Social media in neurosurgery during COVID-19: an evaluation of the role of Neurosurgery Cocktail platform.

IntroductionNeurosurgery is evolving with new techniques and technologies, relies heavily on high-quality education and training. Social networks like Twitter, Facebook, Instagram and LinkedIn have become integral to this training. These platforms enable sharing of surgical experiences, fostering global knowledge-sharing and collaboration among neurosurgeons. Virtual conferences and courses are accessible, enhancing learning regardless of location. While these networks offer real-time communication and collaborative opportunities, they also pose challenges like the spread of misinformation and potential distractions. According to the PICO format, the target population (P) for the purpose of this paper are medical students, neurosurgical residents and consultants on the role of social media (I) in neurosurgery among Low-Middle income countries (C) with the main outcome to understand the collaborative domain of learning.Material and methodThis cross-sectional survey, conducted in June-July 2023, involved 210 medical students, neurosurgery residents, fellows, and practicing neurosurgeons from low and middle-income countries. A structured questionnaire assessed social network usage for neurosurgery training, covering demographic details, usage frequency, and purposes like education, collaboration, and communication. Participants rated these platforms' effectiveness in training on a 1–5 scale. Data collection employed emails, social media groups, and direct messaging, assuring respondent anonymity. The survey aimed to understand and improve social networks' use in neurosurgery, focusing on professional development, challenges, and future potential in training.ResultsIn a survey of 210 participants from low and middle-income countries, 85.5% were male, 14.5% female, with diverse roles: 42.9% neurosurgery residents, 40% practicing neurosurgeons, 14.6% medical students, and 2.4% other healthcare professionals. Experience ranged from 0 to 35 years, with Mexico, Nigeria, and Kenya being the top participating countries. Most respondents rated neurosurgery training resources in their countries as poor or very poor. 88.7% used social media professionally, predominantly WhatsApp and YouTube. Content focused on surgical videos, research papers, and webinars. Concerns included information quality and data privacy. Interactive case discussions, webinars, and lectures were preferred resources, and most see a future role for social media in neurosurgery training.ConclusionsOur study underscores the crucial role of social media in neurosurgery training and practice in low and middle-income countries (LMICs). Key resources include surgical videos, research papers, and webinars. While social media offers a cost-effective, global knowledge-sharing platform, challenges like limited internet access, digital literacy, and misinformation risks remain significant in these regions.

BackgroundThe advent of social media has significantly transformed various medical specialties, including neurosurgery. A systematic review of the literature was conducted to characterize the utilization of social media in neurosurgery and to evaluate the impact of social media usage in neurosurgery. Furthermore, the study aimed to determine the demographics of social media users in neurosurgery and delineate their purposes for engaging with social media platforms.MethodsA comprehensive literature search was conducted across the PubMed, EMBASE, Scopus, and Cochrane databases to identify studies investigating the role of social media in neurosurgery. Articles were screened for relevance, and selected studies were systematically reviewed and analyzed to assess the integration of social media within neurosurgical practices.Results105 studies were included. 2023 represented the year with the most published articles (28%). Most studies (52%) addressed general neurosurgery, followed by intracranial (24%) and spine surgery (24%). X (formerly Twitter) was the most frequently studied platform (46%), followed by YouTube (38%) and Facebook (30%). The primary purposes of social media use were patient education (36%), evaluation of the impact (22%), healthcare provider education (20%), collaboration (9%), research dissemination (8%), and career development (6%). 64% of studies targeted healthcare professionals, while 36% focused on patients. Sentiment towards social media use was positive in 50% of studies, negative in 19%, and neutral or exploratory in 31%.ConclusionThe literature highlights a notable increase in the use of social media in the neurosurgical field, particularly for education, impact analysis and research distribution. Platforms like X have become central for academic exchange and professional networking. Having a social media presence can be beneficial for neurosurgeons and can positively impact patient reviews, the department’s standing, and may even contribute to academic success. Furthermore, social media facilitates interdisciplinary collaboration and access to educational content.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00701-025-06695-1.

