Toxicovigilance 2.0 - modern approaches for the hazard identification and risk assessment of toxicants in human beings: A review

The attempt to define toxicovigilance can be based on defining its fundamental principles: prevention of infections with toxic substances, collecting information on poisonings, both in terms of their sources and side effects, and confirming poisonings, with the aim of improving treatment. Substances referred to include both those originating from animal bites, ingested inadvertently, and those resulting from environmental poisoning in industrial regions of countries, etc. In this review, we provide information about the crucial function of poison control centres in toxicovigilance, the importance of incorporating big data analytics and artificial intelligence to streamline toxicovigilance processes, and examples of toxicovigilance in different countries. In conclusion, we will present the direction that modern toxicovigilance should take, incorporating available artificial intelligence methods to maximise efficiency.

The company we keep. Using hemodialysis social network data to classify patients' kidney transplant attitudes with machine learning algorithms

BACKGROUND

Hemodialysis clinic patient social networks may reinforce positive and negative attitudes towards kidney transplantation. We examined whether a patient's position within the hemodialysis clinic social network could improve machine learning classification of the patient's positive or negative attitude towards kidney transplantation when compared to sociodemographic and clinical variables.

METHODS

We conducted a cross-sectional social network survey of hemodialysis patients in two geographically and demographically different hemodialysis clinics. We evaluated whether machine learning logistic regression models using sociodemographic or network data best predicted the participant's transplant attitude. Models were evaluated for accuracy, precision, recall, and F1-score.

RESULTS

The 110 surveyed participants' mean age was 60 ± 13 years old. Half (55%) identified as male, and 74% identified as Black. At facility 1, 69% of participants had a positive attitude towards transplantation whereas at facility 2, 45% of participants had a positive attitude. The machine learning logistic regression model using network data alone obtained a higher accuracy and F1 score than the sociodemographic and clinical data model (accuracy 65% ± 5% vs. 61% ± 7%, F1 score 76% ± 2% vs. 70% ± 7%). A model with a combination of both sociodemographic and network data had a higher accuracy of 74% ± 3%, and an F1-score of 81% ± 2%.

CONCLUSION

Social network data improved the machine learning algorithm's ability to classify attitudes towards kidney transplantation, further emphasizing the importance of hemodialysis clinic social networks on attitudes towards transplant.

Enhancing the role of the social network in activity (re)engagement post-stroke: a focus group study with rehabilitation professionals

BACKGROUND

People post-stroke are at risk of not being able to participate in valued activities. It is important that rehabilitation professionals prepare people post-stroke for the transition home and provide needed support when they live at home. Several authors have suggested that members of the broad social network should play an active role in rehabilitation. This includes informing them about the importance of activity (re)engagement post-stroke and learning strategies to provide support. It is not clear when and how the broad social network can best be equipped to provide adequate activity support. This study aimed to explore stroke professionals' perspectives on strategies that establish a social network that supports activity (re)engagement of people post-stroke, when strategies are best implemented, and the factors that influence the implementation of these strategies.

METHODS

Two focus groups were executed. Content analysis was used to analyze the transcripts of the recorded conversations.

RESULTS

Eighteen professionals with various professional backgrounds and roles in treating people post-stroke participated. Strategies to establish a supportive social network included identifying, expanding, informing, and actively engaging network members. Working with the network in the immediate post-stroke phase was regarded as important for improving long-term activity outcomes. Participants expressed that most strategies to equip the social network to support people post-stroke need to take place within community care. However, the participants experienced difficulties in implementing network strategies. Perceived barriers included interprofessional collaboration, professional knowledge, self-efficacy, and financial structures.

CONCLUSIONS

Strategies to involve the social network of people post-stroke are not fully implemented. Although identifying members of a social network should begin during inpatient rehabilitation, the main part of actively engaging the network will have to take place when the people post-stroke return home. Implementing social network strategies requires a systematic process focusing on collaboration, knowledge, attitude, and skill development.

