Tag: social media

Categories : PaediatricsTags :

Use of Social Media Linked to ADHD-like Symptoms in Kids

On By ModernMedia

Increased ADHD-related symptoms in children were linked to social media use, but not video games and television

Photo by Emily Wade on Unsplash

Children who spend a significant amount of time on social media tend to experience a gradual decline in their ability to concentrate. This is according to a comprehensive study from Karolinska Institutet, published in Pediatrics Open Science, where researchers followed more than 8000 children from around age 10 through age 14.

The use of screens and digital media has risen sharply in the past 15 years, coinciding with an increase in ADHD diagnoses in Sweden and elsewhere. Researchers at Karolinska Institutet in Sweden and Oregon Health & Science University in the USA have now investigated a possible link between screen habits and ADHD-related symptoms.

The study followed 8324 children aged 9–10 in the USA for four years, with the children reporting how much time they spent on social media, watching TV/videos and playing video games, and their parents assessing their levels of attention and hyperactivity/impulsiveness. 

Social media stands out

Children who spent a significant amount of time on social media platforms, such as Instagram, Snapchat, TikTok, Facebook, Twitter or Messenger, gradually developed inattention symptoms; there was no such association, however, for watching television or playing video games.

“Our study suggests that it is specifically social media that affects children’s ability to concentrate,” says Torkel Klingberg, professor of cognitive neuroscience at the Department of Neuroscience, Karolinska Institutet. “Social media entails constant distractions in the form of messages and notifications, and the mere thought of whether a message has arrived can act as a mental distraction. This affects the ability to stay focused and could explain the association.”

Significance at population level

The association was not influenced by socioeconomic background or a genetic predisposition towards ADHD. Additionally, children who already had symptoms of inattentiveness did not start to use social media more, which suggests that the association leads from use to symptoms and not vice versa.

The researchers found no increase in hyperactive/impulsive behaviour. The effect on concentration was small at the individual level. At a population level, however, it could have a significant impact.

“Greater consumption of social media might explain part of the increase we’re seeing in ADHD diagnoses, even if ADHD is also associated with hyperactivity, which didn’t increase in our study,” says Professor Klingberg.

Well-informed decisions

The researchers stress that the results do not imply that all children who use social media develop concentration difficulties, but there is reason to discuss age limits and platform design. In the study, the average time spent on social media rose from approximately 30 minutes a day for 9-year-olds to 2.5 hours for 13-year-olds, despite the fact that many platforms set their minimum age requirement at 13. 

“We hope that our findings will help parents and policymakers make well-informed decisions on healthy digital consumption that support children’s cognitive development,” says the study’s first author Samson Nivins, postdoctoral researcher at the Department of Women’s and Children’s Health, Karolinska Institutet.

The researchers now plan to follow the children after the age of 14 to see if this association holds. 

Source: Karolinska Institutet

Categories : Mental Health PaediatricsTags :

Social Media Use Drives Distrust Among Gen Z Teenage Girls

On By ModernMedia
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Social media use in adolescence is linked to delayed bedtimes, negative self-image and, especially among teenage girls, greater distrust, shows a new study from University College London. In turn, these changes are associated with more symptoms of depression and anxiety, risk of self-harm, and suicidal behaviours several years later. 

Published in Social Psychiatry and Psychiatric Epidemiology, the study examined how use of social media on the cusp of adolescence (11-years-old) was indirectly associated with a range of psychiatric symptoms, including psychological distress, self-harm and suicidal behaviours, in late adolescence (17-years-old). 

The study found three mechanisms linking social media use in early adolescence to small overall increases in subsequent mental health problems. Both boys and girls who were using social media from early on (at age 11) tended to sleep a little later on average, and had more negative thoughts about their physical appearance at age 14, compared to those who had not used social media. Crucially, teenage girls who had been using social media at age 11 reported greater distrust of other people at age 14.  

