USDA grant funds study of effectiveness of vegetation to curb water pollution

Agricultural pollution-prevention devices called riparian buffers are used to mitigate excess nutrients, sediments and pesticides near streambeds

Grant and Award Announcement

PENN STATE

 

IMAGE: THE STUDY WILL INCLUDE BOTH FIELD STUDIES AND COMPUTER MODELING AND WILL BE FOCUSED ON TWO SMALL STREAM BASINS THAT ARE HEAVILY INFLUENCED BY AGRICULTURE AS CASE STUDY WATERSHEDS. THE RESEARCHERS WILL MEASURE AND ANALYZE RIPARIAN BUFFER PERFORMANCE IN THE HEADWATERS OF MAHANTANGO CREEK IN DAUPHIN COUNTY AND IN THE HALFMOON CREEK WATERSHED IN CENTRE COUNTY. view more 

CREDIT: TYLER GROH/PENN STATE.

UNIVERSITY PARK, Pa. —  At a time when Pennsylvania is actively working to achieve water-quality improvements to meet the state’s obligations for cleaning up the Chesapeake Bay, a multidisciplinary Penn State research team is studying whether agricultural pollution-prevention devices called riparian buffers are working properly. 

Riparian buffers — areas adjacent to streams or wetlands that contain a combination of trees, shrubs and grasses — are managed differently from the surrounding landscape to provide conservation benefits. In agricultural areas, buffers intercept sediment, nutrients, pesticides and chemicals of environmental concern in surface runoff and in shallow subsurface water flow to reduce the amounts that get into waterways.

The most recent Watershed Implementation Plan that Pennsylvania submitted to the U.S. Environmental Protection Agency includes 83,000 acres of new riparian buffers along streams on agricultural lands. The estimated cost to establish those buffers exceeds $20 million annually through 2025. Obviously, it would be helpful for state and federal officials to know how effective buffers really are, according to research team leader Heather Preisendanz, associate professor of agricultural and biological engineering.

Questions have emerged about existing buffers’ capabilities, she explained. In a recent survey of 52 buffers at long-term agricultural research sites, 27 were underperforming by as much as 78%, damaged by breaches called concentrated flow pathways. These torrents of varying intensity undermine buffers’ integrity by “short circuiting” them, essentially enabling surface runoff to enter streams untreated.

Such short-circuiting can render the potential pollution-mitigation properties of buffers ineffective in the most extreme cases.

“If we're going to put such a large portion of our eggs into the buffers basket, then we want to make sure that they are performing the way we need them to,” Preisendanz said. “Pennsylvania is relying on forested buffers to meet 49% of its phosphorus-reduction goals and 16% of its nitrogen-reduction goals. If buffers underperform, then Pennsylvania and other states that use them as an integral component of watershed management plans will struggle to achieve load-reduction goals. We definitely need to understand how to make buffers as effective as possible to meet these goals.”

Funded by a three-year, $750,000 grant from the U.S. Department of Agriculture’s National Institute of Food and Agriculture, Preisendanz and colleagues in the College of Agricultural Sciences will evaluate the role that concentrated flow pathways play in undermining the ability of riparian buffers to mitigate excess nutrients, sediments and pesticides. The researchers will also develop solutions for restoring and maintaining buffer integrity.

The study will include both field studies and computer modeling. The team selected two small stream basins that are heavily influenced by agriculture as case study watersheds. They will measure and analyze riparian buffer performance in the headwaters of Mahantango Creek in Dauphin County and in the Halfmoon Creek watershed in Centre County. Both streams are impaired due to agricultural sources of sediment.

Modeling will include new, innovative methods of measuring the volume, intensity and path of runoff using modern GIS tools and drone image mapping. The researchers will evaluate runoff for nutrient, sediment, pesticides and chemicals of environmental concern, determining the extent to which “hot spots” for nutrients and pesticides overlap with concentrated flow pathways drainage areas.

“This will allow the team to identify the most vulnerable locations in the watersheds and offer appropriate solutions for minimizing the impact of these ‘hot spots’ on water quality,” Preisendanz said.

