bluuebunny/crossref_metadata_2025 huggingface dataset:
OS USOS DO TERRITÓRIO E A GESTÃO DE ÁREAS PROTEGIDAS: O CASO DA APA CARAÍVA TRANCOSO (PORTO SEGURO, BA)
Authors: Côrtes Raíssa Tamassia , Damasco Fernando Souza
Published: November 2020

Frente a acordos internacionais de comprometimento com a conservação da biodiversidade, o governo brasileiro institui o Sistema Nacional de Unidades de Conservação (SNUC), pela Lei Federal nº 9.985/2000, como uma de suas principais estratégias de ordenamento territorial com vistas a conservação de áreas naturais remanescentes. Apesar desta política trazer instrumentos que procuram prever a participação da comunidade no processo de gestão dessas áreas protegidas, sua ineficiência nesse processo indica que outras análises, que considerem o território efetivamente usado pelas comunidades dentro dessas unidades de conservação (UC), podem trazer subsídios para a compreensão do território e para a implementação desses instrumentos. Sendo assim, o presente trabalho apresenta uma metodologia de mapeamento dos usos do território dentro de uma UC de uso sustentável, a Área de Proteção Ambiental Caraíva Trancoso (Porto Seguro, BA). A proposta considera a caracterização da estrutura territorial da UC, a identificação e classificação dos agentes territoriais, para, por fim, espacializar os usos do território. Para além da distribuição geográfica dos tipos de uso e cobertura, o estudo dos usos do território nos permitiram entender como os diferentes sujeitos sociais usam o seu território: como se relacionam com ele e entre si, e de que forma isso reflete no ambiente em que vivem. Essa perspectiva analítica mostrou-se instrumento potencial para a gestão de áreas protegidas que seja verdadeiramente comprometida com os usos tradicionais e com os pressupostos de consulta e participação das comunidades.
O PAPEL CENTRAL DAS UNIDADES DE CONSERVAÇÃO E DA ATIVIDADE TURÍSTICA NA DINÂMICA ESPACIAL DA ILHA GRANDE – RJ
Authors: Gomes Johana Maiy Alecrim Alves
Published: November 2020

A Ilha Grande, recorte espacial do estudo da presente pesquisa, é distrito do município de Angra dos Reis, no litoral sul do estado do Rio de Janeiro. O objetivo do trabalho é investigar o processo do crescimento da atividade turística na área que foi concomitante ao crescimento da implantação de áreas protegidas, analisando o papel central desses dois aspectos na dinâmica espacial da Ilha. Para a realização dessa investigação, foi realizado levantamento e posterior análise bibliográfica acerca dos temas que compõem o trabalho, como a questão de áreas protegidas em comunidades tradicionais, também revisão de legislação ambiental e turística, planos diretores e de manejo, além de trabalhos de campo entre os anos de 2016 e 2019. Diante dos resultados encontrados, é possível afirmar que hoje a Ilha Grande tem seu papel definido enquanto área protegida e turística.
Placement Strategies of World's Top Business Schools
Authors: Shenoy Varun , Aithal P. S.
Published: November 2020

Institutional Ranking in higher education space has become a very important practice and management institutions across the world are greatly profited by the published global rankings based on various criterions. The ranking is usually publicised depending upon Institutional infrastructure, their employment &placements, teaching pedagogy, research
output, faculty-student ratio, international linkage, application of technology in teaching – learning process etc. In this study, we have chosen to research the placement strategies of global top 10 listed institutions 2017 by Financial Times (FT) to ascertain a meaningful picture of their career offerings and strategies in attracting market. An effort is also being put towards exploring various strategic industry-interaction initiatives and interview scheduling practices of top ranked world's management institutions. Their student career statistics are also examined and analysed to ascertain the learning outcome arising post implementation of identified strategies.
A Customized and Flexible Ideal Mobile Banking System using 5G Technology
Authors: Krishna Prasad K. , Aithal P. S.
Published: November 2020

The word Ideal System refers to a system which is optimal or finest in terms of all its characteristics and any existing system can be improved or converted into the Ideal system by comparing existing system to Ideal system and by doing research and innovation. Mobile banking business will enable banking organizations to expand their markets, improve their services to all corners of the world without any barriers in terms of time, location and place. The rapid increase of mobile phone users is closely followed by security problems. The objective of this paper is to suggest some characteristics that will solve problems like security, bandwidth, network coverage, speed and much more. Fifth Generation (5G) mobile wireless communication technology an advanced modern upcoming technology that has significant change or difference in terms of bandwidth, speed access, and zone issues compare to its predecessors. In this paper, the concept of the Ideal mobile banking system is discussed, based on developing a suitable model with the predicted system and environmental characteristics which is ultimately very much user-friendly, customization and flexible in nature. To realize Ideal system model we have taken up 5G mobile wireless communication technologies and discussed how it will support Ideal mobile banking model by providing characteristics in terms of speed, bandwidth, data transfer rate, signaling efficiency and all advanced services. The paper makes an analysis of new model with its advantages, benefits, constraints, and disadvantages.
Evolution of Payment System
Authors: Donald Menezes Amith , Pinto Prakash
Published: November 2020