The three key mechanisms, which involved later bedtimes, more negative perceptions of body image, and distrust, mediated the association between early social media use and subsequent mental health problems. These small but significant relationships held true even after adjusting for socioeconomic and demographic factors, any maternal mental health problems, and children’s prior mental health difficulties (at age 7).  

The findings were based on data from the UK’s nationally representative Millennium Cohort Study, which was designed to track the lives of around 19 000 children born in 2000 to 2001 (and who belong to ‘Gen Z’, that is, children born between 1997 and 2012).  

During 2011-2012, at around age 11, the participants were asked: “How often do you visit a social networking website on the internet, such as Facebook or Bebo?”. Around three years later, they were followed up and asked about their usual bedtime, their trust in others, and their self-perception. A range of mental health challenges were subsequently tracked another three years later, at age 17. 

Lead author, Dr Dimitris Tsomokos (UCL Institute of Education) said: “These findings suggest that interpersonal distrust was a significant driver of psychiatric symptoms among Gen Z girls who used social media from early adolescence. 

“This distrust of others may be a particularly female response to the pressures of social media, which can sadly be fertile ground for social comparison, cyberbullying and perceived exclusion.” 

“We know that teenage girls display more empathetic concern and tend to place higher value on reciprocal relationships, and perhaps this is what drives greater distrust among them.” 

As policymakers and parents grapple with how to navigate technology use in childhood, the study’s authors recommend greater intervention in early adolescence, focused on fostering a sense of trust and social safety. They believe this can help mitigate the negative impacts of social media usage on young people’s long term mental health. 

Source: University College London

Categories : Mental HealthTags :

Tweeting at Night Linked with Worse Mental Wellbeing, New Study Finds

On By ModernMedia

Posting on X (previously known as Twitter) throughout the night is associated with worse mental wellbeing, according to a new study from the University of Bristol published in Scientific Reports.

Tweeting throughout the night explained almost 2% of variation in participants’ mental wellbeing, which is comparable to activities like binge drinking and smoking marijuana (as measured in previous studies).

Researchers suggested that actively using Twitter during the night could both disrupt and delay sleep, which could reduce the quality and quantity of sleep, harming mental wellbeing. Nighttime tweeting showed a weaker relationship with depressive and anxiety symptoms (compared to mental wellbeing), although this became stronger after results were split by age and sex.

Seventy-four per cent of UK adults keep their phone in their bedroom at night, while twenty-six per cent say they would check their phone if they wake up in the night, according to a 2022 YouGov survey.

Regulation and guidance for nighttime social media use

The study’s findings support calls for more regulation and guidance for nighttime use of social media. For example, TikTok, the online video-sharing app, introduced the tool “Wind Down” in March this year which shows meditation videos at night to encourage younger users to stop scrolling.

Researchers say top-down approaches to change the user architecture of apps, like TikTok’s wind-down mode, as well as education campaigns to raise awareness within vulnerable groups, could help improve the safety of social media use.

Daniel Joinson, Doctoral Researcher and lead author of the paper, said: “Whilst social media is often treated like a monolith, its impact on mental health will depend on the exact behaviours the user performs and the experiences they have on these platforms. Our paper highlights the potential harm of a very specific behaviour: nighttime content posting.

“Research like ours could help inform interventions or legislation that aim to deter harmful social media use, whilst enabling beneficial behaviours or experiences. This is made possible by having access to actual social media data, which is essential if we are to build a deeper understanding of the relationship between social media and mental health.”

Novel data collection approaches

The research drew on longitudinal data from 310 adults (aged between 18-60+) in the Children of the 90s study who consented and were eligible to share their Twitter data, with 18,288 tweets included in the data. Participants’ mental health was measured at multiple timepoints using standard questionnaires, including the Short Mood and Feelings Questionnaire (SMFQ). Importantly, instead of classifying people as simply depressed or not, mental health was measured on a scale, giving a more detailed picture. Participants’ tweets from within two weeks of these questionnaires were included in the analysis, but all others were not.

Uniquely, the study used data directly from Twitter (with the consent of the participant). This enabled the researchers to collect precise measurements of the time of day participants posted on Twitter.

