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Background: Novel survey methods are needed to tackle declining response rates. The 2020 National Maternity Survey included a randomised controlled trial (RCT) and social media survey to compare different combinations of sampling and data collection methods with respect to: response rate, respondent representativeness, prevalence estimates of maternity indicators and cost. Methods: A two-armed parallel RCT and concurrent social media survey were conducted. Women in the RCT were sampled from ONS birth registrations and randomised to either a paper or push-to-web survey. Women in the social media survey self-selected through online adverts. The primary outcome was response rate in the paper and push-to-web surveys. In all surveys, respondent representativeness was assessed by comparing distributions of sociodemographic characteristics in respondents with those of the target population. External validity of prevalence estimates of maternity indicators was assessed by comparing weighted survey estimates with estimates from national routine data. Cost was also compared across surveys. Results: The response rate was higher in the paper survey (n = 2,446) compared to the push-to-web survey (n = 2,165)(30.6% versus 27.1%, difference = 3.5%, 95%CI = 2.1–4.9, p < 0.0001). Compared to the target population, respondents in all surveys were less likely to be aged < 25 years, of Black or Minority ethnicity, born outside the UK, living in disadvantaged areas, living without a partner and primiparous. Women in the social media survey (n = 1,316) were less representative of the target population compared to women in the paper and push-to-web surveys. For some maternity indicators, weighted survey estimates were close to estimates from routine data, for other indicators there were discrepancies; no survey demonstrated consistently higher external validity than the other two surveys. Compared to the paper survey, the cost saving per respondent was £5.45 for the push-to-web survey and £22.42 for the social media survey. Conclusions: Push-to-web surveys may cost less than paper surveys but do not necessarily result in higher response rates. Social media surveys cost significantly less than paper and push-to-web surveys, but sample size may be limited by eligibility criteria and recruitment window and respondents may be less representative of the target population. However, reduced representativeness does not necessarily introduce more bias in weighted survey estimates. [ABSTRACT FROM AUTHOR]

The original article can be found online at https://doi.org/10.1186/s12874-023-01833-8.Correction: BMC Med Res Methodol 23, 10 (2023)https://doi.org/10.1186/s12874-023-01833-8Following publication of the original article [[1]], the authors reported an error in the Fig. 4: the colours in the pie charts in Fig. 4 do not all correspond with the legend. See the Fig. 4 corrected.Graph: Fig. 4 Breakdown of total costs across the surveysThe original article [[1]] has been updated.By Siân Harrison; Fiona Alderdice and Maria A. QuigleyReported by Author; Author; Author [Extracted from the article]

Background: Residents' adoption of preventive behaviours proved beneficial in preventing the large-scale transmission of the virus during the early stages of the COVID-19 outbreak. It is critical to investigate how social media triggers residents' preventive behaviour decisions during the COVID-19 outbreak. Methods: This paper selected online shopping as a specific preventive behaviour for empirical investigation. An online cross-sectional survey was conducted through the Sojump website from 1 to 15 March 2020, and a total of 1,289 valid questionnaires were collected from China. This paper uses multiple regression analysis to investigate the heterogeneous impacts of different information sources on residents' online shopping willingness and online shopping behaviour and the heterogeneous impacts of different information content in social media on the transformation of residents' online shopping willingness and online shopping behaviour. Results: The findings indicate that both official-media and self-media positively promote residents' online shopping willingness and behaviour, with official-media having a stronger promotional effect than self-media. Furthermore, official-media and self-media can collaboratively promote residents' online shopping willingness and online shopping behaviour. The ease-of-use and usefulness of information significantly promoted the transformation of residents' online shopping willingness. Conclusions: This study analyses the heterogeneous impacts of social media on residents' preventive behaviours from the perspectives of information source differentiation and information content differentiation, which enriches related studies and provides feasible paths for promoting residents' preventive behaviours. [ABSTRACT FROM AUTHOR]

Background: Structural, interpersonal and individual level factors can present barriers for HIV prevention behaviour among people at high risk of HIV acquisition, including women who sell sex. In this paper we document the contexts in which women selling sex in Kampala meet and provide services to their clients. Methods: We collected qualitative data using semi-structured interviews. Women were eligible to participate if they were 18 years or older, self-identified as sex workers or offered sex for money and spoke Luganda or English. Ten women who met clients in venues and outdoor locations were selected randomly from a clinic for women at high risk of HIV acquisition. Ten other women who met clients online were recruited using snowball sampling. Interviews included demographic data, and themes included reasons for joining and leaving sex work, work locations, nature of relationships with clients and peers, interaction with authorities, regulations on sex work, and reported stigma. We conducted interviews over three months. Data were analysed thematically using a framework analysis approach. The coding framework was based on structural factors identified from literature, but also modified inductively with themes arising from the interviews. Results: Women met clients in physical and virtual spaces. Physical spaces included venues and outdoor locations, and virtual spaces were online platforms like social media applications and websites. Of the 20 women included, 12 used online platforms to meet clients. Generally, women from the clinic sample were less educated and predominantly unmarried, while those from the snowball sample had more education, had professional jobs, or were university students. Women from both samples reported experiences of stigma, violence from clients and authorities, and challenges accessing health care services due to the illegality of sex work. Even though all participants worked in settings where sex work was illegal and consequently endured harsh treatment, those from the snowball sample faced additional threats of cybersecurity attacks, extortion from clients, and high levels of violence from clients. Conclusions: To reduce risk of HIV acquisition among women who sell sex, researchers and implementers should consider these differences in contexts, challenges, and risks to design innovative interventions and programs that reach and include all women. [ABSTRACT FROM AUTHOR]

Background: Medical emergency situations in dental clinics have been contemplated to be an issue in most of the countries by reason of dentist's lack of knowledge and preparedness to attend emergency situations in dental offices. The aim of this paper is to observe the knowledge, attitude, and perceived confidence of the general dental practitioners regarding emergency medical care and its practical application. Questionnaire on knowledge assessment was circulated among 500 dentists using printed questionnaire formats and various social media platforms. The questionnaire included details on treating hypertensive patients, cardiopulmonary resuscitation training, accessibility of medical emergency equipments in the dental clinics, prevalence of medical emergency cases in the dental office and the self-assessed competence to handle medical emergency situations in the dental clinics. Data was surveyed and scrutinized using the Statistical Package for Social Sciences (SPSS), version 17 (SPSS Inc., Chicago IL). Descriptive statistics was tabulated and Chi square tests was applied. Findings: 500 general dental practitioners pan India were involved in the study (294 were females and 207 were males). They were grouped into different age groups (20–30 yrs, 30–40 yrs, 40–50 yrs, 50 and above) and experience (0–5 yrs, 5–10 yrs and more than 10 years). 279 participants did not attend any medical emergency training whereas, 222 participants from all groups attended training program. It was observed that with increased experience in the field, the knowledge, awareness and confidence to treat medical emergency situation in the dental clinics was better. Dentists should update themselves from time-to-time with the latest technologies in the field and need to attend training programs to handle any medical emergency situations in the dental offices. Medical emergencies in a dental clinic can be encountered at any point of time and the clinician should have apt knowledge in handling such situations. Majority of the dentists feel subdued in managing medical situations in dental offices. Training and workshops for handling medical situations in the dental offices should be mandated at the undergraduate and postgraduate levels. This will help the dentist to shape one's confidence in managing such situations without apprehension. Availability of proper infrastructure and equipments is recommended in every dental clinics so as to ease the handling of the situation. Conclusion: This paper enlightens the need of basic life support training on regular basis among the dentists to improve the competence among them and to improve the confidence in handling such situations. [ABSTRACT FROM AUTHOR]

B Correction: BMC Medical Research Methodology 23, 10 (2023) b B https://doi.org/10.1186/s12874-023-01833-8 b Following publication of the original article [[1]], the author requested to correct the word "primiparous" to "multiparous" in the Abstract results and under the paragraph "Representativeness of respondents" in the main results section. Impact of sampling and data collection methods on maternity survey response: a randomised controlled trial of paper and push-to-web surveys and a concurrent social media survey. [Extracted from the article]