Clearing has been an important part of the banking system and will always remain a
part of it for years to come. Clearing in banking indicates the transfer of fund from one
person to another. This clearing of the fund can take place in 2 ways either through
cash or through cheque. There has been no major change in the cash transactions
except for the changes in the value of money. However, the cheque clearing system has
undergone lot of changes. The origin of cheque can be traced back to the first century
AD, where banks in and around Persia used to issue letters of credit called “Sakks”
wherein the banks used to pay the identified payees as per the instructions. This
eliminated the cumbersome process of carrying money or gold which was very risky.
Changes have taken place in cheque clearing over the period of time. From ordinary
cheque clearing to MICR clearing and finally to the latest in clearing ‘Cheque
Truncation System’. This is a conceptual paper which tries to explore the changes that
have taken place in the bank clearing system in the past, present and will also try to
visualise the future of bank clearing.
Review on the Gender Sensitive Women Education- Legal Revolution in Higher Education
Authors: M.D. Pradeep , B.K. Ravindra
Published: November 2020

Education spreads parallel with the life span of a person starting from his birth to death. Education is known to be the instrument which fills human actions with the essence of
values, dignity, ethics and human virtues. Life progress along with the process of civilization equipped with social, moral, cultural attributes in the path of education. The Educational system should be gender sensitive to impart knowledge and disseminate skills to the marginalized sections of the society. The country could excess by facilitating contribution of the marginalized folk in the near future. Autonomous bodies like University Grants Commission (UGC), National Council of Educational Research and Training (NCERT), Central Board of Secondary Education (CBSE) regulates women education system in India. Institutions like United Nation’s International Children’s Educational Fund (UNICEF), Indian Council of Social Science Research (ICSSR), United Nations Educational Scientific and Cultural Organisation (UNESCO), Council of Scientific and Industrial Research (CSIR), Medical Council of India (MCI) and Dental Council of India (DCI) facilitates women education in India. Women Study Centres aided by UGC study the status, problems, issues concerned with women education. The illiteracy among women makes them dependent and deprived in general. Social, economic and political empowerment of women through education is the need of the day. This paper reviews various legislative and policy framework to improve the teaching, learning and evaluation aspects in the higher education in India.
PEMBENTUKAN KEPRIBADIAN MUSLIM DENGAN TARBIYAH ISLAMIYAH
Authors: Saifurrahman Saifurrahman
Published: November 2020

Kepribadian Muslim adalah kepribadian yang pandangan, sikap, pilihan, keputusan, dan perbuatannya sesuai dengan nilai-nilai Islam. Pembentukan Kepribadian Muslim adalah suatu usaha untuk membentuk kepribadian seseorang agar sesuai dengan aqidah dan nilai-nilai Islam. Hal ini sangat penting dilakukan, mengingat kerusakan moral semakin banyak terjadi, padahal mayoritas masyarakat kita beragama Islam, yaitu agama yang dikenal sangat menjunjung tinggi moralitas. Tulisan ini secara garis besar menjelaskan bahwa terdapat sebuah konsep dalam Pembentukan Kepribadian Muslim, yaitu Tarbiyah Islamiyah. Ia merupakan pemikiran, pendapat atau rancangan mengenai cara ideal dalam berinteraksi dengan fitrah manusia untuk memproses perubahan dalam dirinya menuju kondisi yang lebih baik. Secara operasional konsep ini meliputi aspek perbaikan, pembentukan dan penjagaan. Melibatkan diri sendiri dan orang-orang lain. Meliputi aspek akal, fisik dan ruh. Sebagai sarana utama untuk mewujudkan kehidupan pribadi, keluarga dan masyarakat terbaik, sesuai dengan nilai-nilai Islam.
Global Warming: Impacts on Society and Alternative Solutions Taken
Authors: Makosembu Jhon
Published: November 2020

This article discusses the revitalization of agriculture through the knowledge of the extension agents to the community about the socioeconomic of agriculture. The interesting thing is that the potential of each region to develop agribusiness is very different. Therefore, to develop extension services that support the development of agribusiness, it is necessary to examine carefully the potential of each region. So that the diversity of extension materials must be made possible by innovation. Agricultural extension is expected to be the central point of agricultural development. However, in agricultural extension it must be remembered that extension is a form of intervention against farmers. Progressive and effective agricultural extension workers must be supported and collaborate closely with the Agricultural Research Institute including socio-economic research on agricultural extension which simultaneously conducts monitoring and evaluation of agricultural extension continuously. In disseminating information, the extension worker must carry out a reciprocal process, namely conveying information in the form of researchers' findings to farmers. Sustainable agricultural development really requires the support of strong agricultural technology and socio-economic research results. Without this, agricultural development will stagnate. Therefore, people's participation in planting knowledge needs to be increased.
Complications and Diseases in the Postpartum and Their Treatment
Authors: Timbe Johana
Published: November 2020

The general purpose of the study is to know and understand the basic concepts of presentation and position at birth and dystocia during labor. The infection that happened causes complicatons and disease for example Mother’s milk dam, breast infection, Tromboplebitis, and Psychological disorders during Postpartum. Postpartum period which starts from the time the baby is born and the placenta is born until the womb returns to what it was before pregnancy. The paper will discusse about the symtoms, system and treatment of the disease in the Postpartum.
The Function of Immunology, Antigen and Antibody
Authors: Mohsen Tarek
Published: November 2020