However, the authors noted that the study participants were all adults, almost entirely white, and were more likely to be female. This data was collected during the COVID-19 pandemic, a unique time for social media usage and mental health patterns.

The research team are now looking to understand more about how the patterns of emotion expression and social interactions relate to mental health and wellbeing.

Source: University of Bristol

Categories : NeurologyTags :

Brain Study Shows TV and Gaming Boosts Young Adults’ Focus, Social Media Hinders It

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A world-first Swinburne-led study into young adults’ brain activity has found that TV and gaming are associated with increased focus, while social media is associated with decreased focus. 

In this study, published in Nature, 18-25 year olds exposed to phone screens for only three minutes experienced changes in mood, energy, tension, focus and happiness, explains one of the lead researchers Swinburne’s Dr Alexandra Gaillard. 

“Our study was the first to record brain activity during different forms of screen use on young adults using functional near-infrared spectroscopy (fNIRS). We found that different forms of screen use, including social media, are associated with distinct patterns in activity and mood states.” 

“Almost everyone owns a smart phone which they use for at least three hours a day for entertainment. Mood disorders are increasing in prevalence worldwide and we shouldn’t rule out the possibility that phones are a contributor.” 

The study found that oxygenated haemoglobin (HbO) levels increased more following social media use and gaming compared to TV viewing, while deoxygenated haemoglobin (HbR) levels increased more following gaming. 

“These findings suggest that interactive types of entertainment really do get the brain more engaged,” says Dr Gaillard.  

“Interestingly, though, when it came to social media, people reported feeling less focused—and those who felt less focused also showed lower levels of brain activity. On the flip side, gaming actually helped boost focus and showed a rise in deoxygenated haemoglobin, which means the brain was actively using more of the oxygen it was getting. In other words, gaming seemed to get the brain working harder in a good way.” 

With six months to go until Australia’s impending teen social media ban, there are still no clear pathways for age-checking tools and the positive impacts of the policy on different types of technology and platforms.  

Dr Gaillard says that while this study looked at young adults, these findings suggest a similar outcome to teenagers which should be considered by experts when implementing the ban. 

“If this is the effect on a fully developed brain, we urgently need to consider the impacts on teenagers and children who are increasingly using these technologies.” 

The Swinburne research team is calling for further research to understand the complex and nuanced relationship between screen activities and how they engage they brain. 

“Excessive screen time can negatively impact cognitive abilities, attention and executive functioning, but we also know how invaluable they can be in forming connections and a sense of belonging as well as improving educational outcomes.” 

“This isn’t a call for blanket reductions; screens certainly serve a purpose for unwinding and leisure. We ask that young people are conscious of how their activity impacts them and that they make choices that are right for them.” 

Source: Swinburne University

Categories : Dermatology PaediatricsTags :

Burning for Beauty: How TikTok Skin Trends Are Harming Young Girls

On By ModernMedia

It turns out when teens on TikTok say, “Get ready with me,” it can be more harmful than they might realise.

Photo by Steinar Engeland on Unsplash

In the first peer-reviewed study to examine the potential risks and benefits of teen skin-care routines posted on social media, scientists at Northwestern Medicine found girls ages 7 to 18 are using an average of six different products on their faces, with some girls using more than a dozen products. These products tend to be marketed heavily to younger consumers and carry a high risk of skin irritation and allergy, the study found.

The findings are published in the journal Pediatrics.

Each teen daily skin-care regimen costs an average of $168 (which the authors estimate typically lasts a month depending on the size of the products), with some costing more than $500, the study found. As the summer nears, the study authors cautioned that only 26% of daytime skin care regimens included sunscreen – arguably the most important skin care product for any age range, but particularly for kids.

The top-viewed videos contained an average of 11 potentially irritating active ingredients, the study found, putting the content creators at risk of developing skin irritation, sun sensitivity and a skin allergy known as allergic contact dermatitis. Prior evidence has shown that developing such an allergy can limit the kinds of soaps, shampoos and cosmetics users can apply for the rest of their lives.

