Building addiction recovery capital through online participation in a recovery community

The study examines how online participation in a recovery community contributes to personal journeys to addiction recovery. We investigate whether recovery capital building - as indicated by increased levels and quality of online social interactions - and markers of positive identity development predict retention in a recovery program designed around fostering community involvement for early stage recovery addicts. We predicted that high levels and quality of online participation on the group's Facebook page and positive identity development predict retention in the program. To map how participants interact online we conducted social network analysis (SNA) based on naturally occurring online data on the Facebook page of a recovery community. We used computerised linguistic analysis to conduct a sentiment analysis of the textual data (capturing social identity markers). We used linear regression analysis to test whether our indicators of recovery capital predict program retention. To illustrate our findings in the context of the recovery community, we also present case studies of two key participants who moved from the periphery to the centre of the social network. By conducting in-depth interviews with these participants we were able to explore personal experiences of social media usage in the context of their recovery journeys for group members who have undergone some of the most significant changes since joining the community. We found that retention in the program was determined by a) the number of comment 'likes' and 'all likes' received on the Facebook page; b) position in the social network (degree of centrality); and c) linguistic content around group identity and achievement. In conclusion, positive online interactions between members of recovery communities support the recovery process through helping participants to develop recovery capital that binds them to groups supportive of positive change

Using social identity to promote health:the impact of group memberships on health in the context of obesity

As contemporary approaches to addiction treatment are evolving from models predominantly focused on acute bio-psychosocial stabilisation to models similar to managing chronic diseases such as diabetes and high blood pressure (White, 2009), the importance of communities of support becomes more central. The role of social support groups in recovery from addiction (Best et al., 2016), and other health conditions (Jetten, Haslam, & Haslam, 2012) has long been recognised and extensively researched. There has been a move from models predicated on an ‘individual struggle’ to a shared recovery process, that is, from an individual-focused approach to change to more socially oriented alternatives, not only regarding treat - ment per se, but also in how support for recovery is conceptualised (Beckwith, Bliuc, & Best, 2016; White, 1998). Recent definitions of recovery from addiction characterise recovery as a “process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential” (Substance Abuse and Mental Health Services Administration, 2012). SAMHSA’s working definition of recovery encompasses four dimensions necessary to support recovery – health, home, purpose and community – incorporating the recognition that, during this process, social support is paramount (Betty Ford Institute, 2007)

Effectiveness of Teriparatide in Women Over 75 Years of Age with Severe Osteoporosis: 36-Month Results from the European Forsteo Observational Study (EFOS)

This predefined analysis of the European Forsteo Observational Study (EFOS) aimed to describe clinical fracture incidence, back pain, and health-related quality of life (HRQoL) during 18 months of teriparatide treatment and 18 months post-teriparatide in the subgroup of 589 postmenopausal women with osteoporosis aged ≥75 years. Data on clinical fractures, back pain (visual analogue scale, VAS), and HRQoL (EQ-5D) were collected over 36 months. Fracture data were summarized in 6-month intervals and analyzed using logistic regression with repeated measures. A repeated-measures model analyzed changes from baseline in back pain VAS and EQ-VAS. During the 36-month observation period, 87 (14.8 %) women aged ≥75 years sustained a total of 111 new fractures: 37 (33.3 %) vertebral fractures and 74 (66.7 %) nonvertebral fractures. Adjusted odds of fracture was decreased by 80 % in the 30 to <36–month interval compared with the first 6-month interval (P < 0.009). Although the older subgroup had higher back pain scores and poorer HRQoL at baseline than the younger subgroup, both age groups showed significant reductions in back pain and improvements in HRQoL postbaseline. In conclusion, women aged ≥75 years with severe postmenopausal osteoporosis treated with teriparatide in normal clinical practice showed a reduced clinical fracture incidence by 30 months compared with baseline. An improvement in HRQoL and, possibly, an early and significant reduction in back pain were also observed, which lasted for at least 18 months after teriparatide discontinuation when patients were taking other osteoporosis medication. The results should be interpreted in the context of an uncontrolled observational study

Decision to take osteoporosis medication in patients who have had a fracture and are 'high' risk for future fracture: A qualitative study

Abstract Background Patients' values and preferences are fundamental tenets of evidence-based practice, yet current osteoporosis (OP) clinical guidelines pay little attention to these issues in therapeutic decision making. This may be in part due to the fact that few studies have examined the factors that influence the initial decision to take OP medication. The purpose of our study was to examine patients' experiences with the decision to take OP medication after they sustained a fracture. Methods A phenomenological qualitative study was conducted with outpatients identified in a university teaching hospital fracture clinic OP program. Individuals aged 65+ who had sustained a fragility fracture within 5 years, were 'high risk' for future fracture, and were prescribed OP medication were eligible. Analysis of interview data was guided by Giorgi's methodology. Results 21 patients (6 males, 15 females) aged 65-88 years participated. All participants had low bone mass; 9 had OP. Fourteen patients were taking a bisphosphonate while 7 patients were taking no OP medications. For 12 participants, the decision to take OP medication occurred at the time of prescription and involved minimal contemplation (10/12 were on medication). These patients made their decision because they liked/trusted their health care provider. However, 4/10 participants in this group indicated their OP medication-taking status might change. For the remaining 9 patients, the decision was more difficult (4/9 were on medication). These patients were unconvinced by their health care provider, engaged in risk-benefit analyses using other information sources, and were concerned about side effects; 7/9 patients indicated that their OP medication-taking status might change at a later date. Conclusions Almost half of our older patients who had sustained a fracture found the decision to take OP medication a difficult one. In general, the decision was not considered permanent. Health care providers should be aware of their potential role in patients' decisions and monitor patients' decisions over time

