In the year since we first announced the launch of CIM’s Human Aging Project (HAP), the ambitious alliance has seen some exciting developments.
In September, HAP Director Jeremy Walston, geriatrician Peter Abadir and colleagues at Johns Hopkins’ Whiting School of Engineering received news that the National Institutes of Health has funded a $20 million grant that will support important HAP initiatives in artificial intelligence and technology. And over the summer, the first multidisciplinary team in HAP’s Gerotech Incubator Program began working to identify a clinically relevant problem to be solved.
“This $20 million grant brings a lot of pilot money to HAP investigators who have these great ideas that are just getting started, and there is a network of businesses connected with the grant that will allow us to quickly implement many of the solutions for older adults that we have been thinking about,” says Walston. “It’s also wonderful,” he adds, “that the funding will meld nicely with the Gerotech Incubator Program.”
He is referring to a series of seven innovation incubator hubs — focused on challenges in aging including fall prevention, neurodegenerative diseases, sociodemographic stressors and more — which bring together teams that include two to three engineering students, one medical resident or nursing doctoral candidate, two business students from Hopkins’ Carey Business School and several faculty mentors.
In Phase 1 of their work, the teams identify a specific problem to solve, perform a market analysis and ultimately develop a prototype or product. Phase 2 is the “accelerator” mode, during which the teams find funding, test prototypes and develop patents, and solicit support from industry.
To date, more than two dozen master’s students and two dozen faculty members from across Johns Hopkins have signed on to work within these incubators, notes Peter Abadir, a co-leader of the Gerotech program and the Salisbury Family CIM HAP Scholar.
With the nation’s rapidly graying population, there are a variety of important health concerns that need to be addressed — ranging from frailty to incontinence to dementia — says Abadir. “On the other side,” he says, “there is a surge of technologies, an explosion of artificial intelligence, machine learning, robotics and sensing. But for some reason, there have been barriers to working between the technology side and the clinical, health care side. This is where we are putting our innovation hubs to work together.”
Over the summer, the first incubator team of master’s students began an exhaustive investigation in their initial effort to identify an area of focus for their innovation.
“We had a really busy summer, shadowing doctors for days — in the ventilator care unit, the memory clinic,” says team member Joshua Blair, a master’s student in the Whiting School of Engineering’s Center for Bioengineering Innovation and Design program. “We went on home visits, and we shadowed many nurses and physical therapists. We also interviewed a lot of people,” he says, including patients, caregivers, quality assurance workers, hospital administrators, researchers, med-tech executives and more. The team aimed to complete its discovery process and define its project by mid-autumn.
“All of us on the team chose to focus on geriatrics when we came to Johns Hopkins for personal reasons,” says Blair. “From a young age, we were all in positions of being a caregiver for an older person or seeing our grandparents go through something challenging, and this really inspired us to go into the field.”
CIM Director David Hellmann is excited by the rapid progress of initiatives within CIM’s Human Aging Project. Noting that there are currently 10 faculty scholars working within the center, with eight of those scholar posts funded by donors (see sidebar box above), he says, “By leveraging our remarkable assets from across Johns Hopkins, we have the potential to dramatically improve the lives of older adults and to make significant advances within the field of geriatrics.”
Don Willett November 8th, 2021
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Foods that are rich in omega-3 polyunsaturated fatty acid — such as broiled salmon or oatmeal sprinkled with flax seeds and walnuts — are not only delicious: They may also help those suffering from chronic obstructive pulmonary disease (COPD) to breathe easier.
That’s the hypothesis being tested by Johns Hopkins pulmonologist Nadia Hansel, whose team is pushing to improve the lives of people with COPD who live in disadvantaged communities — neighborhoods where food insecurity is an issue and indoor and outdoor air pollution exacerbate respiratory problems.
“We’re really excited about this new study that we are embarking upon,” says Hansel, the CIM Lavinia Currier Scholar. “Think about it: There are diets for cardiovascular disease and diabetes and even kidney disease. But when it comes to lung disease, no one really talks about a dietary intervention.”
“Think about it: There are diets for cardiovascular disease and diabetes and even kidney disease. But when it comes to lung disease, no one really talks about a dietary intervention.” – Nadia Hansel
Hansel’s new research study, which involves 200 people with moderate to severe COPD living in urban Baltimore, is informed by important earlier work. One project, which followed 112 participants with COPD living in the Baltimore area, found that those with higher intake of omega-3-rich foods had fewer respiratory flare-ups and “a trend toward higher lung function,” she notes. Another of her studies, published in June 2019, focused on school-age children with asthma who live in urban Baltimore. That project included placing sensors in participants’ homes to measure levels of indoor particulate matter. “We found that higher omega-3 intake was associated with diminished harmful effect of indoor air pollution exposure on the children’s respiratory symptoms,” says Hansel, who is director of the Division of Pulmonary and Critical Care Medicine.