“That high risk of irritation came from both using multiple active ingredients at the same time, such as hydroxy acids, as well as applying the same active ingredient unknowingly over and over again when that active ingredient was found in three, four, five different products,” said corresponding author Dr. Molly Hales, a postdoctoral research fellow and board-certified dermatologist in the department of dermatology at Northwestern University Feinberg School of Medicine.

For example, in one video included in the study, the content creator applied 10 products on her face in six minutes.

“As she’s applying the products, she begins to express discomfort and burning, and in the final few minutes, she develops a visible skin reaction,” said senior author Dr. Tara Lagu, adjunct lecturer of medicine and medical social sciences at Feinberg and a former Northwestern Medicine hospitalist.

Videos ‘emphasized lighter, brighter skin’

“We saw that there was preferential, encoded racial language in some cases that really emphasized lighter, brighter skin,” Lagu said. “I think there also were real associations between use of these regimens and consumerism.”

These videos offer little to no benefit for the pediatric populations they’re targeting, the study authors concluded. What’s more, given how the algorithms work, it’s nearly impossible for parents or pediatricians to track exactly what children or adolescents are viewing. Lastly, there are dangers beyond skin damage, Hales said.

“It’s problematic to show girls devoting this much time and attention to their skin,” Hales said. “We’re setting a very high standard for these girls. The pursuit of health has become a kind of virtue in our society, but the ideal of ‘health’ is also very wrapped up in ideals of beauty, thinness and whiteness. The insidious thing about ‘skin care’ is that it claims to be about health.”

Studying teens in the TikTok environment

In the study, Hales and another researcher each created a new TikTok account, reporting themselves to be 13 years old. The “For You” tab was used to view relevant content until 100 unique videos were compiled. They collected demographics of content creators, number and types of products used and total cost of regimens and then created a list of products used and their active and inactive ingredients. The Pediatric Baseline Series used in patch testing was used to identify ingredients with elevated risk of inducing allergic contact dermatitis.

Source: Northwestern University

Categories : Addiction Mental HealthTags :

Unhealthy Commodities – Like Alcohol and Social Media – are Connected with Poor Mental Health

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Commercial determinants such as social media, air pollution associated with depression and suicide

Photo by Inzmam Khan

“Unhealthy commodities” such as tobacco, alcohol, ultra-processed foods, social media, and fossil fuels, as well as impacts of fossil fuel consumption such as climate change and air pollution are associated with depression, suicide, and self-harm, according to a study published August 28 by Kate Dun-Campbell from the London School of Hygiene & Tropical Medicine, and colleagues.

Globally, around one out of every eight people currently live with a mental health disorder. These disorders – including depression, suicide, anxiety, and other diseases and disorders – can have many underlying causes. Some of those causes could be related to commercial determinants of health – the ways in which commercial activities and commodities impact health and equity. Commercial determinants of health can be specifically unhealthy, such as alcohol or tobacco consumption, unhealthy food, and the use of fossil fuels. To further understand how these unhealthy commodities might impact mental health, the authors of this study performed an umbrella synthesis of 65 review studies examining connections between six specific commodities – tobacco, alcohol, ultra-processed foods, gambling, social media, and fossil fuels. The author also included studies looking at mental health impacts of fossil fuel use such as climate change and air pollution.

The umbrella review found evidence for links between depression and alcohol, tobacco, gambling, social media, ultra-processed foods and air pollution. Alcohol, tobacco, gambling, social media, climate change and air pollution were associated with suicide, and social media was also associated with self-harm. Climate change and air pollution were also linked to anxiety. The review brought together many different methodologies and measurements, and could not establish the underlying cause of the negative mental health outcomes. But the results indicate that unhealthy commodities should be considered when researchers attempt to understand and improve mental ill health. 

The authors add: “Our review highlights that there is already compelling evidence of the negative impact of unhealthy products on mental health, despite key gaps in understanding the impact of broader commercial practices.”

