Patient characteristics
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"9138",leadTitle:null,fullTitle:"Public Health in Developing Countries - Challenges and Opportunities",title:"Public Health in Developing Countries",subtitle:"Challenges and Opportunities",reviewType:"peer-reviewed",abstract:"Public health entails the use of models, technologies, experience and evidence derived through consumer participation, translational research and population sciences to protect and improve the health of the population. Enhancing public health is of significant importance to the development of a nation, particularly for developing countries where the health care system is underdeveloped, fragile or vulnerable.This book examines progress and challenges with regards to public health in developing countries in two parts: Part 1 “General and Crosscutting Issues in Public Health and Case Studies” and Part 2 “Country-Specific Issues in Public Health.” For example, assuring equity for marginalized indigenous groups and other key populations entails the application of transdisciplinary interventions including legislation, advocacy, financing, empowerment and de-stigmatization. The diverse structural, political, economic, technological, geographical and social landscape of developing countries translates to unique public health challenges, infrastructure and implementation trajectories in addressing issues such as vector-borne diseases and intimate partner violence.This volume will be of interest to researchers, health ministry policy makers, public health professionals and non-governmental organizations whose work entails collaborations with public health systems of developing nations and regions.",isbn:"978-1-78985-874-7",printIsbn:"978-1-78985-873-0",pdfIsbn:"978-1-83962-380-6",doi:"10.5772/intechopen.83134",price:119,priceEur:129,priceUsd:155,slug:"public-health-in-developing-countries-challenges-and-opportunities",numberOfPages:274,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"28c7e86f71905feb65668941c4f259f4",bookSignature:"Edlyne Eze Anugwom and Niyi Awofeso",publishedDate:"September 9th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/9138.jpg",numberOfDownloads:15598,numberOfWosCitations:5,numberOfCrossrefCitations:14,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:40,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:59,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 14th 2019",dateEndSecondStepPublish:"May 2nd 2019",dateEndThirdStepPublish:"July 1st 2019",dateEndFourthStepPublish:"September 19th 2019",dateEndFifthStepPublish:"November 18th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"293469",title:null,name:"Edlyne Eze",middleName:null,surname:"Anugwom",slug:"edlyne-eze-anugwom",fullName:"Edlyne Eze Anugwom",profilePictureURL:"https://mts.intechopen.com/storage/users/293469/images/9729_n.jpg",biography:"Edlyne Anugwom is a Professor of Sociology and Development\nat the University of Nigeria and until recently Georg Forster\nSenior Research Fellow of the Humboldt Foundation at the\nInstitute of African Studies, Leipzig University. He has held\nteaching positions/fellowships in such diverse places as Leiden,\nWassenaar, Birmingham, Bridgewater, Edinburgh, Mainz, Cape\nTown, and others. His research interests are in the areas of social\nresearch, public health, political sociology of development, social conflict and terrorism in Africa. Significant publications include: Research Methods in Social Sciences\n(2010, Fourth Dimension Pub); The Boko Haram Insurgence in Nigeria: Perspectives\nfrom Within (2019, Palgrave Macmillan); From Biafra to the Niger Delta Conflict:\nMemory, Ethnicity and the State in Nigeria (2019, Lexington Books); and Development in Nigeria – Promise on Hold? (2020, Routledge). In addition, he has published\nmore than 100 peer-reviewed journal articles and as many book chapters.",institutionString:"University of Nigeria",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Nigeria, Nsukka",institutionURL:null,country:{name:"Nigeria"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"36610",title:"Prof.",name:"Niyi",middleName:null,surname:"Awofeso",slug:"niyi-awofeso",fullName:"Niyi Awofeso",profilePictureURL:"https://mts.intechopen.com/storage/users/36610/images/system/36610.jpeg",biography:"Niyi Awofeso is currently a professor at the School of Health and Environmental Studies Hamdan Bin Mohammed Smart University (HBMSU), Dubai. He commenced his public health career as an infectious disease physician and acting medical director at Nigeria’s National Tuberculosis and Leprosy Training Centre in 1990. Prior to joining HBMSU in 2013 from the University of Western Australia where he worked as Professor of Health Management, he accumulated extensive research and professional experience at both middle and senior management levels in academia and the international health industry. He holds postgraduate qualifications in infectious diseases medicine, public health, business administration and health administration. He has so far published more than 120 peer-reviewed articles in well-regarded academic journals, authored five books and eight book chapters.",institutionString:"Hamdan Bin Mohammed Smart University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Hamdan Bin Mohammed Smart University",institutionURL:null,country:{name:"United Arab Emirates"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1131",title:"Global Health",slug:"global-health"}],chapters:[{id:"72687",title:"Introductory Chapter: Public Health Afflictions and Challenges in the Developing World",doi:"10.5772/intechopen.93145",slug:"introductory-chapter-public-health-afflictions-and-challenges-in-the-developing-world",totalDownloads:392,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:null,signatures:"Edlyne Eze Anugwom",downloadPdfUrl:"/chapter/pdf-download/72687",previewPdfUrl:"/chapter/pdf-preview/72687",authors:[{id:"293469",title:null,name:"Edlyne Eze",surname:"Anugwom",slug:"edlyne-eze-anugwom",fullName:"Edlyne Eze Anugwom"}],corrections:null},{id:"69468",title:"The Global Burden and Perspectives on Non-Communicable Diseases (NCDs) and the Prevention, Data Availability and Systems Approach of NCDs in Low-resource Countries",doi:"10.5772/intechopen.89516",slug:"the-global-burden-and-perspectives-on-non-communicable-diseases-ncds-and-the-prevention-data-availab",totalDownloads:2723,totalCrossrefCites:5,totalDimensionsCites:15,hasAltmetrics:1,abstract:"The burden of non-communicable diseases (NCDs) is growing swiftly in low-resourced countries resulting in deleterious health resembling the NCDs burden in high-resourced countries. Despite the availability of information on the escalating adverse economic and health effects of NCDs globally, specific strategies designed to address the growing burden of NCDs in low-resourced countries remain substandard. Research engines like EBSCOhost, Science Citation Index, CINAHL database, PsycINFO, Cochrane Database of Systematic Reviews, published and unpublished abstracts and a hand search of reference lists and table of contents of relevant journals and books were searched from January 2011 to June 2019. In total, 84 studies met the inclusion criteria. Most studies confirm that low-resourced countries compared with high-resourced countries battle to implement NCDs prevention strategies; fail to record data on the risk factors of NCDs; medical records and surveillance data are unavailable. Due to a lack of knowledge and skill, low-resourced countries show no urgency to implement a systems approach for NCDs management. The findings confirm disparities between high-resourced and low-resourced countries regarding NCDs prevention, availability of quality data, and strategies to prevent and manage NCDs through a systems approach that can assist healthcare institutions in reducing the damaging effect of NCDs globally.",signatures:"Melkamu Kassa and Jeanne Grace",downloadPdfUrl:"/chapter/pdf-download/69468",previewPdfUrl:"/chapter/pdf-preview/69468",authors:[{id:"306689",title:"Dr.",name:"Melkamu",surname:"Kassa",slug:"melkamu-kassa",fullName:"Melkamu Kassa"},{id:"306691",title:"Dr.",name:"Grace",surname:"Jeanne",slug:"grace-jeanne",fullName:"Grace Jeanne"}],corrections:null},{id:"69370",title:"Non-Communicable Diseases and Urbanization in African Cities: A Narrative Review",doi:"10.5772/intechopen.89507",slug:"non-communicable-diseases-and-urbanization-in-african-cities-a-narrative-review",totalDownloads:1309,totalCrossrefCites:5,totalDimensionsCites:12,hasAltmetrics:1,abstract:"Rapid urbanization in Africa has been linked to the growing burden of non-communicable diseases (NCDs). Urbanization processes have amplified lifestyle risk factors for NCDs (including unhealthy diets, tobacco use, harmful alcohol intake, and physical inactivity), especially among individuals of low and middle social economic status. Nevertheless, African countries are not keeping pace with the ever increasing need for population-level interventions such as health promotion through education, screening, diagnosis, and treatment, as well as structural measures such as policies and legislation to prevent and control the upstream factors driving the NCD epidemic. This chapter highlights the NCD burden in urban Africa, along with the social determinants and existing interventions against NCDs. The chapter concludes by offering insights into policy and legislative opportunities and recommends stronger efforts to apply multisectoral and intersectoral approaches in policy formulation, implementation, and monitoring at multiple levels to address the NCD epidemic in African cities.",signatures:"Kenneth Juma, Pamela A. Juma, Constance Shumba, Peter Otieno and Gershim Asiki",downloadPdfUrl:"/chapter/pdf-download/69370",previewPdfUrl:"/chapter/pdf-preview/69370",authors:[{id:"304657",title:"Dr.",name:"Kenneth",surname:"Juma",slug:"kenneth-juma",fullName:"Kenneth Juma"},{id:"310042",title:"Dr.",name:"Gershim",surname:"Asiki",slug:"gershim-asiki",fullName:"Gershim Asiki"},{id:"310043",title:"Dr.",name:"Pamela",surname:"Juma",slug:"pamela-juma",fullName:"Pamela Juma"},{id:"310045",title:"Dr.",name:"Peter",surname:"Otieno",slug:"peter-otieno",fullName:"Peter Otieno"},{id:"310059",title:"Dr.",name:"Constance",surname:"Shumba",slug:"constance-shumba",fullName:"Constance Shumba"}],corrections:null},{id:"71667",title:"Health Promotion and Its Challenges to Public Health Delivery System in Africa",doi:"10.5772/intechopen.91859",slug:"health-promotion-and-its-challenges-to-public-health-delivery-system-in-africa",totalDownloads:1455,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The chapter examines the place and role of health promotion in the drive for sustainable and effective public health delivery in Africa. It conceptualizes health promotion from a multifaceted and multi-professional perspective hinged on the empowerment of communities and individuals to play active roles and adopt behaviour consistent with the goals of good health. The paper drawing on documentary data sees health promotion as critical to the achievement of health goals in the continent and equally reflects on the theories of health promotion, strategies for health promotion and challenges to health promotion in Africa. It argues that health promotion in the continent can be strengthened through such measures as appropriate legislations, robust funding, gender inclusiveness, stepping up research, regular needs assessment and evaluation, setting needs-driven priorities and building capacity of health promotion to target vulnerable and marginal members of the society, among others.",signatures:"Edlyne Eze Anugwom",downloadPdfUrl:"/chapter/pdf-download/71667",previewPdfUrl:"/chapter/pdf-preview/71667",authors:[{id:"293469",title:null,name:"Edlyne Eze",surname:"Anugwom",slug:"edlyne-eze-anugwom",fullName:"Edlyne Eze Anugwom"}],corrections:null},{id:"72878",title:"Understanding the Science of Indigenous Health System: Key to Sustainable Collaborations",doi:"10.5772/intechopen.92090",slug:"understanding-the-science-of-indigenous-health-system-key-to-sustainable-collaborations",totalDownloads:682,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Most of the health systems in developing countries are dysfunctional and hardly responsive to the needs and demands of patients. Access to a plural healthcare system and reports of patients abandoning western medicine for indigenous medicine are signs of nonresponsive health system. The major contributing factors are the failures of the allopathic health system to recognize that indigenous medicine is a living and practised science, with its own philosophy, beliefs and practices developed over centuries. Indigenous communities and the patient’s worldviews are intertwined with indigenous traditions, practices and beliefs. While the two health systems, allopathic and indigenous, coexist in Africa, they must collaborate in the management of patients. The two systems assign different etiological explanations and meanings to health, disease and illness based on worldviews, epistemologies and methodologies developed over time. Change of mindset, attitudes and practices through decolonization will lead to sustainable collaboration.",signatures:"Mbulaheni S. Nemutandani, SJH Hendrick and FM Mulaudzi",downloadPdfUrl:"/chapter/pdf-download/72878",previewPdfUrl:"/chapter/pdf-preview/72878",authors:[{id:"304220",title:"Prof.",name:"Simon",surname:"Nemutandani",slug:"simon-nemutandani",fullName:"Simon Nemutandani"}],corrections:null},{id:"72270",title:"Public Health Effects of Wood Fuel in Africa: Bioenergy from Tree Commodities as a Sustainable Remedy",doi:"10.5772/intechopen.90603",slug:"public-health-effects-of-wood-fuel-in-africa-bioenergy-from-tree-commodities-as-a-sustainable-remedy",totalDownloads:732,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Globally, about 2.8 million people depend on solid wood fuel for energy, developing countries account for more than 90% of this population. About 70% of households in Sub-Saharan depend on wood fuel for energy. The combustion of solid wood fuel indoors and outdoors emits smoke with particles that have adverse effects on the health of users. This chapter investigates the health effects of wood fuel combustion on the users and evaluates the potential of bioenergy from tree commodities as a sustainable remedy. Through a literature review of literature on health effects of wood fuel, this chapter shows that acute respiratory infections, lung problems, cataract, cardiovascular diseases and bronchitis are common public health issues that wood fuel users suffer from. Bioenergy provides a clean and healthier alternative energy for rural