Means and standard deviations of MCQ-C scores as a function of participants’ anxiety level and gender.
\\n\\n
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{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"}]},book:{item:{type:"book",id:"4625",leadTitle:null,fullTitle:"Complementary Therapies for the Body, Mind and Soul",title:"Complementary Therapies for the Body, Mind and Soul",subtitle:null,reviewType:"peer-reviewed",abstract:"Complementary Therapies (CT) refers to the practices, products, or health systems that are outside the realm of conventional medicine, used to treat disease or to promote health and well-being. Defining CT is difficult, because the field is very broad and constantly changing. The title of this book includes the words body, mind, and soul. The body and the mind (and their reciprocal relations) have been extensively studied scientifically. What about the soul? The book brings some points about this new ground in CT. We hope you find in the present work the sincere desire to collaborate with the dissemination of knowledge. May this book be useful and pleasant to you.",isbn:null,printIsbn:"978-953-51-2158-9",pdfIsbn:"978-953-51-7250-5",doi:"10.5772/59418",price:119,priceEur:129,priceUsd:155,slug:"complementary-therapies-for-the-body-mind-and-soul",numberOfPages:296,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"48cd88cd7a6ffb4ade0088448e5ac56b",bookSignature:"Marcelo Saad",publishedDate:"September 2nd 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4625.jpg",numberOfDownloads:22118,numberOfWosCitations:11,numberOfCrossrefCitations:11,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:26,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:48,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 21st 2014",dateEndSecondStepPublish:"November 11th 2014",dateEndThirdStepPublish:"February 7th 2015",dateEndFourthStepPublish:"March 9th 2015",dateEndFifthStepPublish:"April 8th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"51991",title:"Prof.",name:"Marcelo",middleName:null,surname:"Saad",slug:"marcelo-saad",fullName:"Marcelo Saad",profilePictureURL:"https://mts.intechopen.com/storage/users/51991/images/system/51991.png",biography:"Marcelo Saad, MD, PhD (Brazil), is a physician, board certified in acupuncture. He has a doctorate in the Sciences of Rehabilitation from the Federal University of S. Paulo. He is also current director member of the Spiritist-Medical Association of S. Paulo.\nHe has been invited to the upcoming postgraduate course in Interfaith Hospital Chaplaincy, Santa Marcelina Medical School. Besides his work as a medical acupuncturist in private practice,\nhe is also engaged in scientific publications, editorial collaborations with journals and books, medical lectures, and participation in scholarly tasks. His main interests are religiosity in \nhealthcare, acupuncture, and complementary therapies.",institutionString:"Spiritist Medical Association of Sao Paulo",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"5",institution:{name:"Universidade de Santo Amaro",institutionURL:null,country:{name:"Brazil"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"992",title:"Pharmacology",slug:"complementary-medicine-pharmacology"}],chapters:[{id:"48438",title:"Complementary Therapy with Traditional Chinese Medicine for Treating Atherosclerosis-Related Diseases",doi:"10.5772/60704",slug:"complementary-therapy-with-traditional-chinese-medicine-for-treating-atherosclerosis-related-disease",totalDownloads:1894,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Atherosclerosis-related diseases are the leading cause of morbidity or mortality in the world. They result in serious outcomes such as sudden cardiac death, unstable angina pectoris, acute myocardial infarction, stroke, or intermittent claudication due to vessel obliteration or plaque rupture with subsequent thrombosis. There are some limitations with standard treatments such as antiplatelet drugs, angiotensin-converting enzyme inhibitors, beta-blockers, coronary artery bypass surgery, and percutaneous transluminal coronary angioplasty. Therefore, complementary and alternative medicine is necessary for medication. Traditional Chinese medicine is the main complementary therapy used in the Chinese community. This article aims to explore complementary therapy with traditional Chinese medication for atherosclerosis-related diseases. There is some scientific evidence to support that traditional Chinese medicine could treat atherosclerosis and its associated conditions. Acupuncture through needling on ST36, ST40, PC6, or BL15 could alleviate atherosclerosis-related cardiovascular diseases. Tai chi and meditation have beneficial effects for mental and physical health. In addition, extracts or compounds of single Chinese herbs such as Salvia miltiorrhiza, Panax notoginseng, Ginkgo biloba, Curcuma longa, Crataegus pinnatifida, Paeonia lactiflora, Prunella vulgaris, Polygonum multiflorum, Coptis chinensis, and red yeast rice also could treat atherosclerosis-related diseases through their endothelial protective, antioxidative, anti-inflammatory, inhibiting of smooth muscle cells proliferation, and lipid-lowering effects. In accordance with evidence-based medicine, well-designed and conducted clinical studies such as randomized control clinical trials will be necessary in the future.",signatures:"Yu-Chiang Hung, Chun-Ting Liu and Wen-Long Hu",downloadPdfUrl:"/chapter/pdf-download/48438",previewPdfUrl:"/chapter/pdf-preview/48438",authors:[{id:"49804",title:"Dr.",name:"Yu-Chiang",surname:"Hung",slug:"yu-chiang-hung",fullName:"Yu-Chiang Hung"},{id:"49848",title:"Dr.",name:"Wen-Long",surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu"},{id:"175558",title:"Dr.",name:"Chun-Ting",surname:"Liu",slug:"chun-ting-liu",fullName:"Chun-Ting Liu"}],corrections:null},{id:"48326",title:"Acupuncture in Treatment of Chronic Functional Constipation",doi:"10.5772/60521",slug:"acupuncture-in-treatment-of-chronic-functional-constipation",totalDownloads:1974,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Constipation is not only a symptom but is a predominant presenting symptom in many diseases. The prevalence is between 3 and 27% worldwide, and is especially prevalent in the elderly population. The aetiology is multifactorial. Laxative abuse or enema use are usually a norm in patients’ constipation. Patients tend not to seek further medical aid after several unsuccessful therapies and this can seriously affect their quality of life.",signatures:"Shuqing Ding, Xun Jin, Yijiang Ding, Lingling Wang and Huifeng\nZhou",downloadPdfUrl:"/chapter/pdf-download/48326",previewPdfUrl:"/chapter/pdf-preview/48326",authors:[{id:"173903",title:"Prof.",name:"Shuqing",surname:"Ding",slug:"shuqing-ding",fullName:"Shuqing Ding"}],corrections:null},{id:"49027",title:"Patients Suffering from Intractable Diseases Treated Effectively with Medicines of Kampo and TCM",doi:"10.5772/60573",slug:"patients-suffering-from-intractable-diseases-treated-effectively-with-medicines-of-kampo-and-tcm",totalDownloads:1867,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"There are diseases that cannot be cured by conventional therapies.",signatures:"Yasuyo Hijikata",downloadPdfUrl:"/chapter/pdf-download/49027",previewPdfUrl:"/chapter/pdf-preview/49027",authors:[{id:"68766",title:"Dr.",name:"Yasuyo",surname:"Hijikata",slug:"yasuyo-hijikata",fullName:"Yasuyo Hijikata"}],corrections:null},{id:"49034",title:"Low Back Pain from the Perspective of Traditional Iranian Medicine (TIM)",doi:"10.5772/61170",slug:"low-back-pain-from-the-perspective-of-traditional-iranian-medicine-tim-",totalDownloads:1418,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this chapter the attitudes and opinions of Traditional Iranian medicine (TIM) about “low back pain: (LBP)” are considered. According to TIM, several main mechanisms for this very common disorder are explained. The spine, being far from the body heat source (heart) that sets the spine in coldest position, is considered in terms of temperament. The most common type of low back pain is cold temperament, simple or material. However, movements in the joints would cause heating, but the range of motion of the spine is very limited, so that its temperament remains cold, and the most common type of low back pain is caused by a cold temperament. Pain is the most common symptom whichabates with walking, rubbing, and warming, and usually becomes worse with the cold.",signatures:"Mohammad Reza Vaez Mahdavi, Mohsen Naseri, Nafiseh Hoseini\nYekta, Younes Roohany, Fatemeh Emadi and Soghrat Faghihzadeh",downloadPdfUrl:"/chapter/pdf-download/49034",previewPdfUrl:"/chapter/pdf-preview/49034",authors:[{id:"73334",title:"Prof.",name:"Mohamad Reza",surname:"Vaez Mahdavi",slug:"mohamad-reza-vaez-mahdavi",fullName:"Mohamad Reza Vaez Mahdavi"},{id:"174289",title:"Prof.",name:"Mohammad Reza",surname:"Vaez Mahdavi",slug:"mohammad-reza-vaez-mahdavi",fullName:"Mohammad Reza Vaez Mahdavi"}],corrections:null},{id:"48746",title:"Anticancer Plants in Islamic Traditional Medicine",doi:"10.5772/61111",slug:"anticancer-plants-in-islamic-traditional-medicine",totalDownloads:2174,totalCrossrefCites:6,totalDimensionsCites:14,hasAltmetrics:0,abstract:"Islamic Traditional Medicine (ITM) is a holistic and comprehensive medical school that has antecedents over 12 centuries ago.",signatures:"Behjat Javadi, Milad Iranshahy and Seyed Ahmad Emami",downloadPdfUrl:"/chapter/pdf-download/48746",previewPdfUrl:"/chapter/pdf-preview/48746",authors:[{id:"46265",title:"Dr.",name:"Seyed Ahmad",surname:"Emami",slug:"seyed-ahmad-emami",fullName:"Seyed Ahmad Emami"},{id:"177141",title:"Dr.",name:"Behjat",surname:"Javadi",slug:"behjat-javadi",fullName:"Behjat Javadi"},{id:"177142",title:"Dr.",name:"Milad",surname:"Iranshahy",slug:"milad-iranshahy",fullName:"Milad Iranshahy"}],corrections:null},{id:"48731",title:"Animal Assisted Intervention for Rehabilitation Therapy and Psychotherapy",doi:"10.5772/61117",slug:"animal-assisted-intervention-for-rehabilitation-therapy-and-psychotherapy",totalDownloads:3318,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Animal-assisted Intervention (AAI) is a goal-oriented intervention that intentionally includes or incorporates animals in health, education, and human service for the purpose of therapeutic gains in humans. AAI incorporates human-animal teams in formal human service such as Animal-assisted Therapy (AAT) or Animal-assisted Education (AAE). Animal-assisted Activity (AAA) is the informal AAI often conducted on a volunteer basis by the human-animal team for motivational, educational, and recreational purposes. AAI could be used for rehabilitation therapy and psychotherapy for patients with various symptoms. AAI uses animals, mostly dogs, to aid in healing patients holistically. Dogs have an overwhelming gratitude and exuberance for life and this effect on people is