Internet Discussion Forums Research Articles

The Flip Side of “Spice”: The Adverse Effects of Synthetic Cannabinoids as Discussed on a Swedish Internet Forum

Background Synthetic cannabinoids in smoking mixtures (such as Spice) or as raw powder are sold for recreational use as an alternative to herbal cannabis (hashish and marijuana). Although clinical case studies have documented an array of side effects, there is also information available at Internet based drug discussion forums. Aim Our study investigates experiences of side effects from use of synthetic cannabinoids, as described and anonymously shared on Swedish online discussion forums. Methods A systematic search yielded 254 unique and publicly available self-reports from the Swedish forum flashback.org. These texts were analysed thematically, which resulted in 32 sub-themes, which were combined into three overarching themes. Results & Conclusion The experiences of negative side effects were described as (1) Adverse reactions during acute intoxication; (2) Hangover the day after intoxication; (3) Dependency and withdrawal after long-term use. The first theme was characterized by an array of fierce and unpredictable side effects as tachycardia, anxiety, fear and nausea. The acute intoxication reactions were congruent with the side effects published in clinical case studies. The day after intoxication included residual effects of dullness, apathy, nausea and headache. Long-term use resulted in dependency and experiences of being emotionally numb and disconnected. Furthermore, withdrawal was described as sweating, shaking, loss of appetite and insomnia. Both the hangover and the long-term effects have previously been given little scientific attention and need to be investigated further. Drug related Internet discussion forums constitute an overlooked source of information which can aid in the identification of previously unknown risks and effects.

In Search of the Self: Reconciling the Past and the Present in Immigrants’ Experience by Larisa Fialkova and Maria Yelenevskaya (review)

Reviewed by: In Search of the Self: Reconciling the Past and the Present in Immigrants’ Experience by Larisa Fialkova and Maria Yelenevskaya Irena Vladimirsky (bio) Larisa Fialkova and Maria Yelenevskaya, In Search of the Self: Reconciling the Past and the Present in Immigrants’ Experience (Tartu: ELM Scholarly Press, 2013). 282 pp. Bibliography. ISBN: 978-9949-490-80-6. The book of Larisa Fialkova and Maria Yelenevskaya is based on personal narratives of ex-Soviet immigrants to Israel and Germany and their experiences. More specifically, it relies on a series of interviews and untraditional sources such as Internet forum discussions and artifacts of Russian-speaking media and consumer culture (such as store signs or advertisements) (P. 16). The authors pursue a broad multidisciplinary approach that includes folklore theory, legal anthropology, linguistics, social psychology, and sociology. It is suggested that the experience of ex-Soviet immigrants is formed by an overlapping of three spheres: traditional Soviet culture, traditional Jewish culture, and the dominant culture of the host society (secular Jewish or protestant German). The Introduction provides the reader with a general idea of the field of folklore studies and outlines the scope of the problem of post-Soviet immigration in Germany and Israel. The two societies cannot be regarded as melting pots, but rather [End Page 427] as “salad bowls” where each group of immigrants preserves its own ethnic customs and practices. In Israel, Russian-speaking immigrants composed nearly 21 percent (about 1,300,000 out of 6,200,000) of the country’s population. Unlike the previous wave of immigrants from the region, recent repatriates did not fully integrate into the host society (Pp. 15–17). It is somewhat different in Germany: German culture is perceived by Jewish immigrants from post-Soviet countries as more prestigious than the Soviet and Jewish cultures, and so they are trying harder to join it. Chapter 1 of the first part of the book (dedicated to the case of Israel) examines immigrant narratives regarding two main topics: the concept of space and the feeling of being a stranger within Israeli society. The authors analyzed interviews with 143 respondents who repatriated to Israel in 1989−1999 as adults, and 10 interviews with respondents who were brought to the country as small children (P. 25). Before coming to Israel, most respondents strongly identified themselves as city dwellers. On the basis of their past experience, they perceive the modern city as a place that provides the best opportunities for work and study, the site characterized by well-planned and attractive city landscapes, developed public transportation, entertainment venues, and high security. Israel is one of the most urbanized countries in the world, but the difference between the cities in the center of Israel and those located on the periphery is enormous. Whereas peripheral towns in the eyes of many symbolize stagnation, cities in the center are perceived as symbols of multiple opportunities (P. 45). Ex-Soviet immigrants brought with them traditional Soviet stereotypes about the center and periphery, and the cultural hierarchies of prestige associated with them. Thus, Jews from the Caucasus or Central Asia are perceived as inferior to their “European” counterparts (Pp. 38–40), but within the general Israeli population they are still viewed as superior to the Jews from Ethiopia or ethnic groups such as Arabs and Bedouins. Mobility is another factor of classification along the center–periphery gradient. The best sites of culture and entertainment are located in the central cities and opened in the evenings or on Shabbat (Saturday). Poor public transportation and lack of economic resources (owning a car) complicate the chances for young immigrants to enjoy the attractions of a big city (P. 64). Although over the past years central cities in Israel have lost their former reputation as strongholds of higher security (becoming a frequent target of missile and terrorist attacks), they are still perceived by post-Soviet immigrants as more desirable places to [End Page 428] live. Composing a substantial part of students and junior academic staff in Israeli colleges and universities, they strongly believe that the presence of a college or a university in the city considerably elevates its status (P. 51). True to their self-perception as representatives...

