Are Interracial Couples at Higher Risk of Multiple Chronic Conditions? Evidence from a Nationally Representative Sample.

Interracial relationships are becoming increasingly common in the United States, yet the physical health status of individuals in interracial relationships is not well understood. Using 18 years of pooled data from the National Health Interview Study (2001-2018) (N = 264, 891), we compared the odds of having multiple chronic conditions (MCC) among adults in interracial and same-race unions. We anticipate that individuals in interracial relationships may be at higher risk of MCC than individuals in same-race relationships due to increased exposure to stressors associated with crossing racial boundaries. Findings indicate that the implications of interracial relationships on MCC depended on the racial composition of the couple. We found that White-Black couples had higher odds of MCC than both White-White and Black-Black couples, but Asian-Black and Hispanic-Black couples did not differ from their same-race couple counterparts, indicating a pronounced and unique health disadvantage for White adults paired with Black adults. We also found that Asian-White and Hispanic-White couples had higher odds of MCC relative to their same-race counterparts. In addition, minority-minority couples generally did not differ from their same-race minority couple counterparts in terms of MCC. The results of the study provide new insights into how the racial composition of interracial unions impacts health and how a closer proximity to Whiteness may be a health risk for some minority groups.

A Pilot Randomized Treatment-Controlled Trial Comparing Vitamin B6 with Broad-Spectrum Micronutrients for Premenstrual Syndrome.

Objective: Premenstrual syndrome (PMS) affects 20%-30% of women but current medical treatments are limited in their efficacy. The objective of this study was to compare efficacy of a broad-spectrum micronutrient formula (consisting mainly of minerals and vitamins) to a single vitamin (B6) for treatment of PMS, for which B6 has already been shown to be efficacious. Methods: This double-blind, randomized, treatment-controlled trial allocated 78 (72 completed) regularly menstruating women with PMS to consume micronutrients or vitamin B6 (80 mg/day) daily following a two-cycle baseline period, for three menstrual cycles. The primary outcome measure, Daily Record of Severity of Problems (DRSP), established PMS as well as tracked change in five PMS symptoms: psychological, somatic, total symptoms, impact ratings, and worst day ratings. Results: Linear-mixed model analyses indicated both treatments produced comparable reduction in PMS symptoms with medium effect sizes (ES) across all PMS variables as measured by the DRSP (micronutrient ES = 0.50-0.56; B6 ES = 0.43-0.56), with 72% of the micronutrient and 60% of the vitamin B6 group identified as in full remission in PMS symptoms after three cycles. The micronutrient-treated participants showed greater improvement than the B6 group (between group d = 0.51, p < 0.05) in health-related quality of life. For those women (n = 28) who met criteria for premenstrual dysphoric disorder (PMDD), the DRSP ES were larger for those who had been in the micronutrient condition (ES = 1.28-1.67) as compared with those on B6 (ES = 0.50-0.75), although the group differences were not statistically reliable. There were no group differences in side effects, nor any serious adverse effects reported. Conclusions: Both treatments provided similar benefit for reducing PMS symptoms, with greater effect of micronutrients on quality of life as well as potential clinical benefit of micronutrients for PMDD. This study provides further efficacy data on B6 and also identifies the nutritionally broader spectrum intervention as possibly having specific advantages for those whose symptoms are more severe. As this is the first study to investigate these treatments for PMDD, systematic replication is required.

Comparing heterogeneous SNOMED CT coding of clinical research concepts by examining normalized expressions.

OBJECTIVE: A continual problem confronting the implementation of standardized vocabularies such as SNOMED CT is that their expressive flexibility and power provide more than one way to represent a given concept. The goal of this study was to investigate how the CliniClue Expression Transformer tool could be used to help in discerning similarities and differences among three separate sets of clinical research concepts coded in SNOMED CT by three different paid expert coding companies. METHODS: Initial editing of the companies' coded datasets was required to enable accurate input into CliniClue Version: 2006.2.0030 Expression Transformer tool. The normal forms of the company codings for the 319 clinical research question/answer sets were compared to determine whether they were equivalent or otherwise related (e.g., if one was subsumed by the other). Basic frequencies were computed for (957) pairwise comparisons of each of 319 concepts each coded by the three expert coders, and the implications of the results discussed. RESULTS: The primary finding from this study was that, for each of the paired comparisons, approximately half of the time the companies' codings could be related, primarily via subsumption. The greatest percentage of equivalent concepts between any two companies was 33%. These same two companies also agreed most often on the core clinical concept measure from an earlier study by the authors. CONCLUSION: Heterogeneity among coders using the same controlled terminology appears inescapable despite the extensive efforts of terminological standards developers and implementers. In our study, the computable determination of equivalence of discordantly coded concepts still failed to yield acceptably comparable data. A clearer articulation, and perhaps a simplification, of rules for the consistent use for terminologies such as SNOMED CT is needed.