Real-World Experiences of Parkinson's Disease OFF Time and Role of Demographics.

Purpose: OFF periods are episodes when Parkinson's disease (PD) medications work suboptimally, with symptoms returning and impacting quality of life. We aimed to characterize OFF periods using patient-reported frequency, severity, and duration, as well as determine these characteristics' associations with demographics. Methods: A retrospective cohort study using Fox Insight Data Exploration Network (Fox DEN) database was conducted. Eligible patients had PD and were >18 years. The experience of OFF periods was characterized by frequency (number of episodes/day), duration (duration/episode), and severity (impact on activities). Significance level was Bonferroni-corrected for multivariate analyses. Results: From a population of 6,757 persons with PD, 88% were non-Hispanic Whites (mean age: 66 ± 8.8 years); 52.7% were males versus 47.3% females; mean PD duration was 5.7 ± 5.2; and 51% experienced OFF periods. Subsequent analyses were limited to non-Hispanic Whites, as they constituted a large majority of the participants and were the subgroup that had the sample size to derive reliable inferences. The analyses showed that 67% experienced 1-2 episodes/day, 90% experienced >15-minute episodes, and 55% reported slight-mild severity/episode. Lower age was associated with a higher frequency (incidence rate ratio [IRR]: 0.992; P<0.001) and severity (odds ratio [OR]: 0.985; P=0.001) of OFF episodes. Income of <$35,000 was associated with 15.1% more episodes/day (IRR: 1.15, p<0.001) and 66.5% higher odds of a severe episode (OR: 1.66; P<0.001). Females experienced 7.5% more episodes compared to males (IRR: 1.075; P=0.003). Longer PD duration was associated with 1.3% more episodes/day (IRR: 1.013; P<0.001) and 10% higher odds of a severe episode (OR: 1.10; P<0.001). Conclusions: Lower age, income <$35,000, longer PD duration, female gender, and being unemployed are associated with a higher frequency and severity of OFF periods with no associations for duration/episode among non-Hispanic Whites with PD. In time-constrained clinic environments, clinicians should tailor OFF periods management counseling to vulnerable demographic groups to enhance care delivery.(J Patient Cent Res Rev. 2024;11:8-17.).

Demographics matter: the potentially disproportionate effect of COVID-19 on hospital ratings.

OBJECTIVE: To identify how features of the community in which a hospital serves differentially relate to its patients' experiences based on the quality of that hospital. DESIGN: A Finite Mixture Model (FMM) is used to uncover a mix of two latent groups of hospitals that differ in quality. In the FMM, a multinomial logistic equation relates hospital-level factors to the odds of being in either group. And a multiple linear regression relates the characteristics of communities served by hospitals to the patients' expected ratings of their experiences at hospitals in each group. Thus, this association potentially varies with hospital quality. The analysis was conducted via Stata. SETTING: Hospital Ratings are measured by Hospital Compare using the HCAHPS survey, a patient satisfaction survey required by the Centers for Medicare and Medicaid Services (CMS) for hospitals in the United States. Participants: 2,816 Medicare-certified acute care hospitals across all US states.

The value of early physical maturity to young adult labor market outcomes.

Puberty is the most important developmental milestone closely preceding a young adult's labor market decisions. Thus, we examine the variation in the timing of physical maturity during adolescence to isolate its association with employment and hourly wages for US young adults. Using the National Longitudinal Study of Adolescent to Adult Health data, we find an early maturity premium of about 6% for females and 8% for males, but no employment advantage, in excess of gains from height and physical attractiveness. Cognitive and personality factors significantly explain this premium for both genders, but job attributes are also important for males.

If looks could heal: Child health and paternal investment.

Data from the first two waves of the Fragile Family and Child Wellbeing study indicate that infants who look like their father at birth are healthier one year later. The reason is such father-child resemblance induces a father to spend more time engaged in positive parenting. An extra day (per month) of time-investment by a typical visiting father enhances child health by just over 10% of a standard deviation. This estimate is not biased by the effect of child health on father-involvement or omitted maternal ability, thereby eliminating endogeneity biases that plague existing studies. The result has implications regarding the role of a father's time in enhancing child health, especially in fragile families.