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Health risk exposure during the global COVID-19 pandemic has required people to adopt self-isolation. Public authorities have therefore had the difficult task of sustaining such protective but stressful behaviour. Evidence shows that besides egoistic drives, the motivation for self-isolation behaviour could be altruistic. However, the type and role of prosocial motivation in the current pandemic is underestimated and its interaction with risk exposure and psychological distress is largely unknown. Here we show that affective empathy for the most vulnerable predicts acceptance of lockdown measures. In two retrospective studies, one with a general population and one with COVID-19 positive patients, we found that (1) along with health risk exposure, affective empathy is a predictor of acceptance of lockdown measures (2) social covariates and psychological distress have no significant impact. Our results support the need to focus on altruistic behaviours while informing the public instead of on fear-inducing messages.

ObjectivesAntimicrobial resistance is one of the biggest threats posed to healthcare systems, accounting for hundreds of thousands of deaths worldwide and correlated with poorer health status and increased healthcare costs. The practice of delayed prescription seems to be an effective solution to diminish the unnecessary overprescription of antibiotics, as study results demonstrated that it does not negatively affect health status while engaging patients and addressing their desire for a prescription when visiting the doctor’s office. This study investigates the point of view of family doctors practising in Switzerland, a country where delayed prescription has not yet been introduced. The main scope was to describe the perceived barriers and facilitators towards delayed prescription of antibiotics.DesignA total of five online focus group discussions.SettingFamily medicine.Participants21 family doctors practising in the Italian-speaking region of Switzerland (M=51.24; SD=9.73 years of age; 62% males).ResultsFocus group discussions revealed a generally negative attitude towards delayed antibiotic prescription among participants. Thematic analysis identified three key themes reflecting perceived barriers to its implementation: (1) Maintenance of authority through a gatekeeping role, highlighting concerns about preserving professional control over treatment decisions; (2) Importance of maintaining communication, addressing fears that delayed prescription could undermine clarity and trust in doctor–patient interactions and (3) Healthcare system and guidelines for good practice, which encompasses structural and normative expectations around follow-up visits, pre-existing practices and clinical routines. These themes illustrate the multifaceted nature of physicians’ resistance to adopting delayed prescription in their daily practice.An additional information that emerged from the discussions is the extensive use in the region of a practice similar to delayed prescription, called ‘the stock antibiotic’. However, it is perceived very differently by physicians because it does not enforce a predetermined waiting time on patients.ConclusionsPast research has demonstrated that delayed prescription is an effective practice for reducing antibiotic consumption and promoting patients’ empowerment while maintaining their satisfaction. Nevertheless, the results of this study show that doctors’ perceptions of this practice are not always positive. Any attempt to introduce the practice should start with a careful evaluation of the cultural context and doctors’ opinions, as their willingness to embrace the practice is crucial for its successful adoption. A more practical implication of our results stems from the discovery of the practice of the stock antibiotic, which could be described as a new version of delayed prescription, tailored to the customs and practices of the region. This aspect highlights the importance of exploring local contexts to ensure that prescribing practices can be implemented in alignment with local preferences.

The present study provides a systematic review of level 1 and level 2 screening tools for the early detection of autism under 24 months of age and an evaluation of the psychometric and measurement properties of their studies. Methods: Seven databases (e.g., Scopus, EBSCOhost Research Database) were screened and experts in the autism spectrum disorders (ASD) field were questioned; Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and Consensus-based Standard for the selection of health Measurement INstruments (COSMIN) checklist were applied. Results: the study included 52 papers and 16 measures; most of them were questionnaires, and the Modified-CHecklist for Autism in Toddler (M-CHAT) was the most extensively tested. The measures’ strengths (analytical evaluation of methodological quality according to COSMIN) and limitations (in term of Negative Predictive Value, Positive Predictive Value, sensitivity, and specificity) were described; the quality of the studies, assessed with the application of the COSMIN checklist, highlighted the necessity of further validation studies for all the measures. According to COSMIN results, the M-CHAT, First Years Inventory (FYI), and Quantitative-CHecklist for Autism in Toddler (Q-CHAT) seem to be promising measures that may be applied systematically by health professionals in the future.

