Well-being among Older Adults in Mississippi: Exploring Differences between Metropolitan, Micropolitan, and Noncore Rural Settings

It is a common belief that older adults in rural areas have high subjective well-being, despite often experiencing greater poverty and having access to fewer resources than older adults who live in urban areas, a phenomenon sometimes referred to as the “rural-urban paradox.” However, research does not consistently find high well-being in rural areas, which might be due to research not distinguishing between very rural and semi-rural (or small town) settings. This study compares the subjective well-being of older adults in micropolitan and noncore counties with the well-being of older adults in metropolitan areas in Mississippi (n = 659). Preliminary results indicate metropolitan respondents reporting higher subjective well-being than both micropolitan and noncore respondents. However, after accounting for key covariates, micropolitan residents were found to have significantly lower levels of subjective well- being compared to metropolitan residents. Overall, our study suggests that micropolitan settings may be less conducive to healthy, successful aging when compared to metropolitan settings

Indicators of Supportive Service Need Among Older Adults in Mississippi

Providing quality services is one of the challenges associated with the continued increase in the nation’s older adult population. Effective use of needs assessment data can be useful in assessing service need. This study measures the level of perceived need for supportive services among older adults in Mississippi. Using statewide needs assessment data, this study applies the Behavioral Model to measure the perceived need for supportive services among survey participants aged 60 and older (N = 838). Results indicate that age, race, physical health, and subjective well-being were consistent predictors of perceived need for supportive services. Results suggest the importance of understanding the factors associated with the perceived need for supportive services to more effectively plan service delivery

Secondary attachments and adolescent self concept

This study examined the popular notion that crushes or secondary attachments to celebrity figures are an important aspect of self-concept development during adolescence. In a repeated measures design, 79 male and female 5th, 8th, and 11th graders and college sophomores completed a set of personality scales, first describing themselves and later, describing the favorite celebrity. Repeated measures multivariate analyses of variance (MANOVA) analysis of self-object congruence revealed no significant main or interaction effects for the type of attachment, gender, or age of subject. Significant within subject effects were obtained for the repeated measures factor (self-object congruence). Overall, students perceived their attachment objects to be more agentic, yet less expressive and emotionally vulnerable than themselves. MANOVA analyses indicated that males and older students perceived their attachment objects to be higher in agency than expressivity, whereas females and younger students perceived their attachment objects to be higher in expressivity than agency. These data indicate that the function served by secondary attachments in the development of self-concept may be quite similar for adolescent males and females.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45592/1/11199_2004_Article_BF00288191.pd

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Developmental pathway for potent V1V2-directed HIV-neutralizing antibodies.

CAPRISA, 2014.Antibodies capable of neutralizing HIV-1 often target variable regions 1 and 2 (V1V2) of the HIV-1 envelope, but the mechanism of their elicitation has been unclear. Here we define the developmental pathway by which such antibodies are generated and acquire the requisite molecular characteristics for neutralization. Twelve somatically related neutralizing antibodies (CAP256-VRC26.01-12) were isolated from donor CAP256 (from the Centre for the AIDS Programme of Research in South Africa (CAPRISA)); each antibody contained the protruding tyrosine-sulphated, anionic antigen-binding loop (complementarity-determining region (CDR) H3) characteristic of this category of antibodies. Their unmutated ancestor emerged between weeks 30-38 post-infection with a 35-residue CDR H3, and neutralized the virus that superinfected this individual 15 weeks after initial infection. Improved neutralization breadth and potency occurred by week 59 with modest affinity maturation, and was preceded by extensive diversification of the virus population. HIV-1 V1V2-directed neutralizing antibodies can thus develop relatively rapidly through initial selection of B cells with a long CDR H3, and limited subsequent somatic hypermutation. These data provide important insights relevant to HIV-1 vaccine development