowledge about education, encourages scholarly inquiry related to education, and promotes the use of research to improve education and serve the public good. Find AERA on FacebookTwitterLinkedInInstagram, and Threads

 

A new system for producing green hydrogen cheaply and efficiently


A study developed jointly by IIT and the spin-off BeDimensional has identified a solution based on ruthenium particles and a solar-powered electrolytic system


Peer-Reviewed Publication

ISTITUTO ITALIANO DI TECNOLOGIA - IIT

A new system for producing green hydrogen cheaply and efficiently 

IMAGE: 

IIT AND BEDIMENSIONAL'S RESEARCHERS USED NANOPARTICLES OF RUTHENIUM, A NOBLE METAL THAT IS SIMILAR TO PLATINUM IN ITS CHEMICAL BEHAVIOUR BUT FAR CHEAPER, TO SERVE AS THE ACTIVE PHASE OF THE ELECTROLYSER’S CATHODE, LEADING TO AN INCREASED EFFICIENCY OF THE OVERALL ELECTROLYZER. 

view more 

CREDIT: IIT-ISTITUTO ITALIANO DI TECNOLOGIA




Genoa (Italy), 13 December 2023 - What does it take to produce green hydrogen more efficiently and cheaply? Apparently, small ruthenium particles and a solar-powered system for water electrolysis. This is the solution identified by a joint team involving the Istituto Italiano di Tecnologia (Italian Institute of Technology, IIT) of Genoa, and BeDimensional S.p.A. (an IIT spin-off). The technology, developed in the context of the Joint-lab’s activities and recently published in two high-impact factor journals (Nature Communications and the Journal of the American Chemical Society) is based on a new family of electrocatalysts that could reduce the costs of green hydrogen production on an industrial scale.

Hydrogen is considered as a sustainable energy vector, alternative to fossil fuels. But not all hydrogen is the same when it comes to environmental impact. Indeed, the main way hydrogen is produced nowadays is through the methane steam reforming, a fossil fuel-based process that releases carbon dioxide (CO2) as a by-product. The hydrogen produced by this process is classified as “grey” (when CO2 is release into the atmosphere) or “blue” (when CO2 undergoes capture and geological storage). To significantly reduce emissions to zero by 2050 these processes must be replaced with more environmentally sustainable ones that deliver “green” (i.e. net-zero emissions) hydrogen. The cost of “green” hydrogen critically depends on the energy efficiency of the setup (the electrolyzer) that splits water molecules into hydrogen and oxygen.

The researchers from the joint team of this discovery have developed a new method that guarantees greater efficiency than currently known methods in the conversion of electrical energy (the energy bias exploited to split water molecules) into the chemical energy stored in the hydrogen molecules that are produced. The team has developed a concept of catalyst and have used renewable energy sources, such as the electrical energy produced by a solar panel.

“In our study, we have shown how it is possible to maximise the efficiency of a robust, well-developed technology, despite an initial investment that is slightly greater than what would be needed for a standard electrolyzer. This is because we are using a precious metal such as ruthenium”, commented Yong Zuo and Michele Ferri from the Nanochemistry Group at IIT in Genoa.

The researchers used nanoparticles of ruthenium, a noble metal that is similar to platinum in its chemical behaviour but far cheaper. Ruthenium nanoparticles serve as the active phase of the electrolyser’s cathode, leading to an increased efficiency of the overall electrolyzer.

“We have run electro-chemical analyses and tests under industrially-significant conditions that have enabled us to assess the catalytic activity of our materials. Additionally, theoretical simulations allowed us to understand the catalytic behaviour of ruthenium nanoparticles at the molecular level; in other words, the mechanism of water splitting on their surfaces”, explained Sebastiano Bellani and Marilena Zappia from BeDimensional, who were involved in the discovery. “Combining the data from our experiments with additional process parameters, we have carried out a techno-economic analysis that demonstrated the competitiveness of this technology, when compared to state-of-the-art electrolysers”.

Ruthenium is a precious metal that is obtained in small quantities as a by-product of platinum extraction (30 tonnes per year, as compared to the annual production of 200 tonnes of platinum) but at a lower cost (18.5 dollars per gram as opposed to 30 dollars for platinum). The new technology involves the use of just 40 mg of ruthenium per kilowatt, in stark contrast with the extensive use of platinum (up to 1 gram per kilowatt) and iridium (between 1 and 2.5 grams per kilowatt, with iridium price being around 150 dollars per gram) that characterize proton-exchange membrane electrolysers.