households; tree commodities provide a more sustainable option for millions of Africans who depend on tree commodities for their livelihoods. Estimates show that between 4.26E+06 and 1.14E+07 MW of bioelectricity can be generated from tree commodities, while 6.26E+08 to 1.71E+09 litres of bioethanol and 4.27E+08 to 1.14E+09 litres of biodiesel can potentially be generated from tree commodities. Significant government support, financial investment, public-private partnerships and community sensitisation are required for tree commodities to sustainable provide clean and healthy bioenergy to rural Africa.",signatures:"Serge Mandiefe Piabuo and Janice Tieguhong Puatwoe",downloadPdfUrl:"/chapter/pdf-download/72270",previewPdfUrl:"/chapter/pdf-preview/72270",authors:[{id:"237109",title:"M.Sc.",name:"Serge Mandiefe",surname:"Piabuo",slug:"serge-mandiefe-piabuo",fullName:"Serge Mandiefe Piabuo"},{id:"310642",title:"MSc.",name:"Janice",surname:"Tieguhong Puatwoe",slug:"janice-tieguhong-puatwoe",fullName:"Janice Tieguhong Puatwoe"}],corrections:null},{id:"69631",title:"Cultural Practices and Health Consequences: Health or Habits, the Choice Is Ours",doi:"10.5772/intechopen.89778",slug:"cultural-practices-and-health-consequences-health-or-habits-the-choice-is-ours",totalDownloads:845,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Human beings are social animals with an innate desire to conform to socially accepted norms and values. Over periods of time, some of these norms become standards that all members of the community are expected to adhere to. Deviance from these standards is seen as absurd, wrong, or frankly abnormal. However, many of these cultural mores have no scientific basis and, some of them actually promote behaviors with negative health consequences. This chapter examines the cultural practices of some communities in Africa and their health consequences and, explores ways to address the challenges.",signatures:"Radiance Ogundipe",downloadPdfUrl:"/chapter/pdf-download/69631",previewPdfUrl:"/chapter/pdf-preview/69631",authors:[{id:"302308",title:"Dr.",name:"Radiance",surname:"Ogundipe",slug:"radiance-ogundipe",fullName:"Radiance Ogundipe"}],corrections:null},{id:"70667",title:"Mitigating the Hazard of Lightning Injury and Death across Africa",doi:"10.5772/intechopen.90468",slug:"mitigating-the-hazard-of-lightning-injury-and-death-across-africa",totalDownloads:817,totalCrossrefCites:0,totalDimensionsCites:3,hasAltmetrics:1,abstract:"Lightning injuries, deaths, and the economic consequences of lightning damage to property and infrastructure continue to be a significant public health challenge and economic development issue in many tropical and subtropical areas of the world, especially sub-Saharan Africa. This chapter will discuss the scope of the hazard, known risk factors including common cultural beliefs that inhibit public education, existing data sources, medical effects and long-term disability, lightning formation and detection, injury mechanisms, existing lightning safety programs and their challenges, and the work being done to decrease injuries, death, and property damage from lightning in Africa by the African Centres for Lightning and Electromagnetics Network (ACLENet).",signatures:"Mary Ann Cooper, Ronald L. Holle and Richard Tushemereirwe",downloadPdfUrl:"/chapter/pdf-download/70667",previewPdfUrl:"/chapter/pdf-preview/70667",authors:[{id:"183336",title:"Dr.",name:"Mary Ann",surname:"Cooper",slug:"mary-ann-cooper",fullName:"Mary Ann Cooper"},{id:"305781",title:"Mr.",name:"Ronald L.",surname:"Holle",slug:"ronald-l.-holle",fullName:"Ronald L. Holle"},{id:"309128",title:"Mr.",name:"Richard",surname:"Tushemereirwe",slug:"richard-tushemereirwe",fullName:"Richard Tushemereirwe"}],corrections:null},{id:"72196",title:"Leprosy: Prevention and Control",doi:"10.5772/intechopen.92089",slug:"leprosy-prevention-and-control",totalDownloads:866,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Hansen’s disease is one of the most ancient diseases that is still prevalent in the world. The causative agent, Mycobacterium leprae (M. leprae) has a long incubation period, clinical features after infection are identified late and these acid fast bacilli cannot be cultured – making leprosy a difficult disease to eradicate. Therefore the prevention and control of disease becomes more important. The shift of treatment from dapsone monotherapy to multidrug therapy regimen has given a new hope. The multidrug therapy coupled with the newer vaccines promise better results to prevent further transmission. Globally and locally the efforts to decrease the burden of leprosy by using different strategies has resulted in elimination of leprosy. But there is still a long way to go to make world free of this dreaded disease.",signatures:"Vaseem Anjum",downloadPdfUrl:"/chapter/pdf-download/72196",previewPdfUrl:"/chapter/pdf-preview/72196",authors:[{id:"303053",title:"M.D.",name:"Vaseem",surname:"Anjum",slug:"vaseem-anjum",fullName:"Vaseem Anjum"}],corrections:null},{id:"68036",title:"Laser Applications in Periodontology",doi:"10.5772/intechopen.88046",slug:"laser-applications-in-periodontology",totalDownloads:1244,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Laser have various periodontal applications including calculus removal (erbium yttrium scandium gallium garnet and erbium yttrium aluminum garnet lasers), decontamination of root and implant surfaces and bio stimulation, incision and ablation, osseous surgery, excision of the soft tissue, and bacterial reduction. This chapter analyzes the most important occasions in which lasers are used in implant and periodontal field practices. There is a strong evidence that laser is used for surgical and nonsurgical periodontal therapies including root bio modification, bacterial decline and decontamination of infected implant surface (in peri-implantitis), and removal of the pocket epithelium. This chapter also highlights the most common disadvantages as well as the advantages of using lasers in periodontal therapy. Waterlase® and Periowave™ systems are recent devices that have further revolutionized the laser technology for its favorable clinical applications; however, the procedural cost with the laser device constitutes an obstacle for its routine application.",signatures:"Sura Dakhil Jassim",downloadPdfUrl:"/chapter/pdf-download/68036",previewPdfUrl:"/chapter/pdf-preview/68036",authors:[{id:"302461",title:"Dr.",name:"Sura",surname:"Jassim",slug:"sura-jassim",fullName:"Sura Jassim"}],corrections:null},{id:"71202",title:"Development of a Rough Terrain Wheelchair Design",doi:"10.5772/intechopen.91267",slug:"development-of-a-rough-terrain-wheelchair-design",totalDownloads:507,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Conventional wheelchairs do not cope well in less-resourced rural areas as they are not stable and can topple easily. This chapter seeks to develop a wheelchair design that offers optimum stability and comfort for people in rural areas where there is rough and uneven terrain environment. The design development process entailed the generation of three possible wheelchair design concepts. Wide rear wheel design was further developed to come up with a detailed design with a maximum tipping angle of 43.17 degrees. This could be considered to be a great improvement compared to the conventional wheelchair configuration. The design was made to function using a ratchet lever bar to push the rear wheels forward to initiate motion. It was established that fabrication of the prototype could be done easily at a lower cost cap of USD200 using locally available materials. The proposed wheelchair design would improve the mobility and consequent living conditions of those disabled individuals living in rough terrain rural set up environments.",signatures:"Ignatio Madanhire, Loice Gudukeya and Roy Mushonga",downloadPdfUrl:"/chapter/pdf-download/71202",previewPdfUrl:"/chapter/pdf-preview/71202",authors:[{id:"282665",title:"Dr.",name:"Ignatio",surname:"Madanhire",slug:"ignatio-madanhire",fullName:"Ignatio Madanhire"},{id:"315729",title:"Mr.",name:"Roy",surname:"Mushonga",slug:"roy-mushonga",fullName:"Roy Mushonga"},{id:"315730",title:"Dr.",name:"Loice",surname:"Gudukeya",slug:"loice-gudukeya",fullName:"Loice Gudukeya"}],corrections:null},{id:"70815",title:"Temporal Trend and Inequality in Immunization Coverage in India",doi:"10.5772/intechopen.88298",slug:"temporal-trend-and-inequality-in-immunization-coverage-in-india",totalDownloads:652,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:1,abstract:"Since 1978, India through its various health policies target to achieve the universal immunization, but profound progress is yet to be seen. This paper examine the trend in immunization coverage and differential access among the population subgroups. Data for the analysis was extracted from the two recent rounds of the National Family Health Survey (NFHS) conducted in 2005–2006 and 2015–2016. Descriptive statistics were used to understand the level of coverage, whereas the ratio method and concentration index was used to understand the inequality. The study identified immunization coverage had improved from 44 percent in 2005–2006 to 62 percent in 2015–2016. However, considerable variation was observed among the regions and various wealth quintiles. In the Southern region, 63 percent of children from the poorest wealth quintile were fully immunized compared to 36 percent in North Eastern region. The coverage of full immunization among richest children was found to be 1.5 times higher than that of the poorest. The concentration index remains positive showing the pro-rich inequality. A positive result was found in the Northern and Northeastern region, where the poorest were showing an impeccable improvement over the period. Moreover, the study found the gap by place of residence and gender was close to convergence. The study suggests that the immunization programs have to be inclusive, with widespread reach, leaving no stones unturned. These steps can be beneficial in diminishing inequalities, acting as an essential ingredient in achieving the sustainable development goals.",signatures:"Basant Kumar Panda",downloadPdfUrl:"/chapter/pdf-download/70815",previewPdfUrl:"/chapter/pdf-preview/70815",authors:[{id:"302712",title:"Mr.",name:"Basant",surname:"Panda",slug:"basant-panda",fullName:"Basant Panda"}],corrections:null},{id:"70021",title:"Social and Institutional Support in Breast Cancer Management among Elderly Women in Nigeria",doi:"10.5772/intechopen.88748",slug:"social-and-institutional-support-in-breast-cancer-management-among-elderly-women-in-nigeria",totalDownloads:599,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The focus of the study was on the social and institutional support available in Nigeria for the management of breast cancer among elderly women. It examined the occurrence and sociocultural factors implicated in breast cancer among elderly women in Nigeria. It discovered that there is increasing incidence of breast cancer among elderly women in Nigeria with an equally increasing mortality rate due largely to low awareness of this menace among women who are past childbearing age. In addition to a low level of awareness are other sociocultural factors such as age, income, education, and the belief systems of the people that the study identified as drivers of increasing menace of breast cancer among elderly women. The above are compounded by the scarcity and inaccessibility of cancer treatment and management facilities in Nigeria. Incidentally, counseling services from such professions as social work and clinical psychology are hardly in existence, leaving the burden of management and care entirely to the families of those affected by the ailment. This calls for a rethink of the sociocultural and support context of public health management in Nigeria. This paper examines the availability and adequacy of existing social and institutional support for breast cancer in Nigeria.",signatures:"Kenechukwu N. Anugwom",downloadPdfUrl:"/chapter/pdf-download/70021",previewPdfUrl:"/chapter/pdf-preview/70021",authors:[{id:"302831",title:"Dr.",name:"Kenechukwu",surname:"Anugwom",slug:"kenechukwu-anugwom",fullName:"Kenechukwu Anugwom"}],corrections:null},{id:"68628",title:"The Health and Economic Costs of Violence against Women and Girls on Survivors, Their Families, and Communities in Ghana",doi:"10.5772/intechopen.88690",slug:"the-health-and-economic-costs-of-violence-against-women-and-girls-on-survivors-their-families-and-co",totalDownloads:814,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Violence against women and girls (VAWG) is a worldwide phenomenon. Globally, 35% of women have experienced physical or sexual intimate partner violence (IPV) or non-partner sexual violence in their lives. VAWG is estimated to cost the global economy about US$ eight trillion. Most studies on violence in Ghana discuss domestic violence or some forms of sexual violence but lack a comprehensive view of VAWG and its costs and impacts on communities, businesses, and the national economy. Our international consortium undertook a mixed-methods study to estimate the economic and non-economic losses caused by VAWG. We surveyed 2002 women and 805 male and female employees and conducted 24 in-depth interviews (IDIs) and 8 focus group discussions (FGDs). The study finds that costs of VAWG are high and multi-fold. It estimates costs to health, social relationships, and productivity for individuals, their families, and communities. Individual well-being and capabilities are impacted through absenteeism or missed care work and mental health issues. VAWG deepens household poverty by out-of-pocket expenditures that arise to address medical and legal issues that result from violence. Additionally, VAWG affects the vibrancy of communities as women’s participation and leadership decline. These costs accumulate to have profound effects on the Ghanaian economy and society.",signatures:"Gina Alvarado Merino, Stacey Scriver, Jennifer L. Mueller, Lila O’Brien-Milne, Ama P. Fenny and Nata Duvvury",downloadPdfUrl:"/chapter/pdf-download/68628",previewPdfUrl:"/chapter/pdf-preview/68628",authors:[{id:"302382",title:"Dr.",name:"Gina",surname:"Alvarado",slug:"gina-alvarado",fullName:"Gina Alvarado"},{id:"303963",title:"Dr.",name:"Nata",surname:"Duvvury",slug:"nata-duvvury",fullName:"Nata Duvvury"},{id:"303964",title:"Dr.",name:"Stacey",surname:"Scriver",slug:"stacey-scriver",fullName:"Stacey Scriver"},{id:"309167",title:"Ms.",name:"Jennifer",surname:"Mueller",slug:"jennifer-mueller",fullName:"Jennifer Mueller"},{id:"309168",title:"Ms.",name:"Lila",surname:"O'Brien-Milne",slug:"lila-o'brien-milne",fullName:"Lila