Development of a Rhinovirus Inoculum Using a Reverse Genetics Approach.

BACKGROUND: Experimental inoculation is an important tool for common cold and asthma research. Producing rhinovirus (RV) inocula from nasal secretions has required prolonged observation of the virus donor to exclude extraneous pathogens. We produced a RV-A16 inoculum using reverse genetics and determined the dose necessary to cause moderate colds in seronegative volunteers. METHODS: The consensus sequence of RV-A16 from a previous inoculum was cloned, and inoculum virus was produced using reverse genetics techniques. After safety testing, volunteers were inoculated with either RV-A16 (n = 26) or placebo (n = 10), Jackson cold scores were recorded, and nasal secretions were tested for shedding of RV-A16 ribonucleic acid. RESULTS: The reverse genetics process produced infectious virus that was neutralized by specific antisera and had a mutation rate similar to conventional virus growth techniques. The 1000 median tissue culture infectious dose (TCID50) dose produced moderate colds in most individuals with effects similar to that of a previously tested conventional RV-A16 inoculum. CONCLUSIONS: Reverse genetics techniques produced a RV-A16 inoculum that can cause clinical colds in seronegative volunteers, and they also serve as a stable source of virus for laboratory use. The recombinant production procedures eliminate the need to derive seed virus from nasal secretions, thus precluding introduction of extraneous pathogens through this route.

Formative research to examine collaboration between special supplemental nutrition program for woman, infants, and children and head start programs.

Both the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Head Start/Early Head Start (HS/EHS) Programs serve low-income women and children at high risk for health disparities, yet they do not have a formal state-level partnership in Connecticut. Both programs serve children up to age five, yet children's participation in the WIC Program declines sharply after 2 years of age, limiting the potential benefits of cross-program participation. The goal of this study is to examine current and prospective collaboration efforts among the WIC and HS/EHS Programs in Connecticut and identify barriers to collaboration. An online survey was administered to staff from both programs. Six focus groups were held in January, 2012 with staff and participants from both programs. Results showed areas of existing collaboration between local WIC and HS/EHS Programs, yet also identified many areas where relationships could be strengthened or established. Common themes that were identified included a need for more knowledge among staff about the other program, collaboration involving sharing of client information, and improving referral procedures. Staff from both programs strongly expressed interest in a cross-program collaboration (73 % of HS staff and 86 % of WIC staff). This research serves as a framework for how a state-level collaboration could be established in Connecticut, to enable these two programs to work together more efficiently and effectively for the benefit of mothers and children. Results can provide other State WIC Programs with a blueprint for collaborating with HS/EHS.

Lower airway rhinovirus burden and the seasonal risk of asthma exacerbation.

RATIONALE: Most asthma exacerbations are initiated by viral upper respiratory illnesses. It is unclear whether human rhinovirus (HRV)­induced exacerbations are associated with greater viral replication and neutrophilic inflammation compared with HRV colds. OBJECTIVES: To evaluate viral strain and load in a prospective asthma cohort during a natural cold. METHODS: Adults were enrolled at the first sign of a cold, with daily monitoring of symptoms, medication use, and peak expiratory flow rate until resolution. Serial nasal lavage and induced sputum samples were assessed for viral copy number and inflammatory cell counts. MEASUREMENTS AND MAIN RESULTS: A total of 52 persons with asthma and 14 control subjects without atopy or asthma were studied for over 10 weeks per subject on average; 25 participants developed an asthma exacerbation. Detection of HRVs in the preceding 5 days was the most common attributable exposure related to exacerbation. Compared with other infections, those by a minor group A HRV were 4.4- fold more likely to cause exacerbation (P = 0.038). Overall, sputum neutrophils and the burden of rhinovirus in the lower airway were similar in control subjects without atopy and the asthma group. However, among HRV-infected participants with asthma, exacerbations were associated with greater sputum neutrophil counts (P = 0.005). CONCLUSIONS: HRV infection is a frequent cause of exacerbations in adults with asthma and a cold, and there may be group-specific differences in severity of these events. The absence of large differences in viral burden among groups suggests differential lower airway sensitization to the effects of neutrophilic inflammation in the patients having exacerbations.

What role do local grocery stores play in urban food environments? A case study of Hartford-Connecticut.

INTRODUCTION: Research on urban food environments emphasizes limited access to healthy food, with fewer large supermarkets and higher food prices. Many residents of Hartford, Connecticut, which is often considered a food desert, buy most of their food from small and medium-sized grocery stores. We examined the food environment in greater Hartford, comparing stores in Hartford to those in the surrounding suburbs, and by store size (small, medium, and large). METHODS: We surveyed all small (over 1,000 ft2), medium, and large-sized supermarkets within a 2-mile radius of Hartford (36 total stores). We measured the distance to stores, availability, price and quality of a market basket of 25 items, and rated each store on internal and external appearance. Geographic Information System (GIS) was used for mapping distance to the stores and variation of food availability, quality, and appearance. RESULTS: Contrary to common literature, no significant differences were found in food availability and price between Hartford and suburban stores. However, produce quality, internal, and external store appearance were significantly lower in Hartford compared to suburban stores (all p<0.05). Medium-sized stores had significantly lower prices than small or large supermarkets (p<0.05). Large stores had better scores for internal (p<0.05), external, and produce quality (p<0.01). Most Hartford residents live within 0.5 to 1 mile distance to a grocery store. DISCUSSION: Classifying urban areas with few large supermarkets as 'food deserts' may overlook the availability of healthy foods and low prices that exist within small and medium-sized groceries common in inner cities. Improving produce quality and store appearance can potentially impact the food purchasing decisions of low-income residents in Hartford.

A novel food pantry program: food security, self-sufficiency, and diet-quality outcomes.

BACKGROUND: The number of food pantries in the U.S. has grown dramatically over 3 decades, yet food insecurity remains a persistent public health problem. PURPOSE: The goal of the study was to examine the impact of a food pantry intervention called Freshplace, designed to promote food security. DESIGN: Randomized parallel-group study with equal randomization. SETTING/PARTICIPANTS: Data were collected from June 2010 to June 2012; a total of 228 adults were recruited over 1 year from traditional food pantries and randomized to the Freshplace intervention (n=113) or control group (n=115), with quarterly follow-ups for 12 months. INTERVENTION: The Freshplace intervention included a client-choice pantry, monthly meetings with a project manager to receive motivational interviewing, and targeted referrals to community services. Control group participants went to traditional food pantries where they received bags of food. MAIN OUTCOME MEASURES: Data analyses were conducted from July 2012 to January 2013. Outcomes were food security, self-sufficiency, and fruit and vegetable consumption. Multivariate regression models were used to predict the three outcomes, controlling for gender, age, household size, income, and presence of children in the household. RESULTS: At baseline, half of the sample experienced very low food security. Over 1 year, Freshplace members were less than half as likely to experience very low food security, increased self-sufficiency by 4.1 points, and increased fruits and vegetables by one serving per day compared to the control group, all outcomes p<0.01. CONCLUSIONS: Freshplace may serve as a model for other food pantries to promote food security rather than short-term assistance by addressing the underlying causes of poverty.