Social media uses amongst adolescents: motives, minority stress and eudaimonic well-being / Uso de redes sociales en adolescentes: motivación, estrés de minorías y bienestar eudaimónico

Introduction: The scientific evidence regarding the effects of online social media use on the well-being of adolescents is mixed. In gen-eral, passive uses (receiving, viewing content without interacting) and more screen time are related to lower well-being when compared with active uses (direct interactions and interpersonal exchanges). Objectives:This study ex-amines the types and motives for social media usage amongst adolescents, differentiating them by gender identity and sexual orientation, as well as its effects on eudaimonic well-being and minority stress. Method: A cross-sectional study was conducted with 1259 adolescents, aged 14 to 19 (M= 16.19; SD= 1.08), analysing the Scale of Motives for Using Social Net-working Sites, eudaimonic well-being, the Sexual Minority Adolescent Stress Inventory, screen time and profile type. Results:The results found that longer use time is related to finding partners, social connection and friendships; that gay and bisexual (GB) adolescents perceive more distal stressors online;and that females have higher levels of well-being. Discus-sion: The public profiles of GB males increase self-expression, although minority stress can be related to discrimination, rejection or exclusion. Dif-ferentiated socialization may contribute to a higher level of well-being in females, with both active and passive uses positively effecting eudaimonic well-being in adolescents.(AU)

Introduction: The scientific evidence regarding the effects of online social media use on the well-being of adolescents is mixed. In general, passive uses (receiving, viewing content without interacting) and more screen time are related to lower well-being when compared with active uses (direct interactions and interpersonal exchanges). Objectives: This study examines the types and motives for social media usage amongst adolescents, differentiating them by gender identity and sexual orientation, as well as its effects on eudaimonic well-being and minority stress. Method: A cross-sectional study was conducted with 1259 adolescents, aged 14 to 19 (M = 16.19; SD = 1.08), analysing the Scale of Motives for Using Social Networking Sites, eudaimonic well-being, the Sexual Minority Adolescent Stress Inventory, screen time and profile type. Results: The results found that longer use time is related to finding partners, social connection and friendships; that gay and bisexual (GB) adolescents perceive more distal stressors online; and that females have higher levels of well-being. Discussion: The public profiles of GB males increase self-expression, although minority stress can be related to discrimination, rejection or exclusion. Differentiated socialization may contribute to a higher level of well-being in females, with both active and passive uses positively effecting eudaimonic well-being in adolescents.(AU)

Narcissism, perfectionism, and self-promoting behavior on social networking sites among university students in Pakistan / Narcisismo, perfeccionismo y comportamiento de autopromoción en sitios de redes sociales entre estudiantes universitarios en Pakistán

Existe un debate considerable en la literatura sobre cómo el narcisismo predice diversos comportamientos asociados con la utilidad de los sitios de redes sociales, pero los investigadores han prestado menos atención a explorar los mediadores potenciales de esta relación. Con base en la literatura existente, anticipamos que el narcisismo predice comportamientos de autopromoción en los sitios de redes sociales. El estudio actual también investigó el papel mediador del perfeccionismo multidimensional entre el narcisismo y el comportamiento de autopromoción. Se recopiló un total de 605 cuestionarios completos de estudiantes de universidades de Rawalpindi e Islamabad, Pakistán, mediante un muestreo conveniente. El estudio utilizó el Inventario de Personalidad Narcisista (Ames et al., 2006), un cuestionario de desarrollo propio sobre comportamiento de autopromoción en sitios de redes sociales y la Escala de Perfeccionismo Multidimensional (Hewitt et al., 1991). Los hallazgos indicaron que las mujeres en comparación con los hombres y las solteras en comparación con las casadas obtuvieron puntuaciones más altas en narcisismo. Los niveles educativos más altos se asociaron con tasas más altas de narcisismo. Los resultados también sugieren que el narcisismo se correlaciona con el perfeccionismo orientado a uno mismo y, más significativamente, con el narcisismo orientado a los demás. El perfeccionismo orientado a uno mismo y a los demás medió significativamente la relación entre el narcisismo y el comportamiento de autopromoción en los sitios de redes sociales.(AU)

