Maintaining a way of life: trials and tribulations of farmers market families

Never before in our nation’s history has there been so many ways for consumers to purchase food. From grocery stores, to super centers such as Wal-Mart and Cosco, convenience stores, online purchases, community supported agriculture (CSA), and farmers markets, Americans have a multitude of venues to choose from. Although many Americans currently purchase their foods from grocery stores, a growing number of them are buying locally at their farmers’ markets and from CSAs. As the sustainability movement takes a greater foothold in the American household, local products and local foods are becoming ever more important and prevalent. Yet with all of the statistics surrounding local agriculture, the human element is often lost. A majority of small farmers and their spouses, often the ones who sell at a local level, have to work full time both on and off farm to support their families and farms. This case study examines the professional lives of five local farm families who choose to sell their products at the Fayetteville, Arkansas farmers market. It seeks to understand farmers’ reasons for farming and selling locally, as well as their biggest challenges and rewards. In addition, it seeks to fill gaps in literature, begin to develop an understanding of this phenomenon, and shed light on why these farmers choose to sell at a local level

Maintaining a way of life: trials and tribulations of farmers’ market families

Never before in our nation’s history has there been so many ways for consumers to purchase food. From grocery stores, to super centers such as Wal-Mart and Costco, convenience stores, online purchases, community supported agriculture (CSA), and farmers’ markets, Americans have a multitude of venues to choose from. Although many Americans currently purchase their foods from grocery stores, a growing number of them are buying locally at their farmers’ markets and from CSAs. As the sustainability movement takes a greater foothold in the American household, local products and local foods are becoming ever more important and prevalent. Yet with all of the statistics surrounding local agriculture, the human element is often lost. A majority of small farmers and their spouses, often the ones who sell at a local level, have to work full time both on and off farm to support their families and farms. This case study examines the professional lives of five local farm families who choose to sell their products at the Fayetteville, Arkansas farmers’ market. It seeks to understand farmers’ reasons for farming and selling locally, as well as their biggest challenges and rewards. In addition, it seeks to fill gaps in literature regarding farmers’ motivations for selling at a local level

Association of Early Aspirin Use With In-Hospital Mortality in Patients With Moderate COVID-19

Importance: Prior observational studies suggest that aspirin use may be associated with reduced mortality in high-risk hospitalized patients with COVID-19, but aspirin\u27s efficacy in patients with moderate COVID-19 is not well studied. Objective: To assess whether early aspirin use is associated with lower odds of in-hospital mortality in patients with moderate COVID-19. Design, Setting, and Participants: Observational cohort study of 112 269 hospitalized patients with moderate COVID-19, enrolled from January 1, 2020, through September 10, 2021, at 64 health systems in the United States participating in the National Institute of Health\u27s National COVID Cohort Collaborative (N3C). Exposure: Aspirin use within the first day of hospitalization. Main Outcome and Measures: The primary outcome was 28-day in-hospital mortality, and secondary outcomes were pulmonary embolism and deep vein thrombosis. Odds of in-hospital mortality were calculated using marginal structural Cox and logistic regression models. Inverse probability of treatment weighting was used to reduce bias from confounding and balance characteristics between groups. Results: Among the 2 446 650 COVID-19-positive patients who were screened, 189 287 were hospitalized and 112 269 met study inclusion. For the full cohort, Median age was 63 years (IQR, 47-74 years); 16.1% of patients were African American, 3.8% were Asian, 52.7% were White, 5.0% were of other races and ethnicities, 22.4% were of unknown race and ethnicity. In-hospital mortality occurred in 10.9% of patients. After inverse probability treatment weighting, 28-day in-hospital mortality was significantly lower in those who received aspirin (10.2% vs 11.8%; odds ratio [OR], 0.85; 95% CI, 0.79-0.92; P \u3c .001). The rate of pulmonary embolism, but not deep vein thrombosis, was also significantly lower in patients who received aspirin (1.0% vs 1.4%; OR, 0.71; 95% CI, 0.56-0.90; P = .004). Patients who received early aspirin did not have higher rates of gastrointestinal hemorrhage (0.8% aspirin vs 0.7% no aspirin; OR, 1.04; 95% CI, 0.82-1.33; P = .72), cerebral hemorrhage (0.6% aspirin vs 0.4% no aspirin; OR, 1.32; 95% CI, 0.92-1.88; P = .13), or blood transfusion (2.7% aspirin vs 2.3% no aspirin; OR, 1.14; 95% CI, 0.99-1.32; P = .06). The composite of hemorrhagic complications did not occur more often in those receiving aspirin (3.7% aspirin vs 3.2% no aspirin; OR, 1.13; 95% CI, 1.00-1.28; P = .054). Subgroups who appeared to benefit the most included patients older than 60 years (61-80 years: OR, 0.79; 95% CI, 0.72-0.87; P \u3c .001; \u3e80 years: OR, 0.79; 95% CI, 0.69-0.91; P \u3c .001) and patients with comorbidities (1 comorbidity: 6.4% vs 9.2%; OR, 0.68; 95% CI, 0.55-0.83; P \u3c .001; 2 comorbidities: 10.5% vs 12.8%; OR, 0.80; 95% CI, 0.69-0.93; P = .003; 3 comorbidities: 13.8% vs 17.0%, OR, 0.78; 95% CI, 0.68-0.89; P \u3c .001; \u3e3 comorbidities: 17.0% vs 21.6%; OR, 0.74; 95% CI, 0.66-0.84; P \u3c .001). Conclusions and Relevance: In this cohort study of US adults hospitalized with moderate COVID-19, early aspirin use was associated with lower odds of 28-day in-hospital mortality. A randomized clinical trial that includes diverse patients with moderate COVID-19 is warranted to adequately evaluate aspirin\u27s efficacy in patients with high-risk conditions