Background: The quality of school-based sex and relationships education (SRE) is variable in the UK. Digitally-based interventions can usefully supplement teacher-delivered lessons and positively impact sexual health knowledge. Designed to address gaps in core SRE knowledge, STASH (Sexually Transmitted infections And Sexual Health) is a peer-led social network intervention adapted from the successful ASSIST (A Stop Smoking in Schools Trial) model, and based on Diffusion of Innovation theory. This paper describes how the STASH intervention was developed and refined. Methods: Drawing on the Six Steps in Quality Intervention Development (6SQuID) framework, we tested a provisional programme theory through three iterative stages -: 1) evidence synthesis; 2) intervention co-production; and 3) adaptation - which incorporated evidence review, stakeholder consultation, and website co-development and piloting with young people, sexual health specialists, and educators. Multi-method results were analysed in a matrix of commonalities and differences. Results: Over 21 months, intervention development comprised 20 activities within the three stages. 1) We identified gaps in SRE provision and online resources (e.g. around sexual consent, pleasure, digital literacy), and confirmed critical components including the core ASSIST peer nomination process, the support of schools, and alignment to the national curriculum. We reviewed candidate social media platforms, ruling out all except Facebook on basis of functionality restrictions which precluded their use for our purposes. 2) Drawing on these findings, as well as relevant behaviour change theories and core elements of the ASSIST model, we co-developed new content with young people and other stakeholders, tailored to sexual health and to delivery via closed Facebook groups, as well as face-to-face conversations. 3) A pilot in one school highlighted practical considerations, including around peer nomination, recruitment, awareness raising, and boundaries to message sharing. From this, a revised STASH intervention and programme theory were co-developed with stakeholders. Conclusions: STASH intervention development required extensive adaptation from the ASSIST model. Although labour intensive, our robust co-development approach ensured that an optimised intervention was taken forward for feasibility testing. Evidencing a rigorous approach to operationalising existing intervention development guidance, this paper also highlights the significance of balancing competing stakeholder concerns, resource availability, and an ever-changing landscape for implementation. Trial registration: ISRCTN97369178. [ABSTRACT FROM AUTHOR]

Background: Lyme disease is one of the most commonly reported infectious diseases in the United States (US), accounting for more than 90 % of all vector-borne diseases in North America. Objective: In this paper, self-reported tweets on Twitter were analyzed in order to predict potential Lyme disease cases and accurately assess incidence rates in the US. Methods: The study was done in three stages: (1) Approximately 1.3 million tweets were collected and pre-processed to extract the most relevant Lyme disease tweets with geolocations. A subset of tweets were semi-automatically labelled as relevant or irrelevant to Lyme disease using a set of precise keywords, and the remaining portion were manually labelled, yielding a curated labelled dataset of 77, 500 tweets. (2) This labelled data set was used to train, validate, and test various combinations of NLP word embedding methods and prominent ML classification models, such as TF-IDF and logistic regression, Word2vec and XGboost, and BERTweet, among others, to identify potential Lyme disease tweets. (3) Lastly, the presence of spatio-temporal patterns in the US over a 10-year period were studied. Results: Preliminary results showed that BERTweet outperformed all tested NLP classifiers for identifying Lyme disease tweets, achieving the highest classification accuracy and F1-score of 90 % . There was also a consistent pattern indicating that the West and Northeast regions of the US had a higher tweet rate over time. Conclusions: We focused on the less-studied problem of using Twitter data as a surveillance tool for Lyme disease in the US. Several crucial findings have emerged from the study. First, there is a fairly strong correlation between classified tweet counts and Lyme disease counts, with both following similar trends. Second, in 2015 and early 2016, the social media network like Twitter was essential in raising popular awareness of Lyme disease. Third, counties with a high incidence rate were not necessarily related with a high tweet rate, and vice versa. Fourth, BERTweet can be used as a reliable NLP classifier for detecting relevant Lyme disease tweets. [ABSTRACT FROM AUTHOR]

Background: Developing strategies to change health behaviour is one of the biggest challenges of health promotion programs. Social media, as a popular and innovative communication and education tool, offers opportunities to modify health behaviour. While literature on using social media for health promotion campaigns is growing, there is a need to evaluate the approaches used to change health behaviour, rather than only creating awareness. Objective: The paper reviewed the literature on application of social media in health promotion campaigns with a particular focus on the methodologies used in assessing the outcome of the programs for behaviour change. This fills the void in collating evidence to extend health promotion campaigns to effect sustainable behavioural change. Method: Peer-reviewed articles were identified through multiple science databases. A systematic electronic search was conducted to retrieve review and original papers published between January 2010 and April 2022. The titles and abstracts of the articles were screened according to inclusion and exclusion criteria. All authors independently read the full texts and discussed them to reach a consensus about the themes. Concept mapping was used to present results from analysis of the included papers. Results: Of the 674 citations, 28 (4.1%) studies were included in this review. The methodology approaches of 18 (2.7%) papers, that aimed to evaluate the impact of social media in health promotion campaigns towards behaviour change, were analysed further using concept mapping. The results showed that 10 studies (55.5%) adopted quantitative methods and five studies (27.7%) used mixed methods and three studies (16.6%) used qualitative methods. Facebook and YouTube were used more for intervention purposes to change health behaviour. Twitter and Instagram were used more to observe the trend of changes in health behaviour. Six studies (33.3%) adopted Social Cognitive Theory and one study (5.5%) applied the Transtheoretical Model as the framework to evaluate the outcome. Overall, the results show that though social media has potential in promoting behaviour change, the estimation of this change in long-term lies outside the scope of social media health campaigns. This is also reflected in the methodologies used in existing studies to assess such sustainable changes. The employed measures usually target immediate behaviour or social media engagement rather than addressing the change on a behavioural level. Conclusion: Evaluating the performance of social media campaigns to promote health behaviours towards a sustainable outcome is a complex process. Emerging research is focused on evaluating the potential of social media as an opportunity to create awareness. Such measures require less effort in quantifying and isolating the effect. The design of the campaigns is required to be aligned in relation to stages of the behaviour change. The study provides suggestions on how this can be achieved. [ABSTRACT FROM AUTHOR]

Background: Social media content on Western platforms promoting thinness, or thinspiration, has been found to negatively affect body image perception of users. Less is known about non-Western social media use and its effects on body image concerns. Chinese TikTok, known as Douyin, is a popular short video platform with 600 million daily active users. Recent trends on Douyin encourage users to demonstrate thinness through participation in 'body challenges'. This paper argues that such content is comparable to thinspiration, however, to date hardly any research has been undertaken on these challenges. Thus, this pilot study aimed to analyse the content of three viral challenges and investigate their impact on Douyin users. Methods: Thirty most viewed videos were collected for three challenges (N = 90): the Coin challenge, the A4 Waist challenge, and the Spider leg challenge. Videos were coded for variables relating to thin idealisation, including thin praise, sexualisation and objectification, and analysed through content analytic methods. Video comments (N ≈ 5500) were analysed through thematic analysis, and main themes were identified. Results: Preliminary findings showed that participants who objectified their bodies to a greater extent expressed more negative body image concerns. In addition, comments on the videos had themes of thin praise, self-comparison, and promotion of dieting behaviours. In particular, videos of the A4 Waist challenge were found to incite more negative self-comparison in viewers. Conclusion: Preliminary findings suggest all three challenges promote the thin ideal and encourage body image concerns. Further research about the broader impact of body challenges is needed. [ABSTRACT FROM AUTHOR]

Background: The spread of misinformation of all types threatens people's safety and interrupts resolutions. COVID-19 vaccination has been a widely discussed topic on social media platforms with numerous misleading and fallacious information. This false information has a critical impact on the safety of society as it prevents many people from taking the vaccine, decelerating the world's ability to go back to normal. Therefore, it is vital to analyze the content shared on social media platforms, detect misinformation, identify aspects of misinformation, and efficiently represent related statistics to combat the spread of misleading information about the vaccine. This paper aims to support stakeholders in decision-making by providing solid and current insights into the spatiotemporal progression of the common misinformation aspects of the various available vaccines. Methods: Approximately 3800 tweets were annotated into four expert-verified aspects of vaccine misinformation obtained from reliable medical resources. Next, an Aspect-based Misinformation Analysis Framework was designed using the Light Gradient Boosting Machine (LightGBM) model, which is one of the most advanced, fast, and efficient machine learning models to date. Based on this dataset, spatiotemporal statistical analysis was performed to infer insights into the progression of aspects of vaccine misinformation among the public. Finally, the Pearson correlation coefficient and p-values are calculated for the global misinformation count against the vaccination counts of 43 countries from December 2020 until July 2021. Results: The optimized classification per class (i.e., per an aspect of misinformation) accuracy was 87.4%, 92.7%, 80.1%, and 82.5% for the "Vaccine Constituent," "Adverse Effects," "Agenda," "Efficacy and Clinical Trials" aspects, respectively. The model achieved an Area Under the ROC Curve (AUC) of 90.3% and 89.6% for validation and testing, respectively, which indicates the reliability of the proposed framework in detecting aspects of vaccine misinformation on Twitter. The correlation analysis shows that 37% of the countries addressed in this study were negatively affected by the spread of misinformation on Twitter resulting in reduced number of administered vaccines during the same timeframe. Conclusions: Twitter is a rich source of insight on the progression of vaccine misinformation among the public. Machine Learning models, such as LightGBM, are efficient for multi-class classification and proved reliable in classifying vaccine misinformation aspects even with limited samples in social media datasets. [ABSTRACT FROM AUTHOR]