O'Brien-Milne"},{id:"309169",title:"Dr.",name:"Ama",surname:"Fenny",slug:"ama-fenny",fullName:"Ama Fenny"}],corrections:null},{id:"69588",title:"Obesity in School Children in India",doi:"10.5772/intechopen.89602",slug:"obesity-in-school-children-in-india",totalDownloads:1386,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"The global prevalence of obesity has doubled from 1990 to 2015. Worryingly, the increase is more in children than in adults. In just three decades, the number of school-going children and adolescents with obesity has increased by 10-fold, and the International Association for the Study of Obesity (IASO) and International Obesity Task Force (IOTF) reckon that 200 million school children worldwide are either overweight or obese. The prevalence of obesity among 5- to 19-year-old Indian children, ranged between 3.6 and 11.7%. It is predicted that by 2025 there will be 17 million obese children in India. Urbanisation is the single most important factor linked to obesity in India. Epigenetic, dietary, familial, psychosocial, parental education and parental occupation are other important factors. About 50% of obese children will become obese adults. The prevalence of hypertension, type 2 diabetes dyslipidaemia and non-alcoholic fatty liver disease in children is also increasing parallelly. Prevention of childhood obesity is vital because it is near impossible to get children to lose weight and maintain it. A healthy diet and an active lifestyle should start from the pre-conception time itself and be continued through all stages of childhood.",signatures:"Vangal Krishnaswamy Sashindran and Puja Dudeja",downloadPdfUrl:"/chapter/pdf-download/69588",previewPdfUrl:"/chapter/pdf-preview/69588",authors:[{id:"241625",title:"Dr.",name:"V K",surname:"Sashindran",slug:"v-k-sashindran",fullName:"V K Sashindran"},{id:"310983",title:"Dr.",name:"Puja",surname:"Dudeja",slug:"puja-dudeja",fullName:"Puja Dudeja"}],corrections:null},{id:"70556",title:"Innovations in Vector-Borne Disease Control in India",doi:"10.5772/intechopen.90526",slug:"innovations-in-vector-borne-disease-control-in-india",totalDownloads:579,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"India is the second largest populous and democratic country in the world. Several geo-ecological settings are favorable for most of the vector borne diseases (VBDs) in the country. Malaria, Lymphatic Filariasis (LF), Japanese Encephalitis (JE), Dengue (DEN), Chikungunya (CHIK) and Kala-azar (KA) are major VBDs. Kyasanur Forest Disease (KFD), Plague and Chandipura virus (CHPV) infections have limited and localized foci, but needs attention. Crimean-Congo Hemorrhagic Fever (CCHF) and Zika are recent entries in India that also need to be handled on priority. National Vector Borne Disease Control Program (NVBDCP) is responsible for control and prevention of all these diseases. Malaria, LF, JE, DEN, CHIK and Zika are transmitted by different species of mosquitoes. KA and CHPV are transmitted by shadflies, while KFD, CCHF by ticks; plague by fleas. Scrub typhus (ST) responsible for acute encephalopathy syndrome (AES) is transmitted by Leptotrombidium mite species. It needs specific and strategic action plan in view of the diversified biodiversity. New innovations to strengthen the public health responses are the main intervention protocols. Already two diseases Guineaworm (Dracunculiasis) transmitted by different species of Cyclops, and polio have been successfully eradicated/eliminated from India. Such experience would be very helpful for the elimination of malaria, LF and KA, and all are on the elimination drive.",signatures:"Susanta Kumar Ghosh and Chaitali Ghosh",downloadPdfUrl:"/chapter/pdf-download/70556",previewPdfUrl:"/chapter/pdf-preview/70556",authors:[{id:"301164",title:"Prof.",name:"Susanta",surname:"Ghosh",slug:"susanta-ghosh",fullName:"Susanta Ghosh"},{id:"306830",title:"Dr.",name:"Chaitali",surname:"Ghosh",slug:"chaitali-ghosh",fullName:"Chaitali Ghosh"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6339",title:"Towards Malaria Elimination",subtitle:"A Leap Forward",isOpenForSubmission:!1,hash:"2ab88726cd9291b2b1c29889c948c902",slug:"towards-malaria-elimination-a-leap-forward",bookSignature:"Sylvie Manguin and Vas Dev",coverURL:"https://cdn.intechopen.com/books/images_new/6339.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3432",title:"Current Topics in Public Health",subtitle:null,isOpenForSubmission:!1,hash:"bbfaa5b624db308171170cb70e9de196",slug:"current-topics-in-public-health",bookSignature:"Alfonso J. 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The contents of the book will be written by multiple authors and edited by experts in the field.",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"e8d53d1029a7bccf825aa55d43fecc68",bookSignature:"",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11776.jpg",keywords:null,numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"December 20th 2021",dateEndSecondStepPublish:"January 10th 2022",dateEndThirdStepPublish:"March 11th 2022",dateEndFourthStepPublish:"May 30th 2022",dateEndFifthStepPublish:"July 29th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"6 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:1,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"7",title:"Business, Management and Economics",slug:"business-management-and-economics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:null},relatedBooks:[{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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However, when diagnosed in an early stage, women have a good chance to survive for a longer period of time. Therefore, it is important to focus on the impact of breast cancer and its treatment on long-term psychosocial outcomes. In recent years, quality of life (QOL) has become a primary endpoint in oncology (Movsas, 2003, Sprangers, 2002). Body image is an important aspect of QOL, especially in breast cancer patients (Avis et al., 2005), because of the mutilating effect surgical treatment may have. Body image is a component of the self-concept of a woman, which includes feeling attractive and feminine (Fobair et al., 2006). Body image is defined in different ways, but typically conceived as a multidimensional construct, consisting of perceptual, attitudinal, and behavioral aspects.(Jolly
Women with breast cancer often experience a decrease in satisfaction with body image after surgery, irrespective of type of surgical treatment (Brandberg et al., 2008, Ganz et al., 1992, Kraus, 1999, Lindop and Cannon, 2001). There is no consensus whether the type of surgery received is related to dissatisfaction with body image after surgery. Some studies found that women receiving MTC report lower scores on body image compared with women receiving BCT (Anagnostopoulos and Myrgianni, 2009, Engel et al., 2004, Ganz et al., 1992, Janni et al., 2001, Janz et al., 2005, Kenny et al., 2000, Schou et al., 2005). However, a number of studies did not find type of surgery to be a relevant factor in satisfaction with body image (Fobair et al., 2006, Goldberg et al., 1992, Schover et al., 1995, Wolberg et al., 1989). Furthermore, previous research was also inconsistent regarding adjuvant therapy. Although most studies showed that chemotherapy (Fehlauer et al., 2005, Joly et al., 2000), hormone therapy (Ganz et al., 1998), and radiotherapy (Fehlauer et al., 2005, Hopwood
Women’s perception about their bodies may be influenced by the length of time since treatment. In general, most studies found that body image improved over time (Hopwood
The impact of disease and treatment on general QOL seems to vary with age, marital status, and educational level, with younger women and women with lower levels of education reporting lower QOL scores when patients received chemotherapy (Janz et al., 2005, King et al., 2000). Two studies reported a strong relationship between age and body image (Al-Ghazal et al., 1999, King et al., 2000, Yeo et al., 2004). The largest negative impact of MTC on body image was found amongst young, married women (King et al., 2000, Yeo et al., 2004). In contrast, other studies did not find differences in scores on body image between younger and older women (Engel et al., 2004, Hartl
Body image is not only influenced by life events such as having breast cancer, but also by culture, socio-economic status, and personality (Diener et al., 2003). The personality traits extraversion (the disposition towards cheerfulness, sociability, and high activity) and neuroticism (the tendency to experience distressing emotions, such as fear, guilt, and frustration) may have an effect on QOL (Diener et al., 2003). Only one study examined these characteristics and found that neuroticism was acting as a vulnerability factor for anxiety and/or depressive symptoms one year after breast cancer surgery (Millar et al., 2005). Besides, Costa et al. (Costa et al., 1992) found that neuroticism was correlated with a negative body image and extraversion was correlated with a positive body image. However, there is a lack of prospective data on possible relationships between psychological, clinical, and demographic factors and body image (Hartl et al., 2003, Zimmermann
Women with a palpable lump in the breast or an abnormality on a screening mammography were referred by their general practitioner to the outpatient clinic of the St. Elisabeth Hospital (Tilburg), the Maasland Hospital (Sittard; since August 2004), or the Jeroen Bosch Hospital (Den Bosch; since January 2006) in the Netherlands between September 2002 and September 2007. Women were included if they had an abnormality in the breast, were able to read, speak and write Dutch, and were 18 years or older. Women who had a history of abnormalities in the breast, benign or malignant, or had a breast tumor that was too large (>5 centimeter) for BCT, were excluded from the study. After written informed consent and before the first appointment with the surgeon, the participating women completed a set of questionnaires. Thus, women completed the first set of questionnaires when the diagnosis was still unknown. After this baseline measurement (Time-1), a set of questionnaires was also completed one (Time-2), three (Time-3), six (Time-4), and 12 months (Time-5) after diagnosis (BBP) and/or surgical treatment (BC). The breast cancer group consisted of 219 patients; the women with benign breast problems (BBP group) consisted of 381 patients (See Figure 1). Non-participants (57.8 ± 10.1 yrs) were older than participants (55.0 ± 10.4 yrs; p=.001) in the study. They did not differ on other sociodemographic (i.e., living with a partner, having children, educational level) or clinical characteristics (i.e., disease stage, type of surgery, adjuvant therapy). The length of the questionnaires and the amount of stress the women experienced during the diagnostic period were the reasons for not participating in the study. This study was approved by the local ethics committee.
\n\t\t\tAll women completed questionnaires on personality factors (only at baseline) and the WHOQOL-100 Body Image and Appearance facet (all time points). The BC group also completed the EORTC-QLQ-BR23 Body image subscale from Time-2 onwards. Both instruments were chosen since both subscales complement each other, i.e., the Body and Appearance facet covers more general concerns (satisfaction with they way the body looks, acceptance of bodily appearance, and inhibition by own looks), while the Body image subscale covers feelings of low attractiveness and femininity as a result of cancer or treatment.
\n\t\t\t\tThe Neuroticism-Extraversion-Openness Five Factor Inventory (NEO-FFI) (Costa and McCrae, 1992, Hoekstra et al., 1996) was developed to study an individual’s personality by testing the five domains of the Five Factor or Big Five Model: neuroticism (i.e., the tendency to experience distressing emotions, such as fear, guilt, and frustration), extraversion (i.e., the disposition towards cheerfulness, sociability, and high activity), openness (i.e., the tendency to have a receptive orientation towards varied experiences and ideas), agreeableness (i.e., the inclination towards interpersonal trust and consideration of others) and conscientiousness (i.e., the tendency towards persistence, sense of duty, organizing, planning, and self-discipline). This self-report questionnaire consists of 60 statements. Each statement is rated on a 5-point scale ranging from 1 (
The World Health Organization Quality of Life assessment instrument-100 (WHOQOL-100) (De Vries and Van Heck, 1997, WHOQOL Group, 1998) is a cross-culturally developed generic multi-dimensional quality of life measure. This questionnaire consists of 100 items that are divided in 24 facets covering four domains (Physical health, Psychological health, Social Relationships, and Environment) and an Overall Quality of Life and General Health facet. Each facet is measured with four items using 5-point Likert scales. In the present study, only the facet Body Image and Appearance was used. The facet body image consists of four items, for instance ‘Are you able to accept your bodily appearance?’ A high facet score indicates good body image (score range: 4 - 20). The reliability and validity are adequate and sensitivity is high. (De Vries and Van Heck, 1997, Den Oudsten et al., 2009b, O\'Carroll et al., 2000) The Cronbach’s alpha coefficients of the facet Body Image and Appearance in this study were.85 (BCT group),.87 (BBP group), and.88 (MTC group).
\n\t\t\t\tFlow chart
The EORTC QLQ-BR23 is a 23-item disease-specific questionnaire measuring health status in breast cancer patients. The BR-23 is a supplementary module of the EORTC QLQ C30, which covers the physical, personal, cognitive, emotional, and social domains.(Montazeri et al., 2000, Sprangers et al., 1996) The EORTC QLQ BR-23 incorporates two functional scales (Body Image and Sexual Functioning) and three symptom scales (Arm Symptoms, Breast Symptoms, and Systematic Therapy Side Effects). The remaining items assess sexual enjoyment and being upset by hair loss. The reliability and validity are adequate(Montazeri et al., 2000, Sprangers et al., 1996, Yun et al., 2004). In this study, only the scale Body Image was used. The Body Image scale consists of four items, for instance ‘Did you feel less feminine as a consequence of your illness or treatment?’ This scale was linearly transformed (score range 0-100). A higher score represent higher levels of functioning. The reliability and validity of this scale is adequate.(Sprangers et al., 1996, Yun et al., 2004) The Cronbach’s alpha coefficients of the Body Image scale in this study were.87 (BCT group) and.89 (MTC group).
