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Wednesday, June 3, 2015

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UMD Study Finds Connecting Uninsured Patients to Primary Care Could Reduce ER Use

May 6, 2015

Kelly Blake 301-405-9418
Hillery Tsumba 301-628-3425

Montgomery County, Md. Initiative Could Improve Health, Reduce Costs

COLLEGE PARK, Md. – An intervention to connect low-income uninsured and Medicaid patients to a reliable source of primary health care shows promise for reducing avoidable use of hospital emergency departments in Maryland. A University of Maryland School of Public Health study evaluating the results of the intervention was published this week in the May issue of the journal Health Affairs

For twenty years, use of hospital emergency departments has been on the rise in the United States, particularly among low-income patients who face barriers to accessing health care outside of hospitals, including not having an identifiable primary health care provider. Almost half of emergency room visits are considered “avoidable.” The Emergency Department-Primary Care Connect Initiative of the Primary Care Coalition, which ran from 2009 through 2011, linked low-income uninsured and Medicaid patients to safety-net health clinics. 

“Our study found that uninsured patients with chronic health issues – such as those suffering from hypertension, diabetes, asthma, COPD, congestive heart failure, depression or anxiety – relied less on the emergency department after they were linked to a local health clinic for ongoing care,” says Dr. Karoline Mortensen, assistant professor of health services administration at the University of Maryland School of Public Health and senior researcher. “Connecting patients to primary care and expanding the availability of these safety-net clinics could reduce emergency department visits and provide better continuity of care for vulnerable populations.”  

Funded by a grant from the Centers for Medicare & Medicaid Services and the Maryland Department of Health and Mental Hygiene, the initiative engaged all five of the hospitals operating in Montgomery County, Maryland at the time, and four safety-net clinics serving low-income patients. Using “patient navigators,” individuals trained to help patients find the care they need and can afford, these hospitals referred more than 10,000 low-income, uninsured and Medicaid patients who visited emergency departments to four local primary care clinics, with the goal of encouraging them to establish an ongoing relationship with the clinic and reduce their reliance on costly emergency department care. 

Two hospitals in Montgomery County who participated in the intervention continued the program after the initial grant period concluded because of the benefits they saw for patients and for reducing emergency department visits and associated costs. These hospitals are currently testing a new version of the intervention specifically deigned to link emergency department patients with behavioral health conditions to appropriate community-based services. 

While hospital administrators and health policy experts throughout the country are recognizing that access to primary care improves continuity of care for patients and reduces avoidable use of emergency departments, the implications of this project are particularly important for hospitals in Maryland, which are now operating under a unique all-payer model for hospital payments. Within this new payment structure, Maryland hospitals will have to meet ambitious spending, quality of care, and population health goals. Reducing avoidable use of emergency departments can help in reaching these goals.

The project provides promise not only for hospitals in Maryland but throughout the nation to improve health care experiences and outcomes for their patients. Shared learning systems were an integral component of the project so participants were learning from each other and sharing best practices throughout the project and that learning has now been documented and can be replicated in other communities.

“This was an incredibly rewarding project to work on,” says Barbara H. Eldridge, Manager of Quality Improvement at the Primary Care Coalition. “We created a learning system that permits us to sustain improved communication between patients and their providers, between hospital discharge planners and community based clinics, and across five hospitals operating in Montgomery County.” The initiative has proven successful in Montgomery County, Maryland and is being replicated in communities in other parts of the country. 

“Linking Uninsured Patients Treated In The Emergency Department To Primary Care Shows Some Promise In Maryland” was written by Theresa Y. Kim, Karoline Mortensen, and Barbara Eldridge and published in the journal Health Affairs

University Launches Dynamic, Interactive Information Website UMD Right Now

December 4, 2012

Crystal Brown 301-405-4618 crystalb@umd.edu

College Park, Md. – Today, the University of Maryland launched a brand-new multimedia news and information portal, UMD Right Now, which provides members of the media and the public with real-time information on the university and its extended community.

UMD Right Now replaces Newsdesk, which previously served as the university’s news hub and central resource for members of the media. The new site is aimed at reaching broader audiences and allows visitors to keep up with the latest Maryland news and events, view photos and videos and connect with the university across all of its social media platforms.

