Safe Space Research Articles

Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study

This cadaveric study aimed to evaluate the safety and usability of a novel robotic system for posterior cervical pedicle screw fixation. Three human cadaveric specimens and C2-T3 were included. Freshly frozen human cadaver specimens were prepared and subjected to robot-assisted posterior cervical pedicle screw fixation using the robotic system. The accuracy of screw placement, breach rate, and critical structure violations were evaluated. The results were statistically compared with those of previous studies that used different robotic systems for cervical pedicle screw fixation. The robotic system demonstrated a high accuracy rate in screw placement. A significant number of screws were placed within predetermined safe zones. The total entry offset was 1.08 ± 0.83 mm, the target offset was 1.86 ± 0.50 mm, and the angle offset was 2.14 ± 0.77°. Accuracy rates comparable with those of previous studies using different robotic systems were achieved. The system was also feasible, allowing precise navigation and real-time feedback during the procedure. This cadaveric study validated the safety and usability of the novel robotic system for posterior cervical pedicle screw fixation. The system exhibited high precision in screw placement, and the results support the extension of the indications for robot-assisted pedicle screw fixation from the lumbar spine to the cervical spine.

Grief and Collaborative Storytelling: The Colours of Loss

ABSTRACT This article describes a novel methodology for involving the public in a creative co-produced project about grief, which invited bereaved people to work together to create a fictional story about loss and then reflect on the experience in focus groups. Devised by Crowded Room Theatre Company and researchers at the University of Bristol, the project aimed to explore the risks and benefits of collaborative storytelling about emotionally charged subjects. Thematic analysis of the focus group transcripts generated seven themes: storytelling as protective and enabling; support and understanding; new perspectives; connecting to grief and loved ones who have died; complicated emotions; workshop anxiety; and anticipating the audio story. These findings corroborate research that suggests storytelling can provide a safe space to explore and make meaning from difficult emotions and experiences; it may also appeal to bereaved individuals who are less likely to attend conventional support groups. The audio story created from the workshop recordings is available online (https://www.spreaker.com/episode/the-colours-of-loss–53334166).

DETERMINANTS OF CHILDHOOD OBESITY: A REGRESSION ANALYSIS OF SOCIOECONOMIC AND ENVIRONMENTAL FACTORS

Childhood obesity is a complex public health issue with significant implications for long-term health outcomes and healthcare costs. This study investigates the determinants of childhood obesity, focusing on socioeconomic and environmental factors. Data were collected from 310 children and their families using a structured questionnaire from Jodhpur City. Socioeconomic variables included parental education level and household income, while environmental factors encompassed access to healthy food options and safe outdoor spaces for physical activity. Multiple regression analysis examined the relationship between these factors and childhood obesity, controlling for potential confounders. Results indicate that parental education level and household income were inversely associated with childhood obesity, suggesting that higher socioeconomic status may protect against obesity risk. Additionally, access to healthy food options in the neighborhood emerged as a significant predictor of childhood obesity, highlighting the importance of environmental factors in shaping dietary behaviors. These findings underscore the need for multifaceted interventions targeting socioeconomic disparities and ecological barriers to promote healthy weight among children. Effective strategies may include improving access to nutritious foods and creating supportive environments for community physical activity. Addressing the determinants of childhood obesity is crucial for mitigating its adverse health effects and reducing the burden on healthcare systems. KEYWORDS: Childhood Obesity, Public Health, Healthy Lifestyle, Socioeconomic Factors, Physical Activity

Poetic inquiry into the role of mentorship for marginalized migrants

ABSTRACT This paper explores the role of mentorship on inclusivity and belonging among marginalized migrants, through the experiences of a Pakistani Muslim woman academic in Canada. Using storytelling and poetic inquiry, it examines identity shifts and cultural adaptation, calling for empathetic and inclusive mentorship. Tangled thoughts freefall in poetry, An outsider amongst new faces, Rebuilding my life on my own, I wish to be home, Empty spaces beneath my colored skin, Wearing a migrant suit upon Muslim roots, Like a dandelion in the breeze, The day I heard my own heart break, As its pieces scattered on the concrete, Then my head dropped on a mentors’ shoulder, Where I was heard and seen. Another mentor pulled me up the wobbly ladder, Another introduced me to inclusivity, See the sunlight dance thru the cracks? As I outstretch my safe space, And now my heart overflows with gratitude, For my community of mentors.

