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Member states across the Eastern Mediterranean region face unprecedented health challenges, buffeted by demographic change, a dual disease burden, rising health costs, and the effects of ongoing conflict and population movements - exacerbated in the near-term by instability arising from recent political upheaval in the Middle East. However, health actors in the region are not well positioned to respond to these challenges because of a dearth of good quality health research. This review presents an assessment of the current state of health research systems across the Eastern Mediterranean based on publicly available literature and data sources. The review finds that - while there have been important improvements in productivity in the Region since the early 1990s - overall research performance is poor with critical deficits in system stewardship, research training and human resource development, and basic data surveillance. Translation of research into policy and practice is hampered by weak institutional and financial incentives, and concerns over the political sensitivity of findings. These problems are attributable primarily to chronic under-investment - both financial and political - in Research and Development systems. This review identifies key areas for a regional strategy and how to address challenges, including increased funding, research capacity-building, reform of governance arrangements and sustained political investment in research support. A central finding is that the poverty of publicly available data on research systems makes meaningful cross-comparisons of performance within the EMR difficult. We therefore conclude by calling for work to improve understanding of health research systems across the region as a matter of urgency.

This study compares six metrics commonly used to identify influential players in two of Canada's largest political Twitter communities based on the users, and ranking order of users, identified by each metric. All tweets containing the hashtag #CPC, representing the Conservative Party of Canada (government), and #NDP, representing the New Democratic Party of Canada (official opposition), were collected over a 2-week period in March 2013 and a follower network graph was created. Social network analysis and content analysis were employed to identify influentials. Kendall's τ was the primary quantitative measure for comparison. Categorization of Twitter profiles of users found within the top 20 most influential lists, according to each metric of influence, made up the qualitative portion of analysis. The authors find that measures of centrality-indegree and eigenvector centrality-identify the traditional political elite (media outlets, journalists, politicians) as influential, whereas measures considering the quality of messages and interactions provide a different group of influencers, including political commentators and bloggers. Finally, the authors investigate the possibility of using the local clustering coefficient of nodes to identify those who are both aware of the traditional elite and embedded in tightly knit communities, similar to the "opinion leader," described in the Two-Step Flow Hypothesis.

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As trust in news media and social media dwindles and fears of disinformation and echo chambers spread, individuals need to find ways to access and assess reliable and trustworthy information. Despite low levels of trust in social media, they are used for accessing political information and news. In this study, we examine the information verification practices of opinion leaders (who consume political information above average and share their opinions on social media above average) and of opinion seekers (who seek out political information from friends and family) to understand similarities and differences in their news media trust, fact-checking behaviors, and likeliness of being caught in echo chambers. Based on a survey of French Internet users ( N = 2,000) we find that not only opinion leaders, but also opinion seekers, have higher rates across all three of these dependent variables. We discuss the implications of findings for the development of opinion leadership theory as well as for social media platforms wishing to increase trust.