Asymptomatic or symptomatic SARS-CoV-2 infection plus vaccination confers increased adaptive immunity to variants of concern.

The ongoing evolution of SARS-CoV-2 requires monitoring the capability of immune responses to cross-recognize Variants of Concern (VOC). In this cross-sectional study, we examined serological and cell-mediated immune memory to SARS-CoV-2 variants, including Omicron, among a cohort of 18-21-year-old Marines with a history of either asymptomatic or mild SARS-CoV-2 infection 6 to 14 months earlier. Among the 210 participants in the study, 169 were unvaccinated while 41 received 2 doses of mRNA-based COVID-19 vaccines. Vaccination of previously infected participants strongly boosted neutralizing and binding activity and memory B and T cell responses including the recognition of Omicron, compared to infected but unvaccinated participants. Additionally, no measurable differences were observed in immune memory in healthy young adults with previous symptomatic or asymptomatic infections, for ancestral or variant strains. These results provide mechanistic immunological insights into population-based differences observed in immunity against Omicron and other variants among individuals with different clinical histories.

Home-Based Gait Speed Assessment: Normative Data and Racial/Ethnic Correlates Among Older Adults.

OBJECTIVES: To determine home-based gait speed performance and its associations with sociodemographic and health-related factors among older adults. DESIGN: Cross-sectional analysis of a nationally representative US population sample. SETTING AND PARTICIPANTS: Homes of Health and Retirement Study (HRS) participants. METHODS: Walk test data measured at home over 2.5 m were aggregated for 6983 individuals, aged ≥65 years (mean age 74.8 ± 6.9 years, 54.2% women), from the 2006 and 2008 HRS waves. Means for gait speed at normal pace were determined for demographic and clinical groupings; association of gait speed with demographic, socioeconomic status, and health factors were examined. Four-year mortality was predicted from baseline slow gait status defined using demographic-based cutoff scores as well as commonly recommended cutoff scores (100 or 60 cm/s). RESULTS: Home-based gait speed (cm/s) means were lower for female than male (9.6% difference), older than younger (18.0% difference), African American than white (20.5% difference), and Hispanic than Non-Hispanic (10.3% difference) participants. Differences by age group, race, and ethnicity remained significant within sexes (P < .001). Lower speed was associated with African American race and all health problems; higher speed was associated with higher socioeconomic status and alcohol consumption. Four-year mortality was predicted by slow gait status. Predictive validity was, in general, higher for slow gait cutoff scores defined by demographic characteristics. CONCLUSIONS AND IMPLICATIONS: Mean gait speed measured at home differs among older (aged ≥65 years) US resident population groups defined by sex, age, race, ethnicity, health status, and combinations of these factors, and predicts 4-year mortality when substantially slower than group-based norms. These findings may assist researchers and clinicians in determining normal and abnormal gait performance in older adults in community settings.

Examining Multi-Level Correlates of Suicide by Merging NVDRS and ACS Data.

This paper describes a novel database and an associated suicide event prediction model that surmount longstanding barriers in suicide risk factor research. The database comingles person-level records from the National Violent Death Reporting System (NVDRS) and the American Community Survey (ACS) to establish a case-control study sample that includes all identified suicide cases, while faithfully reflecting general population sociodemographics, in sixteen USA states during the years 2005-2011. It supports a statistical model of individual suicide risk that accommodates person-level factors and the moderation of these factors by their community rates. Named the United States Multi-Level Suicide Data Set (US-MSDS), the database was developed outside the RDC laboratory using publicly available ACS microdata, and reconstructed inside the laboratory using restricted access ACS microdata. Analyses of the latter version yielded findings that largely amplified but also extended those obtained from analyses of the former. This experience shows that the analytic precision achievable using restricted access ACS data can play an important role in conducting social research, although it also indicates that publicly available ACS data have considerable value in conducting preliminary analyses and preparing to use an RDC laboratory. The database development strategy may interest scientists investigating sociodemographic risk factors for other types of low-frequency mortality.

Mending broken hearts: marriage and survival following cardiac surgery.