The aims of the study is the function of , imonology, antigen and antibody. The discussion is the function of antigen and also the types of antigen The type of antigen is based on its determinant: (a) Unideterminant, (b) Unideterminant, (c) Multideterminant (d) Multideterminant. The type of antigen based on the specifics : (a) Heteroantigen (b) Xenoantigen (c) Alloantigen (d) Specific organ antigens (e) Autoantigen . Types of antigens based on their chemical content: (a) Carbohydrates, (b) Lipids (c) Nucleic (d) Protein . (Antibodies have the ability to recognize and attach / attach to antigens that are thought to cause disease by the body and  recognizing and attaching themselves to antigens, the antibody substance always acts as a marker, and then sends a signal to other white blood cells to attack the foreign substance
Gastric Ulcers; Causes, Symptoms, Treatment, and Prevention
Authors: Ndidi Kelichi
Published: November 2020

The study discusses the cause, symptom, medication, and prevention of peptic ulcers. The discussion is the  main cause of ulcer disease at this time is believed to be due to stomach infection by bacteria we called “Helicobacter pyloricus (H. pylori). the main clinical feature of peptic ulcers is chronic, intermittent epigastric pain which typically subsides after ingestion of food or antacids Some complain of burning in the upper stomach or painful hunger one to three hours after eating or at night when the stomach is empty. Smoking is also an important cause of ulcer formation and failure of ulcer treatment. Treatment of peptic ulcers useds special selection, dual therapy with antibiotics, therapeutic regimens, operation measures.
Recent Trend in Biomechanical Energy Harvesting
Authors: Arawade Swapnil , Korwar Ganesh
Published: November 2020

In this literature different biomechanical energy harvesters are reviewed. In the past years a lot of work reported on energy harvesting. Energy crisis is the main issue in front of human so it is essential to find new promising ways to fulfil the need of electricity. Wearable smart devices and small sensor require low electrical power so to power them biomechanical energy harvesters comes into picture. The innovative work done by the researchers in developing new biomechanical energy harvester is discussed and summarized.
T&T Clark Handbook of Ecclesiology
Authors: Bender Kimlyn J. , Stephen Long D.
Published: November 2020

Divided into 3 parts, this handbook provides a wide-ranging survey and analysis of the Christian Church. The first section addresses the scriptural foundations of ecclesiology; the second section outlines the historical and confessional aspects of the topic; and the final part discusses a variety of contemporary and topical themes in ecclesiology.

Compiled and written by leading scholars in the field, the T&T Clark Handbook of Ecclesiology covers a range of key topics in the context of their development and importance in each stream of historic Christianity and the confessional traditions. The contributors cover traditional matters such as creedal notes, but also tackle questions of ordination, orders of ministry, and sacraments. This handbook is extensive enough to provide a true overview of the field, but the essays are also concise enough to be read as reference selections.
Posthumanism and the Digital University
Authors: Gourlay Lesley
Published: November 2020

As digital technologies become increasingly central in our day-to-day lives, there have been profound changes in how we search for information, communicate with others, and express ourselves. This book is concerned with how this communication is altering higher education, and the effects that it is having on universities. It applies a posthumanist framework to help understand how technology is affecting the primacy of the written text.

Analysing data from a research project which looked in detail at how a small group of students approached their studies over a six-month period, this book uses drawings, photography and interviews to form an in-depth understanding of their day-to-day lives as students, and how they navigate the complex digital and material landscape of the contemporary university. It looks at how texts change when they move between paper-based and the digital, how students navigate the complexities of multiple devices and formats, how they make spaces for writing and knowledge while on the move, and how they form part of ‘posthuman’ networks of digital devices and material objects in order to engage in their studies.

Taking a historical perspective, the book concludes that textual practices have always been central to how higher education is organised and how we understand ‘knowledge’, and considers how digital media might continue to change what we call ‘the university’.
100 Acting Exercises for 8 – 18 Year Olds
Authors: Marsden Samantha
Published: November 2020

This book offers a comprehensive guide to teaching acting exercises that will unleash the inner creativity of students aged 8-18.

Theories and techniques of some of the greatest theatre practitioners including Sanford Meisner, Constantin Stanislavski, Lee Strasberg and Uta Hage provide a basis for Samantha Marsden’s original exercises for students between these ages. You won’t find Duck, Duck, Goose, Zap, Zap, Boing – or any other traditional drama games in this book: instead, the craft of acting technique takes the limelight.

These exercises have been tried and tested in the author’s own classroom, and are guaranteed to inspire, ignite imagination and encourage heartfelt performances. Focus points used in leading drama schools such as voice, movement, relaxation, character development and understanding text are recreated for a younger student. They are easy to follow and will be fun, challenging and immensely rewarding for teachers and students alike.

The book features a foreword by Paul Roseby, CEO and Artistic Director of the National Youth Theatre.
Cycling and the British
Authors: Carter Neil
Published: November 2020

Cycling is currently enjoying a boom in popularity. What are the reasons behind this phenomenon? How have perceptions and the popularity of cycling shifted?