How Iranian Students Communicate About Puberty Information: Results of a Network Analysis

Background: To evaluate the structure of students' social networks (So. N) generally and in a specific network (Sp. N), in which students discuss delicate puberty concerns with their classmates, the present research examined the communication networks of students in Hamadan, Iran, a mid-sized city in Iran. Methods: In this cross-sectional study, the data were collected from a total of 350 students in 14 classes from 14 schools using a stratified sampling method. In each class, the communication networks of students were examined by asking direct questions about links among them. The students' centrality indices were computed using UCINET 6 software. Since the size of the classes was different, the centrality index was reported as a percentage, which was the number of reported links over the maximum number of possible ones. Results: The centrality index in So. Ns and Sp. Ns in boys was more than those in girls (55.4% vs 47.6% in So. N, and 33.4% vs 20.1% in Sp. N). The students' centrality indices in So. Ns and Sp. Ns were also positively correlated (r=0.58; p<0.001). In addition, the Sp. N was around 45% lower than So. N in both sexes. Conclusion: The communication styles among students in Sp. N appeared to be very different from those in So. N and the styles were related to demographic traits. As a result, it was determined that a thorough investigation of communication networks was essential for customizing health promotion initiatives for students.

Peer selection and influence for marijuana use in a complete network of first-year college students

BACKGROUND

Marijuana is the most frequently used illicit drug among college students, and there is a need to understand the social processes that contribute to young adults' marijuana use. Substance use behaviors tend to be more similar (homophilous) among individuals with social ties to one another. However, little is known about whether marijuana use homophily within young adult relationships is due to social selection (seeking out ties with similar marijuana use to one's own) or social influence (adopting similar marijuana use behaviors as one's ties), or both.

METHODS

Students (N = 1,489; 54.6% female; M_age = 18.6 years) at one University completed online surveys in their first three semesters of college. Surveys assessed participant characteristics, marijuana use, and ties to up to 10 other students in the whole (sociocentric) network of first-year college students. Stochastic-actor oriented models (SAOMs) were used to analyze the co-evolution of marijuana use and social ties over time.

RESULTS

Participants were more likely to select peers with similar past 30-day marijuana use as themselves. Concurrently, students' past 30-day marijuana use became more similar to their peers' use over time.

DISCUSSION

Evidence for selection and influence effects were highly significant after controlling for network structure and other covariates indicating these processes may work in tandem to increase marijuana use homophily over the first year of college. This highlights the importance of relationships made early in the first-year of college, as these initial peer ties are likely to reinforce marijuana use behaviors that occur within these relationships.

Finding the Invisible Leader: When A Priori Opinion Leader Identification is Impossible

Opinion leaders are increasingly recruited to diffuse information, attitudes, and behaviors to serve communication campaigns. However, this has historically required opinion leader identification before launching the campaign. A priori identification is impossible in many contexts, such as when addressing unfamiliar topics or insular communities. The authors introduce a two-stage campaign approach that resolves this problem, and a public health campaign is used to demonstrate it. This approach is applicable to a wider variety of contexts than traditional a priori opinion leader identification.

Studying leaders & their concerns using online social media during the times of crisis - A COVID case study

Online social media (OSM) has emerged as a prominent platform for debate on a wide range of issues. Even celebrities and public figures often share their opinions on a variety of topics through OSM platforms. One such subject that has gained a lot of coverage on Twitter is the Novel Coronavirus, officially known as COVID-19, which has become a pandemic and has sparked a crisis in human history. In this study, we examine 29 million tweets over three months to study highly influential users, whom we refer to as leaders. We recognize these leaders through social network techniques and analyse their tweets using text analysis. Using a community detection algorithm, we categorize these leaders into four clusters: research, news, health, and politics, with each cluster containing Twitter handles (accounts) of individual users or organizations. e.g., the health cluster includes the World Health Organization (@WHO), the Director-General of WHO (@DrTedros), and so on. The emotion analysis reveals that (i) all clusters show an equal amount of fear in their tweets, (ii) research and news clusters display more sadness than others, and (iii) health and politics clusters are attempting to win public trust. According to the text analysis, the (i) research cluster is more concerned with recognizing symptoms and the development of vaccination; (ii) news and politics clusters are mostly concerned with travel. We then show that we can use our findings to classify tweets into clusters with a score of 96% AUC ROC.

A survey of Big Data dimensions vs Social Networks analysis

The pervasive diffusion of Social Networks (SN) produced an unprecedented amount of heterogeneous data. Thus, traditional approaches quickly became unpractical for real life applications due their intrinsic properties: large amount of user-generated data (text, video, image and audio), data heterogeneity and high speed generation rate. More in detail, the analysis of user generated data by popular social networks (i.e Facebook (https://www.facebook.com/), Twitter (https://www.twitter.com/), Instagram (https://www.instagram.com/), LinkedIn (https://www.linkedin.com/)) poses quite intriguing challenges for both research and industry communities in the task of analyzing user behavior, user interactions, link evolution, opinion spreading and several other important aspects. This survey will focus on the analyses performed in last two decades on these kind of data w.r.t. the dimensions defined for Big Data paradigm (the so called Big Data 6 V's).