Mechanical ventilators for low- and middle-income countries: informing a context-specific and sustainable design

COVID-19 vaccines and treatments: When speed is necessary and not enough.

Solace in Social Media: Women Unite Under COVID-19

Background The use of social media to communicate and disseminate knowledge has increased exponentially, especially in the field of neurosurgery. ‘Neurosurgery cocktail’ (NC) was developed by a group of young neurosurgeons as a means of sharing didactic materials and clinical experiences via social media. It connects 35.000 neurosurgeons worldwide on multiple platforms, primarily Facebook and Twitter. Given the rising utilization of social media in neurosurgery, the popularity of NC has also increased since its inception. In this study, the authors surveyed the social media analytics of NC for both Facebook and Twitter. Besides, we reviewed the literature on the use of social media in neurosurgery. Methods Facebook and Twitter metrics were extracted through each respective platform’s analytics tools from December 2020 (earliest available date for data analysis) through January 2021. A literature search was conducted using PubMed (MEDLINE) and Scopus databases. Results On Facebook, as of January 2021, the group had a total of 25.590 members (87.6% male), most commonly (29%) between 35 and 44 years of age with over 100 countries were represented. As of January 2021, they had amassed 6457 followers on Twitter. During the last 28 d between December 2020 and January 2021, the account published 65 tweets that garnered a total of 196,900 impressions. Twelve articles were identified in our literature review on the use of social media within the neurosurgical community. Conclusions NC is one of the most widely utilized neurosurgical social media resources available. Sharing knowledge has been broadened thanks to the recent social media evolution, and NC has become a leading player in disseminating neurosurgical knowledge.

Background: The COVID-19 pandemic has increased the demand for scaling up digital health solutions such as telemedicine, mobile health (mHealth), artificial intelligence (AI), and social media in low- and middle-income countries (LMICs). The application and acceptability of digital health solutions in LMICs could differ from the contexts of high-income countries. Thus, this study aimed to review various digital health solutions implemented in LMICs during the COVID-19 pandemic.Methods: This systematic review followed PRISMA guidelines and is registered with PROSPERO (CRD42021231836). Searches were performed on PubMed, CINAHL, EMBASE, and SCOPUS for research articles published between January 1, 2020 and March 17, 2021. The inclusion criteria comprised people residing in LMICs, digital health solutions that could improve the overall health and wellbeing, user experiences, and acceptability. RCTs, quasi-experimental studies, and cohort study designs were included. The risk of bias assessments for randomized studies and non-randomized intervention studies were performed.Findings: Of the 2200 studies retrieved from search, 1912 studies were screened after removal of duplicates. Of the 270 full texts assessed for eligibility, six studies were included in the narrative synthesis. The studies were from Zimbabwe, China, and Turkey. Two studies were RCTs, one was cohort, and three were non-randomized intervention studies. Three studies focused on telemedicine and three on social media. All studies indicated positive results with the intervention. However, each study employed different digital health technology and measured different outcomes, and, thus, meta-analysis was not possible.Interpretation: Digital health interventions can be an effective way to improve health and provide health consultations during the pandemic. However, the available evidence from this review cannot determine the effectiveness of digital health solutions in LMICs. Remote consultations with the aid of social media, teleconsultation, and internet hospitals are the future of healthcare. Therefore, well-designed intervention studies in digital health are necessary.Funding Statement: None.Declaration of Interests: We declare no competing interests.

Introduction to "Recontextualizing Physician Associations: Revisiting Context, Scope, Methodology".