Finally, the researchers plan to conduct farmer surveys to evaluate the willingness of farmers to adopt runoff-control technologies and develop a coupled water quality and socioeconomic model that can inform watershed-scale decision making regarding adoption of new riparian buffers.

Results of the field-based studies will be used to develop and validate computer-based toolkits that can predict the occurrence of concentrated flow pathways, Preisendanz pointed out. “Overall, the results of this project will provide the data and tools needed to restore and maintain buffer integrity,” she said.

Other team members include Patrick Drohan, professor of pedology; Cibin Raj, associate professor of agricultural and biological engineering; Katherine Zipp, associate professor of environmental and resource economics; Daniel Brent, assistant professor in the Department of Agricultural Economics, Sociology, and Education; Tyler Groh, assistant research professor in ecosystem science and management and watershed management specialist for Penn State Extension; and Tamie Veith, agricultural engineer with USDA-Agricultural Research Service Pasture Systems and Watershed Management Research Unit.

Also, Henry Kibuye, a graduate student studying bioenewable systems, has been assigned to this research project. He was selected as a recipient of the Extension Support Assistantship by Penn State Extension.

This illustration shows the fate and transport of pesticide after application in an agroecosystem. It shows how concentrated flow pathways play a major role in contaminating streams.

CREDIT

Penn State

New catalyst could dramatically cut methane pollution from millions of engines

Researchers demonstrate a way to remove the potent greenhouse gas from the exhaust of engines that burn natural gas.

Peer-Reviewed Publication

DOE/SLAC NATIONAL ACCELERATOR LABORATORY

 

IMAGE: TODAY'S CATALYSTS FOR REMOVING UNBURNT METHANE FROM NATURAL GAS ENGINE EXHAUST ARE EITHER INEFFICIENT AT LOW, START-UP TEMPERATURES OR BREAK DOWN AT HIGHER OPERATING TEMPERATURES. A NEW SINGLE-ATOM CATALYST DEVELOPED BY SLAC NATIONAL ACCELERATOR LABORATORY AND WASHINGTON STATE UNIVERSITY SOLVES BOTH THESE PROBLEMS AND REMOVES 90% OF THE METHANE. THIS ILLUSTRATION DEPICTS INDIVIDUAL PALLADIUM ATOMS (WHITE) REMOVING METHANE (WHITE BUBBLES) AT THE SURFACE OF THE CATALYST. view more 

CREDIT: CORTLAND JOHNSON/PACIFIC NORTHWEST NATIONAL LABORATORY

Individual palladium atoms attached to the surface of a catalyst can remove 90% of unburned methane from natural-gas engine exhaust at low temperatures, scientists reported today in the journal Nature Catalysis. 

While more research needs to be done, they said, the advance in single atom catalysis has the potential to lower exhaust emissions of methane, one of the worst greenhouse gases, which traps heat at about 25 times the rate of carbon dioxide. 

Researchers from the Department of Energy’s SLAC National Accelerator Laboratory and Washington State University showed that the catalyst removed methane from engine exhaust at both the lower temperatures where engines start up ­­­and the higher temperatures where they operate most efficiently, but where catalysts often break down. 

“It’s almost a self-modulating process which miraculously overcomes the challenges that people have been fighting – low temperature inactivity and high temperature instability,” said Yong Wang, Regents Professor in WSU’s Gene and Linda Voiland School of Chemical Engineering and Bioengineering and one of four lead authors on the paper. 

A growing source of methane pollution 

Engines that run on natural gas power 30 million to 40 million vehicles worldwide and are popular in Europe and Asia. The natural gas industry also uses them to run compressors that pump gas to people’s homes. They are generally considered cleaner than gasoline or diesel engines, creating less carbon and particulate pollution.

However, when natural-gas engines start up, they emit unburnt, heat-trapping methane because their catalytic converters don’t work well at low temperatures. Today's catalysts for methane removal are either inefficient at lower exhaust temperatures or they severely degrade at higher temperatures. 