Perceptions of network based recruitment for hepatitis C testing and treatment among persons who inject drugs: a qualitative exploration

BACKGROUND

Social network interventions that take advantage of existing individual and group relationships may help overcome the significant patient, provider, and system level barriers that contribute to low hepatitis C Virus (HCV) treatment uptake among people who inject drugs (PWID).

METHODS

We conducted semi-structured interviews with 20 HCV antibody positive PWID (15 male, 5 female) in Baltimore, Maryland, USA. We utilized thematic analysis and employed both inductive and deductive coding techniques to assess perceptions of barriers and facilitators of social network interventions for HCV testing, linkage to care, and treatment among PWID.

RESULTS

PWID perceived a high prevalence of HCV within their social networks, especially within injection drug use networks. Overwhelmingly, participants reported a willingness to discuss HCV and provide informational, instrumental, and emotional support to their network members. Support included sharing knowledge, such as where and how to access HCV care, as well as sharing lived experiences about HCV treatment that could help peers build trust within networks. Participants who were already linked into HCV care had an increased understanding of using social network interventions to provide peer navigation, by accompanying network members to HCV related appointments. Across interviews, drug use related stigma and feeling undeserving of HCV treatment due to previous negative experiences accessing the health care system emerged as a major barrier to linkage to HCV treatment and cure. Undeservingness was often internalized and projected onto network members. To overcome this, participants supported access to low-barrier HCV treatment in alternative locations such as community-based or mobile clinics and drug treatment centers.

CONCLUSION

Social network based interventions have potential to increase HCV treatment uptake among PWID. To be successful, these interventions will need to train peers to share accurate information and personal experiences with HCV testing and treatment and enhance their ability to provide support to network members who face significant stigma related to both HCV and drug use.

Social integration and inflammation in individuals with and without posttraumatic stress disorder

BACKGROUND

Posttraumatic stress disorder (PTSD) is associated with increased risk for morbidity and mortality, which may be mediated through elevated inflammation. In contrast, social support appears to protect against morbidity and mortality, reduce levels of inflammation, and improve PTSD outcomes.

METHODS

We examined relationships among social isolation, perceived social support, and inflammation in Veterans Affairs (VA) patients with and without PTSD. Our sample included 735 (35% PTSD+) participants from the Mind Your Heart Study (mean age = 58 ± 11; 94% male). Social isolation was assessed with the Berkman Syme Social Network Index; perceived social support with the Multidimensional Scale of Perceived Social Support; and PTSD with the Clinician Administered PTSD Scale. Inflammation was indexed by high sensitivity C-reactive protein, white blood cell count, and fibrinogen. Hierarchical linear regression was used to examine associations between social measures and inflammation. PROCESS was used to examine the interactive effects of social relationships and PTSD on inflammation.

RESULTS

Social isolation, but not low perceived social support, trended towards an association with elevated inflammation in the full sample. However, considering groups with and without PTSD separately, social isolation was significantly associated with all inflammatory markers among individuals without PTSD, but not among those with PTSD.

CONCLUSIONS

Social integration is associated with reduced inflammation in individuals without, but not with, PTSD. Socially integrated individuals with PTSD did not have lower levels of inflammatory markers than socially isolated individuals with PTSD.

Identification of influential users on Twitter: A novel weighted correlated influence measure for Covid-19

In the era of advanced mobile technology, freedom of expression over social media has become prevalent among online users. This generates a huge amount of communication that eventually forms a ground for extensive research and analysis. The social network analysis allows identifying the influential people in society over microblogging platforms. Twitter, being an evolving social media platform, has become increasingly vital for online dialogues, trends, and content virality. Applications of discovering influential users over Twitter are manifold. It includes viral marketing, brand analysis, news dissemination, health awareness spreading, propagating political movement, and opinion leaders for empowering governance. In our research, we have proposed a sustainable approach, namely Weighted Correlated Influence (WCI), which incorporates the relative impact of timeline-based and trend-specific features of online users. Our methodology considers merging the profile activity and underlying network topology to designate online users with an influence score, which represents the combined effect. To quantify the performance of our proposed method, the Twitter trend #CoronavirusPandemic is used. Also, the results are validated for another social media trend. The experimental outcomes depict enhanced performance of proposed WCI over existing methods that are based on precision, recall, and F1-measure for validation.

