Deena J. Chisolm, PhD
Empowering Today’s Youth to Understand and Manage Their Health
To take on a system, help communities, and educate children on health literacy are some overwhelming tasks that one local woman has made her mission. Born and raised in Springfield, Ohio, Deena J. Chisolm, PhD is Director of the Center for Innovation in Pediatric Practice and Vice President of Health Services Research at the Abigail Wexner Research Institute at Nationwide Children’s Hospital.
She is also Professor of Pediatrics and Public Health at the Ohio State University. Growing up, Deena was always a kid that did well in school especially when it came to math and science. She was also fighting a chronic illness, asthma. This became a huge part of her identity, one that would ultimately pave the way to her career.
When Deena was 15-years-old, she spent much of her time babysitting her five-year-old sister and her three-year-old brother. One afternoon while her siblings were playing outside with neighborhood friends, she found herself in their apartment trying to breathe. As luck would have it, her little brother came in for a drink and found her barely breathing. His quick thinking sent him out to get an adult and Deena was rushed to the emergency room where she was put into the intensive care unit.
After overhearing a conversation between two nurses, she learned that she had been labeled a “frequent flyer,” a term referring to patients who frequently visited the emergency room due to lack of preventative care. This negative label reflected their perception of her as a black girl, on Medicaid, who just didn’t take care of herself, but she knew that taking care of a chronic illness while dealing with social and economic challenges was hard.
Dr. Chisolm credits her asthma diagnosis to her lifelong love of health science. She knew early on she wanted to incorporate that passion into her career but didn’t know exactly what she wanted to do. She never felt like being a clinician was the right fit, but she knew she wanted to help teens like herself. While at Miami University, she studied biology education, training to teach high school biology and general science but she never lost her desire to focus on health.
As she neared graduation and had to decide whether to embark on a teaching career, one of her professors suggested she talk to recruiters from the Ohio State University who were visiting campus in search of minority students with an interest in health promotion and disease prevention. Their description of the program intrigued her and after visiting the OSU campus as part of the minority-focused Graduate and Professional Student Visitation day and completing the interview process, she received a fellowship in preventative medicine at The Ohio State University and was on her way.
She found her niche. It was the perfect blend of health care, math, and statistics. It also let her engage directly with communities in need. During the summer after her first year, she worked at a prenatal care clinic serving low income women where she helped patients prepare to be moms by presenting workshops on healthy behaviors, parenting skills, and seeking assistance with social needs like managing finances, mental health, benefits, and transportation. “This was great experience and really helped to mold who I am today,” Dr. Chisolm says. It crystalized her understanding that healthcare is only one part of health and that patients also need knowledge, resources, and respect.
Following graduation from the master’s program at The Ohio State University, Dr. Chisolm got married and accepted a position at the Ohio Department of Health in HIV/AIDS surveillance. She analyzed data on reported cases to see how the disease was distributed and where interventions were most needed. She learned a lot about turning data into information and information into policy.
“How data is presented can determine how dollars are allocated,” explains Dr. Chisolm. “It is important to know how to communicate it in a way that is honest and that policy makers can understand.” She carried these data skills to additional position in health care quality and consulting.
Years later, she returned to the Ohio State University College of Medicine where she became the manager of outcomes management for the medical center while completing her PhD in Public Health. In 2004, Dr. Chisolm accepted a faculty position at Nationwide Children’s Hospital as a researcher for improving health and health care of people in vulnerable situations, such as minorities, the LGBTQIA community, or those living in poverty.
As a health services epidemiologist, Dr. Chisolm seeks to understand how healthcare delivery and healthcare policy create health for children and how child, family and community factors influence that relationship. Her research relies on use of large data sets, statistical methods, and patient reported experiences. Dr. Chisolm explains that her research focuses on two main factors:
Patient empowerment
Research that looks at how young people use information and information technology to manage health and make healthcare decisions, how they interact with the medical community, and how they develop the skills to find, understand, and use health information to maximize their health.
Social Determinants of Health
Research that explores how factors like housing instability, food insecurity, poverty, and racism influence health and how healthcare systems can recognize and help address these factors. This includes styling the outcomes of Nationwide Children’s Hospitals Healthy Neighborhoods/Healthy Families Program which partners with community organizations to advance the southside of Columbus, through enhancing housing, education, health, economic development, and community safety.