Accuracy of cup placement compared with preoperative surgeon targets in primary total hip arthroplasty using standard instrumentation and techniques: a global, multicenter study

BackgroundAcetabular cup positioning in total hip arthroplasty (THA) is closely related to outcomes. The literature has suggested cup parameters defined by the Lewinnek safe zone; however, the validity of such measures is in question. Several studies have raised concerns about the benefits of using the Lewinnek safe zone as a predictor of success. In this study we elected to use prospective surgeon targets as the basis for comparison to see how successful surgeons are positioning their cup using standard instruments and techniques.MethodsA prospective, global, multicenter study was conducted. Cup positioning success was defined as a composite endpoint. Both cup inclination and version needed to be within 10° of the surgeon target to be considered a success. Radiographic analysis was conducted by a third-party reviewer.ResultsIn 170 subjects, inclination, target versus actual, was 44.8° [standard deviation (SD 0.9°)] and 43.1° (SD 7.6°), respectively (p = 0.0029). Inclination was considered successful in 84.1% of cases. Mean version, target versus actual, was 19.4° (SD 3.9°) and 27.2° (SD 5.6°), respectively (p < 0.0001). Version was considered successful in 63.4% of cases, and combined position (inclination and version) was considered successful in 53.1%.ConclusionThis study shows that with traditional methods of placing the cup intraoperatively, surgeons are only accurate 53.1% of the time compared with a predicted preoperative plan. This study suggests that the inconsistency in cup positioning based on the surgeon’s planned target is potentially another important variable to consider while using a mechanical guide or in freehand techniques for cup placement in THA.Trial Registration: This study is registered on ClinicalTrials.gov, NCT03189303.

Membangun Kesehatan Mental Generasi Alpha: Urgensi Konseling dalam Mengatasi Tantangan Bullying di Era Sosial Media Melalui Komunikasi Empati

This research aims to determine the urgency of counseling in overcoming the challenges of bullying in the era of social media through empathetic communication. This research is a qualitative-descriptive study with a phenomenological approach to observe and describe natural phenomena that occur in the alpha generation in the social media era. Research data was obtained from bullying cases on social media, as well as from journal articles and other relevant literature. Analysis of this research data involves data reduction, data presentation, and conclusion. The validity of the research data was carried out using triangulation testing. The results of this research show that building the mental health of the Alpha generation through counseling is essential in the modern era filled with technology. Counseling creates a safe space to share experiences and feelings, helping them manage technological stress and social pressure. Addressing bullying in the age of social media requires empathetic communication, approaching the perpetrator with tact, providing positive support, and creating a safe place to talk. This can form a culture that is friendly, and supportive, and teaches the values of diversity and respect for others. Counseling and empathetic communication are not only solutions to psychological problems and bullying, but also a strong foundation for the mental and emotional well-being of the Alpha generation in an ever-changing world.

Kerklike tug: Verleentheid of nuwe geleentheid?

Church discipline: embarrassment or a new opportunity? In 2004, 2007 and 2011 the General Synod of the Dutch Reformed Church decided that the way in which church discipline functions in the church, should be researched and investigated. This article is based on the doctoral study of the co-author, who tragically died of COVID-19 during the pandemic of 2020-2021. She investigated the development of church discipline in the Dutch Reformed Church from 1652 to the present day, to determine why church discipline has become an embarrassment to the church. This article is based on a part of the outcome of her research. The article discusses the purpose, nature of and need for church discipline, and states that the way in which members of the church understand discipline in the church, should change. The authors emphasise that church discipline must be built on the foundation of brotherly love within the framework of tolerant care. This will not only help to change the understanding of informal and formal church discipline but will also challenge the church to create a safe space for confession, forgiveness, and reconciliation. By doing so, church discipline as tolerant care will become part of the spiritual journey of members of the church. As such, it will change from being an embarrassment to becoming a huge opportunity for spiritual growth.Intradisciplinary and/or interdisciplinary implications: The article focuses on church discipline as tolerant care. In doing so, church discipline does not only function as part of the study field of Church Polity, but it also incorporates Practical Theology. The most important implication is that discipline is understood as care.

