Selfies: A boon or bane?

Selfie accidents and crimes in Egypt: A comprehensive discussion of the medico-legal implications

Selfies are self-surveillance images or videos captured by individuals using digital cameras that, in the attempt to obtain content, may lead to selfie-related injuries or deaths. Criminal selfies refer to offenders who take selfies with their victim(s) during crimes. Globally, both phenomena are underestimated due to deficient official data and the social nature of these incidents. This pioneering media-based retrospective study on selfie-related trauma aims to offset the literature deficit on this topic in Egypt, as an Arabic-speaking country, and extend the global understanding beyond the Western context. We utilised the Egyptian newspaper articles published between January 2014 and May 2023. We identified 25 reports of selfie-related accidents that resulted in 29 casualties with an 82.8% fatality rate. Male victims outnumbered female victims and the mean age was 21.8 years, with most victims aged in their twenties. Regarding the causes of selfie-related deaths, drowning in the Nile ranked first (43.4%) followed by falling from a height (26%). Unless suicide was suspected (n = 1), the remaining cases were considered accidental. We also found four reported criminal selfies that were associated with intimate partner violence. Three of these offenders were male, of which two had a history of drug addiction. In contrast to selfie cases, only one offender belonged to the second decade age group. Overall, selfie-related deaths were infrequent, with an average of three incidents per year. In conclusion, audio-visual communication has altered the modus operandi of crimes, so the digital media analysis should supplement the criminological and medicolegal processes.

Selfie-Related Incidents: Narrative Review and Media Content Analysis

BACKGROUND

Selfie-related injury has become a public health concern amid the near ubiquitous use of smartphones and social media apps. Of particular concern are selfie-related deaths at aquatic locations; areas often frequented because of their photogenic allure. Unfortunately, such places exhibit hazards inherent with their environment.

OBJECTIVE

This study aimed to ascertain current evidence regarding selfie-related injuries and recommended risk treatment measures in the academic literature as well as how selfie-related injuries and deaths were being reported by the media, allowing us to identify key challenges facing land managers and public health practitioners in mitigating selfie-related injuries and deaths.

METHODS

Between October and December 2022, we performed a narrative review of peer-reviewed literature published since January 2011. Literature was screened to identify causal factors implicated in selfie-related deaths and injuries, as well as risk treatments recommended. Furthermore, we used an environmental scan methodology to search for media reports of selfie-related injuries and deaths at aquatic locations in Australia and the United States. Individual cases of selfie-related aquatic injuries and deaths sourced from news reports were analyzed to assess epidemiological characteristics, and a thematic content analysis was conducted to identify key themes of news reporting on selfie-related deaths and injuries.

RESULTS

In total, 5 peer-reviewed studies were included. Four studies identified falls from height as the most common injury mechanism in selfie incidents. Drowning was the second most common cause of death. Recommended risk treatments were limited but included the adoption of "no selfie zones," physical barriers, signage, and provision of information on dangerous locations to social media users. In total, 12 cases were identified from media reports (4 injuries and 8 fatalities; 7 in Australia and 5 in the United States). The mean age of the reported victims was 22.1 (SD 6.93) years with victims more likely to be female tourists. Content analysis revealed 3 key themes from media reports: "blame," "warning," and "prevention and education." Few media reports (n=8) provided safety recommendations.

CONCLUSIONS

The selfie-related incident phenomenon should be viewed as a public health problem that requires a public health risk communication response. To date, little attention has been paid to averting selfie-related incidents through behavior change methodologies or direct messaging to users, including through social media apps. Although previous research has recommended "no selfie zones," barriers, and signage as ways to prevent selfie incidents, our results suggest this may not be enough, and it may be prudent to also engage in direct safety messaging to social media users. Media reporting of selfie incidents should focus on preventive messaging rather than blame or warning.

Social Media and Selfie-Related Mortality Amid COVID-19: Interrupted Time Series Analysis

BACKGROUND

COVID-19 had a considerable impact on mortality, but its effect on behaviors associated with social media remains unclear. As travel decreased due to lockdowns during the pandemic, selfie-related mortality may have decreased, as fewer individuals were taking smartphone photographs in risky locations.

OBJECTIVE

In this study, we examined the effect of the COVID-19 pandemic on trends in selfie-related mortality.