Supportive communicative experiences within close relationships, such as dyadic support, have a protective effect on individuals’ health and emotional well-being. However, little is known about how partners interact in determining their own and others’ health or the mechanisms through which dyadic support influences physical health. We addressed those gaps by studying 1088 romantic couples from three consecutive years (T1, T2, T3; Swiss Household Panel). The study applied a data analysis strategy called Actor Partner Interdependence Model extended Mediation, which allows for mediation processes while considering the interdependence, or non-independence, of data coming from partners. Results showed that dyadic support was positively associated with perceived health over two years through the mediation of optimistic attitudes and depressive mood, both for person and partner effects. The present study demonstrates the interplay between the dyadic process and personality dispositions in maintaining good health.

There are only two countries in the world (the United States and New Zealand) that allow the pharmaceutical branch to advertise prescription medication directly to consumers. There is pressure on governments to allow direct-to-consumer advertising (DTCA) for prescription drugs elsewhere too. One argument the industry uses frequently is the claim that exposure to DCTA, through various methods and occasions, is supposed to improve customers' knowledge of a disease and treatment. This argument has been part of the health care community's wider discussion of whether DTCA of prescription drugs benefits the population's general interest or is only an attempt to increase the sales of the pharmaceutical branch. Belief in true learning by DTCA is rooted in concepts of empowered consumers and their autonomous and empowered decision-making. In this study, we tested the hypotheses that contact with DTCA increases recipients' literacy/knowledge, especially regarding the side effects of treatment (hypothesis 1), and empowerment (hypothesis 2). We further hypothesized that DTCA exposure would not increase depression knowledge (ie, about treatments, symptoms, and prevalence) (hypothesis 3). A snowball sample of 180 participants was randomly split into three experimental groups receiving (1) a traditional information sheet, (2) a DTCA video clip for an antidepressant prescription drug, or (3) both. The video was original material from the United States translated into Italian for the experiment. Dependent variables were measures of depression knowledge (regarding treatments, symptoms and prevalence, and antidepressant side effects), depression literacy, and empowerment. None of the experimental groups differed significantly from the others in the empowerment measure (hypothesis 2 not confirmed). Partial confirmation of hypothesis 1 was obtained. Lower values on the depression literacy scale were obtained when participants had been given the video compared to the sheet condition. However, the general depression knowledge and its subscale on side effects reached higher scores when participants were exposed to the DTCA, alone or in combination with the information sheet. Finally, participants showed lower scores on knowledge about treatment and symptoms or prevalence after watching the video compared to the sheet condition (hypothesis 3 confirmed). Symptoms and prevalence knowledge increased only when the video was presented in combination with the sheet. There is no evidence for an increase in empowerment following DTCA exposure. An increase in knowledge of the side effects of the medication was observed in the group exposed to the DTCA video. This was the only result that confirmed the hypothesis of the beneficial effect of DTCA videos on knowledge. Written information proved to be the most suitable way to convey knowledge on treatments and symptoms prevalence. Our findings support the necessity of studying health literacy and patient empowerment together and the consequences of such an increase in knowledge in terms of help-seeking behavior.

Background Delayed prescription is a strategy used in various countries to reduce antibiotic overuse and contend the effects of antibiotic resistance; however this practice is not yet used in Switzerland. The present qualitative study was thus conducted to investigate Swiss patients’ attitudes towards the possible implementation of delayed prescription. Method Five focus groups with the general population based on a fixed script of questions to elicit opinions on delayed prescription. Results A total of 29 participants were involved (M = 39,76 years of age, SD = 15,91; 19 females). Participants naturally polarized into two distinct groups: one expressing attitudes against delayed prescription and the other in favor of such practice. One driver for their opposing stance was their pre-existing negative attitudes about the use of antibiotics. Other relevant themes contributing to the formation of one’s opinion on delayed prescription included the participants’ perceived convenience of this prescribing practice and their desired level of autonomy during and after a medical encounter. Another theme that emerged was the potential impact of these stances on the interpersonal relationship between doctors and their patients. Conclusion The present study highlights the existence of several barriers and facilitators perceived by patients. Should delayed prescription be implemented in Switzerland, these results will inform policymakers about patients’ attitudes towards the practice. Doctors may also benefit from this study as it identifies the limitations to consider when discussing treatment options with patients.