\n\t\t\t\tPatients were asked to respond to a number of questions concerning age, marital status, having children, and years of education. Marital status was dichotomized in two categories, i.e. being involved in a relationship or not being involved in a relationship.
\n\t\t\t\tData concerning diagnosis, type of surgical treatment (BCT or MTC), disease stage, and type of adjuvant treatment (chemotherapy, hormone therapy, and radiotherapy) were obtained from the medical records of the included patients.
\n\t\t\tStudent t-tests and chi-square tests were used to examine differences between participants and non-participants and women who had undergone BCT and MTC. General linear model for repeated measures was used to examine if scores on Body Image changed over time, if scores on Body Image were different for (women with a benign diagnosis,) women who undergone BCT or MTC, and if the pattern of Body Image scores over time was different for BCT and MTC. Subsequently, multivariate analysis of covariance (MANCOVA) with repeated measures was performed to adjust for the effect of potential confounders on the relationship between body image and group (benign breast problems, MTC, BCT). Radiotherapy and disease stage were selected as covariates based on statistical differences between treatment groups on baseline characteristics. Post-hoc paired samples t-tests were conducted to determine differences in body image for group separately. Linear regression analyses were performed to examine which, and to what extent, sociodemographic, clinical, and personality variables predicted the scores on body image (WHOQOL-100, EORTC QLQ-BR23). For the time points, one, three, six, and 12 months after surgery, a hierarchical multiple regression analysis (method: enter) was conducted. As a first step, aiming at minimizing the number of independent variables in the final regression analysis, separate preliminary regression analyses were performed with sociodemographic (age, marital status, educational level, work status), clinical (disease stage, type of surgery, chemotherapy, radiotherapy, and hormone therapy), psychological (body image at baseline), and personality factors (neuroticism, extraversion, agreeableness, openness to experiences, conscientiousness) as independent variables. Subsequently, significant predictors (p<.05) were entered in the final regression analysis. Chemotherapy, radiotherapy, and hormone therapy were not entered at Time-2 as a factor, since women with breast cancer did not yet received adjuvant therapy at that time. Mean and standard deviations are provided as (M ± SD). SPSS 17.0 was used for all calculations.
\n\t\t\tThe sociodemographic, clinical, and psychological characteristics of women who received BCT or MTC and the women who had a benign breast problem are summarized in Table 1.
\n\t\t\t\n\t\t\t\t\t\t | BBP (n = 381) | \n\t\t\t\t\t\tBCT (n = 106) | \n\t\t\t\t\t\tMTC (n = 113) | \n\t\t\t\t\t\tp-value | \n\t\t\t\t\t
Demographics | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t |
Age at diagnosis, yrs | \n\t\t\t\t\t\t52.9 ± 10.4 | \n\t\t\t\t\t\t58.4 ± 8.5 | \n\t\t\t\t\t\t58.5 ± 9.7 | \n\t\t\t\t\t\t.91 | \n\t\t\t\t\t
No partner | \n\t\t\t\t\t\t50 (13.1%) | \n\t\t\t\t\t\t14 (13.2%) | \n\t\t\t\t\t\t21 (18.6%) | \n\t\t\t\t\t\t.29 | \n\t\t\t\t\t
No children | \n\t\t\t\t\t\t57 (14.9% | \n\t\t\t\t\t\t14 (13.2%) | \n\t\t\t\t\t\t14 (12.4%) | \n\t\t\t\t\t\t.77 | \n\t\t\t\t\t
Educational level 0-9 years 10-14 years "/ 14 years | \n\t\t\t\t\t\t123 (32.1%) 171 (44.6%) 72 (18.8%) | \n\t\t\t\t\t\t38 (35.8%) 46 (43.4%) 19 (17.9%) | \n\t\t\t\t\t\t43 (38.1%) 47 (41.6%) 17 (15.0%) | \n\t\t\t\t\t\t.84 | \n\t\t\t\t\t
Clinical values | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t |
Disease stage Stage 0 Stage I Stage IIa Stage IIb | \n\t\t\t\t\t\t- | \n\t\t\t\t\t\t8 (7.5%) 60 (56.6%) 33 (31.1%) 5 (4.7%) | \n\t\t\t\t\t\t17 (15.5%) 32 (28.3%) 34 (30.1%) 30 (26.5%) | \n\t\t\t\t\t\t<.0001 | \n\t\t\t\t\t
Adjuvant therapy¹ | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t |
Chemotherapy | \n\t\t\t\t\t\t- | \n\t\t\t\t\t\t20 (18.9%) | \n\t\t\t\t\t\t41 (36.3%) | \n\t\t\t\t\t\t.01 | \n\t\t\t\t\t
Radiotherapy | \n\t\t\t\t\t\t- | \n\t\t\t\t\t\t96 (90.6%) | \n\t\t\t\t\t\t20 (17.7%) | \n\t\t\t\t\t\t<.0001 | \n\t\t\t\t\t
Hormone therapy | \n\t\t\t\t\t\t- | \n\t\t\t\t\t\t32 (30.2%) | \n\t\t\t\t\t\t52 (46.0%) | \n\t\t\t\t\t\t.02 | \n\t\t\t\t\t
Psychological | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t\t | \n\t\t\t\t\t |
Body image WHOQOL2 [range: 4-20]\n\t\t\t\t\t\t\t\t \n\t\t\t\t\t\t\tNeuroticism [range: 12-60] Extraversion [range: 12-60] Openess to experience [range: 12-60] Agreeableness [range: 12-60] Conscientiousness [range: 12-60] | \n\t\t\t\t\t\t16.0 ± 3.3 31.1 ± 6.9 40.1 ± 5.8 36.7 ± 5.4 43.7 ± 4.2 45.4 ± 4.9 | \n\t\t\t\t\t\t16.6 ± 2.8 30.7 ± 7.5 40.6 ± 5.7 36.2 ± 6.6 43.7 ± 4.2 45.9 ± 5.6 | \n\t\t\t\t\t\t16.5 ± 3.1 29.4 ± 7.1 41.9 ± 5.4 35.0 ± 4.9 43.3 ± 4.2 45.9 ± 5.2 | \n\t\t\t\t\t\t.81 .23 .09 .20 .44 .96 | \n\t\t\t\t\t
Note: 1 more than one treatment possible; 2 higher scores on body image indicate higher quality of lifeAbbreviations: BBP: Benign Breast Problems; BCT: Breast-Conserving Therapy; MTC = mastectomy \n\t\t\t\t\t\t | \n\t\t\t\t\t
Patient characteristics
Patients who underwent MTC were more often treated with chemotherapy and hormone therapy, compared to patients who received BCT (p
\n\t\t\t\tFigure 2 shows the change in scores on WHOQOL-facet Body Image. Body Image changed significantly over time [F(4,239) = 3.0; p =.020], after correcting for potential confounders. Furthermore, an interaction effect was found for time by surgical treatment, indicating that the pattern of change over time in Body Image is different for women with MTC, women with BCT, and women with BBP [F(8,480) = 2.8; p =.004]. From Time-1 to Time-2, women with MTC reported a significant deterioration in their Body Image (p=.035), while women with BCT and BBP were stable. Although their Body Image improved in time, they had significantly lower scores at Time-5 when compared to Time-1 (p =.004). Radiotherapy and disease stage did not interact with Body Image (p >.05). Overall, women with BBP and women with BCT and MTC did not score differently on Body Image, except at Time-2 (p<.036).
\n\t\t\tMean scores on Body Image and Appearance (WHOQOL-100) across time for women who undergonebreast-conserving therapy (BCT) and mastectomy (MTC) and women with a benign diagnosis
\n\t\t\t\tFigure 3 shows the change in scores on EORTC QLQ BR-23 subscale Body Image. In the adjusted analysis, Body Image improved significantly over time when correcting for potential confounders [F(3,93) = 2.8; p =.043]. Scores on Time-4 (85.2 ± 20.3), and Time-5 (86.4 ± 18.4) were statistically higher compared with the scores on Time-2 (79.7 ± 23.1; ps<.05). On average, women with BCT and MTC scored differently on Body Image, i.e. women with BCT scored significantly higher on Body Image [F(1,95) = 7.4; p =.008]. However, no interaction effect was found, indicating that the pattern of change over time in Body Image was not significantly different for both groups (p =.348). Radiotherapy and disease stage did not interact with Body Image (p >.05).
\n\t\t\tMean scores on Body Image (EORTC QLQ-BR23) across time for women who undergone breastconserving therapy (BCT) and mastectomy (MTC)
\n\t\t\t\tTable 2 shows those factors associated with Body Image (WHOQOL-100) scores across time. Being older, receiving chemotherapy, high scores on neuroticism, and low scores on agreeableness were significantly associated with lower Body Image scores at all time points. The regression models at different time points explained 26% to 32% of the variance. Table 3 shows those factors associated with Body Image (EORTC QLQ BR23) scores across time. High scores on neuroticism were significantly associated with lower Body Image scores at all time points. The regression models at different time points explained 16% to 30% of the variance. Chemotherapy, radiotherapy, and hormone therapy were not entered in the regression analysis at Time-2 and Time-3, since women not received this treatment yet.
\n\t\t\tTimepoint | \n\t\t\t\t\t\tFactor | \n\t\t\t\t\t\tβ-value | \n\t\t\t\t\t\tR2 | \n\t\t\t\t\t\tAdjusted R2 | \n\t\t\t\t\t\tp-value | \n\t\t\t\t\t
Time-2* | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.31 | \n\t\t\t\t\t\t.34 | \n\t\t\t\t\t\t.32 | \n\t\t\t\t\t\t<.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | BCT/MTC | \n\t\t\t\t\t\t-.21 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .005 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.31 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Agreeableness | \n\t\t\t\t\t\t.20 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .011 | \n\t\t\t\t\t
Time-3* | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.35 | \n\t\t\t\t\t\t.27 | \n\t\t\t\t\t\t.26 | \n\t\t\t\t\t\t<.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Disease stage | \n\t\t\t\t\t\t-.25 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.29 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
Time-4 | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.18 | \n\t\t\t\t\t\t.29 | \n\t\t\t\t\t\t.26 | \n\t\t\t\t\t\t.024 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Educational level | \n\t\t\t\t\t\t.08 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .328 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Chemotherapy | \n\t\t\t\t\t\t-.28 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.23 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .006 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Agreeableness | \n\t\t\t\t\t\t.24 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .003 | \n\t\t\t\t\t
Time-5 | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.22 | \n\t\t\t\t\t\t.30 | \n\t\t\t\t\t\t.28 | \n\t\t\t\t\t\t.006 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Chemotherapy | \n\t\t\t\t\t\t-.16 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .038 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.30 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Agreeableness | \n\t\t\t\t\t\t.26 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .001 | \n\t\t\t\t\t
Note: *chemotherapy was not entered at Time-2 and Time-3 as a factor, since women with breast cancer had not yet received chemotherapy \n\t\t\t\t\t\t | \n\t\t\t\t\t
Final results of hierarchical multiple regression analysis with body image (WHOQOL-100) as the dependent variable, for one (Time-2), three (Time-3), six (Time-4), and 12 months after surgery (Time-5)
Body image is an important aspect of QOL in women with breast cancer. For years, it was hypothesized that MTC contributed to some extent to the development of psychological problems of women with breast cancer. It was intuitively thought that BCT would remove some of the stress because of its less mutilating effect compared to MTC.(Meyer and Aspegren, 1989) Until now, body image was mostly studied in cross-sectional designs. Therefore, this prospective study examined the impact of surgical treatment, personality, and sociodemographic factors on body image during a follow-up period of one year after primary surgical treatment. In addition, this study examined if scores on body image were lower in women who received MTC compared to women who underwent BCT or women with benign breast problems. In general, a temporary decrease was found in body image scores due to treatment. Although we found that scores of women with MTC were lower compared with women with benign breast problems and women with BCT, the results were only significant at one month after surgery. Type of surgical treatment predicted body image at one month (WHOQOL-100; EORTC QLQ-BR23), three months (EORTC QLQ-BR23), and six months after surgical treatment (EORTC QLQ-BR23). Most studies found BCT to be superior with regard to scores on body image, which is in line with our study. (Avis et al., 2004, Ganz et al., 2002, Hartl et al., 2003, King et al., 2000, Schou et al., 2005, Yeo et al., 2004) BCT patients were more satisfied with their appearance than patients who received MTC. (Engel et al., 2004, Janni et al., 2001)
\n\t\t\tTimepoint | \n\t\t\t\t\t\tFactor | \n\t\t\t\t\t\tβ-value | \n\t\t\t\t\t\tR2 | \n\t\t\t\t\t\tAdjusted R2 | \n\t\t\t\t\t\tp-value | \n\t\t\t\t\t
Time-2* | \n\t\t\t\t\t\tBCT/MTC | \n\t\t\t\t\t\t-.29 | \n\t\t\t\t\t\t.18 | \n\t\t\t\t\t\t.16 | \n\t\t\t\t\t\t.001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.24 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .008 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Agreeableness | \n\t\t\t\t\t\t.16 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .079 | \n\t\t\t\t\t
Time-3* | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.26 | \n\t\t\t\t\t\t.33 | \n\t\t\t\t\t\t.31 | \n\t\t\t\t\t\t<.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | BCT/MTC | \n\t\t\t\t\t\t-.30 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.43 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Conscientiousness | \n\t\t\t\t\t\t-.29 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
Time-4 | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.28 | \n\t\t\t\t\t\t.34 | \n\t\t\t\t\t\t.30 | \n\t\t\t\t\t\t.001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Educational level | \n\t\t\t\t\t\t.07 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .400 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | BCT/MTC | \n\t\t\t\t\t\t-.21 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .007 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Chemotherapy | \n\t\t\t\t\t\t-.16 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .044 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.32 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | <.0001 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Agreeableness | \n\t\t\t\t\t\t.19 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .024 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Conscientiousness | \n\t\t\t\t\t\t-.22 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .007 | \n\t\t\t\t\t
Time-5 | \n\t\t\t\t\t\tAge | \n\t\t\t\t\t\t.22 | \n\t\t\t\t\t\t.23 | \n\t\t\t\t\t\t.20 | \n\t\t\t\t\t\t.006 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Neuroticism | \n\t\t\t\t\t\t-.25 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .004 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Agreeableness | \n\t\t\t\t\t\t.27 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .002 | \n\t\t\t\t\t
\n\t\t\t\t\t\t | Conscientiousness | \n\t\t\t\t\t\t-.29 | \n\t\t\t\t\t\t\n\t\t\t\t\t\t | \n\t\t\t\t\t\t | .001 | \n\t\t\t\t\t
Note: *chemotherapy was not entered at Time-2 and Time-3 as a factor, since women with breast cancer had not yet received chemotherapy \n\t\t\t\t\t\t | \n\t\t\t\t\t
Final results of hierarchical multiple regression analysis with body image (EORTC-QLQ BR23) as the dependent variable, for one (Time-2), three (Time-3), six (Time-4), and 12 months after surgery (Time-5)
Studies in this field show a wide variation with regard to the methodological aspects. First, different instruments were used to assess body image. There is a wide variation in body image scales, and they are composed of different items. For example, some instruments contain items assessing satisfaction with body image, as the breast specific module from the European Organization for Research and Treatment of Cancer (EORTC QLQ-BR23)(Fehlauer et al., 2005, Janz et al., 2005), or with the Cancer Rehabilitation Evaluation System (CARES). (Avis et al., 2004, Ganz et al., 1992) Others constructed their own scale or added questions to general questionnaires to measure body image.(Engel et al., 2004, Hartl et al., 2003, Janni et al., 2001, King et al., 2000) In this study, a generic QOL instrument (WHOQOL-100) and a disease-specific health status instrument (EORTC QLQ BR-23) were used. The results based on both instruments indicated that body image scores changed significantly over time, irrespective of diagnosis/treatment. However, this effect was partly explained by the differences in scores between the baseline measure and the first follow-up measure (WHOQOL-100), when body image scores dropped considerably in the MTC group. Body image scores measured with the EORTC-QLQ BR23 also improved significantly; but, this measure could not register the drop in body image scores between Time-1 and Time-2, since it can only be assessed in a cancer population. In our study, the baseline assessment was before diagnosis. (Engel et al., 2004) Our findings are in line with other studies. For instance, Ganz et al. (Ganz et al., 1992) reported an improvement in body image one year after surgery in both surgical groups, just as Bloom et al. (Bloom et al., 2004) did between baseline (soon after diagnosis) and five year follow-up. In our study, body image scores completely returned to baseline values, except for the body image scores of women with MTC. It is possible that a study in which a longer follow-up is taken, body image will further improve.