En] Exploring safety and agency in social media: a case study of online crossdressing

Introduction. Are there safe spaces for the construction of online communities with diverse gender identities and sexual desires? What makes some online spaces safer than others? And for whom? Does the architecture of these spaces influence the ways in which users navigate the Internet? Methodology. To address these questions, we conducted a digital ethnography on a social media platform oriented towards the Spanish-speaking crossdresser community. Findings and analysis. Our analysis suggests that this platform acts as a digital counterpublic, as it allows users to inhabit a safe environment for self-expression, building support networks, organizing as a collective, and articulating their sexual intimacies. Based on these findings, we infer that online safety and agency are closely interrelated, the latter being a result of the first. In addition, we found that the concept of online safety should be evaluated on a case-by-case basis, in accordance with the feminist perspective, where online safety is always construed in a situated manner and conceives the subjects of study as active agents involved in the definition of the concept itself. Ethical considerations. The research process raised ethical questions of great relevance to the conclusions of this study, suggesting that the same factors to be considered when conducting research in digital platforms should be contemplated when designing and navigating online safe spaces. We thus propose that, both in carrying out online qualitative research and in the construction of online safe spaces, the following aspects should be taken into consideration: the implications of the privacy settings offered by the platform, the vulnerability of the users that populate it, the sensitivity of the topics covered by the platform’s community and, last but not least, an ongoing negotiation and reaffirmation of consent in the utilization of the users’ personal data.

“You Can Be Whatever You Want to Be” Except for on Shabbat: Challenging the Traditional Shabbat Party

ABSTRACT Within Orthodox Jewish early childhood programs, gender roles of the Shabbat Party promote heteronormative gender expectations that contend with values about children, teaching, and Judaism. Interviews with 15 educators suggested tensions between gender flexible attitudes and beliefs that gender unfolds naturally. Pretend play was considered a safe space for challenging gender, regulated by perceived sociocultural and religious boundaries. Conversely, the Shabbat Party roles were rigidly instituted without much examination of their implications for gender and Jewish identity development. While a few dissenting voices revealed an emerging gender consciousness, the ongoing need for dialogue, reflection, and gender flexible practices are recommended.

One-Point Technique in Brainstem Cavernous Malformation Surgery: Evaluation of Approaches and Outcomes From a Different Perspective.

Brainstem cavernous malformations (BCMs) are a distinct clinical entity that carry a high risk of patient morbidity because of location and risk of hemorrhage. Surgical management of these lesions requires intimate knowledge of surgical anatomy and skull base approaches. This article is intended to highlight a modern approach for the treatment of BCMs, with an emphasis on the use of the one-point technique to guide resection. We describe a case series of BCMs treated through a variety of skull base approaches, describing our decision-making strategy. We review the concept of the one-point technique focusing on the safest access to the malformation through 2 representative cases and also perform a retrospective review of 32 consecutive patients who underwent BCM resection to present outcomes and the comparison of two-point vs one-point techniques. Consecutive series of 32 patients in whom the one-point technique was used is presented. In 8 patients (25%), the traditional two-point technique would suggest a different trajectory than the one-point technique. Postoperative MRI confirmed complete resection in 30 patients (95%), and 29 patients (91%) had modified Rankin Scale (0-2) at follow-up. All patients in whom the one-point technique guided a different trajectory had gross total removal of the cavernous malformation, with one patient having long-term new neurological impairment from the surgery. There were no mortalities. Despite surgical advances in recent decades and more widespread understanding of surgical anatomy and safe entry zones, surgical resection of BCMs remains a formidable challenge. While not necessarily the shortest access, the one-point technique offers a safe approach considering all the different modalities in our armamentarium and can be used as part of a strategy to determine the optimal approach to resect BCMs.