There is considerable debate in the literature about how narcis-sism predicts various behaviors associated with the utility of social net-working sites, but researchers have paid less attention to exploring the po-tential mediators of this relationship.Based on the existing literature, we anticipated that narcissism predicts self-promoting behaviors on social networking sites. The current study also investigated the mediating role of multidimensional perfectionismbetween narcissism and self-promoting behavior. A total of 605 complete questionnaires weregathered fromstu-dents from universities from Rawalpindi and Islamabad, Pakistan using convenient sampling. The study used Narcissistic Personality Inventory (Ames et al., 2006), self-developed Self-promoting Behavior on social net-working sites questionnaire, and the Multidimensional Perfectionism Scale (Hewitt et al., 1991). Findings indicated that females as compared to males and single as comparedto married individuals scored higher on narcissism. Higher educational levels were associated with higher rates of narcissism. The results also suggestthat narcissism correlated with self-oriented per-fectionism, and more significantlywith others-oriented narcissism. Self-oriented and others-oriented perfectionism significantly mediated the rela-tionship between narcissism and self-promoting behavior on social net-working sites.(AU)

Current insights on social media as a tool for the dissemination of research and education in surgery: a narrative review.

The purpose of our narrative review is to summarize the utilization of social media (SoMe) platforms for research communication within the field of surgery. We searched the PubMed database for articles in the last decade that discuss the utilization of SoMe in surgery and then categorized the diverse purposes of SoMe. SoMe proved to be a powerful tool for disseminating articles. Employing strategic methods like visual abstracts enhances article citation rates, the impact factor, h-index, and Altmetric score (an emerging alternative metric that comprehensively and instantly quantifies the social impact of scientific papers). SoMe also proved valuable for surgical education, with online videos shared widely for surgical training. However, it is essential to acknowledge the associated risk of inconsistency in quality. Moreover, SoMe facilitates discussion on specific topics through hashtags or closed groups and is instrumental in recruiting surgeons, with over half of general surgery residency programs in the US efficiently leveraging these platforms to attract the attention of potential candidates. Thus, there is a wealth of evidence supporting the effective use of SoMe for surgeons. In the contemporary era where SoMe is widely utilized, surgeons should be well-versed in this evidence.

Social Media-Based Brief Video Interventions to Support Youths' Mental Health.

Social media platforms are communication forums with potential benefits and disadvantages for youths' mental health. In this column, the author focuses on two main themes. First, recognizing the need for carefully crafted interventions, the author advocates for the use of crowdsourcing platforms to test and refine social media-based video content. These platforms enable the development of engaging, safe, and stigma-reducing videos tailored to meet the needs of diverse youths. Second, the author proposes the establishment of strategic frameworks designed to empower youths to produce and share these videos effectively, enhancing the positive effect of social media on mental health discourse.

Insights on associations between the frequency of use of diverse social media products and social networks use disorder tendencies from a German speaking sample.

OBJECTIVE: In the present work we investigate how individual differences in at least occasionally using distinct social media platforms is linked to social networks use disorder (SNUD) tendencies. A final sample of n = 2200 participants filled in the AICA-C-9 measure to get insights into individual differences in overuse of social media and participants also indicated which platforms they used at least once a month. RESULTS: The analysis revealed a robust positive association between number of at least occasionally used social media apps and SNUD tendencies (r = .44, p < .001). Further, platforms differed in terms of their "addictive potential", if one takes associations between frequency of distinct platforms use and SNUD tendencies as a proxy for this (and of course the actual descriptive statistics of the SNUD scale for the (non-)frequent user groups of the different platforms). In this regard, at least occasionally using some platforms (here Tumblr, Twitter and TikTok) was associated with highest SNUD tendencies. Moreover, largest differences in terms of effect sizes between the occasional and non-occasional user groups regarding SNUD scores could be observed for Instagram, WhatsApp, and TikTok. The present work bases on data from a larger project investigating associations between SNUD and tobacco use disorder.

Digital technology and mental health: Chinese university students' perspectives on the impact of social media.