\n\t\t\tOlder women were more satisfied with their bodies, which is in line with the majority of other studies in this field. (Al-Ghazal et al., 1999, Fehlauer et al., 2005, Janz et al., 2005, Kenny et al., 2000, King et al., 2000) However, it should be noted that the results on the direction of the relationship between age and body image in the literature is inconsistent. That is, several studies did not find differences in body image scores between age groups(Engel et al., 2004, Schou et al., 2005) or found that body image issues may be particularly salient for younger women(Avis et al., 2005). Since older women are often excluded from clinical studies, future studies should examine the psychosocial concerns in this age group.
\n\t\t\tAdjuvant therapies, like radiotherapy and hormone therapy were not strongly related to body image. Chemotherapy predicted scores on body image at all time points included. From the few studies that are available on this topic, women who received chemotherapy reported lower scores on body image (Janz et al., 2005, Schover et al., 1995), probably due to the loss of hair that is accompanied by this type of treatment.
\n\t\t\tPersonality characteristics (neuroticism and agreeableness) played an important role in predicting outcome in this study. Neuroticism contributed in a negative way to scores on body image at all follow-up measures, after controlling for all other variables. This result is consistent with other research on personality in breast cancer, in which patients, who experienced high levels of chronic stress one year after treatment for breast cancer, were characterized by higher levels of neuroticism. (Millar et al., 2005) In other studies, this trait also in part explained the variance in depressive symptoms after breast cancer surgery (Den Oudsten et al., 2009a, Golden-Kreutz and Andersen, 2004), as well as of poor adjustment to mastectomy. (Morris et al., 1977)
\n\t\t\tAfter discussing the results of the study, certain limitations and strengths should be acknowledged. Strength of the underlying study is the baseline measurement, before the diagnosis is known. At the same time, this is also a weakness, because women are probably scared and nervous because an abnormality has been seen on the mammography (i.e., only applies for those women who had a screening mammography) or that a lump (whether it is benign or malign) is in the breast. However, in this study the BBP group showed stable scores regarding body image. The optimal moment for the baseline measurement would be before visiting the doctor or taking a mammography, and then it is probably of better prospective value. The one-year follow-up period is another advantage of this study, because body image is a concept that probably changes over time when a woman is confronted with a threat to her body image. Moreover, this study included also a control group consisting of women with benign breast problems. Few studies have included a comparison group. (Andrykowski et al., 1996) Finally, the data was collected in several hospitals in the Netherlands, which may facilitation generalization in women with breast cancer. Studies, like the current one, often show relatively high attrition(Arving et al., 2008). Our study had 73.5% of the women with early stage BC in the study at one-year after surgical treatment. This may have influenced our results. However, women with breast cancer who dropped out of the study did not differ from women remaining in the study, except for age with women staying in the study being significantly younger. A limitation of this study is that a specific body image scale would have been appropriate, for instance Body Image Scale(Hopwood et al., 2001). In addition to the EORTC QLQ BR23 items on body image, this scale includes also items on change in self-consciousness with appearance, less sexually attractive, less feminine, dissatisfaction with appearance when dressed, dissatisfaction with scars, body feeling less whole, and avoidance of people because of appearance. These topics were not assessed in our study. However, it should be noted that the women with BBP could not have been assessed on body image.
\n\t\t\tMore longitudinal studies need to focus on body image, whether body image in the MTC group will eventually return to baseline values (i.e., before the breast cancer diagnosis), but also examine the associations with self-esteem, sexual functioning, and quality of life. In addition, studies should also include elderly women. Moreover, it is also reasonable to take women’s partners into account, since patients and partners coping with cancer will exchange experiences and influencing each others acceptation process. (Manne and Badr, 2008, 2009) Recently, Zimmerman et al. (Zimmermann
In conclusion, results from this study confirm previous findings that breast cancer temporarily affects satisfaction with body image in a negative way. Results are more obvious for women who underwent MTC, than for women who have had BCT. Older women seemed to have more problems with body image after surgery. Overall, it is important for women facing breast cancer to get assistance in adjusting to alterations in body image. (Kraus, 1999) Personality factors that influence these changes should be taken into account.
\n\t\tPoultry production has occupied a leading role in the agriculture industry worldwide in recent years. The compound annual growth rate of poultry protein between 2015 and 2025 is estimated to be +2.4% [1]. Asia, South America and Africa characterized by rapid urbanization, poverty and hot climate recorded the highest growth increment in poultry production [1, 2]. The trend of continuous growth of poultry production in those regions is obvious because it remains the fastest route to bridging the protein demand-supply gap.
\nExtreme weather conditions in the tropical regions of the world have proven generally detrimental to livestock production and is particularly of interest in chicken because of the latter’s high sensitivity to temperature change [3, 4, 5, 6]. Just like mammals, the avian species have the ability to regulate their body temperatures by losing or generating heat in response to environmental temperature. If the body temperature of a bird, which normally runs between 39.4 and 40°C, is allowed to increase, the bird will not perform well. Heat stress in poultry production had resulted in under-nutrition, stunted growth, reduction in egg production and size, laying of premature eggs and even death [7, 8, 9, 10, 11]. This problem is further compounded by the high body heat generated by genetically improved laying birds with increased metabolic activity resulting from the high rate of egg production [12, 13, 14, 15].
\nPoultry housing design plays a vital role in the determination of the internal climatic conditions of the house for optimum health, growth and productive performance of the birds. Consequently, the type of poultry housing system employed by the proposed poultry farm is a function of the prevailing climatic conditions of the region where the farm is located. While open poultry house system has been adjudged a good method of housing in the tropical countries because of the simplicity of its construction, ease of heat management and minimal management cost, the controlled housing system is the most common in the temperate regions of the world [16, 17].
\nBirds are warm-blooded ‘homoeothermic’ flighty feathered oviparous vertebrates that possess a high metabolic rate, with a normal breathing rate of 40–50 breaths per minute [17]. On the average, birds maintain an internal body temperature of between 39 and 42.2°C [18, 19, 20]. During hot weather, poultry birds maintain thermo-neutral temperature by losing heat mainly through conduction, convection, radiation and evaporative cooling [2, 20, 21].
\nSensible heat loss through convection, radiation and conduction is only effective if the environmental temperature is below or within the bird’s thermoneutral zone. However, evaporative cooling accounts for about 60% of the heat dissipated during body temperature regulation within the thermoneutral zone [2]. Sensible heat loss includes heat loss through opened surfaces such as wattles, shanks and other featherless areas around the neck and wings [21]. Heat loss for body temperature regulation through this process does not alter the bird’s behavioral patterns, feed intake, or metabolism [22]. The effectiveness of sensible heat lost is a function of the temperature difference between the bird and its environment.
\nWhere the environmental temperature exceeds 24°C evaporative cooling (latent heat loss) becomes the major method of dissipating heat in birds regardless the age [21]. Loss of heat through evaporative cooling at temperatures beyond the thermoneutral zone requires the bird to re-direct energy required for growth and development to panting. However, panting can lead to dehydration and respiratory alkalosis because of inadequate water supply and drop in blood pH due to excessive ejection of carbon dioxide [21]. During panting, evaporative cooling occurs when water evaporates from the respiratory system of the bird. However, this can be hindered by high humidity. This is problematic in high humid environments where poultry farmers employ evaporation cooling as the primary method of air-temperature reduction during the hot periods of the year [2].
\nIncreasing the volume and velocity of air moving over birds enhances heat loss in birds due to convection, removal of heat trapped within the poultry house, and reduction of the effect of high humidity on evaporative cooling [2]. Simmons et al. [23], conducted a study that subjected 3 weeks old male broilers in a controlled environment for 4 weeks to a cyclic temperature of 25–30–25°C at varying wind speed of still air (<0.25 m/s), 2 m/s and 3 m/s. It was observed that the increased wind speed favored older birds in growth and development.
\nWater is an essential commodity in poultry production for the nutrients it possesses and its impact on feed consumption [24]. Nipple drinkers to provide cleaner water, reduce water spillage and labour for drinker cleaning has replaced the conventional open water system. May et al. [25], observed that chicken consumed more water when reared with conventional open water system in an experiment that compared the conventional open water system to nipple drinking. However, when these drinkers were used to rear chicken in a controlled room with air velocity of 0.25 and 2.1 m/s, birds in the higher air velocity with nipple drinkers did not differ from those on open water drinkers, but experienced increased weight gain and better feed conversion than birds at the lower air velocity [26]. Therefore, it is important to provide and maintain the required ventilation to ensure that the poultry house is conducive for the birds to regulate their body temperature by sensible heat loss.
\nHeat Stress is a general problem in the poultry industry, especially in the production of chicken meat and egg. Heat stress is experienced by chicken when the environmental temperature equals or rises above 26.7°C. At this temperature and beyond the birds begin to pant and can be detrimental to attaining the bird’s optimum growth rate, hatching ability, egg size, egg shell quality and egg production. The problem of heat stress can be further compounded in a hot environment when the humidity rises. Heat stress has been reported to have adverse effect on broilers comfort, growth rate, feed conversion, and live weight gain [21].
\nIn poultry production, the sudden exposure of birds to high temperature short periods is referred to as acute heat stress while exposure for extended periods is referred to as chronic stress. Chronic stress has deleterious effects on birds reared in open-sided houses, which is commonly used in the tropics. It has been reported to have adverse effect on growth and production efficiency, egg quality, meat quality, embryonic development, reproductive performance, immunity and disease incidence’s in broilers, laying hens and breeders [21, 27, 28, 29, 30, 31].