Factors associated with referring close contacts to an app with individually-tailored vaccine information

BACKGROUND

Infants too young to be fully vaccinated are vulnerable to potentially deadly influenza and pertussis infections. The cocooning strategy limits this risk by vaccinating those likely to interact with the infant and mother during this vulnerable time, such as close friends and family members. Distribution of accurate and accessible vaccine information through existing social networks could be an important tool in increasing vaccine confidence and coverage.

METHODS

We surveyed 1095 pregnant women from diverse prenatal care practices in Georgia and Colorado. These women were surveyed through a mobile app to assess vaccine intentions, attitudes, beliefs, norms, and levels of trust, and then presented brief individually-tailored educational videos about maternal and infant vaccines and the cocooning strategy. They were then given the opportunity to refer up to six contacts to enroll in the app and receive similar vaccine education.

RESULTS

Twenty-eight percent of these women referred at least one contact, with an average of 2.67 contacts per referring woman. Most referrals (93%) were partners, parents, siblings, relatives, or close friends. Attitudinal constructs significantly associated with increased likelihood of referring contacts included: intention to receive maternal influenza vaccine, perceived safety of maternal Tdap vaccine, perceived efficacy of maternal influenza vaccine, perceived susceptibility to and severity of influenza during pregnancy, and trust in vaccine information from the Centers for Disease Control and Prevention (CDC) and academic institutions. Uncertainty about infant vaccine intentions was associated with decreased likelihood of referring contacts.

CONCLUSIONS

Pregnant women who valued vaccination and trusted vaccine information from academic institutions were more likely to refer an educational app about vaccines than those who did not. Further research is needed to determine the potential impact of this strategy on vaccine coverage when implemented on a large scale.

TRIAL REGISTRATION

The survey informing this article was part of a randomized controlled trial funded by the National Institutes of Health [clinicaltrials.gov registration number NCT02898688].

Social Network Organization, Structure, and Patterns of Influence Within a Community of Transgender Women in Lima, Peru: Implications for Biomedical HIV Prevention

Understanding social network structures can contribute to the introduction of new HIV prevention strategies with socially marginalized populations like transgender women (TW). We conducted 20 semi-structured interviews and four focus groups (n = 32) with TW from selected social networks in Lima, Peru between May and July, 2015. Participants described layers of social influence from diverse actors in their social networks. The majority identified a close relative as their primary social support, with whom they confided secrets but avoided issues of transgender identity, sexuality, and sex work. Participants described close circles of TW friends with whom they shared information about gender identity, body modification, and sexual partners, but avoided issues like HIV. Community leadership included political leaders (who advocated for transgender rights) as well as social leaders (who introduced TW to hormone therapy, body modification, and commercial sex). Detailed analysis of TW social networks can contribute to implementation and acceptability of new HIV prevention technologies.

Adverse Drug Reaction Detection in Social Media by Deepm Learning Methods

Objective

Health-related studies have been recently at the heart attention of the media. Social media, such as Twitter, has become a valuable online tool to describe the early detection of various adverse drug reactions (ADRs). Different medications have adverse effects on various cells and tissues, sometimes more than one cell population would be adversely affected. These types of side effect are occasionally associated with the direct or indirect influence of prescribed drugs but do not have general unfavorable mutagenic consequences on patients. This study aimed to demonstrate a quick and accurate method to collect and classify information based on the distribution of approved data on Twitter.

Materials and Methods

In this classification method, we selected "ask a patient" dataset and combination of Twitter "Ask a Patient" datasets that comprised of 6,623, 26,934, and 11,623 reviews. We used deep learning methods with the word2vec to classify ADR comments posted by the users and present an architecture by HAN, FastText, and CNN.

Results

Natural language processing (NLP) deep learning is able to address more advanced peculiarity in learning information compared to other types of machine learning. Moreover, the current study highlighted the advantage of incorporating various semantic features, including topics and concepts.

Conclusion

Our approach predicts drug safety with the accuracy of 93% (the combination of Twitter and "Ask a Patient" datasets) in a binary manner. Despite the apparent benefit of various conventional classifiers, deep learning- based text classification methods seem to be precise and influential tools to detect ADR.