“We designed UMD Right Now to be a comprehensive, vibrant site where visitors can find new and exciting things happening at Maryland,” said Linda Martin, executive director, Web and New Media Strategies. “Through social media, video, photos and news information, we hope to engage visitors and compel the community to explore all that Maryland has to offer.”

The new website, umdrightnow.umd.edu, contains up-to-date news releases and announcements, facts and figures about the university, a searchable database of faculty and staff experts, information highlighting innovation and entrepreneurship at UMD, additional resources for news media and other campus and athletics news.

“UMD RightNow is the place to go to find out all the things happening on and around campus on any given day,” said Crystal Brown, chief communications officer. “This website brings real-time news, events and information right to your fingertips.”

For more information and contact information for the Office of University Communications, please visit umdrightnow.umd.edu.

UMD Teams Awarded More Than Five Million Dollars to Improve Power Plant Cooling

June 2, 2015

Jennifer Rooks 301-405-1458
Lee Tune 301-405-4679

COLLEGE PARK, Md. – The U.S. Energy Department’s Advanced Research Projects Agency-Energy (ARPA-E) has awarded two University of Maryland research teams more than five million dollars in funding to improve power plant cooling technologies.

Image of a classic coal fired power plantThe majority of electricity used in the U.S. is produced by steam-driven turbine generators that rely on water cooling systems that collectively use billions of gallons of water each day. Dry-cooling systems - which use air to cool and transfer waste heat – are a potentially transformational alternative, with multiple environmental and energy advantages. However, to date, significant technical and market challenges have hindered the widespread use of dry-cooling technologies.

The UMD projects are 2 of 23 funded as part of a $60 million investment by ARPA-E's Advanced Research in a Dry Cooling (ARID) program to spur transformative new power plant cooling technologies such as innovative, ultra-high-performance air-cooled heat exchangers and supplemental cooling systems and/or cool-storage systems that can cost-effectively and efficiently reject waste heat.

The first project, "Novel Microemulsion Absorption Systems for Supplemental Power Plant Cooling," aims at developing an absorption cooling systems for power plants which utilizes a novel microemulsion liquid absorbent.

Led by Department of Mechanical Engineering Associate Professor Bao Yang, the project's principal investigators include Professor Michael Ohadi and Minta Martin Professor Reinhard Radermacher, who is also the director of UMD’s Center for Environmental Energy Engineering. The team will also work with partners at Stony Brook University, the Electric Power Research Institute, WorleyParsons Group and Rocky Research.

"It is a team effort," Yang said. "Each partner has unique technical expertise to bring to this project."

Yang's team and its partners will use a novel microemulsion liquid absorbent, recently invented by the UMD researchers for use in absorption cooling systems for power plants. These materials absorbents can absorb water vapor (refrigerant), and release the water as liquid during desorption, thus achieving a high coefficient of performance. Waste heat from the power plant flue gas will drive the microemulsion cooling system to provide supplemental cooling below the ambient temperature.

The second project, led by Professor Michael Ohadi, "Novel Polymer Composite Heat Exchanger for Dry Cooling of Power Plants," also targets improving power plant cooling technologies through the development and application of new composite heat exchangers that use a low-cost, high conductivity medium encapsulated in a polymeric material that is highly durable, low cost and has a high resistance to corrosion.

Ohadi's UMD team includes Professor Hugh Bruck, Associate Research Scientist Serguei Dessiatoun and Assistant Research Scientist Amir Shooshtari, who will serve as co-PIs, along with Professor Joshua Pearce at Michigan Technological University and Dr. Arun Muley at Boeing Research and Technology, Huntington Beach. Dr. Justin Zachary at ExperTech Engineering Corp. will serve as consultant on the power plant feasibility studies and serve as the link between the project and the power plant community.

The team's novel polymer composite heat exchangers for indirect air cooling of power plants are superior to current state-of-the-art metallic heat exchangers in terms of cost, performance, lifespan and corrosion resistance. In addition, the team can keep production and assembly costs low by using onsite additive manufacturing (3-D printing) technologies.