astounding. Furthermore, AAI has been researched and its effectiveness on patients’ outcomes and healing is documented. With a soaring trend of the incorporation of complementary therapies into the mainstream of therapy and health care, animal-facilitated therapy has become a popular interest for the therapy team to integrate into a patient’s plan of therapy.",signatures:"Okjin Kim, Sunhwa Hong, Hyun-A Lee, Yung-Ho Chung and Si-Jong\nLee",downloadPdfUrl:"/chapter/pdf-download/48731",previewPdfUrl:"/chapter/pdf-preview/48731",authors:[{id:"174303",title:"Prof.",name:"Okjin",surname:"Kim",slug:"okjin-kim",fullName:"Okjin Kim"},{id:"174309",title:"Prof.",name:"Sunhwa",surname:"Hong",slug:"sunhwa-hong",fullName:"Sunhwa Hong"},{id:"174310",title:"Prof.",name:"Hyun-A",surname:"Lee",slug:"hyun-a-lee",fullName:"Hyun-A Lee"},{id:"175622",title:"Prof.",name:"Yung-Ho",surname:"Chung",slug:"yung-ho-chung",fullName:"Yung-Ho Chung"},{id:"175623",title:"Prof.",name:"Si-Jong",surname:"Lee",slug:"si-jong-lee",fullName:"Si-Jong Lee"}],corrections:null},{id:"48659",title:"Kampo, a Traditional Japanese Medicine, for the Body, Mind, and Soul",doi:"10.5772/60702",slug:"kampo-a-traditional-japanese-medicine-for-the-body-mind-and-soul",totalDownloads:1450,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Traditional Japanese (Kampo) medicine is widely used to treat numerous conditions. Kampo medicine includes herbal formulas, acupuncture, moxibustion, and massage. After the Great East Japan Earthquake (GEJE), Kampo medicine was used to treat the imbalances in the body, mind, and soul in severely affected areas. The effects of the Kampo medicine saikokeishikankyoto (SKK) for the treatment of post-traumatic stress disorder (PTSD) have been proven in our clinical study. In this chapter, we have summarized both our reports from the Kampo medical clinics that were set up after the GEJE disaster and our findings of the clinical study on PTSD treatment in disaster survivors.",signatures:"Shin Takayama, Takehiro Numata, Natsumi Saito, Soichiro Kaneko\nand Tetsuharu Kamiya",downloadPdfUrl:"/chapter/pdf-download/48659",previewPdfUrl:"/chapter/pdf-preview/48659",authors:[{id:"57951",title:"Dr.",name:"Shin",surname:"Takayama",slug:"shin-takayama",fullName:"Shin Takayama"}],corrections:null},{id:"48608",title:"Yoga & Qigong — A Self-reliant Practice for Health of Body & Mind",doi:"10.5772/60568",slug:"yoga-qigong-a-self-reliant-practice-for-health-of-body-mind",totalDownloads:2033,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Yoga originated from India and is becoming popular worldwide. Qigong originated from China and is less known outside China. Interestingly, both Indian Yoga and Chinese Qigong emphasize on three common components in their fundamental practices, viz. (i) stretching of muscles, tendons and ligaments when thousands of proprioceptive receptors which initiate the “gate theory” of neurological control of pain perception are stimulated; (ii) controlled breathing which harmonizes the somatic and autonomic systems of neurological activities; and (iii) the wonderful outcome after such simple voluntary efforts, a state of tranquility of the mind, which could be understood as Meditation. A comprehensive review on the reports on Yoga and Qigong practices affecting the important physiological processes and mental states of the practitioners is completed to provide reliable information about the value of the practices. Result of the review shows that there are sufficient evidences today, after many carefully planned research studies, on the supportive effects of both Yoga and Qigong on not only neuromuscular pathologies but also problems in cardiovascular, pulmonary and most remarkably, mental health. Yoga and Qigong practices are good for both the body and mind.",signatures:"Ping-chung Leung",downloadPdfUrl:"/chapter/pdf-download/48608",previewPdfUrl:"/chapter/pdf-preview/48608",authors:[{id:"58131",title:"Prof.",name:"Ping-Chung",surname:"Leung",slug:"ping-chung-leung",fullName:"Ping-Chung Leung"}],corrections:null},{id:"48527",title:"Role of Acupuncture in the Treatment of Drug Addiction",doi:"10.5772/60655",slug:"role-of-acupuncture-in-the-treatment-of-drug-addiction",totalDownloads:1730,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"This review systematically assessed the clinical evidence for and against acupuncture as a treatment for drug addiction. The existing scientific rationale and possible mechanisms for the effectiveness of acupuncture on drug addiction were also evaluated. We used computerized literature searches in English and Chinese and examined texts written before these computerized databases existed. We also used search terms of treatment and neurobiology for drug abuse and dependence. Acupuncture showed evidence for relevant neurobiological mechanisms in the treatment of drug addiction. Although positive findings regarding the use of acupuncture to treat drug dependence have been reported by many clinical studies, the data do not allow us to make conclusions that acupuncture was an effective treatment for drug addiction, given that many studies reviewed here were hampered by small numbers of patients, insufficient reporting of randomization and allocation concealment methods, and strength of the inference. However, considering the potential of acupuncture demonstrated in the included studies, further rigorous randomized controlled trials with long follow-up are warranted.",signatures:"Anfeng Xiang, Boyuan Zhang and Sheng Liu",downloadPdfUrl:"/chapter/pdf-download/48527",previewPdfUrl:"/chapter/pdf-preview/48527",authors:[{id:"173908",title:"Dr.",name:"Sheng",surname:"Liu",slug:"sheng-liu",fullName:"Sheng Liu"},{id:"175883",title:"Dr.",name:"Sheng",surname:"Liu",slug:"sheng-liu",fullName:"Sheng Liu"}],corrections:null},{id:"48500",title:"Distant Healing Techniques and Distant Intercessory Prayer – A Tentative Scientific Conciliation",doi:"10.5772/60722",slug:"distant-healing-techniques-and-distant-intercessory-prayer-a-tentative-scientific-conciliation",totalDownloads:2009,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:'Currently there is a lack of a universally accepted theory that would constitute the base for the DH paradigm, and some fundamental issues about the mechanisms of DH remain non-responded. Even so, there is sparse documentation that intentions of one person can remotely influence mental and body functions of another person. With the available data, it becomes difficult to formulate an opinion about the validity of such techniques in healthcare. The question of DH may be put under the frame "Is the glass half empty or half full?". People who look at the issue of DH and see a half empty glass usually raise these points: Scientific evidence of benefit is poor, from scarce studies, many of them with methodological limitations; There is a lack of a coherent theory aligned to the ordinary reality based upon Newtonian science; Practical obstacles for healthcare include high variability of outcomes and low relevance of clinical effects. People who look at the issue of DH and see a half full glass usually raise these points: the positive results from some serious and well designed researches may indicate a possible hidden reality; emerging understanding of the mind and its non-local properties may explain the gap of distance; commitment to the patients\' claims for a humanistic, comprehensive and integrative healthcare. We may cite two poles of ignorance and the balanced position related to the discussion of DH. The first pole is the obstinate skepticism (arrogant and prejudiced attachment to materialism), that denies the full half. The opposite pole is the naive mysticism (unrealistic trust on paranormal potentialities), that denies the empty half. The balanced position is called here the option for the open-minded scientificism. Some opportunities of advancement in this field would arise from these points: new and adequate research designs complying with limitations of the phenomenon; the progressive consolidation of a new, post-materialist scientific paradigm; optimizing the efficacy of the phenomenon knowing better its interfering factors.',signatures:"Marcelo Saad and Roberta de Medeiros",downloadPdfUrl:"/chapter/pdf-download/48500",previewPdfUrl:"/chapter/pdf-preview/48500",authors:[{id:"51991",title:"Prof.",name:"Marcelo",surname:"Saad",slug:"marcelo-saad",fullName:"Marcelo Saad"},{id:"62007",title:"Dr.",name:"Roberta",surname:"De Medeiros",slug:"roberta-de-medeiros",fullName:"Roberta De Medeiros"}],corrections:null},{id:"48662",title:"Why is Qi-Invigorating Therapy in Chinese Medicine Suitable for Mitochondrial Diseases? A Bioenergetic Perspective",doi:"10.5772/60675",slug:"why-is-qi-invigorating-therapy-in-chinese-medicine-suitable-for-mitochondrial-diseases-a-bioenergeti",totalDownloads:2251,totalCrossrefCites:2,totalDimensionsCites:3,hasAltmetrics:1,abstract:"The central player in bioenergetics is the mitochondrion. Bioenergetic dysfunction is emerging as a cornerstone for understanding the pathophysiology of mitochondrial diseases. Accompanying the depth of mitochondrial research and the rapid development of mitochondrial medicine, however, is rapid amplification of the number of mitochondrial diseases; mitochondrial dysfunction would undermine the function of cells, tissues, and organs, thereby causing cancer, diabetes, obesity, strokes, cardiovascular diseases, neurodegenerative diseases, and ageing, etc. Currently, there are no effective treatments; Western medicine is in crisis when it comes to mitochondrial diseases.",signatures:"Xing-Tai Li, Hai-Xue Kuang and Jia Zhao",downloadPdfUrl:"/chapter/pdf-download/48662",previewPdfUrl:"/chapter/pdf-preview/48662",authors:[{id:"44740",title:"Prof.",name:"Haixue",surname:"Kuang",slug:"haixue-kuang",fullName:"Haixue Kuang"},{id:"73821",title:"Dr.",name:"Xing-Tai",surname:"Li",slug:"xing-tai-li",fullName:"Xing-Tai Li"},{id:"122689",title:"Dr.",name:"Jia",surname:"Zhao",slug:"jia-zhao",fullName:"Jia Zhao"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"2975",title:"Complementary Therapies for the Contemporary Healthcare",subtitle:null,isOpenForSubmission:!1,hash:"604c4ba43197c3ba1506c55c763d4ca7",slug:"complementary-therapies-for-the-contemporary-healthcare",bookSignature:"Marcelo Saad and Roberta de Medeiros",coverURL:"https://cdn.intechopen.com/books/images_new/2975.jpg",editedByType:"Edited by",editors:[{id:"51991",title:"Prof.",name:"Marcelo",surname:"Saad",slug:"marcelo-saad",fullName:"Marcelo Saad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1316",title:"Acupuncture",subtitle:"Clinical Practice, Particular Techniques and Special 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The terms dental anxiety, fear, and phobia, though often used mutually, differ depending on the situation within which they occur. Nevertheless, a distinction has been made between these terminologies.