Methods for dreaming about and reimagining digital education

Utilising emancipatory approaches to educational technology in higher education allows welcoming creative and artistic modes of inquiry. This article presents two methods, a virtual makerspace and a guided fantasy story that were applied in a project concerned with rewilding higher education pedagogy. It is argued that the methods encouraged curiosity and care to address diversity and inclusion. They afforded mindfulness of individual needs and welcomed explorations of new directions that challenged potential biases (gender, race, disability or professionality). The article illustrates how these two methods may offer a safe space to dream and imagine educational spaces.

Is There Safety Outside the “Safe Zone” in Total Hip Replacement? A Retrospective Observational Study

Background and Objectives: The safe zone in total hip replacement was introduced many years ago. Its aim was to provide guidelines for orthopedic surgeons in order to avoid complications such as instability. With the growing interest in spinopelvic alignment, some new insights suggest that the safe zone is an obsolete concept. This study aims to show that, even outside the safe zone, the effect of total hip replacement can be satisfactory. This could be used as preliminary study for an analysis of a larger group. Materials and Methods: Fifty-nine consecutive patients with end-stage osteoarthritis treated by total hip replacement were enrolled into the study and divided into two groups: inside the safe zone and outside the safe zone. A physical examination during postoperative visits was performed; the range of movement was measured using a goniometer; and the HHS and VAS were taken to measure functional outcomes and pain, respectively. An analysis of the radiological outcomes was performed. Results: There was no significant difference in regard to changes in total offset, pain, HHS and other complications. There were no signs of instability among patients during the follow-up. Conclusions: The results of this study show that the “safe zone” is a more complicated term that was previously thought. A proper soft tissue balance and spinopelvic alignment could be factors that change the “safe zone” for each patient and make it more individual.

Well-being in newly qualified doctors: exploring the value of peer-led reflective sessions

IntroductionFollowing the COVID-19 pandemic and ongoing pressures within the National Health Service, there has been an increasing concern about the well-being of junior doctors in the UK. Newly qualified doctors...

Enabling comprehensive assessment of marine eutrophication impacts and their evaluation against regional safe operating space

Abstract Purpose Nitrogen emissions from human activities are contributing to elevated levels of eutrophication in coastal ecosystems. Mechanisms involved in marine eutrophication show strong geographical variation. Existing life cycle impact assessment (LCIA) and absolute environmental sustainability assessment (AESA) methods for marine eutrophication do not adequately represent this variability, do not have a full global coverage, and suffer from other limitations, such as poor estimation of coastal residence times. This study aims to advance LCIA and AESA for marine eutrophication. Methods We aligned and combined recent advancements in marine eutrophication LCIA and AESA methods into one method. By re-running models underlying the combined methods and incorporating additional data sources, we included marine regions missing in previous methods and improved fate modeling, with the inclusion of denitrification and plant uptake in the air emission-terrestrial deposition pathway. To demonstrate and validate our method, we applied it in a case study. Results The developed method allows the assessment of marine eutrophication impacts from emissions to soil, freshwater, and air at high resolution (0.083° and 2° × 2.5° for inland and air emissions, respectively) and spatial coverage (all ice-free global continents). In the case study, we demonstrate the added value of our method by showing that the now quantified spatial variability within spatial units, e.g., river basins, can be large and have a strong influence on the modeled marine eutrophication from the case study. Compared to existing methods, our method identifies larger occupations of safe operating space for marine eutrophication, mainly due to the high resolution of the coastal compartment, reflecting a more realistic areal extent of marine eutrophication impacts. Conclusions Although limited by factors such as simulations based on a single reference year for modeling inland and air fate, our method is readily applicable to assess the marine eutrophication impact of nitrogen emitted to any environmental compartment and relate it to the safe operating space. With substantial advancement of existing approaches, our method improves the basis for decision-making for managing nitrogen and reducing emissions to levels within the safe operating space.

