In the College of Nursing, Monday could be renamed Research Day. Collaboratively established by four senior faculty members and coordinated through the Center for Research and Scholarship, a noon to 1 p.m. Monday Research Forum is now a regularly scheduled event in the college.
While some weeks are dedicated to inviting scholars and outstanding researchers from other institutions, Mondays are also an excellent time for college faculty and research associates to learn about new projects, ongoing efforts and opportunities for collaboration within the college and across Ohio State.
“I hope we can begin to think of research and innovation in a new way,” said Happ. “We don’t have the luxury of studying research for the sake of general knowledge. There is too much human suffering. There are many people with serious health conditions and illnesses that require us to examine methods to prevent disease and improve healing. We must systematically utilize a scientific method that can improve patient care, speed healing and promote optimum health and wellness.”
On a recent Monday in April, Research Forum attendees heard several new faculty members offer an overview of their current and upcoming research projects and programs.
Shannon Gillespie, PhD, RN, assistant professor
Assistant Professor Shannon Gillespie is working on a study to identify novel biomarkers for the prediction of preterm birth. “We currently have only a foggy picture of who is a risk,” she explained to her new colleagues.
For this study, she is focused on the inflammatory pathway to preterm birth, with an additional eye on markers of risk that may trace to alternative preterm birth pathways. In a recent study of 92 African-American women assessed at 28 to 30 weeks of pregnancy and followed to birth, about 50 provided consent for this additional work and had a natural (spontaneous) birth. Ten percent of these women gave birth preterm. Gillespie will compare the epigenomes of women with preterm birth and full-term birth to determine if there are signals unique to women who go on to give birth preterm. Discovering screening biomarkers in pathways active in the disease process could allow, for the first time, targeted prevention of preterm birth.
While a doctoral student, Gillespie also worked on a study that measured how a biomarker called brain-derived neurotropic factor (BDNF) affects pregnant women. The study, published in the journal Psychoneuroendocrinology, showed that low BDNF levels precede depression in the mother and low birth weight in the baby. These findings were exciting for Gillespie because they meant that testing biomarkers in pregnant women, such as BDNF levels, could predict complications before they happen, in order to help prevent them. She is currently developing a program in precision health in pregnancy “to help clinicians select the right preventive intervention for the right obstetric patient at the right time, by developing screening tools for use in pregnancy,” she said.
Her efforts were inspired by a family experience with cancer. “Cancer care has been transformed by the precision health approach, which allows clinicians to optimize care of their patients by taking into account tumor biology and individual differences in the patients,” she said. “We’ve not yet made these strides in prenatal care. The impact of this approach could be considerable.”
Lynda Hardy, PhD, RN, FAAN
Lynda Hardy joined the College of Nursing in April as director of data science and discovery and a clinical associate professor.
She has had a diverse research career in cardiovascular health, women and children’s health issues, and infectious diseases, and she is now utilizing big data with an eye towards disease prevention.
“I want to be able to maximize data that has already been collected to determine methods of disease prevention in order to promote wellness,” Hardy said. Dean Melnyk’s focus on wellness in the College of Nursing and across The Ohio State University was a driving factor in Hardy's decision to relocate to Ohio State from the University of Tennessee College of Nursing, where she served as associate dean for research. “This is an exciting time in healthcare. The intersection of the nursing profession and data science will provide evidence-based methods for disease prevention and provide better patient outcomes.”
Hardy also has extensive experience in research administration, most recently serving as senior program director at National Institutes of Health/National Institute of Nursing Research (NIH/NINR).
“We are so thrilled to have someone with Dr. Hardy’s experience, skill and vision in our Center for Research and Scholarship,” said Mary Beth Happ, PhD, RN, FAAN, associate dean for research and innovation and distinguished professor of critical-care research. “She hit the ground running at Ohio State by providing thoughtful critique and guidance to faculty research proposals and collaborating across campus as a member of the Data Analytics and Brain Science Discovery [research] theme interprofessional faculty groups.”
“I look forward to mentoring faculty investigators to help them develop a better understanding of navigating the grants process,” said Hardy.
Lisa Militello, PhD, MPH, RN, CPNP, assistant professor
Lisa Millitello’s current research project is focused on improving healthy lifestyle behaviors in families with pre-school children, utilizing text messages and other personal software to limit childhood obesity.
Tara O’Brien PhD, RN, CNE, assistant professor
“Our lives are typically organized by a system of routines and events that are interrelated,” explained O’Brien, who is studying how to increase the activity level of kidney transplant recipients. Previous studies have demonstrated better outcomes for transplant patients who exercise regularly.
O’Brien’s’ current study, "Increasing Activity Post-Kidney Transplant with System CHANGE," includes 60 transplant patients who are randomly placed in either the control group or the study group. Patients in the control group receive a document that explains the standard of care for kidney transplant patients along with an activity tracker.