No Spouse, No Son, No Daughter, No Kin in Contemporary China: Prevalence, Correlates, and Differences in Economic Support

OBJECTIVES

China's recent demographic and social changes might undermine the sustainability of its family-oriented system for elder care. We investigate kin availability among adults aged 45+ in contemporary China, with an emphasis on child gender.

METHOD

Using nationally representative survey data from the China Health and Retirement Longitudinal Study (2011), we examine the prevalence and correlates of lacking different kin types and combinations, and we test associations between kin availability and received economic support.

RESULTS

Kinlessness is low in China (less than 2% lack a spouse/partner and children), but kin availability is patterned by gender, age group, and sociodemographic characteristics. More than twice as many older adults have no spouse/partner and no daughter (3.2%) as those who have no spouse/partner and no son (1.4%). Adults without close kin are disadvantaged across health, wealth, and economic support. In contrast to traditional expectations, we find that those with only daughters are more similar to those with mixed sex children, whereas those with only sons are more similar to those without children in receipt of economic support.

DISCUSSION

Access to kin forms the basis of an emergent system of stratification in China, which will be amplified as cohorts with only one child age into older adulthood.

Portal Nodes Screening for Large Scale Social Networks

Network autoregression model (NAM), as a powerful tool to study user social behaviors on large scale social networks, has drawn great attention in recent years. In this paper, we are interested in identifying the influential users (i.e., portal nodes) in a social network under the framework of NAM. Especially, we consider the autoregression model that allows to have a heterogenous and sparse network effect coefficients. Therefore, the portal nodes take influential powers which are corresponding to the nonzero network effect coefficients. A screening procedure is designed to screen out the portal nodes and the strong screening consistency is established theoretically. A quasi maximum likelihood method is applied to estimate the influential powers. The asymptotic normality of the resulting estimator is established. Further selection procedure is given by taking advantage of the local linear approximation algorithm. Extensive numerical studies are conducted by using a Sina Weibo dataset for illustration purpose.

The Association between Frequency of Social Contact and Frailty in Older People: Korean Frailty and Aging Cohort Study (KFACS)

BACKGROUND

The trend of aging society is occurring globally, and with it, one of the health problems that is emerging is frailty. Efforts are being made to account for the increasing prevalence of frailty, and various modifiable factors are being considered in regards to frailty. Because social contact has shown beneficial effects in terms of health in previous studies, it is increasingly being considered in relation to frailty. The purpose of this study was to assess the association of different types of social contact with frailty status.

METHODS

A total of 1,200 Korean elders aged 70-84 years old were included in the study. Using Fried's Cardiovascular Health Study index to categorize the frailty status, the relationship between frailty status and frequency of contact (i.e., with family members, friends, or neighbors) was analyzed using multinomial logistic regression accounting for confounders.

RESULTS

Adjusting for all covariates, frequency of contact with friends was the most statistically significant. Less frequent contact was associated with a significantly higher odds of pre-frailty: monthly (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.27-3.20), and rarely (OR, 1.87; 95% CI, 1.17-2.99), with daily contact group as reference. Also, those contacting friends monthly (OR, 5.04; 95% CI, 2.29-11.08) or rarely (OR, 3.23; 95% CI, 1.58-6.61) were more likely to be frail compared to the daily group.

CONCLUSION

Frequency of social contact, especially with friends, is strongly associated with frailty.

[Changes attributed to a program based on the action-training of health agents. What do the associations say?]

OBJECTIVE

Interventions aimed at improving health must take into account the health inequalities and the target the population in need. The mihsalud program (Women, Children and Men creating health) promotes health in vulnerable populations through engaging and collaborating with the local third sector. The objective of the study was to describe the changes attributed to the mihsalud programme and the process of action-training of community-based health volunteers (ASBC in Spanish) as perceived by the local organizations where they work or volunteer.

METHODS

Qualitative descriptive study through semi-structured interviews with representatives of organizations that trained ASBC during 2012 in Valencia. Twelve semi-structured interviews were conducted with representatives of organizations which had trained some of their volunteers to become ASBC during the 2012 action-training session. The interviews were transcribed verbatim and analysed with the programme for qualitative analysis Nvivo. Themathic analysis was performed: transcripts were coded line by line from an inductive perspective.

