$120 Million for States Made Available as Part of Recovery Act Community Prevention and Wellness Initiative

The Department of Health and Human Services (HHS) today announced the release of $120 million in American Recovery and Reinvestment Act (ARRA) funds for prevention and wellness programs for U.S. states and territories, building on the recent announcement of the $373 million funding opportunity for communities and tribes around the country. In all, the comprehensive Communities Putting Prevention to Work initiative will make $650 million available for public health efforts to address obesity, increase physical activity, improve nutrition, and decrease smoking.

"Today's announcement is an important step toward a healthier America," said HHS Secretary Kathleen Sebelius. "We know that many chronic diseases are preventable, and the resources now available through the American Recovery and Reinvestment Act will assist states and
territories in the implementation of proven prevention and wellness programs that will save lives and lower health care costs for all Americans."

The $120 million in cooperative agreements will be awarded to states and territories for three components: statewide policy and environmental change, tobacco cessation through quitlines and media campaigns, and special initiatives to create health-promoting policies and environments. For the first two components, dollar amounts awarded to each state and territory will be based on population size and number of smokers. For the third component, states will apply for special funds through a competitive process based on the potential health impact of
the proposed activities. States and territories will have two years to complete their work. They will coordinate their efforts with other Communities Putting Prevention to Work initiatives in large cities, urban areas, small cities, rural areas, and tribal areas.

"State health departments are the backbone of the public health system and are uniquely positioned to support and leverage local efforts for chronic disease prevention and control," said Thomas Frieden, M.D., M.P.H., director of the Centers of Disease Control and Prevention (CDC).
"We expect that as a result of this nationwide project, most Americans will live in states with improved obesity-related and tobacco policies, we will make a national shift toward healthy environments, and we will increase significantly the number of people who are able to stop
smoking."

Funded projects will emphasize state-level policy and environmental changes that will help communities and schools support healthy choices. For example, states will make use of their collective purchasing power to improve the selection and availability of healthy foods in public
venues.

"Chronic diseases are the leading cause of premature death in the country, account for spiraling health care costs, and cause disability and suffering for millions of Americans," said Janet Collins, Ph.D., director of CDC's National Center for Chronic Disease Prevention and Health Promotion. "The good news is that we can greatly reduce the toll of chronic disease by reducing just four risk factors -- tobacco use, physical inactivity, poor nutrition, and obesity. With these new funds, states and territories will work to improve the environments where their residents live, work, learn, and play so that healthy choices become the easy choice."

States and territories interested in applying for cooperative agreements can find more information at www.grants.gov. The application deadline is Nov. 24, 2009. Deadlines for additional projects that are part of the Communities Putting Prevention to Work initiative will be announced soon.

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FDA Researchers Contribute Insights into Avian Flu Virus

An in-depth analysis of blood from patients recovering from the H5N1 avian influenza virus has provided important insights into how to combat the potentially lethal virus.

The findings by U.S. Food and Drug Administration scientists and collaborators better explain what part of the “bird flu” virus is seen by the immune system once a person becomes infected. As one result of this research, a protein of the bird flu virus called PB1-F2 was identified as a potentially potent target for attack by immune systems to stop the spread of the virus.

“Analysis of blood from patients recovering from the H5N1 avian influenza virus can lead to new tools for testing the potential protective activity of vaccines under development,” said Karen Midthun, M.D., acting director of the FDA’s Center for Biologics Evaluation and Research (CBER). “The findings could also lead to new tests to detect infections, and improved therapies.”

Since 2003, more than 400 people worldwide have been infected with the bird flu virus. About 60 percent of them have died. No cases of avian flu have been reported in the United States. Most of the avian flu infections in humans involve people who have had direct contact with infected poultry. However, there is a potential risk for a global influenza pandemic should the virus acquire the ability to spread directly from person to person.

The study, titled “Antigenic Fingerprinting of an H5N1 Avian Influenza Using Convalescent Sera and Monoclonal Antibodies reveals Potential Vaccine and Diagnostic Targets,” appears in the April 20, 2009, edition of the online journal PLoS Medicine. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000049

The researchers adapted an existing technique using genetically modified viruses (phages) to create a library of fragments representing all of the proteins found in the H5N1 virus. Scientists mixed these fragments with antibodies from five Vietnamese patients recovering from the H5N1 infection and observed which fragments attracted the patient’s antibodies.

Several targets that are likely to trigger strong antibody responses to the H5N1 virus were identified, including PB1-F2, a protein that researchers believe contributes significantly to the virus’s ability to cause disease.

“We believe this is the first evidence of the human immune system reacting this strongly against PB1-F2,” said Hana Golding, Ph.D., chief of CBER’s Laboratory of Retrovirus Research and senior author of the article. “This is an indication that it may be a good target for a drug or vaccine.”

The study’s other authors include first author Surender Khurana, Yonaira Rivera, Jody Manischewitz, and Lisa R. King (FDA); Kanta Subbarao, Amorsolo L. Suguitan Jr. (National Institute of Allergies and Infectious Diseases); Cameron P. Simmons (Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam); and Antonio Lanzavecchia (Institute for Research in Biomedicine, Bellinzona, Switzerland).

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Obese Acute Rehabilitation Patients Fare Better than Normal Weight Patients

Obese patients undergoing rehabilitation at an acute rehabilitation hospital recovered faster than patients of normal weight, according to a study by an Emory University researcher.

The findings, reported in the January 2008 issue of the American Journal of Physical Medicine & Rehabilitation, debunk previous assumptions that the obese or overweight have a slower recovery than do those who are normal weight.

"The study's findings are the opposite of what you might expect," says David T. Burke, MD, lead study author and chair of the Department of Rehabilitation Medicine in the Emory School of Medicine.

"After several analyses of the data, we continued to get the same results -- even across various diagnostic categories. We can't deny that this is a real phenomenon," Dr. Burke adds.

The study assessed the association of body mass index (BMI) with the functional independence measure (FIM) scores of 1,077 inpatients admitted to the medicine service of an acute rehabilitation hospital. FIM measures the ability of a person to mobilize and care for their basic needs after a severe injury or illness. The study also examined whether the association between patients' BMI and FIM was different across motor and cognitive skill categories.

Patients in the study were transferred to the rehabilitation hospital during the course of hospitalization for severe and complex medical issues including, renal/dialysis, infectious disease and other conditions.

The results showed that from the time of admission to the rehabilitation hospital to the time of discharge, median gains and the speed of the gains in FIM scores were highest among the most obese group (BMI of 30-35 or higher), followed by the obese group (BMI of 35-49). All obese patients progressed faster than did those who were in the normal weight category and those categorized as underweight. The findings held even after adjusting for age, gender and length of in-hospital stay.

"While this study shows us that obese patients can tolerate exercise and physical activity, and in fact recover more quickly than normal weight patients, it didn't answer the question of why this is the case," Dr. Burke says. "These findings surprised us all. We are currently engaged in studies that will help us understand these results."

The study article is titled "Association between body mass index and functional independence measure in patients with deconditioning." Dr. Burke served as the study's principal investigator and collaborated with Harvard Medical School researchers.