Background: There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. Methods: Aim: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020–21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. Results: The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. Conclusion: There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of cancer death for both men and women in the United States. The National Lung Screening Trial (NLST) demonstrated that low-dose computed tomography (LDCT) screening can reduce lung cancer mortality among high-risk individuals, but uptake of lung screening remains low. Social media platforms have the potential to reach a large number of people, including those who are at high risk for lung cancer but who may not be aware of or have access to lung screening. Methods: This paper discusses the protocol for a randomized controlled trial (RCT) that leverages FBTA to reach screening-eligible individuals in the community at large and intervene with a public-facing, tailored health communication intervention (LungTalk) to increase awareness of, and knowledge about, lung screening. Discussion: This study will provide important information to inform the ability to refine implementation processes for national population efforts to scale a public-facing health communication focused intervention using social media to increase screening uptake of appropriate, high-risk individuals. Trial registration: The trial is registered at clinicaltrials.gov (#NCT05824273). [ABSTRACT FROM AUTHOR]

Background: Blogging can help to maximise the impact of one's work in academia and beyond by making research findings accessible for multiple knowledge users, such as healthcare professionals and the public, as well as other researchers. As part of the knowledge exchange and dissemination activities of the Model for Dementia Palliative Care Project, this study explored stakeholders' views of blogs as a means to translate research findings. Methods: A web-based survey was developed, piloted, and revised. It was distributed electronically via key dementia and palliative care organisations websites, newsletters, social media platforms, and within the staff mailing lists of five Universities in Ireland. Data were analysed using descriptive statistics and content analysis. Results: Complete responses were received from 128 participants. The majority of respondents were healthcare researchers (n = 53), followed by healthcare providers (n = 46). The preferred methods of reviewing research findings were scientific papers, websites and news articles. Respondents read healthcare blogs "sometimes" (39.1%), with < 19% reading them "often" or "very often". Receiving an email notification might increase the likelihood of reading a new blog post for 83% of respondents. Barriers to engaging with blogs included lack of time, preference for other media, lack of awareness regarding available blogs, and concerns about the credibility and source of information. An appropriate length and the author of the blog were key features that encouraged engagement with a blog. Conclusions: Despite respondents choosing a scientific paper as their preferred method to consume research findings, many indicated an openness to reading blogs on their area of interest. Creating concise, relevant, and credible blogs, and suitably promoting them, could increase the impact and reach of healthcare research, such as in the emerging field of dementia palliative care, and thus promote translation of research findings into practice. [ABSTRACT FROM AUTHOR]

Purpose: Social media has led to fundamental changes in the way that people look for and share health related information. There is increasing interest in using this spontaneously generated patient experience data as a data source for health research. The aim was to summarise the state of the art regarding how and why SGOPE data has been used in health research. We determined the sites and platforms used as data sources, the purposes of the studies, the tools and methods being used, and any identified research gaps.Methods: A scoping umbrella review was conducted looking at review papers from 2015 to Jan 2021 that studied the use of SGOPE data for health research. Using keyword searches we identified 1759 papers from which we included 58 relevant studies in our review.Results: Data was used from many individual general or health specific platforms, although Twitter was the most widely used data source. The most frequent purposes were surveillance based, tracking infectious disease, adverse event identification and mental health triaging. Despite the developments in machine learning the reviews included lots of small qualitative studies. Most NLP used supervised methods for sentiment analysis and classification. Very early days, methods need development. Methods not being explained. Disciplinary differences - accuracy tweaks vs application. There is little evidence of any work that either compares the results in both methods on the same data set or brings the ideas together.Conclusion: Tools, methods, and techniques are still at an early stage of development, but strong consensus exists that this data source will become very important to patient centred health research. [ABSTRACT FROM AUTHOR]

Background: Bulimia nervosa (BN) is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight. The aim of this study was to evaluate the mediating role of anxiety and depression between problematic social media use (PSMU) and BN among a sample of Lebanese university students. Methods: This cross-sectional study was carried out between July and September 2021; a total of 363 university students was recruited through convenience sampling. The PROCESS SPSS Macro version 3.4, model four was used to test the indirect effect and calculate three pathways. Pathway A determined the regression coefficient for the effect of PSMU on mental health issues (depression/anxiety); Pathway B examined the association between mental health issues on BN, and Pathway C' estimated the direct effect of PSMU on BN. Pathway AB was used to calculate the indirect effect of PSMU on BN via depression/anxiety. Results: Results showed that depression and anxiety partially mediated the association between PSMU and BN. Higher levels of PSMU were associated with more depression and anxiety; higher depression and anxiety were associated with more BN. PSMU was directly and significantly associated with more BN. When entering anxiety (M1) then depression (M2) as consecutive mediators in a first model, the results showed that only depression mediated the association between PSMU and bulimia. When taking depression (M1) then anxiety (M2) as consecutive mediators in a second model, the results showed that the mediation PSMU → Depression → Anxiety → Bulimia was significant. Higher PSMU was significantly associated with more depression, which was significantly associated with more anxiety, which was significantly associated with more bulimia. Finally, higher PSMU was directly and significantly associated with more bulimia Conclusion: The current paper highlights the relationship that social media use has on BN and other aspects of mental health such as anxiety and depression in Lebanon. Future studies should replicate the mediation analysis conducted in the current study while taking into account other eating disorders. Additional investigations of BN and its correlates must strive to improve the comprehension of these associations' pathways through designs that allow to draw temporal frameworks, in order to efficiently treat this eating disorder and prevent its negative outcomes. Plain English summary: Bulimia nervosa, an eating disorder, is characterized by an impulsive consumption of food in a short period of time, followed by behaviors that compensate the eating such as vomiting or excessive exercise in order to avoid weight gain. Individuals with problematic social media use were found to have higher levels of bulimia symptoms. Symptoms of bulimia can also be associated with both depression and anxiety. The aim of the current study was to examine the mediating role of anxiety and depression between problematic social media use and bulimia nervosa. The results of our study found that problematic social media use was directly associated with more bulimia nervosa and also associated with higher depression and anxiety, both of which were associated with bulimia nervosa. Tackling associated disorders may help reduce symptoms of bulimia nervosa. Clinicians should carefully examine these associations while assessing and implementing treatment plans. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that experimentation with e-cigarettes among young people is increasing. Social media is widely used by young people with user-generated content and influencer marketing particularly influential in promoting products. This paper documents a snapshot of online user-generated content and influencer marketing related to e-cigarettes on YouTube and Instagram. Methods: Scoping review of relevant e-cigarette-related content on two social media platforms popular with youths, YouTube and Instagram, between June and August 2021. Content analysis was undertaken to examine text, audio, and video content, recording age restrictions, health warnings, page characteristics, and post characteristics. Narrative post content was coded using a coding frame that was developed inductively in response to emergent categories. Results: Vaping was portrayed positively on social media; of the posts analysed, 86.5% (n = 90 of 104) of Instagram posts and 66.0% (n = 64 of 97) of YouTube videos. Warnings about age restrictions and health (e.g., nicotine addiction/toxicity) did not feature in the majority of posts; 43.3% (n = 42) of YouTube videos (n = 42) contained an age warning compared to 20.2% of Instagram posts (n = 21). While 25.8% (n = 25) of YouTube videos and 21.2% of Instagram (n = 22) posts contained a health warning. Conclusion: Of concern is the fact that the vast majority of YouTube and Instagram content about e-cigarettes promoted their use, and typically the content does not contain age and/or health warnings. These findings may highlight a priority for governmental policy to restrict the ability of marketers to reach youths with social media content promoting e-cigarettes. [ABSTRACT FROM AUTHOR]

Background: Nowadays, more and more women are engaging in entrepreneurial activities. Meanwhile, female entrepreneurs' health problems have been increasingly reported worldwide. What factors would influence female entrepreneurs' health are the subject of this paper.Methods: This paper focuses on the effects of entrepreneurial experience and age of firm on female entrepreneurs' health through the analysis of 2 years of tracking data in the Bohai Economic Rim, which is one of the most developed areas for entrepreneurial activities in China.Results: Results from the samples of female entrepreneurs demonstrate that increasing entrepreneurial experience and growing firm age could help female entrepreneurs to activate multiple positive identities. These identities can help female entrepreneurs cope with gender stereotype threat and maintain good health.Conclusion: This paper contributes to entrepreneur health research in two aspects. First, this study focused on entrepreneurial history indexed by entrepreneurial experience and firm age, enriching the field of female entrepreneurship. Second, this study further explored the mechanism that women cope with stereotype threat in the context of entrepreneurship. At the same time, this paper addresses ways that policy-makers and social media are responsible to help female entrepreneurs stay healthy. [ABSTRACT FROM AUTHOR]