Background: To address the growing concerns about mental health issues among Chinese university students, our study investigates the impact of social media on their mental health. This study intends to shed light on how these students' use of social media platforms contributes to these mental health issues, given that it has been estimated that up to 30% of university students in China suffer from mental health issues. Methods: We investigate the extent of this issue by looking at how Chinese social media platforms like WeChat, Weibo, and QQ impact students' mental health. To gain a comprehensive insight into students' perspectives, this study's sole methodology is qualitative semi-structured interviews. Our core claim asserts that social media considerably affects Chinese university students' mental health, with both positive and negative consequences. Results: The findings show how closely social media use and Chinese university students' mental health are related. These networks let people connect and get support but also encourage social comparison and stigma towards mental illness. Students use a variety of coping skills, such as self-regulation techniques, digital detoxification techniques, and looking for emotional support in online networks. These results highlight the need for a complex understanding of social media's effects on mental health. Our study also recognizes students' capacity for adaptation and resilience as they traverse the digital world, offering theoretical and practical applications for successfully juggling online and offline lives. Conclusion: In the end, our study contributes to a thorough and culturally sensitive understanding of how social media affects the mental health of Chinese university students.

Mitigating Harms of Social Media for Adolescent Body Image and Eating Disorders: A Review.

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior.

Systematic discrepancies in the delivery of political ads on Facebook and Instagram.

Political advertising on social media has become a central element in election campaigns. However, granular information about political advertising on social media was previously unavailable, thus raising concerns regarding fairness, accountability, and transparency in the electoral process. In this article, we analyze targeted political advertising on social media via a unique, large-scale dataset of over 80,000 political ads from Meta during the 2021 German federal election, with more than 1.1 billion impressions. For each political ad, our dataset records granular information about targeting strategies, spending, and actual impressions. We then study (i) the prevalence of targeted ads across the political spectrum; (ii) the discrepancies between targeted and actual audiences due to algorithmic ad delivery; and (iii) which targeting strategies on social media attain a wide reach at low cost. We find that targeted ads are prevalent across the entire political spectrum. Moreover, there are considerable discrepancies between targeted and actual audiences, and systematic differences in the reach of political ads (in impressions-per-EUR) among parties, where the algorithm favor ads from populists over others.

A Simple and Systematic Approach to Qualitative Data Extraction From Social Media for Novice Health Care Researchers: Tutorial.

Social media analyses have become increasingly popular among health care researchers. Social media continues to grow its user base and, when analyzed, offers unique insight into health problems. The process of obtaining data for social media analyses varies greatly and involves ethical considerations. Data extraction is often facilitated by software tools, some of which are open source, while others are costly and therefore not accessible to all researchers. The use of software for data extraction is accompanied by additional challenges related to the uniqueness of social media data. Thus, this paper serves as a tutorial for a simple method of extracting social media data that is accessible to novice health care researchers and public health professionals who are interested in pursuing social media research. The discussed methods were used to extract data from Facebook for a study of maternal perspectives on sudden unexpected infant death.

Social Media Authentication and Users' Assessments of Health Information: Random Assignment Survey Experiment.

BACKGROUND: In an effort to signal the authenticity of user accounts, social networking sites (SNSs) such as Facebook and X, formerly known as Twitter, use visual heuristics (blue checkmarks) to signify whether accounts are verified. While these verification badges are generally well recognized (and often coveted) by SNS users, relatively little is known about how they affect users' perceptions of accuracy or their likelihood of engaging with web-based information. This is particularly true in the case of information posted by medical experts and health care professionals. OBJECTIVE: This study aims to use an experimental survey design to assess the effect of these verification badges on SNS users' assessments of information accuracy as well as their proclivity to recirculate health information or follow verified medical experts in their social network. METHODS: A survey experiment using random assignment was conducted on a representative sample of 534 adult SNS users in Florida, United States. A total of 2 separate experimental scenarios exposed users to vaccine-related posts from verified medical experts on X. In each case, the original post contained a platform-issued verification badge (treatment group), which was subsequently edited out of the image as an experimental control. For each scenario, respondents were randomly assigned to either the treatment or control group, and responses to 3 follow-up questions were assessed through a series of chi-square analyses and 2 logit regression models. Responses were fielded using a stratified quota sampling approach to ensure representativeness of the state's population based on age, sex, race, ethnicity, and political affiliation. RESULTS: Users' assessments of information accuracy were not significantly impacted by the presence or absence of verification badges, and users exposed to the experimental treatment (verification badge) were not any more likely to repost the message or follow the author. While verification badges did not influence users' assessments or subsequent behaviors, reliance on social media for health-related information and political affiliation were substantial predictors of accuracy assessments in both experimental scenarios. In scenario 1, which included a post addressing COVID-19 vaccine efficacy, users who relied on social media "a great deal" for health information were 2 times more likely to assess the post as accurate (odds ratio 2.033, 95% CI 1.129-3.661; P=.01). In scenario 2, which included a post about measles vaccines, registered Republicans were nearly 6 times less likely to assess the post as accurate (odds ratio 0.171, 95% CI 0.097-0.299; P<.001). CONCLUSIONS: For health professionals and medical experts wishing to leverage social networks to combat misinformation and spread reliable health-related content, account verification appears to offer little by way of added value. On the basis of prior research, other heuristics and communication strategies are likely to yield better results.