RESULTS

Three main categories were identified: 1) The role of the ASBC: The associations recognise the role of the ASBC among their peers and the importance of the training received in the program; 2) Perceived changes: The associations recognize having a broader vision of health, identify the role of the figure ASBC that coordinates with health professionals in their health area and networking with other associations that were previously unknown; 3) Challenges and opportunities: Lack of support for the continuity of projects with ASBC due to the precariousness of small organisations and coordination with services, recognition at the local level and promotion of participation and interculturality through ASBC and their peers.

CONCLUSIONS

The organizations recognize that the program and ASBC have made collaboration with health sector possible, have promoted health among their peers and have encouraged networking with other organizations and areas.

[Italian health centers and Web Marketing strategy: necessary improvements, even in nephrology]

The complete digitalization of the health system is an objective that Italy, from 2014, is pursuing with great difficulty, spurred by the many European initiatives dedicated to it. Despite the social and cultural background seems to be clearly ready for an application of the renewal strategies, e-Health and m-Health are struggling to get off the ground throughout the territory. The main difficulties are find at local level and don't spare any medical discipline, nephrology included. The characteristics of the official websites belonging to the local health centers demonstrate it. Today, these institutions are still sparsely present on Social Media or in the Italian Smart Mobile Technology landscape. The article illustrates the main features of the phenomenon and calls for reflection on the necessity to accelerate the digital innovation of the communication with patients. This is a possible strategy for reducing chronicity through prevention, and, potentially, for decreasing health costs.

Social network moderators of naltrexone and behavioral treatment effects on heavy drinking in the COMBINE study

BACKGROUND

Oral naltrexone is an efficacious medication for treatment of alcohol dependence, but small effect sizes and variability in outcomes suggest the presence of person-level moderators of naltrexone response. Identification of contextual or psychosocial moderators may assist in guiding clinical recommendations. Given the established importance of social networks in drinking outcomes, as well as the potential effects of naltrexone in reducing cue reactivity which may be especially important among those with more heavy drinkers and more alcohol cues in their networks, we examined pretreatment social network variables as potential moderators of naltrexone treatment effects in the COMBINE study.

METHODS

The sample included all COMBINE study participants in medication conditions with full data on the Important People Inventory (IPI) and covariates at intake (N = 1,197). The intake IPI assessed whether participants had any frequent drinkers in their network and the average frequency of contact with these drinkers. The effects of treatment condition, pretreatment network variables, and their interactions on percent heavy drinking days were tested in hierarchical linear models, controlling for demographics and baseline clinical covariates.

RESULTS

In treatment conditions involving medical management and combined behavioral intervention (CBI), the effects of active naltrexone on heavy drinking were significantly greater for individuals with frequent drinkers in their network (z = -2.66, p < 0.01) and greater frequency of contact with those drinkers (z = -3.19, p < 0.01). These network variables did not moderate the effects of active naltrexone without CBI.

CONCLUSIONS

When delivered in conjunction with behavioral interventions, naltrexone can be more potent for alcohol-dependent adults who have greater contact with frequent drinkers prior to treatment, which may indicate patterns of environmental exposure to alcohol. Contextual, social risk factors are a potential avenue to guide personalized treatment of alcohol dependence.

Social and Psychological Effects of the Internet Use

Background and Aims:

Over the past two decades there was an upsurge of the use of Internet in human life. With this continuous development, Internet users are able to communicate with any part of the globe, to shop online, to use it as a mean of education, to work remotely and to conduct financial transactions. Unfortunately, this rapid development of the Internet has a detrimental impact in our life, which leads to various phenomena such as cyber bullying, cyber porn, cyber suicide, Internet addiction, social isolation, cyber racism etc. The main purpose of this paper is to record and analyze all these social and psychological effects that appears to users due to the extensive use of the Internet.

Materials and Methods:

This review study was a thorough search of bibliography data conducted through Internet and library research studies. Key words were extracted from search engines and data bases including Google, Yahoo, Scholar Google, PubMed.

Findings:

The findings of this study showed that the Internet offers a quick access to information and facilitates communication however; it is quite dangerous, especially for young users. For this reason, users should be aware of it and face critically any information that is handed from the website

Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs

BACKGROUND

Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes.

METHODS

Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three-level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol-related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team's primary care patient panel.