“There’s a big drive towards using natural gas, but when you use it for combustion engines, there will always be unburnt natural gas from the exhaust, and you have to find a way to remove that. If not, you cause more severe global warming,” said co-author Frank Abild-Pedersen, a SLAC staff scientist and co-director of the lab’s SUNCAT Center for Interface Science and Catalysis, which is run jointly with Stanford University. “If you can remove 90% of the methane from the exhaust and keep the reaction stable, that’s tremendous.”

A catalyst with single atoms of the chemically active metal dispersed on a support also uses every atom of the expensive and precious metal, Wang added. 

“If you can make them more reactive,” he said, “that’s the icing on the cake.”

Unexpected help from a fellow pollutant 

In their work, the researchers showed that their catalyst made from single palladium atoms on a cerium oxide support efficiently removed methane from engine exhaust, even when the engine was just starting. 

They also found that trace amounts of carbon monoxide that are always present in engine exhaust played a key role in dynamically forming active sites for the reaction at room temperature. The carbon monoxide helped the single atoms of palladium migrate to form two- or three-atom clusters that efficiently break apart the methane molecules at low temperatures. 

Then, as the exhaust temperatures rose, the clusters broke up into single atoms and redispersed, so that the catalyst was thermally stable. This reversible process enabled the catalyst to work effectively and used every palladium atom the entire time the engine was running – including when it started cold.

“We were really able to find a way to keep the supported palladium catalyst stable and highly active and, because of the diverse expertise across the team, to understand why this was occurring,” said SLAC staff scientist Christopher Tassone. 

The researchers are working to further advance the catalyst technology. They would like to better understand why palladium behaves in one way while other precious metals such as platinum act differently. 

The research has a way to go before it will be put inside a car, but the researchers are collaborating with industry partners as well as with DOE’s Pacific Northwest National Laboratory to move the work closer to commercialization. 

Along with Wang, Abild-Pedersen, and Tassone, Dong Jiang, senior research associate in WSU’s Voiland School, also led the work. The work was funded by the DOE Office of Science, and included research carried out at SLAC’s Stanford Synchrotron Radiation Lightsource (SSRL), Argonne National Laboratory’s Advanced Photon Source (APS) and the National Energy Research Scientific Computing Center (NERSC), which are all DOE Office of Science user facilities. 

This article has been adapted from a press release written by Washington State University.

Citation: Dong Jiang et al., Nature Catalysis, 20 July 2023 (10.1038/s41929-023-00983-8)

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SLAC is a vibrant multiprogram laboratory that explores how the universe works at the biggest, smallest and fastest scales and invents powerful tools used by scientists around the globe. With research spanning particle physics, astrophysics and cosmology, materials, chemistry, bio- and energy sciences and scientific computing, we help solve real-world problems and advance the interests of the nation.

SLAC is operated by Stanford University for the U.S. Department of Energy’s Office of Science. The Office of Science is the single largest supporter of basic research in the physical sciences in the United States and is working to address some of the most pressing challenges of our time.

JOURNAL

Nature Catalysis

DOI

10.1038/s41929-023-00983-8 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Dynamic and reversible transformations of sub-nanometer-sized palladium on ceria for efficient methane removal

ARTICLE PUBLICATION DATE

20-Jul-2023

Catalyst can control methane emissions in natural gas engines

Peer-Reviewed Publication

WASHINGTON STATE UNIVERSITY

A catalyst using a single or just a few palladium atoms removed 90% of unburned methane from natural gas engine exhaust at low temperatures in a recent study. While more research needs to be done, the advance in single atom catalysis has the potential to lower exhaust emissions of methane, one of the worst greenhouse gases that traps heat at about 25 times the rate of carbon dioxide.

Reporting in the journal, Nature Catalysis, a research effort between Washington State University and SLAC National Accelerator Laboratory showed that the single-atom catalyst was able to remove methane from engine exhaust at lower temperatures, less than 350 degrees Celsius (662 degrees Fahrenheit), while maintaining reaction stability at higher temperatures.