METHODS

We identified fatal selfie-related injuries reported in web-based news reports worldwide between March 2014 and April 2021, including the deaths of individuals attempting a selfie photograph or anyone else present during the incident. The main outcome measure was the total number of selfie-related deaths per month. We used interrupted time series regression to estimate the monthly change in the number of selfie-related deaths over time, comparing the period before the pandemic (March 2014 to February 2020) with the period during the pandemic (March 2020 to April 2021).

RESULTS

The study included a total of 332 selfie-related deaths occurring between March 2014 and April 2021, with 18 (5.4%) deaths during the pandemic. Most selfie-related deaths occurred in India (n=153, 46.1%) and involved men (n=221, 66.6%) and young individuals (n=296, 89.2%). During the pandemic, two-thirds of selfie-related deaths were due to falls, whereas a greater proportion of selfie-related deaths before the pandemic were due to drowning. Based on interrupted time series regression, there was an average of 1.3 selfie-related deaths per month during the pandemic, compared with 4.3 deaths per month before the pandemic. The number of selfie-related deaths decreased by 2.6 in the first month of the pandemic alone and continued to decrease thereafter.

CONCLUSIONS

Our findings indicate that the COVID-19 pandemic led to a marked decrease in selfie-related mortality, suggesting that lockdowns and travel restrictions likely prevented hazardous selfie-taking. The decrease in selfie-related mortality occurred despite a potential increase in social media use during the pandemic.

Preventing selfie-related incidents: Taking a public health approach to reduce unnecessary burden on emergency medicine services

Unintentional deaths from selfies have received limited exposure in emergency medicine literature; yet trauma remains the leading cause of death and disability in children and young adults, and most of those implicated in a selfie incident are in this demographic. Selfie-related injuries and deaths may be a relatively new phenomenon, but data suggest they are a public health hazard that is not going away. Emergency medicine practitioners may have a role to play in the primary and secondary prevention of selfie incidents, including delivering opportunistic behaviour change messaging to those who are at risk of being injured or killed in a selfie-related incident, particularly young (14-25 years) males. Emergency medicine specialists should be aware of the dangers of selfie-related incidents and understand their polytraumatic presentation.

Assessment of Selfie addiction among undergraduate medical Students

Background: Selfie’ means “A photograph that one has taken of oneself or a self portrait photograph typically taken with a smart phone or digital camera and shared via social media”. Considering the dependency on Internet and selfie taking behavior among professional students, the study was undertaken. Aims and Objective- to determine the demographic profile of selfie users and different variables related to selfie taking and posting and its association with risky dangerous selfie. Material and Methods: A cross-sectional study conducted among 220 undergraduate medical students were using smartphone. Data was collected and analyzed using SPSS version 21. Results: Male students of middle class family of urban areas were more involved in taking selfie. Females were comparatively spending more time (2-3 hrs) on Internet (X2 =19.494 and p = .001).Total 14% students were taking 3-5 selfie and posted on social media(Statistically significant,X2 =7.882,p =0.019). 19(8.63%) participants admitted of taking dangerous selfie of which male 13(14.0%) more than female 06(8.4%).  Conclusion: Age and gender affects the number of selfies one clicks. This is developing a new mental disorder ‘selfitis’ as well as desire to take dangerous selfie. There is need of health awareness programme, IEC regarding importance of healthy life style.

The Mediating Role of Selfitis in the Associations between Self-Esteem, Problematic Social Media Use, Problematic Smartphone Use, Body-Self Appearance, and Psychological Distress among Young Ghanaian Adults

Selfie-related activities have become pervasive to the point that they may affect the mental health of people who engage in them. To ascertain this mechanism, this study examined the mediating role of selfitis in the associations between self-esteem, problematic social media use, problematic smartphone use, body-self appearance, and psychological distress among young Ghanaian adults. A total of 651 participants completed a questionnaire with measures on self-esteem, body-self appearance, problematic social media use, problematic smartphone use, depression, anxiety, stress, coping skills, and selfitis. There were direct associations between all the variables except between self-esteem and selfitis. In addition, selfitis mediated the associations between problematic social media use, problematic smartphone use, body-self appearance, and psychological distress except between self-esteem and psychological distress. These findings suggest that selfitis can serve as a pathway by which people who overly engage in problematic social media use, problematic smartphone use, and have poor body-self appearance may experience psychological distress. Hence, there is a need for health communicators, school authorities, and opinion leaders to educate young adults on the consequences of the problematic use of technology, especially for selfitis behaviour. Future studies can examine the factors that predict selfitis behaviour among adults.