Dental anxiety is extremely common, and most people experience some degree of the anxiety especially if they are about to have a certain dental procedure done which they have never experienced before. Moreover, someone with a dental phobia will avoid dental care at all costs until either a physical problem or the psychological burden of the phobia becomes overwhelming. In this chapter, the term dental anxiety is employed.
Dental anxiety is reported to be a global public health concern due to its effects on individual’s oral health and quality of life. The prevalence of the condition in children ranges from 5 to 61% [2, 3] and in adults from 1 to 52% [4, 5, 6, 7, 8, 9, 10, 11, 12], inclusive of participants with both moderate and high dental anxiety.
A majority of studies done reveal that females of all age groups, younger age and people who are classified to have low level of education are at more risk of having dental anxiety [2, 11]. The main reasons cited for the observed differences are more linked to environmental factors rather than biological makeup among children. However, Folayan and coworkers [13] revealed no differences in the prevalence of dental anxiety with sociodemography in children, while Minja et al. [11] showed no sex difference in their study among adults.
Individuals with poor oral health status are reported to perceive dental anxiety than their counter parts with good oral health status. Clinically, these patients are observed to have high number of decayed and missing teeth and less restored teeth [14, 15, 16]. DeDonno [17] revealed an association between participants’ dental anxiety and oral hygiene, whereby individuals with dental anxiety were seen to have poor oral hygiene. Furthermore, patients who are dentally anxious are usually least satisfied with the appearance of their teeth [18].
Population studies show that individuals with dental anxiety have difficulties to attend to a dentist [19]. Dental anxiety has also been reported to impact on individuals’ daily living including modification of eating habits, such as avoidance of hard to chew and foods that cause sensitivity. Further to this, individuals with dental anxiety are reported to have a high tendency to self-medication so as to avoid visiting a dentist [20].
The role of culture and norms in modifying individual’s perception of dental fear and anxiety is also of prime importance when explaining these phenomena. Culture has been reported to have influence on perceiving dental anxiety [21]. Studies have shown that dental anxiety expression significantly varied according to ethnicity as well as religion due to the engraved dental anxiety coping mechanisms and expression among different cultures [22]. Generally, it has been reported that societies with cultures that emphasize on greater self-control, emotional restraint, and compliance to social rule (such as some Asian and African countries) were more likely to score higher in their fears/anxiety [23].
In order to understand the dental anxiety well, it is important to explain its pathway, causes, diagnosis, and management.
Five theories are thought to better explain the pathways of dental anxiety:
In
Dental anxiety has a wide range of causes and hence it is considered complex and multifactorial [25]. The causes may be patient, provider, or environment related. The patient-related causes include past dental experience, pain, influence of family, or peer experience and personality, whereas provider-related causes include communication techniques and provider’s bad behavior. Environmental-related causes include sounds of drills or other apprehensive patients, unpleasant smell/clinic area, and sight of blood or local anesthetic injections [26].
The importance of proper diagnosis of dental anxiety cannot be underrated. Identifying anxious patients helps a dental care provider to plan for appropriate ways and procedures for managing the patient. Several means have been developed to identify patients who have dental anxiety before treatment is initiated, so as to assist a dentist to provide appropriate treatment with no negative consequences to both the patient and provider. The measures are grouped into two:
Using reliable and easy-to-administer tools for assessment of dental anxiety at the dental setting is beneficial for the dental team [27]. Despite the presence of a number of pretreatment questionnaires for patient administration, very few dental health-care providers utilize them [28]. Using self-reported questionnaire has been reported to be useful to assist in disclosing as well as reducing dental anxiety, as it might be a way for the dental team to gently build rapport with a patient [29]. A number of self-rated tools are available and no single instrument can be regarded as a gold standard set of questions. Mentioned here are the most commonly used and have shown acceptable psychometric properties for use in different languages worldwide. These measures are simple, easy to use, and acceptable to both patients and dental team [30, 31, 32]. They include a four-item Corah’s dental anxiety scale (CDAS) and a five-item modified dental anxiety scale (MDAS) which proved to be suitable for use among adults. The results can be utilized in grouping patients according to the level of dental anxiety that is
Measuring patients’ vital signs can add into the identification of patients with dental anxiety at the dental clinic setting. These measures are assessment of blood pressure, pulse rate, pulse oximetry to assess blood oxygen levels which is affected by stress and anxiety, finger temperature, and galvanic skin response that measures skin conductance of weak electric current [29, 34].
When managing a patient with dental anxiety, utilization of different measures to counter anxiety will depend on the patient’s history, age, and cooperation. In all instances, a dental care provider needs to portray behavior that will contribute to reducing anxiety to the patient. These include, but not limited to, being composed and relaxed, friendly to the patient, avoiding being judgmental or instilling pain, being supportive and encouraging to the patient, and working efficiently [26, 29]. Different measures are employed in managing patients with dental anxiety as explained below according to the age group of the patient.
In managing children with dental anxiety, the following is suggested:
Allocate enough time for appointment.
Communicate effectively.
Utilize the four “s” principle by reducing triggers of stress. These are
Distract the patient using music, video.
Give a sense of control over the procedure by involving the patient during treatment, like to raise hand when feeling pain or uncomfortable.
Reduce pain by giving enough anesthesia.
Provision of cognitive behavioral therapy (CBT).
Provision of relaxation therapy for older children that will assist patients to gain control over their psychological state. The techniques can be given before and even during the procedure. These may include
In highly anxious patients who could not do any of the psychotherapeutics, pharmacotherapy may be indicated such as:
Conscious sedation technique, whereby drugs are provided to render an anxious patient to a depressive state. The routes of application can be oral, sublingual, intramuscular, rectal, and in dental setting with enough resources, intravenous administration, or inhalation using nitrous oxide (N2O) gas.
When the above techniques do not help, the practitioner can refer the patient to a specialist psychologist for further management or can resort to general anesthesia if equipment and trained personnel are available.
All the techniques used in children can be utilized when managing adults with dental anxiety. In addition, the following techniques can be employed:
Utilization of computer-assisted relaxation learning (CARL), which is a self-paced treatment by patients to cope with dental anxiety (needle specific) without the presence of a therapist.
Individual systematic desensitization, whereby patients are gradually introduced to a fearful stimulus and learn to cope with anxiety by utilizing another method such as CARL or relaxation therapy methods.
For patients whose anxiety is induced by a needle, computer-controlled local anesthesia can be used; or electronic dental anesthesia, wherein anesthesia is achieved based on “gate-control theory of pain,” with no use of a needle. This method, though, is expensive and requires special training.
Adults could also be referred for group therapy with specialist psychologist and behavioral therapist.
A patient will calm down, hence be receptive of oral health information provided for his/her own benefit. Furthermore, the patient will allow receiving the required treatment. Ultimately, the patient will be positively motivated, on a long-term basis and thus acquire positive attitudes toward dentistry.
This will assist service provider to be at peace, hence facilitate accurate provision of the required treatment. The whole scenario will, eventually, minimize occupational stress.
Generally, dental procedures take a couple of minutes to accomplish, and therefore require a patient to be calm and cooperative in the dental chair. Unfortunately, this is not always the case, since some patients are apprehensive probably because most procedures are either believed or are actually associated with some degree of pain to the patient. Furthermore, dental patients are usually “alert” or “not ill,” thus in full perception of all that is happening. This situation contributes to acquisition of dental anxiety.
It has been observed that individuals with dental anxiety tend to fail to keep appointments, avoid attending to a dentist for dental care or complying with prescribed treatment [35]. This tendency cuts across all individuals regardless of their socioeconomic status or geographical location. Dental anxiety is also associated with poor dental health conditions [36]. Research shows that anxious patients possess poor oral health when compared to nonanxious counterparts in terms of decayed, missing, and filled teeth [37]. Moreover, poor oral health conditions negatively impact individuals’ quality of life [38, 39]. Generally, dental anxious patients have been viewed as unreliable and of poor economic risk [26].
The cycle of dental anxiety (Figure 1) explains the interrelationship of the above. Whereby, an individual with dental anxiety is usually worried and anticipates that something bad is going to happen if she/he visits a dentist; thenceforth, tends to delay or avoid dental attendance. This action deprives the individual from receiving dental preventive care and treatment and thus leads to deterioration of oral health, poor oral health status, and poor dental-related quality of life. Poor oral health, coupled with feeling of guilt, shame, inferiority, and worry of being reprimanded by a dentist for oral neglect, further increases dental anxiety and the cycle continues [40, 41]. Failure to provide the required treatment to counter dental anxiety, the vicious cycle will continue. It has been suggested that effective treatment of dental anxiety will improve dental attendance and ultimately the oral health of individuals [42].
The vicious cycle of dental anxiety [
Good oral health-care delivery entails harmonious environment contributed to by both providers and patients as well as dental environment. When either party’s attributes are not positive toward reaching a harmonious environment, it may interfere with attaining the intended management goals.
Provider’s good communication skills coupled with proper use of behavior management techniques as well as positive behavior toward dental patients play a significant role in creating a harmonious dental treatment environment. The reverse may induce dental anxiety or exacerbate the already anxious situation [43]. Ultimately, treatment may take longer or may have to be rescheduled but may also be compromised. Various consequences of this situation include loosing patients, bad provider reputation, and negative professional image, as well as negative economic implications. Consequences affecting the patient directly include eliciting pain and contributing to patients’ unpleasant dental experience. Handling an anxious patient when not prepared has been reported to add stress on the dentist and the dental team as a whole [44].
Delaying, rescheduling, or avoiding dental visit due to dental anxiety leads to seeing a dentist only when it is inevitable, which may end up into a need for complicated treatment [36]. The latter might bring about more anxiety, failure to abide to instructions, or comply to preventive care hence exaggerate oral health problems [43]. Unfortunately, causes of dental anxiety such as personality, past dental experience, or family/peer influence are basically out of patients’ control. Therefore, they need to be assisted to overcome the anxiety, which is a sole responsibility of the dental team. The dental team should have a broad approach on patient’s needs, not be judgmental while managing the patient, instead do all that is required to allay the patient’s anxiety, thus facilitating provision of proper care.