Harm reduction and knowledge exchange-a qualitative analysis of drug-related Internet discussion forums.

BackgroundNovel psychoactive substances (NPS) are continuously and increasingly appearing on the international drug market. Global Internet forums are a publicly available reality where users anonymously discuss and share information about NPS. The aim of this study was to explore and characterize the discussions about NPS on international Internet forums.MethodsThe most post-frequent NPS discussions were collected from three “leading edge” international Internet forums. A total of 13,082 posts from 60 threads of discussion were systematically examined and interpreted to reveal recurring topics and patterns. Each thread was coded with emerging topics and supporting quotations from the data set. Eventually, codes with coherent meaning were arranged into 51 broader categories of abstraction, which were combined into four overarching themes.ResultsFour themes emerged during the analysis: (1) uncovering the substance facts, (2) dosage and administration, (3) subjectively experienced effects, and (4) support and safety. The first theme dealt primarily with substance identification, pharmacology, and assessed not only purity but also legal status and acquisition. The second theme focused on administration techniques, dose recommendations, technical talk about equipment, and preferred settings for drug use. The third theme involved a multitude of self-reported experiences, in which many different aspects of intoxication were depicted in great detail. The users emphasized both positive and negative experiences. The last theme incorporated the efforts of the communities to prevent and minimize harm by sharing information about potential risks of the harmful effects or contraindications of a substance. Also, online support and guidance were given to intoxicated persons who experienced bad or fearful reactions.ConclusionsThe findings showed that the discussions were characterized by a social process in which users supported each other and exchanged an extensive and cumulative amount of knowledge about NPS and how to use them safely. Although this publicly available knowledge could entail an increase in drug use, the main characteristics of the discussions in general were a concern for safety and harm reduction, not for recruiting new users. Drug-related Internet forums could be used as a location for drug prevention, as well as a source of information for further research about NPS.

A search for hope and understanding: An analysis of threatened miscarriage internet forums

Objectivethreatened miscarriage is a common complication of early pregnancy, which increases the risk of miscarriage or pregnancy complications such as premature birth. Currently there is limited evidence to recommend beneficial medical treatments or lifestyle changes, resulting in a ‘watchful waiting’ approach. The aim of this study was to describe women's experiences of threatened miscarriage through examining postings to Internet discussion forums. Designa Goggle alert for threatened miscarriage was created with emails containing hyperlinks sent to the first author and collected over a seven month period (April to November 2011). Data was analysed using thematic analysis. Findingsone hundred and twenty one discussion threads were collected. The overarching theme that emerged was one of ‘a search for hope and understanding’. Within this there were four sub themes that illustrated this search. ‘A reason for hope: stories and real life experiences’ illustrated how women sought hope for a viable pregnancy through others. ‘Becoming the expert,’ captures how women gave advice from their own experiences. ‘A safe place to share’ and ‘connecting to empathic support’ illustrates how women used this medium for long distance support. Key conclusioninternet discussion forums were used by women to seek hope and support they were not receiving from their health professionals. Women urged each other to remain hopeful despite a negative medical prognosis. There was an acceptance of a lay expertise within the forums that was valid enough to challenge medical expertise. Implications for practicehealth practitioners may need education that helps them balance their delivery of medical information with hope in order to increase feelings of trust. With women seeing the Internet as a useful form of support, it may be relevant for practitioners to consider recommending relevant Internet sites and discuss this with women.