Radiographic study of direct anterior approach hip arthroplasty: a 10–15 year follow-up of Chinese patients

BackgroundControversy remains over whether different surgical approaches exert an impact on the component positioning in total hip arthroplasty. We conducted a retrospective study to reveal the long-term position of prostheses in the first group of patients in China who underwent direct anterior hip arthroplasty.MethodsCollected were data from 350 patients who underwent direct anterior hip arthroplasty between 2008 and 2013, including demographic information, imaging data, Harris hip scores, and surgical complications. Variables, measured radiographically or by CT, included hip offset, leg length discrepancy, component position, and stability within one week after surgery and at the last follow-up. The data were subjected to statistical analysis by using paired t-tests and Pearson chi-square tests.ResultsData were harvested by follow-up and self-reported questionnaires. The postoperative follow-up lasted for 13.1 years on average (minimum, 10 years; maximum, 15 years), and the overall survival rate of hip prostheses was 96.3%. The mean Harris score at the final follow-up was 91.8 points. After excluding patients with significant preoperative hip deformities, the incidence of postoperative limb inequality (> 5 mm) was 4.9% at the last follow-up, and the incidence of hip offset discrepancy (> 5 mm) was 14.6%. The overall proportion of the acetabular components located in the Lewinnek safe zone was 77.7%, whereas the proportion of femoral prostheses in the safe zone (< 3° inclination) was 94.0%. Based on the revised data and the last follow-up imaging, the total proportion of acetabular and femoral prostheses with a radiolucence of > 2 mm was 5.1%.ConclusionDirect anterior approach hip arthroplasty could achieve excellent component positioning and long-term prosthesis survival in patients without severe hip deformities.

Redefining Academic Safe Space for Responsible Management Education

AbstractIn a time of increasing polarization, how can we address sensitive topics and ensure that university classrooms remain places of healthy discussions and ethical deliberations? This paper addresses this important question by drawing on unique qualitative data from our students’ accounts of their experience in an organizational ethics course. We developed the course using a novel pedagogical strategy centered around the creation of an artistic portfolio. We find that student engagement in an alternative individual space, such as the artistic portfolio, supports them in developing (inter)personal skills in preparation for constructive participation in sensitive discussions and ethical deliberation in the classroom. Additionally, engagement with the artistic portfolio provides them with an alternative means for alleviating tension that arises from these discussions and a space for expressing their opinions. Our findings highlight the role of the portfolio as an individual safe haven that supports teachers in facilitating a positive classroom atmosphere and guides students through challenging discussions and deliberations intrinsic to responsible management education. Considering these new insights, we advocate for a shift from a collective to an individual perspective on safety in academia. This transition liberates the classroom from the constraints and limitations often associated with the establishment of collective safe spaces.

Safety-critical control of planar quadcopters under dynamic event-triggered mechanism

This paper aims to solve the problem of safety-critical control, i.e., safe flight of planar quadcopters in complex environments. By introducing input-to-state safe barrier function (ISSf-BF), the attitude, position, speed, and other key parameters of planar quadcopters are fully considered to realize safety-critical control. Also, a dynamic event-triggered mechanism (DETM) is constructed, and Zeno phenomenon is ruled out based on the constructed DETM. By monitoring the relative distance and speed changes between planar quadcopters and the boundary of the safe zone, the control action is triggered only when the control strategy needs to be adjusted, which effectively reduces the unnecessary waste of computation and communication resources. Finally, a series of simulation experiments are demonstrated to verify the feasibility of the proposed method.

Forest Disputes: Socially Engaged Art and Forest Science for Understanding Sustainability Challenges

This paper explores activist art's potential in promoting environmental awareness and community engagement, drawing from the International Socially Engaged Art Symposium (ISEAS). Focused on a Western Lapland ISEAS event, the study highlights art workshops addressing forest use conflicts facilitated by artist-scientist teams. These workshops offer a secure space for participants to express environmental concerns, fostering creative expression and dialogue. The study suggests that art-based interventions powerfully promote environmental awareness and community engagement by creating safe spaces for collaborative dialogue. Through ISEAS experiences, the paper demonstrates how activist art facilitates meaningful community engagement, fostering a deeper understanding of environmental challenges. 