Background: Social media has been used to disseminate the contents of scientific articles. To measure the impact of this, a new tool called Altmetric was created. Altmetric aims to quantify the impact of each article through online media. This systematic review aims to describe the associations between the publishing journal and published article variables and Altmetric scores. Methods: Searches on MEDLINE, EMBASE, CINAHL, CENTRAL, and Cochrane Library were conducted. We extracted data related to both the publishing article and the publishing journal associated with Altmetric scores. The methodological quality of included articles was analyzed by the Appraisal Tool for Cross-sectional Studies. Results: A total of 19 articles were considered eligible. These articles summarized a total of 573,842 studies. Citation counts, journal impact factor, access counts, papers published as open access, and press releases generated by the publishing journal were associated with Altmetric scores. The magnitude of these associations ranged from weak to strong. Conclusion: Citation counts and journal impact factor are the most common variables associated with Altmetric scores. Other variables such as access counts, papers published in open access journals, and the use of press releases are also likely to be associated with online media attention. Systematic review registration: This review does not contain health-related outcomes. Therefore, it is not eligible for registration. [ABSTRACT FROM AUTHOR]

Background: Recent research has documented the potential associations existing between the use of social media (SM) and the occurrence/development and treatment of Eating Disorders (ED). However, the literature directly addressing the use of SM TikTok among children and adolescents with ED is still scarce. Methods: In January–February 2021, during the second Italian national lockdown due to the SARS-CoV-2 pandemic, an anonymous paper survey was conducted in an Italian third-level center for ED in childhood and adolescence. Demographics, frequency of use of TikTok, frequently viewed topics and hashtags, experienced body-shaming, as well as the use of TikTok (active search, use of proposed contents) and perceived influences of this SM on eating attitudes and self-esteem were assessed. Groups of patients with different perceived SM-induced effects were compared to determine the frequency of their interaction with 3 specific contents (diet, Pro-Anorexia Nervosa (pro-Ana) and pro-ED recovery). Results: Seventy-eight patients (93.6% females, mean age 14.5 ± 2.1 years) were enrolled in the study. For 62.8%, TikTok represented the main SM, used for 1.4 ± 1.0 h/day, with diet (21.8%) as the most frequently used topic category. Pro-Ana and pro-ED recovery contents ("#foryou" and "#edrecovery" as the most frequent, respectively) were both actively searched by patients and proposed by the SM in a significant number of cases. For 59.0%, using TikTok reduced self-esteem, while 26.9% reported TikTok-related significant changes in their daily lives, and 3.8% reported experiences of body-shaming. Patients describing a negative effect of TikTok on their self-esteem more frequently searched and browsed "diet" (p = 0.007) and pro-ED recovery (p = 0.007) contents. Positive qualitative feedback on the SM was also reported. Conclusions: This study documents the use of the SM TikTok among children and adolescents with ED. Individuals with a perceived negative effect of this SM on their self-esteem may show greater interaction with specific content. Further studies are needed to investigate the psychopathological factors influencing the relationship between ED and the use of SM. [ABSTRACT FROM AUTHOR]

Advances in machine learning and digital data provide vast potential for mental health predictions. However, research using machine learning in the field of eating disorders is just beginning to emerge. This paper provides a narrative review of existing research and explores potential benefits, limitations, and ethical considerations of using machine learning to aid in the detection, prevention, and treatment of eating disorders. Current research primarily uses machine learning to predict eating disorder status from females' responses to validated surveys, social media posts, or neuroimaging data often with relatively high levels of accuracy. This early work provides evidence for the potential of machine learning to improve current eating disorder screening methods. However, the ability of these algorithms to generalise to other samples or be used on a mass scale is only beginning to be explored. One key benefit of machine learning over traditional statistical methods is the ability of machine learning to simultaneously examine large numbers (100s to 1000s) of multimodal predictors and their complex non-linear interactions, but few studies have explored this potential in the field of eating disorders. Machine learning is also being used to develop chatbots to provide psychoeducation and coping skills training around body image and eating disorders, with implications for early intervention. The use of machine learning to personalise treatment options, provide ecological momentary interventions, and aid the work of clinicians is also discussed. Machine learning provides vast potential for the accurate, rapid, and cost-effective detection, prevention, and treatment of eating disorders. More research is needed with large samples of diverse participants to ensure that machine learning models are accurate, unbiased, and generalisable to all people with eating disorders. There are important limitations and ethical considerations with utilising machine learning methods in practice. Thus, rather than a magical solution, machine learning should be seen as an important tool to aid the work of researchers, and eventually clinicians, in the early identification, prevention, and treatment of eating disorders. Plain English Summary: Machine learning models are computer algorithms that learn from data to reach an optimal solution for a problem. These algorithms provide exciting potential for the accurate, accessible, and cost-effective early identification, prevention, and treatment of eating disorders, but this potential is just beginning to be explored. Research to date has mainly used machine learning to predict women's eating disorder status with relatively high levels of accuracy from responses to validated surveys, social media posts, or neuroimaging data. These studies show potential for the use of machine learning in the field, but we are far from using these methods in practice. Useful avenues for future research include the use of machine learning to personalise prevention and treatment options, provide ecological momentary interventions via smartphones, and to aid clinicians with their treatment fidelity and effectiveness. More research is needed with large samples of diverse participants to ensure that machine learning models are accurate, unbiased, and generalisable to all people with eating disorders. There are limitations and ethical considerations with using these methods in practice. If accurate and generalisable machine learning models can be created in the field of eating disorders, it could improve the way we identify, prevent, and treat these debilitating disorders. [ABSTRACT FROM AUTHOR]

Background: Addiction to drugs and alcohol constitutes one of the significant factors underlying the decline in life expectancy in the US. Several context-specific reasons influence drug use and recovery. In particular emotional distress, physical pain, relationships, and self-development efforts are known to be some of the factors associated with addiction recovery. Unfortunately, many of these factors are not directly observable and quantifying, and assessing their impact can be difficult. Based on social media posts of users engaged in substance use and recovery on the forum Reddit, we employed two psycholinguistic tools, Linguistic Inquiry and Word Count and Empath and activities of substance users on various Reddit sub-forums to analyze behavior underlining addiction recovery and relapse. We then employed a statistical analysis technique called structural equation modeling to assess the effects of these latent factors on recovery and relapse. Results: We found that both emotional distress and physical pain significantly influence addiction recovery behavior. Self-development activities and social relationships of the substance users were also found to enable recovery. Furthermore, within the context of self-development activities, those that were related to influencing the mental and physical well-being of substance users were found to be positively associated with addiction recovery. We also determined that lack of social activities and physical exercise can enable a relapse. Moreover, geography, especially life in rural areas, appears to have a greater correlation with addiction relapse. Conclusions: The paper describes how observable variables can be extracted from social media and then be used to model important latent constructs that impact addiction recovery and relapse. We also report factors that impact self-induced addiction recovery and relapse. To the best of our knowledge, this paper represents the first use of structural equation modeling of social media data with the goal of analyzing factors influencing addiction recovery. [ABSTRACT FROM AUTHOR]

Most cardiac imaging conferences have adopted social media as a means of disseminating conference highlights to a global audience well beyond the confines of the conference location. A deliberate and thoughtful social media campaign has the potential to increase the reach of the conference and allow for augmented engagement. The coronavirus disease 2019 (COVID-19) pandemic triggered a radical transformation in not just the delivery of healthcare but also the dissemination of science within the medical community. In the past, in-person medical conferences were an integral annual tradition for most medical professionals to stay up to date with the latest in the field. Social distancing requirements of the COVID-19 pandemic resulted in either cancelling medical conferences or shifting to a virtual format. Following suit, for the first time in its history, the 2021 Society for Cardiovascular Magnetic Resonance (SCMR) annual meeting was an all-virtual event. This called for a modified social media strategy which aimed to re-create the sociability of an in-person conference whilst also promoting global dissemination of the science being presented. This paper describes the employment of social media as well as the evolution through the SCMR scientific sessions for 2020 and 2021 that serves as a model for future cardiovascular conferences. [ABSTRACT FROM AUTHOR]