‘Maybe it is prejudice … but it is NOT racism’: Negotiating racism in discussion forums about Gypsies

This article addresses the ways in which opposition towards Gypsies is debated, with particular regard to whether or not this opposition constitutes racism or prejudice towards a group shown to be vulnerable and subject to discrimination. A discursive analysis of a corpus of internet discussion forums about Gypsies in the UK is undertaken. The analysis demonstrates that opposition towards Gypsies can be presented as racist; however, such accusations are met with criticism so that writers become accountable for making them. While writers do go to rhetorical lengths to dissociate themselves from being presented as racist, there is nevertheless an acceptance that opposition to Gypsies may constitute prejudice. This prejudice is presented as an inevitable result of Gypsies’ behaviour and, of particular note, appears to be deemed acceptable. The implications of this finding for the discursive literature on taboos against, and denials of, racism are discussed.

Quantitative Agent Based Model of User Behavior in an Internet Discussion Forum

The paper presents an agent based simulation of opinion evolution, based on a nonlinear emotion/information/opinion (E/I/O) individual dynamics, to an actual Internet discussion forum. The goal is to reproduce the results of two-year long observations and analyses of the user communication behavior and of the expressed opinions and emotions, via simulations using an agent based model. The model allowed to derive various characteristics of the forum, including the distribution of user activity and popularity (outdegree and indegree), the distribution of length of dialogs between the participants, their political sympathies and the emotional content and purpose of the comments. The parameters used in the model have intuitive meanings, and can be translated into psychological observables.

Dangerous Agent or Saviour? HPV Vaccine Representations on Online Discussion Forums in Romania

Whereas Romanian health officials have launched two national human papillomavirus (HPV) vaccination campaigns, the uptake rate remained insignificant. Understanding local perceptions of the vaccine is necessary, as they could inform future educational programmes. Given that social media provide new opportunities to communicate about vaccination, this paper sought to explore the public's constructions of the HPV vaccine as they were expressed on Internet discussion forums. Twenty discussion forums, with a total sample size of 2,240 comments (2007-2012), were included. We conducted a thematic analysis with a focus on language, informed by a discourse analytic approach. Positive discourses relying on evidence-based arguments or cancer-related experiences battled with negative discourses that focused mostly on pseudo-scientific information and affect-based testimonials. Both camps made use of appeals to authority in order to provide powerful messages. Critics expressed high levels of mistrust in the health system and perceived the vaccine as dangerous, as part of a conspiracy, as unnecessary or as a promoter of promiscuity. By contrast, supporters considered the HPV vaccine to be helpful and criticized the irrationality of opponents. Ambivalence and uncertainty also emerged, along with criticism toward the suboptimal organization of the vaccination programmes. Findings highlight ways in which views about the vaccine are embedded in broader perspectives about science, the national medical system, society development and economic inequality. Online posts are likely to elicit fear and doubts around vaccination, which in turn may impair decisions. Findings indicate that targeted education campaigns are needed in order to address public concerns about vaccination.