Dental environment is generally perceived by patients to be unfriendly, offensive, and anxiety-provoking, especially so by anxious patients. The looks of the dental chair and its accessories may not give an appealing first impression. Smell of the medicaments as well as invasive contact in the mouth, sound of the drill, sight of blood are some of the situations that most patients may have difficulties to tolerate [45]. The dental environment condition, coupled with the nature and duration of dental treatment procedures, may bring about or amplify patient dental anxiety. This situation will interfere with delivery of dental care. It is, therefore, the responsibility of the dental team to make sure that the dental environment is friendly to patients with or without dental anxiety.
Like in any other disease/condition, prevention before development of dental anxiety is important for effective management of patients. This may entail putting in place modifications to address operators, patients, or dental clinic environment concerns. Further to this, strategies aiming at the community may be critical.
Operators/dental team character plays a big role in determining future behavior of dental patients. Particularly, what the patient experiences at his/her first visit to a dentist is what shapes his/her attitudes with dental care services [46]. Positive behavior of operator and the dental team will automatically influence positive attitudes and minimize chances for dental anxiety. On the contrary, a bad operator/dental team behavior may induce, as well as exaggerate, dental anxiety in patients [43, 47]. To prevent operators/dental team from inducing dental anxiety, starting from the moment the patient enters the dental clinic to exiting, it is advisable for the team to have good communication skills, be sympathetic, have empathy, and be able to control temper. To make this happen, proper training and continuing education on prevention of dental anxiety are of paramount importance. Therefore, the provider and dental team at large should strive to intentionally acquire these characteristics, which will lead to having positive behavior toward patients, particularly to be understanding to anxious ones.
Every dental patient has his/her own preconceived ideas about dental care. Apparently, each patient might be anxious depending on his/her personality trait, past dental experience, influence from family and peers, etc. Therefore, all patients attending the dental clinic should be calmed down and be made to relax regardless of whether the patient is anxious or not, (Figure 2a and b). This is a sole responsibility of the dental team [48].
(a) A 7-year-old child presenting with dental anxiety trying to stop the doctor from performing oral examination. (b) The same child while a dentist employs behavior management techniques to allay the child’s dental anxiety (pictures by courtesy of Dr. Gustav Rwekaza).
Most patients consider the dental environment to be unfriendly and anxiety provoking. For this reason, various efforts have been made by dental professionals to modify the environment so as to counter that effect (Figures 3 and 4). The efforts include avoiding white uniforms by using attractive colorful attire, minimizing bright lights, playing soft/relaxing music, placement of nondental attractions in waiting rooms, making reception and waiting rooms colorful for children, minimizing noise from dental instruments/equipment by sound proofing the operating rooms, and intentionally engaging a receptionist who is charming, positive, and having caring attitudes to patients. Other measures are utilization of aromatherapy and sensory-adapted dental environment (SDE). Aromatherapy in dental settings is done using essential oils, the most common ones being smell of orange and lavender. Lavender smell has been shown to produce positive physiological and pharmacological effects which proved to be effective in reducing state anxiety [49]. Similarly, SDE, which has been utilized and proved to be effective for management of dental anxiety, is also helpful in reducing the anxiety and relaxing the patient [45].
A patient-friendly dental clinic reception (picture by Jacob Francis, courtesy of Smiles dental clinic).
A child-friendly dental surgery (picture by Jacob Francis, courtesy of Smiles dental clinic).
At community level, prevention of dental anxiety through giving education is a responsibility of the dental team. The education should primarily be directed to children since the onset of dental anxiety often occurs in childhood. This implies that early intervention will help to prevent the problem from extending into adulthood, but adults should also be involved. Among measures of intervention at community level, it is to inform the community on the impact of dental anxiety on individual’s oral health status, oral health-care attendance, and service delivery. Another measure is to educate and discourage individuals from sharing their dental fears and/or negative dental experiences in such a way that it may influence others to develop dental anxiety or negativity toward dentistry. Furthermore, it is beneficial to empower the community to prevent dental diseases, to encourage them on the importance of regular visit to a dentist for checkup, and to strongly disapprove the use of dental visit/services as punitive measure or to shape behavior [24, 48]. Moreover, population screening for dental anxiety will assist in identifying those who are affected thus earmarking them for preventive intervention.
Dental anxiety is a problem affecting populations of all ages, from all geographical locations. It affects individuals’ oral health status, interferes with dental attendance and service delivery. Dental professionals, therefore, have a major role to play in the management and prevention of dental anxiety among dental patients and the community at large.
We recommend that:
Dental professional associations and dental teaching institutions should conduct workshops and continuing education and professional development (CPD) courses for the dental fraternity on management and prevention of dental anxiety.
Dental professionals to educate themselves on the different options of management and prevention of dental anxiety.
Dental professionals to educate community on dental anxiety.
Authors acknowledge funding support by Swedish International Development Agency (Sida) through Muhimbili University of Health and Allied Sciences (MUHAS).
The authors of this chapter declare no conflict of interest.
The world population has begun to hear about COVID-19 (Coronavirus Disease-2019) in December 2019, when a severe form of viral infection (SARS-CoV-2) was identified in Wuhan District, China. A few months later (March, 2020) the virus had spread to 114 countries with more than 118.000 cases and 4.291 deaths: On March 11th, 2020, pandemic status was declared [1]. Currently, as we are writing (December 15, 2021), the weekly epidemiological update of the virus shows 268 934 575 people infected and 5 297 850 persons lost their lives [2]. The pandemic strongly impacts the quality of life and mental health of populations worldwide, with psychological distress and increased anxiety symptoms both in adults [3] and adolescents [4, 5, 6].
First, studies on the consequences of COVID-19 in children have been conducted in China. Leilei et al. [7] observed that nearly 40% of adolescents had experienced a condition of psychological distress. Jiao et al. [8] found that children and adolescents (aged between 3–18 y.o.) showed anxious manifestations and looked for the proximity of others, were distracted, irritable, and afraid to ask about the pandemic.
Similar consequences in the child population were tracked in other parts of the world. A review [9] of studies from the United States, China, Europe, Australia, India, Malaysia, Korea, Thailand, Israel, Iran, and Russia shows that conditions of social distancing and loneliness—particularly when total lockdown was imposed— strongly impact adolescents\' mental health. Data globally confirm an increase in symptoms of anxiety and depression during the quarantine period [9].
From the beginning of the COVID-19 pandemic, parents to have observed internalizing and externalizing symptoms in their children. A Spanish/Italian study [10] indicates that nearly 85% of parents perceived changes in the emotional and behavioral state of their children (aged between 3–18 y.o.). The most frequent symptoms were difficulty concentrating (76,6%), boredom (52%), irritability (39%), restlessness (38,8%), nervousness (38%), feelings of loneliness (31,3%), unquietness (30,4%), and worry (30,1%). Spanish parents declared more symptoms than Italians (differences probably due to stricter restrictive measures). Necessarily having to remain in the (limited) space of one\'s home and the prohibition to go out seemed to increase anxiety levels and other related problems, such as sleep disorders and worry. Moreover, children\'s symptoms resulted positively related to parental well-being, particularly with the level of parents’ distress for imposed modifications in daily life. In Italy—where the “stay at home” period lasted from early March to May 2020—parents reported increased distress for fears of contagion, working difficulties, and the need to schedule daily routine for children, including school homework and “distance learning” [11, 12]. This increased distress, in turn, escalated the children’s problems with a bidirectional influence on the parent’s and children’s psychological adjustment [13]. Data from Hawes et al. [14] show also a link between worry about contracting the virus, school-related problems, and symptoms, such as depression, generalized anxiety, and panic/somatic symptoms in adolescents and young adults (12–22 y.o.).
Developmental and clinical literature show that children and adolescents with anxiety symptoms suffer more intense worries and have repetitive thoughts and “thinking about worry” (“meta-worry” [15, 16]). Worry is a chain of repetitive and verbal thoughts about potentially dangerous consequences of events. According to Wells\' model [17], it is not the content of the thoughts or the intensity of the worries to characterize people with emotional disorders, but meta-cognitive beliefs about worries. Meta-beliefs are intrusive and disturbing thoughts where the focus is worry itself and the functioning of one\'s mind. The positive beliefs are based on the advantages or benefits of worrying as a coping strategy (e.g., “Worrying helps me to avoid problems in the future”). The negative beliefs include the thoughts of uncontrollability and the dangerousness of worry (e.g., “If I worry a lot, I could make myself sick”). Positive beliefs lead to increased worry, and when levels of worry get excessive, people become to be worried about the negative consequences of thinking, monitor their thinking, or active attempts to suppress dangerous thoughts. These cognitive experiences are associated with negative emotions and distress [17].
As with adults [17, 18], worry intensity and negative meta-beliefs about worry (dangerousness and uncontrollability) resulted positively linked with anxiety symptoms in children [19, 20] and adolescents [21]. Particularly, negative meta-cognitive beliefs are more frequent in children with clinical anxiety disorders compared to nonclinical groups [22, 23, 24]. Similarly, Natalucci et al. [25] found an association between cognitive monitoring (i.e., the tendency to be aware of one\'s own thoughts), negative meta-cognitive beliefs, and internalizing disorders. These data globally support the link between frequent worry, meta-worry, and increased anxiety symptoms in children. Therefore, we can suppose that, in the context of the COVID-19 pandemic and related worries, in children with a tendency to worry and to monitor their internal states (meta-worry) the risk of developing anxious symptoms may increase. In agreement with Wells’s model [17, 18], meta-beliefs about worry could play an additional role in feeding and maintaining children’s anxiety symptoms.
Orgilés et al. [10] noted that more than 30% of parents observed an increase in worry in their children, especially when one of the parents left the home. Zhou et al. [26] report that approximately 40% of adolescents (aged 12–18 y.o.) declared they worried about a variety of things and were unable to control their worries. A survey [27] with an extensive sample (age range 18–70 y.o.) shows that worries about the possibility of contracting COVID-19 is present primarily in individuals with state anxiety. Among respondents with state anxiety, 33.3% were “very worried” about being infected with COVID-19, whereas only 2.2% were “not worried at all.”