This book charts the historical development of cycling both as a leisure and sporting activity since the 19th century and explores the wider political and cultural context in which cycling in Britain emerged. In particular, it examines cycling’s relationship with environmental politics and its place in popular culture. Neil Carter successfully traverses several historical sub-disciplines, including the history of transport, leisure, sport, medicine and politics, employing the analytical tools of class, gender, political culture, the role of the state and commercialism to demonstrate how British identity has shaped and been shaped by cycling.

At a time when it has become part of debates over transport and health, Cycling and the British: A Modern History provides a timely and clear analysis of the changes and continuities in attitudes towards cycling.
The Invention of The Self
Authors: Spira Andrew
Published: November 2020

The Invention of the Self: Personal Identity in the Age of Art proposes that the notion of personal identity is a psycho-social construction that has evolved over many centuries. While this idea has been widely discussed in recent years, The Invention of the Self approaches it from a completely new point of view. Rather than rely on the thinking subject’s attempts to identify itself consciously and verbally, it focuses on the traces that the self-sense has unconsciously left in the fabric of its environment in the form of non-verbal cultural conventions, co-evolving with them. Covering a millennium of western European cultural history, it amounts to an ‘anthropology of personal identity in the West’.

The Invention of the Self follows a broadly chronological path, tracing the self-sense from its emergence from the collectivity of the medieval Church to its consummation in the individualistic concept of artistic genius in the nineteenth century. On the one hand, it traces the development of tangible conventions, such as spaces, objects, images, gestures, behaviours and language, that were conducive to the exercise of the self-sense in the world. On the other hand, it observes the emergence of intangible dispositions, such as new sensibilities and experiences of emotion, which functioned as mental environments in which the self-sense could thrive. The Invention of the Self aims to bridge a gap that exists between cultural history and philosophy. Regarding cultural history (especially art history), it elicits significances from its material that have been thoroughly overlooked. Regarding philosophy, it highlights the crucial role that material culture plays in the formation of philosophical ideas. It argues that the sense of personal self is as much revealed by cultural conventions – and as a cultural convention – as it is observable to the mind as an object of philosophical enquiry.
Introducing Fashion Theory
Authors: Reilly Andrew
Published: November 2020

Quickly get up to speed with fashion theories from scarcity to conformity, explained with clear, practical examples and accessible case studies. Introducing Fashion Theory makes complex concepts easy to digest.

Andrew Reilly looks at the different ways a style can become a fashion and how it can spread or decline. With student-friendly features such as discussion questions, activities, and further reading, after completing this text you will have a good foundation for understanding how, where, why, and when fashion exists.

This second edition, re-titled from Key Concepts for the Fashion Industry, includes expanded coverage of cultural appropriation, corporate greenwashing, and the connection between counterfeit goods and crime.
Ludic Dreaming
Authors: Cecchetto David , Couroux Marc , Hiebert Ted , Priest Eldritch
Published: November 2020

Ludic Dreaming uses (sometimes fictional) dreams as a method for examining sound and contemporary technoculture’s esoteric exchanges, refusing both the strictures of visually dominated logic and the celebratory tone that so often characterizes the “sonic turn.’ Instead, through a series of eight quasi-analytical essays on the condition of listening, the book forwards a robust engagement with sounds (human and nonhuman alike) that leverages particularity in its full, radical singularity: what is a dream, after all, if not an incipient physics that isn’t held to the scientific demand for repeatability? Thus, these studies declare their challenge to the conventions of argumentation and situate themselves at a threshold between theory and fiction, one that encourages reader and writer alike to make lateral connections between otherwise wildly incongruent subjects and states of affairs.

Put differently, Ludic Dreaming is a how-to book for listening away from the seeming fatality of contemporary technologies, which is to say, away from the seeming inevitability of late capitalistic nihilism.
Deleuze and the Gynesis of Horror
Authors: Hawkins Sunny
Published: November 2020

Applying Deleuze’s schizoanalytic techniques to film theory, Deleuze and the Gynesis of Horror demonstrates how an embodied approach to horror film analysis can help us understand how film affects its viewers and distinguish those films which reify static, hegemonic, “molar” beings from those which prompt fluid, nonbinary, “molecular” becomings. It does so by analyzing the politics of reproduction in contemporary films such as Ex Machina; Mary Shelley’s Frankenstein; Mad Max: Fury Road; the Twilight saga; and the original Alien quadrilogy and its more recent prequels, Prometheus and Alien: Covenant.