Do Customers Speak Their Minds? Using Forums and Search for Predicting Sales

A large body of research uses data from social media websites to predict offline economic outcomes such as sales. However, recent research also points out that such data may be subject to various limitations and biases that may hurt predictive accuracy. At the same time, a growing body of research shows that a new source of online information — search engine logs — has the potential to predict offline outcomes. We study the relationship between these two important data sources in the context of sales predictions. Focusing on the automotive industry — a classic example of a domain of high-involvement products — we use Google’s comprehensive index of internet discussion forums, in addition to Google search trend data. We find that adding search trend data to models based on the more commonly-used social media data significantly improves predictive accuracy. We also find that predictive models based on inexpensive search trend data provide predictive accuracy that is comparable, at least, to that of social media data-based predictive models. Last, we show that the improvement in accuracy is considerably larger for “value” car brands, while for “premium” car brands the improvement obtained is more moderate.

‘Krokodil’ and what a long strange trip it's been

New evidence with regard to an under documented practice – the home manufacture of anabolic androgenic steroids (AAS) for injection, known as ‘homebrewing’ – in contemporary injecting performance and image enhancing drug (PIED) culture is the subject of this paper.Data was collected from five publicly accessible internet discussion forums and coded using NVivo software. For the purposes of this study, threads in relation to homebrewing (n = 14) were extracted from the final set of records for ethnographic content analysis.Motivation to perform homebrewing was largely grounded in the circumnavigation of unreliable online sourcing routes for AAS products, financial losses and potential harms associated with contaminated and counterfeit injectables. Instructions on how to perform homebrewing were found within discussion threads. Identified areas of concern included potential for sterility and dosing issues, injecting harms, isolation from health services.This study provides a snapshot of online communal activity around practice of homebrewing AAS amongst individuals who inject AAS. Further research in this area is warranted, and will be of benefit to healthcare workers, treatment providers and policy makers particularly as this relates to evidence informed and targeted harm reduction policies and effective public health interventions.

(Im)politeness and disagreement in two Hong Kong Internet discussion forums

The study of politeness and disagreement in computer-mediated communication (CMC) is a bourgeoning area of study in pragmatics. Adopting the discursive and interactional approaches, this paper investigates the issue in two Hong Kong Internet discussion forums based on the forum interlocutors’ disagreement strategies. Lay participants (i.e., forum browsers) were also invited to rate the identified disagreement strategies in the parameters of politeness, appropriateness and positively/negatively marked behavior on a 5-point Likert scale. The correlations among the three parameters were analyzed statistically. A follow-up interview was administered to better understand the relationship between disagreement and the three parameters of relational work.Eleven types of disagreement strategies were identified. Most strategies were direct and unmitigated but generally perceived as politic, appropriate, and not negatively marked by lay participants. The three parameters were found to be correlated statistically, and some shared criteria between them were discovered from the interview data. In addition, each Internet forum is a unique community characterized by distinctive features. The identified disagreement strategies have yielded some support for the applicability of the discursive and interactional approaches to the analysis of politeness and disagreement in CMC; the statistical analysis and lay participants’ judgment and rating have shed some light on the complicated relational work in performing the speech act.

School PE through Internet discussion forums

Background: Physical education is a subject that generates strong feelings and emotions, as can be seen in written accounts of PE experiences. It is also important to listen to students' voices in the research context. Nowadays, students can be listened to in a new way – through the Internet. Various discussion forums on the Internet make it possible for people to express themselves through real or imagined messages. It might be easier to express highly sensitive and even intimate thoughts on the Internet. Thus, the Internet might be an interesting open forum for teachers to think about new ways of developing teaching practices that would reduce negative experiences of PE.Purpose: The purpose of this study was to examine what kinds of extrinsic factors underlie the opinions expressed in Internet discussion forums on experiences of PE in Finnish schools.Research design: The data for this research were collected from open Internet discussion forums during a randomly chosen week in April 2007. Using qualitative content analysis all the messages (total n = 356) from nine forums were grouped into positive, both positive and negative, and negative messages. The messages were divided into smaller segments such as paragraphs, sentences or even words, and labelled opinions (total n = 652).Data analysis: Based on Carlson's model, these opinions were further grouped into intrinsic and extrinsic factors. This study concentrated on the extrinsic factors behind the opinions, as these can more easily be influenced by pedagogical developments. Six extrinsic factors were identified: teacher's personality and behaviour, curriculum, assessment, class environment, facilities and equipment, and out of school influences and other factors.Findings: The results showed clearly that of the total of extrinsic factors only 8% were in the category of positive opinions and up to 61% in the category of negative opinions. The findings revealed that the teacher plays a crucial role in students' enjoyment of PE, as is indicated by the fact that the personality and behaviour of the teacher was mentioned the most often (40% of all opinions). Almost every fourth opinion concerned the class environment. In the third place, accounting for 16% of opinions, were issues related to the curriculum.Conclusions: Based on the results of the study, we conclude that more focus is needed on the pedagogical and emotional aspects of the learning environment. In PE teacher training it should be ensured that all future teachers have good socio-emotional skills and tools for creating a safe class environment. Teachers also need to widen their understanding on the strong role of emotions and experiences, as these can include humiliation and shame.