This is a registered study protocol on a randomized controlled trial (RCT) testing an intervention aimed to improve men's adherence to evidence-based guidelines on BRCA1/2 germline genetic testing. BRCA1- and BRCA2-associated Hereditary Breast and Ovarian Cancer Syndrome (HBOC) increases the relative and absolute risk of developing breast and ovarian cancer and, to a lesser extent, prostate and pancreatic cancer. Men face BRCA-related cancer risks as women do, although with a different magnitude, and they may also transmit the mutations to their children. Notwithstanding, men are under-tested compared to women and the communication is not tailored on their needs. The present RCT applies principles of the Health Action Process Approach (HAPA) in testing the psychological determinants of the men's adherence to evidence based guidelines on BRCA1/2 germline genetic and testing the efficacy of two messages. A total of 264 participants will be involved, among the men's relatives of women with verified germline mutations. The study entails a pre- post- evaluation with randomization of the participants in two conditions corresponding to the two messages. The expected results provide answers related to the impact of action self-efficacy, outcome expectancy (personal or familiar), risk perception, health risk aversion, intolerance of uncertainty, perceived barriers, and coping self-efficacy on informed decision-making. Data gathered from this study may inform health care providers, policy makers, and public health managers about the communication strategy for men and about the psychological variables influencing decision-making. Name of the Registry: Clinical Trials. Trial registration number: NCT04683068. Date of registration: 16/12/2020. URL of trial registry record: https://www.clinicaltrials.gov/.

In this paper, a computational approach is proposed and put into practice to assess the capability of children having had diagnosed Autism Spectrum Disorders (ASD) to produce facial expressions. The proposed approach is based on computer vision components working on sequence of images acquired by an off-the-shelf camera in unconstrained conditions. Action unit intensities are estimated by analyzing local appearance and then both temporal and geometrical relationships, learned by Convolutional Neural Networks, are exploited to regularize gathered estimates. To cope with stereotyped movements and to highlight even subtle voluntary movements of facial muscles, a personalized and contextual statistical modeling of non-emotional face is formulated and used as a reference. Experimental results demonstrate how the proposed pipeline can improve the analysis of facial expressions produced by ASD children. A comparison of system’s outputs with the evaluations performed by psychologists, on the same group of ASD children, makes evident how the performed quantitative analysis of children’s abilities helps to go beyond the traditional qualitative ASD assessment/diagnosis protocols, whose outcomes are affected by human limitations in observing and understanding multi-cues behaviors such as facial expressions.

Background International research shows that social isolation is harmful for health, especially for the elderly. Its objective and subjective dimensions are important to distinguish as each stands in a different relation with health. The first aim of the present study is the validation of three scales measuring objective and subjective isolation in an Italian elderly population. The second aim is to analyze subjective and objective social isolation and to appraise their association with health among seniors. Methods This cross-sectional survey collected data from 306 over 65 s participants. Questionnaires were administered face-to-face by one author and encompassed: social disconnectedness scale; perceived isolation scale; abbreviated Lubben Social Network Scale; measures of general and mental health, and depression. Results The three scales measuring social isolation demonstrated acceptable psychometric properties and validity. Objective and subjective social isolation were not directly associated with physical health, whereas subjective isolation is strongly linked to worse mental health and depression. Higher level of subjective isolation was associated with lower level of physical health through the mediation of mental health. Subjective isolation served as a mediator in the relation between objective isolation and health. Moderation analysis demonstrated that low values of objective isolation predicted high values of mental health but only when subjective isolation was low. None of these relations were moderated by socio-demographic variables. Conclusion Subjective and objective isolation are clearly two separate dimensions and the scales validated in this paper showed to be potentially culturally invariant. Researchers should work to find instruments able to depict the complexity of the construct of social isolation.

Nowadays, smartphone-Mediated Communication (SMC) has become a popular form of social interactions. The present experimental study manipulated three aspects of messaging in a WhatsApp chat as a form of SMC: synchronicity (immediate vs. time-lagged response), modality (with or without emojis), and valence (empathic accurate vs. empathic inaccurate response). The aim of this study was to investigate whether these three aspects had an impact on perceived social support, interpersonal trust, and personality attribution of the communication partner. The partial mediation of perceived social presence (the evaluation of the communication partner's accessibility) and subjective social presence (the perception of being concordant with him/her) was also examined. Participants were 160 young adults, balanced in gender. They were randomly assigned to different the experimental conditions where they engaged in a manipulated WhatsApp chat with a fictitious same-gender communication partner. Post-questionnaire data were analyzed using Structural Equation Modeling. Message valence (empathic accurate response) and modality (with emojis) significantly predicted higher levels of both forms of social presence. Synchronicity (immediate response) predicted higher levels of perceived but not subjective social presence. Social presence, in turn, was positively associated with social support, while subjective, but not perceived social presence, was positively associated with personality attribution. Neither perceived nor subjective social presence were related to interpersonal trust. Our results show that both what is said and how it is said impact the experience of interpersonal relations in SMC.