An integrated approach for sewage diversion: Case of the Huayuan mine, Hunan Province, China

Environment protection is a core priority for many governments in this century. Most environmental problems have diverse causes: emission of greenhouse gases from fossil fuels, resource depletion, or intense mining activities such as the Huayuan manganese mine. The positioning of mining factories and water treatment stations impacts the surrounding groundwater reservoir. As the mine expands, the environmental impact also increases, and the previous plan based on monitoring wastewater leakage has become inappropriate. Therefore, to solve this issue, a new study is required to understand the lateral resistivity distribution underground and to define a new station location for water treatment and divert the sewage to that station. In this study, the audio-frequency magnetotelluric method is used. Surveys of two long lines that cross the mining area to its boundaries are carried out. Data are robustly processed and inverted. Based on the inverted models, in addition to the geologic information, drilling inspections, and solid waste distributions map, the integrated interpretation develops two sites on the top of impermeable layers, which constitute a buffer point between the unsafe (high concentration of pollutants) and the safe zones in the northwestern part of the mine. From the resistivity distribution combined with the water quality analysis, a relationship between the fault structures reveals an interconnected conductive zone (CZ) in the southeastern part. As the main channels for water circulating underground, these CZs delineate the main groundwater reservoir with a clastic aquifer layer. However, close to factories, the water from faults contains solid wastes, thereby making the groundwater in that zone nonpotable, unlike the safety zone located in the northwestern part. This workflow can become a field guide to improve the environment of mines and the deployment of hydrogeologic drilling in a safe area.

Abstract PO2-11-12: The power of storytelling to heal, build community, and understand the experiences of Black breast cancer survivors

Abstract Background: The BRIDGE community focus group was designed to support and empower current and former Black breast cancer patients. The overarching goals of the focus group were to provide a mechanism for participants to amplify their voices through storytelling, foster healing, and establish a supportive community. Additionally, the research team aimed to gather qualitative data on social support, treatment adherence barriers, interactions with medical providers, and experiences with race and racism within and outside of the healthcare system. Approach: The focus group consisted of six sessions, each with a specific agenda and activities. Participants were encouraged to keep journals throughout the program. Each session began with an icebreaker and journal discussion. Session-specific activities were designed to encourage self-reflection, exploration of personal identities, and discussion of fears. These topics were explored through creative outlets such as role-play, storyboards, and jewelry-making. Each session ended with a unifying affirmation and opportunity for fellowship. Results: We enrolled 10 Black women previously diagnosed with breast cancer and provided a safe space for them to reflect on their breast cancer journey, associated fears, and the role of race in their healthcare experience. Participants discussed positive and negative experiences with healthcare providers, highlighting the knowledge and access gaps that often exist in marginalized communities. The program also provided insights into the multi-level concept of support and its impact on breast cancer outcomes. Participants discussed the positive aspects of familial and community support but identified several areas where system and structural supports may have improved their outcomes. After completing all six sessions, women reported an improvement in their overall self-actualization and purpose—with several describing their time in the program as ‘life-changing’. Notably, the focus group facilitated deep connection and friendship among participants and improved general wellness and satisfaction. Discussion: Through the sharing of personal narratives and supportive discussions, the focus group created a safe environment where participants felt empowered to express their emotions, address challenges, and dismantle fears related to breast cancer mortality. The BRIDGE research team will summarize the themes that emerged across sessions to share with scientific, clinical, and community stakeholders. In parallel, they will explore opportunities for continued community building and support for participants beyond the focus group sessions. Overall, this storytelling focus group showcased the significance of amplifying the voices of historically marginalized groups, providing support, and fostering community. The insights gained have the potential to inform future interventions and support services for Black breast cancer survivors, addressing their unique needs and challenges and ultimately improving cancer health equity. Citation Format: Lauren McCullough, Cynthia Young, Chava Bowden, Madison Gardner, Breanna Berry, Alexix Smith, Jacquelyn Anthony Bryant. The power of storytelling to heal, build community, and understand the experiences of Black breast cancer survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-12.