“It’s almost a self-modulating process which miraculously overcomes the challenges that people have been fighting – low temperature inactivity and high temperature instability,” said Yong Wang, Regents Professor in WSU’s Gene and Linda Voiland School of Chemical Engineering and Bioengineering and a corresponding author on the paper.

Natural gas engines are used in about 30 million to 40 million vehicles worldwide and are popular in Europe and Asia. The gas industry also uses them to run compressors that pump natural gas to people’s homes. They are generally considered cleaner than gasoline or diesel engines, creating less carbon and particulate pollution.

However, when these natural gas-powered engines start up, they emit unburnt, heat-trapping methane because their catalytic converters don’t work well at low temperatures. The catalysts for methane removal are either inefficient at lower exhaust temperatures or they severely degrade at higher temperatures.

“There’s a big drive towards using natural gas, but when you use it for combustion engines, there will always be unburnt natural gas from the exhaust, and you have to find a way to remove that. If not, you cause more severe global warming,” said co-author Frank Abild-Pedersen, a staff scientist at SLAC National Accelerator Laboratory. “If you can remove 90% of the methane from the exhaust and keep the reaction stable, that’s tremendous.”

A single-atom catalyst with the active metals singly dispersed on a support also uses every atom of the expensive and precious metals, Wang added.

“If you can make them more reactive, that’s the icing on the cake,” he said.

In their work, the researchers were able to show that their catalyst made from single palladium atoms on a cerium oxide support efficiently removed methane from engine exhaust, even when the engine was just starting.

They found that trace amounts of carbon monoxide that are always present in engine exhaust played a key role in dynamically forming active sites for the reaction at room temperature. The carbon monoxide helped the single atoms of palladium migrate to form two- or three-atom clusters that efficiently break apart the methane molecules at low temperatures.

Then, as the exhaust temperatures rose, the sub-nanometer-sized clusters re-dispersed to single atoms again so that the catalyst was thermally stable. This reversible process enables the catalyst to work effectively and uses every palladium atom the entire time the engine was running – including when it started cold.

“We were really able to find a way to keep the supported palladium catalyst stable and highly active and because of the diverse expertise across the team, to understand why this was occurring,” said Christopher Tassone, a staff scientist at SLAC National Accelerator Laboratory and co-author on the paper.

The researchers are working to further advance the catalyst technology. They would like to better understand why palladium behaves in one way while other precious metals such as platinum act differently.

The research has a way to go before it will be put inside a car, but the researchers are collaborating with industry partners as well as with Pacific Northwest National Laboratory to someday move the work closer to commercialization.

In addition to Wang, Abild-Pedersen, and Tassone, Dong Jiang, senior research associate in the Voiland School, also led the work. The work was funded by the U.S. Department of Energy’s Office of Basic Energy Sciences.

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JOURNAL

Nature Catalysis

DOI

10.1038/s41929-023-00983-8 

ARTICLE TITLE

Dynamic and reversible transformations of subnanometre-sized palladium on ceria for efficient methane removal

ARTICLE PUBLICATION DATE

20-Jul-2023

UBC Okanagan researchers investigate new use for plastic bottles

Instead of going to a landfill, they may help with future soil stabilization

Peer-Reviewed Publication

UNIVERSITY OF BRITISH COLUMBIA OKANAGAN CAMPUS

For years, unrecycled plastic bottles have been dumped in landfills. Now, thanks to new research from UBC Okanagan, those bottles may have a second life in that landfill—stabilizing its earth walls.

Used plastic bottles and textiles pose an increasing problem for landfills worldwide. Researchers say nearly a hundred million metric tons of polyethylene terephthalate (PET), also known as microplastics, are produced globally each year—with a fraction of that number being recycled—making it one of the largest sources of plastic waste.

“One way we can manage plastic waste is through integrating it into geotechnical construction,” explains doctoral student Alok Chandra. “By finding new ways to use these discarded plastics, we can divert them from landfills and use them to stabilize cover materials within landfills.”

