FP-20-15 Married & Living Apart Together

Living apart together (LAT) relationships are an emerging relationship form typically defined as unmarried couples in a committed, long-term relationship who choose to live apart (maintain separate residences) rather than cohabit or marry (Connidis, et al., 2017). Other researchers have classified married couples who live separately as LATs, as well (Binstock & Thornton, 2004). This profile examines the LAT status of newly married individuals who report having entered a marriage in the last year. We define newlywed LATs as those not living with their spouse for reasons other than marital discord1. Using data from IPUMS-USA, we present their characteristics by times married, age, and educational attainment

Forage Systems to Optimize Agronomic and Economic Performance in Organic Dairy Systems

Organic dairy production in the USA is growing, but most forage systems research focuses on conventional production practices. As a result, organic dairy producers have limited science-based information to assist with farm and livestock management. The objective of this project was to use a multi-faceted approach to determine the ideal species mixtures for organic dairy production as well as document forage quality, forage yield, soil characteristics, milk production and milk quality during the grazing season. The forages studied ranged from a single species monoculture to a four species mixture of warm and cool season grasses and legumes. Nine distinct forage systems were seeded into small plots at the University of Tennessee and University of Kentucky research farms using organic practices. These plots were monitored for three years for yield, quality, species composition, and soil characteristics. The four best performing forage systems were planted in small paddocks on organic dairy farms in Tennessee and Kentucky to evaluate forage yield, forage quality, seasonality of production, and suitability for on-farm milk production. The superior forage system was established on a 4 ha paddock and compared the existing forage system used by each of the dairy farms. These larger paddocks allowed continued measurements of forage yield and quality, as well as measurements of milk production, milk quality, and grazing behaviour of the animals. The information from this project is currently being incorporated into a total farm management system for organic dairy producers in the Southeastern USA

Fine-mapping type 2 diabetes loci to single-variant resolution using high-density imputation and islet-specific epigenome maps

We expanded GWAS discovery for type 2 diabetes (T2D) by combining data from 898,130 European-descent individuals (9% cases), after imputation to high-density reference panels. With these data, we (i) extend the inventory of T2D-risk variants (243 loci,135 newly implicated in T2D predisposition, comprising 403 distinct association signals); (ii) enrich discovery of lower-frequency risk alleles (80 index variants with minor allele frequency 2); (iii) substantially improve fine-mapping of causal variants (at 51 signals, one variant accounted for >80% posterior probability of association (PPA)); (iv) extend fine-mapping through integration of tissue-specific epigenomic information (islet regulatory annotations extend the number of variants with PPA >80% to 73); (v) highlight validated therapeutic targets (18 genes with associations attributable to coding variants); and (vi) demonstrate enhanced potential for clinical translation (genome-wide chip heritability explains 18% of T2D risk; individuals in the extremes of a T2D polygenic risk score differ more than ninefold in prevalence).Peer reviewe

Long Term Cost-of-Illness in Stroke: An International Review

An international review of the costs of stroke was conducted to explore data sources, and cost variables as well as to compare estimates of the annual aggregated cost (prevalence-based) and total per patient long-term cost (incidence-based) of care. Dutch, English, French, German, Italian and Spanish literature was searched using the keywords stroke, ischaemic stroke, haemorrhagic stroke, cerebrovascular accident, cerebral infarction, cost(s), economics, and cost analysis. Criteria for study inclusion were: provides estimates of direct and/or indirect costs of stroke, published after 1989, methods described in adequate detail, and for studies of long-term costs, estimates based on a minimum 5 years of care following the event. Cost estimates are presented in original currencies and US dollars. Among studies representing Australia, New Zealand, Western Europe and North America, six prevalence studies reported total annual aggregated costs of $US7975 (1988 values) to$US54 546 (1993 values) per patient; eight incidence-based studies reported total long-term per patient costs of $US18 538 (1991 values) to$US228 038 (1990 values). Identifiable factors underlying variation included: perspective employed, cost variables considered, and exclusion of comorbidities. Although lack of uniformity hampers inter-study comparisons, it is evident that stroke poses a significant economic burden. Consensus on standard cost variables and methods for projections of resource use and survival over time are clearly warranted.Cost of illness, Pharmacoeconomics, Stroke

Prepandemic and Pandemic Marriages among Same-Sex and Different-Sex Couples

Most states experienced declines in marriages during the pandemic, with variation across states. Given that marriages to same-sex couples make up a small share of total marriages, these trends are overwhelmingly representative of marriages of different-sex couples. To test if the decline observed among marriages of different-sex couples is also observed among marriages of same-sex couples, the authors calculated ratios (2020 marriage count divided by 2019 marriage count) for 13 states, disaggregating marriages of same- and different-sex couples. The 13 states selected were the only states in which same-sex marriage administrative data were available. The results reveal disparate effects of the pandemic on marriage counts for same-sex and different-sex couples. For 11 of the states examined, marriages of same-sex couples either did not decline or declined less than marriages of different-sex couples. Further investigation is warranted as more state-level data on same-sex marriage become available

