Personal profile of the adolescents in romantic relationship.
\r\n\tOver the years, the concept of maintenance became more comprehensive, reducing fault occurrence and increasing industrial system availability. Besides, reliability, safety, and criticality requirements were associated with the system or equipment under analysis. Maintenance strategies or schemes can be classified as corrective (run-to-break), preventive (time-based), and predictive (condition-based maintenance). Corrective maintenance is only performed after an occurrence of a fault. Therefore, it involves unexpected breakdowns, high costs, changes in the production chain, and it could lead to catastrophic events. Preventive maintenance and interventions occur based on a scheduled maintenance plan or the equipment's mean time between failures. Although it is more effective than corrective maintenance, unexpected failure may still occur by preventing most failures. Additionally, the process cost is still high, especially the costs associated with labor, inventory, and unnecessary replacement of equipment or components.
\r\n\tOn the other hand, predictive maintenance analyses the equipment condition so that a possible fault can still be identified at an early stage. Predictive maintenance aims to identify a machine anomaly so that it does not result in a fault. Such maintenance involves advanced monitoring, processing, and signal analysis techniques, which are generally performed non-invasively and, in many cases, in real-time. In the case of machines or processes, these techniques can be developed based on vibration, temperature, acoustic emission, or electrical current signal monitoring. It should be noted that monitoring such signals or parameters to verify the operating condition is called condition monitoring. Condition monitoring aims to observe the machine's current operational condition and predict its future condition, keeping it under a systematic analysis during its remaining life. In this sense, a fault condition can be detected and identified from systematic machine condition monitoring. A diagnosis procedure can be established, whereby properly investigating the fault symptoms and prognosis.
\r\n\t
\r\n\tThis book will aim to merge all these ideas in a single volume, aggregate new maintenance experiences, apply new techniques and approaches, and report field experiences to establish new maintenance processes and management paradigms.
\r\n\t
Adolescence is a crucial period for every individual with ample rapid physical, psychological and social changes [1, 2, 3]. In this critical transitional phase, boys and girls progress from same-sex to other-sex relationships, including involvement with romantic partners. Growing social expectations for dating behaviors, biological motivations, socio-emotional intelligence, and cognitive maturity during adolescence promotes young people to engage in romantic relationships [4, 5]. Most adolescents in their conversations discussed romantic relationships with no discomfort and reported to have significant preoccupation and rumination which further cause for strong emotions [6]. Many adolescents, particularly girls, whether single or in a relationship tend to spend more time discussing romantic relationships and pondering over past or future relationships [7]. Hence, romantic involvement during adolescence has received much attention.
\nIndia has one of the fastest growing youth populations in the world. The vast majority of adolescents, (children in the 10–19 age group) account for 22.8% of the population of India and girls below 19 years of age constitute one-fourth of India‘s fast growing population [8]. There are 1.5 million girls in India under the age of 15 already married. Of these, 20% or approximately 300,000 are mothers to at least one child. They are more prone to trafficking, HIV infection, and Substance abuse. Only 1% adolescents receive quality counseling, health and medical services [9]. Many of these issues addressed through various government programmes, policies and school health programme, and adolescent education programmes [10].
\nIncreased interest in romantic relationships is central in adolescents’ lives and has long been considered defining features of adolescence [1]. Romantic relationships have significant influence on emotional wellbeing of adolescents. In western context, romantic relationship has gained developmental significance and majority of adolescents involved in romantic relationship. In Indian context, scientific literature on Adolescent girls in romantic relationship is very minimal and studies focused upon sexuality related issues and pre-marital sexual relationship [11, 12, 13]. Due to social and cultural aspects, few adolescent girls who are involved in romantic relationship run away from home. These girls would come under care and protection under many circumstances such as child marriage, teenage pregnancy, sexual abuse, etc. it is important to understand their issues to provide psycho social intervention and facilitate healthy transition to adulthood [11, 12, 13].
\nAdolescence is a period of transition from childhood to adulthood, where adolescents try to establish a personal sense of individual identity and feelings of self-worth. During Adolescence there are certain important developmental tasks, such as, development of an identity; the transformation of family relationships; the development of close relationship with peers; the development of sexuality; scholastic achievement and career planning. Romantic experiences are believed to influence the course of a number of above mentioned developmental tasks [6]. Increased interest in romantic relationships is central in adolescents’ lives and has long been considered defining features of adolescence [14]. Romantic relationship during adolescence follows a developmental course. Initial interactions typically occur in mixed boy-girl groups; then group dating begins, with several pairs engaging in some activity together [15]. Romantic relationships been defined as ‘mutually acknowledged on-going voluntary interactions; in comparison to most other peer relationships, romantic ones typically have a distinctive intensity, which is usually marked by expressions of affection and current or anticipated sexual behavior, of course, some behaviors are simultaneously affectionate and sexual in nature [10].
\nRomantic relationship initially conceptualized as relatively unimportant compared to adults’ relationships, adolescent romantic relationships have been shown in research to be often long term and bear significant resemblance to the features of adult romantic relationships [16, 17]. It is only within the last 2 decades that researchers have considered the potential impact of romantic experiences on adolescents’ functioning. Since last 2 decades, academician and researchers have conducted research to understand romantic relationship among adolescents.
\nCultures vary widely in the norms, attitudes, and customs surrounding marriage. Marriage is a sacred institution in India [18], with long-established norms and customs with strict cultural sanctions against those who do not follow such unwritten norms [19]. In India unlike west, do not have a concept of ‘dating’. The concept of dating is not heard by many adolescents, any attraction or liking of opposite sex ends up in marriage. Children are expected to be under the control and supervision of their parents until their marriage. Parents act as protector and also as provider for their children until they are married. When a boy and girl in romantic relationship would elope or runaway for getting married, mainly because of their parents not approving their relationship nor agreeing for their marriage. Caste, religion, socio economic status, character, etc., are important factors for marriage. In West, individuals select their own marital partner, whereas in India, parents and the extended family members select the marital partner and ensure that the partner is a good match within their caste and family network [20].
\nJanardhana et al., [21] in their reports of proving psycho social interventions for children in difficult circumstances under the care and protection of Child Welfare Committee (annual and six monthly reports) and in their studies Janardhana and Manjula [12, 13, 21] have mentioned about individual, family and other factors associated with romantic relationship. Adolescent girls in romantic relationship were aged between 13 and 18 years. Few were dropped out of school, majority of them are high school/college going. More than half of the adolescents in romantic relationship had poor academic performance and low academic achievement motivation. Few adolescents girls were asked to stop studies because parents knew about their romantic relationship. They had poor knowledge about personal safety, sexuality and reproductive health. Alcohol in parents, disturbed family routine, parental discord, poor parental supervision and monitoring, poor quality of relationship between parents and children, poor communication between parents and children, rejection of girls by their parents are some of the family factors associated with adolescent in romantic relationship. Caste, socio economic status, boy’s background were some of the main reasons for their rejection of romantic relationship.
\nPerceptions and attitudes towards romantic relationships have evolved in the Indian context. In the current scenario, meeting socially for companionship and going beyond companionship has become quite popular among adolescents particularly those residing in urban areas. Dating was considered taboo decades ago, but now, it is quite common. Adolescent dating culture has been noted to be increasing in the country [22]. In India, globalization, urbanization, rapid economic growth and the extensive reach of media has changed the realities of young people in just a generation. Young people are exposed to new ideas and are better informed about their rights and responsibilities. The declining age of puberty and the increasing age of marriage have created a growing window of opportunities in which young people more chances to engage premarital romantic and sexual relationships [23].