Selfie-related deaths using web epidemiological intelligence tool (2008-2021): a cross-sectional study

The quest for extreme selfies killed 379 people since 2008. One in three was a traveller. Falls from height, transport and drowning were the top three causes. Many selfie deaths are the result of tourists taking risks in unfamiliar terrain. Travel medicine practitioners should routinely counsel travellers on responsible self-photography.

The Central Arizona Conservation Alliance Programs: Use of Social Media and App-Supported Community Science for Landscape-Scale Habitat Restoration, Governance Support, and Community Resilience-Building

Land managers are currently faced with a nexus of challenges, both ecological and social, when trying to govern natural open spaces. While social media has led to many challenges for effective land management and governance, the technology has the potential to support key activities related to habitat restoration, awareness-raising for policy changes, and increased community resilience as the impacts of increased use and climate change become more apparent. Through the use of a case study examining the work of the Central Arizona Conservation Alliance’s social media ambassadorship and its app-supported community science projects, we examine the potential and realized positive impact that technology such as social media and smartphone apps can create for land managers and surrounding communities.

“For the Gram”: An Exploration of the Conflict between Influencers and Citizen-Consumers in the Public Lands Marketing System

Capturing memories is integral to public lands visitors’ consumer experiences. Today, social media allows us to share photographs and videos in the public domain, whether it be for instant gratification, economic gain, or both. The phenomenon of sharing public lands digital imagery on social media has created tensions in the public lands marketing system (PLMS) between those wanting to preserve the outdoors and those seeking to monetize it. Using the Instagram account @publiclandshateyou as a case study site, this research utilizes an interpretive “thick data” visual analysis to examine how interlinked marketing systems (e.g., travel, tourism, outdoor recreation), which includes the social media marketing system (SMMS) contribute to this conflict in the PLMS. Findings indicate that citizen-consumer oriented practices, rooted in “sense of place,” attempt to bring change to the interlinked marketing systems.

Online Newspaper Reports on Ambulance Accidents in Austria, Germany, and Switzerland: Retrospective Cross-sectional Review

Background

Ambulance accidents are an unfortunate indirect result of ambulance emergency calls, which create hazardous environments for personnel, patients, and bystanders. However, in European German-speaking countries, factors contributing to ambulance accidents have not been optimally researched and analyzed.

Objective

The objective of this study was to extract, analyze, and compare data from online newspaper articles on ambulance accidents for Austria, Germany, and Switzerland. We hope to highlight future strategies to offset the deficit in research data and official registers for prevention of ambulance and emergency vehicle accidents.

Methods

Ambulance accident data were collected from Austrian, German, and Swiss free web-based daily newspapers, as listed in Wikipedia, for the period between January 2014 and January 2019. All included newspapers were searched for articles reporting ambulance accidents using German terms representing “ambulance” and “ambulance accident.” Characteristics of the accidents were compiled and analyzed. Only ground ambulance accidents were covered.

Results

In Germany, a total of 597 ambulance accidents were recorded, corresponding to 0.719 (95% CI 0.663-0.779) per 100,000 inhabitants; 453 of these accidents left 1170 people injured, corresponding to 1.409 (95% CI 1.330-1.492) per 100,000 inhabitants, and 28 of these accidents caused 31 fatalities, corresponding to 0.037 (95% CI 0.025-0.053) per 100,000 inhabitants. In Austria, a total of 62 ambulance accidents were recorded, corresponding to 0.698 (95% CI 0.535-0.894) per 100,000 inhabitants; 47 of these accidents left 115 people injured, corresponding to 1.294 (95% CI 1.068-1.553) per 100,000 inhabitants, and 6 of these accidents caused 7 fatalities, corresponding to 0.079 (95% CI 0.032-0.162) per 100,000 inhabitants. In Switzerland, a total of 25 ambulance accidents were recorded, corresponding to 0.293 (95% CI 0.189-0.432) per 100,000 inhabitants; 11 of these accidents left 18 people injured, corresponding to 0.211(95% CI 0.113-0.308) per 100,000 inhabitants. There were no fatalities. In each of the three countries, the majority of the accidents involved another car (77%-81%). In Germany and Switzerland, most accidents occurred at an intersection. In Germany, Austria, and Switzerland, 38.7%, 26%, and 4%, respectively, of ambulance accidents occurred at intersections for which the ambulance had a red light (P<.001). In all three countries, most of the casualties were staff and not uncommonly a third party. Most accidents took place on weekdays and during the daytime. Ambulance accidents were evenly distributed across the four seasons. The direction of travel was reported in 28%-37% of the accidents and the patient was in the ambulance approximately 50% of the time in all countries. The cause of the ambulance accidents was reported to be the ambulance itself in 125 (48.1% of accidents where the cause was reported), 22 (42%), and 8 (40%) accidents in Germany, Austria, and Switzerland, respectively (P=.02), and another vehicle in 118 (45.4%), 29 (56%), and 9 (45%) accidents, respectively (P<.001). A total of 292 accidents occurred while blue lights and sirens were used, which caused 3 deaths and 577 injuries.