RESULTS

Teams (n = 31) whose registered nurses displayed more strong (at least daily) face-to-face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol-related hospital days (rate ratio [RR] = 0.90; 95% confidence interval [CI]: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1,030 (95% CI: -$1,819, -$241) lower alcohol-related patient healthcare costs per 1,000 team patients in the past 12 months. Conversely, teams whose primary care practitioner (PCP) had more strong face-to-face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol-related hospital days (RR = 1.12; 95% CI: 1.03, 1.23) and $1,428 (95% CI: $378, $2,478) higher alcohol-related healthcare costs per 1,000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and comorbidity diagnoses.

CONCLUSIONS

Excessive alcohol-using patients may fair better if cared for by teams whose face-to-face and electronic communication networks include more team members and whose communication to the PCP has been streamlined to fewer team members.

The influence of social networking sites on health behavior change: a systematic review and meta-analysis

OBJECTIVE

Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors.

MATERIALS AND METHODS

Five databases were scanned using a predefined search strategy. Studies were included if they focused on patients/consumers, involved an SNS intervention, had an outcome related to health behavior change, and were prospective. Studies were screened by independent investigators, and assessed using Cochrane's 'risk of bias' tool. Randomized controlled trials were pooled in a meta-analysis.

RESULTS

The database search retrieved 4656 citations; 12 studies (7411 participants) met the inclusion criteria. Facebook was the most utilized SNS, followed by health-specific SNSs, and Twitter. Eight randomized controlled trials were combined in a meta-analysis. A positive effect of SNS interventions on health behavior outcomes was found (Hedges' g 0.24; 95% CI 0.04 to 0.43). There was considerable heterogeneity (I(2) = 84.0%; T(2) = 0.058) and no evidence of publication bias.

DISCUSSION

To the best of our knowledge, this is the first meta-analysis evaluating the effectiveness of SNS interventions in changing health-related behaviors. Most studies evaluated multi-component interventions, posing problems in isolating the specific effect of the SNS. Health behavior change theories were seldom mentioned in the included articles, but two particularly innovative studies used 'network alteration', showing a positive effect. Overall, SNS interventions appeared to be effective in promoting changes in health-related behaviors, and further research regarding the application of these promising tools is warranted.

CONCLUSIONS

Our study showed a positive effect of SNS interventions on health behavior-related outcomes, but there was considerable heterogeneity. Protocol registration The protocol for this systematic review is registered at http://www.crd.york.ac.uk/PROSPERO with the number CRD42013004140.

Living Arrangement and Loneliness Among Lesbian, Gay, and Bisexual Older Adults

PURPOSE OF THE STUDY

Loneliness is a key health risk for older adults. Utilizing the loneliness model, we examine the relationship between living arrangement and loneliness among lesbian, gay, and bisexual (LGB) older adults, taking into consideration potential correlates including social resources and personal constraints.

DESIGN AND METHODS

We use data from a national survey of LGB adults aged 50 and older (N = 2,444). Types of living arrangement include living with a partner or spouse, living alone, and living with someone other than a partner or spouse.

RESULTS

Compared with LGB older adults living with a partner or spouse, both those living alone and living with others reported higher degrees of loneliness, even after controlling for other correlates. The results of a multivariate regression analysis reveal that social support, social network size, and internalized stigma partially account for the relationship between living arrangement and loneliness.

IMPLICATIONS

Living arrangement was found to be an independent correlate of loneliness among LGB older adults. Targeted interventions are needed to reduce loneliness for those living alone and those living with someone other than a partner or spouse in part by enhancing social resources and reducing risks of internalized stigma. Eliminating discriminatory policies against same-sex partnerships and partnered living arrangements is recommended.

The application of network scale up method on estimating the prevalence of some disabilities in the southeast of Iran

BACKGROUND

More than a billion people have some form of disabilities worldwide. Persons living with a disability have many needs (including physically, mentally, and socially needs). Estimating the size of disabled population is a challenge in health systems. An innovative indirect method to estimate the size of populations is network scale up (NSU) having widely used for hidden populations. The method is based-on the social network of individuals. We assessed the capability of NSU to estimate persons living with a disability being a middle population (neither non-hidden nor hidden populations) in the Southeast of Iran (Kerman City, southeast Iran).

METHODS

A total of 3052 of Kermanian people over 20 year old were interviewed by simple random sampling. We asked them whether they knew acquaintances with complete blindness, severe visual impairment, deafness, severe hearing impairment, limb defects, and mental retardation, if yes; we wanted them to count them.