The study was published in PLOS Global Health.

Provided by PLOS

Categories : General Interest Medical IndustryTags :

Social Media’s Double-edged Sword: Boosting Connections or Risking Careers?

On By ModernMedia
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Social media has become an integral part of our daily lives, revolutionising how we communicate, connect and share information. So much so that insights suggest that over 5 billion people worldwide use social media, with 259 million users coming online within the last year. Closer to home, of the 45 million internet users in South Africa, 26 million use social media. 

Platforms such as Facebook, Instagram, LinkedIn and X (formerly Twitter), have bridged gaps, brought distant loved ones closer, and created communities around shared interests and passions. While these platforms have enriched our personal lives in countless ways, they are also a mixed blessing, impacting the professional lives of some individuals in unprecedented ways.

According to Jennifer Barkhuizen, Head of Marketing at MIE, companies are increasingly relying on screening the social media platforms of potential and current employees to gain a window into a candidate’s true self, and provide insights into their hobbies, interests and overall personality. 

“For companies, social media has become an invaluable tool to find the perfect cultural fit for their organisations. However, this practice also uncovers another side of the coin, exposing any unprofessional or inappropriate behaviour that companies may not want to be associated with,” she says.

A significant 70% of recruiters, both across the human resources industry and those within companies, now use social media to screen potential candidates, a trend that continues to grow rapidly. As the digital footprint of individuals becomes more prominent, the trend of social media screening is expected to continue its upward trajectory, reshaping the recruitment landscape.

While the increasing reliance on social media screening by recruiters is bolstering the recruitment process, it is also having a profound psychosocial impact on employees. 

“Knowing that their online activities are being screened can lead to anxiety and a sense of privacy being invaded,” adds Barkhuizen. “Employees may feel pressured to meticulously curate their online presence and the content that they post, which can be mentally exhausting and foster a sense of inauthenticity. The fear of being judged for past posts or casual comments can undermine personal freedom and contribute to a perpetual state of vigilance.” 

Although social media screening helps companies make more informed hiring decisions, it is crucial to acknowledge and address the psychological burden it places on individuals navigating the increasingly blurred lines between their personal and professional lives.

For individuals, balancing positive and negative content on social media is crucial, particularly in the context of social recruiting. Here, studies indicate that positive content, such as showcasing achievements, sharing inspirational messages, and participating in professional discussions, can significantly enhance a candidate’s appeal. Furthermore, positive interactions on social media can create a favourable impression, portraying candidates as engaged, motivated and a cultural fit for the organisation.

“Conversely, negative content, including illicit activity, unprofessional behaviour and controversial opinions, can be detrimental and raise red flags about a candidate’s suitability for a professional environment,” explains Barkhuizen. “So much so that a survey conducted by CareerBuilder found that of the 70% of employers who screen candidates on social media, 54% have decided not to hire a candidate based on their online presence.”

Barkhuizen adds that while people seek to be publicly visible online as they look to share their own ‘personal brand’, thoughts and opinions with the world, it is only when an individual crosses into engaging in undesirable or illicit content that they risk their own reputation and that of their employer.

Despite social media screening potentially leading to anxiety for individuals, it’s a crucial step for businesses to ensure they hire the right candidates. This practice helps protect the company’s reputation by identifying online behaviour that could negatively impact the organisation. It also helps ensure a good cultural fit by revealing candidates’ values and interests, aligning them with the company’s ethos. 

To mitigate the risks associated with using social media during the screening process, Barkhuizen points to five key best practices that HR professionals should abide by. These include:

  1. Develop a social media screening policy: Document a policy outlining the purpose, scope and procedure for social media screening to minimise bias or discrimination. Separate decision-makers from those conducting checks to ensure a fair and compliant hiring process.
  2. Educate staff: Train staff on the legal and ethical aspects of social media screening, ensuring they apply the process consistently to all candidates in the same job category,
  3. Be transparent: Inform candidates about the screening process and obtain their written consent if a social media check is conducted. 
  4. Be respectful: Respect candidates’ privacy settings and only view publicly available information. Avoid “friending” or “following” candidates during the hiring process.
  5. Be impartial and job-specific: Focus on professional information relevant to the job, such as skills and accomplishments. Document information consistently and avoid using protected characteristics like race, religion or gender. To this end, it is advisable to use a third party supplier to avoid bias. 