Background: Latina adolescents in the USA report some of the lowest rates of physical activity of any demographic subgroup; this is paralleled by a markedly higher lifetime risk of obesity, type 2 diabetes, and other conditions related to inactivity. Despite this, to date, no fully powered clinical trials have tested physical activity interventions specifically for this population. High use of mobile technologies (including text messages, smartphone apps, and social media) suggests this could be an appropriate intervention channel, while also having potential for broad reach. This paper describes the protocol for Chicas Fuertes, a fully powered randomized trial of a mobile technology-based physical activity intervention for Latina adolescents.Methods: We plan to recruit 200 Latina teens (age 13-18) in San Diego, CA, currently engaging in ≤ 150 min/week of moderate-to-vigorous physical activity (MVPA) to be assigned 1:1 to the intervention or control groups. Those randomly assigned to the intervention group receive a one-on-one goal setting session followed by 6 months of mobile technology-based intervention, including a personalized website, Fitbit activity tracker and app, individually tailored text messages based on Fitbit data, and daily intervention content on Instagram. Those randomized to the control group receive only a Fitbit activity tracker. The main outcome is change in weekly minutes of MVPA from baseline to 6 months, measured both objectively (ActiGraph accelerometers and Fitbit Inspire HR) and subjectively (7-Day Physical Activity Recall Interview). Additional outcomes are maintenance of activity change at 12 months and changes in psychosocial constructs, including social support and self-efficacy, engagement with mobile technology channels, and costs of intervention delivery. We are also examining the potential mediators and moderators of the intervention. The efficacy of the intervention is analyzed using a mixed effects regression model, adjusting for any potential confounders not balanced by randomization. All analyses of accelerometer measured MVPA are also adjusted for wear time.Discussion: The Chicas Fuertes trial uses widely available mobile technologies to target critical health behavior, physical activity, in Latina teens, a population with a high lifetime risk of lifestyle-related diseases. The results will speak to the efficacy and acceptability of the intervention, which has the potential for broad dissemination.Trial Registration: ClinicalTrials.gov NCT04190225 . Registered on November 20, 2019. [ABSTRACT FROM AUTHOR]

This paper discusses the challenges of disseminating COVID-19 information to migrant populations by sharing our trial-and-error approach. In 2018, the Migrants' Neighbor Network & Action (MINNA), a consortium of individuals and organizations that addressed the issues of accessing relevant information and services for migrants in Japan, was launched. Amidst the COVID-19 pandemic, the MINNA attempted to investigate and improve access to health information among Vietnamese, Nepali, and Burmese migrants in Japan. We had three assumptions in distribution of information to reach a large audience, such as building a multilingual website, requesting stakeholders to disseminate information, or posting on Facebook. None of our assumptions were sufficient to reach the target audience in the context of COVID-19, as total number of views that accessed our materials were less than 300 at most. We viewed these myths as the result of overlooking critical elements of effective communication strategies. Eventually, MINNA managed to establish communication with the manager of a Facebook page with the largest number of followers from the Vietnamese community in Japan. Compared with our previous attempts, the messages were delivered to a large audience on the Facebook page, such as the article on COVID-19 vaccines that was viewed more than 300,000 times. In public health emergencies, interactive process of information dissemination is necessary. It is a key component for risk communication and should be prioritized. Breakthroughs in communicating with a larger audience could be possible through partnerships with online communities. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may have profound effects on their mental and physical health, personal relationships and professional efficacy.Methods: With mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.Results: A total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.Conclusion: It is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19's impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as 'compensatory' to one another, with coping mechanisms buffering and fortifying the physician's overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. [ABSTRACT FROM AUTHOR]

Background: Twenty miles per hour (20mph) speed limits (equivalent to roughly 30kmh) have become part of public health policies to reduce urban road collisions and casualties, especially in Western countries. Public opinion plays a crucial role in opposition to and acceptance of policies that are advocated for improving public health. Twenty miles per hour speed limit policies were implemented in Edinburgh and Belfast from 2016 to 2018. In this paper, we extract public opinion and sentiments expressed about the new 20mph speed limits in those cities using publicly available Twitter data. Methods: We analysed public sentiments from Twitter data and classified the public comments in plain English into the categories 'positive', 'neutral', and 'negative'. We also explored the frequency and sources of the tweets. Results: The total volume of tweets was higher for Edinburgh than for Belfast, but the volume of tweets followed a similar pattern, peaking around 2016, which is when the schemes were implemented. Overall, the tone of the tweets was positive or neutral towards the implementation of the speed limit policies. This finding was surprising as there is a perception among policymakers that there would have been public backlash against these sorts of policy changes. The commonly used hashtags focused largely on road safety and other potential benefits, for example to air pollution. Conclusions: Overall, public attitudes towards the policies were positive, thus policymakers should be less anxious about potential public backlash when considering the scale-up of 20mph speed restrictions. [ABSTRACT FROM AUTHOR]

Background: Twenty miles per hour (20mph) speed limits (equivalent to roughly 30kmh) have become part of public health policies to reduce urban road collisions and casualties, especially in Western countries. Public opinion plays a crucial role in opposition to and acceptance of policies that are advocated for improving public health. Twenty miles per hour speed limit policies were implemented in Edinburgh and Belfast from 2016 to 2018. In this paper, we extract public opinion and sentiments expressed about the new 20mph speed limits in those cities using publicly available Twitter data.Methods: We analysed public sentiments from Twitter data and classified the public comments in plain English into the categories 'positive', 'neutral', and 'negative'. We also explored the frequency and sources of the tweets.Results: The total volume of tweets was higher for Edinburgh than for Belfast, but the volume of tweets followed a similar pattern, peaking around 2016, which is when the schemes were implemented. Overall, the tone of the tweets was positive or neutral towards the implementation of the speed limit policies. This finding was surprising as there is a perception among policymakers that there would have been public backlash against these sorts of policy changes. The commonly used hashtags focused largely on road safety and other potential benefits, for example to air pollution.Conclusions: Overall, public attitudes towards the policies were positive, thus policymakers should be less anxious about potential public backlash when considering the scale-up of 20mph speed restrictions. [ABSTRACT FROM AUTHOR]

Background: Patient-based analysis of social media is a growing research field with the aim of delivering precision medicine but it requires accurate classification of posts relating to patients' experiences. We motivate the need for this type of classification as a pre-processing step for further analysis of social media data in the context of related work in this area. In this paper we present experiments for a three-way document classification by patient voice, professional voice or other. We present results for a convolutional neural network classifier trained on English data from two different data sources (Reddit and Twitter) and two domains (cardiovascular and skin diseases).Results: We found that document classification by patient voice, professional voice or other can be done consistently manually (0.92 accuracy). Annotators agreed roughly equally for each domain (cardiovascular and skin) but they agreed more when annotating Reddit posts compared to Twitter posts. Best classification performance was obtained when training two separate classifiers for each data source, one for Reddit and one for Twitter posts, when evaluating on in-source test data for both test sets combined with an overall accuracy of 0.95 (and macro-average F1 of 0.92) and an F1-score of 0.95 for patient voice only.Conclusion: The main conclusion resulting from this work is that combining social media data from platforms with different characteristics for training a patient and professional voice classifier does not result in best possible performance. We showed that it is best to train separate models per data source (Reddit and Twitter) instead of a model using the combined training data from both sources. We also found that it is preferable to train separate models per domain (cardiovascular and skin) while showing that the difference to the combined model is only minor (0.01 accuracy). Our highest overall F1-score (0.95) obtained for classifying posts as patient voice is a very good starting point for further analysis of social media data reflecting the experience of patients. [ABSTRACT FROM AUTHOR]

Background: Researching access to health services, and ways to improve equity, frequently requires researchers to recruit people facing social disadvantage. Recruitment can be challenging, and there is limited high quality evidence to guide researchers. This paper describes experiences of recruiting 1068 participants facing social disadvantage for a randomised controlled trial of prescription charges, and provides evidence on the advantages and disadvantages of recruitment methods. Methods: Those living in areas of higher social deprivation, taking medicines for diabetes, taking anti-psychotic medicines, or with COPD were eligible to participate in the study. Several strategies were trialled to meet recruitment targets. We initially attempted to recruit participants in person, and then switched to a phone-based system, eventually utilising a market research company to deal with incoming calls. We used a range of strategies to publicise the study, including pamphlets in pharmacies and medical centres, media (especially local newspapers) and social media. Results: Enrolling people on the phone was cheaper on average than recruiting in person, but as we refined our approach over time, the cost of the latter dropped significantly. In person recruitment had many advantages, such as enhancing our understanding of potential participants' concerns. Forty-nine percent of our participants are Māori, which we attribute to having Māori researchers on the team, recruiting in areas of high Māori population, team members' existing links with Māori health providers, and engaging and working with Māori providers. Conclusions: Recruiting people facing social disadvantage requires careful planning and flexible recruitment strategies. Support from organisations trusted by potential participants is essential. Registration: The Free Meds study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618001486213). [ABSTRACT FROM AUTHOR]

