A Twitter discourse analysis of negative feelings and stigma related to NAFLD, NASH and obesity

International audienceBackground: People with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are stigmatized, partly since 'non-alcoholic' is in the name, but also because of obesity, which is a common condition in this group. Stigma is pervasive in social media and can contribute to poorer health outcomes. We examine how stigma and negative feelings concerning NAFLD/NASH and obesity manifest on Twitter. Methods: Using a self-developed search terms index, we collected NAFLD/NASH tweets from May to October 2019 (Phase I). Because stigmatizing NAFLD/NASH tweets were limited, Phase II focused on obesity (November-December 2019). Via sentiment analysis, >5000 tweets were annotated as positive, neutral or negative and used to train machine learning-based Natural Language Processing software, applied to 193 747 randomly sampled tweets. All tweets collected were analysed. Results: In Phase I, 16 835 tweets for NAFLD and 2376 for NASH were retrieved. Of the annotated NAFLD/NASH tweets, 97/1130 (8.6%) and 63/535 (11.8%), respectively, related to obesity and 13/1130 (1.2%) and 5/535 (0.9%), to stigma; they primarily focused on scientific discourse and unverified information. Of the 193 747 non-annotated obesity tweets (Phase II), the algorithm classified 40.0% as related to obesity, of which 85.2% were negative, 1.0% positive and 13.7% neutral. Conclusions: NAFLD/NASH tweets mostly indicated an unmet information need and showed no clear signs of stigma. However, the negative content of obesity tweets was recurrent. As obesity-related stigma is associated with reduced care engagement and lifestyle modification, the main NAFLD/NASH treatment, stigma-reducing interventions in social media should be included in the liver health agenda

Roles of culture in gambling and gambling disorder

The roles of culture in understanding gambling and gambling disorder (GD) as well as the prevention and treatment of problem gambling (PG) are systematically presented. Relevant academic databases as well as other academically grounded published articles, government reports and conference papers accessed via online searches from 1975 to 2016 were used. Our review showed that although there were mixed findings in relation to the rate of gambling, there were strong evidences for higher rates of GD among culturally and linguistically diverse (CALD) samples compared to Caucasians or the general population. Cultural factors—such as ethnic, familial and national cultures—implicated in the maintenance of problem gambling are important considerations for future theoretical and practical developments in our increasingly globalised populations. Building cultural competencies and openness among various stakeholders (governmental, treatment providers, communities and academia) is a promising pathway in effective remediation and engagement with recovering or help-seeking gamblers and family members. Designing and implementing effective and culturally sensitive prevention and treatment programmes with the assistance of key community and/or religious leaders as well as family members will help minimise gambling among at-risk members, attract CALD problem gamblers (PGs) to treatment as well as treat and retain CALD PGs in treatment. Finally, although it is important to consider the impact of culture on PG, clinicians need to acknowledge CALD clients’ individual differences when devising prevention and treatment plans, and researchers need to acknowledge the fluidity of the concept of culture in their investigations