Conclusions

This study draws attention to much needed auxiliary sources of data that may allow for creation of a contemporary registry of all ambulance accidents in Austria, Germany, and Switzerland. To improve risk management and set European standards, it should be mandatory to collect standardized goal-directed and representative information using various sources (including the wide range presented by the press and social media), which should then be made available for audit, analysis, and research.

Secular trends in fall-related hospitalizations in adolescents, youth and adults: a population-based study

Background

Falls are one of the major causes of injury globally. However, there is a lack of population-based studies on falls among adolescents, young and middle-aged adults. We therefore aimed to conduct a large-scale population study on the secular trend in incidence of fall-related hospitalization.

Methods

A population-wide electronic database, Hong Kong's Clinical Data Analysis and Reporting System (CDARS), was used in this retrospective cohort study. Patients aged≥10, hospitalized with diagnosis of accidental falls (ICD-9-CM E880-E888) from 2005-2018, were included. Outcome measures included the number, age- and sex-standardized incidence rate of fall-related hospital admissions, their length of stay (LOS) and 1-year all-cause mortality. Linear regression and average annual percentage change (AAPC) using joinpoint regression were computed for trend analysis.

Findings

From 2005 to 2018, a total of 336,439 patients aged≥10 were identified with fall-related hospitalization. Among these fall patients, 33.7% occurred at age<60. The number of fall-related hospital admissions episodes increased significantly by 83.7% during the study period. The standardized incidence rate of falls per 1000 person-years increased from 3.67 (95% CI 3.62-3.72) in 2005 to 4.79 (95% CI 4.74-4.84) in 2018. Although the total hospitalized bed-days increased from 178,723 days in 2005, to 299,273 days in 2018 (+67.5%,p<.0001), the median length of stay per episode of falls decreased from 4.90 days to 3.79 days (p<.0001).

Interpretation

Continuous increase in the incidence of fall-related hospitalization in people aged≥10 was observed. This suggested that falls are a public health issue in all ages. Further studies on the differences in the underlying risk factors and comorbidities between younger and older fall patients are warranted.

Funding

None.

Travel medicine meets conservation medicine in St. Kitts: Disinhibition, cognitive-affective inconsistency, and disease risk among vacationers around green monkeys (Chlorocebus sabaeus)

Despite concern about environmental protection, travelers often underestimate the contribution they may have to disease transmission to other species, as well as the risk of becoming infected themselves. Tourists in general tend to accept more physical risks when traveling than when at home, and much of this can be blamed on the temporary loss of situational awareness and loss of inhibition with a corresponding relaxed attitude toward safety. To better understand environmental attitudes and travel health knowledge and behaviors, a detailed survey of adult tourists was distributed on the island of St. Kitts, home to many green monkeys. Data from 1097 respondents were collected at two locations where cruise ship passengers typically visit the island. Results revealed that even though individuals with more positive environmental attitudes were more willing to take steps to mitigate tourism-related disease transmission, they were also more likely to report wanting to touch or feed a monkey/ape. Similarly, those more willing to prevent the spread of diseases (e.g., wear a mask and report any illnesses to park authorities) were actually more likely to want to touch or feed a monkey/ape. The human desire for physical contact with other species may be partly the result of biophilia, emotionally arousing events (like contact with exotic species) that can lead to further disinhibition, and social media platforms that provide opportunities for exhibitionism. The attitude-behavior incongruency identified here may also be explained through cognitive-affective inconsistency: environmentally-oriented individuals believe that it is prudent to take steps to prevent zoonotic disease transmission but also desire to touch or feed exotic species as it may be emotionally rewarding. Individuals for whom physically interacting with monkeys/apes may be emotionally rewarding may not alter their behavior in response to cognitive means of persuasion; techniques aimed at appealing to emotions may be more effective.