In today’s digital landscape, where social media is a powerful yet double-edged sword, leveraging the expertise of industry leaders such as MIE can make a significant difference. 

With trusted and innovative smart vetting solutions, MIE’s extensive industry knowledge ensures thorough and reliable background checks, helping businesses navigate the complexities of social media screening to make informed, strategic hiring decisions while safeguarding their reputation and maintaining a positive workplace culture.

Categories : Neurology PaediatricsTags :

Poor Sleep, Social Media Use and Adolescents’ Developing Brains

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Photo by Steinar Engeland on Unsplash

A new study to be presented at the SLEEP 2024 annual meeting found a distinct relationship between sleep duration, social media usage, and brain activation across brain regions that are key for executive control and reward processing.

Results show a correlation between shorter sleep duration and greater social media usage in teens. The analysis points to involvement of areas within the frontolimbic brain regions, such as the inferior and middle frontal gyri, in these relationships. The inferior frontal gyrus, key in inhibitory control, may play a crucial role in how adolescents regulate their engagement with rewarding stimuli such as social media. The middle frontal gyrus, involved in executive functions and critical in assessing and responding to rewards, is essential in managing decisions related to the balancing of immediate rewards from social media with other priorities like sleep. These results suggest a nuanced interaction between specific brain regions during adolescence and their influence on behaviour and sleep in the context of digital media usage.

“As these young brains undergo significant changes, our findings suggest that poor sleep and high social media engagement could potentially alter neural reward sensitivity,” said Orsolya Kiss, who has a doctorate in cognitive psychology and is a research scientist at SRI International. “This intricate interplay shows that both digital engagement and sleep quality significantly influence brain activity, with clear implications for adolescent brain development.”

This study involved data from 6516 adolescents, aged 10–14 years, from the Adolescent Brain Cognitive Development Study. Participants answered questionnaires about sleep duration and recreational social media use. Brain activities were analysed from functional MRI scans during the monetary incentive delay task, targeting regions associated with reward processing. The study used three different sets of models and switched predictors and outcomes each time. Results were adjusted for age, COVID-19 pandemic timing, and socio-demographic characteristics.

Kiss noted that these results provide new insights into how two significant aspects of modern adolescent life, social media usage and sleep duration, interact and impact brain development.

“Understanding the specific brain regions involved in these interactions helps us identify potential risks and benefits associated with digital engagement and sleep habits,” Kiss said. “This knowledge is especially important as it could guide the development of more precise, evidence-based interventions aimed at promoting healthier habits.”

The American Academy of Sleep Medicine recommends that teenagers 13 to 18 years of age should sleep 8 to 10 hours on a regular basis. The AASM also encourages adolescents to disconnect from all electronic devices at least 30 minutes to an hour before bedtime.

Source: American Academy of Sleep Medicine

Categories : Diet and NutritionTags :

Social Media can Influence Young People to Eat More Healthily

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Photo by Alex Haney

Researchers from Aston University have found that people following healthy eating accounts on social media for as little as two weeks ate more fruit and vegetables and less junk food.

Previous research has shown that positive social norms about fruit and vegetables increases individuals’ consumption. The research team sought to investigate whether positive representation of healthier food on social media would have the same effect. The research was led by Dr Lily Hawkins, whose PhD study it was, supervised by Dr Jason Thomas and Professor Claire Farrow in the School of Psychology.

The researchers recruited 52 volunteers, all social media users, with a mean age of 22, and split them into two groups. Volunteers in the first group, known as the intervention group, were asked to follow healthy eating Instagram accounts in addition to their usual accounts. Volunteers in the second group, known as the control group, were asked to follow interior design accounts. The experiment lasted two weeks, and the volunteers recorded what they ate and drank during the time period.