Chandra and his supervisor, UBCO Engineering Professor Dr. Sumi Siddiqua, have developed a new method of incorporating PET waste into clay soil stabilization.

“Due to its nontoxicity, low biodegradability and accessibility, it shows considerable potential for use in landfill designs. However, a considerable amount of research is still required,” says Dr. Siddiqua. “This not only solves the solid waste problem but also increases the economic value of waste and encourages its re-circulation back from already polluted lands and oceans.”

The study suggests the reused material strengthens the soil and serves as a water-resistant layer that will keep pollutants such as lead from escaping the landfill.

“Our results show great potential, but there is still some work to be done before we will integrate the PET waste into landfill soil stabilization management,” says Chandra.

The research is published in the journal Waste Management and funded by the Natural Sciences and Engineering Research Council of Canada Discovery Grants Program.

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JOURNAL

Waste Management

DOI

10.1016/j.wasman.2023.04.030 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Sustainable utilization of chemically depolymerized polyethylene terephthalate (PET) waste to enhance sand-bentonite clay liners

New resources to improve patient and public involvement in health research

Long COVID-based research used to form new tools for maximising involvement from patients and public groups

Peer-Reviewed Publication

UNIVERSITY OF BIRMINGHAM

Patients and members of the public will be able to more easily take part in impactful research thanks to a new tool developed by the University of Birmingham’s work on Long COVID.

These resources are detailed in a paper published today in Nature Medicine from researchers working within the University of Birmingham’s Institute of Applied Health Research, the NIHR Birmingham Biomedical Research Centre (BRC) and NIHR Applied Research Collaboration West Midlands, reporting the evaluation of patient and public involvement and engagement (PPIE) for the Therapies for Long COVID in non-hospitalised individuals (TLC) Study.

Researchers can use the new tool to guide in the planning, implementation and evaluation of projects that work with patient and public groups. The tool draws on best practice and enables researchers to follow checklists to ensure that all aspects of PPIE work are incorporated into research design.

The TLC Study was funded by the UK’s National Institute for Health and Care Research (NIHR) and UK Research and Innovation to investigate the burden of Long COVID on patients, provide a better understanding of the condition, and explore potential interventions. As the long-term effects of Long COVID are yet to be fully understood, involving individuals with lived experiences of the condition was key to the success of the study.

The paper covers the impacts and outcomes of PPIE throughout all stages of research, reflecting on areas of success and improvement – from the development of the grant application and study set up, to study design, the co-creation of data gathering tools and interventions, and the dissemination of the findings.

Researchers faced especially tight time and resource constraints, as the TLC study was conducted in the context of urgent population-level medical need and its outcomes would inform national policy. However, by adopting a flexible approach with public contributors and providing different opportunities and modalities to get involved, the group succeeded in maximising patient involvement within the constraints of the study timeline.

As a legacy of this work, the TLC Study Group created two checklists with key and desirable considerations for PPI to be used in all studies. These are based on items that were deemed the most important by patient partners and researchers involved in the project, and cover all stages and aspects of research.

The full list of domains on the checklists comprises: development of grant proposal, project set-up, study design, undertaking research, dissemination of study findings and engagement, practical considerations, membership of PPIE group, and evaluation of PPIE. By using this tool, other medical researchers will now be able to better plan, implement, and evaluate PPIE for future studies.  

Professor Melanie Calvert, Director of the University of Birmingham’s Centre for Patient-Reported Outcomes Research (CPROR), co-lead of the BRC Patient Reported Outcomes research theme and co-PI for the TLC study, said: “Patient partners play a central role in our research team, helping us understand what matters to them and ways to make our research more inclusive and accessible. Building relationships is key, but it takes time and there is a lot to consider to ensure meaningful engagement. Together with our patient partners, we have summarised key considerations for patient and public involvement in health research. Although we provide checklists, this should not be a tick box exercise – our work aims to support a considered approach to working in partnership with patients and the public to influence and shape research, that can in turn inform care and improve health outcomes.”