\nIt is important we understand the effect of internal climatic conditions of the poultry house on the birds, how the birds respond to them, and their implications on heat management for poultry production. The information will provide guidance on parameters for the open poultry house architectural design that will alleviate heat stress to ensure optimum poultry production in the tropics. The climatic factors of interest include temperature, relative humidity, air composition and velocity, and lighting condition.
\nThere is a huge debate on the ideal temperature range required for the various classes and age groups of chicken to attain optimum production. This could be because of other climatic factors such as humidity and wind velocity, which influence temperature change and previous adaptation of chicken to climatic change. Generally, chicken perform under a wide range of temperature regardless of its class (broiler, pullet or breeder) or age. However, exposure of chicken to high temperature has been reported to hinder the performance in chicken production [17]. It could also be further compounded by increased relative humidity for its negative effect on evaporative cooling [32].
\nKetelaars [16] recommended a temperature of 30–32°C at chicken height for day old chicks. Thereafter, the temperature should be decreased by 3–4°C till the chicks are 4 weeks old as shown in \nTable 1\n. Daghir [19] reported that a temperature range of 18–22°C is required for growing broilers. In other reviews done by Holik [15], it was concluded that birds are comfortable when environmental temperature is within the range of 18–24°C. However, it should be noted that the optimum performance of chicken is dependent on the market value of the product in relation to feeding cost.
\nAge of chicken (week) | \nTemperature range (°C) | \n
---|---|
1 | \n30–32 | \n
2 | \n30–26 | \n
3 | \n26–23 | \n
4 | \n23–20 | \n
≥5 | \n20 | \n
Recommended temperature schedule.
It is a challenge to maintain the optimum production temperature in the tropics therefore, it is important that the poultry house designer pay considerable attention to temperature change.
\nIn a review done by Oloyo [17], it was reported that internal temperature above 26.7°C combined with high relative humidity adversely affected the feed efficiency, feathering, pigmentation, and weight gain of chicken. Furthermore, at internal temperature range of 35–37.8°C the birds’ performances were poor regardless of the change in relative humidity. This means higher humidity can improve the performance of the birds at lower temperature. However, humidity must be controlled for it can provide habitat for microorganisms thus, exposing the birds to the threat of disease [18, 33].
\nRelative humidity has a strong relationship with temperature change. At the brooding stage, particularly in the earlier weeks the internal relative humidity may be low or too low because of the warming the chicken requires at that age or when the chicks are thirsty or hatched at higher temperature. Soon enough, the internal relative humidity increases because of the water vapor generated by the evaporative cooling act of chicken to regulate their body temperature as they grow [16]. Consequently, ages 3 weeks and above are very critical periods in chicken production regardless the class of chicken.
\nIn Oloyo [17], it was reported that laying birds during brooding and after brooding require a relative humidity range of 60–80 and 50–70% respectively for optimum performance.
\nThe decomposition of bird’s fecal material produces unpleasant and polluted gases, which include ammonia, carbon dioxide, methane and hydrogen sulphide. These gases are of particular interest because of their adverse effects on the performance of birds, cages, human poultry houses and the environment at large [16, 18, 34, 35, 36, 37, 38]. Consequently, for optimum production for chicken a concentration level of 25 ppm and not more than 2500 ppm for ammonia and carbon dioxide was recommended [18, 39]. It was recommended for good birds’ health management that removal of fecal material from the poultry house should be done frequently to reduce the volume of gas emission [17].
\nHigh internal temperature can be controlled to an extent by varying the air velocity within the poultry house. Also, Air velocity plays an important role in convectional cooling and the regulation of air quality [2, 18]. In hot climatic regions, it is recommended that the ventilation capacity should be at least “5m3 per chicken per hour, with inlets amounting to 1.5cm2 per m3 ventilation” [16]. Hulzebosch [18] reported that still air velocity (0.1–0.2 m/s) could be maintained if the temperature remains within 25–30°C. However, Lacy and Czarick [40], under the same temperature condition reported a better growth rate at 2 and 3 m/s air velocity respectively for broilers.
\nIn the quest to further understand the effect of air velocity on chicken, [23], factored the ages of chicken within the temperature range 25–30°C with varying air velocity. The study demonstrated that 6 weeks old broilers benefited from increased air velocity of 2 and 3 m/s than 4 weeks old broilers. This could be because of the high temperature required by younger birds at brooding stage.
\nLighting at early age in birds have little or no effect on hormonal system, it merely aids birds’ activeness including feed intake, growth, and physical and physiological activities [15, 41, 42]. Subsequently, increase in lighting periods and light intensity may cause tiredness, cannibalism, immune responses, leg abnormalities and even death [41, 43, 44, 45, 46, 47].
\nThe lighting program commonly used is the continuous lighting program of 16 hours light and 8 hours darkness and it has proven successful for overall chicken performance [15, 48, 49, 50]. However, it has been reported that alternating short light and dark period known as intermittent lighting enhances chicken performance [16, 51, 52, 53, 54]. The continuous lighting program with a minimum light intensity of 20 lux is recommended at post-hatch stage (1–7 days old) to help the chick adapt to their environment and aid feeding [41]. Consequently, the light intensity is reduced to about 3–5 lux and intermittent lighting system is introduced for easy control of the birds’ activeness for better performance and productivity [16, 41].
\nBirds reared under yellow, green, and blue light sources have been reported to have improved body weight compared to those reared under red and orange light sources [55, 56, 57]. Lewis and Morris [55] in a review concluded that the birds reared under blue light show docile trait while those reared under red light were more active and aggressive. In addition, it was noted that the red light improved sexual activities in birds.
\nThe importance of the type of poultry housing system employed for chicken production cannot be over emphasized. It protects the birds from the harsh environmental climatic conditions, which may have adverse effect on the chickens’ performance and productivity. In a poultry house, the overall heat generated is the sum of heat generated by the birds, the surrounding environment and biodegradation of fecal material [58, 59, 60]. Thus, the type of housing system to be used is a major determinant factor in the type of management to be adopted in the poultry farm. The housing systems used in the tropical region that is, naturally ventilated open housing system and mechanically ventilated open housing system are discussed here.
\nThe open poultry housing system has been identified with the tropical region for its simplicity, economic implications and ease of management of heat generation within the building through natural ventilation [2, 32, 61]. However, it is prone to the invasion of insect, rodents, birds and other small predators that can disturb the welfare, productivity and performance of chicken. In the quest to alleviate this problem, dwarf sidewalls are raised to the roof eaves with corrugated wire mesh to keep predators away. Also, gutter filled with insecticides to prevent the invasion of insects are built around the house. Discussed below are design considerations to be factored in when designing an open poultry house for optimum poultry performance and productivity.
\nIn order to reduce the exposure of sidewall to direct to direct sun radiation the poultry house should be orientated in the east-west direction [2, 60]. This is very vital, because heat stress in birds can be hastened when they are exposed to direct solar radiation. Deep litter rearing may allow the birds avoid direct sunlight but this may lead to clustering or overcrowding of birds in an area of the house. Consequently, make cooling difficult and in severe cases this leads to stampede and even death [2].
\nThe east-west orientation of a poultry house may reduce the benefit of prevailing winds blowing from east or west. Therefore, Daghir [2] recommended that the width of the building should not exceed 12 m to prevent this problem. In addition, the problem of uneven air exchange rate and temperature within the building is eradicated.
\nFurthermore, the design must factor in the activities and services rendered by poultry farmers and professionals within the building. These activities may include transfer of chicken, feeding, de-pecking, waste management, vaccination, and so on. Therefore, longer pen house could be strenuous to maintain especially when the activities are carried out manually. Doors can be placed at interval of 15–30 m to make for easy circulation and service delivery [2]. Qureshi [32] recommended that for battery cages, it is rather advisable to factor in the number of tiers to be used. Two–tier cage system facilitates easy air exchange within the building whereas, three and four tier cage system can be problematic for air exchange. Therefore, it is recommend that rows of cages should not exceed three with center aisles not less than 1.2 m and a minimum height difference of 1 m from the ceiling.
\nA roof slope of 45° was recommended because the angle reduces the heat gain of the roof from the direct solar radiation; maximizes the distance of the bird from the heat accumulated under the roof; quick escape of the heat accumulated under the roof through ridge opening, maximizes air space to improve air exchange rate; and open space above for installation of equipment [2, 60, 62]. On the other hand, the slope in the insulated roof is dependent on the quality of the insulation.
\nRoof overhang can be used to shade the sidewalls of a building from direct and indirect solar radiation. However, the length of the roof overhang is dependent on the height of the sidewalls [2]. Heat gain by the sidewall can be reduced to about 30% by roof overhang shading if properly applied at a roof slope of 45° [60].
\nNaturally, hot air rises above cooler air due to difference in air density. Introduction of ridge opening can aid ventilation through stack effect in the poultry house. Adequate setback between buildings is required to prevent inadequate airflow and circulation [2, 61]. However, ridge opening has been reported to be ineffective in insulated poultry houses because of temperature uniformity within the house [63].
\nThe sidewall consists of a dwarf wall built up to the roof eave with a permeable membrane such as a corrugated wire mesh and an adjustable curtain. A minimum height of 0.4 m is recommended to prevent the house from water seepage, direct and indirect solar radiation, pests and predators [2]. The corrugated wire mesh allows easy airflow within and outside the building, while the adjustable curtain is used to control the flow and air velocity. However, the curtain may be transparent or of varying colors to aid its use in managing intermittent lighting scheme [2, 15, 63].
\nAdequate setback between buildings is required to prevent inadequate air exchange rates in building. Factors such as wind speed, wind direction and topography are major determinants for consideration in defining the optimal house spacing. However, the spacing between buildings can be determined by the expression below [63].
\nwhere D, housing spacing (ridge of the closest wall of the next house); H, height of the adjacent building; L, length of the adjacent building.
\nVegetation should be kept as minimal as possible and at average height to reduce the nest of wild birds and invasion of rodents and other predators. Also, the branch of trees should be kept at eaves level to prevent obstruction of airflow across the house [2].
\nFarmers in the tropics have successfully used locally sourced materials such as thatched roof and bamboo as roofing materials for the construction of naturally ventilated poultry houses [32]. However, a minimum R-value of 1.25 m2 C/W was recommended for ceiling insulation in naturally ventilated poultry house. Environmental temperature higher than 40°C would require a minimum R-value of 2.25 m2 C/W [2]. The various methods of insulating poultry house ceiling include dropped ceiling, rigid board insulation, spray polyurethane insulation and reflective insulation [2].
\nRooftop sprinklers have proven to be efficient for substantially cooling the roof [2, 60]. However, material of choice in this situation must be able to withstand the constant exposure to water [2]. Evaporative cooling in birds in hot weather can be subdued by using fogging system. With high water pressure it generates mist, which aids cooling in birds. However, the level of humidity within the house must be monitored for it could be detrimental to the health of birds at high temperature [2, 60]. Circulation fan eases heat stress by providing increased air velocity to increase convection cooling. Generally, circulation fans generate air velocity of 0.5 m/s or more and cover an area 15 times its horizontal diameter by five times its vertical diameter [2]. Furthermore, for effective use of circulation fans it should be installed at the center 1–1.5 m above the floor and tilted downward at an angle 5o.
\nShrubs and grasses reduce reflective and direct solar radiation by shading and convection cooling [60]. Vegetation should be kept clean and trimmed to keep away predators and pests [2]. The planting of tall trees along the sidewalls can provide a form of canopy to shade the sidewalls from exposure to direct or reflective solar radiation during the hot periods of the day.
\nThe limitation of attaining adequate internal environmental conditions required for optimum birds’ performance under extreme weather conditions has led to the use of the mechanically ventilated housing system. Also, the mechanically ventilated house provides more control over air exchange, wind velocity and wind direction [2, 16]. Mechanically ventilated system entails the use of either positive or negative pressure system. The negative-pressure system which is the most commonly used in mechanical ventilated house, expels air out of the building by fans through an air inlet system to create low pressure within the house to allow fresh air to rush in through the same air inlet system [2].
\nThe negative-pressure systems can be achieved through inlet or tunnel ventilation. Inlet ventilation system uniformly distributes exhaust fans and air inlets across the house whereas, tunnel ventilation exhaust fans are located at one end and inlet pipes at the other end. This provides the tunnel ventilation with an advantage of greater air speed in turn creating more positive air exchange [2].
\nFor proper ventilation control, it is required that the house be highly insulated and tightly constructed [2]. However, the sidewall can be equipped with insulated adjustable curtains instead of solid wall for use in the cooler periods of the year or incase of power failure emergency. It is important to note that solid wall have higher insulation value that adjustable curtains.
\nHigh external temperature coupled with the heat generated from the activities within the poultry house increases the temperature of the internal air. An effective mechanical ventilation system has to exchange the air quickly to ensure the internal air temperature maintains not more than 2.8°C difference from the external air temperature. The expression below can be used to calculate the appropriate exhaust fan required for effective ventilation [2].
\nwhere, A, area of the building surface (m2); R, insulation value of the wall material (m2C/W); To, temperature outside (°C); Ti, temperature inside (°C).