Internet discussion forums as part of a student-centred teaching concept of pharmacology.

Introduction: The world wide web opens up new opportunities to interconnect electronic and classroom teaching and to promote active student participation. In this project article we describe the use of internet discussion forums as part of a student-centred teaching concept of pharmacology and discuss its advantages and disadvantages based on evaluation data and current literature. Methods and Results: Final year medical students at the Technische Universität München (Munich, Germany) with the elective pharmacology moderated an internet forum that allowed all students to discuss pharmacology-related questions. Evaluation results of forum participants and elective students demonstrated a learning benefit of internet forums in pharmacology teaching. Conclusion: Internet discussion forums offer an easy-to-implement and effective way to actively engage students and increase the learning benefit of electronic and classroom teaching in pharmacology.

Lognormal distributions of user post lengths in Internet discussions - a consequence of the Weber-Fechner law?

The paper presents an analysis of the length of comments posted in Internet discussion fora, based on a collection of large datasets from several sources. We found that despite differences in the forum language, the discussed topics and user emotions, the comment length distributions are very regular and described by the lognormal form with a very high precision. We discuss possible origins of this regularity and the existence of a universal mechanism deciding the length of the user posts. We suggest that the observed lognormal dependence may be due to an entropy maximizing combination of two psychological factors which are perceived on a non-linear, logarithmic scale in accordance with the Weber-Fechner law, namely the time spent on post related considerations and the comment length itself. This hypothesis is supported by an experimental check of text length recognition capacity, confirming proportionality of the ‘just noticeable differences’ for text lengths - the basis of the Weber-Fechner law.

Disclosure of Gender Identity in Internet Forums: A Case Study of Saudi Arabian Forum Communication

Internet discussion forums provide opportunities for largely anonymous communication among participants. The extent to which these opportunities are taken up is of particular interest in cultures where gender relations are highly regulated and cross-gender communication is strictly limited, such as in Saudi Arabian society. This article studies participation in a public discussion forum of expatriate Saudi students. It focuses on the nature of information (whether accurate or not) that participants choose to reveal about themselves, and its effect on the forum participation. Particular attention is paid to whether and how the gender of the participants is revealed. The analysis demonstrates that few participants take advantage of the possibility of not revealing gender. Rather, gender is emphasized in most usernames and can usually be deduced from the message content. Although there is no pressure to reveal name, age, marital status, etc., reactions to the rare messages where the gender of the writer is not indicated show that clues to gender are considered essential to all but the briefest exchanges. This encourages participants to limit contact with participants of the opposite sex, as a result of which the forum communication remains largely gender segregated.

Surfs up: maximizing technical workforce performance

Pondering the concept of peak performance management draws attention to notions such as motivation, collaboration, employee engagement, continuous process improvement, quality initiatives, and workforce harmony. Even self-starters may profit by innovative guidance from managers or peers. Effective leadership can help stimulate enthusiasm, strengthen productivity, and deliver outcomes that heighten customer satisfaction levels. Internet discussion forums tend to differ on what formal credentials are essential for managers to have who are assigned supervisory roles in high-tech organizations. For example, is it best to have significant years of developmental career experience, as well as a MBA degree coupled with a technologically adept discipline-specific graduate degree? Websites described below share suggestions, viewpoints, and methods for energizing technical personnel at all levels to maximize talents and strive for excellence.