Background: Data-sharing policies in randomized clinical trials (RCTs) should have an evaluation component. The main objective of this case-control study was to assess the impact of published re-uses of RCT data in terms of media attention (Altmetric) and citation rates.Methods: Re-uses of RCT data published up to December 2019 (cases) were searched for by two reviewers on 3 repositories (CSDR, YODA project, and Vivli) and matched to control papers published in the same journal. The Altmetric Attention Score (primary outcome), components of this score (e.g. mention of policy sources, media attention) and the total number of citations were compared between these two groups.Results: 89 re-uses were identified: 48 (53.9%) secondary analyses, 34 (38.2%) meta-analyses, 4 (4.5%) methodological analyses and 3 (3.4%) re-analyses. The median (interquartile range) Altmetric Attention Scores were 5.9 (1.3-22.2) for re-use and 2.8 (0.3-12.3) for controls (p = 0.14). No statistical difference was found on any of the components of in the Altmetric Attention Score. The median (interquartile range) numbers of citations were 3 (1-8) for reuses and 4 (1 - 11.5) for controls (p = 0.30). Only 6/89 re-uses (6.7%) were cited in a policy source.Conclusions: Using all available re-uses of RCT data to date from major data repositories, we were not able to demonstrate that re-uses attracted more attention than a matched sample of studies published in the same journals. Small average differences are still possible, as the sample size was limited. However matching choices have some limitations so results should be interpreted very cautiously. Also, citations by policy sources for re-uses were rare.Trial Registration: Registration: osf.io/fp62e. [ABSTRACT FROM AUTHOR]

Background: It is well known that recruitment is a challenging aspect of any study involving human subjects. This challenge is exacerbated when the population sought is reticent to participate in research as is the case with pregnant women and individuals with depression. This paper compares recruitment methods used for the Food, Feelings, and Family Study, an observational, longitudinal pilot study concerning how diet and bisphenol A exposure affect maternal mood and cognitive function during and after pregnancy.Methods: Pregnant women were recruited to this study over a period of 15 months using traditional methods, social media including paid and unpaid posts, and emails broadcast to the university community. Contingency analysis using the Pearson's Chi-square test was used to determine if recruitment method was associated with likelihood of participation. T-tests were used to analyze Facebook advertisement success. ANOVAs and Fisher exact tests were used to determine if recruitment method was related to continuous and categorical demographics, respectively.Results: Social media resulted in the largest number of recruits, followed by traditional methods and broadcast email. Women recruited through social media were less likely to participate. In contrast, use of broadcast email resulted in a smaller pool of recruits but these recruits were more likely to be eligible for and complete the study. Most women recruited via social media were the result of unpaid posts to the study's Facebook page. Paid posts lasting at least 4 days were the most successful. Recruitment method was not associated with participant demographics.Conclusions: Social media has the potential to recruit a large pool of potential subjects; however, when studies require a large time investment such as the case here, women recruited through social media are less likely to participate and complete the study than women recruited through other means.Trial Registration: N/A. This study does not describe a health care intervention. [ABSTRACT FROM AUTHOR]

Our recent paper (https://doi.org/10.1186/s41073-020-00096-x) reported that 43% of reviewer comment sets (n=1491) shared with authors contained at least one unprofessional comment or an incomplete, inaccurate of unsubstantiated critique (IIUC). Publication of this work sparked an online (i.e., Twitter, Instagram, Facebook, and Reddit) conversation surrounding professionalism in peer review. We collected and analyzed these social media comments as they offered real-time responses to our work and provided insight into the views held by commenters and potential peer-reviewers that would be difficult to quantify using existing empirical tools (96 comments from July 24th to September 3rd, 2020). Overall, 75% of comments were positive, of which 59% were supportive and 16% shared similar personal experiences. However, a subset of negative comments emerged (22% of comments were negative and 6% were an unsubstantiated critique of the methodology), that provided potential insight into the reasons underlying unprofessional comments were made during the peer-review process. These comments were classified into three main themes: (1) forced niceness will adversely impact the peer-review process and allow for publication of poor-quality science (5% of online comments); (2) dismissing comments as not offensive to another person because they were not deemed personally offensive to the reader (6%); and (3) authors brought unprofessional comments upon themselves as they submitted substandard work (5%). Here, we argue against these themes as justifications for directing unprofessional comments towards authors during the peer review process. We argue that it is possible to be both critical and professional, and that no author deserves to be the recipient of demeaning ad hominem attacks regardless of supposed provocation. Suggesting otherwise only serves to propagate a toxic culture within peer review. While we previously postulated that establishing a peer-reviewer code of conduct could help improve the peer-review system, we now posit that priority should be given to repairing the negative cultural zeitgeist that exists in peer-review. [ABSTRACT FROM AUTHOR]

Our recent paper (https://doi.org/10.1186/s41073-020-00096-x) reported that 43% of reviewer comment sets (n=1491) shared with authors contained at least one unprofessional comment or an incomplete, inaccurate of unsubstantiated critique (IIUC). Publication of this work sparked an online (i.e., Twitter, Instagram, Facebook, and Reddit) conversation surrounding professionalism in peer review. We collected and analyzed these social media comments as they offered real-time responses to our work and provided insight into the views held by commenters and potential peer-reviewers that would be difficult to quantify using existing empirical tools (96 comments from July 24th to September 3rd, 2020). Overall, 75% of comments were positive, of which 59% were supportive and 16% shared similar personal experiences. However, a subset of negative comments emerged (22% of comments were negative and 6% were an unsubstantiated critique of the methodology), that provided potential insight into the reasons underlying unprofessional comments were made during the peer-review process. These comments were classified into three main themes: (1) forced niceness will adversely impact the peer-review process and allow for publication of poor-quality science (5% of online comments); (2) dismissing comments as not offensive to another person because they were not deemed personally offensive to the reader (6%); and (3) authors brought unprofessional comments upon themselves as they submitted substandard work (5%). Here, we argue against these themes as justifications for directing unprofessional comments towards authors during the peer review process. We argue that it is possible to be both critical and professional, and that no author deserves to be the recipient of demeaning ad hominem attacks regardless of supposed provocation. Suggesting otherwise only serves to propagate a toxic culture within peer review. While we previously postulated that establishing a peer-reviewer code of conduct could help improve the peer-review system, we now posit that priority should be given to repairing the negative cultural zeitgeist that exists in peer-review. [ABSTRACT FROM AUTHOR]

Background: Prescription medication (PM) misuse/abuse has emerged as a national crisis in the United States, and social media has been suggested as a potential resource for performing active monitoring. However, automating a social media-based monitoring system is challenging-requiring advanced natural language processing (NLP) and machine learning methods. In this paper, we describe the development and evaluation of automatic text classification models for detecting self-reports of PM abuse from Twitter.Methods: We experimented with state-of-the-art bi-directional transformer-based language models, which utilize tweet-level representations that enable transfer learning (e.g., BERT, RoBERTa, XLNet, AlBERT, and DistilBERT), proposed fusion-based approaches, and compared the developed models with several traditional machine learning, including deep learning, approaches. Using a public dataset, we evaluated the performances of the classifiers on their abilities to classify the non-majority "abuse/misuse" class.Results: Our proposed fusion-based model performs significantly better than the best traditional model (F1-score [95% CI]: 0.67 [0.64-0.69] vs. 0.45 [0.42-0.48]). We illustrate, via experimentation using varying training set sizes, that the transformer-based models are more stable and require less annotated data compared to the other models. The significant improvements achieved by our best-performing classification model over past approaches makes it suitable for automated continuous monitoring of nonmedical PM use from Twitter.Conclusions: BERT, BERT-like and fusion-based models outperform traditional machine learning and deep learning models, achieving substantial improvements over many years of past research on the topic of prescription medication misuse/abuse classification from social media, which had been shown to be a complex task due to the unique ways in which information about nonmedical use is presented. Several challenges associated with the lack of context and the nature of social media language need to be overcome to further improve BERT and BERT-like models. These experimental driven challenges are represented as potential future research directions. [ABSTRACT FROM AUTHOR]