\nIndia being a collectivist culture allows families to play a dominant role in taking major decisions centering lives of children and adolescents. Choice marriages are still discouraged and parental acceptance is crucial for marriage. Parents often believe that strict supervision of children inhibits their formation of romantic or sexual partnerships [24]. Despite strict supervision, disapproval of interactions with opposite gender, there are opportunities for social mixing and young people have devised ways of developing romantic partnerships with the opposite sex [25]. These emphases on how adolescents in India are fascinated between conflicting ideas. It has been observed that on one hand adolescents have strong desires for romantic exploration and on other hand strict parental supervision and traditional values on premarital relationships. This has led to the expansion of research interest in the area and has resulted in various research initiatives.
\nWith changes from parent-arranged marriages to dating, individual choice courtship emerged as an activity in its own right, creating a new institution in culture. It involves individual choice with a defined time period. It also differs from parent-arranged marriages in the aspect of sexual permissiveness, the extent to which couples physically intimate before marriage [26].
\nThe dimensions of individualism and collectivism are key constructs in understanding the social structuring of relationships. In individualistic societies like America, romantic love is an important base for marriage where love is known to promote personal growth through the relationship. Whereas, marriage in collectivistic societies such as India love and intimacy were less important factors, however, studies among young adults show signs of change towards greater valuing of love as a basis for marriage [27].
\nRegarding gender differences and choice marriage, the Indian woman’s self-construct is more suggestive of a relational rather than individualized self. The joint family system structures the woman’s relationships as well as prepares her to undertake the roles of a wife and mother. After marriage, the sources of emotional intimacy are the mother-child relationship and that with other women in the household [28].
\nThe socialization process plays an important role in Indian context, as girls restricted to have interaction with opposite gender apart from apart from male members of her family. There was a common perception among parents to think of their daughter’s marriage soon after they attain menarche. To prevent premarital sexual behaviors many parents go for an early marriage of their daughter. Religious beliefs also seem to have a significant impact on attitudes towards sexuality [29]. However, with the growing awareness on prohibition of child marriage, education for girls and socio-economic-political changes in India age of marriage is increasing [30, 31].
\nAdolescent sexuality is known to be influenced by the interaction of multiple factors such as bio-psycho-social, economical, political, cultural and legal factors [32]. The institution of marriage regulates sexual relations; hence premarital sex is discouraged and disapproved. Social and religious sanctions against premarital sex have traditionally been strong determinants to its practice [33]. With the advent of socioeconomic development, there has been significant influence on the sexual attitude of adolescents. Currently, it has become more open and independent from the traditional ties and cultural norms on sexual behaviors.
\nIn India there are several legislations, schemes and policies for wellbeing of children. One among them is Juvenile Justice (Care and Protection) Act, 2000 for providing care and protection to children in difficult circumstances. Adolescent girls in romantic relationship faces care and protection issue under following circumstances- run away from home with their romantic partners, getting married below legal age, sexual abuse by romantic partners, teenage pregnancy, interpersonal issues with parents for being in romantic involvement, etc. During the process of care and protection, adolescent girls come under institutional care for temporary period of time, they do require psycho social care, family counseling and legal support. The current study would focus on this population.
\nThe Juvenile Justice (care and protection of children) Act 2015 is tone of the primary laws for children in need of care and protection. This is designed for the care, protection, development and rehabilitation of neglected children and delinquent juveniles, as well as for the adjudication of and disposal of certain matters related to them. This law is child-friendly and provides for the proper care, protection and rehabilitation of children in need of care and protection. A clear distinction has been made in the law between the juvenile offender and the children in difficult circumstances. The other salient features of this enactment are: (i) it prescribes a uniform age of 18 years below which both boys and girls are to be treated as children (ii) the Act directs that the cases related to juveniles should be completed within a period of 4 months (iii) it has been made compulsory to set up a Juvenile Justice Board (previously known as Juvenile Court) and Child Welfare Committee either for a District or a group of Districts. (iv) Special emphasis has been given for rehabilitation and social reintegration of the children and the alternatives provided for this are adoption, foster care, sponsorship and after-care. The new Act allows for the adoption of a child within the purview of this Act by any community [34].
\nIntegrated Child Protection Scheme (ICPS): The scheme is a central government sponsored mechanism that aims to introduce and implement an effective system of child protection that rests on the cardinal principles of “protection of child rights” and “best interest of the child”. It seeks convergence of the governmental and non-governmental/civil society sectors for creation of a safety net for children through integration of various preventive, curative, rehabilitation and protection services. There are wide range of services for children to ensure care and protection of children. These include institutional and non-institutional care and services, child line, foster care, sponsorship, shelter homes, promotion of family based care, after care programmes, adoption, Health, education, vocational training, development programmes, legal assistance and rehabilitation, etc. These services have been delivered at the district level through District Child Protection unit and statutory bodies such as Child Welfare Committee and Juvenile Justice Boards have been actively involved in ensuring protection of children.
\nAdolescent mental health is an integral part of School mental health programmes focuses on developmental needs of children and adolescents and focusing on prevention of high risk behaviors and promotion of mental health among them [35]. School Mental Health Programmes in India focused upon Life Skills education, Developmental needs, substance use, Sexuality, HIV/AIDS, Mental Health Orientation to teachers, student enrichment, etc. Manuals were prepared as part of program [36].
\nIncreased interest in romantic relationship is the central part of their life and considered as defining features of adolescence. Existing literature on Adolescent romantic relationship highlighted that, Romantic relationship becomes increasingly significant in the lives of young people as they move from early to late adolescence [37]. It is one among the important developmental tasks in adolescence [15] and can influence the course of other developmental tasks [38]. The quality of adolescent romantic relationships can have long lasting effects on self-esteem and shape personal values regarding romance, intimate relationships, and sexuality [39, 40]. While healthy romantic relationships have many potential benefits for youth, unhealthy relationships pose risks that may have long-lasting impact [41].
\nThe present study aimed at understanding the psychosocial issues of adolescent girls in RR under care and protection framework. This study was carried out as part of a project providing psychosocial interventions for children in difficult circumstances under the care and protection of child welfare committee, supported by Karnataka state integrated child protection society, Government of Karnataka. The researchers are from the Department of Psychiatric Social Work, National Institute of Mental Health And Neuro Sciences, providing services for the children in difficult circumstances referred from child welfare committee on daily basis. Children, who are referred from the CWC for temporary institutional care in the children home, constitute same for the study. Children speaking Kannada, Telugu and English constitute the sample for the study. Children reporting to be above 18 years (with documentary proof were excluded from the study as they would not be governed by child welfare committee. Psychosocial care was provided to adolescent girls in RR, under care and protection issues. Case reports, with detail notes of the therapist was documented, the present study analyses the case reports in understanding the issues of adolescents in RR issues and the process of interventions provided. The individual files have been maintained by a psychiatric social worker, eliciting information about the RR, marriage with the romantic partner, reason for run away with the marital partner, and to their decisions about their future life, carrier and family life.
\nThe cases seen in 8 months were taken for the study. Ethical aspects were taken into consideration with regard to maintaining anonymity of the participants; the study findings does not affect the dignity of children, and they all received psychosocial care services as part of the project. Initially, frequency analysis was done with regard to socio demographic variables, themes were identified and later codes were made to understand the individual and family issues related to adolescents in RR. The data was analyzed using R software, and frequency analysis was done.
