A Study of Selected Demographic Factors Associated with the Number and Characteristics of Marriages Solemnized in South Dakota: 1960-1972

The marriage statistics for South Dakota from 1960 to 1970 reveal that the number of marriages has steadily increased since 1960. The number of births, however, has steadily decreased in number in South Dakota since 1960. Perhaps this is understandable inasmuch as Paul H. Jacobson points out that the analysis and interpretation of marriage statistics is the least developed branch of American vital statistics. This is an important area for study, however, because any community is highly influenced by the proportion of its population that is single, married, widowed, or divorced. The marital condition of a population influences its birth rate, thus producing changes in the composition of the population. Marital status composition of the population is a demographic factor that helps produce population change and influence local community life. Marital status has great importance for group survival through childbearing, for it is generally accepted that it is through the legal cohabiting of males and females that childbearing is generally approved and accepted. Because of this, the rate of marriages together with their dissolution are vital processes, and statistics of marriage and divorce are vital statistics. Besides affecting the birthrate, marital status also affects other community processes such as: labor force participation, school attendance, urban-rural residence, and many other important processes. David Glass summarizes the importance of marital status data in the following terms: It is through the intervening variable of marriage that replacement indices become sociologically meaningful. In the more developed societies, recent changes in the level and trend of fertility owe much to changes in the amount of, and age at, marriage. A final indication of the importance of this problem is the emphasis placed upon it-by the state legislature. This year two House bills (HB have been introduced that will place tighter restrictions on marriages solemnized in South Dakota. The new bills ask for a three-day waiting period for remarriage after filing for a divorce. In actuality, the six months amounts to four months because it takes two months before a divorce becomes final, leaving four more months before the parties involved could remarry. Knowledge generated by the study of this problem may assist in the area planning of various governmental, educational, economic, religious, and recreational agencies in South Dakota for the coming year. It is also hoped that it may bring about some standardization of the marriage laws of the various states, because some states are indicating they will not recognize those marriages where couples cross state lines to marry to avoid their home state laws on marriage

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used