Surgeons practicing in high-income countries (HIC) like the United States, which spends an estimated 765 billion dollars per year on unnecessary healthcare costs, are generally not accustomed to resource limitations.1 However, the coronavirus disease 2019 (COVID-19) pandemic has strained the usually robust healthcare system in HIC. Lack of adequate testing, small reserves of ventilators and global supply chain disruptions, among other causes, have led to shortages affecting care for critically ill patients – most notably human resources, ventilators, and personal protective equipment (PPE).2 This has transformed hospitals in HIC to a "resource variable environment" with uncertainty of the supplies, intensive care unit (ICU) beds, and staff available at any given time. Although this challenging environment is novel for many providers in HIC, these constraints are commonplace for providers in low- and middle-income countries (LMIC). Only 12% of the world's specialist surgical and anesthesia workforce practice in the world's poorest regions in Africa and Southeast Asia, where a third of the world's population lives and the majority of the world's surgical burden lies.3,4 LMIC also face a severe shortage of ICU capacity, for example, Uganda has only 0.1 ICU beds per 100,000 population, compared with 20 beds per 100,000 in the United States.5,6 Approximately 1 in every 4 hospitals in LMIC do not have access to oxygen, rendering them unable to provide timely, basic care for many patients.3 At most hospitals in LMIC, PPE shortages are the norm and essential care is provided by family members at the bedside.3,7 To overcome these and other daily challenges, LMIC providers must often improvise, adapt, and innovate. Many hospitals in HIC rely on just-in-time inventory management, which can be an effective method to cut down on costs, as it calls for minimal reserves of healthcare supplies. However, the widespread use of such strategies, which are reliant on consistent and tightly controlled supply chains, have made HIC vulnerable to PPE and supply shortages should demand sharply increase, as has been seen with the COVID-19 pandemic. In some HIC hospitals, healthcare workers facing PPE shortages have already had to adopt common practices from LMIC, such as using bin liners instead of gowns and wearing reusable cloth masks. HIC providers have also implemented evidence based adaptations, such as creating reusable elastomeric respirators, the development of open source ventilators, and reprocessing N95 masks using the hydrogen peroxide vapor sterilization technique.8–11 In many LMIC, healthcare supply chains are vulnerable at baseline, and providers are regularly faced with shortages of supplies and PPE. Items that are considered disposable in HIC, such as endotracheal (ET) tubes and electrocautery tips and pads, are often reused after high level disinfection. Equipment shortages in LMIC have led to the expanded use of regional anesthesia with intravenous (IV) sedation, and most surgeries are performed open rather than via laparoscopy. Operating room supplies are opened only as-needed and evaluated after each case; only the most essential available instruments for every case are opened, and key instruments are prioritized for sterilization throughout the day. Similar strategies towards the pragmatic use of operating room resources could be considered in HIC and may even decrease perioperative costs.12 Public private partnerships and innovative local production strategies have emerged in LMIC in response to widespread oxygen shortages.13,14 Such strategies may be considered in HIC should there be an oxygen shortage during the COVID-19 pandemic. Additionally, surgical gowns, head covers, and surgical drapes in LMIC are cloth, requiring washing and reuse, whereas such supplies are disposable in the majority of hospitals in HIC, particularly in the US. The use of disposable surgical textiles is largely driven by reimbursements to hospitals based on volume of purchases, and there is a lack of evidence to suggest that the use of disposables have an overall cost or safety benefit.15 Transitioning to increased use of reusable products where possible would make HIC hospitals less vulnerable to supply chain disruptions and would additionally have a substantial sustainability benefit. Amid the COVID-19 pandemic, the number of patients requiring mechanical ventilation in the US could range between 1.4 and 31 patients per available ventilator, which would necessitate thoughtful resource allocation should HIC face a ventilator shortage.16 Even outside the setting of pandemics, LMIC face a constant shortage of ventilators and ICU care, even in national referral hospitals.17 As a result, many young patients die from reversible etiologies, such as surgical disease, postsurgical complications, infectious diseases, trauma, and peripartum maternal or neonatal complications.18 Providers in these settings routinely make difficult ethical and practical decisions about the allocation of ICU care, often informed by the local context and cultural factors. This extends through the entirety of the perioperative journey, from who can be offered surgery, to operative approaches and postoperative care. Scoring systems appropriate for the LMIC context have been developed, and take into account some of these factors.19,20 Other mitigation strategies include the development of high-dependency units, which have increased capacity for monitoring and oxygen delivery, and training programs for the limited numbers of ward nurses emphasizing early recognition and intervention for critically ill patients.21 Should ventilator shortages become apparent, a planning exercise for this type of scenario in HIC may be worthwhile given the current reality of ventilator shortages to potential need. A large volume of critically-ill patients combined with potentially high rates of healthcare worker infections and exposures has led to staffing shortages in both HIC and LMIC during COVID-19. LMIC already face severe staffing shortages due to a variety of factors, including low numbers of graduates, poor salaries and working conditions, and high attrition rates.22 Addressing such shortages has required a number of innovations, some of which could potentially be adapted for use in HIC. A program to engage family members in multiple aspects of patient care has been used successfully by Narayana Health in India. Family members were trained to perform tasks such as monitoring fluid balance, taking and recording vital signs, and assisting with incentive spirometry, which not only cut costs and addressed staffing shortages, but reduced postoperative complication