Health Policy
Research that explores how healthcare delivery and healthcare payment can be transformed help every child reach their maximal health outcomes.
“The research we are doing at Nationwide Children’s as part of the Healthy Neighborhoods/Healthy Families program is changing the health of the community in not only our healthcare, but in crime reduction, housing issues and community development,” says Dr. Chisolm.
“Our research on health policy expands our focus to the state and national level approaches to improving health.” In the end, Dr. Chisolm’s personal mission is to change the health care system that judged her as a youth to one that values, respects, and optimally serves children like her today.
Outside her work in research, Dr. Chisolm serves as the Chairman of the Ohio Commission on Minority Health and is a Board member of the Health Policy Institute of Ohio. She is a 30-year member of Alpha Kappa Alpha Sorority, Incorporated, where African American Women give back to the community in areas of education, health, and social services. When she has some downtime, Dr. Chisolm enjoys fitness. She loves to workout, run in 5k fundraisers, cycle, and bake.
She has been married to her husband, Jerard, for 27 years. In a 2018 TEDx Talk, Dr. Chisolm reinforced how important it is to build optimal health identities for teens. She notes, “if we help teens reach their optimal health potential as adults, we enhance health equity in our society.”
Lauren O. Bakaletz, PhD
Researching Better Treatment and Prevention for Infections of the Respiratory Tract
At one time or another, we have all experienced an ear infection. Whether it be our own or one of our children. They seem unpredictable. Usually follow cold symptoms. Can be quite painful.
One research scientist at Nationwide Children’s Hospital has created a program that is focused on determining the molecular mechanisms that underlie polymicrobial infections of the respiratory tract, with primary emphasis on otitis media or middle ear infection, chronic sinus infections and COPD (chronic obstructive pulmonary disease).
Lauren O. Bakaletz, PhD, principal investigator and the director of the Center for Microbial Pathogenesis at the Abigail Wexner Research Institute at Nationwide Children’s Hospital and Professor of both Pediatrics and Otolaryngology at the Ohio State University College of Medicine, was always interested in biology.
She majored in microbiology during her undergraduate and graduate school programs with a focus on diseases of the respiratory system. Her doctorate study was focused on whooping cough but this worked evolved into the study of middle ear infections, specifically why they occur, how they can be detected, and in what manner they can be treated, or preferably, prevented.
“Along the way, I worked with protein chemists to learn about vaccine development and delivery. It became a fascinating area for me,” says Dr. Bakaletz. “I now appreciate the vast amount of work that goes into vaccine development, from discovery to vaccine approval. All that goes into it – trials, obstacles, financing, legalities, delivery to diverse groups, public education, and protecting novel ideas.”
Learning how to get a vaccine made became an important part of her journey. When Dr. Bakaletz began working at Nationwide Children’s Hospital, she was thrilled to be in an environment that heavily supports entrepreneurial scientists. “I am fortunate to get an opportunity to translate our work in the laboratory to those who can benefit from it the most. This has allowed me to make progress and I also get to work in partnership with colleagues that are inspiring,” Dr. Bakaletz says. “Nationwide Children’s Hospital is a tremendous community of basic and clinician scientists with great passion for their work.”
Conducting research at Nationwide Children’s gives Dr. Bakaletz and other researchers the ability to be close to the patient population. With close access to children and clinical samples, this has helped with making great forward progress toward development of novel treatments and vaccine candidates.
At Nationwide Children’s, The Bakaletz Lab research focuses on attempting to understand the pathogenic mechanisms that are active in the highly prevalent pediatric disease, otitis media (OM) (or middle ear infection), as well as how this understanding applies to many other respiratory tract infections. “Specifically, we are interested in explaining how upper respiratory tract viruses predispose the middle ear to invasion by any of the three predominant bacterial pathogens of OM (nontypeable Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae),” adds Dr. Bakaletz.
“We are also interested in understanding how bacterial biofilms (a collective of one or more types of microorganisms that can grow as a 3D community on many different surfaces) contribute to the recurrence and chronicity of OM, chronic rhinosinusitis, bronchitis, chronic cough, and exacerbations of both chronic obstructive pulmonary disease (COPD) and cystic fibrosis.”