Marriage has long been linked to lower risk for adult mortality in population and clinical studies. In a regional sample of patients (n = 569) undergoing cardiac surgery, we compared 5-year hazards of mortality for married persons with those of widowed, separated or divorced, and never married persons using data from medical records and psychosocial interviews. After adjusting for demographics and pre- and postsurgical health, unmarried persons had 1.90 times the hazard of mortality of married persons; the disaggregated widowed, never married, and divorced or separated groups had similar hazards, as did men and women. The adjusted hazard for immediate postsurgical mortality was 3.33; the adjusted hazard for long-term mortality was 1.71, and this was mediated by married persons' lower smoking rates. The findings underscore the role of spouses (both male and female) in caregiving during health crises and the social control of health behaviors.

Looking Inside the Black Box of "Attendance at Services": New Measures for Exploring an Old Dimension in Religion and Health Research.

Research in religion and health has spurred new interest in measuring religiousness. Measurement efforts have focused on subjective facets of religiousness such as spirituality and beliefs, and less attention has been paid to congregate aspects, beyond the single item measuring attendance at services. We evaluate some new measures for religious experiences occurring during congregational worship services. Respondents (N=576) were religiously-diverse community-dwelling adults interviewed prior to cardiac surgery. Exploratory factor analysis of the new items with a pool of standard items yielded a readily interpretable solution, involving seven correlated but distinct factors and one index variable, with high levels of internal consistency. We describe religious affiliation and demographic differences in these measures. Attendance at religious services provides multifaceted physical, emotional, social, and spiritual experiences that may promote physical health through multiple pathways.

Psychosocial factors in heart surgery: presurgical vulnerability and postsurgical recovery.

OBJECTIVE: Distress and low perceived social support were examined as indicators of psychosocial vulnerability in patients about to undergo heart surgery. DESIGN: A total of 550 study patients underwent heart surgeries, including bypass grafting and valve procedures. Psychosocial interviews were conducted about five days before surgery, and biomedical data were obtained from hospital records. MAIN OUTCOME MEASURES: Sociodemographic, personality, religious, and biomedical factors were evaluated as predictors of psychosocial vulnerability, and all five sets of variables were evaluated as contributors to hospital length of stay (LOS). RESULTS: Patients scoring higher on one or more indicator of presurgical psychosocial vulnerability were younger, more likely to be female, less likely to be married, less well educated, lower in dispositional optimism, higher in trait anger, and lower in religiousness. Older age, depression, low support, and low trait anger each showed an independent, prospective association with greater LOS, and several other predictors had prospective relationships with LOS that were statistically mediated by depression or perceived support. CONCLUSION: Evidence that multiple psychosocial factors may influence adaptation to heart surgery has implications for understanding and ameliorating presurgical distress and for improving postsurgical recovery.

Course of depressive symptoms in patients undergoing heart surgery: confirmatory analysis of the factor pattern and latent mean structure of the Center for Epidemiologic Studies Depression Scale.

OBJECTIVE: The purpose of this study was to examine the dimensionality, stability, and course of depressive symptoms over the 12-month period beginning approximately 1 week before heart surgery. METHODS: The Center for Epidemiological Studies Depression Scale (CES-D) was administered to 570 patients before heart surgery and 1, 3.5, 6.5, and 12.5 months later. RESULTS: Confirmatory factor analysis rejected a four-factor model as a result of small variances for two interpersonal items. With their elimination, a three-factor solution (negative affect, low positive affect, somatic/vegetative symptoms) showed good psychometric properties. Except for the somatic/vegetative factor at the 1-month follow up, there was a high degree of stability in the factor pattern over a 12-month period beginning approximately 1 week before heart surgery. Latent mean structure analysis indicated that, apart from elevations in several somatic/vegetative symptoms during the month after surgery, means for all three depressive symptoms declined over time. The recovery of positive affect showed a steeper trajectory toward the end of the follow-up period by comparison with the rates of decline for depressed affect and somatic/vegetative symptoms. CONCLUSIONS: These findings support using 18 CES-D items to measure three depressive symptom dimensions in heart patients and may reflect a normative pattern of adjustment to heart surgery.