By using ruthenium, the researchers at IIT and BeDimensional have improved the efficiency of alkaline electrolysers, a technology that has been used for decades due to its robustness and durability. For example, this technology was on board of the Apollo 11 capsule that brought humanity to the moon in 1969. The new family of ruthenium-based cathodes for alkaline electrolysers that has been developed is very efficient and has a long operating life, being therefore capable of reducing the production costs of green hydrogen.

“In the future, we plan to apply this and other technologies, such as nanostructured catalysts based on sustainable two-dimensional materials, in up-scaled electrolysers powered by electrical energy from renewable sources, including electricity produced by photovoltaic panels”, concluded the researchers.

 

Clinical trial aims to curb hypertension, mental health issues in postpartum women


Grant and Award Announcement

UNIVERSITY AT BUFFALO

UBuffalo-PCORI-researchers 

IMAGE: 

FROM LEFT: THADDEUS “TED” WATERS AND PAMELA REED, BOTH OF THE JACOBS SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES, AND PAULINE MENDOLA FROM THE SCHOOL OF PUBLIC HEALTH AND HEALTH PROFESSIONS. THEY ARE AMONG THE UB INVESTIGATORS ON A CLINICAL TRIAL THAT WILL TEST TWO HEALTH CARE DELIVERY MODELS' EFFECTIVENESS IN TREATING POSTPARTUM HYPERTENSION.

view more 

CREDIT: MEREDITH FORREST KULWICKI / UNIVERSITY AT BUFFALO




BUFFALO, N.Y. — The University at Buffalo is among three institutions selected for a major new clinical trial aimed at curbing hypertension and mental health issues in postpartum women, particularly those from marginalized populations.

The study will enroll 6,000 postpartum women from priority populations — mostly Black and Latinx women — in three medical centers: Yale New Haven Hospital, UMass Medical Center, and Kaleida Health’s John R. Oishei Children’s Hospital. The project is being funded through an $18.8 million grant from the Patient-Centered Outcomes Research Institute (PCORI), with UB receiving $3.7 million. Study recruitment is underway.

“Women who have hypertensive disorders during pregnancy are at higher risk throughout their lives for adverse cardiovascular outcomes,” said Vanessa Barnabei, MD, PhD, professor emerita in the Department of Obstetrics and Gynecology in the Jacobs School of Medicine and Biomedical Sciences, who played a critical role in securing the funding for UB before retiring.

The adverse health impacts have a more profound effect for Black, American Indian/Alaskan Native and Latinx women due to social determinants of health.

“Maternal health is one of the most important health priorities for the African American community. Hypertension as well as the social determinants of health have created unacceptable birth outcomes in the community,” said George F. Nicholas, pastor of Lincoln Memorial United Methodist Church in Buffalo and convener of the African American Health Equity Task Force, a partner on the research project.

“This grant will enable us to obtain important information on how to improve birth outcomes for women and children in the community,” Nicholas said.

“This study takes a patient-centered approach focusing on patient needs and preferences of care delivery with the hope of improving the physical health and mental well-being of women while also addressing health care inequities in our community,” said Pamela D. Reed, MD, senior research project director for the study.

“Funding for this type of work is so important if we are to decrease the inequities in our current health care delivery system,” Reed adds.

The UB investigators on the research project are:

  • Thaddeus Waters, MD, Amol S. Lele Clinical Professor and chief of maternal-fetal medicine in the Department of Obstetrics and Gynecology, Jacobs School. He is also medical director for the maternal-fetal medicine and regional perinatal program at John R. Oishei Children’s Hospital in Buffalo.
     
  • Pauline Mendola, PhD, chair of the Department of Epidemiology and Environmental Health in the School of Public Health and Health Professions.

Other UB collaborators include Michael J. LaMonte, PhD, research professor, and Lina Mu, PhD, MD, associate professor, both in the Department of Epidemiology and Environmental Health; and Heather Link, MD, clinical assistant professor, and J’Leise Sosa, MD, clinical assistant professor of obstetrics and gynecology, from Kaleida Health.

The study is being led by the Yale School of Public Health.

Researchers will compare with the current standard of care, and with each other, the effectiveness of two health care delivery models focused on early detection and control of postpartum hypertension, as well as the social and mental health factors known to impact maternal outcomes. The two models are:

  1. A remote medical model that incorporates standard procedures along with home blood pressure monitoring and treatment, weekly virtual visits from a medical professional for six to 12 weeks, and screening for social determinants of health and anxiety/depression, with referrals for mental health services if needed.
     