\nFifty girls who were in RR were selected for the study Mean age is 16.34 years (SD ± 0.93) with a range of 14–18 years. About 60% were in high school, 32% of them were in Pre University College. One joined for BE (bachelor of engineering) and remaining did not attend formal education. About 50% of the participants discontinued their studies, 20% of them completed the course, 14% were currently pursuing the course and 10% had dropped from studies. About 78% were from lower socio economic status, 18% from middle socio economic status and 4% from higher socio economic status. About 80% belonged to Hindu religion, 12% belonged to Christian religion, and remaining 8% belonged to Muslim religion. The mean age of menarche is 12.46. About 56% of the participants are from nuclear family, 26% from single parent families and remaining 18% are from joint family (Table 1).
\nSl. No. | \nVariable | \nFrequency N = 50 | \nPercentage | \n
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1 | \nAge | \nMean 16.34 SD ± 0.939 | \n|
2 | \nEducation | \nHigh school 30 Pursuing PUC 16 No formal education 03 Pursuing BE 01 | \n60% 32% | \n
3 | \nStatus of education | \nCompleted 10 Discontinued 25 Drop out 5 No formal education 3 Ongoing 7 | \n20% 50% 10% 06% 14% | \n
4 | \nSocio economic status | \nHigh 2 Middle 9 Low 39 | \n4% 18% 78% | \n
5 | \nReligion | \nHindu 40 Muslim 4 Christian 6 | \n80% 8% 12% | \n
6 | \nAge at menarche | \nMean 12.46 | \n|
7 | \nType of family | \nJoint 9 Nuclear 28 Single parent 13 | \n18% 56% 26% | \n
Personal profile of the adolescents in romantic relationship.
Little more than 95% of the adolescent girls in RR ran away with their romantic partner. Remaining 6% of participants did not run away from home; however they came under care and protection mechanisms on the request of parents. The reason for run away with their romantic partner was to get married (62%) and another 38% of them had ambiguity regarding their marriage with the romantic partner. Little more than 70% of the adolescent girls believed that having sexual intercourse with their romantic partner would get their marriage approval. Most Adolescents reported that marriage gave them sanction for the sexual relationship. Another 28% of them did not have sexual relationship. Nearly 76% were not aware about the safe sex practices, sexual health, reproductive health, and pregnancy, etc. (Table 2).
\nAt individual level | \nAt family level | \n
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Provides information about the psychosocial issues among adolescents and their families.
The case files analysis reveals that most adolescents were worried about parent’s rejection of their romantic partner and had guilt feeling that they were not able to meet the expectations of parents nor they were able to fulfill the dreams of their parents. Most adolescents were also aware that their romantic involvement has been one of the reasons for academic decline; some have to be dropped out from schools as their parents knew about their romantic relationships. Parents started restricting their movement by stopping to attend school. Always adolescents in romantic relationship are under the conflict over prioritizing between their parents vs. their romantic partner, when they forced to choose one.
\nAdolescents in romantic relationship are also worried about legal action against their romantic partner, they wanted their romantic partners to be out from the correctional settings, and they do not want their romantic partner to be punished alone. Often Adolescents in romantic relationship are confused about prioritizing between going back to their family or to go back with their romantic partner. Adolescents feel that they have brought dishonor to the family. They are more worried about the reactions of their family members, especially extended relatives and neighbors. This confusion would govern their decision making about going to back along with their parents or to be in the rehabilitation center, wait for their romantic partners. They would be confused to take decisions about child bearing issues, as they are under aged and physically weak to bear the child in their womb.
\nDisturbed family functioning due to conflict over daughter’s relationship, challenges in dealing with behavioral issues of adolescents in romantic relationship context, parenting issues like balancing warmth and control, accepting adolescent’s autonomy, and deviance behavior. Parents finds difficult to accept daughter’s decision about their romantic partner, and would be in a helpless situation of not able to convince their daughter about their reason of caste and the economic conditions for rejecting their selection. Social issues such as family honor, parents find it difficult to explain and answer to their relatives and neighbors. Parents find difficult to cope with issues like, first time entering into the police station for registering complaint and attending judicial court procedures. Parents are often confused in prioritizing between importance of Social factors versus understanding daughter’s decision and needs.
\nBased on the above understanding the authors are proposing a conceptual understanding of romantic relationship in the Indian context.
\n\nFigures 1 and 2 describe the psychosocial issues identified among adolescents girls and their families. These model (as the figure is given below this text).
\nFactors contributing for romantic relationship in the Indian context. Note: Conceptual frame work was written based on the on the observations from the project of Dr. N Janardhana, Principal Investigator, ‘psychosocial interventions for children in difficult circumstances’, supported by KSICPS, Government of Karnataka and the doctoral research of MS Manjula, guided by Dr. N. Janardhana and Dr. Nirmala B.P.
The above model depicts several factors associated with romantic involvement of adolescent girls. Modeling and learning from others’ experiences play an important role in developing perceptions of romantic involvement and concept of ideal partner and ideal relationships. Understanding on healthy and unhealthy relationships in romantic involvement also one of the determinant of forming romantic relationship. This enables them to have norms in their relationship and to prepare for engage in healthy relationships.
\nThe socialization process, socio-cultural norms on marriage, premarital relationships add to their concept of ideal romantic relationships and frames expectations on romantic partner. These influence them to look for stable relationships. Adolescents from late adolescence, school going with average academic performance had shown interest in forming romantic relationship. Adolescents hailing from lower socioeconomic status and difficult family situations, changes in family structure followed by transition such as single parent family, living with extended family members have higher chances of engage in romantic involvement. Poor parental monitoring and supervision of activities of adolescent girls may leave the unattended, which may impact on parent-adolescent relationship in future.
\nRomantic partner’s characteristics are major determinants of forming romantic relationship and the quality of relationship between romantic partners. Adolescent girls formed romantic relationship with young/middle adults, who belonged to lower socioeconomic status and hailed from different caste. The deprived emotional needs were fulfilled by their romantic partners and their needs were acknowledged and validated. Romantic partners were source of support and encouragement and they felt happy in their presence and contributed for quality of relationship.
\nThe course of romantic relationship is been given in the below diagram based on initiation phase, middle phase and commitment phase. The process of romantic relationship been described based on the experiences of adolescents in romantic relationship. Relationship in the below diagram described how the friendship got turned into infatuation and then eloping with their boyfriend to get marriage so that their marriage gets recognized from their parents (Figure 2).
\nThe course of romantic relationship. Note: Conceptual frame work for understanding the course of romantic relationship was written based on the on the observations from the project of Dr. N Janardhana, Principal Investigator, ‘psychosocial interventions for children in difficult circumstances’, supported by KSICPS, Government of Karnataka and the doctoral research of MS Manjula, guided by Dr. N. Janardhana and Dr. Nirmala B.P.
Based on the above understanding of romantic relationship, we have delivered following interventions for girls in romantic relationship1. The described psychosocial issues provided the framework for developing the psychosocial intervention for adolescent girls in the romantic relationship and their families. Psychosocial interventions have been formed based on the Social casework and group work approach. These interventions categorized as individual interventions, family interventions (sessions with parents and conjoint sessions with parents and adolescent).
\n\n
Individual interventions with adolescent girls aimed at enhancing psychosocial competence among adolescent girls to deal effectively with the psychosocial issues and facilitate them fulfill the developmental tasks of adolescence. To achieve this aim, preventive, promotive, curative and rehabilitative approaches can be adopted.
\nWorking with family is an integral part for providing psycho-social interventions to adolescents. Family factors such as relationship with family members, early experiences in childhood, parenting practices, family dynamics, and parental response towards romantic involvement have contributed to partner selection and adopting risk behaviors among adolescents. Hence, it would be beneficial to give family interventions to this particular cohort. Family plays an important role in the process of care plan for adolescent girls and ensuring care and protection for them in the future. It is also essential to discuss the concerns of parents as romantic involvement of their daughter and associated issues can have significant impact on the family.