“These new projects emphasize ARPA-E’s commitment to developing a wide range of technology   options to ensure a more affordable and sustainable energy future,” said ARPA-E Director Dr. Ellen D. Williams. “Investing in innovative dry cooling technologies for power plants as well as intermediate density fusion illustrates ARPA-E’s role in accelerating energy research and development.”

Both Yang and Radermacher are also part of two additional ARPA-E funded projects awarded in December 2014 as part of a new federally-funded research initiative to design and create personal technologies for keeping individuals comfortably cool or warm, while shrinking the energy needs of the buildings they occupy.

Yang, Ohadi and Dessiatoun are faculty in the Center for Environmental Energy Engineering. In addition, Yang, Ohadi and Radermacher are also members of the University of Maryland Energy Research Center.

PALS Delivers One Million Dollars in Project Value to Maryland Communities

June 2, 2015

Maggie Haslam 202-258-8946

UMD students present year-end sustainability projects to College Park and City of Frederick for UMD’s Partnership for Action Learning in Sustainability 

COLLEGE PARK, Md. — Sixteen disciplines. Three hundred and fifty students. Nearly one million dollars in project value. This year, a new campus-wide program proved its strength in numbers, delivering sustainable solutions to environmental, social and economic challenges to two Maryland cities. Twenty-nine projects—which ranged from calculating greenhouse gas emissions to re-envisioning a downtown block—were the culmination of coursework from the inaugural year of the University of Maryland’s Partnership for Action Learning in Sustainability, or PALS. 

Developed by the University’s National Center for Smart Growth, PALS pairs faculty expertise and student ingenuity with sustainability challenges facing Maryland communities. The PALS mission is to provide high quality, low-cost assistance to local governments while creating an active and valuable real-world learning experience for UMD students.  PALS initiated its first partnership with The City of Frederick, Maryland in September of 2014, adding a second, smaller collaboration with College Park in January. 

An interdisciplinary course that combines architecture, sculpture and urban planning, entitled “Making Place: Public Art & Design on the Border, challenged students to explore City-University connections through guerilla art and urban whimsy.  PALS students, faculty and administrators presented their second semester project findings to city officials, campus administrators and community stakeholders at public events in each city this past month. The year-end presentations offered both cities a snapshot of work and effort by the students, whose goal was to provide information and analysis that will help influence decision-making down the line, as well as offer recommendations for possible action. 

The College Park presentation, which took place May 21, provided an overview of four projects addressing specific goals identified by the city: a calculation of College Park’s annual greenhouse gas emissions; designs for a new City Hall-University building; an examination of waste management practices; and how thought-provoking public art can bridge the town-gown relationship.

Students from Professor Robert Nelson’s public policy course, who addressed greenhouse gas emissions with the assistance of Environmental Finance Center Program Manager Sean Williamson, proposed a new initiative, the Small Town Energy Program (STEP) as a way to continue the City’s trend of lowering its emissions. Modeled after successful programs in peer communities like University Park, the STEP Program would use a minimalist budget to provide residents audits and energy coaches, banking on the notion that most residents want to lower energy costs and shrink carbon footprints.

“I’m excited that we’re doing this and excited to see this presentation,” said College Park Councilman P.J. Brennan. “Reducing our greenhouse gas initiatives is a key goal for the City and this is an important step.” 

“This partnership goes beyond our land grant mission as a university because the City of College Park is our home,” said Uri Avin, Director of the PALS Program. “Our students feel a duty and desire to make College Park a more vibrant, connected community. PALS is one way we can collaborate with the City to achieve that goal.” 

Students from the College Park Scholars program brainstorm ideas to simplify composting efforts for Frederick restaurantsFrederick’s event on May 25 highlighted seven of the nine spring projects developed by the Program, with several projects zeroing in on the more industrialized East Frederick area, exploring ways to connect the city, spur job growth and create a strong sense of place. A number of the teams consulted peer projects in developing their recommendations, a testament to the program’s interdisciplinary reach. 

“What sets PALS courses apart from a typical learning experience is that we are working in tandem with all these other courses across campus,” explains Assistant Professor of Architecture Jana Vandergoot. “We’ve had so many great interactions between faculty and students from other programs. It’s been a bit of a game-changer for my students.”