Dr Lee Aiyegbusi, Associate Professor at the University of Birmingham’s CPROR, co-lead of the BRC Patient Reported Outcomes research theme, and PPI lead of the TLC study, commented: “The active involvement and engagement of patient partners has had tangible and substantial impacts on the TLC study. We hope that other researchers can draw on our experience and use the checklists which we have developed and reported in this article to facilitate patient and public involvement and engagement in future health research.”

Patient partner Flic Jeyes said: “Research is fantastic in moving the world forward and providing us with evidence to prepare us all for tomorrow. Including PPI in research ensures that studies focus on real life needs, as lived and breathed by real people, and have a tangible impact for the communities we live in.

“Working with the University of Birmingham as a PPI partner to the TLC study I have felt empowered to contribute, while being encouraged to respect my own needs and limitations as someone living with Long COVID. I have been able to grow in confidence, offer suggestions that influenced the direction of the study, and learnt to balance that with a long-term health condition.”

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JOURNAL

Nature Medicine

DOI

10.1038/s41591-023-02445-x 

ARTICLE TITLE

Considerations for patient and public involvement and engagement in health research

ARTICLE PUBLICATION DATE

20-Jul-2023

PCORI makes first funding awards to advance the science on engaging patients, caregivers and other partners in health research

Seven projects to focus on bolstering approaches and measures for effective engagement in research

Grant and Award Announcement

PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE

 

IMAGE: THE PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE (PCORI) IS AN INDEPENDENT NONPROFIT ORGANIZATION AUTHORIZED BY CONGRESS IN 2010. ITS MISSION IS TO FUND RESEARCH THAT WILL PROVIDE PATIENTS, THEIR CAREGIVERS AND CLINICIANS WITH THE EVIDENCE-BASED INFORMATION NEEDED TO MAKE BETTER-INFORMED HEALTH CARE DECISIONS. PCORI IS COMMITTED TO CONTINUOUSLY SEEKING INPUT FROM A BROAD RANGE OF STAKEHOLDERS TO GUIDE ITS WORK. view more 

CREDIT: HTTPS://WWW.PCORI.ORG/ABOUT/GOVERNANCE/TRADEMARK-USAGE-GUIDELINES

WASHINGTON, DC – The Patient-Centered Outcomes Research Institute (PCORI) today announced the approval of $9 million for the first seven studies through its groundbreaking Science of Engagement initiative. An unprecedented research program dedicated to funding studies to demonstrate how best to engage patients, caregivers and other health care community members in comparative clinical effectiveness research (CER) and other health research, the initiative aims to grow a more robust evidence base to advance patient-centered, community-driven approaches to conducting research.

 

Since its establishment in 2010, PCORI has accelerated the movement toward transforming health research into a community-driven, participatory enterprise that involves those who ultimately use and rely on study results as partners throughout the research life cycle. PCORI’s efforts have produced a growing number of resources for building multistakeholder research teams and collaboration in CER studies.

 

Although these and others’ efforts over many years have shown that partner engagement enhances studies in meaningful ways, little systematic evidence exists about why engagement activities achieve the observed effects and which methods are most successful so that those approaches can be employed by others. Additionally, there are critical evidence gaps about how to facilitate and promote inclusion of historically underrepresented populations as partners in patient-centered CER as well as how to measure the impact of including a diverse array of patients and other research partners on study outcomes.

 

“The time is right to catalyze this nascent field of study called the science of engagement in order to transform our nation’s health research enterprise into a truly patient-centered, community-driven endeavor. Such an enterprise engages those who for far too long have been largely left out of health research,” said PCORI Executive Director Nakela L. Cook, M.D., MPH. “As more and more research teams seek to conduct research in a patient-centered way, PCORI’s Science of Engagement initiative addresses the surging demand for data on how to do it robustly, inclusively and genuinely, and for validated and rigorous ways to measure its effects.”

 

The first seven studies funded through this initiative focus on the foundational areas of developing or validating measures of engagement and developing and testing engagement techniques. One project, for example, will develop a survey of co-creation in the design and conduct of studies and another will develop a survey of adolescent engagement in research. Another study will compare methods for engaging children, adolescents and their parents with low health literacy.