\nFamily interventions emphasize upon systemic approach and different schools of family therapies are psycho-dynamic approach, structural family therapy, strategic family therapy, solution focused, problem solving, cognitive behavioral family therapy, psycho-education, narrative approach, integrated approach, etc.
\nThe major issues identified at the family level are authoritative and punitive parenting, enmeshed boundaries, parental autonomy on children’s marriage, impaired parent- child relationship, loss of trust and maladaptive coping strategies, etc. Families belong to the developmental life cycle stage of families with adolescent children reported significant challenges. For those families with dysfunctions, may need therapy sessions as either joint or conjoint sessions. The main aim of family interventions is to reduce risk factors in family, promote protective factors and enhance parent’s skills to deal with the issues and safeguard care and protection of adolescents.
\nThis approach focuses on providing therapeutic services for adolescent girls in the institutions and in a clinical setup. Specific techniques derived from different therapies such as Supportive psychotherapy, cognitive behavior therapy, Emotions focused therapy, Interpersonal relationship therapy, Solution focused therapy, Strength-based approach, Dialectical behavior therapy and Motivation enhancement therapy, etc. can be adopted in the therapy process.
\nIndividual therapy sessions focus on addressing their thoughts, emotions and behaviors associated with romantic involvement and enhancing their abilities to deal with the current situations and crisis. Individual therapy can focus on the following areas.
Establishing therapeutic alliance by being nonjudgmental, ensuring confidentiality, and emphasizing on their active participation in the therapy process.
Supportive interventions using ventilation, emotional catharsis, validation of their concerns and experiences.
Provide
Insight facilitation: reflection on their perspectives on romantic involvement, process of selecting partner, commitment for stable relationship, their role in each phase of romantic involvement, decision making process in run away, sexual activity, marriage, pregnancy and childbearing, consequences of risk behaviors on different areas such as family, academics, mental health, social consequences and facilitating understanding on current situation from multiple perspectives.
Adopting
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The promotive approach focuses on the enhancement of skills and competence among adolescents. Following areas can be focused on the promotion of mental health among adolescent girls.
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Prevention of further risk behaviors in future—facilitate discussion with the girl on identifying triggers/precipitating factors which may make them repeat risk-taking behaviors and enable their critical thinking to come up with strategies to address them.
Preparing them Emphasize upon healthy relationship during courtship, adhere to law and advantages of following desired behaviors.
Providing information on resource agencies and contact details to seek help during the crisis.
Enable them to face the social consequences such as criticism, labeling and cope effectively.
Working with family is an integral part of providing Psycho-Social interventions for adolescents. Family factors such as the relationship with family members, early experiences in family, parenting practices, family dynamics, and parental response towards romantic involvement have contributed to romantic involvement and risk behaviors among adolescents. Hence, it is very important to have family interventions. Apart from these, family plays a crucial role in the process of care plan for adolescent girls and ensuring care and protection in the future. It is also essential to address their concerns too as a romantic involvement of their daughter and associated issues have a significant impact on the family.
\nFamily interventions emphasize upon systemic approach and family therapy services can be formed based on different schools of family therapy such as structural family therapy, strategic family therapy, solution focused, problem-solving, cognitive behavioral family therapy, integrated approach, etc.
\nThe major issues identified at the family level are authoritative and punitive parenting, enmeshed boundaries, parental autonomy on children’s marriage, impaired parent-adolescent relationship, loss of trust and maladaptive coping strategies, etc. These families are in the family life stage of families with adolescents and reported significant challenges. Family therapy sessions can be carried out as joint and conjoint sessions. The main aim of family interventions is to prevent risk factors in the family, promote protective factors and enhance parent’s skills to deal with the issues and ensure care and protection of adolescents.
\nIndividual sessions with parents or conjoint parent-adolescent can focus on the following areas in the family interventions;
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Conjoint sessions with parents and adolescent girls can focus on the following areas:
\n
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The course of the romantic relationship identified knowledge about romantic partner, strategies used by romantic partner or respondents to initiate the relationship, process of accepting and forming the relationship, discussing about maintaining relationship—open versus hiding relationship, factors contributed them to take decision of run away from home, their quality of relationship and intimacy.
\nIn the current study, romantic partner were first met in the neighborhood, near the area of residence or school, on the way to school or through social media. Most of them were familiar to each other and thus initiated the friendship. In most of the cases, boys took the initiative to propose by approaching directly, through common friends, telephonic conversations or through social media like Facebook. It is interesting to note that men initiated the relationship forming, which shows the socio-culture influence in initiating the relationship. Though respondents had more expressiveness, with regard to initiating the relationship they were shy, had inhibitions. Hence, they have taken time to respond to agree to the relationship. Meantime they focused on background check with close friends and get convinced before saying yes for the relationship. However, most of them were not completely aware about the family background of the romantic partners. During the course of the relationship, they tried to maintain the secrecy from family and peers to avoid the complications. Most of them thought of getting married after few years with the consent of parents.
\nStudies on premarital relationships among youth in India demonstrated that despite strict parental supervision, girls found ways of forming romantic friendships and engaging in sexual relations [41]. During the later stages of the relationship, when the family got to know about their romantic involvement, they had decided to elope with their romantic partner due to fear of family, lack parental approval and punitive behaviors to prevent their romantic involvement. Similar results were found in the case reports and quantitative results. Run away from home was used as the immediate solution to continue in romantic involvement and avoid issues in the family. In a study on dynamics of parent-child relationship in romantic involvement context, lack of parental support for choice marriage, restrictive parenting style were found as major issues [12].
\nThe days spend with romantic partner developed intimacy—initially as a force from romantic partner and also for the social reasons like sex as a means to convince family for the marriage and current marital status as an approval to engage in physical intimacy. Studies on sexuality and reproductive health behaviors among youths in India identified physical intimacy among youth both in romantic and non-romantic context, safe and unsafe sexual behaviors [42, 43, 44]. While staying with their romantic partner they received care, supportive gesture and open communication, which indicates the quality of relationship with their romantic partner and they were the main source of emotional support to them.
\nThe above findings on course on romantic relationship are similar to the romantic involvement model during adolescence; Initiation Phase—beginning of interest in the opposite sex; superficial selection process; interactions are weak attempts at establishing a romantic relationship (physical characteristics); Affiliation Phase—observes behaviors and attitudes; focus on companionship (social characteristics); Intimate Phase—focus of the paired relationship is intimacy (deep feelings of emotional attachment) and often sexual activity and the last phase; Committed Phase—adolescent romantic relationships are established and exclusive at times, resembling the marriage relationship; more intense relationships; more caring towards their romantic partner; better at resolving conflict within the relationship [45].
\nInterventions for adolescents to deal with their RR includes rapport establishment, not taking sides of either adolescent or their parents. Interventions started with their understanding of personal safety, sexuality and reproductive health, and its importance. Discussions were held on the legal framework governing children in India. Help adolescent to look at their developmental tasks like academic involvement or vocational training. Support was extended to adolescents to set short term and long term goals. Preventive and promotive mental health interventions for enhancing psychosocial competence were provided. Supportive therapeutic interventions could assist adolescent girls to learn healthy ways of relating to others [46]. Helping professionals need to recognize, respond to the issues and problems of adolescent in RR [47]; dealing with their relationship with the parents; dealing with the community attitudes; building support network. Carlson [48] asserted that counselors working with youth must not only recognize violent actions, but also seek to understand the underlying issues causing such behavior.