Author Sunny Hawkins argues that films which promote a “monstrous philosophy” of qualitative, affirmative difference as difference-in-itself, and which tend to be more molecular than molar in their expressions, can help us trace a “line of flight” from the gender binary in the real world. Deleuze and the Gynesis of Horror demonstrates how the techniques of horror film – editing, sound and visual effects, lighting and colour, camera movement – work in tandem with a film’s content to affect the viewer’s body in ways that disrupt the sense of self as a whole, unified subject with a stable, monolithic identity and, in some cases, can serve to breakdown the binary between self/Other, as we come to realize that we are none of us static, categorizable beings but are, as Henri Bergson said, “living things constantly becoming.”
Deeltijdpensioen: ervaren belemmeringen bij werknemers en werkgevers
Authors: van Solinge Hanna , van Dalen Harry , Henkens Kène
Published: November 2020

Deeltijdpensioen wordt gezien als een veelbelovend instrument om langer doorwerken voor meer mensen mogelijk te maken. In dit artikel onderzochten we het gebruik van en de belangstelling voor deeltijdpensionering, en de belemmeringen om van deeltijdpensioen gebruik te maken. Dit vanuit
het perspectief van de werknemer én de werkgever. Er is gebruik gemaakt van twee databronnen: een groep van werknemers van 60 jaar en ouder, gevolgd over de periode 2015-2018, en een groep van Nederlandse werkgevers met meer dan 10 werknemers in 2019. De resultaten van deze studie laten
zien dat er onder werknemers aanzienlijke belangstelling is voor deeltijdpensioen, maar dat er nog weinig daadwerkelijk gebruikt van wordt gemaakt. Mensen informeren zich maar beperkt en dan vooral over de financiële consequenties.
De voor- en nadelen van verplicht thuiswerken tijdens de lockdown
Authors: van Veldhoven Marc , van Gelder Marco
Published: November 2020

Ten gevolge van de uitbraak van het Covid-19-virus werd in Europa vanaf half maart 2020 een lockdown afgekondigd in de meeste landen. Vanaf dat moment moesten kenniswerkers verplicht thuiswerken. Dit leverde een ongekend experiment op met werken op afstand. Middels een vragenlijstonderzoek
onder bijna 5000 Europese kenniswerkers uit negen landen is onderzocht hoe deze kenniswerkers in de vroege fase van de lockdown de voor- en nadelen van het thuiswerken hebben ervaren. Enerzijds rapporteren we hier over wat de belangrijkste ervaren voor- en nadelen zijn, en hoe Nederlandse
kenniswerkers zich verhouden tot kenniswerkers uit de andere acht Europese landen. Anderzijds onderzoeken we of de beleving van het thuiswerken, die bestaat uit vele afzonderlijke facetten, kan worden gereduceerd tot enkele kerndimensies. Er blijken inderdaad zes dergelijke kerndimensies te
zijn, drie hiervan hebben betrekking op mogelijke voordelen, de andere drie op mogelijke nadelen. Ook bespreken we hoe de voordelen zich verhouden tot de nadelen. Tenslotte bediscussiëren we wat deze resultaten ons vertellen met het oog op het HR-beleid na de lockdown, zowel voor de korte
termijn als voor de lange termijn.
Cambial-age related correlations of stable isotopes and tree-ring
widths in wood samples of tree-line conifers
Authors: Arosio Tito , Ziehmer-Wenz Malin M. , Nicolussi Kurt , Schlüchter Christian , Leuenberger Markus
Published: November 2020

Abstract. A recent analysis of stable isotopes of the Alpine Holocene Tree-Ring Dataset, consisting of samples from 192 larch and cembran pine trees, revealed that δD and δ18O exhibit no trends in adult trees, but evidence trends in the juvenile period of the first 100 years of cambial age. In this work we applied the Spearman statistical analysis on different cambial age classes to verify if these changes were correlated with tree-ring width values, that are known to show age trends. The results prove a significant correlation between tree-ring-width (TRW) and both hydrogen and oxygen stable isotopes before 100 year of cambial age, but not afterwards, in both larch and cembran pine. A trend in the correlation values was also found between the two water isotopes, while no trend was found in correlations involving δ13C. We hypothesized the δD and δ18O values reflect the higher xylogenesis activity of the juvenile period, that is associated with reduced atom exchanges of photosynthates with xylem water. The result indicates that the climate response of δD and δ18O may differ in the juvenile and mature period of tree life at treeline.
Ribbed bedforms in palaeo-ice streams reveal shear margin
positions, lobe shutdown and the interaction of meltwater drainage
and ice velocity patterns
Authors: Vérité Jean , Ravier Édouard , Bourgeois Olivier , Pochat Stéphane , Lelandais Thomas , Mourgues Régis , Clark Christopher D. , Bessin Paul , Peigné David , Atkinson Nigel
Published: November 2020

Abstract. Conceptual ice stream landsystems derived from geomorphological and sedimentological observations provide constraints on ice-meltwater-till-bedrock interactions on palaeo-ice stream beds. Within these landsystems, the spatial distribution and formation processes of ribbed bedforms remain unclear. We explore the conditions under which these bedforms develop and their spatial organisation with (i) an experimental model that reproduces the dynamics of ice streams and subglacial landsystems and (ii) an analysis of the distribution of ribbed bedforms on selected examples of paleo-ice stream beds of the Laurentide Ice Sheet. We find that a specific kind of ribbed bedforms can develop subglacially from a flat bed beneath shear margins (i.e., lateral ribbed bedforms) and lobes (i.e., submarginal ribbed bedforms) of ice streams. These bedforms initiate where the ice flow undergoes high velocity gradients and the ice-bed interface is unlubricated. We suggest that (i) their orientation reflects the local stress state along the ice-bed interface and (ii) their development reveals distinctive types of subglacial drainage patterns below these two kinds of margins: linked-cavities and efficient meltwater channels respectively. These ribbed bedforms are thus convenient geomorphic markers to reconstruct palaeo-ice stream margins and constrain palaeo-ice flow dynamics and palaeo-meltwater drainage characteristics.
Macao College Freshman Students’ Beliefs and Intentions regarding Learning English as a Foreign Language (EFL): A Theory of Planned Behaviour Perspective
Authors: Hu Bo , Chen Hong , Xie Qiqiang , Li Yulong
Published: November 2020