 

Several of the projects will consider strategies to improve outreach to and involvement of populations that have been underrepresented in research, including people with limited health literacy skills, people from underserved communities, and children and adolescents.

 

Research teams for all funded studies will participate in a PCORI Science of Engagement Learning Network that will provide opportunities to engage in peer learning and sharing as well as offer lessons learned to the field.

 

PCORI launched the Science of Engagement initiative in 2022 with an initial investment of up to $36 million over three years to bolster development of a toolbox of validated measures of engagement. Future Science of Engagement funding awards will advance evidence on the mechanisms by which engagement techniques contribute to research studies’ processes and outcomes and test which approaches are most effective.

 

“The comprehensive approach and scale with which PCORI has implemented engagement—requiring engagement in all the comparative clinical effectiveness research studies it funds—has served and continues to serve as a laboratory for innovation,” said Harv Feldman, M.D., MSCE, PCORI’s deputy executive director for patient-centered research programs. “PCORI is building on its important work in this area to date to advance a systematic understanding of how to most effectively conduct engagement in research with different individuals and communities. This will strengthen patient-centered, community-driven CER as well as benefit the entire health research enterprise.”

 

The Science of Engagement funding awards were approved pending a business and programmatic review by PCORI staff and the issuance of formal award contracts. With these latest awards, PCORI has invested more than $4 billion to fund patient-centered CER and support other projects designed to enhance CER methods, engagement, dissemination and implementation, and the infrastructure necessary to conduct CER efficiently. Details of all studies and projects approved for PCORI funding to date are available on PCORI’s website.

 

About PCORI  

The Patient-Centered Outcomes Research Institute (PCORI) is an independent nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions. PCORI is committed to continuously seeking input from a broad range of stakeholders to guide its work. 

Wake Forest University School of Medicine approved for $4.4 million PCORI funding award to study telehealth

Grant and Award Announcement

ATRIUM HEALTH WAKE FOREST BAPTIST

WINSTON-SALEM, N.C. – July 20, 2023 – A team of researchers at Wake Forest University School of Medicine has been approved for a $4.4 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to assess the benefits of expanding telehealth by primary care physicians to children with complex chronic conditions and their caregivers. The project is a collaboration with Atrium Health Wake Forest Baptist Brenner Children's in Winston-Salem and Atrium Health Levine Children’s in Charlotte.

The award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract. 

Telehealth experienced a rapid expansion with the COVID-19 pandemic, but questions remain about the most effective, evidence-based ways to incorporate telehealth as part of routine care, especially in chronic disease management, and how best to mitigate health disparities.

“In-person appointments can be incredibly challenging for families with medically fragile children,” said Savithri Nageswaran, MBBS, professor of pediatrics at Wake Forest University School of Medicine and co-principal investigator of the study. “Caregivers often must miss work to attend the many in-person appointments these children need, which can cause a financial strain. There’s also an enormous amount of planning ahead of time, given the medical complexity of the child, with feeding and medicines.”

Researchers will conduct a multicenter randomized control trial to test the benefits of a telehealth intervention called enhanced primary care (E-PRIME) at 36 primary care pediatric offices across North Carolina.

The research team plans to enroll 400 children who will be randomized to either the early (first six months of the study) or delayed implementation (later six months of the study) of E-PRIME.

“Our primary objective is to improve the delivery of care to these children,” said Sabina Gesell, Ph.D., professor of social sciences at Wake Forest University School of Medicine and co-principal investigator of the study. “We would really like to understand health disparities in this population, and we expect to recruit at least 180 children from minority groups.”

The research team will evaluate the effectiveness of E-PRIME by measuring hospitalizations, emergency room visit rates and caregiver stress. All participants will be followed for one year.

“This study was selected for PCORI funding for its potential to answer the need for real-world evidence about how best to incorporate telehealth into the primary care of people with multiple chronic conditions and how this may differ among populations at risk for health disparities,” said Nakela L. Cook, M.D., the executive director of PCORI. “We look forward to following the study’s progress and working with Wake Forest University School of Medicine to share the results.”  