Development and psychometric assessment of the Sociocultural Influences on Exercise Behaviours in Adolescents Questionnaire.

OBJECTIVES: This research aimed to construct and psychometrically test a measure of multiple sociocultural dimensions (i.e. family, peers, media) theoretically associated with exercise behaviours/attitudes in adolescents; the Sociocultural Influences on Exercise Behaviours in Adolescents Questionnaire (SIEBAQ). METHODS AND MEASUREMENT: Part 1 of this study focused on measure construction and psychometric testing, involving item generation and exploratory factor analysis (EFA) to refine the item pool, with 905 adolescents (Mage 13.66 years (SD = 0.94); girls = 442). Part 2 sought to explore the convergent validity of the SIEBAQ (n = 846; n = 414 girls). RESULTS: EFA resulted in a 47-item measure with a nine-factor structure (including social media modelling, parent exercise expectations, peer co-participation; α = 0.72-0.92). Correlations revealed weak-moderate significant relationships between the SIEBAQ and related constructs (e.g. compulsive exercise, sociocultural attitudes towards appearance). Regression analyses with the SIEBAQ identified social media modelling of exercise as a significant predictor of compulsive exercise in boys and girls. Proving exercise ability to significant others also significantly predicted compulsive exercise outcomes. CONCLUSION: This newly developed measure holds promise. Further psychometric testing and validation of the SIEBAQ is the recommended next step to confirm the measure's nine-factor structure identified through EFA.

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial.

BACKGROUND: Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations. OBJECTIVE: This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer. METHODS: This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn. RESULTS: The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant. CONCLUSIONS: The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed). TRIAL REGISTRATION: ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.

Issues Related to the Use of Visual Social Networks and Perceived Usefulness of Social Media Literacy During the Recovery Phase: Qualitative Research Among Girls With Eating Disorders.

BACKGROUND: The patient-centered approach is essential for quality health care and patient safety. Understanding the service user's perspective on the factors maintaining the health problem is crucial for successful treatment, especially for patients who do not recognize their condition as clinically relevant or concerning. Despite the association between intensive use of visual social media and body dissatisfaction and eating disorders, little is known about the meanings users assign to posting or searching for edited photos and the strategies they use to protect themselves from digital risks. OBJECTIVE: This study aims to examine how young women recovering from eating disorders in Northern Italy perceive the health risks and potential benefits associated with visual social networks (ie, Instagram and Snapchat). The literature has found these platforms to be detrimental to online body comparisons. It also explores the perceived usefulness, willingness, and personal interest in coconstructing social media literacy programs with girls recovering from eating disorders. METHODS: A total of 30 semistructured interviews were conducted with adolescent girls aged 14-17 years at the end of their treatment for eating disorders. The following areas of research were addressed: (1) the meanings associated with the use of Instagram and Snapchat; (2) the investment in the photographic dimension and feedback; (3) the impact of visual social networks on body experiences; (4) the potential and risks perceived in their use; (5) the importance of supporting girls undergoing treatment for eating disorders in using social networks; and (6) the usefulness and willingness to co-design social network literacy programs. Content analysis was applied. RESULTS: A total of 7 main contents emerged: active or passive role in using social networks, the impact of online interactions on body image, investment in the photographic dimension, effects on self-representation, perceived risks, self-protective strategies, and potential benefits. The findings highlight a strong awareness of the processes that trigger body comparisons in the virtual context, creating insecurity and worsening the relationship with oneself. The self-protective behaviors identified are the development of critical thinking, the avoidance of sensitive content, increased control over social networking site use, and a certain skepticism toward developing antagonistic ideologies. All these topics were considered fundamental. CONCLUSIONS: The findings provide important insights for health professionals working with youth in preparing media literacy programs. These programs aim to reduce potential risks and amplify the positive effects of online resources. They underscore the importance of addressing this issue during hospitalization to develop skills and critical thinking aimed at changing small habits that perpetuate the problem in everyday life. The inherent limitations in current service practices, which may not adequately address individual needs or impact posttreatment life, must also be considered.