Caring for Hypertension on Initiation: Costs and Effectiveness (CHOICE): A Naturalistic Design and Rationale for the Study of Patterns of Care in Hypertension

Background: Success in treating hypertension is greater in clinical trials than in actual practice. To prospectively study real-world antihypertension treatment patterns, therefore, naturalistic studies are essential. Objective: The primary objective of the Caring for Hypertension on Initiation: Costs and Effectiveness (CHOICE) study was to evaluate the feasibility of performing a naturalistic study in patients with newly diagnosed hypertension in terms of enrollment, adequacy, and the timeliness of data collection and study procedures. Methods: The CHOICE study prospectively collected actual practice data from physicians, who were blind to the study purpose and hypotheses, treating newly diagnosed hypertensive patients. The initial therapy was randomly assigned to either Group 1 (diuretics or beta-adrenoceptor antagonists) or Group 2 (calcium channel antagonists or ACE inhibitors). The protocol made no demands on usual medical care in scheduling visits and changing treatment during follow-up. Only a final visit at 5 +- 1 months was mandated. Direct involvement of the CHOICE study team was minimized using a remote study monitoring system to collect data and communicate with study sites. Results: Within 30 weeks, a total of 55 physicians enrolled 512 patients with a mean age blood pressure of 158/99mm Hg. In all, 46 different antihypertensive medications were prescribed and 2554 office visits (range 1-16 visits per patient) were attended. Other medical resource use was low during the study period. A final, clean database was ready for analysis 30 days after the last patient visit. Conclusion: The results of this pilot study demonstrate that CHOICE is a feasible framework within which the real-world effectiveness and cost effectiveness of initial therapy for patients with newly diagnosed hypertension can be studied. Protocol flexibility and a novel electronic data entry system are core elements of this naturalistic design.ACE-inhibitors, Beta-1-adrenergic-receptor-antagonists, Calcium-channel-agonists, Diuretics, Hypertension

sj-docx-1-srd-10.1177_23780231231222772 – Supplemental material for Visualizing Concentrations of Couples and Same-Sex Couples across U.S. Counties

Supplemental material, sj-docx-1-srd-10.1177_23780231231222772 for Visualizing Concentrations of Couples and Same-Sex Couples across U.S. Counties by Francesca A. Marino, Krista K. Westrick-Payne, Wendy D. Manning and Susan L. Brown in Socius</p

Transfusions and patient burden in chemotherapy-induced anaemia in France

Objectives: To estimate the patient burden in terms of the time spent on outpatient red blood cell (RBC) transfusions indicated for chemotherapy induced-anaemia (CIA) in patients with cancer in France. Methods: A retrospective chart review of patients with cancer receiving an outpatient RBC transfusion was conducted at seven treatment centres in France. Total treatment time for one transfusion visit per patient was measured as the elapsed time between pre- and post-transfusion vital sign assessment, including time from transfusion start to stop. Elapsed time from haemoglobin (Hb) level testing to transfusion start and from blood draw for compatibility testing to transfusion start were recorded. In addition, estimated travel time and distance to the transfusion centre, and clinical and demographic information were collected. Results: A total of 103 patients [63.1% men; mean age 66.2 years, standard deviation (SD) 11.9] were enrolled in the study (1 August 2010–31 October 2010). The four most frequent diagnoses were lung cancer (31.1%), urological cancer (15.5%), gynecological cancer (14.6%) and gastrointestinal/colorectal cancer (14.6%). Mean elapsed time between prevital and postvital sign assessment was 4.0 h [95% confidence interval (CI) 1.9–6.1], including a mean of 3.4 h (95% CI 2.5–4.2) for the transfusion itself. Hb level testing (mean pre-transfusion Hb level 8.0 g/dl, SD 0.8) and blood draw for compatibility testing were completed in a mean of 28.8 h (95% CI 1.3–56.2) and 9.4 h (95% CI 0–21.4) prior to transfusion respectively. Patients’ one-way mean travel time to the transfusion centre was 32.9 min (95% CI 28.5–37.4) and mean distance travelled was 25.4 km (95% CI 11.6–39.3). Conclusion: In France, CIA treatment with RBC transfusion is a time-consuming activity for patients that includes multiple trips to a medical facility, blood testing and the transfusion procedure itself. This burden is important to consider in the context of optimizing proactive monitoring and planning for supportive oncology care