‘It is Our Custom from Der alter Heim ’: The Role of Orthodox Jewish Women’s Internet Forums in Reinventing and Transmitting Historical and Religious Tradition

‘It is Our Custom from Der alter Heim’: The Role of Orthodox Jewish Women’s Internet Forums in Reinventing and Transmitting Historical and Religious Tradition Judy Baumel-Schwartz Introduction There is a story of a Hassidic sect whose members would bend their knees at a point during the Simchat Torh hakafot.1 When asked about the custom, younger members explained that it was of Kabbalistic origin and done for generations in “Der alter Heim,” (“the old home,” e.g. Europe). Hearing this, an elderly Hassid shook his head. “The young, they talk such foolishness. Our last Rebbe in Poland was very tall and our shteibl had a low beam on one side,” he recalled. “When the Rebbe reached the beam during the hakufes (hakafot) he would bend his knees to pass underneath.” After the war, one of the hassidim who found refuge in America remembered the Rebbe’s action, but didn’t recall the reason, so today an entire sect bends their knees at that phrase, even though there is no longer a tall Rebbe, no longer a low beam, and no longer a wooden shteibl. In their study of invented traditions, Eric Hobsbawm and Terence Ranger argue that traditions which claim to be ancient can actually be recent in origin, invented as the result of a single event or over a short time. Using invented continuities, which fictitiously link them to a suitable historical past, these traditions and customs are “responses to novel situations which take the form of reference to old situations, or which establish their own past by quasi-obligatory repetition.”2 According to Hobsbawm, invented traditions occur more frequently at times of rapid social transformation when older traditions are disappearing. This is both a result of societal change and a response to the growing need for social cohesion and collective identity in a society in flux. This article focuses on an unconventional medium of transmitting revived customs and invented traditions in a society in flux. The society in question is Orthodox and particularly ultra-Orthodox (Haredi) Jewry since the end of the Second World War, and the medium under discussion is Orthodox Jewish [End Page 23] women’s Internet forums, colloquially known as “virtual communities.” In this article I posit that although none of the forums were created for this purpose, over time some have become vehicles for transmitting revived customs and invented traditions to a younger generation of Orthodox and Haredi women. What role do such forums play in imparting and transmitting revived customs and invented traditions which are now an integral part of Orthodox society? What can the dynamics of these discussions teach us about the historical development and unfolding culture of the world of Orthodox women? What can we learn from the discussions about gendered family tasks, women’s education and comportment, religious ritual, and accepted boundaries of female behavior in the Orthodox and Haredi sectors? These are some of the broader issues that I will address through an examination and analysis of Internet forum discussions about customs of “Der alter Heim.” Here I claim that by embracing the task of transmitting information about customs to Orthodox women and encouraging discussions about traditions and their origins, these forums have also become a central source of information among an expanding group of Orthodox women. By functioning as a virtual quasi-religious authority regarding the correct way these customs should be practiced, these forums also act as a constructor of collective identity and an expanding source of stability within a society in flux. In view of the growing interest in the internal dynamics of the Orthodox and particularly the ultra-Orthodox world, 3 I claim that we can use these forums to better understand the changing nature of this “society in flux.” In particular, I believe that they can assist us in perceiving and interpreting some of the changes that have taken place in Orthodox and Haredi “women’s society”4 over the past decades and charting some of the internal responses to the challenges which this society has faced. Who are the Women? The subjects of our study are Modern Orthodox (MO)5 and ultra-Orthodox women, known as Haredim.6 MO and Haredim...