This paper investigated Macao college freshman students’ English learning under the framework of the Theory of Planned Behaviour (TPB), and a total of 544 valid questionnaire responses were collected for the analyses. Factors like attitudes towards English learning, subjective norms, and perceived behaviour control of Macao college freshmen were analysed with varimax rotation using Principal Component methods. Gender and previous learning places have a significant difference in those factors and their learning intention. The findings showed that the TPB explained Macao college freshman students’ English learning beliefs and attitudes. This study provides valuable implications for ways to increase student attitude. English instructors should understand freshman students’ English learning intention and adopt efficient teaching methods to increase their motivation.
Integrating Mindfulness and Biofeedback in the Treatment of Posttraumatic Stress Disorder
Authors: Oded Yuval
Published: November 2020

Teaching mindfulness skills as part of psychological rehabilitation for PTSD patients can be highly beneficial. However, certain factors must be considered such as determining at what stage of therapy to introduce mindfulness training, the length of the practices, and the focal point of the training (e.g., attention, open focus, loving kindness). This article will address these considerations and outline ways in which psychophysiological monitoring and biofeedback can assist therapists in guiding their clients through the process. Specifically, it will highlight how the elevated arousal levels typical of PTSD and the lack of physiological habituation result in rigid and negatively biased attention, which in turn propels the elevated arousal levels into a vicious cycle. Mindfulness practices and approach may help achieve increased flexibility; however, the process must be tailored for each client in accordance with the severity of his or her PTSD symptoms.
Stairway to Togetherness: Taking Mindfulness and Biofeedback into the Intersubjective Realm
Authors: Oren Nimrod Tom , Gronich Dror , Rolnick Arnon
Published: November 2020

This paper proposes an integration of three therapeutic languages—biofeedback, mindfulness, and multiple-person oriented therapy (family, couple, etc.)—using a novel narrative we call the “Stairway to Togetherness.” Relying on recent theoretical and empirical developments, we present a model that combines these three languages into a single coherent therapeutic approach. This approach points to a new direction for multiperson therapy, emphasizing mindfulness interventions, conflict de-escalation, and psychophysiological mutual-regulation patterns, as opposed to content-based and behavioral interventions that have so far been the norm. We suggest that mindfulness and biofeedback practices and insights can find a proper place in the context of multiperson therapy, by making the intersubjective space between individuals the object of mindful attention. We show how mindfulness principles apply to this relational space, and how biofeedback can support this endeavor. A metaphor of a four-story home is provided to help couples navigate their relationship as they attempt to reach a place of felt togetherness—a therapeutic goal that goes beyond problem solving or communication training. Although this paper focuses on couples therapy, it can easily encompass other forms of multi-person therapy.
The Effect of Head and Neck Position on Head Rotation, Cervical Muscle Tension, and Symptoms
Authors: Harvey Richard , Peper Erik , Booiman Annette , Cedillo Alejandro Heredia , Villagomez Elizabeth
Published: November 2020

Slouching posture may be observed when people interact with digital devices such as sitting at a computer screen or looking downwards at a smartphone while sitting or walking. The study investigated two procedures: the effect of head position on perceived head rotation and the effect of neck scrunching on symptom development. In the first study, 87 students sat in either a head-erect or head-forward position and rotated their heads from side to side. Ninety-two percent of the participants reported that they significantly increased their head rotation range during the head-erect position as comparted to the head-forward position, and that it was much easier to rotate their head in the erect position (M = 8.5; SD = 2.4) than in the slouched position (M = 4.3; SD = 1.9), F(1, 171) = 152, p < 0.001. In the second study, 125 students were asked to scrunch their neck for 30 seconds. After neck scrunching, 98.4% of participants reported experiencing an average pain rating of 5.3 on a scale from 0 (none) to 10 (severe), which consisted of pressure in the head (M = 6.7), stiff neck (M = 5.9), eye tension (M = 4) and headaches (M = 3.8). For a subset of 12 students, the effects of head-forward position and neck scrunching (compression) on cervical and trapezius muscles was monitored with electromyography. The average cervical surface electromyography (sEMG) was higher during head-forward position and neck scrunching than during pre- and post-baseline, and the average trapezius sEMG was higher during the neck scrunching than during pre- and post-baseline. For most participants, the effect of their head/neck position on rotation and neck scrunching on symptom development was a total surprise. Experiential practices can provide somatic feedback as an education tool to teach awareness and thus motivate participants to change their body posture so that they reduce slouching and neck scrunching.
A Guide to Monitoring Respiration
Authors: Gilbert Christopher
Published: November 2020