Background: The abundance of easy and accessible information and the rapid development of social networking sites (SNSs) have proven that the world is small and within reach. The great implication of this interconnectivity is attributable to the change in the learning and sharing environment, which for the most part is something that classrooms are lacking. Considering the potential implications of SNSs in nursing education reveals the benefits of SNSs in allowing students to communicate and interact with a wider audience and beyond the classroom. The aim of this study is to identify the extent of SNS utilization, the perceived benefits of SNSs and the potential of SNSs for improving the study habits of nursing students in five countries (Israel, Iraq, Oman, the Philippines and Turkey). Methods: This study is a quantitative cross-sectional study that determined the relationship between the utilization of SNSs, the perceived benefits of SNSs, and the potential of SNSs for improving the study habits of nursing students in the five participating countries (Israel, Iraq, Oman, the Philippines, and Turkey). This paper is based on carefully analysing the survey responses of a sample of 1137 students from an online hosting site. The online instrument focuses on the extent of the utilization and benefits of SNSs according to their accessibility, usability, efficiency and reliability. Results: Based on the Pearson correlation coefficient (r) our findings, reveal a significant positive correlation between the extent of a possible improvement in study habits and the extent of SNS utilization in terms of the four domains, namely, accessibility (r = 0.246), usability (r = 0.377), reliability (r = 0.287) and efficiency (r = 0.387). Conclusion: It can be concluded that there is a significant positive correlation between students' study habits and the extent of SNS utilization, meaning that the more students devote themselves to their study habits, the higher the level of SNS utilization. The use of SNSs by nursing students has positive and negative implications, and there is greater potential for further improving approaches to nursing education through the adaptation of curricula based on the proper utilization of SNSs. [ABSTRACT FROM AUTHOR]

Background: Since the emergence of social media in 2004, a growing percentage of patients use this technology for health related reasons. To reflect on the alleged beneficial and potentially harmful effects of social media use by patients, the aim of this paper is to provide an overview of the extant literature on the effects of social media use for health related reasons on patients and their relationship with healthcare professionals.Methods: We conducted a systematic literature review on empirical research regarding the effects of social media use by patients for health related reasons. The papers we included met the following selection criteria: (1) published in a peer-reviewed journal, (2) written in English, (3) full text available to the researcher, (4) contain primary empirical data, (5) the users of social media are patients, (6) the effects of patients using social media are clearly stated, (7) satisfy established quality criteria.Results: Initially, a total of 1,743 articles were identified from which 22 were included in the study. From these articles six categories of patients' use of social media were identified, namely: emotional, information, esteem, network support, social comparison and emotional expression. The types of use were found to lead to seven identified types of effects on patients, namely improved self-management and control, enhanced psychological well-being, and enhanced subjective well-being, diminished subjective well-being, addiction to social media, loss of privacy, and being targeted for promotion. Social media use by patients was found to affect the healthcare professional and patient relationship, by leading to more equal communication between the patient and healthcare professional, increased switching of doctors, harmonious relationships, and suboptimal interaction between the patient and healthcare professional.Conclusions: Our review provides insights into the emerging utilization of social media in healthcare. In particular, it identifies types of use by patients as well as the effects of such use, which may differ between patients and doctors. Accordingly, our results framework and propositions can serve to guide future research, and they also have practical implications for healthcare providers and policy makers. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence for the effectiveness of social media to promote healthy behaviour among Indigenous Australians, including to reduce smoking. Social media has significant potential to stimulate interpersonal influence to quit, however an important knowledge gap is how and what content people choose to share with friends and family. This paper explores the decision making processes of community members for sharing tobacco control content with family and friends on Facebook.Methods: Community researchers were paid to choose and share at least one tobacco control post per week for a period of 6 months on their personal Facebook page. They documented reasons for their choices, which were coded and analysed to determine features of messages most likely to be shared, and salient considerations in the decision-making process.Results: Posts which are child-focused, feature Indigenous content, and are perceived as practical, relevant and credible, with a direct and unambiguous message, were most likely to be shared. Posts which included disgusting imagery about health impacts, were focused on the environment, or were ambiguous or sarcastic were less likely to be shared. Decisions were also based on whether content was perceived to contain new information, to be helpful for their friends, and to be consistent with the participant's online identity, as well as the perceived sensitivity of content. The potential impact on expensive mobile data for videos was also a factor.Conclusions: When designing tobacco control messages to be shared on social media, health promoters should take into account how information will align with positive self-image and can contribute to social capital among the intended audience, and generate interpersonal engagement. Content should complement, rather than attempt to replicate, some message features that are effective on traditional broadcast media. This study shows the potential for health services to incorporate a strategy of using paid local social media 'champions' or 'ambassadors' to disseminate tobacco control messages on Facebook through community networks. [ABSTRACT FROM AUTHOR]

Introduction: The use of social media and digital technologies has grown rapidly in Australia and around the world, including among Indigenous young people who face social disadvantage. Given the potential to use social media for communication, providing information and as part of creating and responding to social change, this paper explores published literature to understand how Indigenous Australian youth use digital technologies and social media, and its positive and negative impacts. Methods: Online literature searches were conducted in three databases: PubMed, Google Scholar and Informit in August 2014; with further searches of additional relevant databases (Engineering Village; Communication & mass media complete; Computers & applied sciences complete; Web of Science) undertaken in May 2015. In addition, relevant literature was gathered using citation snowballing so that additional peer-reviewed and grey literature was included. Articles were deemed relevant if they discussed social media and/or digital technologies and Indigenous Australians. After reading and reviewing all relevant articles, a thematic analysis was used to identify overall themes and identify specific examples. Results: A total of 22 papers were included in the review. Several major themes were identified about how and why Indigenous young people use social media: identity, power and control, cultural compatibility and community and family connections. Examples of marketing for health and health promotion approaches that utilize social media and digital technologies were identified. Negative uses of social media such as cyber bullying, cyber racism and the exchange of sexually explicit content between minors are common with limited approaches to dealing with this at the community level. Discussion: Strong cultural identity and community and family connections, which can be enhanced through social media, are linked to improved educational and health outcomes. The confidence that Indigenous young people demonstrate when approaching the use of social media invites its further use, including in arenas where this group may not usually participate, such as in research. Conclusions: Future research could examine ways to minimise the misuse of social media while maximising its positive potential in the lives of Indigenous young people. Future research should also focus on the positive application of social media and showing evidence in health promotion interventions in order to reduce health inequities between Indigenous and non-Indigenous young people. [ABSTRACT FROM AUTHOR]

Background: Caregivers of people with dementia (PwD) face burden, feelings of loneliness, and social isolation. Previous studies have shown promising effects of online e-health interventions. Using social media may facilitate support for dementia caregiver networks. In an iterative step-wise approach, a social support tool entitled "Inlife" was developed. This paper describes the design of a study evaluating the effects of Inlife and its process characteristics.Methods: A mixed-method, randomised controlled trial with 122 caregivers of PwD will be conducted. Participants will be assigned to either the Inlife social support intervention or a waiting-list control group. After 16 weeks, the control group will obtain access to the Inlife environment. Data will be collected at baseline (T0) and at 8-week (T1), 16-week (T2) and 42-week follow up (T3). The 16-week follow-up assessment (T2) is the primary endpoint to evaluate the results on the primary and secondary outcomes, measured by self-reported questionnaires. The primary outcomes include feelings of caregiver competence and perceived social support. The secondary outcomes include received support, feelings of loneliness, psychological complaints (e.g., anxiety, stress), and quality of life. A process evaluation, including semi-structured interviews, will be conducted to examine the internal and external validity of the intervention.Discussion: Using a mixed-method design, our study will provide valuable insights into the usability, effectiveness, and factors related to implementation of the Inlife intervention. Our study results will indicate whether Inlife could be a valuable social support resource in future routine dementia care.Trial Registration: Dutch trial register, NTR6131 . Registered on 20 October 2016. [ABSTRACT FROM AUTHOR]

Background: The rapid growth in the use of mobile technology in Australia has outpaced its governance, especially in healthcare settings. Whilst some Australian professional bodies and organisations have developed standards and guidelines to direct appropriate use of social media and mobile technology, clear governance arrangements regarding when, where and how to use mobile technology at point of care in nursing are currently lacking. Discussion: This paper analyses how the use of mobile technology by nurses at point of care is governed. It highlights the existence of a mobile technology paradox: an identified inability of nurses to access mobile technology in a context where it is increasingly recognised that its use in situ can enhance nursing practice while contributing to mobile learning and continuing professional development. While the recent release of the Registered Nurse Standards for Practice and accompanying Standard for Continuing Professional Development provides some direction regarding professional standards to support the use of mobile technology for mobile learning, we argue a more inclusive approach is required if emerging technologies are to be fully embraced. We describe how an implementation framework, underpinned by more detailed standards, guidelines and codes, could enable the nursing profession to be leaders in embedding mobile technology in healthcare environments nationally and globally. Conclusion: The prevalence of mobile technology in Australia has outpaced its governance in healthcare environments. Its limited availability at point of care is hindering nursing practice, mobile learning and continuing professional development. We discuss the emergence of mobile technology and impediments for its use by nurses in situ. We analyse the professional codes governing nursing, outlining potential reforms to enable implementation of mobile technology at point of care by nurses. [ABSTRACT FROM AUTHOR]