Similarities and differences in the psychological factors associated with generalised problematic internet use, problematic social media use, and problematic online gaming.

Problematic online behaviours are a concern among university students. Although previous research has identified that psychological distress, cognitive distortions, conscientiousness and neuroticism traits, motor impulsivity, and emotion regulation strategies have a significant direct effect on generalised problematic Internet use (GPIU), problematic social media use (PSMU), and problematic online gaming (POG), it is still necessary to determine the extent to which these psychological factors, taken together, are associated with each of the problematic online behaviours. In a sample of 690 Spanish university students, the present study examined the relationship of these psychological factors with GPIU, PSMU, and POG. Correlation and regression analyses were performed. Results reported that (1) high psychological distress, low conscientiousness trait and high motor impulsivity were common associated factors of GPIU and PSMU, but not of POG; (2) high levels of cognitive distortions and cognitive reappraisal were common associated factors of GPIU, PSMU and POG; and (3) expressive suppression and neuroticism trait had no effect on any of the three problematic online behaviours. The findings will help to develop effective prevention and intervention strategies for each problematic online behaviour in the university context.

Social media discourse on ageism, sexism, and racism: Analysis of 150 million tweets over 15 years.

BACKGROUND: Ageism is a major but oft-overlooked social determinant of health. In fact, it is widely accepted among scholars that ageism is one of the least acknowledged forms of inequality, although few empirical attempts have been made to substantiate this claim. This is the first study that quantifies the amount of discourse dedicated to ageism, sexism, and racism on Twitter. Specifically, we rely on the usage of hashtags as a proxy for the frequency of discussions surrounding each form of inequality over a 15-year period from 2007 to 2022. We also identify key events that triggered spikes in Twitter activity for each form of inequality. METHODS: Hashtags related to racism and sexism were extracted from past scholarship. We also employed a snowball sampling method whereby we queried the hashtags using Twitter's search function to identify other hashtags. As limited research has been conducted on ageism-related hashtags, we queried hashtags utilized by advocacy groups and adopted a snowball sampling method to compile other relevant hashtags. Tweets collected (N = 154,353,047) spanned 15 years, from August 23, 2007 to December 31, 2022. RESULTS: From 2007 to 2022, racism-related hashtags were used the most, followed by sexism-related hashtags and ageism-related hashtags. Racism-related hashtags (N = 99,250,348) were mentioned about 60 times more than ageism-related hashtags (N = 1,648,926). Sexism-related hashtags (N = 38,933,113) were mentioned 24 times more than ageism-related hashtags. The increasing linear trend of tweets associated with ageism (p < 0.001), sexism (p < 0.05), and racism (p < 0.05) reached significance. Incidents of racism and sexism often generated widespread public outrage. Conversely, instances of ageism rarely caused spikes in social media activity. Rather, these spikes were mainly observed during events such as the release of a report on ageism, a conference related to aging, or observances such as International Day of Older Persons. CONCLUSION: There is a need to hasten moves to raise awareness of ageism. To ensure that discussions on ageism are not confined to academic and policy circles, advocacy campaigns could be held to educate the public on the issue and its negative concomitants.

Exploring Twitter chatter to assess the type and availability of cannabis-related products in Thailand.

Cannabis-related tweets were collected between January and April 2022 to estimate the availability and characteristics of cannabis products advertised on Twitter amid the legalization of recreational cannabis in Thailand. The Twitter API was called using the tweepy Python library to collect cannabis-related tweets in the Thai language. A total of 185,558 unique tweets were collected over the duration of the data collection period based on 83 search terms. Twenty thousand random tweets were manually coded by four Thai native speakers to assess the volume and characteristics of tweets proposing cannabis. 72.6% of collected tweets from the 20,000 random samples were coded as relevant to the study. 54.6% of relevant tweets were advertising cannabis products, 29.8% were personal communications, and 15.6% were related to news or media content. Among the tweets that advertised cannabis products, 94.4% proposed cannabis flower, 2.4% cannabis edibles and 1.8% cannabis concentrates. Consumption of potent forms of cannabis such as cannabis edibles and concentrates increase the risk of harmful side-effects, especially in a population with limited knowledge about these products. Our findings call for additional monitoring efforts and for increasing the public awareness on potent cannabis products emerging in Thailand.