More simply explained, bacteria live in our body and when we get a virus, it allows bacteria to grow unrestricted and to gain access to places they don’t belong. Often the secondary infection is far greater than the initial virus infection, causing serious illness or death. “If we can find out how the virus is allowing the bacteria to misbehave, it can help us to treat or prevent the infection,” observes Dr. Bakaletz.
Dr. Bakaletz and her team know that the antibiotics available to us today are effective in quieting the types of infections they study, but actually curing those infections is another thing plus antibiotic resistance among bacteria is a huge global problem and thus they are seeking to find out how to make those therapies more effective.
“Our long-term goal is to develop novel methods to more effectively treat or preferably, to prevent, otitis media and other respiratory tract infections where there is a biofilm component to the disease course,” notes Dr. Bakaletz.
At Nationwide Children’s Hospital, Dr. Bakaletz is the co-founder of two internal ventures. The first being Scioto Biosciences. Founded in 2017, Scioto Biosciences is a preclinical stage company developing innovative therapies to transform the delivery of microbiome therapeutics. The second venture is Clarametyx Biosciences Inc. Formed earlier this year, the subsidiary will target bacterial resistance mechanisms to fight life-threatening infections.
She is also the director for the Center for Microbial Pathogenesis and Vice President for Basic Sciences at the Abigail Wexner Research Institute and former chair of a National Institute of Health study section that reviewed grant applications on host interactions with bacterial pathogens.
While mentoring faculty, attempting to secure funding to support her laboratory’s research and running research companies are enough for anyone to have on their plate, Dr. Bakaletz does find time for some extracurricular activities. She and her husband, Steven, ensure that they have time together with Lauren’s three daughters, sons-in-law, and three young grandchildren.
Their family all reside within the Columbus area which makes spending time together one of the things that is most important to her. In addition to regular gatherings, they enjoy a vacation once a year where she spends quality time with the entire family. She also loves to cook, horseback ride, and travel – with an annual trip to Paris – where she and Steven got engaged.
“The support of women in leadership roles at Nationwide Children’s Hospital is incredible,” Bakaletz comments. “Managing the research in the lab with trying to translate those discoveries to what the patient and family of a patient needs is a tremendously rewarding career.”
Elaine R. Mardis, PhD
Adding Genomics to the Diagnosis and Treatment of Children
Genomics: an interdisciplinary field of biology focusing on the structure, function, evolution, mapping, and editing of genomes. A genome is an organism’s complete set of DNA, including all of its genes.
Genomics is becoming a part of the puzzle that medical providers depend on to more successfully diagnose and treat patient illness.
Dr. Elaine Mardis, Co-Executive Director of the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital and a Professor of pediatrics at the Ohio State University College of Medicine, grew up in the central plains, in western Nebraska. The daughter of a chemistry professor, she spent a lot of time in his lab. She attributes this to her love of science.
After high school, Dr. Mardis went on to get her undergraduate degree in Zoology. Her honors research project focused on fruit fly genetics. During her senior year, her interest in molecular biology grew and this became the beginning of her journey with genomics.
Dr. Mardis was fortunate to have been surrounded by some amazing mentors in genomics. Her thesis mentor, Professor Bruce Roe, PhD, was one who encouraged her to obtain her PhD. Dr. Roe learned much of his sequencing knowledge from the esteemed biochemist, Dr. Frederick Sanger.
Sanger was a member of the Medical Research Council at Cambridge University and was awarded two Nobel Prizes in Chemistry, one in 1958 and one in 1980 (the second for devising how to sequence DNA). His method is commonly used today in the study of genomics. Dr. Roe was the first to bring the Sanger methods to the United States.
In 1984, Dr. Mardis joined Dr. Roe in his lab to pursue her PhD. She worked with Dr. Roe and his team on how to scale up the Sanger methods including the use of automation and robotics. His was the first lab to start interfacing chemistry techniques and informatics in efforts that ultimately contributed to the sequencing of the human genome.
After Dr. Mardis received her PhD, she took some time to work in the industry to gain non-academic knowledge and learn skills unrelated to basic research, such as personnel management and reagent manufacturing. “As time moved forward, I didn’t realize how much acquiring these skills would benefit me in my work,” comments Dr. Mardis. “Those skills helped me to better structure and build large teams, and ultimately contributed to the good manufacturing processes and standard operating procedures needed to sequence the human genome.”