Adverse neighborhood conditions play an important role beyond individual characteristics. There is increasing interest in identifying specific characteristics of the social and built environments adversely affecting health outcomes. Most research has assessed aspects of such exposures via self-reported instruments or census data. Potential threats in the local environment may be subject to short-term changes that can only be measured with more nimble technology. The advent of new technologies may offer new opportunities to obtain geospatial data about neighborhoods that may circumvent the limitations of traditional data sources. This overview describes the utility, validity and reliability of selected emerging technologies to measure neighborhood conditions for public health applications. It also describes next steps for future research and opportunities for interventions. The paper presents an overview of the literature on measurement of the built and social environment in public health (Google Street View, webcams, crowdsourcing, remote sensing, social media, unmanned aerial vehicles, and lifespace) and location-based interventions. Emerging technologies such as Google Street View, social media, drones, webcams, and crowdsourcing may serve as effective and inexpensive tools to measure the ever-changing environment. Georeferenced social media responses may help identify where to target intervention activities, but also to passively evaluate their effectiveness. Future studies should measure exposure across key time points during the life-course as part of the exposome paradigm and integrate various types of data sources to measure environmental contexts. By harnessing these technologies, public health research can not only monitor populations and the environment, but intervene using novel strategies to improve the public health. [ABSTRACT FROM AUTHOR]

In life-threatening conditions such as cancer and rare diseases, where there is no cure and no U.S. Food and Drug Administration (FDA)-approved therapy, patients sometimes seek access to an unapproved, experimental therapy through expanded access programs as their last, best hope for treatment to save their lives. Since the 1980s, the policies and the practice of expanded access have evolved, but a common challenge remains that there is no obligation, and often little incentive, for manufacturers to offer expanded access programs, especially for individual patients. In recent years, online campaigns seeking access to an experimental therapy have become more common, paralleling growth in and representing an intersection of social media, digital health, and patient advocacy.Mackey and Schoenfeld have examined the evolution of expanded access policy, practice, and trends, as well as case studies of online campaigns to access experimental therapies, to arrive at several recommendations for the future of expanded access. This commentary puts their paper in context, examines their recommendations, and suggests further reforms.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0568-8. [ABSTRACT FROM AUTHOR]

In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented. This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America. 1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants. 2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with the health interventions they need at scale. Yet, there exist several promising and innovative examples of providing comprehensive sexuality education through conventional approaches and using new media, improving access to health services, and reaching adolescents as well as families and community members using community-based interventions were presented at the Congress. 3. Better measurement. Evaluation designs and indicators chosen to measure the effect and impact of interventions are not always sensitive to subtle and incremental changes. This can create a gap between measured effectiveness and the impact perceived by the targeted populations. Thus, one conclusion is that we need more evidence to better determine the factors impeding progress in ASRH in Latin American, to innovate and respond flexibly to changing social dynamics and cultural practices, and to better measure the impact of existing intervention strategies. Yet, this Congress offered a starting point from which to build a multi-agency and multi-country effort to generate specific evidence on ASRH with the aim of guiding policy and program decision-making. In a region that contains substantial barriers of access to ASRH education and services, and some of the highest adolescent pregnancy rates in the world, the participants agreed that there is no time to lose. [ABSTRACT FROM AUTHOR]

Background Previous research has shown that the media can play a role in shaping consumer perceptions during a public health crisis. In order for public health professionals to communicate wellinformed health information to the media, it is important that they understand how media view their role in transmitting public health information to consumers and decide what information to present. This paper reports the perceptions of media actors from three countries about their role in reporting information during a food incident. This information is used to present ideas and suggestions for public health professionals working with media during food incidents. Methods Thirty three semi-structured interviews with media actors from Australia, New Zealand and the United Kingdom were conducted and analysed thematically. Media actors were recruited via purposive sampling using a sampling strategy, from a variety of formats including newspaper, television, radio and online. Results Media actors said that during a food incident, they play two roles. First, they play a role in communicating information to consumers by acting as a conduit for information between the public and the relevant authorities. Second, they play a role as investigators by acting as a public watchdog. Conclusion Media actors are an important source of consumer information during food incidents. Public health professionals can work with media by actively approaching them with information about food incidents; promoting to media that as public health professionals, they are best placed to provide the facts about food incidents; and by providing angles for further investigation and directing media to relevant and correct information to inform such investigations. Public health professionals who adapt how they work with media are more likely to influence media to portray messages that fit what they would like the public to know and that are in line with public health recommendations and enable consumers to engage in safe and health promoting behaviours in response to food incidents. [ABSTRACT FROM AUTHOR]

Background Online content is a primary source of healthcare information for internet-using adults and a rich resource for health researchers. This paper explores the methodological and ethical issues of engaging in health research using social media. Methods A metamethod was performed on systematically selected studies that used social media as a data source for exploring public awareness and beliefs about Human Papillomaviruses (HPV) and HPV vaccination. Seven electronic databases were searched using a variety of search terms identified for each of three concepts: social media, HPV vaccine, and research method. Abstracts were assessed for eligibility of inclusion; six studies met the eligibility criteria and were subjected to content analysis. A 10-item coding scheme was developed to assess the clarity, congruence and transparency of research design, epistemological and methodological underpinnings and ethical considerations. Results The designs of the six selected studies were sound, although most studies could have been more transparent about how they built in rigor to ensure the trustworthiness and credibility of findings. Statistical analysis that intended to measure trends and patterns did so without the benefit of randomized sampling and other design elements for ensuring generalizability or reproducibility of findings beyond the specified virtual community. Most researchers did not sufficiently engage virtual users in the research process or consider the risk of privacy incursion. Most studies did not seek ethical approval from an institutional research board or permission from host websites or web service providers. Conclusions The metamethod exposed missed opportunities for using the dialogical character of social media as well as a lack of attention to the unique ethical issues inherent in operating in a virtual community where social boundaries and issues of public and private are ambiguous. This suggests the need for more self-conscious and ethical research practices when using social media as a data source. Given the relative newness of virtual communities, researchers and ethics review boards must work together to develop expertise in evaluating the design of studies undertaken with virtual communities. We recommend that the principles of concern for welfare, respect for person, and justice to be applied in research using social media. [ABSTRACT FROM AUTHOR]

"Immune boosting" is a trending topic during the COVID-19 pandemic. The concept of "immune boosting" is scientifically misleading and often used to market unproven products and therapies. This paper presents an analysis of popular immune-boosting posts from Instagram. Of the sampled posts, all promoted "immune boosting" as beneficial, nearly all involved commercial interests, and many used scientific and medical rhetoric in their messaging. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

Background: Vaccination misinformation is associated with serious public health consequences, such as a decrease in vaccination rates and a risk of disease outbreaks. Although social media offers organisations promoting vaccination unparalleled opportunities to promote evidence and counterbalance misinformation, we know relatively little about their internal workings. The aim of this paper is to explore the strategies, perspectives and experiences of communicators working within such organisations as they promote vaccination and respond to misinformation on social media.Methods: Using qualitative methods, we purposively sampled 21 participants responsible for routine social media activity and strategy from Australian organisations actively promoting vaccination on social media, including government health departments, local health services, advocacy groups, professional associations and technical/scientific organisations. We conducted semi-structured, in-depth interviews to explore their perspectives and practices. Applying Risk Communication principles as a lens, we used Framework Analysis to explore the data both inductively and deductively.Results: Organisations promoting vaccination face multiple challenges on social media, including misinformation, anti-science sentiment, a complex vaccination narrative and anti-vaccine activists. They developed a range of sophisticated strategies in response, including communicating with openness in an evidence-informed way; creating safe spaces to encourage audience dialogue; fostering community partnerships; and countering misinformation with care.Conclusions: We recommend that communicators consider directly countering misinformation because of the potential influence on their silent audience, i.e. those observing but not openly commenting, liking or sharing posts. Refutations should be straightforward, succinct and avoid emphasizing misinformation. Communicators should consider pairing scientific evidence with stories that speak to audience beliefs and values. Finally, organisations could enhance vaccine promotion and their own credibility on social media by forming strong links with organisations sharing similar values and goals. [ABSTRACT FROM AUTHOR]