When facing stressful situations, people active intentional responses to demands and emotions, also known as coping strategies [28]. Studies on coping in children and adolescents for a long time have been based on the theoretical model developed by Lazarus and Folkman [29] with adults. Authors define coping as “constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” ([29], p. 141). The most common strategies in children and adolescents are family support seeking, problem-solving, escape, and distraction. Younger children seem to prefer escape, support-seeking, and distraction, whereas adolescents adopt internal dialogue and problem-solving thanks to the development of logical-formal thinking, the ability to control their behavior, and emotion regulation [30]. Recent studies have been conducted with the aim to establish the ways adolescents cope with pandemic-related psychological distress. Studies with adolescents (e.g., [31]) highlight that adolescents’ active coping— based on doing something to reduce stress, such as thinking positively, distancing oneself from sources of stress, problem-solving, and asking for help is a protective factor to depression, anxiety, and stress development. Conversely, dysfunctional coping, such as avoidance behaviors, keeping feelings to oneself, and not seeking support resulted in a risk factor for distress and internalizing disorders [30]. Similar results emerge from the research by Türk et al. [32]. During the pandemic crisis, children who used dysfunctional coping strategies (e.g., avoidance coping) had higher anxiety levels; contrarily, children who adopted positive strategies, such as trying to lead a healthy lifestyle, experienced lower levels of anxiety. Furthermore, dysfunctional coping results are also associated with adolescent’s risk behaviors, such as internet addiction, alcohol, and other substance abuse [33].
The main scope of the study was:
To evaluate the incidence of anxiety conditions in an adolescents’ community sample in the context of the health emergency for COVID-19;
To analyze the associations between anxiety symptoms, meta-cognitive beliefs (meta-worry), and adolescents’ coping strategies.
The hypothesis to test were:
Adolescents with elevated anxiety report higher meta-cognitive beliefs, particularly cognitive monitoring of worrying and beliefs about damage and uncontrollability of one\'s worry (negative meta-worry; cf. [22]);
Adolescents with high levels of anxiety show less frequent use of adaptive coping strategies (task-oriented) and more frequent use of maladaptive coping strategies (i.e., emotion-oriented and avoidance coping).
As far as we know, there are currently no studies that have investigated the role of meta-beliefs about worry as a vulnerability factor associated with adolescents’ anxiety in the context of COVID-19. Therefore, the purpose of the study was also
To estimate which factors between dysfunctional coping strategies and/or meta-worry beliefs predict elevated levels of adolescents’ anxiety.
The study was conducted at the beginning of the COVID-19 pandemic during the months of the total lockdown in Italy (2020, March-April), when the Italian government imposed severe measures to contain the transmission of infection among the population (home-confinement, teleworking, closure of schools/university, nonessential shops, and recreational places, such as gyms or cinemas, cf. [34]).
Participants were involved in the study via online sampling. An invitation to participate in the study as volunteers was diffused through some common social media networks (i.e., WhatsApp, Facebook, and Instagram). In total, 284 adolescents aged between 16 and 18 y.o. participated in the study: 201 girls (
Participants filled out the following self-report questionnaires:
The anxiety total score is obtained by summing the three subscale scores. Higher scores indicate higher anxiety levels.
For the purpose of the present study, we used the anxiety total score (Cronbach’s alpha = 0.89). As reported in Sozzari et al. [35], a cut-off of 60
The MCQ-C is composed of 24 items presenting a series of meta-cognitive beliefs about worry and the tendency of intrusive thinking. The subscales are: (1)
The Italian questionnaire has a good internal consistency, with Cronbach’s alphas ranging from 0.84 (task-oriented and avoidance coping) to 0.86 (emotion-oriented coping).
The data were analyzed using
Finally, to test the hypothesis on the associations among meta-cognitive beliefs (MCQ-C), coping strategies (CISS), and adolescent anxiety (RCMAS-2), the correlations between all measures were calculated using Pearson’s
Separate RCMAS-2 total score (
Based on total anxiety scores, the number of participants with anxiety symptoms in the clinical range (
Statistics (M and DS) for meta-worry beliefs (MCQ-C subscales) as a function of adolescents’ anxiety and gender are presented in Table 1. By the MANOVA it emerges that adolescents with clinical anxiety obtain higher scores in all scales of the MCQ-C, with the exception of the positive meta-worry; in addition, differences emerge for gender factors, with girls reporting higher scores in positive meta-worry, negative meta-worry, and SPR subscales (see Table 2).
MCQ-C scale | Anxiety | Gender | ||
---|---|---|---|---|
Positive meta-worry | Normal | Boys | 10.15 | 2.96 |
Girls | 9.69 | 2.74 | ||
Clinical range | Boys | 11.04 | 3.29 | |
Girls | 9.83 | 2.74 | ||
Total | Boys | 10.41 | 3.07 | |
Girls | 9.75 | 2.73 | ||
Negative meta-worry | Normal | Boys | 7.24 | 2.47 |
Girls | 8.61 | 3.27 | ||
Clinical range | Boys | 9.75 | 3.04 | |
Girls | 11.48 | 3.24 | ||
Total | Boys | 7.96 | 2.87 | |
Girls | 9.77 | 3.54 | ||
Cognitive monitoring | Normal | Boys | 17.73 | 3.24 |
Girls | 18.70 | 3.99 | ||
Clinical range | Boys | 20.83 | 3.68 | |
Girls | 20.80 | 3.88 | ||
Total | Boys | 18.63 | 3.64 | |
Girls | 19.55 | 4.07 | ||
SPR | Normal | Boys | 11.03 | 3.66 |
Girls | 12.57 | 3.46 | ||
Clinical range | Boys | 15.13 | 3.89 | |
Girls | 16.12 | 4.26 | ||
Total | Boys | 12.22 | 4.15 | |
Girls | 14.00 | 4.17 |
Means and standard deviations of MCQ-C scores as a function of participants’ anxiety level and gender.
MCQ-C = meta-cognitions questionnaire for children; and SPR = superstition, punishment, and responsibility.
Source | Measure | ηp2 | |||||
---|---|---|---|---|---|---|---|
Anxiety level | Positive meta-worry | 13.240 | 1 | 13.240 | 1.646 | 0.20 | 0.006 |
Negative meta-worry | 365.818 | 1 | 365.818 | 38.220 | 0.120 | ||
Cognitive monitoring | 341.923 | 1 | 341.923 | 23.833 | 0.078 | ||
SPR | 736.023 | 1 | 736.023 | 51.488 | 0.155 | ||
Gender | Positive meta-worry | 35.398 | 1 | 35.398 | 4.402 | 0.015 | |
Negative meta-worry | 121.391 | 1 | 121.391 | 12.683 | 0.043 | ||
Cognitive monitoring | 11.151 | 1 | 11.151 | 0.777 | 0.379 | 0.003 | |
SPR | 81.334 | 1 | 81.334 | 5.690 | 0.020 | ||
Anxiety level * Gender | Positive meta-worry | 7.163 | 1 | 7.163 | 0.891 | 0.346 | 0.003 |
Negative meta-worry | 1.638 | 1 | 1.638 | 0.171 | 0.679 | 0.001 | |
Cognitive monitoring | 12.663 | 1 | 12.663 | 0.883 | 0.348 | 0.003 | |
SPR | 3.714 | 1 | 3.714 | 0.260 | 0.611 | 0.001 | |
Error | Positive meta-worry | 2251.757 | 280 | 8.042 | |||
Negative meta-worry | 2679.992 | 280 | 9.571 | ||||
Cognitive monitoring | 4017.034 | 280 | 14.347 | ||||
SPR | 4002.648 | 280 | 14.295 |
Statistics of between subjects effect tests from the MANOVA 2 (Anxiety level: normal
SPR = Superstition, punishment, and responsibility; SS = sum of squares; df = degrees of freedom; and MS = mean of squares.
Significant results are in boldface.
Tables 3 and 4 report distribution and inferential statistics, respectively, referred to the CISS scale as a function of anxiety level (normal
CISS scale | Anxiety | Gender | M | SD |
---|---|---|---|---|
Task-oriented coping | Normal | Boys | 58.88 | 8.30 |
Girls | 57.72 | 10.46 | ||
Clinical range | Boys | 52.21 | 13.17 | |
Girls | 55.11 | 10.97 | ||
Total | Boys | 56.95 | 10.33 | |
Girls | 56.67 | 10.72 | ||
Emotion-oriented coping | Normal | Boys | 40.81 | 12.46 |
Girls | 45.07 | 10.71 | ||
Clinical range | Boys | 54.00 | 10.41 | |
Girls | 60.64 | 9.75 | ||
Total | Boys | 44.63 | 13.29 | |
Girls | 51.34 | 12.84 | ||
Avoidance coping | Normal | Boys | 50.73 | 13.30 |
Girls | 53.25 | 13.22 | ||
Clinical range | Boys | 54.13 | 12.01 | |
Girls | 52.40 | 11.93 | ||
Total | Boys | 51.71 | 12.96 | |
Girls | 52.91 | 12.69 | ||
Distraction | Normal | Boys | 24.34 | 6.39 |
Girls | 24.27 | 6.73 | ||
Clinical range | Boys | 25.21 | 6.66 | |
Girls | 24.88 | 6.95 | ||
Total | Boys | 24.59 | 6.44 | |
Girls | 24.51 | 6.81 | ||
Social Diversion | Normal | Boys | 33.61 | 17.41 |
Girls | 41.36 | 19.80 | ||
Clinical range | Boys | 33.79 | 15.23 | |
Girls | 36.80 | 19.45 | ||
Total | Boys | 33.66 | 16.71 | |
Girls | 39.52 | 19.74 |
Means and standard deviations of CISS scores as a function of participants’ anxiety level and gender.
CISS = Coping inventory for stressful situations.
