Purpose The purpose of this study was to gain new insights into the epidemiologic characteristics of patients with atlas fractures and to retrospectively evaluate complication rates after surgical and non-surgical treatment. Methods In a retrospective study, consecutive patients diagnosed with a fracture of the atlas between 01/2008 and 07/2018 were analyzed. Data on epidemiology, concomitant injuries, fracture patterns and complications were obtained by chart and imaging review. Results In total, 189 patients (mean age 72 years, SD 19; 57.1% male) were treated. The most frequent trauma mechanism was a low-energy trauma (59.8%). A concomitant injury of the cervical spine was found in 59.8%, a combined C1/C2 injury in 56.6% and a concomitant fracture of the thoraco-lumbar spine in 15.4%. When classified according to Gehweiler, there were: 23.3% type 1, 22.2% type 2, 32.8% type 3, 19.0% type 4 and 1.1% type 5. Treatment of isolated atlas fractures (n = 67) consisted of non-operative management in 67.1%, halo fixation in 6.0% and open surgical treatment in 26.9%. In patients with combined injuries, the therapy was essentially dictated by the concomitant subaxial cervical injuries. Conclusions Atlas fractures occurred mainly in elderly people and in the majority of the cases were associated with other injuries of the head and spine. Most atlas fractures were treated conservatively. However, surgical treatment has become a safe and valid option in unstable fracture patterns involving the anterior and posterior arch (type 3) or those involving the articular surfaces (type 4).1. Atlas fractures occurred mainly in elderly people and in the majority of the cases were associated with other injuries of the head and spine.
2.A concomitant injury of the cervical spine was found in 59.8 %, a combined C1/C2 injury in 56.6 %.3. Most atlas fractures were treated conservatively. However, surgical treatment has become a safe and valid option in unstable fracture patterns involving the anterior and posterior arch (type 3) or those involving the articular surfaces (type 4).Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The standardized, indicated school-based prevention program "Networks Against School Shootings" combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence. An evaluation study in 98 German schools with 3,473 school staff participants (M age = 46.2 years) used a quasi-experimental comparison group design with three measurement points (pre, post, and 7 months followup) with schools randomly allocated to implementation conditions. The study found increases in teachers' expertise and evaluation skills, enhanced abilities to identify students experiencing a psychosocial crisis, and positive secondary effects (e.g., teacher-student interaction, feelings of safety).
Digital communication technologies play an important role in the social development of young people, but can create vulnerabilities to cyberbullying and other negative online experiences. The Blurred Lives project aimed to tackle cyberbullying innovatively using a co-participatory approach, collaborating with 14-16-year olds living in areas of socioeconomic disadvantage in five European countries. In phase one, 2,658 teenagers were surveyed on their internet use and any unpleasant online experiences. This data informed the second phase where the participating countries worked together with 237 adolescents across 10 schools with adult facilitators to create original anti-cyberbullying resources for teachers, parents/carers, peers, and social media providers using the Quality Circle approach. This methodology adopts an ethos of working together to solve a problem in small, peer-led groups. Each group was tasked with creating a resource for one of the target audience groups. The final resources comprise a rich variety of different formats including videos, comic strips, a board game, leaflets, posters, and newsletters. The pupil feedback highlights, for most but not all participants, an increased knowledge of cyberbullying and e-safety skills, as well as enhanced problem-solving skills, levels of confidence, and group work skills. Several operational challenges are also discussed, including the importance of school-level support, planning, staffing, and finding an appropriate balance between facilitator support and pupil agency.
The standardized, indicated school-based prevention program "Networks Against School Shootings" (NETWASS) combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence. The present review summarized the underlying program theory, gives examples from German cases of severe targeted violence, gives an overview of the program components, and a summary of the evaluation study and its results. Finally, the NETWASS crisis prevention approach is reflected with regard to its feasibility for the prevention of violent extremism.
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