\nUnder the project entitled “psychosocial interventions for children in difficult circumstances” services were provided at the children home for girls, Bangalore. Adolescent girls and their families those who approached Child Welfare Committee in romantic involvement context were also received psychosocial interventions. The above mentioned areas of interventions were provided to them based on their needs and issues and found to be useful in this set up [12, 13, 48].
\nRomantic relationship during adolescence has received developmental significance and has both positive and negative outcomes for adolescents. Many adolescents due to many factors like high risk behaviors, unhealthy relationship, violation of legal norms and others force them to be in crisis situation. This affects their relationship with family, academics and other opportunities, affecting their development process. Providing interventions to these children and adolescents is important. Understanding adolescent issues from developmental perspective helps in designing programmes for adolescents and their family members. This would facilitate healthy transition to adulthood and enables them to take part in societal development.
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\\n\\n\\n\\nIntechOpen is committed to disseminating high-quality scientific research in a manner that exemplifies the best practice in scholarly publishing. IntechOpen is an official member of the Committee on Publication Ethics (COPE), which advocates the maintenance of the highest ethical standards for all parties involved in the act of publishing, including Authors, Academic Editors of the book, Peer Reviewers, the publisher and Societies, where applicable.
\\n\\nIn line with publication ethics practices recommended by COPE, ICMJE, and other similar organizations, IntechOpen's contributing Authors, Academic Editors, and Peer Reviewers are required to declare fully all possible conflicts of interest.
\\n\\n\\n\\nIntechOpen's Authorship Policy is based on ICMJE criteria for authorship. In order to be identified as an Author, the following requirements must be met:
\\n\\nAll scientific works are subject to Peer Review prior to publishing. IntechOpen is a member of the Committee on Publication Ethics (COPE) and all participating referees and Academic Editors are expected to review submitted scientific works in line with the COPE Ethical Guidelines for Peer Reviewers where applicable.
\\n\\n\\n\\nThe Internet has changed the dynamics of scholarly communication and publishing which is why we find it necessary to clearly indicate our stance on what we consider to be a published scientific work. A significant number of working papers, early drafts, and similar works in progress are shared openly online between members of the scientific community. It has become common practice for researchers to announce their work on a personal website or a blog in order to gather comments and suggestions from other researchers. Such works and online postings are ‘published’ in the sense that they are made publicly available, but this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
\\n\\n\\n\\nTo identify instances of fraud and misconduct during the publishing process, IntechOpen implements a robust policy governing such occurrences. In line with our general commitment to openness, and in order to maintain the highest scientific standards, we are committed to transparency about our editorial policy regarding retractions and corrections.
\\n\\n\\n\\nWhen faced with potential misconduct, IntechOpen accepts its responsibility to maintain the integrity of the academic record. For particularly complex cases, IntechOpen might ask for the assistance of formal industry bodies or seek advice from an appropriate team of advisors.
\\n\\nIntechOpen's advisors are professionals and scholars with broad knowledge and understanding of different aspects of the scientific publishing process: editorial, authorship, and reviewing roles; publication ethics, copyright, and general legal issues; as well as bibliographic and technical standards.
\\n\\nIn order to provide us with unbiased insights, without compromising the privacy of third parties, IntechOpen presents problematic cases to its advisors in an anonymized format.
\\n\\nIntechOpen publishes books in the English language. If you are interested in the translation of Book Chapters, please check IntechOpen's Translation Policy.
\\n\\n\\n\\nIn line with the Principles of Transparency and Best Practice in Scholarly Publishing, you can access a more detailed description of IntechOpen's Advertising Policy.
\\n\\n\\n\\nAt IntechOpen we realize that exceptional circumstances can occur, resulting in a request for a refund. We will honor all justified requests in the specific instances outlined in our Refund Policy.
\\n\\n\\n\\nAll chapters will be published via IntechOpen's 'Online First' service meaning chapters will be published individually, immediately after review and before the entire book is ready for publication, allowing content to be shared, searched and cited straightaway, thereby generating early stage interest and momentum for your research
\\n\\nOnline First Chapters are considered published on the day they are posted and are citable from that date.
\\n\\nChapters will remain listed as Online First until the final versions of the books are published online. Following publication of the full monograph, Chapters will be redirected from the Online First version and will be available only through the final link of the official published page.
\\n\\nYou are invited to download, use, reproduce, make derivative works of, display, distribute and cite the Online First works. You can find "How to Cite and Reference" by following the link at the end of each online book chapter. Please be aware that it is possible that further editing and changes might be made before the final release of the book.
\\n\\nIf there are supplemental materials to the chapter, these will be published at the time the final book is published online.
\\n\\nReaders and Authors can notify us if they find any errors in the works published under Online First. All major errors will be accompanied by a separate correction notice, erratum or corrigendum (Retraction and Correction Policy.)
\\n\\nIntechOpen books are available online by accessing all published content on a chapter level.
\\n\\n\\n\\nIntechOpen publishes different types of publications.
\\n\\n\\n\\n\\n"}]'},components:[{type:"htmlEditorComponent",content:'
All published Book Chapters are licensed under a Creative Commons Attribution 3.0 Unported License. Monographs are licensed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license granted to all others. Our Copyright Policy aims to guarantee that original material is published while at the same time giving significant freedom to our Authors. IntechOpen upholds a flexible Copyright Policy meaning that there is no copyright transfer to the publisher and Authors hold exclusive copyright to their work.
\n\n\n\nWith the purpose of protecting our Authors' copyright and the transparent reuse of Open Access content, IntechOpen has developed an Attribution Policy for works published under Creative Commons licenses.
\n\n\n\nIntechOpen is committed to disseminating high-quality scientific research in a manner that exemplifies the best practice in scholarly publishing. IntechOpen is an official member of the Committee on Publication Ethics (COPE), which advocates the maintenance of the highest ethical standards for all parties involved in the act of publishing, including Authors, Academic Editors of the book, Peer Reviewers, the publisher and Societies, where applicable.
\n\nIn line with publication ethics practices recommended by COPE, ICMJE, and other similar organizations, IntechOpen's contributing Authors, Academic Editors, and Peer Reviewers are required to declare fully all possible conflicts of interest.
\n\n\n\nIntechOpen's Authorship Policy is based on ICMJE criteria for authorship. In order to be identified as an Author, the following requirements must be met:
\n\nAll scientific works are subject to Peer Review prior to publishing. IntechOpen is a member of the Committee on Publication Ethics (COPE) and all participating referees and Academic Editors are expected to review submitted scientific works in line with the COPE Ethical Guidelines for Peer Reviewers where applicable.
\n\n\n\nThe Internet has changed the dynamics of scholarly communication and publishing which is why we find it necessary to clearly indicate our stance on what we consider to be a published scientific work. A significant number of working papers, early drafts, and similar works in progress are shared openly online between members of the scientific community. It has become common practice for researchers to announce their work on a personal website or a blog in order to gather comments and suggestions from other researchers. Such works and online postings are ‘published’ in the sense that they are made publicly available, but this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
\n\n\n\nTo identify instances of fraud and misconduct during the publishing process, IntechOpen implements a robust policy governing such occurrences. In line with our general commitment to openness, and in order to maintain the highest scientific standards, we are committed to transparency about our editorial policy regarding retractions and corrections.
\n\n\n\nWhen faced with potential misconduct, IntechOpen accepts its responsibility to maintain the integrity of the academic record. For particularly complex cases, IntechOpen might ask for the assistance of formal industry bodies or seek advice from an appropriate team of advisors.