Source | CISS scale | ηp2 | |||||
---|---|---|---|---|---|---|---|
Anxiety level | Task-oriented coping | 1087.671 | 1 | 1087.671 | 9.940 | 0.034 | |
Emotion-oriented coping | 10432.436 | 1 | 10432.436 | 89.147 | 0.241 | ||
Avoidance coping | 81.442 | 1 | 81.442 | 0.498 | 0.481 | 0.002 | |
Distraction | 27.595 | 1 | 27.595 | 0.611 | 0.435 | 0.002 | |
Social diversion | 241.316 | 1 | 241.316 | 0.677 | 0.411 | 0.002 | |
Gender | Task-oriented coping | 38.464 | 1 | 38.464 | 0.352 | 0.554 | 0.001 |
Emotion-oriented coping | 1496.981 | 1 | 1496.981 | 12.792 | 0.044 | ||
Avoidance coping | 7.896 | 1 | 7.896 | 0.048 | 0.826 | 0.000 | |
Distraction | 2.059 | 1 | 2.059 | 0.046 | 0.831 | 0.000 | |
Social diversion | 1459.810 | 1 | 1459.810 | 4.095 | 0.014 | ||
Anxiety level × Gender (interaction) | Task-oriented coping | 207.789 | 1 | 207.789 | 1.899 | 0.169 | 0.007 |
Emotion-oriented coping | 71.968 | 1 | 71.968 | 0.615 | 0.434 | 0.002 | |
Avoidance coping | 227.910 | 1 | 227.910 | 1.395 | 0.239 | 0.005 | |
Distraction | 0.849 | 1 | 0.849 | 0.019 | 0.891 | 0.000 | |
Social diversion | 283.027 | 1 | 283.027 | 0.794 | 0.374 | 0.003 | |
Error | Task-oriented coping | 30638.053 | 280 | 109.422 | |||
Emotion-oriented coping | 32767.033 | 280 | 117.025 | ||||
Avoidance coping | 45750.144 | 280 | 163.393 | ||||
Distraction | 12647.411 | 280 | 45.169 | ||||
Social diversion | 99814.423 | 280 | 356.480 |
Statistics of between subjects effect tests from the MANOVA 2 (Anxiety level: normal
Pearson’s
Scale | RCMAS-2 | MCQ-C | Coping | |||||
---|---|---|---|---|---|---|---|---|
1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | |
1. RCMAS-2 Anxiety | 1 | |||||||
2. MCQ-C – Positive meta-worry | 0.07 | 1 | ||||||
3. MCQ-C – Negative meta-worry | 0.58** | 0.27** | 1 | |||||
4. MCQ-C – Cognitive monitoring | 0.40** | 0.35** | 0.50** | 1 | ||||
5. MCQ-C – SPR | 0.55** | 0.20** | 0.64** | 0.54** | 1 | |||
6. Task-oriented coping | −0.20** | 0.37** | 0.01 | 0.24** | 0.05 | 1 | ||
7. Emotion-oriented coping | 0.73** | 0.15* | 0.69** | 0.43** | 0.63** | 0.05 | 1 | |
8. Avoidance coping | −0.01 | 0.06 | 0.00 | 0.12* | 0.12 | 0.40** | 0.21** | 1 |
Pearson’s
Correlation is significant at the 0.05 level (two-tailed).
Correlation is significant at the 0.01 level (two-tailed).
RCMAS-2 = Revised children\'s manifest anxiety scale-2; MCQ-C = meta-cognitions questionnaire for children; and SPR = superstition, punishment, and responsibility.
A linear regression analysis (stepwise method) considering the anxiety levels (RCMAS-2 total) as the criterion variable and meta-worry beliefs (MCQ-C subscales) and coping strategies (CISS subscales) as predictors were carried out. Results are displayed in Table 6.
Model | Predictor | B | SE B | β | t | Rc2 | F per ΔR2 |
---|---|---|---|---|---|---|---|
Step 1 | Emotion-oriented coping | 0.63 | 0.04 | 0.73 | 18.117* | 0.536 | 328.24* |
Step 2 | Emotion-oriented coping | 0.64 | 0.03 | 0.74 | 19.539* | 0.590 | 38.23* |
Task-oriented coping | −0.25 | 0.04 | −0.24 | −6.183* | |||
Step 3 | Emotion-oriented coping | 0.57 | 0.04 | 0.67 | 16.255* | 0.613 | 17.65* |
Task-oriented coping | −0.30 | 0.04 | −0.28 | −7.209* | |||
Cognitive monitoring | 0.51 | 0.12 | 0.18 | 4.201* |
Summary of stepwise regression analysis for variables predicting anxiety levels (RCMAS-2 scores).
p ≤ 0.001.
A three-factor model explains the greater proportion of variance [i.e.,
The aim of the present study was to explore the psychological impact of COVID-19 on Italian adolescents, a population of young people among the most affected by the pandemic, and the restrictions on daily life due to the long lockdown among western countries. Fear of contagion and death, home confinement, the lack of direct contact with peers, and the interruption of recreational and school activities abruptly changed the daily life of teenagers, with immediate effects on perceived stress and psychopathological symptoms whose long-term maintenance is currently unknown [41]. Particularly, this study investigated the relative contribution of meta-cognitive beliefs about worries and coping styles in predicting adolescents’ anxiety symptoms. In fact, while there are several studies on the role of coping in reacting to COVID-19-related distress [6, 31, 32], no research as far as we know has explored how meta-worry beliefs contribute to anxiety. According to Wells’s [17] meta-cognitive model, people who are aware of their worries and who try to control them experience higher levels of anxiety, which tend to be maintained over time.
First, the participants were subdivided into two subsamples with/without clinical anxiety symptoms, according to RCMAS-2 (
Data from the present study also agree with gender differences observed in studies prior to COVID-19 [23, 43] and during the pandemic [14, 26, 44], with girls reporting more anxiety symptoms than boys.
In line with the hypotheses, participants with elevated anxiety report higher scores in meta-cognitive processes, with the only exception of positive meta-worry. In other words, in this study, anxious adolescents perceived their worries as most dangerous and uncontrollable (e.g., “I can’t control my worries”), they spent more time to monitor their thoughts (“I must stop worrying”), or they seemed more superstitious about the influence of their thoughts on reality (“If I keep worrying something bad will happen”). Otherwise, the positive beliefs—thinking about worry’s usefulness—seem to have a subordinate role in participants’ anxiety. Unlike adults [17], the role of positive meta-worry in the genesis and maintenance of children’s internalizing disorders has not always been confirmed [e.g., 45, 46]. Instead, data from the present study are to be added to the more consistent ones about the link between negative meta-beliefs (dangerousness/uncontrollability of worry) and the intensity of children’s worry (e.g., [16, 47]).
The present study aimed also to explore the association between adolescents’ anxiety and coping strategies to mitigate stress during the period of total lockdown. Supporting the starting hypothesis, we found that adolescents with low anxiety levels use more often active coping (e.g., use problem-solving skills) compared with anxious adolescents. Conversely, participants with clinical levels of anxiety declared a more intense use of emotion-focused coping (e.g., altering one\'s feelings and thoughts about events) in trying to reduce the emotional reactivity derived from the stressful experience. In addition, emotion-oriented coping was engaged more frequently in girls than boys. Avoidance coping (e.g., withdrawing or distracting oneself from the awareness of the problem) result positively related with cognitive monitoring, that is, the tendency to engage in meta-cognitive self-reflection and active control of one\'s feelings and thoughts. However, this task-irrelevant thinking maintained by cognitive monitoring may increase opportunities for negative appraisals of intrusive thoughts, increasing anxiety symptoms [48]. Therefore, avoidance and emotion-focused coping, together with maladaptive cognitive processes, intensify rather than attenuate anxiety. In addition, maladaptive coping strategies, as a preferred coping strategy, distract attention from the external environment and from the search for more effective solutions (such as changing the situation through active action; cf. [48]). In confirmation of this, in the present study, adolescent’s anxiety symptoms resulted linked with increased use of maladaptive coping strategies for managing emotions and/or avoiding stressful events, but decreased activation of task-oriented coping.
A stepwise regression was conducted to assess which factors among meta-worry beliefs and coping strategies predicted adolescents’ anxiety. It was found that emotion-focused coping is the strongest predictor of anxiety, followed by task-oriented coping with a reverse negative direction. Cognitive monitoring, with a positive direction, added a small but significant amount of variance in anxiety levels. Therefore, it would seem that emotion-based coping is a risk factor for elevated anxiety symptoms, while task-oriented coping seems to act as a protective factor. Cognitive monitoring influences anxious expression, but to a lesser extent if compared to coping strategies.
In sum, our data, together with findings by Zhang et al. [31] and Türk et al. [32], suggest that an emphasis on emotion-focused coping and avoidance coping may have accentuated anxiety symptoms in teenagers. Our findings are also consistent with Hussong et al. [49], who underline cumulative stress associated with teenagers’ experience with the COVID-19 pandemic: In fact, while initially, the restrictions due to the pandemic might seem short-lived (such as a temporary closure of schools and distancing from friends), uncertainty has increased over the weeks. In their longitudinal study (May–July 2020), authors found that increased symptoms (both internalizing/ externalizing) were mitigated in teenagers with problem-focused coping and greater self-efficacy (a greater sense of agency and positive affect), but were exacerbated in teenagers with an emotion-focused coping style.
This study has certainly some limitations to be addressed. First, the cross-sectional research design cannot provide a causal relationship between the health and social crisis due to COVID-19 and the increased anxiety symptoms in adolescents. Only for descriptive purposes, we compare the results of the present study with those of our quite similar study for design (community sample) and anxiety measures [23]. Although this previous study is not strictly comparable to a pre-COVID-19 baseline—as there are no within-subject repeated measures— some considerations are plausible. We note that in the current sample the adolescents with clinical symptoms resulted more than triple (37%) of those observed in the previous study (11.6%). Future studies could examine with longitudinal design the changes not only in anxiety symptoms but also in the strategies with which children and adolescents can cope with COVID-19 worries and restrictions on daily life. A longitudinal approach will be needed in future research as the health and social crisis due to COVID-19 is persisting around the world and the long-term psychological impact on the population is unknown [50].
A second limit is the sample composition, predominantly female and numerically small. The research was conducted in Italy, the first of the European countries to be involved in the acute phases of the COVID-19 outbreak and to experience a long total lockdown (10 weeks, March–May 2020; [34, 51]. Home confinement, social distancing from family and peers, fears, and worries experienced by the Italian youths have affected their psychological distress [11, 12, 13], but these conditions cannot be generalized to other groups for different detrimental impacts across countries. Other studies evidence that poverty and socioeconomic disadvantage, living in rural rather than urban areas, high local prevalence of COVID-19 infection, loss of a loved person for COVID-19, and exposure to social media disseminating fears are all contextual factors associated with higher distress and internalizing disorders [52]. Finally, the study measures are self-reported and the questionnaires were disseminated through the web. This online sampling strategy was necessary as the research was conducted during the period of the total lockdown, but self-selection among the participants cannot be excluded. Similarly, preexisting physical or psychopathological conditions that may have increased participants\' vulnerability to anxiety have not been evaluated (cf. [50]).