Patients in the study will be learning about methods to change their behaviors to increase activity, utilizing a program called System CHANGE, originally developed by researchers at Case Western University. Study participants meet with an intervention specialist who helps them identify a method for increasing their daily activity. They are encouraged to examine their daily, weekly and monthly routines, including the friends and family with whom they spend time. They develop techniques for increasing their daily number of steps based on changes in their routines. “The solution must not focus on trying harder or remembering,” said O’Brien. “Each patient develops a different method for reaching their goal of increasing their number of daily steps. One patient moved their coffee maker next to their treadmill. Some patients got a dog.”
Patients in the study also participate in a monthly group meeting to discuss their progress. They receive a report generated by their activity tracker and assess their progress. If needed, they can modify or even change their tactic for increasing their activity.
O'Brien recently completed a study funded by the International Transplant Nursing Society exploring the use of mobile health apps among kidney transplant recipients. She is currently funded by the National Institutes of Health National Institute of Nursing Research (2016-2019) for her study.
Carmen Giurgescu, PhD, RN, WHNP, associate professor
Associate Professor Carmen Giurgescu discussed her NIH-funded study that examines the pathways by which social stressors and systemic inflammation can lead to preterm births among African-American women.
“African-American women are one-and-a-half times more likely to have a preterm birth compared with non-Hispanic white women,” explained Giurgescu, “In 2015 in the United States, African-American women had a preterm birth rate of 13.4 percent, a rate considerably higher than their non-Hispanic white counterparts of 8.9 percent.” She has spent the past 10 years conducting quantitative as well as qualitative and mixed methods design studies that focused on social stressors of disadvantaged neighborhoods and experiences of racial discrimination, which uniquely affect African-American women. “Compared with pregnant non-Hispanic white women, pregnant African-American women are more likely to live in neighborhoods with higher poverty and violent crimes and be exposed to racial discrimination”, said Giurgescu. “These social stressors may increase emotional distress and levels of systemic inflammation for these women and ultimately increase their risk for preterm birth.”
In their prior pilot studies, Giurgescu and her research team found that women who live in disadvantaged neighborhoods and experience racial discrimination are more likely to experience psychological distress and depressive symptoms, have higher levels of systemic inflammation and be at higher risk for preterm birth. Although social support can mitigate the effects of social stressors on preterm birth, much more research is needed to understand fully how to support African-American women to prevent preterm births. In the R01 study funded by the National Institute of Minority Health and Health Disparities, Giurgescu and her colleagues will validate the impact of social stressors, emotional distress, social support and systemic inflammation on preterm birth in a larger sample of pregnant African-American women. They hope to advance scientific understanding of the etiology of preterm birth in order to implement healthcare delivery innovations to improve birth outcomes for African-American women.
Giurgescu encouraged her colleagues to persevere when applying for funding. Her recently funded grant “got funded the sixth time we submitted it,” she said, with a smile.
Jodi Ford, PhD, RN, associate professor
Associate Professor Jodi Ford is the director of the new Stress Science Laboratory in the College of Nursing Biomedical Research Lab. Ford plans to bring together stress research in nursing and well as interdisciplinary collaborators from across campus and even at partnering organizations like Wright Patterson Air Force Base (WPAFB). She is particularly focused on non-invasive methods of collecting physiological measurements of stress in order to determine stress levels in adolescents.
“We are planning a training session for fall semester on the background and measurement process of using hair cortisol,” she said. Patients do not seem to mind having a small piece of their hair cut off for the study compared to asking patients to provide a blood sample.
Ford’s lab was recently awarded a seed grant from Ohio State’s Initiative in Population Research (IPR) for her study "Linking Biological and Social Pathways to Adolescent Health."
The pilot study tests a high-quality, feasible and cost-effective protocol for the collection of chronic stress biomarkers to investigate the biological impact of social risk on adolescent health and behavior. The biomarker data collection will be conducted with Principal Investigator Christopher R. Browning, PhD, a professor of sociology at Ohio State in a separate study. The research was recently funded by the National Institutes of Health (NIH) and William T. Grant Foundation to conduct a prospective cohort study of adolescents in Franklin County on Adolescent Health and Development in Context. Browning and Donna McCarthy, PhD, RN, a professor at Marquette University, are co-investigators with Ford on the IPR pilot study.
The Ohio State’s Initiative in Population Research (IPR) awards four to eight seed grants annually to faculty affiliates for work toward submission of proposals for external funding.
Ford’s primary program of research under her designation as a Robert Wood Johnson Foundation Nurse Faculty Scholar for 2010-2013 focused on the contribution of social contexts to adolescent and young adult health and the psychosocial, behavioral and biological pathways through which they operate.
In a note to the College of Nursing announcing Ford’s appointment to the role of Stress Science Lab director, Dean Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, noted, “Jodi has an outstanding record of research expertise in the area of stress science. Now, in this role, she will mentor and assist faculty and doctoral students as well as provide workshops and training on integrating stress biomarkers into their research. I am confident that Jodi will provide the leadership to establish our college as a national leader in stress science.”