\n\nIntechOpen's advisors are professionals and scholars with broad knowledge and understanding of different aspects of the scientific publishing process: editorial, authorship, and reviewing roles; publication ethics, copyright, and general legal issues; as well as bibliographic and technical standards.
\n\nIn order to provide us with unbiased insights, without compromising the privacy of third parties, IntechOpen presents problematic cases to its advisors in an anonymized format.
\n\nIntechOpen publishes books in the English language. If you are interested in the translation of Book Chapters, please check IntechOpen's Translation Policy.
\n\n\n\nIn line with the Principles of Transparency and Best Practice in Scholarly Publishing, you can access a more detailed description of IntechOpen's Advertising Policy.
\n\n\n\nAt IntechOpen we realize that exceptional circumstances can occur, resulting in a request for a refund. We will honor all justified requests in the specific instances outlined in our Refund Policy.
\n\n\n\nAll chapters will be published via IntechOpen's 'Online First' service meaning chapters will be published individually, immediately after review and before the entire book is ready for publication, allowing content to be shared, searched and cited straightaway, thereby generating early stage interest and momentum for your research
\n\nOnline First Chapters are considered published on the day they are posted and are citable from that date.
\n\nChapters will remain listed as Online First until the final versions of the books are published online. Following publication of the full monograph, Chapters will be redirected from the Online First version and will be available only through the final link of the official published page.
\n\nYou are invited to download, use, reproduce, make derivative works of, display, distribute and cite the Online First works. You can find "How to Cite and Reference" by following the link at the end of each online book chapter. Please be aware that it is possible that further editing and changes might be made before the final release of the book.
\n\nIf there are supplemental materials to the chapter, these will be published at the time the final book is published online.
\n\nReaders and Authors can notify us if they find any errors in the works published under Online First. All major errors will be accompanied by a separate correction notice, erratum or corrigendum (Retraction and Correction Policy.)
\n\nIntechOpen books are available online by accessing all published content on a chapter level.
\n\n\n\nIntechOpen publishes different types of publications.
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On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. 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Many health care providers are expected to be able to intubate the patients for different indications. As the case in any medical intervention, endotracheal intubation can cause complications. These complications are categorized as early or late according to the time of onset of the presenting symptoms. This chapter will discuss the long term complications of endotracheal intubation that might be encountered by the treating physicians. The chapter will stress on the predisposing factors for these complications and the available methods to avoid and treat them.",book:{id:"6495",slug:"tracheal-intubation",title:"Tracheal Intubation",fullTitle:"Tracheal Intubation"},signatures:"Abdelfattah A. Touman and Grigoris K. 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Knowledge of the functional anatomy of the airway in these forms the basis of understanding the pathological conditions that may occur. The upper airway extends from the mouth to the trachea. It includes the mouth, the nose, the palate, the uvula, the pharynx, and the larynx. This section also describes the functional physiology of this airway. Managing the airway of a patient with craniofacial disorders poses many challenges to the anesthesiologist. Anatomical abnormalities may affect only intubation, only airway management, or both. This section also focuses on the abnormal airways in obesity, pregnancy, children and neonate, and patients with abnormal facial defects.",book:{id:"6495",slug:"tracheal-intubation",title:"Tracheal Intubation",fullTitle:"Tracheal Intubation"},signatures:"Aslı Mete and İlknur Hatice Akbudak",authors:[{id:"237495",title:"Dr.",name:"Asli",middleName:null,surname:"Mete",slug:"asli-mete",fullName:"Asli Mete"},{id:"237882",title:"Dr.",name:"Ilknur",middleName:"Hatice",surname:"Akbudak",slug:"ilknur-akbudak",fullName:"Ilknur Akbudak"}]},{id:"53912",doi:"10.5772/67048",title:"Pharmacology of Local Anaesthetics and Commonly Used Recipes in Clinical Practice",slug:"pharmacology-of-local-anaesthetics-and-commonly-used-recipes-in-clinical-practice",totalDownloads:4089,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"Local anaesthetics are commonly used drugs in clinical anaesthesia. The knowledge of their pharmacology is paramount for safe and optimal use of this group of drugs. This chapter consists of two sections. The first section will address the chemical and physical properties, pharmacokinetics and pharmacodynamics of the local anaesthetics. In the second section, examples of the commonly used doses and additives used for various peripheral and regional anaesthetics will be discussed. We will also address the treatment of toxicity as a result of inadvertent intravascular injection of the local anaesthetics.",book:{id:"5490",slug:"current-topics-in-anesthesiology",title:"Current Topics in Anesthesiology",fullTitle:"Current Topics in Anesthesiology"},signatures:"Jesse Musokota Mumba, Freddy Kasandji Kabambi and Christian\nTshebeletso Ngaka",authors:[{id:"190178",title:"Dr.",name:"Jesse",middleName:"Musokota",surname:"Mumba",slug:"jesse-mumba",fullName:"Jesse Mumba"},{id:"190180",title:"Dr.",name:"Freddy Kasandji",middleName:null,surname:"Kabambi",slug:"freddy-kasandji-kabambi",fullName:"Freddy Kasandji Kabambi"},{id:"192695",title:"Dr.",name:"Christian Tshebeletso",middleName:null,surname:"Ngaka",slug:"christian-tshebeletso-ngaka",fullName:"Christian Tshebeletso Ngaka"}]},{id:"53159",doi:"10.5772/66574",title:"Postoperative Cognitive Dysfunction: Preclinical Highlights and Perspectives on Preventive Strategies",slug:"postoperative-cognitive-dysfunction-preclinical-highlights-and-perspectives-on-preventive-strategies",totalDownloads:1966,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"One of the common complications associated with anaesthesia and surgery in geriatric patients is the postoperative cognitive dysfunction (POCD). This cognitive impairment affects the long-term prognosis and has been shown to be associated with long-term disability, higher health care costs, and even increased mortality. On the other hand, clinical research on POCD is in its infancy, the condition has not been clarified, and since no strategy for management is currently available, it is imperative to develop specific methods for prevention and management. Although its pathogenesis involves various factors, accumulating evidence suggests that surgery elicits an inflammatory response in the hippocampus, a brain area closely related to cognitive function, playing a key role in the development of POCD. Several studies suggest that age-related phenotypic change of microglia is associated with pathogenic neuroinflammation, and more importantly it may be modifiable. In this chapter, we discuss the current overview and preclinical highlights regarding POCD. We further discuss some perspectives on preventive strategies for POCD, based on the findings of our preclinical research and the available literature.",book:{id:"5490",slug:"current-topics-in-anesthesiology",title:"Current Topics in Anesthesiology",fullTitle:"Current Topics in Anesthesiology"},signatures:"Fabricio M. Locatelli and Takashi Kawano",authors:[{id:"169688",title:"Dr.",name:"Takashi",middleName:null,surname:"Kawano",slug:"takashi-kawano",fullName:"Takashi Kawano"},{id:"191676",title:"Dr.",name:"Fabricio",middleName:null,surname:"Locatelli",slug:"fabricio-locatelli",fullName:"Fabricio Locatelli"}]},{id:"77934",doi:"10.5772/intechopen.99282",title:"Regional Analgesia for Knee Surgeries: Thinking beyond