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Abstract Background Web discussions on health issues are becoming very relevant in the general public. In this context, little information is available regarding cardiovascular diseases, which remain the first cause of morbidity, disability and mortality worldwide. The central objective of the study was to conduct a Web listening analysis on discussions about cardiovascular diseases in Italy, comparing the data relative to the 2-year pre-COVID-19 pandemic period with those collected during the COVID-19 pandemic lockdown (March-July 2020), with quantification of conversations on cardiovascular disease and Web-based discussions and specific evaluation of COVID-19 lockdown impact. Methods A retrospective Web listening analysis using publicly available data was conducted, using validated methods that allow to estimate cardiovascular disease awareness. Digital sources were identified to retrieve data (Italian language), relevant to cardiovascular disease topics. Data were analysed by Google Trends methodology and the Digital Intelligence Platform Brandwatch. Natural Language Processing algorithms enabled comparative analysis, topic detection, classification, leading to a 279,790-item dataset. Results News channels and Twitter were the most important platforms feeding cardiovascular disease information. Facebook was mostly relevant for information sharing. In the pre-COVID-19 period, cardiovascular disease ranked 5th among main health issues (vaccines, tumors, influenza, diabetes) on the Web, and the most discussed cardiovascular disease themes were symptoms/diagnosis (34%), treatments (20%), disease causes/triggers (11%), disease information (9%), quality of life (8%). Conversations on cardiovascular disease prevention were marginal (5%). The COVID-19 pandemic lockdown strongly impacted on discussed topics; novel themes emerged: hospitalization, death risk/occurrence, greater cardiovascular disease risk. Discussions on cardiovascular disease prevention remained marginal (4%). COVID-19 pandemic increased fear of severe COVID-19 among patients with cardiovascular disease and worsened quality of relationship/contact with physicians. Conclusions A limited awareness of cardiovascular disease and their prevention was observed before and during the COVID-19 pandemic. Patients/caregivers need more information and contact with physicians, as it emerged during COVID-19 pandemic. It is urgent to promote novel prevention strategies and to engage people leveraging digital channels and social media. Graphical Abstract

We designed and evaluated a whack-a-mole (WAM) style game (see Figure 1) in a clinical randomized controlled trial (RCT) with reminder-assisted but self-initiated use over the period of a month with 43 participants from a post-lesion pool. While game play did not moderate rehabilitative progress indices of standard neuropsychological control tests, it did significantly improve in-game performance when compared to the control group. Its performance indicators and interaction data were highly accurate in predicting neglect and which hand the patients used for input. Patients found playing beneficial to their rehabilitation and attributed gains in the attention training properties of the game. The game showed potential for bedside assessment, insight support, and motivation by providing knowledge about rehabilitative progress.

Objective: Our aim is to determine the clinical correlates of impaired insight in patients with mild cognitive impairment (MCI) by examining its impact on cognition, functional status, neuropsychiatric symptoms, and caregiver burden.Methods: The study involved 75 patients with MCI and their caregivers. Patients and caregivers underwent a comprehensive evaluation including the Clinical Dementia Rating, memory tests, and the Functional Assessment Questionnaire. Behavioral symptoms were assessed by the Neuropsychiatric Inventory, caregiver burden by the Zarit Burden Inventory, and insight by comparing self-report on the AD8 dementia screening tool to informant collateral. Patients were asked about their perceptions of their memory, and answers were compared with informants' responses. Patient mood was assessed with the Hospital Anxiety Depression Scale.Results: There was a significant difference in AD8 scores among patients who retained versus lacked insight. Zarit Burden Inventory scores showed a significant rise as patient insight declined; the burden appeared greater on spouse versus non-spouse caregivers. Patients with poor insight had significantly worse ratings in Clinical Dementia Rating domains of personal care and judgment, while patients who retained insight had significantly higher depression and anxiety. Insight impairment was associated with worse caregiver mood.Conclusions: Decreased patient awareness for cognitive problems was significantly associated with higher caregiver burden, independent of neuropsychiatric symptoms, functional abilities, and cognition. Personal care, judgment, and problem-solving skills could contribute to caregiver burden. Increased awareness seemed a source of patient depression and anxiety. The research highlights the need to focus on the needs of MCI caregivers and to incorporate psychosocial assessments of caregiver-patient dyads into office visits. [ABSTRACT FROM AUTHOR]

Schizophrenia and other psychotic disorders are a source of significant morbidity, both for patients and caregivers. The first 2-5 years after the onset of psychosis are a critical period wherein treatment might effect disproportionate improvements in long-term outcomes. Specialized services have been developed with the goal of providing early and effective treatment-however, engaging young patients in these services remains a challenge. In this study we sought to uncover possible reasons for this finding by collecting participants' narratives of their early treatment experience. We conducted in-depth, semi-structured interviews with 11 patients currently enrolled in a first episode psychosis program in Connecticut. Transcripts were analyzed using inductive thematic analysis. Participants reported that prior to them entering specialized treatment services, their initial contact with psychiatric care was brought about by abrupt behavioral changes that were noticed by others, and that this lead to treatment that was disconnected from their own concerns, which centered around more everyday challenges. This initial contact did not serve to engender trust or facilitate engagement in further treatment. Additional examples of disconnect were noted even after participants had entered specialized services, and these centered around the patients preference for conceptualizing their difficulties, treatment and recovery in multi-dimensional terms that emphasized social inclusion and vocational achievement. Participants in our study highlighted several areas of disconnect in the course of their early treatment. There is an opportunity to enhance early engagement by offering patients concrete evidence that their treatment priorities are understood and will be addressed. [ABSTRACT FROM AUTHOR]

Abstract: In South Africa health care practitioners are commonly professionals who speak only one, or at most two, of the languages spoken by their patients. This provides for language provision challenges, since many patients are not proficient in English or Afrikaans and ad hoc and haphazard arrangements are made for interpreting by untrained personnel. As part of a larger study (conducted in 2010) in a public psychiatric hospital, we report here on the potential consequences for diagnostic assessments of 13 psychiatric evaluations mediated by ad hoc interpreters who were employed as health care workers and household aides. The psychiatric evaluations were recorded and transcribed verbatim. The first author checked for accuracy of transcription and translations, and the two members of the author team who are both senior African language academics rechecked transcription and translation. We used the typology developed by Vasquez and Javier (1991) to study interpreter errors (i.e. omissions, additions and substitutions). All errors were independently rated by a senior psychiatrist and a senior clinical psychologist to determine whether the errors were likely to have a bearing on clinical decisions concerning the patient and to rate whether errors deemed clinically significant contributed to making the patient appear more ill psychiatrically, or less ill. Of the 57 errors recorded, 46% were rated as likely to have an impact on the goal of the clinical session. Raters concurred that the clinically significant errors contributed towards potentially making the patient look more psychiatrically ill. Detailed analyses of evaluations demonstrate the complexity of informal interpreter positioning regarding issues of diagnosis and cultural factors in illness. Evaluations conducted where clinicians and interpreters are not trained in language and interpreting issues may create a distorted picture of the patients' mental health conditions. [Copyright &y& Elsevier]