Cheese production, consumption, imports, exports (in ‘000 tonnes) and retail price during 2018–2019.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 179 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 252 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
\n'}],latestNews:[{slug:"stanford-university-identifies-top-2-scientists-over-1-000-are-intechopen-authors-and-editors-20210122",title:"Stanford University Identifies Top 2% Scientists, Over 1,000 are IntechOpen Authors and Editors"},{slug:"intechopen-authors-included-in-the-highly-cited-researchers-list-for-2020-20210121",title:"IntechOpen Authors Included in the Highly Cited Researchers List for 2020"},{slug:"intechopen-maintains-position-as-the-world-s-largest-oa-book-publisher-20201218",title:"IntechOpen Maintains Position as the World’s Largest OA Book Publisher"},{slug:"all-intechopen-books-available-on-perlego-20201215",title:"All IntechOpen Books Available on Perlego"},{slug:"oiv-awards-recognizes-intechopen-s-editors-20201127",title:"OIV Awards Recognizes IntechOpen's Editors"},{slug:"intechopen-joins-crossref-s-initiative-for-open-abstracts-i4oa-to-boost-the-discovery-of-research-20201005",title:"IntechOpen joins Crossref's Initiative for Open Abstracts (I4OA) to Boost the Discovery of Research"},{slug:"intechopen-hits-milestone-5-000-open-access-books-published-20200908",title:"IntechOpen hits milestone: 5,000 Open Access books published!"},{slug:"intechopen-books-hosted-on-the-mathworks-book-program-20200819",title:"IntechOpen Books Hosted on the MathWorks Book Program"}]},book:{item:{type:"book",id:"5859",leadTitle:null,fullTitle:"Qualitative versus Quantitative Research",title:"Qualitative versus Quantitative Research",subtitle:null,reviewType:"peer-reviewed",abstract:"The objective of this book is to fill the gap combining several studies from qualitative and quantitative research methods. The various chapters presented here follow several approaches that researchers explore in different context. This book intends to contribute to better understanding of the application areas of qualitative research method and to show how these business practices in social sciences can stimulate in various areas.",isbn:"978-953-51-3286-8",printIsbn:"978-953-51-3285-1",pdfIsbn:"978-953-51-4774-9",doi:"10.5772/65619",price:119,priceEur:129,priceUsd:155,slug:"qualitative-versus-quantitative-research",numberOfPages:110,isOpenForSubmission:!1,isInWos:1,hash:"d5ed2bf861d5745f24ef585da095d217",bookSignature:"Sonyel Oflazoglu",publishedDate:"June 28th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5859.jpg",numberOfDownloads:8118,numberOfWosCitations:11,numberOfCrossrefCitations:12,numberOfDimensionsCitations:19,hasAltmetrics:0,numberOfTotalCitations:42,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 12th 2016",dateEndSecondStepPublish:"November 2nd 2016",dateEndThirdStepPublish:"January 29th 2017",dateEndFourthStepPublish:"April 29th 2017",dateEndFifthStepPublish:"June 28th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,editors:[{id:"187211",title:"Dr.",name:"Sonyel",middleName:null,surname:"Oflazoglu",slug:"sonyel-oflazoglu",fullName:"Sonyel Oflazoglu",profilePictureURL:"https://mts.intechopen.com/storage/users/187211/images/5783_n.jpg",biography:"Sonyel Oflazoğlu is an assistant professor of Entrepreneurship and Marketing at the Department of Marketing, Mustafa Kemal University, Turkey. She got her MS degree from Mustafa Kemal University, Institute of Social Sciences, Business Administration, and then she worked as a research assistant at Ankara University, Faculty of Political Sciences, in 2003. In 2008, she got a fellowship from the European Union to study PhD candidate student as a visiting researcher at Bucks New University, England; she received her PhD degree in 2010. Her research focuses on business networks, qualitative and quantitative research methods, consumer behaviour and entrepreneurship and innovation. She has authored several journal articles and book chapters, which were published through international publishers. Currently Dr. Oflazoğlu is involved in several research projects on social sciences.