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health-care decisions.

FOR PROFIT HEALTHCARE U$A

New findings show private equity investments in healthcare may not lower costs or improve quality of care

A research team supervised by a health policy researcher at the University of Chicago has found that increasingly common private equity investments in healthcare are generally associated with higher costs to patients and payers.

Peer-Reviewed Publication

UNIVERSITY OF CHICAGO MEDICAL CENTER

A research team supervised by a health policy researcher at the University of Chicago has found that increasingly common private equity investments in healthcare are generally associated with higher costs to patients and payers. That’s according to a new study published July 19 in The BMJ. The study is thought to be the first systematic review of global private equity ownership trends in medical settings.

“Over the last few decades, private equity activity in healthcare has exploded, with financial institutions buying up hospitals, nursing homes and fertility clinics — pretty much every area of healthcare,” said Joseph Dov Bruch, PhD, Assistant Professor of Public Health Sciences at UChicago, who is the study’s co-senior author. “News reports have highlighted increasing investment by private equity and a number of studies have set out to examine the phenomenon, but until now there has been no large systematic review of global private equity activity in healthcare. This study is intended to fill that gap.”

Private equity funding can come from multiple types of institutions, with different firms implementing varying investment strategies. As a result, Bruch said, the team wanted to review broad trends to gauge impact on the healthcare sector as a whole rather than limiting analysis to a specific setting.

Although the influence of the financial sector has grown across many fields, “private equity is uniquely interested in healthcare because of the many loopholes and cost-cutting strategies that exist within this industry,” said Bruch.

Performing a global search, Bruch and his research team found 55 previous academic research studies that investigated private equity in healthcare and performed a systematic review across four dimensions: healthcare quality, cost to payers and patients, cost to healthcare operators and health outcomes. They found that in every studied healthcare setting, private equity acquisitions have increased in prevalence since 2000. Across the four dimensions, private equity investment was most closely associated with up to a 32 percent increase in costs for payers and patients. Private equity ownership was also associated with mixed to harmful effects on healthcare quality, while the impact on health outcomes and operator costs was inconclusive.

Proponents of private equity have argued the cash infusions from financial firms provide direct downstream benefits for patients. However, this hypothesis was not supported by the results of the team’s review. The authors did not identify any consistently beneficial impacts of private equity ownership.

“The fact that we are not seeing improvements means we’re not seeing clear indications that private equity makes healthcare more efficient by reducing administrative burden, streamlining processes or offering technology advances,” said Bruch.

The researchers hope the study will make healthcare providers, policymakers and members of the public more aware of the growing influence of the financial sector in the healthcare system. In addition, the team said, healthcare providers may need to pay more attention to the financial burden placed on patients. And the researchers said they believe their findings may spark greater policymaker discussion on antitrust regulation and corporate practice of medicine laws.

While patients may not be able to identify specific changes in the care they receive, Bruch said it is good to be aware that one’s hospital, nursing home, doctor’s office or fertility treatment center may be owned by private equity and that these firms have specific financial targets that may inform care decisions.

“Private equity has been made to be a bogeyman,” said Bruch. “It certainly is an important financial actor growing in activity, and evidence suggests it should raise important concerns for patients, but it is a symptom of a health system that is becoming increasingly financialized.”

The team is continuing their research to examine the role of venture capital, management consultants, financial lenders and real estate investment trusts in healthcare.

The study, “Evaluating trends in private equity ownership and impacts on health outcomes, costs, and quality: systematic review,” was published in The BMJ in July 2023. Study co-authors include Alexander Borsa of Columbia University, Geronimo Bejarano of the University of Texas, and Moriah Ellen of the University of Toronto and the Ben-Gurion University of the Negev.

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JOURNAL

BMJ

DOI

10.1136/bmj-2023-075244 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Evaluating trends in private equity ownership and impacts on health outcomes, costs, and quality: systematic review

ARTICLE PUBLICATION DATE

19-Jul-2023