Prevalence and determinants of the dangerous selfie among medical and nursing students: a cross-sectional study from eastern India

BACKGROUND

Globally, there has been an exponential rise in smartphone use and selfie taking among youth. To make selfies exciting, dangerous selfies are often taken that may lead to catastrophic consequences, including death. This study aims to estimate the prevalence of dangerous selfies and to determine the factors associated with dangerous selfies among medical and nursing students in India.

METHODS

The study was conducted at the All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India, in April-August 2018. The inclusion criteria were students enrolled in the Bachelor of Medicine and Bachelor of Surgery (MBBS) and nursing courses of AIIMS, Bhubaneswar. Students who did not use smartphones were excluded from the study. The interview schedule and Selfitis Behaviour Scale (SBS) were used to collect information on sociodemographic variables, smartphone use and variables related to selfies and dangerous selfies. Forward stepwise logistic regression was undertaken with the probability of entry and removal as 0.05 and 0.10, respectively.

RESULTS

Of 633 eligible participants, 595 were included in the study. The mean (SD) age of the participants was 21.2 (1.6) years. More than half (56.8%) of the participants were female, 384 (64.5%) were medical students and 211 (35.5%) were nursing students. Nearly two-thirds of the participants (70.6%) preferred to take selfie. One hundred thirty three (40.3%) of the participants posted selfies on social media daily. The prevalence of dangerous selfies was 8.74% (95% CI: 6.73-11.28). Eight injury episodes while taking selfies were reported by seven (1.2%) participants. Being male (AOR 4.96, 95% CI 2.53-9.74), posting selfies on social media daily (AOR 3.33, 95% CI 1.71-6.47) and an SBS score > 75 (AOR 4.97, 95% CI 1.43-17.28) were independent predictors of dangerous selfies.

CONCLUSION

Nearly one in ten medical and nursing students reported having taken a dangerous selfie, and one in one hundred reported having been injured while attempting to take a selfie. Being male, posting selfies on social media daily and an SBS score > 75 were independent predictors of dangerous selfies. Further research is required to identify the community burden of dangerous selfies and to develop strategies to prevent selfie-related fatalities among youths.

Media-Based Research on Selfie-Related Deaths in Italy

BACKGROUND

The incidence of taking selfies and sharing them on social media as well as selfie-related dangerous behaviors is increasing, particularly among young people, also leading to selfie-related trauma and death. This study was performed to obtain epidemiological characteristics of selfie-related mortality in Italy.

METHODS

Scientific literature and Italian media were reviewed.

RESULTS

Twelve victims from 11 events, from 2014 to 2018, were analyzed (sex, age, accident types, the nationality, the Italian region where the incident took place, if the person involved was indigenous or a tourist, the dynamics and the causa mortis, if other people have been involved in the selfie, and if other people were deceased). The majority of selfie victims were male teenagers, the average age was 23.6 years, the most preferred site of taking selfies was the natural environment followed by the railway one, the most frequently reported event or accident type was falling from a height, and the most frequent causes of selfie-related deaths were multitrauma and drowning.

CONCLUSIONS

Selfie-related deaths in Italy appear to be an issue and appear to be increasing. Particularly, male teenagers and young adults are at high risk for selfie-related deaths. Measures should be taken to reduce their incidence.

Future Teachers’ Smartphone Uses and Dependence

Smartphones are indeed becoming an essential tool in the daily lives and relations of their users in recent years, thanks to their uses and potential. However, excessive and inappropriate use can lead to dependence syndromes. The objectives of our study were to ascertain how these devices are being used and whether students are at risk of addiction. The study was carried out based on a survey with students—future teachers—from two Spanish universities. A sample of 453 students between the ages of 18 and 47 was analyzed, 76.8% female and 23.2% male. Smartphones were found to be the preferred Internet connection device for 80% of students, 38% of students connect to the Internet five hours or more a day (which can be considered an addiction) and smartphones are used primarily to connect with others (social media and instant messaging). The abusive use of smartphones affects men’s behavior more than women and can lead them to neglect other activities, while smartphones affect women more in the emotional field, in matters related to boredom, impatience, and irritability.