Professionals can monitor respiration using six biofeedback modalities: strain gauges, surface electromyography, capnometers, oximeters, inspirometers, and feedback thermometers. This article emphasizes the importance of the breathing rhythm, describes how to effectively use each modality, and explains how to minimize contamination by artifacts that masquerade as respiratory activity.
A Guide to Normal Values for Biofeedback
Authors: Khazan Inna
Published: November 2020

This article provides readers with a guide for evaluating physiological readings during biofeedback assessment and treatment, with the goal of facilitating treatment planning and tracking of treatment progress and outcomes. The author reviews expected values for measurements of breathing, heart rate, heart rate variability, peripheral temperature, and skin conductance.
Care for Biofeedback and Neurofeedback Instrumentation
Authors: Moss Donald , Hagedorn David , Combatalade Didier , Neblett Randy
Published: November 2020

Hagedorn (2014) has highlighted the infection risks in biofeedback and neurofeedback practice and identified broad strategies for mitigating infection risk. In the age of Clostridum difficile, Methicillin-resistant Staphylococcus aureus, and human immunodeficiency virus, infection risk cannot be ignored in any health discipline that attaches sensors to patients' skin in most treatments. The present article discusses specific guidelines for care and hygiene of biofeedback and neurofeedback instruments, encoders, cables, and sensors. Attention to practice standards can greatly reduce the risk to practitioner and client alike.
Anterior Approach to the Subaxial Cervical Spine: Pearls and Pitfalls
Authors: Razi Afshin , Saleh Hesham , DeLacure Mark D. , Kim Yong
Published: November 2020

Since its introduction by Smith and Robinson, the anterior approach to the subaxial cervical spine has become one of the standard procedures for numerous cervical spine pathologies, including, but not limited to degenerative disease, trauma, tumor, deformity, and instability. Along with its increasing popularity and improvements in anterior instrumentation techniques, a comprehensive knowledge of the surgical anatomy during the anterior exposure is critical for trainees and experienced spine surgeons alike to minimize the infrequent but potentially devastating risks associated with this approach. Understanding the anatomy and techniques to minimize damage to relevant structures can reduce the risks of developing notable postoperative complications and morbidity.
A Comparison of Acute Complications and Mortality Between Geriatric Knee and Hip Fractures: A Matched Cohort Study
Authors: Wolfstadt Jesse I. , Atrey Amit , Nowak Lauren L. , Stavrakis Alexandra , Melo Luana T. , Backstein David , Schemitsch Emil H. , Nauth Aaron , Khoshbin Amir
Published: November 2020

Introduction:

To compare acute complication and mortality rates for operatively treated, closed, isolated, low-energy geriatric knee fractures (distal femur [DFF] or tibial plateau [TPF]) with hip fractures (HFs).

Methods:

This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program. We identified all patients ≥ 70 years from 2011 to 2016 who underwent surgery for DFF, TPF, or HF. We recorded patient demographics, functional status, complications, and mortality. We matched DFF:TPF:HF patients on a 1:1:10 ratio based on age, sex, body mass index, baseline functional status, and comorbidity. We used the chi square, Fisher exact, and Mann Whitney U tests to compare unadjusted differences between groups and multivariable logistic regression to compare the risk of complications, readmission, or death while adjusting for relevant covariates.

Results:

When compared with HF, patients in the DFF and TPF groups had longer length of stay and time to index surgery and were more likely to be discharged home. The rate of deep vein thrombosis was significantly higher in the TPF group (TPF = 3.9%, DFF = 1.3%, and HF = 1.2%, P = 0.005).

Conclusion:

Geriatric knee fractures pose a similar risk of acute complications, mortality, and readmission compared with patients with HF. Future studies investigating strategies to decrease risk in this patient cohort are warranted.

Level of Evidence:

Therapeutic Level III
Candidate Quality Measures for Orthopaedic Surgery Outreach Trips: A Systematic Review
Authors: Shapiro Lauren M. , Park Meewon O. , Mariano David J. , Welch Jessica M. , Kamal Robin N.
Published: November 2020

Introduction:

Up to 30% of the global burden of disease is secondary to surgical conditions, most of which falls on those in low- and middle-income countries (LMICs). Ensuring that the quality of care delivered during outreach trips to address these conditions is foundational. Limited work has been done to develop and implement tools to assess and improve the quality of care for these trips. The purpose of this study was to identify candidate quality measures that address orthopaedic surgery outreach trips in LMICs.

Methods:

We conducted a systematic review of MEDLINE/PubMed, EMBASE, Web of Science, Google Scholar, and other databases to identify candidate quality measures relevant to orthopaedic surgery outreach to LMICs. Quality measures were then categorized by system management, sustainability, or both system management and sustainability according to the framework and structures, processes, and outcomes of Bido et al according to the Donabedian domains.

Results:

Our initial search yielded 3,891 articles, 22 of which met the inclusion criteria. Seventy-nine candidate quality measures were identified. Regarding the framework of Bido et al, 55 of 79 (70%) were related to system management, 8 (10%) were related to sustainability, and 16 (20%) were related to both system management and sustainability. According to Donabedian domains, 43 of 79 (54%) were structure measures, 25 (32%) were process measures, and 11 (14%) were outcome measures.