Interpretation of food risks by mothers of kindergarten children in St. Petersburg, Russia, and their strategies of risk handling

This study discusses different types of food risks and different strategies of risk handling as conceived by mothers of kindergarten children in Russia. The research includes an analysis of Internet forum discussions and semi-structured interviews; it mainly used data from well-educated, middle-class, and married women from St. Petersburg and Moscow. Three groups of food risks have derived from the analysis of the empirical data: risks stemmed from the non-observance of sanitary and other rules, risks from products coveted by children, and “invisible” risks. The second group of risks, the food obsessions of the children, was the one which the mothers were mainly concerned with and most actively tried to manage. Consequently, a broad range of their strategies became apparent, varying from denial and patience to the shaping of collective action groups. The strategies are formulated into three large groups: resistance, non-resistance, and adaptation. Generally mothers mainly dealt with the second group of food risks and adaptation was the preferred strategy.

What E-patients Want From the Doctor-Patient Relationship: Content Analysis of Posts on Discussion Boards

BackgroundPeople with long-term conditions are encouraged to take control and ownership of managing their condition. Interactions between health care staff and patients become partnerships with sharing of expertise. This has changed the doctor-patient relationship and the division of roles and responsibilities that traditionally existed, but what each party expects from the other may not always be clear. Information that people with long-term conditions share on Internet discussion boards can provide useful insights into their expectations of health care staff. This paper reports on a small study about the expectations that people with a long-term condition (diabetes) have of their doctors using information gleaned from Internet discussion boards.ObjectiveThe aim of this study was to ascertain what people with diabetes who use Internet discussion forums want from their doctors. The study objectives were to identify what people with diabetes (1) consider their role in condition management, (2) consider their doctor’s role in managing their condition, (3) see as positive elements of their interactions with medical staff, and (4) find problematic in their interactions with medical staff.MethodsThe study used qualitative methodology to explore the experiences, views, and perceptions of individuals participating on 4 Internet message boards. Posts made on the discussion boards were analyzed using the principles of qualitative content analysis. The meanings of sections of data were noted using codes that were developed inductively; those with similar codes were merged into subcategories and related subcategories were combined to form categories.ResultsThe key themes identified in the study were ownership of condition management, power issues between people with long-term conditions and doctors, and ways in which people seek to manage their doctors.ConclusionsPeople with diabetes valued doctors who showed respect for them and their knowledge, and were willing to listen and openly discuss their options. Patients felt that they could and should take responsibility for and control of their day-to-day disease management. They saw doctors as having a role in this process, but when this was lacking, many people felt able to use alternative means to achieve their goal, although the doctor’s function in terms of gatekeeping resources could create difficulties for them in this respect.

Building an online community to promote communication and collaborative learning between health professionals and young people who self‐harm: an exploratory study

Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa. We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice. We allocated 77 young people aged 16-25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; 25%; 50% respectively) to allow us to observe the effect of the professionals on online interaction. The young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private-professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators. Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.

The Representation of Suicide on the Internet: Implications for Clinicians

BackgroundSuicide is one of the major causes of death in the world, leading to approximately 1 million deaths per year. While much of what is said about suicide and its causes is still taboo in most contemporary societies and cultures, internet websites and discussion forums have become an important and controversial source of information on the subject. A great deal of ambivalence is discernible as to whether online communication about suicide primarily should be seen as an opportunity or a serious threat.ObjectiveTo investigate how the subject of suicide is represented on the Internet, based on hits generated by the search engine Google.MethodsIn an exploratory design, Google search results on the target word “suicide”, for the years 2005, 2009, and 2012 respectively, were systematically analyzed and compared.ResultsThe study shows that web pages of institutional origin on the subject predominate, that the content provided by these institutions concerns primarily research and prevention, and that the form of communication used by these senders is almost exclusively monological. However, besides these institutional pages there are a substantial number of private senders and pages, often anti-medical and against treatment of depression and other mental problems, characterized by dialogue, confessions and narratives, and to a higher degree, an alternative pro-suicide stance.ConclusionsTo counteract the influence of anti-medical and pro-suicide information, the role of the Internet should be discussed with the patient in clinical practice. Dialogical and confessional communications provide an opportunity for the clinician to gain a deeper perspective into perceptions of patients, regarding both their afflictions and the role of medical treatment in their lives.