Borders",slug:"regional-analgesia-for-knee-surgeries-thinking-beyond-borders",totalDownloads:304,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Knee surgeries are the most commonly performed joint surgeries in the modern world, which help maintain the quality of life by improving joint functions. These include open trauma, sports injury, or joint replacement surgeries. Among various available regional analgesia options for knee surgeries, the goal is to choose motor-sparing, opioid-sparing, and procedure-specific modalities. Therefore, it is essential to know the complex anatomy of the knee joint, essential steps of various surgical procedures, and innervations of the pain-generating structures for a particular surgery. Background knowledge of all these essentials helps select the most appropriate regional analgesia technique for knee surgeries.",book:{id:"10708",slug:"topics-in-regional-anesthesia",title:"Topics in Regional Anesthesia",fullTitle:"Topics in Regional Anesthesia"},signatures:"Kartik Sonawane and Hrudini Dixit",authors:[{id:"351728",title:"Dr.",name:"Kartik",middleName:null,surname:"Sonawane",slug:"kartik-sonawane",fullName:"Kartik Sonawane"},{id:"351737",title:"Dr.",name:"Hrudini",middleName:null,surname:"Dixit",slug:"hrudini-dixit",fullName:"Hrudini Dixit"}]}],mostDownloadedChaptersLast30Days:[{id:"65467",title:"Anesthesia Management for Large-Volume Liposuction",slug:"anesthesia-management-for-large-volume-liposuction",totalDownloads:5965,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The apparent easiness with which liposuction is performed favors that patients, young surgeons, and anesthesiologists without experience in this field ignore the many events that occur during this procedure. Liposuction is a procedure to improve the body contour and not a surgery to reduce weight, although recently people who have failed in their plans to lose weight look at liposuction as a means to contour their body figure. Tumescent liposuction of large volumes requires a meticulous selection of each patient; their preoperative evaluation and perioperative management are essential to obtain the expected results. The various techniques of general anesthesia are the most recommended and should be monitored in the usual way, as well as monitoring the total doses of infiltrated local anesthetics to avoid systemic toxicity. The management of intravenous fluids is controversial, but the current trend is the restricted use of hydrosaline solutions. The most feared complications are deep vein thrombosis, pulmonary thromboembolism, fat embolism, lung edema, hypothermia, infections and even death. The adherence to the management guidelines and prophylaxis of venous thrombosis/thromboembolism is mandatory.",book:{id:"6221",slug:"anesthesia-topics-for-plastic-and-reconstructive-surgery",title:"Anesthesia Topics for Plastic and Reconstructive Surgery",fullTitle:"Anesthesia Topics for Plastic and Reconstructive Surgery"},signatures:"Sergio Granados-Tinajero, Carlos Buenrostro-Vásquez, Cecilia\nCárdenas-Maytorena and Marcela Contreras-López",authors:[{id:"273532",title:"Dr.",name:"Sergio Octavio",middleName:null,surname:"Granados Tinajero",slug:"sergio-octavio-granados-tinajero",fullName:"Sergio Octavio Granados Tinajero"}]},{id:"53389",title:"Anesthesia for Urological Surgery",slug:"anesthesia-for-urological-surgery",totalDownloads:3545,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Because of the variable techniques and patients’ positions used in urological surgery, anesthesia for urologic surgery requires advanced knowledge and special transactions. In this matter, it is important to follow current approaches for anesthesiologists. Different surgical procedures and complications due to different positions or anesthesia were evaluated separately to be more concise. We have researched recent literature and created this chapter about new technologies in urological surgery and development in anesthesia for urological surgery.",book:{id:"5490",slug:"current-topics-in-anesthesiology",title:"Current Topics in Anesthesiology",fullTitle:"Current Topics in Anesthesiology"},signatures:"Zeki Tuncel Tekgül, Burcu Özalp Horsanali and Mustafa Ozan\nHorsanali",authors:[{id:"59702",title:"Dr.",name:"Mustafa Ozan",middleName:null,surname:"Horsanali",slug:"mustafa-ozan-horsanali",fullName:"Mustafa Ozan Horsanali"},{id:"190164",title:"Dr.",name:"Zeki Tuncel",middleName:null,surname:"Tekgül",slug:"zeki-tuncel-tekgul",fullName:"Zeki Tuncel Tekgül"},{id:"195091",title:"Dr.",name:"Burcu Özalp",middleName:null,surname:"Horsanalı",slug:"burcu-ozalp-horsanali",fullName:"Burcu Özalp Horsanalı"}]},{id:"61712",title:"Functional Anatomy and Physiology of Airway",slug:"functional-anatomy-and-physiology-of-airway",totalDownloads:3739,totalCrossrefCites:1,totalDimensionsCites:5,abstract:"In this chapter, we scope the importance of functional anatomy and physiology of the upper airway. The upper airway has an important role in transporting air to the lungs. Both the anatomical structure of the airways and the functional properties of the mucosa, cartilages, and neural and lymphatic tissues influence the characteristics of the air that is inhaled. The airway changes in size, shape, and position throughout its development from the neonate to the adults. Knowledge of the functional anatomy of the airway in these forms the basis of understanding the pathological conditions that may occur. The upper airway extends from the mouth to the trachea. It includes the mouth, the nose, the palate, the uvula, the pharynx, and the larynx. This section also describes the functional physiology of this airway. Managing the airway of a patient with craniofacial disorders poses many challenges to the anesthesiologist. Anatomical abnormalities may affect only intubation, only airway management, or both. This section also focuses on the abnormal airways in obesity, pregnancy, children and neonate, and patients with abnormal facial defects.",book:{id:"6495",slug:"tracheal-intubation",title:"Tracheal Intubation",fullTitle:"Tracheal Intubation"},signatures:"Aslı Mete and İlknur Hatice Akbudak",authors:[{id:"237495",title:"Dr.",name:"Asli",middleName:null,surname:"Mete",slug:"asli-mete",fullName:"Asli Mete"},{id:"237882",title:"Dr.",name:"Ilknur",middleName:"Hatice",surname:"Akbudak",slug:"ilknur-akbudak",fullName:"Ilknur Akbudak"}]},{id:"60582",title:"Indications for Endotracheal Intubation",slug:"indications-for-endotracheal-intubation",totalDownloads:3689,totalCrossrefCites:1,totalDimensionsCites:0,abstract:"Endotracheal intubation may be required when respiratory distress or airway integrity cannot be achieved or maintained for any reason. It should be considered that intubation may be required when evaluating the patient, and that in the long term, airway protection will be needed or that the problem cannot be solved by noninvasive ventilation via airway aids and devices. Identifying the problem causing the patient’s respiratory failure helps in making the decision to intubate. In fact, the clinician must be fast and self-confident when deciding on intubation. It is difficult to decide in some complex situations. It is very important to evaluate the patient, according to clinical status, age, and comorbidity, and to determine urgent intubation need. In non-diagnostic cases, further research is needed to investigate the causes of the condition such as hypoxia/hypercapnia resulting in patient respiratory distress. Different voice tone, swallowing difficulties, coughing attacks, stridor, dyspnea can be a sign of upper airway obstruction. Arterial blood gas analysis will facilitate our decision to make intubation. Non-invasive pulse oximetry and continuous capnography values may also be a guide, but the most important thing is that delayed intubation decision may bring life-threatening situations.",book:{id:"6495",slug:"tracheal-intubation",title:"Tracheal Intubation",fullTitle:"Tracheal Intubation"},signatures:"Yeliz Şahiner",authors:[{id:"236458",title:"Dr.",name:"Yeliz",middleName:null,surname:"Şahiner",slug:"yeliz-sahiner",fullName:"Yeliz Şahiner"}]},{id:"64750",title:"Perioperative Complications in Plastic Surgery",slug:"perioperative-complications-in-plastic-surgery",totalDownloads:1398,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Anesthetic complications in the perioperative period in plastic surgery