Recent reports on the burden of cardiovascular disease (CVD) in the USA indicate that despite significant declines in CVD mortality in the late 20th century, this decline is now decelerating and may be worsened by inequalities in health care. Social factors contribute to most of the cardiovascular health disparities documented to date. Hispanics/Latinos and African-Americans share a higher prevalence of cardiovascular risk factors and experience higher rates of poverty and social stressors than non-Hispanic Whites. We propose that the use of social and behavioral data beyond basic and sometimes loose identifiers of race/ethnicity, educational attainment, and occupation would inform clinical practice and greatly facilitate the provision of adequate guidance and support to patients regarding continuity of care, adherence to medications and treatment plans, and engagement of participants in future research. This perspective briefly highlights factors deemed to be critical for the advancement of Hispanic/Latino health and delineates pathways toward future applications.

Obsessive Compulsive Disorder (OCD) is increasingly recognised to be relatively common and responsive to some drug treatments (serotonin reuptake inhibitors). Clinical studies utilising recognised diagnostic criteria have identified some relevant negative prognostic factors: early age at disease onset, severe baseline disease, and failure of previous drug treatments all of which reduce the apparent success rates of SRI drugs. Furthermore, patients with comorbid tics seem to respond best to a combination of SRI activity and dopamine blockade. Short term efficacy studies are best performed with a parallel group design and a duration of around 3 months. Long term efficacy studies should probably use the relapse prevention design, with open label responders randomised to double blind continuation or placebo. Does finding has not been properly explored, and any one fixed dose will only be optimal for some patients. Efficacy can be reliably measured using the YBOCs, NIMH-OC and CGI rating scales.

Research into early intervention for Alzheimer's disease (AD) and dementia has involved cohort data from large epidemiological studies and data from specifically designed intervention trials. Cohort data indicate that use of nootropics and Ginkgo biloba extract may be associated with a reduced incidence of dementia and death. Data from large trials have often been inconclusive due to issues with poor medication adherence. However, such trials do indicate potential benefits with Gingko biloba extract in terms of reduced incidence of dementia of the AD type, vascular dementia and mixed pathology, reduced progression in terms of the clinical dementia rating and improvements in attention and memory. Furthermore, Gingko biloba extract EGb 761® is a useful option for long-term intervention on the basis of decades of previous experience and an excellent safety record. However, benefits can be expected only with sufficient medication adherence and treatment duration, so clear evidence of a disease-modifying benefit of this extract is needed from adequately designed trials using modern methods to ensure high levels of adherence.