In 1993, she joined the faculty at Washington University School of Medicine where she spent 23 years at The McDonnell Genome Institute. Her initial efforts were focused on technology development aimed at the Human Genome Project, running a group studying the interface between automation, robotics and high throughput DNA sequencing. This international effort to decode the human genome sequence was completed in 2004, and the group at Washington University contributed 20% of the overall sequence of 3 billion bases.
Essentially, this reference is the ‘instruction set’ that encodes proteins, which are the workhorses in human cells. The reference also provided a keystone against which additional sequences could be compared to identify genetic changes, especially of interest in diagnosis of genetic diseases.
Much of Dr. Mardis’ subsequent research has focused on using the human genome as a template for discovering how changes in our genome result in human diseases such as autism and cancer. The pace of this discovery was accelerated in the mid-2000’s by the transition to a new type of sequencing technology called massively parallel sequencing.
Dr. Mardis was eager to begin applying the knowledge from large-scale discovery and massively parallel sequencing technology to the real-time study of genetic diseases. To realize this goal, she joined Nationwide Children’s Hospital in 2016 as the co-Executive Director of the Steve and Cindy Rasmussen Institute for Genomic Medicine (IGM) and was named the Nationwide Foundation Endowed Chair in Genomic Medicine. She is also a Professor of Pediatrics at The Ohio State University College of Medicine.
“We are excited to build momentum and enthusiasm with our pediatric physicians, for the power of genomics,” adds Dr. Mardis. “IGM is blurring the lines between research and clinical practice and beginning to offer genomics-based information to clinicians who are seeing patients in different clinics in our hospital, from neurology, to oncology, to behavioral health.” Better understanding the biology of cancer through the lens of genomics was an obvious place to begin at Nationwide Children’s.
“Until we understand the biology, we can’t determine effective treatment,” Dr. Mardis says. “There was a void that needed to be filled and that was genomics.” As such, IGM introduced a cancer genomics study in early 2018 that has studied over 220 children with cancer to-date, returning information relevant to their care in over 90% of the children studied.
Two essential groups were brought together at IGM, the research element and the clinical element. “It is necessary to be rigorous and in a well-documented environment in order for us to support the importance of genomic information,” says Dr. Mardis. “We are using new methods and partnering with physicians to make this happen in pediatric cancer, pediatric epilepsy, in our neonatal facilities, and in our behavioral health practice, for starters.”
The addition of genomic information may help more quickly identify, diagnose, and treat childhood illness. “Significant large-scale discovery efforts have taken place since the sequence of the human genome was completed, detailing the ways in which our genomic DNA can be altered in the context of numerous diseases. We rely on the resulting databases and the medical literature to help interpret the data from individual patients,” she adds.
The goal of IGM is to change the face of pediatric medicine by adding information to patient diagnoses, to explain the underlying changes to DNA that have resulted in disease, to inform treatment possibilities, and to provide better outcomes for the patients. Even in cases where no treatment can be determined, it is often comforting for parents to understand why their child became ill. “I see genomics as being increasingly applied and more broadly included in the practice of pediatric medicine. The goal is to make it part of the medical procedure and diagnosis for each and every child,” Mardis notes.
Dr. Elaine Mardis is the first person from Nationwide Children’s Hospital to be elected into the National Academy of Medicine (in 2019). She is just completing her term as president of the American Association for Cancer Research, the oldest organization devoted to cancer research and an international association made up of over 40,000 members from 130 countries.
“My life is my work. It is incredibly gratifying that our work is having a tangible impact on patients’ lives,” says Dr. Mardis.
She is eager to acknowledge that Nationwide Children’s hospital leadership had the vision to identify genomics as an increasingly important aspect of medical care, which led to the creation of IGM in 2016 with her longtime research partner, Dr. Richard Wilson. She also cites the Nationwide Insurance Innovation Fund as being an integral contributor to IGM funding, providing the support to pursue cutting-edge genomic studies that are driving the inclusion of genomics into medical care. “What we do takes a lot of people with diverse expertise but unified by our goals. I am very thankful for our amazing staff and our hospital leadership for buying into this vision and helping make it a reality.”