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Mustafa Kemal University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"439",title:"Operation Management",slug:"business-management-and-economics-business-administration-operation-management"}],chapters:[{id:"54613",title:"Qualitative Method Versus Quantitative Method in Marketing Research: An Application Example at Oba Restaurant",doi:"10.5772/67848",slug:"qualitative-method-versus-quantitative-method-in-marketing-research-an-application-example-at-oba-re",totalDownloads:1649,totalCrossrefCites:1,totalDimensionsCites:2,signatures:"Yusuf Bilgin",downloadPdfUrl:"/chapter/pdf-download/54613",previewPdfUrl:"/chapter/pdf-preview/54613",authors:[{id:"198044",title:"Dr.",name:"Yusuf",surname:"Bilgin",slug:"yusuf-bilgin",fullName:"Yusuf Bilgin"}],corrections:null},{id:"54935",title:"Ethnography of Naming as a Religious Identity: Case of Antakya",doi:"10.5772/intechopen.68326",slug:"ethnography-of-naming-as-a-religious-identity-case-of-antakya",totalDownloads:902,totalCrossrefCites:1,totalDimensionsCites:2,signatures:"Kadriye Şahin",downloadPdfUrl:"/chapter/pdf-download/54935",previewPdfUrl:"/chapter/pdf-preview/54935",authors:[{id:"198238",title:"Ph.D.",name:"Kadriye",surname:"Şahin",slug:"kadriye-sahin",fullName:"Kadriye Şahin"}],corrections:null},{id:"55098",title:"Research Methods in Library and Information Science",doi:"10.5772/intechopen.68749",slug:"research-methods-in-library-and-information-science",totalDownloads:3321,totalCrossrefCites:10,totalDimensionsCites:13,signatures:"Aspasia Togia and Afrodite Malliari",downloadPdfUrl:"/chapter/pdf-download/55098",previewPdfUrl:"/chapter/pdf-preview/55098",authors:[{id:"199801",title:"Dr.",name:"Aspasia",surname:"Togia",slug:"aspasia-togia",fullName:"Aspasia Togia"},{id:"200167",title:"Dr.",name:"Afrodite",surname:"Malliari",slug:"afrodite-malliari",fullName:"Afrodite Malliari"}],corrections:null},{id:"55873",title:"Assessment of Care for Cultural Competence in Healthcare Services: A Systematic Rewiev of Qualitative Studies",doi:"10.5772/intechopen.69477",slug:"assessment-of-care-for-cultural-competence-in-healthcare-services-a-systematic-rewiev-of-qualitative",totalDownloads:1032,totalCrossrefCites:0,totalDimensionsCites:0,signatures:"Seyma Demir and Yasemin Yildirim Usta",downloadPdfUrl:"/chapter/pdf-download/55873",previewPdfUrl:"/chapter/pdf-preview/55873",authors:[{id:"198029",title:"Associate Prof.",name:"Yasemin",surname:"Yıldırım Usta",slug:"yasemin-yildirim-usta",fullName:"Yasemin Yıldırım Usta"},{id:"200268",title:"MSc.",name:"Şeyma",surname:"Demir",slug:"seyma-demir",fullName:"Şeyma Demir"}],corrections:null},{id:"54805",title:"Limits and Possibilities to Combine Quantitative and Qualitative Approaches",doi:"10.5772/intechopen.68195",slug:"limits-and-possibilities-to-combine-quantitative-and-qualitative-approaches",totalDownloads:1221,totalCrossrefCites:0,totalDimensionsCites:2,signatures:"Maria Cecília de Souza Minayo",downloadPdfUrl:"/chapter/pdf-download/54805",previewPdfUrl:"/chapter/pdf-preview/54805",authors:[{id:"198978",title:"Ph.D.",name:"Maria Cecília",surname:"De Souza Minayo",slug:"maria-cecilia-de-souza-minayo",fullName:"Maria Cecília De Souza Minayo"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},relatedBooks:[{type:"book",id:"6583",title:"Marketing",subtitle:null,isOpenForSubmission:!1,hash:"8ff1f842b67cc0b3301ea477c31d934b",slug:"marketing",bookSignature:"Sonyel Oflazo?lu",coverURL:"https://cdn.intechopen.com/books/images_new/6583.jpg",editedByType:"Edited by",editors:[{id:"187211",title:"Dr.",name:"Sonyel",surname:"Oflazoglu",slug:"sonyel-oflazoglu",fullName:"Sonyel Oflazoglu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2175",title:"Risk Management",subtitle:"Current Issues and Challenges",isOpenForSubmission:!1,hash:"c6406ba890ef4569efd8298e1121685d",slug:"risk-management-current-issues-and-challenges",bookSignature:"Nerija Banaitiene",coverURL:"https://cdn.intechopen.com/books/images_new/2175.jpg",editedByType:"Edited by",editors:[{id:"139414",title:"Dr.",name:"Nerija",surname:"Banaitiene",slug:"nerija-banaitiene",fullName:"Nerija Banaitiene"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"146",title:"Risk Management Trends",subtitle:null,isOpenForSubmission:!1,hash:"b787e4bce18617fb8b4778d72d78e25b",slug:"risk-management-trends",bookSignature:"Giancarlo Nota",coverURL:"https://cdn.intechopen.com/books/images_new/146.jpg",editedByType:"Edited by",editors:[{id:"10232",title:"Prof.",name:"Giancarlo",surname:"Nota",slug:"giancarlo-nota",fullName:"Giancarlo Nota"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5396",title:"Entrepreneurship",subtitle:"Practice-Oriented