rates.23 Due to social distancing guidelines and visitor restrictions in hospitals this may be most effectively utilized for post-hospitalization care and rehabilitation programs as support staff and rehab centers are also part of the overwhelmed healthcare community. In LMIC, both physician and nonphysician general practitioners are commonly called upon to perform essential surgery.24 Such task sharing, where healthcare workers are reorganized and required to work in alternative roles to meet changes in workforce demands, is a common solution to staffing shortages in LMIC. During the COVID-19 pandemic, this practice been a necessary adaptation in HIC as the imminent need for many specialties declined, whereas intensivists and generalists have been in high demand. In our own HIC institutions we have seen the re-allocation of surgical critical care physicians and surgeons into roles assisting in the medical intensive care units and medical floors helping care for both COVID and non-COVID medical patients. This crisis has brought attention to the need to address the shortage of more broadly trained personnel and generalist physicians, which is largely attributed to the high costs of medical school and procedure-based reimbursement strategies, resulting in higher salaries for specialist physicians.25 Going forward, the expansion of policies to incentivize young doctors to enter general practice, such as tuition reimbursement and a transition to value-based payment strategies in both HIC and LMIC may be necessary. The widespread, immediate implications of the acute shortages during the COVID-19 pandemic have highlighted the need for systems strengthening in both HIC and LMIC and have forced us to re-examine our approach to healthcare delivery. Telemedicine is being optimized globally more than ever before to prevent surges through forward triage, minimize healthcare worker exposures and address workforce shortages.26 The widespread implementation of telehealth interventions can be leveraged long after the pandemic ends to overcome challenges of distance and patient access in both HIC and LMIC. This will need to be done thoughtfully to ensure that alternatives are developed when necessary for vulnerable populations that may have challenges in technology use. Disruption in the global supply chain for healthcare supplies has underscored the importance of building redundancies into the system, and has led to the opening up of new local supply chains by linking local stakeholders.27 Shortages of PPE and other essential equipment have also highlighted the need for a transparent, centrally controlled strategic reserve of medical supplies. Hospitals have had to rapidly scale up ICU capacity, which has underlined the value of redundant capacities and flexibility within the healthcare system. These lessons have highlighted the need for long-term investment to build flexible, resilient health systems and are sure to help providers in both HIC and LMIC care for more patients safely and effectively both during this pandemic and long after it ends. Learning how LMIC providers manage resource limitations through global surgery collaborations can give surgeons working in HIC valuable perspective that has become increasingly relevant during the COVID-19 pandemic. The rapid expansion of social media has facilitated such collaborations, and is a valuable tool for networking, mentorship, and information sharing. Additionally, the rapid sharing of research findings via social media is enhancing our ability as a global health community to respond to this pandemic in a strong evidence based manner. However, it is essential that social media be used responsibly, and that precautions are taken to prevent the spread of misinformation. For surgeons working in HIC, there is much to learn from counterparts in LMIC. Healthcare systems in many LMIC, particularly in Africa, have more experience responding to infectious disease pandemics, especially in contact tracing and community mobilization. The extensive network of community health workers in LMIC is an essential component of grass roots public health infrastructure that HIC may be able to emulate.28 Triage systems, finite resources, and limited personnel in LMIC require constant thoughtfulness regarding testing, treatment, and disposition. More importantly, working in a resource-variable environment requires fostering a set of soft skills that LMIC practitioners utilize on a daily basis. These include adaptability, resourcefulness, frugality of supplies, humility, and leadership among others. These lessons highlight the importance of fostering bilateral partnerships and increasing relevance of global health competencies to surgical training. Examples such as task sharing illustrate that HIC can adapt and can respond to these challenges with resilience.29 This requires vigilant monitoring of the situation and constant improvisation in the face of unpredictable challenges. These and other nontechnical skills are always essential to ensure safe and high quality surgical care but become especially pertinent during this trying time. The most vulnerable populations, often linked to the underlying social determinants of health such as poverty, food security, literacy, sex, and racial and ethnic factors, are most at risk of adverse outcomes during these health and social shocks. There is already data demonstrating that racial and ethnic minorities in the US and UK are at increased risk of death from COVID-19.30 Difficulty in accessing care for emergent conditions exists at baseline for these populations, and extensive backlogs for essential operations are commonplace, especially in LMIC. This is likely only to get worse during the current crisis and underscores the importance of our professional commitment to health equity – regardless of geography. New estimates of the "collateral damage" caused by the pandemic are very concerning and also illustrate the urgent need to mitigate this impact through local and global coordinated action.31 The overall lack of collective and individual health equity around the globe dramatically weakens our global heath security and without addressing this disparity, the even the best attempts by HIC to ensure safeguard domestic health will always be undermined.32 The grave reality is in both LMIC and now in HIC, population needs vastly outpace our resources, and it is the patients who are affected unless we too improvise, adapt, and innovate. Global surgery collaborations with reciprocity between partners, with trainees and faculty working together, enhance our capacity to share our collective expertise and navigate this pandemic resiliently.