\nThe value of To is the hottest external temperature that is excepted of the external environment. However, when calculating heat gain for roof in a house with attic space, the value To it is assumed to be 55°C whereas the To value for ceilings with insulation directly below the roof is assumed to be 65°C [2]. On the other hand, Ti is best assumed as 27°C to ensure comfort for birds. The value of R will be the overall sum of the insulation value of the wall section.
\nThe total heat produced (sensible and latent) in commercial broiler is 7.9 W/kg while broiler, pullets and broiler breeders is 5.1 W/kg [2, 64]. The heat generated by birds is expressed below [2].
\nwhere sensible heat, 50% of the total heat produced by birds.
\nHowever, the air movement capacity to maintain 2.8°C between intake and exhaust air is expressed below.
\nThere are a number of negative-pressure air inlet pipes used to control the internal climatic condition by controlling the entry location, speed and direction of fresh air. However, the exhaust fan determines how much air enters the house.
\nThe pressure difference between the internal and external environment determines the entry speed of fresh air [2]. However, the pressure is a function of the number and sizes of the air inlets. Therefore, the easy manipulation of differential pressure allows for possible control of airflow pattern within the building and of negative-pressure air inlet pipes used to control the internal climatic condition.
\nFor easy control and distribution of air within the poultry house, the exhaust fan must develop a static pressure of about 12–25 Pa [2].
\nAir inlet design should be located strategically as the direction of air depends on external climatic condition, age and class of the chicken. Normally, air inlets should be designed to direct air towards the ceiling at cooler time while another should be directed towards the floor during the hot periods of the year [2].
\nStatic pressure of about 12–25 Pa was recommended for easy control of the air inlet for a static pressure above or below that range can lead to supply of insufficient air velocity [2].
\nThe exhaust fans are installed on one side while the air inlet pipes are along the other side of the poultry house. It is best suited to narrow poultry houses (less than 10 m) because it leads to difference in environmental conditions in the house with larger width [2].
\nThe exhaust fans are placed below the air inlet pipes on both sides of the building walls [2]. However, a distance not less than twice the diameter of the fan should be between the exhaust fans and the air inlet pipes. Air movement is directed towards the center, and drawn through the floor by the exhaust fans. It is also best suited for narrow house with not more than 12 m width [2].
\nThe exhaust fans are placed on the lower sidewalls while, air inlets are placed in the ceiling. This kind of ventilation requires proper ceiling insulation and it best suitable for hot climate areas. The ventilation method is greatly recommended for rearing laying hen [2].
\nFresh air enters through the air inlet pipes at a velocity of 3.5–6 m/s, however this velocity is quickly dropped to about 1 m/s depending on the size and type of the house. Hence, circulation fans are used to boost the air speed to ensure air movement is sufficient in the building [2].
\nTunnel ventilation system is designed to meet the specified air velocity and air exchange rate. However, the required air velocity is dependent on the class of birds in question. \nTable 2\n shows the recommended air speed required for rearing various classes of poultry birds [2].
\nHouse type | \nAir speed (m/s) | \n
---|---|
Broilers | \n2.5–3 | \n
Pullets | \n1.75–2.25 | \n
Broiler breeders | \n2.25–3 | \n
Commercial layer | \n2.5–3 | \n
Recommended air velocities in tunnel-ventilated houses.
The tunnel fan capacity is determined by the same method used for inlet ventilation system. Unlike the inlet ventilation system where the adequate air velocity is propelled by circulation fan, the required average air velocity within tunnel house is calculated by the expression below [2].
\nwhere air velocity, m/s; tunnel fan capacity, m3/h; cross section area, m2.
\nHowever, it is important to note that the cross sectional area of the house adversely affect the air speed within the house. Therefore, it is advisable to design narrow and long house with lower ceilings [2]. Consequently the expression below can be used to design the desired air velocity.
\nwhere desired air velocity, m/s; tunnel fan capacity, m3/h; cross section area, m2.
\nIn cases where there is land constraints, air deflectors can be installed houses with large cross-sectional area to reduce the cross sectional area within the poultry house. Air deflectors are curtains that extend from the ceiling not more than 2.5–3 m from the ground. Air deflectors have been reported to increase air velocity for a distance approximately 1.2 and 6–9 m upward and downwind of the deflector respectively. However, it is important to ensure that the air deflector exceed 2.5 m from the ground to have it from disrupting the performance of fans and air exchange rate by increasing static pressure [2].
\nNormally, the air velocity in a tunnel house is assumed uniform across the house. However, it can vary slightly depending on the smoothness of the building surfaces, presence of poultry equipment and other obstructions that deflect air. The difference between the air velocity in the center and the side of the house can vary from 15 to 40% [2].
\nGenerally, it is best to install the fans on one end and the inlet in opposite end to ensure the maximum air speed is achieved in the tunnel house. However in cases where the poultry house is over 180 m long and the air velocity required for airflow in one direction exceeds 3.5 m/s it is advisable to apply the bi-directional tunnel house system. The fans are located at end-walls of the building and the tunnel inlet at the center of the house. The air velocity in both direction is reduce to half of the required velocity while retaining the same air exchange rate to ensure the temperature difference between the inlet and the fan remains the same [2].
\nThe fans can be installed at the end-walls or the sidewalls near the end, and this installation arrangement does not affect the performances of the fans. However, dead spot can be noticed when the fan is installed on the sidewalls as the width of the houses increase.
\nIn the absence of evaporative cooling pads, it is recommended that the inlet area should be at least 10% greater than the cross sectional area of the house. Meanwhile, the pad used determines inlet size for tunnel house with evaporative cooling pads. It is recommended that inlet opening on the sidewall should be installed as close as possible to the end wall. However, if the house width exceeds 15 m it is advisable to install the inlet openings on the end-wall [2].
\nIt has been recommended that tunnel ventilated system should be used in hot weather because cool weather reduce the air exchange rate. Consequently, it was recommended that a minimum of 60% of the tunnel fan capacity should be controlled by the traditional inlet system before upgrading to tunnel ventilation for easy switch during cooler weathers [2].
\nIt is the simplest type of exhaust fan. Its shutters are used to when the fan is not in use. However, the exterior shutter restricts airflow as air spins off its blades on contact. In the case of interior fan on the other hand, the shutters are on the intake side of the fan thus, lessening the restriction of airflow. It has bigger shutters, which allows for more air movement. Daghir [2] reported that airflow is increased by 5–10% compared to exterior shutter fan.
\nIt increases fan performance by 5–10% as it eases the transitioning of drawn towards the fans [2].
\nThe fans blades are driven by a simple pulley mechanism. It may be upgraded with an automatic belt tensioner to prevent belt slippage [2].
\nThe fan’s blades are attached directly to the motor shaft eliminating the use of belt. They are less energy efficient compared to belt-driven fans [2].
\nHeat loss in birds through convection, radiation and conduction is only effective if the environmental temperature is below or within the bird’s thermoneutral zone. Naturally ventilated open housing system has been explored in the tropics to improve the environment for optimum production in birds. Studies show that when the volume and velocity of air is increased heat loss is enhanced in birds through convection. Also, the proper consideration of architectural elements such as building orientation, roof slope, roof overhang, landscape, building height, building width, building length, etc. have been reported to enhance naturally ventilated buildings for optimum production in chicken. In addition, the incorporation of cooling systems such as fogging system, sprinkling system and circulation fan in naturally ventilated design house systems have proven positive in optimizing birds’ performances in general.
\nConsequently, in cases where the environmental temperature is severely high and unbearable for birds the mechanical ventilated open housing system have been introduced. The use of Tunnel and inlet ventilation system have been reported to sustain improved birds’ production in this regions regardless the extreme weather conditions. However, to design an effective, mechanically ventilated house due attention should be given when calculating the fan capacity of the house, heat generated by the birds, sizes of inlet, level of installation, positioning of inlet pipes and exhaust fan and finally the capacity of circulation fans required in inlet ventilated systems.
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Recently, investigations on hydrogenation as one of the chemical processes used can be potentially utilised for efficient and viable means for biofuel production.",book:{id:"5426",slug:"new-advances-in-hydrogenation-processes-fundamentals-and-applications",title:"New Advances in Hydrogenation Processes",fullTitle:"New Advances in Hydrogenation Processes - Fundamentals and Applications"},signatures:"Bawadi Abdullah, Syed Anuar Faua Ad Syed Muhammad and Nik\nAzmi Nik Mahmood",authors:[{id:"188743",title:"Dr.",name:"Bawadi",middleName:null,surname:"Abdullah",slug:"bawadi-abdullah",fullName:"Bawadi Abdullah"},{id:"188839",title:"MSc.",name:"Nik Azmi",middleName:null,surname:"Nik Mahmood",slug:"nik-azmi-nik-mahmood",fullName:"Nik Azmi Nik Mahmood"},{id:"189820",title:"Dr.",name:"Syed Anuar Faua Ad",middleName:null,surname:"Syed Muhammad",slug:"syed-anuar-faua-ad-syed-muhammad",fullName:"Syed Anuar Faua Ad Syed Muhammad"}]},{id:"52449",doi:"10.5772/65407",title:"Recent Advances in Heterogeneous Catalytic Hydrogenation of CO2 to Methane",slug:"recent-advances-in-heterogeneous-catalytic-hydrogenation-of-co2-to-methane",totalDownloads:2890,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"With the accelerating industrialization, urbanization process, and continuously upgrading of consumption structures, the CO2 from combustion of coal, oil, natural gas, and other hydrocarbon fuels is unbelievably increased over the past decade. As an important carbon resource, CO2 gained more and more attention because of its converting properties to lower hydrocarbon, such as methane, methanol, and formic acid. Among them, CO2 methanation is considered to be an extremely efficient method due to its high CO2 conversion and CH4 selectivity. However, the CO2 methanation process requires high reaction temperatures (300–400°C), which limits the theoretical yield of methane. Thus, it is desirable to find a new strategy for the efficient conversion of CO2 to methane at relatively low reaction temperature, and the key issue is using the catalysts in the process. The advances in the noble metal catalysts, Ni-based catalysts, and Co-based catalysts, for catalytic hydrogenation CO2 to methane are reviewed in this paper, and the effects of the supports and the addition of second metal on CO2 methanation as well as the reaction mechanisms are focused.",book:{id:"5426",slug:"new-advances-in-hydrogenation-processes-fundamentals-and-applications",title:"New Advances in Hydrogenation Processes",fullTitle:"New Advances in Hydrogenation Processes - Fundamentals and Applications"},signatures:"Zuzeng Qin, Yuwen Zhou, Yuexiu Jiang, Zili Liu and Hongbing Ji",authors:[{id:"5795",title:"Dr.",name:"Hongbing",middleName:null,surname:"Ji",slug:"hongbing-ji",fullName:"Hongbing Ji"},{id:"188601",title:"Dr.",name:"Zuzeng",middleName:null,surname:"Qin",slug:"zuzeng-qin",fullName:"Zuzeng Qin"},{id:"194474",title:"Mr.",name:"Yuwen",middleName:null,surname:"Zhou",slug:"yuwen-zhou",fullName:"Yuwen Zhou"},{id:"194475",title:"Prof.",name:"Zili",middleName:null,surname:"Liu",slug:"zili-liu",fullName:"Zili Liu"}]},{id:"53666",doi:"10.5772/66967",title:"Supported Nickel-Based Catalysts for Partial Hydrogenation of Edible Oils",slug:"supported-nickel-based-catalysts-for-partial-hydrogenation-of-edible-oils",totalDownloads:2434,totalCrossrefCites:1,totalDimensionsCites:7,abstract:"Nickel-based catalysts, supported on diatomite, silica gel and perlite, with high nickel loadings, have been prepared by precipitation-deposition method. Various nickel precursor salts were used for the preparation of catalyst precursors. In the precursor state, the catalysts were characterized using nitrogen physisorption, mercury porosimetry, infrared, and X-ray diffraction spectroscopy. The reducibility of catalyst precursors was evaluated using hydrogen temperature programmed reduction. Hydrogen chemisorption and X-ray photoelectron spectroscopy measurements were performed with the aim of characterizing the chemical state of the catalyst precursors. This research was focused on the study of some major factors on the state, dispersion and reducibility of a deposited Ni2+ phase by the combined use of mentioned experimental techniques. We have examined the influence of the nature of support and the use of modifiers on activity of nickel-based catalysts in the partial hydrogenation of sunflower and soybean oils. Nitrogen physisorption