But gaining access to foods with omega-3 is challenging for many people living in under-resourced communities. “We’ve found that low-income individuals with COPD often have diets well below the recommended levels of omega-3, and there are several reasons for that,” says Hansel, the David Marine Professor of Medicine. “People often live far from grocery stores that offer fresh, healthy foods that are rich in omega-3, and these items tend to be more expensive, which can be prohibitive. There’s also personal food preference, and there may be some unfamiliarity with preparing healthful foods.”
“It really is a shift in the paradigm to think that healthier eating can impact inflammatory lung diseases such as COPD or asthma.” – Nadia Hansel
To overcome those obstacles, in this latest study, Hansel and her team will be providing $50 weekly vouchers to Amazon Fresh. “These groceries will be delivered directly to their door each week,” she says — particularly helpful for COPD sufferers, who often are homebound.
Participants in one arm of the randomized study will receive vouchers for foods that are rich in omega-3, as well as personalized counseling from a dietary health coach who will offer culturally informed education around nutrition and food preparation. Participants in the other arm of the study will receive $50 vouchers for food of their choice. They will receive phone calls with nutrition information that is more generally available, without it being personalized.
To measure levels of indoor air pollution, Hansel and her team will use low-cost sensors that have been shown to be very accurate in measuring indoor particulate matter (as well as carbon dioxide concentration) over several months. The scientists will measure participants’ respiratory health through blood and urine tests, questionnaires, and exercise tests.
Once the 12-week study is complete, the team will follow up with participants over three more months to see how well they sustain healthy eating after the food vouchers end. And the scientists will conduct informal interviews to find out ways in which the nutritional counseling was effective or could be improved. “The goal is to develop an intervention that can be successfully sustained once the study period is over,” says Hansel, who is associate dean of research at Johns Hopkins Bayview Medical Center.
Dietary solutions could be a real game-changer, she believes.
“To date, few studies have examined COPD intervention strategies beyond smoking cessation. It really is a shift in the paradigm to think that healthier eating can impact inflammatory lung diseases such as COPD or asthma,” says Hansel, whose team includes physicians Pete Miller, Michelle Eakin, Kirsten Koehler, Emily Brigham, Nirupama Putcha, Meredith McCormack and Susan Oh.
“Our hope is that we can ultimately provide a framework for dietary interventions that could be used to combat other chronic conditions that disproportionately impact low-income communities.”
Don Willett November 8th, 2021
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Providing outstanding patient care has long been central to the work of many faculty members at Johns Hopkins, and since 2008, outstanding clinicians have been recognized with induction into the Miller Coulson Academy of Clinical Excellence, a key initiative of the Center for Innovative Medicine.
But until recently, clinical excellence hasn’t been rewarded on the promotions track.
“The general sentiment is that while we have a tripartite mission at Hopkins — research, education and patient care — it was really a pogo stick when it came to evaluations for promotion: Research was dominant,” says Rosalyn Stewart, director of the Johns Hopkins After Care Clinic and director of the Johns Hopkins Hospital Substance Use Consultation Service.
Now, that’s changed. In November 2020, Stewart became the first faculty member at Johns Hopkins Medicine to be promoted to full professor on the new Clinical Excellence track.
As of June 30, 15 faculty members from hospitals across Johns Hopkins Medicine had been approved for promotion on the new track, with six achieving full professor and nine attaining associate professor status. Two dozen more faculty members are at various stages of the evaluation process.
“It’s been a very moving experience,” says psychiatrist Meg Chisolm, who co-leads the promotions committee, with ophthalmologist (and Miller Coulson Academy member) Sharon Solomon and CIM Director David Hellmann. “People on our committee were brought to tears to see that great clinicians at Johns Hopkins — many of whom had trained hundreds of outstanding clinicians who went on to get promoted at other institutions — are finally getting recognized.”
Chisolm credits leaders of the Miller Coulson Academy for establishing the criteria to measure clinical excellence, including a “360-degree” review. “They set the bar very high,” says Chisolm, herself a Miller Coulson Academy scholar.
“As an institution, we pride ourselves on doing things rigorously and objectively, but up until the Miller Coulson Academy, there was general skepticism that clinical excellence could be measured in a clear and consistent way,” says Cynthia Rand, senior associate dean for faculty. “But the Miller Coulson Academy really made a mark, both locally at Johns Hopkins and nationally, by developing a truly rigorous process for measuring excellence in clinical care.”
With the 360-degree review, nominees in the new promotion track are evaluated by clinical peers, leaders, staff members and learners, as well as from patients and their family members (when applicable). There are 25 to 30 evaluations in all. To be promoted to associate professor, applicants must be rated in the top 25% of their field. To attain full professor, they must be rated in the top 10%. “Many applicants far exceed those levels,” Chisolm has found.
