Cyberbullying and problematic social media use: an insight into the positive role of social support in adolescents-data from the Health Behaviour in School-aged Children study in Italy.

OBJECTIVES: The global spread of electronic devices has made cyberbullying and problematic social media use (PSMU) emerging public health concerns. This study aimed to investigate the prevalence of cyberbullying and PMSU among adolescents in northwestern Italy. We also explored the association between cyberbullying and PSMU and whether this association was moderated by social support. STUDY DESIGN: Data were collected as part of the Italian 2018 Health Behaviour in School-aged Children (HBSC) study in the Piedmont region; 186 school classes participated, comprising 3022 children aged 11, 13 and 15 years. The prevalence of cyberbullying and PSMU were estimated in subgroups of age and gender. Multivariate logistic regression was used to investigate the association between cyberbullying and PSMU, before and after taking into account social support. RESULTS: Girls reported higher cyber-victimisation and PSMU than boys (9.1% vs 6.0% and 10.2% vs 6.1%, respectively), and the risk of cyber-victimisation was higher in the presence of PSMU. This risk was attenuated in the presence of social support. CONCLUSIONS: PSMU is an important driver of cyberbullying, although social support can mediate these behaviours. Public health interventions are needed to guide adolescents how to use social media appropriately and to prevent cyberbullying and the mental health problems they can provoke.

Neurological outcomes after surgery for spinal metastases in symptomatic patients: Does the type of decompression play a role? A comparison between different strategies in a 10-year experience.

INTRODUCTION: The impact of neurological deficits plays a role of inestimable importance in patients with a neoplastic disease. The role of surgery for the management of symptomatic spinal cord compression (SSCC) cannot be overemphasized, as surgery represents often the first and paramount step in patients presenting with motor deficits. The traditional paradigm of simple bilateral laminectomy for the treatment of spinal cord compression has been reviewed. The need to achieve a proper circumferential decompression of the spinal sac has been progressively highlighted in combination with the development of the more comprehensive and multidisciplinary concept of separation surgery. OBJECTIVE: The aim of this paper is to analyze different strategies of decompression, while evaluating whether circumferential/anterior decompression is able to guarantee a better control and restoration of neurological functions in patients with motor impairment, if compared to traditional posterior decompression. MATERIALS AND METHODS: This is a retrospective observational study investigating symptomatic patients that underwent surgical treatment for spinal metastases at author's Institutions from January 2010 to June 2019. Data recorded concerned patient demographics, tumor histology, peri-operative and follow-up neurological status (ASIA), ambulation ability, stability (SINS), grade (ESCC) and source of epidural compression and type of decompression (anterior/anterior-lateral (AD); posterior/posterior-lateral (PD/PDL); circumferential (CD)). RESULTS: A total number of 84 patients was included. AD/CD patients showed higher chance of neurological improvement and reduced rates of worsening compared to PD/PLD group (94.1%/100% vs 60.4%; 11.8% vs 45.8% respectively). Univariate logistic regression identified immediate post-operative improvement to be a significative protective factor for worsening at last follow-up. Stratifying patients for site of compression and considering anterior and circumferential groups, immediate post-operative neurological improvement, was mostly associated with AD and CD (p 0.011 and 0.025 respectively). Walking at last follow up was influenced by post-operative maintenance of ambulation (p 0.001). CONCLUSION: The necessity to remove the epidural metastatic compression from its source should be considered of paramount importance. Since the majority of spinal cord compression involves firstly the ventral part of the sac, CD/AD are associated with better neurological outcomes and should be achieved in case of circumferential or anterior/anterolateral compression.