The prevalence and correlates of depression before and after the COVID-19 pandemic declaration among urban refugee adolescents and youth in informal settlements in Kampala, Uganda: A longitudinal cohort study

Decision letter: COVID-19 as a catalyst for reimagining cervical cancer prevention

Global pandemic perspectives: public health, mental health, and lessons for the future

Perioperative Provider Safety in Low- and Middle-income Countries During the COVID-19 Pandemic: A Call for Renewed Investments in Resources and Training.

PurposeThe use of social media and information exchange increased during Covid-19 pandemic because people are isolated and working from home. The use of social media enhances information exchange in a global society, therefore customers are uncertain and not in a better position to take decisions before the situation goes worst everywhere in the world. The current study helps to understand how social media facilitate social and global engagement and information exchange which ultimately leads to the development of the customer psychology of stockpiling. This study aims to develop a research framework which helps to understand the customer psychology of stockpiling during a global pandemic.Design/methodology/approachThis study opted for a social constructionist approach because it can help to understand both individual and social subjective realities with respect to stockpiling behaviour due to the fear and risk of Covid-19 pandemic. For this purpose, the researcher collected data from 40 customers of UK retail stores who actively use social media. The data were collected during telephonic interviews and thematic analysis was used for data analysis.FindingsResults highlighted that institutional communication and social public interpretation of uncertainties and risk enhanced misinformation and sensationalism through social media platforms; therefore, stockpiling behaviour increased during Covid-19 pandemic. The fear of items being out of stock, illness, misinformation, family fear and going out were some of the possible causes that led to the development of panic stockpiling behaviour. The global uncertainty proof, as well as a public social consensus for staying at home and protecting the future also increased customers’ intention to buy in bulk for their future. Although social media played an important role in transferring relevant and timely information, it also increased uncertainty and social proof which may have led to stockpiling of retail products.Research limitations/implicationsThe results of this study are beneficial for understanding how Covid-19 creates and enhances uncertainties and risks at both global and national level which developed into customer panic stockpiling behaviour, even when there is no promotional scheme or decrease in prices. This study helps marketers understand the psychology of customer stockpiling during a global pandemic. This study also helps to understand the role of social media, which promotes social interpretations of uncertainties and risk which ultimately enhance panic stockpiling among customers.Originality/valueLimited research is available which provides an understanding of how social media can play a role in socially generated uncertainties and risks, which enhance misinformation and sensationalism, as well as the development of stockpiling behaviour. This study provided a stockpiling behaviour model based on the theory of uncertainty and social proof. The results of this study are unique as there is limited literature available which connects social media, uncertainties and risk, Covid-19 pandemic and stockpiling behaviour among educated people.