Applicants are evaluated based on several domains of clinical excellence. “They must be clinical leaders,” says Chisolm. “Most have built clinical programs, instituting innovations and improvements in the way patient care is provided, and their work is being emulated across the country. Some have established programs in other countries.”
In addition, successful applicants must be actively engaged in teaching the next generation — teaching, mentoring and encouraging young health care professionals and family members. Finally, they must be actively engaged in the mission of discovery, pursuing quality improvement projects or participating as a clinical expert on a scientific project.
“There are diets for cardiovascular disease and diabetes and even kidney disease. But when it comes to lung disease, no one really talks about a dietary intervention.” – Nadia Hansel
Hansel’s new research study, which involves 200 people with moderate to severe COPD living in urban Baltimore, is informed by important earlier work. One project, which followed 112 participants with COPD living in the Baltimore area, found that those with higher intake of omega-3-rich foods had fewer respiratory flare-ups and “a trend toward higher lung function,” she notes. Another of her studies, published in June 2019, focused on school-age children with asthma who live in urban Baltimore. That project included placing sensors in participants’ homes to measure levels of indoor particulate matter. “We found that higher omega-3 intake was associated with diminished harmful effect of indoor air pollution exposure on the children’s respiratory symptoms,” says Hansel, who is director of the Division of Pulmonary and Critical Care Medicine.
But gaining access to foods with omega-3 is challenging for many people living in under-resourced communities. “We’ve found that low-income individuals with COPD often have diets well below the recommended levels of omega-3, and there are several reasons for that,” says Hansel, the David Marine Professor of Medicine. “People often live far from grocery stores that offer fresh, healthy foods that are rich in omega-3, and these items tend to be more expensive, which can be prohibitive. There’s also personal food preference, and there may be some unfamiliarity with preparing healthful foods.”
“The Miller Coulson Academy really made a mark, both locally at Johns Hopkins and nationally, by developing a truly rigorous process for measuring excellence in clinical care.” – Cynthia Rand
Chisolm believes the new promotions track will be crucial to attracting and retaining top clinicians at Johns Hopkins in the years ahead. Perhaps even more importantly, it will give clinicians across Johns Hopkins a way forward to pursue the calling that drew them to medicine in the first place.
“Before this track was established,” says Chisolm, “there were faculty members who were pulled away from their true passion, caring for patients, because they needed to put so much time into research, writing papers and traveling to conferences in order to get promoted.”
Stewart couldn’t agree more. Winner of a 2016 Innovations in Clinical Care Award for work done in establishing the Johns Hopkins After Care Clinic team, the newly minted full professor says, “The new track really adds value to the work clinicians love doing!”
Don Willett November 8th, 2021
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Bayview Honored for Social Responsibility
In September, the Lown Institute released its annual hospitals index, and Johns Hopkins Bayview Medical Center ranked #3 in the nation — out of 3,709 U.S. hospitals — in social responsibility. The think tank assessed hospitals across eight areas. Two in which Bayview scored especially strongly were inclusivity (how well it serves people of color, those with lower incomes and those with lower levels of education) and community benefit (how well the hospital invests in community health).
“No discussion about Bayview and social responsibility would be complete without mention of Dr. David Hellman, professor of medicine, director of the Center for Innovative Medicine and former vice dean for Bayview, for whom this has long been a major focus,” notes Jimmy Potash, Henry Phipps Professor of Psychiatry and Behavioral Sciences, department director and psychiatrist-in-chief.
Potash continues: “In an interview, Dr. Hellmann said: ‘I firmly believe that medicine is a public trust and that it is our joyful opportunity and obligation to get up each day and ask how we in health care can pay back society a higher dividend for the extraordinary investment society has made in us.’ Amen.”
A Calling Inspired by Classic Movies
Jade Cobern, a preventive medicine resident at Johns Hopkins, has earned international distinction for medical writing in social media by FPM, the Fellowship of Postgraduate Medicine, in the United Kingdom. Cobern was honored for her online essay, “A Calling to Medicine from Hollywood,” which appeared on CLOSLER.org, the website of the Miller Coulson Academy of Excellence. In the article, Cobern shares how a childhood watching classic movies — notably those starring Audrey Hepburn — inspired her decision to become a doctor.
CIM Scholars on the Move
CIM scholars, as was said about immigrants in the play Hamilton, “Get the job done!” Congratulations to Jessica Colburn, who became director of the fellowship program for geriatrics; Michelle Sharp, who was awarded a National Institutes of Health grant to expand her research on sarcoidosis; Erica Johnson, who was appointed associate vice chair for diversity, equity and inclusion in education for the Department of Medicine; and Kim Peairs, who has functioned as the JHM medical director for COVID-19 vaccinations, providing more than 250,000 vaccinations to Johns Hopkins employees and patients. All four serve as Mary & David Gallo CIM Scholars.
Don Willett November 8th, 2021
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