“The exercises we completed in this class were unlike any I’ve ever experienced in or outside academic work,” explained UMD sophomore Matthew Reilly, whose College Park Scholars course created a composting and organics recovery plan for Frederick restaurants. Reilly’s classmate, Austin Font, added, “It taught me to consider and think in different ways and I find myself applying that thinking to situations everywhere now. It was a great opportunity.”

Frederick will benefit from one final course this summer, an urban planning studio taught by Professor Jim Cohen that will utilize the work conducted this past year to offer recommendations for enhancing Frederick’s existing sustainability plan. PALS commences a new partnership with Howard County this fall and plans to unveil coursework later this summer. 

“PALS has been a great partnership and has provided invaluable information for our City; we’ll be able to use it for a long time coming,” said Frederick Mayor Randy McClement. “I think it shows what a true partnership in education can do.” 

To learn more about PALS, visit www.smartgrowth.umd.edu/pals.html

Annual HCIL Symposium Highlights Latest in Technology Research & Innovation

June 1, 2015

Tom Ventsias 301-405-5933

More than 200 attend 32nd annual event featuring wearable technology, data visualization and more 

COLLEGE PARK, Md. – From wearable technology that teaches kids about human anatomy, to digital tools that let medical professionals quickly visualize electronic health records, the annual Human-Computer Interaction Lab (HCIL) Symposium at the University of Maryland highlighted the latest in research, innovation and education related to how people interact with technology.

The 32nd annual event held last week was hosted by UMD's College of Information Studies (iSchool), the Institute for Advanced Computer Studies (UMIACS), and the College of Computer, Mathematical, and Natural Sciences (CMNS), and featured presentations, tutorials, and workshops for more than 200 attendees. 

June Ahn, iSchool and College of Education, will assume the role of director of HCIL on July 1. One of the workshops highlighted EventFlow, a unique application that helps users explore and analyze patterns-of-point and interval-based events from patient history records and other information sources. Developed by Distinguished University Professor of Computer Science, Ben Shneiderman, and HCIL Associate Director of Research, Catherine Plaisant, EventFlow offers a novel solution for displaying events, simplifying their visual impact, and making meaningful queries.

“We’ve made great strides in the past year to improve EventFlow to meet the diverse needs that emerged from 18 case studies,” says Shneiderman, who was the founding director of HCIL from 1983 to 2000.

Studying event sequences has been very difficult until now, Shneiderman adds, but EventFlow has opened up vast possibilities for research in medical histories, cybersecurity, e-commerce customer histories, and social media logs.

In one of the symposium’s plenary talks, Jon Froehlich, an assistant professor of computer science, discussed a series of wearable visualizations that include a “smart” jersey called Social Fabric Fitness for visualizing live fitness data, and a shirt called BodyVis aimed at helping children learn about their bodies and healthy living.

Niklas Elmqvist, iSchool and UMIACS, presents his research on visualization on devices other than a traditional desktop computer.

With BodyVis, students can discover their own anatomy through sensors and interactive displays that are attached to the clothing they wear, Froehlich says. For example, a life-sized pair of lungs on a shirt would light up to show how air flows in and out of a child’s lungs in tandem with their breathing.

Froehlich, the principal investigator on the project, is working with Tamara Clegg, an assistant professor in the College of Education and the iSchool, Leyla Norooz, a first-year doctoral student in the iSchool, and Seokbin Kang, a first-year doctoral student in computer science. 

In another plenary talk, Niklas Elmqvist, an associate professor in the iSchool and program director of the HCI Masters program, discussed his research on how people can make better use of the increasingly diverse ecosystem of digital devices that they carry with them.

This includes devices such as smartphones, Google Glass, Microsoft HoloLens, and smart watches, as well as those devices that people are increasingly encountering in their                                                                          physical surroundings such as large displays, depth                                                                                cameras, and motion capture systems.