Discussion:

Quality measures addressing orthopaedic surgery outreach trips are lacking in quantity and breadth, limiting the ability to assess and improve the safety and quality of care provided. The candidate quality measures identified disproportionately focus on systems management and structures, with few related to sustainability and few addressing outcomes. Patients receiving care on outreach trips would benefit from the implementation of the measures identified in this review and from the development of quality measures that capture all domains of care and emphasize outcomes.

Level of Evidence:

Level III
Aseptic Tibial Implant Loosening After Total Knee Arthroplasty: Preventable?
Authors: Menken Luke G. , Fleuriscar Jean , Weiner Travis , Berliner Zachary P. , Rodriguez Jose A.
Published: November 2020

Aseptic loosening is a considerable complication that affects the longevity of total knee arthroplasty (TKA) implants. Surgeon technique may help minimize aseptic loosening after TKA. Meticulous cementation of the prosthesis and the bone surface during various stages of cement polymerization will maximize cement adherence to the prosthesis and the bone, respectively. Pressurization of the cement in the canal and at the cut surface to achieve at least 2 mm of cement depth penetration has been reported to increase TKA implant longevity.
The Implementation of Lean Six Sigma Principles to Improve the Value of Care Delivery for Total Joint Arthroplasty Patients: The Perioperative Institute of Surgical Excellence Experience
Authors: El-Othmani Mouhanad M. , Crespi Zachary , Pallekonda Vinay , Sayeed Zain , Saleh Khaled J.
Published: November 2020

Background:

With the projected increase in the volume of total joint arthroplasty (TJA), minimizing variations in surgery times, hospital length of stay (LOS), discharge dispositions, and inhospital complication rates would help reduce costs and improve the quality of care. As the move toward bundle payment models gains further traction, providers will be reimbursed based on the quality and cost associated with the surgical episode. As such, it remains critical to design and implement high-quality cost-effective perioperative delivery care models. Lean Six Sigma (LSS) methodology has been well described in the healthcare field as a superior strategy in designing processes aimed at reducing waste while minimizing error rates. We present an institutional experience with the design and implementation of a LSS quality improvement process specific to the TJA pathway, with a hypothesis of expected decrease in case cancellation rate, inhospital LOS, 30-day readmissions, and inpatient rehabilitation utilization after program implementation.

Methods:

In 2017, the Perioperative Institute of Surgical Excellence (PISE) program for lower limb TJA was designed and implemented at our institution over a 4-month duration. The program was designed following LSS principles as a low-cost easily adoptable model with a goal to reduce hospital LOS, case cancellation rate, 30-day readmissions, and inpatient rehabilitation utilization.

Results:

A total of 328 patients (128 total hip arthroplasty and 200 total knee arthroplasty) were included in PISE compared with a total of 255 patients (106 total hip arthroplasty and 149 total knee arthroplasty) for the preimplementation cohort. After implementation of the model, and compared with a similar 4-month preimplementation duration, the pilot results revealed an increase in monthly case load by 28.6%, decrease in the 30-day readmission rate by 1.16%, inpatient rehabilitation utilization by 60%, a reduction of the average LOS by 0.8 days, and a case cancellations decrease by 51%.

Conclusion:

The implementation of the pilot protocol for PISE within our institution was successful in decreasing LOS, inpatient rehabilitation utilization, 30-day readmission, and case cancellation. Further assessment is needed to ascertain sustainability of the protocol over a longer duration and generalizability of the results at different institutions and surgeons.
Cognitive Biases in Orthopaedic Surgery
Authors: Janssen Stein J. , Teunis Teun , Ring David , Parisien Robert C.
Published: November 2020

Introduction:

Cognitive biases are known to affect all aspects of human decision-making and reasoning. Examples include misjudgment of probability, preferential attention to evidence that confirms one's beliefs, and preference for certainty. It is not known whether cognitive biases influence orthopaedic surgeon decision-making. This study measured the influence of a few cognitive biases on orthopaedic decision-making in hypothetical vignettes. The questions we addressed were as follows: Do orthopaedic surgeons display the cognitive biases of base rate neglect and confirmation bias in hypothetical vignettes? Can anchoring and framing biases be demonstrated?

Methods:

One hundred ninety-six orthopaedic surgeons completed a survey consisting of three vignettes evaluating base rate neglect, five evaluating confirmation bias, and two separate vignettes each randomly exposing half of the group to different anchors and frames.

Results:

For the three vignettes evaluating base rate neglect, 43% (84 of 196) chose answers consistent with base rate neglect in vignette 1, 88% (173 of 196) in vignette 2, and 35% (69 of 196) in vignette 3. Regarding confirmation bias, 51% (100 of 196) chose an answer consistent with confirmation bias for vignette 1, 11% (22 of 196) for vignette 2, 22% (43 of 196) for vignette 3, 22% (44 of 196) for vignette 4, and 29% (56 of 196) for vignette 5. There was a measurable anchoring heuristic (56% versus 34%; a difference of 22%) and framing effect (77% versus 61%; a difference of 16%).

Conclusion:

The influence of cognitive biases can be documented in patient vignettes presented to orthopaedic surgeons. Strategies can anticipate cognitive bias and develop practice debiasing strategies to limit potential error.