The COVID-19 pandemic, as a holistic event of cultural trauma, significantly influenced social structures and behaviors globally. Under its impact, social movements leveraged digital platforms to sustain and amplify their causes, creating new forms of solidarity and resistance, and fostering a rise in digital and hybrid collective actions. Concurrently, social media thrived as a transformative tool for social change, revolutionizing communication, mobilization, and advocacy. Platforms like WhatsApp and X redefined traditional activism by enabling rapid information dissemination and facilitating global grassroots movements. This technological evolution has provided marginalized communities, including the indigenous peoples of Southern Africa, with a powerful voice. These communities face challenges such as land rights disputes, environmental degradation, and socioeconomic marginalization. Social media allows them to raise awareness, galvanize support, and engage with a broader audience beyond their geographical confines. The paper hypothesizes that social media plays a multifaceted role in supporting indigenous movements, by not only providing a platform for activists to organize and advocate, but also enabling engagement with the general public and influencing the perspectives and actions of policymakers and other audiences. Through the lenses of rural or indigenous activists who leverage these digital platforms to drive change, audiences who consume and interact with digital content and feeds, and policymakers who are increasingly mindful of the power of social media narratives, this paper aims to understand the complex interplay of forces that shape the trajectory of digital indigenism (indigenous digital activism). The paper employs a mixed-methods approach to investigate the influence of social media on social movements among indigenous communities in Southern Africa. The methodology incorporates (a) netnography and in-depth interviews to explore the experiences and strategies of indigenous activists, (b) the counterpublics framework to understand the formation and dynamics of indigenous digital activism, and (c) the Technology-Media-Movements Complex (TMMC) as a theoretical anchor to analyze the interplay between technology, media, and social movements. The case study of the Community Leaders Network (CLN) of Southern Africa is used to contextualize the findings. Findings reveal that indigenous activists recognize the power of social media in amplifying their voices but use these platforms out of necessity rather than preference. They find social media solutions often misaligned with their contextual needs, citing concerns over platform constraints, privacy issues, cultural insensitivity, superficial engagement metrics, and breaches of consent. Additionally, they reckon that the global emphasis on social media engagement can divert focus from essential field activities that directly benefit local communities, causing social media fatigue. It was also revealed that trying to convey practical information to an audience with preconceived notions is incredibly time-consuming and often feels like an endless loop for indigenous activists. Subsequently, they expressed a desire for platforms that consider users' mental well-being in their architectural design and incorporate cultural and linguistic practices, suggesting a preference for digital environments that are more aligned with values and modes of communication that contrast with western models. The results underscore social media's complex role in indigenous movements, highlighting its empowering potential while also presenting significant challenges due to algorithms and platform dynamics. While the ability to share stories, disseminate information about rights abuses, and mobilize support has significantly transformed social movement dynamics in rural communities, social media's potential for advocacy and mobilization is tempered by challenges that can limit their effectiveness. The findings highlight a pressing need for social media innovations that resonate with indigenous cultural identities, ensuring that their narratives are disseminated in a manner that faithfully preserves their authenticity. The paper discusses the implications of these findings for policymakers, activists, audiences and technology developers, emphasizing the importance of creating digital spaces that are culturally sensitive and supportive of indigenous activism.