RESULTS

Based on the network scale up method, the prevalence of the populations was estimated at 5.21/1000 in Kerman City where severe visual impairment was 1.35, mental retardation was 1.039, severe hearing impairment was 1.005, limb defects was 0.78, deafness was 0.59, and complete blindness was 0.56 (per 1000 inhabitants).

CONCLUSIONS

The results were not exactly comparable to previous studies using different methods such as surveys. Although the method has some limitations, considering its easiness and cost-effectiveness, modified NSU could be used when direct methods are not practicable.

Bayesian Analysis for Exponential Random Graph Models Using the Adaptive Exchange Sampler

Exponential random graph models have been widely used in social network analysis. However, these models are extremely difficult to handle from a statistical viewpoint, because of the intractable normalizing constant and model degeneracy. In this paper, we consider a fully Bayesian analysis for exponential random graph models using the adaptive exchange sampler, which solves the intractable normalizing constant and model degeneracy issues encountered in Markov chain Monte Carlo (MCMC) simulations. The adaptive exchange sampler can be viewed as a MCMC extension of the exchange algorithm, and it generates auxiliary networks via an importance sampling procedure from an auxiliary Markov chain running in parallel. The convergence of this algorithm is established under mild conditions. The adaptive exchange sampler is illustrated using a few social networks, including the Florentine business network, molecule synthetic network, and dolphins network. The results indicate that the adaptive exchange algorithm can produce more accurate estimates than approximate exchange algorithms, while maintaining the same computational efficiency.

The role of drinking in new and existing friendships across high school settings

We use 9 Add Health high schools with longitudinal network data to assess whether adolescent drinkers choose friends who drink, prefer friends whose friends drink, if selection differs between new and existing friendships, and between schools. Utilizing dynamic social network models that control for friend influences on individual alcohol use, the results show that drinkers do not strongly prefer friends who drink. Instead, they favor close friends whose friends’ drink, suggesting that alcohol matters for selection on the social groups and environments that friends connect each other to. The role of alcohol use differs by whether friendships are new or existing, however, with bridging connections being less stable. Moreover, selection processes, and the implications of alcohol use for friendship, vary in important ways between schools.

Using a knowledge utilization framework to explore how findings from one study can be applied to other nursing contexts

AIM

To discuss the complexities of moving research into practice and through a case example, explore how empirical findings from one specific study could be applied to nursing in other contexts.

BACKGROUND

The processes of moving research findings into practice are complex and multidimensional. In this paper, an innovative approach to social support, network-focused nursing (NFN), is used as a case example to illustrate these complexities. Social support is associated with better recovery and survival after illness and based on this, a NFN programme was developed in a Danish oncology youth unit. Subsequently, a research study was undertaken to investigate the programme and based on the findings, the concept NFN was developed.

METHODS

A knowledge utilization framework is used to explore how empirical findings from the NFN study could be applied to nursing more generally. Aligned with this, the specific considerations for implementing NFN are explicated.

DISCUSSION

Strong leadership, education, management support and effective communication are critical factors for research utilization. Moving research into practice requires openness to new ideas. Nursing and healthcare policies therefore need to support environments in which creativity and innovation can flourish. NFN was developed in teenager and young adult cancer care, but its principles may be transferable to other clinical environments.

CONCLUSIONS

It is important that nurse managers and policy makers ensure that support and education are available to nurses to facilitate moving research into practice. Moreover, resources need to be considered, particularly in countries where financial and organizational infrastructures may be weak.

EXPLANATIONS FOR EDUCATION GRADIENTS IN DEPRESSION-THE CASE OF KOREA

OBJECTIVES

We examine gender differences in educational gradients in depressive symptoms of married couples and identify what accounts for education gradients for husbands and wives.

METHODS

We use a nationally representative sample of married couples from the 2006 Korean Longitudinal Study of Aging, which collected information about depressive symptoms and risk factors for both spouses.

RESULTS

For married couples, we find significant education gradients in depressive symptoms for both husbands and wives. Economic resources, physical health, children, and the relationship of spouse explain educational gradients of both husbands and wives. On the other hand, work and organized social activities are important pathways for husbands, but not for wives. In contrast, spouse's educational attainment accounts for wives' educational gradient, but not husbands'.

CONCLUSIONS

Education is a strong predictor of depressive symptoms, but the pathways linking education to depressive symptoms differ between men and women.