Elmqvist also highlighted several research projects he is collaborating on, including Proxemic Lenses, where movie industry motion capture equipment is used to fully track the location and posture of people in a 3-D space; QR-Vis, where QR-codes are used to let people download visualizations and data to their devices without the need for a network connection; and DataCube/SenseDesk, where an entire office cubicle becomes an intelligent sense-making environment.

UMD Study Finds Online Hookup Sites Increase HIV Rates in Sometimes-Surprising Ways

May 29, 2015

Greg Muraski 301-405-5283

COLLEGE PARK, Md. – The introduction of Craigslist led to an increase in HIV-infection cases of 13.5 percent in Florida over a four-year period, according to a new study conducted at the University of Maryland's Robert H. Smith of Business. The estimated medical costs for those patients will amount to $710 million over the course of their lives.

Online hookup sites have made it easier for people to have casual sex—and also easier to transmit sexually transmitted diseases.  The new study measured the magnitude of the effect of one platform on HIV-infection rates in one state, and offered a detailed look at the varying effects on subpopulations by race, gender and socio-economic status. Looking at the period 2002 to 2006, it found that Craigslist led to an additional 1,149 Floridians contracting HIV.

The study "underscores the need for broader communication and dissemination of the risks posed by the type of online matching platforms studied here," noted Ritu Agarwal, a professor at the University of Maryland's Robert H. Smith School of Business and founding director of the Center for Health Information and Decision Systems (CHIDS), and Brad N. Greenwood, a 2013 Smith Ph.D. and assistant professor at Temple University’s Fox School of Business.

The study also found that the new HIV cases came disproportionately from one racial-ethnic group, African Americans, who accounted for some 63 percent of the new cases. "That is a bit of paradox," says Agarwal, "because research suggests that the African American community is one which uses the Internet the least, even though the gap is narrowing."

Greenwood described African Americans as suffering the effects of a "double digital divide." He said, "Not only have studies shown there is lower utilization of the Internet for welfare-enhancing activities, but now there's evidence of utilization for negative activities as well."

Craigslist's arrival in different cities and different counties at different times made it possible to isolate the effects of the matching platforms; the phased rollout amounted to a "natural experiment." (Other matching sites, like Grindr or Tinder, have tended to become available across broad areas all at once, although neither of those platforms existed when this study was done, and Craigslist remains the largest). Agarwal and Greenwood focused on whether there was a change in HIV cases in the first full calendar quarter after Craigslist’s arrival in a county or city. For patient data, the researchers drew on a census that included data on some 12 million patients; omitting institutions that had no HIV cases or which were open for only part of the period studied, there were 223 hospitals in the sample. 

There was also an increase in new HIV cases among Latinos and Caucasians—although only intermittently statistically significant and not statistically different from each other. The lack of difference between Latinos and Caucasians was notable, as Latinos have a higher baseline rate of HIV infection. One explanation could be that fewer Latinos may have sought treatment. Or Florida's Latino community, which is especially large and well-off, may not be reflective of national trends.

Another counterintuitive result was that more cases came from non-Medicaid patients, the wealthier patients, than from the population covered by the government program.  That was the case even though the base rate of HIV infection is higher among lower-income citizens. “It could be the case that higher-income people face a higher social penalty for engaging in casual, quasi-anonymous sex, and that the freedom of internet anonymity changes their behavior more than it does for the less wealthy,” Agarwal suggested. "Or it could be a byproduct of substantially better internet access." (Together with the finding for African Americans, that would suggest that degree of internet access affects different sub-populations in different ways).

HIV-prevention efforts tend to focus on the highest-risk populations, such as the economically disadvantaged, but public-health officials should be aware than online platforms may be "changing the game," says Agarwal.

Perhaps most surprising of all, given the relatively high rates of infection among bi- and homosexual men, there was not a statistically significant difference in HIV-infection-rate increases across men and women.

It could be the case that homosexual men with HIV who used Craigslist were more likely to practice safe sex than infected heterosexuals, the authors speculated. Or matching platforms may lead to more homosexual activity by men who do not identify publically as homosexuals, who then spread the virus to their female partners. The question demands more research, the authors said.