and mercury porosimetry data showed that synthesis operating conditions and pore structure of supports have a profound effect on the textural properties of catalyst precursors. The analysis of infrared and X-ray diffraction spectra showed the existence of chemical species and phases which indicate the different extent of interaction between the support and the active metal. Temperature programmed reduction study revealed that the reduction features depend on the identity of the nickel precursor salt and its interaction with the support. A stronger interaction of the supported Ni2+ phase with support hinders the reduction of catalyst precursors. Hydrogen chemisorption results showed the presence of nickel crystallites varying from 5 to 47 nm in size. The X-ray photoelectron spectroscopy data confirmed the formation surface species with different strength of interaction and different nickel crystallite sizes. The hydrogenation results showed significant differences, depending on the support and the modifier, as well as structural characteristics of reduced catalyst precursors. The results show the importance of modifiers in the control of the activity and selectivity of the partial hydrogenation process. The developed kinetic models of the hydrogenation of soybean and sunflower oils over studied catalytic systems were found useful in the prediction of the rate of reactions, product selectivity and catalytic activity.",book:{id:"5426",slug:"new-advances-in-hydrogenation-processes-fundamentals-and-applications",title:"New Advances in Hydrogenation Processes",fullTitle:"New Advances in Hydrogenation Processes - Fundamentals and Applications"},signatures:"Miroslav Stanković, Jugoslav Krstić, Margarita Gabrovska, Vojkan\nRadonjić, Dimitrinka Nikolova, Davor Lončarević and Dušan\nJovanović",authors:[{id:"189814",title:"Dr.",name:"Miroslav",middleName:null,surname:"Stanković",slug:"miroslav-stankovic",fullName:"Miroslav Stanković"}]},{id:"52488",doi:"10.5772/65448",title:"Hydrogenation Catalysis in Biobased Ionic Liquids",slug:"hydrogenation-catalysis-in-biobased-ionic-liquids",totalDownloads:1753,totalCrossrefCites:1,totalDimensionsCites:6,abstract:"This chapter is dedicated to hydrogenation procedures of (poly)-alkenes or unsaturated ketones in various biobased and not-biobased ionic liquids. The first part of this chapter defines the concept of biobased ionic liquids and their preparation. In the second part, hydrogenation processes performed in non-biobased ionic liquids are described. Finally, in the last part, the two themes are mixed and recent examples of hydrogenation procedures of alkenes, polyalkenes or unsaturated ketones in biobased ionic liquids are developed.",book:{id:"5426",slug:"new-advances-in-hydrogenation-processes-fundamentals-and-applications",title:"New Advances in Hydrogenation Processes",fullTitle:"New Advances in Hydrogenation Processes - Fundamentals and Applications"},signatures:"Safa Hayouni, Nadège Ferlin and Sandrine Bouquillon",authors:[{id:"188732",title:"Prof.",name:"Sandrine",middleName:null,surname:"Bouquillon",slug:"sandrine-bouquillon",fullName:"Sandrine Bouquillon"},{id:"189857",title:"Dr.",name:"Nadège",middleName:null,surname:"Ferlin",slug:"nadege-ferlin",fullName:"Nadège Ferlin"},{id:"189858",title:"MSc.",name:"Safa",middleName:null,surname:"Hayouni",slug:"safa-hayouni",fullName:"Safa Hayouni"}]},{id:"53136",doi:"10.5772/65518",title:"Recent Developments in the Use of Flow Hydrogenation in the Field of Medicinal Chemistry",slug:"recent-developments-in-the-use-of-flow-hydrogenation-in-the-field-of-medicinal-chemistry",totalDownloads:2384,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"This chapter focuses on recent applications of flow hydrogenation in medicinal chemistry. Flow reactors can enhance laboratory safety, reducing the risks associated with pyrophoric catalysts, due to their containment in catalyst cartridges or omnifit columns. Flow hydrogenation reduces the risks arising from hydrogen gas, with either hydrogen generated in situ from water, or precise management of the gas flow rate through tube-in-tube reactors. There is an increasing body of evidence that flow hydrogenation enhances reduction outcomes across nitro, imine, nitrile, amide, azide, and azo reductions, together with de-aromatisation and hydrodehalogenation. In addition, olefin, alkyne, carbonyl, and benzyl reductions have been widely examined. Further, protocols involving multistage flow reactions involving hydrogenation are highlighted.",book:{id:"5426",slug:"new-advances-in-hydrogenation-processes-fundamentals-and-applications",title:"New Advances in Hydrogenation Processes",fullTitle:"New Advances in Hydrogenation Processes - Fundamentals and Applications"},signatures:"Cecilia C. Russell, Jennifer R. Baker, Peter J. Cossar and Adam\nMcCluskey",authors:[{id:"44482",title:"Prof.",name:"Adam",middleName:null,surname:"McCluskey",slug:"adam-mccluskey",fullName:"Adam McCluskey"}]}],mostDownloadedChaptersLast30Days:[{id:"55862",title:"Olefin Metathesis by Group VI (Mo, W) Metal Compounds",slug:"olefin-metathesis-by-group-vi-mo-w-metal-compounds",totalDownloads:1785,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Olefin metathesis is an important reaction not only in petroleum chemistry but also in fine chemistry. Professors Grubbs, Schrock, and Chauvin obtained the Nobel Prize in 2005 for the development of this reaction (determination of the mechanism and synthesis of homogeneous catalysts). This reaction can be described as the redistribution of carbon chains of olefins via a breaking of their C═C double bonds. It is catalyzed by metal carbenes and the catalytic cycle passes through a metallacyclobutane. The purpose of this chapter is to give an overview of catalysts based on tungsten or molybdenum active for this reaction. Numerous tungsten and molybdenum organometallic complexes displaying a carbene functionality were synthesized. Some of them are highly active in olefin metathesis. Industrially, tungsten oxide on silica is used as a precursor of the propene production by olefin metathesis of but-2-ene and ethylene. However, the active sites are not well known but they can be modeled by grafting, via surface organometallic chemistry, perhydrocarbyl complexes of molybdenum or tungsten on oxide surfaces. After a review of the complexes used in homogeneous catalysis, a review of the industrial catalysts and their models will be given.",book:{id:"5822",slug:"alkenes",title:"Alkenes",fullTitle:"Alkenes"},signatures:"Frédéric Lefebvre, Yassine Bouhoute, Kai C. Szeto, Nicolas Merle,\nAimery de Mallmann, Régis Gauvin and Mostafa Taoufik",authors:[{id:"198132",title:"Dr.",name:"Frederic",middleName:null,surname:"Lefebvre",slug:"frederic-lefebvre",fullName:"Frederic Lefebvre"},{id:"205605",title:"Dr.",name:"Yassine",middleName:null,surname:"Bouhoute",slug:"yassine-bouhoute",fullName:"Yassine Bouhoute"},{id:"205606",title:"Dr.",name:"Kai",middleName:null,surname:"Szeto",slug:"kai-szeto",fullName:"Kai Szeto"},{id:"205607",title:"Dr.",name:"Nicolas",middleName:null,surname:"Merle",slug:"nicolas-merle",fullName:"Nicolas Merle"},{id:"205608",title:"Dr.",name:"Aimery",middleName:null,surname:"De Mallmann",slug:"aimery-de-mallmann",fullName:"Aimery De Mallmann"},{id:"205609",title:"Dr.",name:"Régis",middleName:null,surname:"Gauvin",slug:"regis-gauvin",fullName:"Régis Gauvin"},{id:"205610",title:"Dr.",name:"Mostafa",middleName:null,surname:"Taoufik",slug:"mostafa-taoufik",fullName:"Mostafa Taoufik"}]},{id:"53512",title:"Catalytic Hydrogenation of Benzoic Acid",slug:"catalytic-hydrogenation-of-benzoic-acid",totalDownloads:2259,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Hydrogenation of benzoic acid using mono- and bimetallic catalyst of Ru, Pd, Co, and Re yielded different products. It was observed that 5% Ru/C was an active catalyst for hydrogenation of both aromatic ring and carboxylic group, while Pd/C catalyst hydrogenated only aromatic ring. Ru-Sn/Al2O3 is a chemoselective catalyst for hydrogenation of –COOH group of benzoic acid.",book:{id:"5426",slug:"new-advances-in-hydrogenation-processes-fundamentals-and-applications",title:"New Advances in Hydrogenation Processes",fullTitle:"New Advances in Hydrogenation Processes - Fundamentals and Applications"},signatures:"Sunil B. Shinde and Raj M. Deshpande",authors:[{id:"188266",title:"Dr.",name:"Sunil",middleName:"Babaji",surname:"Shinde",slug:"sunil-shinde",fullName:"Sunil Shinde"},{id:"189343",title:"Dr.",name:"Raj",middleName:null,surname:"Deshpande",slug:"raj-deshpande",fullName:"Raj Deshpande"}]},{id:"65034",title:"Decomposition Mechanisms of BODIPY Dyes",slug:"decomposition-mechanisms-of-bodipy-dyes",totalDownloads:1234,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"The stability of metal complexes in both thermodynamic and kinetic aspects always was a matter of interest in the field of coordination chemistry. Practical implementation of a fluorophores in a field of molecular biology also is essentially constrained by their solvolytic and protolytic stability. The aforementioned emphasizes interest in a search for factors of quantitative stability-based discrimination on a row of BODIPY derivatives. This chapter shows that thermodynamic stability of a dipyrrinates varies to a large extent from a mostly undestructable solvolytically BODIPYs to a very volatile in the same aspect rare-earth element complexes.",book:{id:"7345",slug:"bodipy-dyes-a-privilege-molecular-scaffold-with-tunable-properties",title:"BODIPY Dyes",fullTitle:"BODIPY Dyes - A Privilege Molecular Scaffold with Tunable Properties"},signatures:"Yuriy S. Marfin, Sergey D. Usoltsev and Evgeniy V. Rumyantsev",authors:null},{id:"56012",title:"Alkene and Olefin Functionalization by Organoaluminum Compounds, Catalyzed with Zirconocenes: Mechanisms and Prospects",slug:"alkene-and-olefin-functionalization-by-organoaluminum-compounds-catalyzed-with-zirconocenes-mechanis",totalDownloads:1405,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Alkene and olefin functionalization via addition of electro‐ or nucleophilic reagents is one of the convenient synthetic methods for the insertion of heteroatoms into organic molecules. The use of organometallic reagents in these reactions in combination with the specific catalysts provides high substrate conversion and process selectivity. The introduction of this approach into the chemistry of organoaluminum compounds leads to the development of chemo‐, regio‐ and stereoselective catalytic methods of alkene and olefin functionalization. The chapter focuses on the modern concepts of the alkene hydro‐, carbo‐ and cycloalumination mechanisms, that is, the experimental and theoretical data on the intermediate structures involved in the product formation, the effects of the catalyst and organoaluminum compound structure, reaction conditions on the activity and selectivity of the bimetallic systems. The prospects of the development of enantioselective methods using these catalytic systems for the alkene and olefin transformations are considered.",book:{id:"5822",slug:"alkenes",title:"Alkenes",fullTitle:"Alkenes"},signatures:"Lyudmila V. Parfenova, Pavel V. Kovyazin, Tatyana V. Tyumkina,\nLeonard M. Khalilov and Usein M. Dzhemilev",authors:[{id:"199608",title:"Prof.",name:"Lyudmila",middleName:null,surname:"Parfenova",slug:"lyudmila-parfenova",fullName:"Lyudmila Parfenova"},{id:"199611",title:"Dr.",name:"Tatyana",middleName:null,surname:"Tyumkina",slug:"tatyana-tyumkina",fullName:"Tatyana Tyumkina"},{id:"199612",title:"Dr.",name:"Pavel",middleName:null,surname:"Kovyazin",slug:"pavel-kovyazin",fullName:"Pavel Kovyazin"},{id:"199613",title:"Prof.",name:"Leonard",middleName:null,surname:"Khalilov",slug:"leonard-khalilov",fullName:"Leonard Khalilov"},{id:"199614",title:"Prof.",name:"Usein",middleName:null,surname:"Dzhemilev",slug:"usein-dzhemilev",fullName:"Usein Dzhemilev"}]},{id:"62646",title:"Redox Chemistry of BODIPY Dyes",slug:"redox-chemistry-of-bodipy-dyes",totalDownloads:1662,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"The implementation of BODIPY dyes in electron transfer reactions is an exciting new frontier that expands the toolbox of the dye molecule that has primarily been implemented in biological and chemical sensing applications. BODIPY dyes are capable of reversible reductions at the average reduction potential of −1.53 V vs. ferrocene/ferrocenium, varying about 700 mV from this average value depending on the substitution of the BODIPY core. BODIPY dyes are also capable of reversible oxidations, exhibiting an average oxidation potential of 610 mV with the ability to manipulate the oxidation potential up to 600 mV from the average potential. The respective azaBODIPY dyes are on average about 600 mV easier to reduce (more positive potentials) and are oxidized at almost identical oxidation potentials to the respective BODIPY dyes. The oxidation and reduction potentials of BODIPY dyes are heavily dependent on substitution of the BODIPY core, which allows for a high degree of tunability in the redox potentials. This characteristic makes BODIPY dye molecules good candidates for use as photoredox catalysts, redox flow batteries, redox-active ligands, light harvesting antenna, and many other applications in materials science, biology, and chemical synthesis.",book:{id:"7345",slug:"bodipy-dyes-a-privilege-molecular-scaffold-with-tunable-properties",title:"BODIPY Dyes",fullTitle:"BODIPY Dyes - A Privilege Molecular Scaffold with Tunable Properties"},signatures:"Brena L. Thompson and Zachariah Heiden",authors:null}],onlineFirstChaptersFilter:{topicId:"499",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:31,numberOfPublishedChapters:314,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:18,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:14,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"June 24th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:31,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",isOpenForSubmission:!0,annualVolume:11410,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,annualVolume:11411,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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