  2. A community health model, which incorporates standard of care and the remote model with community health workers trained in a strength-based trauma-informed approach, which respects the influences of a patient’s past experiences when addressing their current health needs.

“The goal of the study is to have a lasting impact on long-term health,” Waters said. “If the study is successful, the model used in the trial can be brought to more patients and meaningfully address post-delivery morbidity and mortality, which disproportionately affects our community.”

Leveraging community health workers

A key part of the study calls for leveraging a community-based approach toward treating postpartum women. The community health worker model has been recognized by the World Health Organization and other agencies for its effectiveness in addressing health inequities due to the fact that community health workers are uniquely poised to play a role in providing better care by sharing the language, socio-economic status and life experiences of their clients.

“The incorporation of the community health care worker is a model for the future,” said Waters. “We believe this study will demonstrate the value of this approach by addressing the gaps in care for patients at high risk of complications after delivery and improving long term outcomes related to cardiovascular and mental health.”

Researchers will be working with project partner Cicatelli Associates Inc. (CAI), a New York-based nonprofit with a local Buffalo office that helps organizations improve health care and social services for marginalized communities.

CAI will be central to the delivery of asynchronous e-learning modules and synchronous virtual instructor‐led trainings to the health care providers and community health workers and doulas involved in study. Sample training topics will include the impact of systemic racism on health disparities among women and pregnant women, and trauma through an anti‐racist lens to understand sensitivity and reactivity to stress within the study population.

“Pregnancy risks are unacceptably high among women in priority populations who have been historically underserved and who have experienced discrimination and racism,” said Lindsay Senter, CAI vice president of research and evaluation. “We are thrilled to take part in ground-breaking research that places community voices front and center, to ensure that members of marginalized communities are engaged and have a voice in creating the systems that serve them.”

The team will recruit and train community health workers to perform mental health assessments and work with patients directly in their neighborhoods. Nurse practitioners will conduct follow-ups with patients who’ve been identified as having continued high blood pressure postpartum to set them up with additional treatment.

In addition, CAI is leading development of a local community advisory board to help inform the implementation of the trial.

Improving clinical outcomes

The study’s primary objective is to improve clinical outcomes, including mental health outcomes, among postpartum at‐risk women experiencing health disparities by increasing awareness, detection and timely care of postpartum hypertension, mental health and cardiovascular complications.

“This is a topic that is near and dear to my heart,” Mendola said. “Postpartum is a very vulnerable time, and it is really important for women’s health and neonatal health, yet it doesn’t get the attention that it really deserves due to its long-term health impacts. We as a clinical community are excited about the opportunity to address some of these issues and help women during a time in which they really need that help but have trouble accessing it.”

The focus on women who identify as Black, Latinx or American Indian/Alaska Native is especially significant, Mendola says. “This study provides another avenue to try to address the striking disparities in maternal mortality and morbidity by race. Black moms are two to three times more likely to die from hypertension during pregnancy than white moms, and their hypertension typically occurs at a much higher rate than mothers of other races and ethnicities.”

Hypertension, or high blood pressure, as well as mental health, are of particular concern during the postpartum period, especially since most new mothers will receive checkups only at two and six weeks postpartum. In fact, at Oishei Children’s Hospital, the numbers continue to climb: In 2021, 16% of women who gave birth there had one of the four types of high blood pressure during pregnancy, up from around 5% in 2009.

“This is a really key time in women’s lives, and it makes a difference for their lifespan and continued health,” Mendola said. “Some of the things we may be able to address in this study and deal with in a proactive way will help improve the women’s cardiometabolic health for the rest of their lives.”

Oishei Children’s Hospital is thrilled to be one of the three study sites.

“As the region’s only state-designated Regional Perinatal Center, Oishei Children’s Hospital provides the most comprehensive specialized care for our community’s highest risk moms and babies,” said Stephen J. Turkovich, MD, president and chief medical officer of Oishei Children’s Hospital.

“Beyond the four walls of the hospital, our robust network of maternal-fetal medicine specialists and community-based clinics are uniquely positioned to provide complex care services for pregnant moms throughout Western New York. I’m optimistic that through investments in research and alternative care models for postpartum at‐risk women, we can help close the health disparities gap and improve health outcomes,” Turkovich said.