Agarwal and Greenwood were careful to note that they weren't making a statement about the overall value of Craigslist. Nevertheless, the study offers a reminder of the downside of connectivity. "While there is a general belief that connectivity is good on average, unfortunately 'on average' means that some people are going to benefit more and others are going to lose more," Agarwal says.  “We need to better understand both the beneficial as well as the punitive effects of the Internet on individual and public health."

"Matching Platforms and HIV Incidence: An Empirical Investigation of Race, Gender, and Socio-Economic Status," by Brad N. Greenwood and Ritu Agarwal, is forthcoming in Management Science. Read more here

UMD Study Finds Climate Change Debate Fueled by 'Echo Chambers'

May 27, 2015

Laura Ours 301-405-5722

COLLEGE PARK, Md. — A new study from researchers at the University of Maryland (UMD) and the National Socio-Environmental Synthesis Center (SESYNC) demonstrates that the highly contentious debate on climate change is fueled in part by how information flows throughout policy networks.

The UMD and SESYNC researchers found that “echo chambers”—social network structures in which individuals with the same viewpoint share information with each other—play a significant role in climate policy communication. The researchers say that echo chambers may help explain why, despite a well-documented scientific consensus on the causes and drivers of global changes in climate, half of U.S. senators voted earlier this year against an amendment affirming that climate change is human-induced. 

“Our research shows how the echo chamber can block progress toward a political resolution on climate change. Individuals who get their information from the same sources with the same perspective may be under the impression that theirs is the dominant perspective, regardless of what the science says,” said Dr. Dana R. Fisher, a professor of sociology at UMD and corresponding author who led the research.

In summer 2010, researchers surveyed the most active members of the U.S. climate policy network, including members of Congress and leaders of non-governmental organizations and business and trade unions. Respondents were asked questions about their attitudes toward climate science and climate policy, as well as questions to establish their policy network connections. For example, respondents were asked to identify their sources of expert scientific information about climate change and with whom they collaborate on a regular basis regarding the issue of climate change.

“This time period was particularly interesting for studying climate policy because legislation regulating carbon dioxide emissions had passed through the House of Representatives and was being considered in the Senate. If passed, this bill would have been the first case of federal climate legislation passing through the U.S. Congress,” said Fisher.

The researchers then used an exponential random graph (ERG) model—a complex statistical model for analyzing data about social and other networks—to test for the presence and significance of echo chambers among members of the U.S. climate policy network. In the “echo,” two people who have the same outlook or opinion on a relevant issue share information, reinforcing what each already believes. In the “chamber,” individuals hear information originating from one initial source through multiple channels.

“The model we used gives us a framework for empirically testing the significance of echo chambers,” said Dr. Lorien Jasny, a computational social scientist at SESYNC and lead author of the paper. “We find that the occurrences of echo chambers are indeed statistically significant, meaning our model provides a potential explanation for why climate change denial persists in spite of the consensus reached by the scientific community.”

The researchers say that echo chambers explain why outlier positions—for example, that climate-warming trends over the past century are likely not due to human activities—gain traction in the political sphere. The answer lies in the disproportionate connections among ideologically similar political communicators.

“Information has become a partisan choice, and those choices bias toward sources that reinforce beliefs rather than challenge them, regardless of the source’s legitimacy,” Fisher said.

Jasny and Fisher point out that the debate on climate change is not indicative of inconclusive science. Rather, the debate is illustrative of how echo chambers influence information flows in policy networks.

“Our research underscores how important it is for people on both sides of the climate debate to be careful about where they get their information. If their sources are limited to those that repeat and amplify a single perspective, they can’t be certain about the reliability or objectivity of their information,” said Jasny.

The research paper, “An empirical examination of echo chambers in US climate policy networks,” Lorien Jasny, Joseph Waggle, and Dana R. Fisher, will be published online May 25 in the journal Nature Climate Change


June 3
New UMD study provides an exciting preview in advance of New Horizons flyby.  Read
June 2
UMD projects are 2 of 23 funded as part of a $60 million investment by ARPA-E's Advanced Research in a Dry Cooling... Read
June 2
UMD students present year-end sustainability projects to College Park and City of Frederick for UMD’s Partnership for... Read
June 1
More than 200 attend 32nd annual UMD event featuring wearable technology, data visualization and more. Read