Despite these limitations, the findings of present study evidence maladaptive coping and cognitive factors associated with adolescents’ anxiety. Particularly, emotion-focused seem to affect anxiety symptoms to a greater extent than meta-cognitive beliefs, whereas task-oriented coping predicted lower anxiety. Findings highlight the need for active interventions aimed to enhance adolescents’ psychological resources to cope with daily pandemic-related stress.
The development of interventions aimed to increase adolescents’ resilience to COVID-19 related stress is a priority for both researchers and health professionals, particularly in the perspective that the crisis due to COVID-19 disease may persist for a long time negatively affecting daily life and well-being of young populations. Anxiety symptoms exhibit some continuity over time, leading to the need for early intervention. Cognitive-behavioral therapies, together with the most recent procedures that include meta-cognitive components, are the recommended approaches for adolescents [53, 54]. Particularly, addressing meta-cognitive beliefs about worry is an effective and promising approach for children’s anxiety treatment [55].
Intervention programs that enhance effective coping strategies should be promoted by services and health professionals to ensure adequate psychological support to youths. The effectiveness of coping-centered programs is well known: For example, Essau et al. [56] have demonstrated that 10 weeks of training on coping skills (e.g., problem solving, self-reward for trying, and achieving goals), identifying and modifying anxiety-related thoughts, reduced anxiety and depression symptoms in children and adolescents. More recently, Orgilés et al. [57] have developed a program aimed to enhance coping skills and resilience to deal with the COVID-19 pandemic. Results show that children in the intervention group reported less symptoms of anxiety, unstable mood, sleep problems, and cognitive impairments during home confinement than children who did not receive the intervention. In this control group, children continued to use more likely emotionally oriented strategies. which were associated with greater psychological distress. Having more family/social support and having the opportunity to engage in physical activity are also protective factors associated with reduced anxiety [58]. Since the emergency for COVID-19 is far from over, the challenge for scholars and professionals will be to disseminate effective programs also use innovative strategies (such as school-based or app-based support; cf. [59]) in order to reach a larger population of young people.
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",metaTitle:"Copyright Policy",metaDescription:"Copyright is the term used to describe the rights related to the publication and distribution of original works. Most importantly from a publisher's perspective, copyright governs how authors, publishers and the general public can use, publish and distribute publications.",metaKeywords:null,canonicalURL:"/page/copyright-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"Copyright is the term used to describe the rights related to the publication and distribution of original Works. Most importantly from a publisher's perspective, copyright governs how Authors, publishers and the general public can use, publish, and distribute publications.
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\\n"}]'},components:[{type:"htmlEditorComponent",content:'Copyright is the term used to describe the rights related to the publication and distribution of original Works. Most importantly from a publisher's perspective, copyright governs how Authors, publishers and the general public can use, publish, and distribute publications.
\n\nIntechOpen only publishes manuscripts for which it has publishing rights. This is governed by a publication agreement between the Author and IntechOpen. This agreement is accepted by the Author when the manuscript is submitted and deals with both the rights of the publisher and Author, as well as any obligations concerning a particular manuscript. However, in accepting this agreement, Authors continue to retain significant rights to use and share their publications.
\n\nHOW COPYRIGHT WORKS WITH OPEN ACCESS LICENSES?
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\n\nCompilation - a collection of Works distributed in a Book that IntechOpen has selected, and for which the coordination of the preparation, arrangement and publication has been the responsibility of IntechOpen. Any Work included is accepted in its entirety in unmodified form and is published with one or more other contributions, each constituting a separate and independent Work, but which together are assembled into a collective whole.
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\n\nIntechOpen - Registered publisher with office at 5 Princes Gate Court, London, SW7 2QJ - UNITED KINGDOM
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The CC BY 3.0 and CC BY 4.0 license permits Works to be freely shared in any medium or format, as well as the reuse and adaptation of the original contents of Works (e.g. figures and tables created by the Authors), as long as the source Work is cited and its Authors are acknowledged in the following manner:
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Membrane-based systems overcome many of the disadvantages of alkaline liquid systems, because the carrier fluid is deionized water, and the membrane-based cell design enables differential pressure operation.",book:{id:"7325",slug:"nanostructures-in-energy-generation-transmission-and-storage",title:"Nanostructures in Energy Generation, Transmission and Storage",fullTitle:"Nanostructures in Energy Generation, Transmission and Storage"},signatures:"Radenka Maric and Haoran Yu",authors:null},{id:"72636",title:"Nanocomposite Materials",slug:"nanocomposite-materials",totalDownloads:2293,totalCrossrefCites:6,totalDimensionsCites:15,abstract:"Nanocomposites are the heterogeneous/hybrid materials that are produced by the mixtures of polymers with inorganic solids (clays to oxides) at the nanometric scale. Their structures are found to be more complicated than that of microcomposites. They are highly influenced by the structure, composition, interfacial interactions, and components of individual property. Most popularly, nanocomposites are prepared by the process within in situ growth and polymerization of biopolymer and inorganic matrix. With the rapid estimated demand of these striking potentially advanced materials, make them very much useful in various industries ranging from small scale to large to very large manufacturing units. With a great deal to mankind with environmental friendly, these offer advanced technologies in addition to the enhanced business opportunities to several industrial sectors like automobile, construction, electronics and electrical, food packaging, and technology transfer.",book:{id:"10072",slug:"nanotechnology-and-the-environment",title:"Nanotechnology and the Environment",fullTitle:"Nanotechnology and the Environment"},signatures:"Mousumi Sen",authors:[{id:"310218",title:"Dr.",name:"Mousumi",middleName:null,surname:"Sen",slug:"mousumi-sen",fullName:"Mousumi Sen"}]},{id:"64843",title:"Polymer Nanocomposites with Different Types of Nanofiller",slug:"polymer-nanocomposites-with-different-types-of-nanofiller",totalDownloads:4207,totalCrossrefCites:21,totalDimensionsCites:64,abstract:"The development of polymer nanocomposites has been an area of high scientific and industrial interest in the recent years, due to several improvements achieved in these materials, as a result of the combination of a polymeric matrix and, usually, an inorganic nanomaterial. The improved performance of those materials can include mechanical strength, toughness and stiffness, electrical and thermal conductivity, superior flame retardancy and higher barrier to moisture and gases. Nanocomposites can also show unique design possibilities, which offer excellent advantages in creating functional materials with desired properties for specific applications. The possibility of using natural resources and the fact of being environmentally friendly have also offered new opportunities for applications. This chapter aims to review the main topics and recent progresses related to polymer nanocomposites, such as techniques of characterization, methods of production, structures, compatibilization and applications. First, the most important concepts about nanocomposites will be presented. Additionally, an approach on the different types of filler that can be used as reinforcement in polymeric matrices will be made. After that, sections about methods of production and structures of nanocomposites will be detailed. Finally, some properties and potential applications that have been achieved in polymer nanocomposites will be highlighted.",book:{id:"6854",slug:"nanocomposites-recent-evolutions",title:"Nanocomposites",fullTitle:"Nanocomposites - Recent Evolutions"},signatures:"Amanda Dantas de Oliveira and Cesar Augusto Gonçalves Beatrice",authors:[{id:"249768",title:"Ph.D.",name:"Amanda",middleName:null,surname:"Oliveira",slug:"amanda-oliveira",fullName:"Amanda Oliveira"},{id:"254512",title:"Ph.D.",name:"Cesar",middleName:"Augusto Gonçalves",surname:"Beatrice",slug:"cesar-beatrice",fullName:"Cesar Beatrice"}]},{id:"38951",title:"Carbon Nanotube Transparent Electrode",slug:"carbon-nanotube-transparent-electrode",totalDownloads:4070,totalCrossrefCites:3,totalDimensionsCites:5,abstract:null,book:{id:"3077",slug:"syntheses-and-applications-of-carbon-nanotubes-and-their-composites",title:"Syntheses and Applications of Carbon Nanotubes and Their Composites",fullTitle:"Syntheses and Applications of Carbon Nanotubes and Their Composites"},signatures:"Jing Sun and Ranran Wang",authors:[{id:"153508",title:"Prof.",name:"Jing",middleName:null,surname:"Sun",slug:"jing-sun",fullName:"Jing Sun"},{id:"153596",title:"Ms.",name:"Ranran",middleName:null,surname:"Wang",slug:"ranran-wang",fullName:"Ranran Wang"}]}],onlineFirstChaptersFilter:{topicId:"17",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82924",title:"Chitosan-Based Nanocomposites for Biological Applications",slug:"chitosan-based-nanocomposites-for-biological-applications",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106379",abstract:"Chitosan is an important natural cationic polymer. Chitosan is produced as a deacetylated form of chitin, and its excellent biocompatible, biodegradable, nontoxic, natural chemical, and thermal stability properties have led to its common use in especially biomedical applications. The combination of nanomaterials and chitosan has been considered an excellent approach to overcoming the handicaps associated with biopolymer. The chitosan-based nanocomposites are potentially efficient in a number of areas including medical fields. Chitosan is biodegradable, biocompatible, basic, nontoxic, and also approved by GRAS (Generally recognized as safe by the United States Food and Drug Administration [US FDA]). Chitosan-based nanocomposites have different applications in drug delivery including ocular, per-oral, pulmonary, nasal mucosal, gene, buccal drug, vaccine, vaginal, and cancer therapy. Chitosan has low toxicity in both in vitro and in vivo models. In this chapter, we discussed the preparation techniques and various forms of chitosan materials in biomedical applications. In addition, this chapter explores recent research on chitosan-based nanocomposites for medical studies.",book:{id:"11755",title:"Nanoclay - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11755.jpg"},signatures:"Serap Yalcin and Nevin Cankaya"},{id:"82964",title:"Pharmacodynamic Implications of Transcranial Photobiomodulation and Quantum Physics in Clinical Medicine",slug:"pharmacodynamic-implications-of-transcranial-photobiomodulation-and-quantum-physics-in-clinical-medi",totalDownloads:7,totalDimensionsCites:0,doi:"10.5772/intechopen.106553",abstract:"Photobiomodulation (PBM) is the application of light therapy that utilizes photons to alter the activity of molecular and cellular processes in the tissue where the stimulation is applied. Because the photons associated with the therapeutic mechanisms of PBM affect processes associated with the mitochondria, it is hypothesized that PBM increases ATP synthesis. Alteration of the mitochondrial respiratory enzyme, cytochrome c oxidase (CCO), is hypothesized to induce healing to damaged tissues via regeneration. Utilization of PBM has been examined in clinical disorders which include but are not limited to Alzheimer’s/dementia, epilepsy, and age-related macular degeneration. Transcranial PBM (tPBM) utilizes quantum dot light emitting diodes (QLEDs). QLEDs allow for narrow wavelength emissions from applications of PBM to alter electrophysiological activity and tissue regeneration. This chapter aims to evaluate the mechanisms of QLED applications of PBM and its applications as a photodynamic therapy in the medical sciences. Further, this chapter will examine the quantum mechanics of tPBM and its ability to affect electrophysiological activity according to the electroencephalogram (EEG) across the delta, theta, alpha, beta frequency bands.",book:{id:"11756",title:"Quantum Dots - Recent Advances, New Perspectives and Contemporary Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11756.jpg"},signatures:"Kristin S. Williams"},{id:"83020",title:"Determination of Qubit Entanglement in One-step Double Photoionization of Helium Atom",slug:"determination-of-qubit-entanglement-in-one-step-double-photoionization-of-helium-atom",totalDownloads:4,totalDimensionsCites:0,doi:"10.5772/intechopen.106047",abstract:"Quantum entanglement is a unique phenomenon of quantum mechanics that explains how two subatomic particles are correlated even if they are separated by a vast distance. The phenomena of quantum entanglement are useful resources for quantum information. In this chapter, we will study the entanglement properties of bipartite states of two electronic qubits, without observing spin-orbit interaction (SOI), produced by single-step double photoionization in helium atom following the absorption of a single photon. In absence of SOI, Russell-Saunders coupling (L-S coupling) is applicable. We observe that the entanglement depends significantly on the direction of the ejection, as well as the spin quantization of photoelectrons.",book:{id:"11756",title:"Quantum Dots - Recent Advances, New Perspectives and Contemporary Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11756.jpg"},signatures:"Minakshi Chakraborty and Sandip Sen"},{id:"82909",title:"Solar Energy Conversion Efficiency, Growth Mechanism and Design of III–V Nanowire-Based Solar Cells: Review",slug:"solar-energy-conversion-efficiency-growth-mechanism-and-design-of-iii-v-nanowire-based-solar-cells-r",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.105985",abstract:"Nanowires (NWs) are 1D nanostructures with unique and wonderful optical and electrical properties. Due to their highly anisotropic shape and enormous index of refraction, they behave as optical antennae with improved absorption and emission properties, and thus better photovoltaic cell efficiency compared to a planar material with equivalent volume. Implying important advantages of reduced material usage and cost as well as due to its direct bandgap and its flexibility for designing solar cells, we choose to review III–V NWs. Their bandgap can easily be tunable for growing on the cheapest Si substrate. The recent developments in NW-based photovoltaics with attractive III–V NWs with different growth mechanisms, device fabrication, and performance results are studied. Recently, III–V NW solar cells have achieved an interesting efficiency above 10%. GaAsP NW has achieved 10.2%; InP NW has achieved 13.8%; GaAs NW has achieved 15.3%; and moreover the highest 17.8% efficiency is achieved by InP NW. While the III–V NW solar cells are much more vital and promising, their current efficiencies are still much lower than the theoretically predicted maximum efficiency of 48%. In this review, the chapter focused on the synthesis processes of III–V nanowires, vapor-liquid-solid growing mechanisms, solar light harvesting of III–V nanowire solar cells, and designing high-efficiency and low-cost III–V nanowire solar cells.",book:{id:"11461",title:"Advances in Nanowires Synthesis and Applications to Sensing Technologies \ufeff",coverURL:"https://cdn.intechopen.com/books/images_new/11461.jpg"},signatures:"Fikadu Takele Geldasa"},{id:"82660",title:"Organoclay Nano-Adsorbent: Preparation, Characterization and Applications",slug:"organoclay-nano-adsorbent-preparation-characterization-and-applications",totalDownloads:8,totalDimensionsCites:0,doi:"10.5772/intechopen.105903",abstract:"Organoclay has a tremendous impact on both fundamental studies and practical applications in numerous fields. In this context, this chapter investigates the performance of Organoclay in wastewater treatment. In particular, the adsorption of various hazardous substances has been reviewed. This study aims to give an overview of the preparation methods of Organoclay. The second purpose was to discuss the removal efficiency and reliability of various pollutants by organoclay. The third goal discussed the isotherms and kinetics used for the data interpretation. This work revealed that the characteristics of Organoclay depend mainly on the type of clay used and the nature of the intercalated surfactant. Sorption efficiency was found to depend on the nature of Organoclay, type of pollutant, pH, contact time and the concentration of pollutant.",book:{id:"11755",title:"Nanoclay - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11755.jpg"},signatures:"Kawthar Yahya, Wissem Hamdi and Noureddine Hamdi"},{id:"81789",title:"Processing of Graphene/Elastomer Nanocomposites: A Minireview",slug:"processing-of-graphene-elastomer-nanocomposites-a-minireview",totalDownloads:17,totalDimensionsCites:0,doi:"10.5772/intechopen.104849",abstract:"Since the isolation and identification of graphene, the academic and industrial communities are utilizing its superior properties. This minireview deals with the processing of graphene-based fillers/elastomer nanocomposites. The incorporation of graphene in an elastomeric matrices has significant effects on the properties of nanocomposites. The dispersion of graphene in elastomers is discussed. The processing of graphene/elastomer nanocomposites is discussed. The mechanical properties of the elastomeric matrix can be enhanced due to the presence of graphene. In this review and due to space limitations, we will present an example of improvements in the mechanical characteristics of graphene/styrene-butadiene (SBR) elastomer nanocomposites.",book:{id:"10825",title:"Nanocomposite Materials",coverURL:"https://cdn.intechopen.com/books/images_new/10825.jpg"},signatures:"Mohammed A. 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",coverUrl:"https://cdn.intechopen.com/series/covers/23.jpg",latestPublicationDate:"August 18th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"280770",title:"Dr.",name:"Katherine K.M.",middleName:null,surname:"Stavropoulos",slug:"katherine-k.m.-stavropoulos",fullName:"Katherine K.M. Stavropoulos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRdFuQAK/Profile_Picture_2022-05-24T09:03:48.jpg",biography:"Katherine Stavropoulos received her BA in Psychology from Trinity College, in Connecticut, USA and her Ph.D. in Experimental Psychology from the University of California, San Diego. She completed her postdoctoral work at the Yale Child Study Center with Dr. James McPartland. Dr. Stavropoulos’ doctoral dissertation explored neural correlates of reward anticipation to social versus nonsocial stimuli in children with and without autism spectrum disorders (ASD). She has been a faculty member at the University of California, Riverside in the School of Education since 2016. Her research focuses on translational studies to explore the reward system in ASD, as well as how anxiety contributes to social challenges in ASD. She also investigates how behavioral interventions affect neural activity, behavior, and school performance in children with ASD. She is also involved in the diagnosis of children with ASD and is a licensed clinical psychologist in California. She is the Assistant Director of the SEARCH Center at UCR and is a faculty member in the Graduate Program in Neuroscience.",institutionString:null,institution:{name:"University of California, Riverside",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:2,paginationItems:[{id:"89",title:"Education",coverUrl:"https://cdn.intechopen.com/series_topics/covers/89.jpg",isOpenForSubmission:!1,editor:{id:"260066",title:"Associate Prof.",name:"Michail",middleName:null,surname:"Kalogiannakis",slug:"michail-kalogiannakis",fullName:"Michail Kalogiannakis",profilePictureURL:"https://mts.intechopen.com/storage/users/260066/images/system/260066.jpg",biography:"Michail Kalogiannakis is an Associate Professor of the Department of Preschool Education, University of Crete, and an Associate Tutor at School of Humanities at the Hellenic Open University. He graduated from the Physics Department of the University of Crete and continued his post-graduate studies at the University Paris 7-Denis Diderot (D.E.A. in Didactic of Physics), University Paris 5-René Descartes-Sorbonne (D.E.A. in Science Education) and received his Ph.D. degree at the University Paris 5-René Descartes-Sorbonne (PhD in Science Education). His research interests include science education in early childhood, science teaching and learning, e-learning, the use of ICT in science education, games simulations, and mobile learning. He has published over 120 articles in international conferences and journals and has served on the program committees of numerous international conferences.",institutionString:"University of Crete",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},editorTwo:{id:"422488",title:"Dr.",name:"Maria",middleName:null,surname:"Ampartzaki",slug:"maria-ampartzaki",fullName:"Maria Ampartzaki",profilePictureURL:"https://mts.intechopen.com/storage/users/422488/images/system/422488.jpg",biography:"Dr Maria Ampartzaki is an Assistant Professor in Early Childhood Education in the Department of Preschool Education at the University of Crete. Her research interests include ICT in education, science education in the early years, inquiry-based and art-based learning, teachers’ professional development, action research, and the Pedagogy of Multiliteracies, among others. She has run and participated in several funded and non-funded projects on the teaching of Science, Social Sciences, and ICT in education. She also has the experience of participating in five Erasmus+ projects.",institutionString:"University of Crete",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},editorThree:null},{id:"90",title:"Human Development",coverUrl:"https://cdn.intechopen.com/series_topics/covers/90.jpg",isOpenForSubmission:!0,editor:{id:"191040",title:"Ph.D.",name:"Tal",middleName:null,surname:"Dotan Ben-Soussan",slug:"tal-dotan-ben-soussan",fullName:"Tal Dotan Ben-Soussan",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBf1QAG/Profile_Picture_2022-03-18T07:56:11.jpg",biography:"Tal Dotan Ben-Soussan, Ph.D., is the director of the Research Institute for Neuroscience, Education and Didactics (RINED) – Paoletti Foundation. 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His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"August 18th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:4,numberOfPublishedChapters:126,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},subseries:[{id:"3",title:"Bacterial Infectious Diseases",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools",scope:"