The Most Bothersome Aspects of Off Periods Reported by Individuals with Parkinson's Disease.

INTRODUCTION: The off periods in Parkinson's disease have a significantly negative impact on quality of life. What the most bothersome aspects of off periods are from the patient's perspective are not well studied, nor is the degree to which screening tools for wearing off such as the Wearing Off Questionnaires (WOQs) capture what bothers patients most. METHODS: A questionnaire was deployed to eligible participants of Fox Insight, an online study of individuals with self-reported Parkinson's disease. Inclusion criteria were the use of ≥1 dopaminergic medications and an affirmative response to a question on experiencing off periods. Participants provided free-text responses regarding the top 3 most bothersome symptoms they experience when off. A determination was made regarding whether each response would have been captured by the 32-item, 19-item, and 9-item WOQs. RESULTS: The final sample had 2106 participants, a mean age of 66.6 years, 52.3% were men, and had a disease duration of 4.9 years. The WOQ-32 items covered all of the most bothersome symptoms for 53.2% of respondents. Among bothersome aspects of off not captured by the WOQs, 597 (66.2%) were specific symptoms, with freezing of gait, apathy, and memory problems being the most common. The functional consequences of off periods were most bothersome to 232 (25.7%), with walking problems being the most common. The emotional response to off periods was the most bothersome aspect to 169 respondents (18.7%). DISCUSSION: This study emphasizes the value of narrative data in understanding patient experiences, and what bothers patients most about off periods. The WOQs, although of established utility in the screening for wearing off, may not capture those symptoms most bothersome to patients.

Dangerous Enough: Moderating Racial Bias with Contextual Threat Cues.

Research shows that participants shoot armed Blacks more frequently and quickly than armed Whites, but make don't-shoot responses more frequently and quickly for unarmed Whites than unarmed Blacks. We argue that this bias reflects the perception of threat - specifically, threat associated with Black males. Other danger cues (not just race) may create a similar predisposition to shoot, and if these cues promote shooting when the target is White, they should attenuate racial bias. We embedded targets in threatening andsafe backgrounds. Racial bias was evident in safe contexts but disappeared when context signaled danger, and this reduction was largely due to an increased tendency to shoot White targets.