Communication Sciences Research CenterThe Communication Sciences Research Center (CSRC) incorporates research in and houses the laboratories for the Divisions of Audiology, Speech-Language Pathology and the Reading and Literacy Discovery Center. CSRC is currently pursing four major lines of research involving hearing and reading. Drs. Moore and Hunter focus on hearing and listening difficulties in infants and children. Dr. Hunter’s recently completed NIH grant (R01-DC010202) developed and tested new techniques to measure the function of the middle and inner ear, especially useful for babies undergoing neonatal hearing screening within the first couple of days after birth. Supported by the Center for Disease Control and Prevention (CDC) (Grant U01DD001007), she has since shown that working closely with Women, Infant and Children (WIC) centers in the community dramatically reduces the number of families who slip through the care net after their child fails neonatal screening (Pediatrics, 2016). New NIH funding to Drs. Moore, Hunter, Dimitrijevic and Holland (R01-DC014078) utilizes cutting edge techniques to measure subtle (‘sub-clinical’) aspects of ear and brain function in school aged children with listening difficulties (Int. J. Psychophysiology, 2015). These findings may be relevant to many common forms of learning disorders (e.g. dyslexia) in children for which subtle hearing disorders have long been suspected. Drs. Horowitz-Kraus, Holland, and our newest faculty member, pediatrician John S. Hutton, are members of the Reading & Literacy Discovery Center and are leading research in dyslexia and emergent literacy. New NIH funding to Drs. Horowitz-Kraus and Holland (R01-HD086011) is supporting their efforts to examine the neurobiological basis for a new executive function model for dyslexia as well as a new computer based intervention for this form of dyslexia (Dyslexia, 2016). Dr. Hutton joined the RLDC/CSRC faculty in July 2016 following his research fellowship in the Division of General and Community Pediatrics at Cincinnati Children's. With pilot funding from the Thrasher Foundation, Read Aloud 15 MINUTES organization and Candace Kendle Charitable Trust, he is exploring the influence of early literacy exposure (Pediatrics, 2015) and reading vs. video exposure on the neural circuitry supporting reading comprehension and imagination.
Occupational Therapy and Physical Therapy Research
The Division of Occupational Therapy, Physical Therapy and Therapeutic Recreation continues to pursue lines of research with the vision to be the leader at improving child health through the systematic generation, adoption and rapid integration of rehabilitation knowledge in order to promote healthy behaviors, engagement in valued activity and improved quality of life. In FY2016, the focus was primarily on three strategic goals: 1) Improve outcome, cost and value for patients with neuromuscular and developmental disorders seeking rehabilitation services; 2) Become an international leader in the rehabilitation management of patients with mild traumatic brain injury; and 3) Reduce anterior cruciate ligament re-injury rates after discharge from physical therapy. Central to these goals, the Division published over 20 peer-reviewed manuscripts in high impact journals such as the American Journal of Sports Medicine, Pediatric Physical Therapy and Neuropediatrics. Division investigators successfully procured internal funding, as well as extramural funding, from the NIH and various foundations. In recognition of outstanding work, our clinical scientists received several prestigious honors, including the Toby Long Paper of the Year for the most outstanding manuscript published in the Pediatric Physical Therapy Journal, the Orthopaedic Research and Education Foundation (OREF) Clinical Research Award, and the Sports Physical Therapy Section of the American Physical Therapy Association’s Excellence in Research Award.
The goals of the Pharmacy Research program are to establish a clinical research program focused on drug transporter pharmacogenetics/genomics to identify new gene-drug pairs for personalized interventions in the areas of rheumatology and oncology.
In a study, funded by the Cincinnati Children's Center for Pediatric Genomics (CpG), Dr. Laura Ramsey is studying how the drug methotrexate works in a mouse model of arthritis lacking a methotrexate transporter. Methotrexate is a drug used to treat many autoimmune diseases and some cancers. Preliminary data show that genetic variants influence response to methotrexate in children with juvenile idiopathic arthritis. By removing methotrexate from the blood by a transporter, resulting in reduced function, there is more methotrexate in the blood. She will determine the concentration of the drug in the blood of the mice and use it to find a dose of methotrexate that will provide the same drug level in the mice lacking the transporter as normal mice. This study may help determine which patients are going to be good responders to methotrexate and could start with a lower dose to avoid toxic side effects. She has also received an educational grant to assemble an expert council to write a guideline for dosing glucarpidase, an antidote to toxic methotrexate levels. She recently received an Early Career Investigator Scholarship Award sponsored by the Brandt Family Scholars Fund to present at the Mayo Clinic Individualizing Medicine Conference.
Dr. Timothy Phoenix was recently jointly recruited by Research in Patient Services and the James Winkle College of Pharmacy. He has begun studying the genetic influences on brain tumor pathogenesis and treatment response in collaboration with the Brain Tumor Program at Cincinnati Children's. Genomic advances have identified 20+ subgroups of brain tumors with distinct molecular expression patterns and genomic alterations, and may be further defined by including blood brain barrier function across pediatric brain tumor entities. This will aid drug development efforts for subgroup specific targeted therapies. Based on his previous studies of signaling and blood brain barrier function in medulloblastoma, he will study whether inhibiting blood brain barrier function in other tumors can improve drug penetration and treatment response.
Using Human Factors to Improve Employee and Patient Safety
Nancy Daraiseh, PhD, an assistant professor in pediatrics through the James M. Anderson Center for Health Systems of Excellence, is using human factors methods to assess risk exposure by healthcare workers and developing feasible interventions for reducing occupational injuries to employees in medical/surgical units and psychiatry. Dr. Daraiseh’s work shows the prevalence of stress outcomes among pediatric healthcare workers. She has applied human factors methods to improving health-care delivery in the neonatal intensive care unit, preventing injuries in psychiatry, measuring the impact of noise exposure on provider health as well as monitoring stress-related employee outcomes and improving injury-reporting systems. Her work is also establishing evidence linking employee and patent safety.
Improving Outcomes after Pediatric Cardiac Surgery
Sandra Staveski, PhD, RN, CPNP-AC, an assistant professor of nursing, focuses on improving outcomes of children after cardiac surgery through preventing harm they may experience during hospitalization and at home. Her current work focuses on two areas: 1) development of a novel clinician-parent home care education intervention aimed at facilitating safe transition from hospital to home care for post-operative pediatric cardiac patients; and 2) exploring the epidemiology of delirium in post-operative pediatric cardiac surgery patients. In 2016, Dr. Staveski received a Patient Services Mentored Research Career Development (PS2) grant, as well as funding from Children’s Heart Association of Cincinnati, and the CCTST to pursue these research activities. She has recently completed an international survey on delirium management of children after cardiac surgery.
Understanding Effects of Nurse Certification on Patient Outcomes
Heather Tubbs Cooley, PhD, RN, assistant professor of nursing, who is also affiliated with the James M. Anderson Center for Health Systems Excellence, was named an American Nurses Foundation Scholar for the 2015-2016 academic year, to evaluate effects of nurse certification on patient outcomes in neonatal intensive care. Professional nursing organizations advocate nurse certification as a way to validate clinical competence in a specialty area of nursing and improve nursing care quality, yet evidence to support a linkage between certification and patient outcomes is lacking. Dr. Tubbs Cooley and colleagues are evaluating a certification-outcomes relationship between individual nurse certification and individual patient outcomes, and also between shift composition of certified nurses on shift-level outcomes in neonatal intensive care. The results of the study will provide nurse executives with empirical results that can inform hospital financial investments in nurse workforce certification. The study is a collaboration with the Ohio State University, and the University of North Carolina at Chapel Hill.