are extremely rare, although they can be catastrophic and sometimes fatal. The proper selection and correct preoperative assessment of patients are the key to stay away from unwanted events. Preanesthesia evaluation is mandatory in each patient and must include clinical history, complete physical examination, and routine and special laboratory tests in patients with associated pathologies. Anesthetic management is based on these results, type of surgery, experience of the anesthesiologist, and the operating environment. The anesthetic technique can be local, regional, or general with standard noninvasive monitoring. It is recommended that an anesthesiologist be present in all plastic surgery procedures. Complications are usually the result of moving away from the guidelines already established for an excellent practice or the result of sentinel events rather than human errors. Pulmonary embolism is probably the most feared complication, with soft tissue infections being the most frequent complication in plastic surgery. Less common complications include arrhythmias, overhydration, allergies, bleeding, skin necrosis, dehiscence of wounds, brain damage, and dead. Anesthesiologists, surgeons, nurses, and all personnel involved in the care of these patients must work as a team of highly qualified and updated professionals.",book:{id:"6221",slug:"anesthesia-topics-for-plastic-and-reconstructive-surgery",title:"Anesthesia Topics for Plastic and Reconstructive Surgery",fullTitle:"Anesthesia Topics for Plastic and Reconstructive Surgery"},signatures:"Víctor M. Whizar-Lugo, Jaime Campos-León and Alejandro\nMoreno-Guillen",authors:[{id:"169249",title:"Prof.",name:"Víctor M.",middleName:null,surname:"Whizar-Lugo",slug:"victor-m.-whizar-lugo",fullName:"Víctor M. 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He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"1",title:"Oral Health",coverUrl:"https://cdn.intechopen.com/series_topics/covers/1.jpg",editor:{id:"173955",title:"Prof.",name:"Sandra",middleName:null,surname:"Marinho",slug:"sandra-marinho",fullName:"Sandra Marinho",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRGYMQA4/Profile_Picture_2022-06-01T13:22:41.png",biography:"Dr. Sandra A. Marinho is an Associate Professor and Brazilian researcher at the State University of Paraíba (Universidade Estadual da Paraíba- UEPB), Campus VIII, located in Araruna, state of Paraíba since 2011. She holds a degree in Dentistry from the Federal University of Alfenas (UNIFAL), while her specialization and professional improvement in Stomatology took place at Hospital Heliopolis (São Paulo, SP). Her qualifications are: a specialist in Dental Imaging and Radiology, Master in Dentistry (Periodontics) from the University of São Paulo (FORP-USP, Ribeirão Preto, SP), and Doctor (Ph.D.) in Dentistry (Stomatology Clinic) from Hospital São Lucas of the Pontifical Catholic University of Rio Grande do Sul (HSL-PUCRS, Porto Alegre, RS). She held a postdoctoral internship at the Federal University from Jequitinhonha and Mucuri Valleys (UFVJM, Diamantina, MG). She is currently a member of the Brazilian Society for Dental Research (SBPqO) and the Brazilian Society of Stomatology and Pathology (SOBEP). Dr. Marinho's experience in Dentistry mainly covers the following subjects: oral diagnosis, oral radiology; oral medicine; lesions and oral infections; oral pathology, laser therapy and epidemiological studies.",institutionString:null,institution:{name:"State University of Paraíba",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"267724",title:"Dr.",name:"Febronia",middleName:null,surname:"Kahabuka",slug:"febronia-kahabuka",fullName:"Febronia Kahabuka",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZpJQAW/Profile_Picture_2022-06-27T12:00:42.JPG",institutionString:null,institution:null}]},{id:"2",title:"Prosthodontics and Implant Dentistry",coverUrl:"https://cdn.intechopen.com/series_topics/covers/2.jpg",editor:{id:"179568",title:"Associate Prof.",name:"Wen Lin",middleName:null,surname:"Chai",slug:"wen-lin-chai",fullName:"Wen Lin Chai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRHGAQA4/Profile_Picture_2022-05-23T14:31:12.png",biography:"Professor Dr. Chai Wen Lin is currently a lecturer at the Department of Restorative Dentistry, Faculty of Dentistry of the University of Malaya. She obtained a Master of Dental Science in 2006 and a Ph.D. in 2011. Her Ph.D. research work on the soft tissue-implant interface at the University of Sheffield has yielded several important publications in the key implant journals. She was awarded an Excellent Exchange Award by the University of Sheffield which gave her the opportunity to work at the famous Faculty of Dentistry of the University of Gothenburg, Sweden, under the tutelage of Prof. Peter Thomsen. In 2016, she was appointed as a visiting scholar at UCLA, USA, with attachment in Hospital Dentistry, and involvement in research work related to zirconia implant. In 2016, her contribution to dentistry was recognized by the Royal College of Surgeon of Edinburgh with her being awarded a Fellowship in Dental Surgery. She has authored numerous papers published both in local and international journals. She was the Editor of the Malaysian Dental Journal for several years. 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His passion for teaching then led him to join the faculty of dentistry at University Malaya and he has since became a valuable lecturer and clinical specialist in the Department of Restorative Dentistry. He is currently the removable prosthodontic undergraduate year 3 coordinator, head of the undergraduate module on occlusion and a member of the multidisciplinary team for the TMD clinic. He has previous membership in the British Society for Restorative Dentistry, the Malaysian Association of Aesthetic Dentistry and he is currently a lifetime member of the Malaysian Association for Prosthodontics. Currently, he is also the examiner for the Restorative Specialty Membership Examinations, Royal College of Surgeons, England. He has authored and co-authored handful of both local and international journal articles. 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She obtained her Ph.D. in Veterinary Sciences from the University of Trás-os-Montes e Alto Douro, Portugal. After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. She is also a frequent referee for various journals.",institutionString:null,institution:{name:"University of Évora",institutionURL:null,country:{name:"Portugal"}}}]},{type:"book",id:"7144",title:"Veterinary Anatomy and Physiology",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7144.jpg",slug:"veterinary-anatomy-and-physiology",publishedDate:"March 13th 2019",editedByType:"Edited by",bookSignature:"Catrin Sian Rutland and Valentina Kubale",hash:"75cdacb570e0e6d15a5f6e69640d87c9",volumeInSeries:2,fullTitle:"Veterinary Anatomy and Physiology",editors:[{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}}]},{type:"book",id:"8524",title:"Lactation in Farm Animals",subtitle:"Biology, Physiological Basis, Nutritional Requirements, and Modelization",coverURL:"https://cdn.intechopen.com/books/images_new/8524.jpg",slug:"lactation-in-farm-animals-biology-physiological-basis-nutritional-requirements-and-modelization",publishedDate:"January 22nd 2020",editedByType:"Edited by",bookSignature:"Naceur M'Hamdi",hash:"2aa2a9a0ec13040bbf0455e34625504e",volumeInSeries:3,fullTitle:"Lactation in Farm Animals - Biology, Physiological Basis, Nutritional Requirements, and Modelization",editors:[{id:"73376",title:"Dr.",name:"Naceur",middleName:null,surname:"M'Hamdi",slug:"naceur-m'hamdi",fullName:"Naceur M'Hamdi",profilePictureURL:"https://mts.intechopen.com/storage/users/73376/images/system/73376.jpg",biography:"Naceur M’HAMDI is Associate Professor at the National Agronomic Institute of Tunisia, University of Carthage. He is also Member of the Laboratory of genetic, animal and feed resource and member of Animal science Department of INAT. He graduated from Higher School of Agriculture of Mateur, University of Carthage, in 2002 and completed his masters in 2006. Dr. M’HAMDI completed his PhD thesis in Genetic welfare indicators of dairy cattle at Higher Institute of Agronomy of Chott-Meriem, University of Sousse, in 2011. 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