Advancing orthopaedic trauma care through WhatsApp: An analysis of clinical and non-clinical applications, challenges, and future directions.

The integration of WhatsApp, a widely-used instant messaging application (IMA), into the realm of orthopaedics and trauma surgery has emerged as a significant development in recent years. This paper explores the multifaceted role of WhatsApp in orthopaedics, focusing on its clinical and non-clinical applications, advantages, disadvantages, and future prospects. The study synthesizes findings from various research papers, emphasizing the growing reliance on mobile technology in healthcare. WhatsApp's role in orthopaedics is notable for its ease of use, real-time communication, and accessibility. Clinically, it facilitates triage, teleconsultation, diagnosis, treatment, patient advice, and post-operative monitoring. Non-clinically, it supports telemedicine, teleradiology, virtual fracture clinics, research, and education in orthopaedic surgery. The application has proven beneficial in enhancing communication among healthcare teams, providing quick responses, and motivating junior physicians. Its use in educational settings has been shown to improve learner's understanding and patient care. However, the use of WhatsApp in orthopaedics is not without challenges. Risks include the potential spread of misleading information, privacy concerns, and issues with image quality affecting diagnosis and treatment decisions. The paper acknowledges the importance of maintaining professional boundaries and the need for oversight measures to ensure content accuracy. Looking forward, the potential of WhatsApp and similar IMAs in orthopaedics lies in their ability to streamline data collection and retrieval, improve doctor-patient communication, and address challenges like bureaucratic red tape and limited resources. The paper suggests that future orthopaedic practice, particularly in emergency departments, will increasingly rely on such technologies for efficient patient management. This shift, however, must be approached with an understanding of the ethical, legal, and practical implications of integrating social media and mobile technology in healthcare.

Social media use, knowledge, attitudes, and risky sexual behavior of HIV transmission: A survey among boarding school adolescent students in Indonesia.

Background: Social media has many positive and negative influences on individuals, especially for adolescents related to HIV. However, little is known about how social media impacts HIV-related outcomes among adolescents in boarding schools. Objective: This study aims to investigate the social media use, knowledge, attitudes, and sexual behavior at risk of HIV transmission and their relationship with the demographic characteristics of adolescent students at boarding schools. Methods: This study was school-based and used a cross-sectional design. The questionnaires were used to assess social network site usage, knowledge, attitudes, and risky behavior. Cluster random sampling involved students (n = 214) from three boarding schools in Cirebon City, West Java, Indonesia, in 2022. Chi-square tests and Cramer's V were used to explore correlations between social and demographic factors. Results: A considerable number of adolescent students exhibited high social media addiction (58.4%), with the majority possessing limited knowledge of HIV transmission (54.7%). Additionally, nearly half displayed a negative attitude towards preventing HIV transmission (47.2%), while only a small fraction engaged in risky behavior (2.8%). Bivariate analysis revealed that social media use was moderately associated with the type of social media application (φc = 0.246, p <0.05). Knowledge of HIV transmission exhibited a moderate correlation with age (φc = 0.331, p <0.05), education level (φc = 0.240, p <0.001), and exposure to information (φc = 0.269, p <0.001). Similarly, attitudes toward HIV prevention demonstrated moderate associations with age (φc = 0.341, p = 0.001), education level (φc = 0.317, p <0.001), and exposure to information (φc = 0.266, p <0.001). Furthermore, risky sexual behavior exhibited a strong association with exposure to pornographic content (φc = 0.730, p <0.001). Conclusion: The study found a high prevalence of social media usage among adolescents, coupled with low knowledge about HIV, negative attitudes, and risky behavior. Significant relationships were observed between social media use, knowledge, attitudes, and risky sexual behavior related to HIV transmission and demographic characteristics. This study emphasizes the vital role of nurses and healthcare professionals in implementing targeted educational interventions in boarding schools to address gaps in HIV risk knowledge influenced by social media, ultimately improving strategies for adolescents' sexual health.