Overall, participants following the healthy eating accounts ate an extra 1.4 portions of fruit and vegetables per day and 0.8 fewer energy dense items, such as high-calorie snacks and sugar-sweetened drinks, per day. This is a substantial improvement compared to previous educational and social media-based interventions attempting to improve diets.

Dr Thomas and the team believe affiliation is a key component of the change in eating behaviour. For example, the effect was more pronounced amongst participants who felt affiliated with other Instagram users.

The 2018 NHS Health Survey for England study showed that only 28% of the UK population consumed the recommended five portions of fruit and vegetables per day. Low consumption of such food is linked to heart disease, cancer and stroke, so identifying ways to encourage higher consumption is vital. Exposing people to positive social norms, using posters in canteens encouraging vegetable consumption, or in bars to discourage dangerous levels of drinking, have been shown to work. Social media is so prevalent now that the researchers believe it could be an ideal way to spread positive social norms around high fruit and vegetable consumption, particularly amongst younger people.

Dr Hawkins, who is now at the University of Exeter, said: “Our previous research has demonstrated that social norms on social media may nudge food consumption, but this pilot demonstrates that this translates to the real world. Of course, we would like to now understand whether this can be replicated in a larger, community sample.”

Source: Aston University

Categories : Ethics and Law Surgeries & ProceduresTags :

Plastic Surgeon Loses Medical Licence for Streaming Surgeries on TikTok

On By ModernMedia
Photo by Piron Guillaume on Unspalsh

A plastic surgeon in the US has had her medical licence permanently revoked for livestreaming parts of her surgeries and causing harm to her patients while doing so, according to the Washington Post.

Dr Katherine Grawe, who was also fined US$4500, streamed her operations with between 100 000 and 500 000 viewers at a time, speaking to the camera and on occasion answering viewers’ questions.

Three of her patients whose surgeries she had streamed experienced complications – infections, a perforated intestine and a loss of brain function – that required further medical care. She told the Washington Post that she did not believe that her livestreaming her surgeries had resulted in harm to her patients.

“Nobody wants a complication, and we never want things to go poorly, but any complications that happened with me were not because I was not paying attention,” Grawe said. “My whole goal in life is to give these people confidence and make them more beautiful. And, unfortunately, they suffered these complications, and I feel very sad for them. I would never want anything bad to happen to them.”

She specialised in cosmetic surgery for women’s breasts, as well as tummy tucks and other procedures, Grawe said. She is also being sued by the three patients who had complications. Since she started practising in 2010 with her Dr Roxy practice, she built up a social media following and eventually began livestreaming on TikTok in an effort to break down “this scary wall” between patients and doctors. Her patients all signed consent forms for their procedures to be livestreamed.

Grawe’s licence was suspended in November, and she pleaded with the board, saying that she would never livestream her surgeries again. The board was not moved by her appeal. “Dr Grawe’s social media was more important to her than the lives of the patients she treated,” the board stated.

The board had warned her in 2018 over patient confidentiality concerns in her livestreaming, and again in 2021.

Surgeries conducted in front of an audience are nothing new in medicine; medical students and clinicians alike observe procedures to learn and share knowledge. Some operating theatres are specially designed to host audiences behind windows overlooking the operating table. In the 21st century, it has become commonplace for educational livestreaming of surgeries, with considerable benefits for surgeons and increased anatomy knowledge scores.

There is also some evidence of risks to patients: one review found no increased risk of harm in urology, but this was not true for other surgical fields. Thirteen

Unlike in-person viewing of surgeries, data protection considerations must be employed as operating on a patient often may reveal identifiable information even if not livestreaming to a wide audience. Certain video conferencing platforms may not be secure, and recordings of the procedure may inadvertently be accessible to others, eg being stored on network drives, on the cloud without password protection and so on. There are secure communication apps that can be used to confidentially view and share patient data, such as TigerConnect, Medic Bleep, Forward Health and Siilo.