Increased fracture rate in women with breast cancer: a review of the hidden risk

Women with breast cancer, particularly individuals diagnosed at a relatively early age, have an increased incidence of fractures. Fractures can have serious clinical consequences including the need for major surgery, increased morbidity and mortality, increased cost of disease management, and reduced quality of life for patients. The primary cause of the increased fracture risk appears to be an accelerated decrease in bone mineral density (BMD) resulting from the loss of estrogenic signaling that occurs with most treatments for breast cancer, including aromatase inhibitors. However, factors other than BMD levels alone may influence treatment decisions to reduce fracture risk in this setting. Our purpose is to review current evidence for BMD loss and fracture risk during treatment for breast cancer and discuss pharmacologic means to reduce this risk.Journal ArticleResearch Support, Non-U.S. Gov'tReviewSCOPUS: re.jinfo:eu-repo/semantics/publishe

Modifiable risk factors associated with bone deficits in childhood cancer survivors

<p>Abstract</p> <p>Background</p> <p>To determine the prevalence and severity of bone deficits in a cohort of childhood cancer survivors (CCS) compared to a healthy sibling control group, and the modifiable factors associated with bone deficits in CCS.</p> <p>Methods</p> <p>Cross-sectional study of bone health in 319 CCS and 208 healthy sibling controls. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA). Generalized estimating equations were used to compare measures between CCS and controls. Among CCS, multivariable logistic regression was used to evaluate odds ratios for BMD Z-score ≤ -1.</p> <p>Results</p> <p>All subjects were younger than 18 years of age. Average time since treatment was 10.1 years (range 4.3 - 17.8 years). CCS were 3.3 times more likely to have whole body BMD Z-score ≤ -1 than controls (95% CI: 1.4-7.8; p = 0.007) and 1.7 times more likely to have lumbar spine BMD Z-score ≤ -1 than controls (95% CI: 1.0-2.7; p = 0.03). Among CCS, hypogonadism, lower lean body mass, higher daily television/computer screen time, lower physical activity, and higher inflammatory marker IL-6, increased the odds of having a BMD Z-score ≤ -1.</p> <p>Conclusions</p> <p>CCS, less than 18 years of age, have bone deficits compared to a healthy control group. Sedentary lifestyle and inflammation may play a role in bone deficits in CCS. Counseling CCS and their caretakers on decreasing television/computer screen time and increasing activity may improve bone health.</p

Online networks of racial hate: A systematic review of 10 years of research on cyber-racism

© 2018 Elsevier Ltd The ways in which the Internet can facilitate the expression and spread of racist views and ideologies have been the subject of a growing body of research across disciplines. To date, however, there has been no systematic reviews of this research. To synthesise current knowledge on the topic and identify directions for future research, we systematically review a decade of research on cyber-racism as perpetrated by groups and individuals (i.e., according to the source of cyber-racism). Overall, the cyber-racism research reviewed shows that racist groups and individuals use different communication channels, are driven by different goals, adopt different strategies, and the effects of their communication are distinctive. Despite these differences, both groups and individuals share a high level of skill and sophistication when expressing cyber-racism. Most of the studies reviewed relied on qualitative analyses of online textual data. Our review suggests there is a need for researchers to employ a broader array of methods, devote more attention to targets’ perspectives, and extend their focus by exploring issues such as the roles of Internet in mobilising isolated racist individuals and in enabling ideological clustering of supporters of racist ideologies

Mapping social identity change in online networks of addiction recovery

Sustainable addiction recovery is determined in part by how social and community resources can be mobilised to support long-term identity change. Given the current growth in technology, we ask what the role of online social interactions is in supporting long-term identity change for people in recovery. The paper also explores the relationship between the evolution of online social networks and key events that members experience in the outside world, based on a project examining changes in online participation over eight months among members of a UK addiction recovery community built around a social enterprise for employment and housing. The social enterprise had an open Facebook page that was used by staff, clients and by a diverse range of individuals not directly involved in the organisation. Based on an analysis of naturally occurring online data on the Facebook page, social network analysis (SNA) and computerised linguistic analysis that quantified emotion and belonging language in posts and subsequent 'likes', we found that variations in the structure of the online social network and the content of communication are consistent with ‘core’ members’ experience of those events. Our findings indicate that strong recovery networks supported by positive social interactions can contribute to achieving long-term identity change that supports sustaining engagement in recovery communities