Perspectives",isOpenForSubmission:!1,hash:"297a3f7f82b2fba856f51501cf3e6864",slug:"entrepreneurship-practice-oriented-perspectives",bookSignature:"Mario Franco",coverURL:"https://cdn.intechopen.com/books/images_new/5396.jpg",editedByType:"Edited by",editors:[{id:"105529",title:"Dr.",name:"Mario",surname:"Franco",slug:"mario-franco",fullName:"Mario Franco"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6535",title:"Contemporary Issues and Research in Operations Management",subtitle:null,isOpenForSubmission:!1,hash:"1cda5f95443dc740a295ff54da00793f",slug:"contemporary-issues-and-research-in-operations-management",bookSignature:"Gary P. Moynihan",coverURL:"https://cdn.intechopen.com/books/images_new/6535.jpg",editedByType:"Edited by",editors:[{id:"16974",title:"Dr.",name:"Gary",surname:"Moynihan",slug:"gary-moynihan",fullName:"Gary Moynihan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5748",title:"Theory and Application on Cognitive Factors and Risk Management",subtitle:"New Trends and Procedures",isOpenForSubmission:!1,hash:"3b1562b00413a902d3e060b18d00c92e",slug:"theory-and-application-on-cognitive-factors-and-risk-management-new-trends-and-procedures",bookSignature:"Fabio De Felice and Antonella Petrillo",coverURL:"https://cdn.intechopen.com/books/images_new/5748.jpg",editedByType:"Edited by",editors:[{id:"161682",title:"Prof.",name:"Fabio",surname:"De Felice",slug:"fabio-de-felice",fullName:"Fabio De Felice"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"66065",slug:"corrigendum-to-eating-disorders-as-new-forms-of-addiction",title:"Corrigendum to: Eating Disorders as New Forms of Addiction",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/66065.pdf",downloadPdfUrl:"/chapter/pdf-download/66065",previewPdfUrl:"/chapter/pdf-preview/66065",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/66065",risUrl:"/chapter/ris/66065",chapter:{id:"52200",slug:"eating-disorders-as-new-forms-of-addiction",signatures:"Francisco J. Vaz-Leal, María I. Ramos-Fuentes, Laura Rodríguez-\nSantos and M. Cristina Álvarez-Mateos",dateSubmitted:"April 9th 2016",dateReviewed:"August 12th 2016",datePrePublished:null,datePublished:"February 1st 2017",book:{id:"5372",title:"Eating Disorders",subtitle:"A Paradigm of the Biopsychosocial Model of Illness",fullTitle:"Eating Disorders - A Paradigm of the Biopsychosocial Model of Illness",slug:"eating-disorders-a-paradigm-of-the-biopsychosocial-model-of-illness",publishedDate:"February 1st 2017",bookSignature:"Ignacio Jauregui-Lobera",coverURL:"https://cdn.intechopen.com/books/images_new/5372.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"55769",title:"Prof.",name:"Ignacio",middleName:null,surname:"Jáuregui Lobera",slug:"ignacio-jauregui-lobera",fullName:"Ignacio Jáuregui Lobera"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"188555",title:"Prof.",name:"Francisco J.",middleName:null,surname:"Vaz-Leal",fullName:"Francisco J. Vaz-Leal",slug:"francisco-j.-vaz-leal",email:"fjvazleal@gmail.com",position:null,institution:null},{id:"188719",title:"Dr.",name:"María Cristina",middleName:null,surname:"Álvarez Mateos",fullName:"María Cristina Álvarez Mateos",slug:"maria-cristina-alvarez-mateos",email:"cristinaalvarezmateos@gmail.com",position:null,institution:null},{id:"195142",title:"Dr.",name:"Laura",middleName:null,surname:"Rodríguez Santos",fullName:"Laura Rodríguez Santos",slug:"laura-rodriguez-santos",email:"laura@unex.es",position:null,institution:null},{id:"195143",title:"Dr.",name:"María I",middleName:null,surname:"Ramos Fuentes",fullName:"María I Ramos Fuentes",slug:"maria-i-ramos-fuentes",email:"miramos@unex.es",position:null,institution:null}]}},chapter:{id:"52200",slug:"eating-disorders-as-new-forms-of-addiction",signatures:"Francisco J. Vaz-Leal, María I. Ramos-Fuentes, Laura Rodríguez-\nSantos and M. Cristina Álvarez-Mateos",dateSubmitted:"April 9th 2016",dateReviewed:"August 12th 2016",datePrePublished:null,datePublished:"February 1st 2017",book:{id:"5372",title:"Eating Disorders",subtitle:"A Paradigm of the Biopsychosocial Model of Illness",fullTitle:"Eating Disorders - A Paradigm of the Biopsychosocial Model of Illness",slug:"eating-disorders-a-paradigm-of-the-biopsychosocial-model-of-illness",publishedDate:"February 1st 2017",bookSignature:"Ignacio Jauregui-Lobera",coverURL:"https://cdn.intechopen.com/books/images_new/5372.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"55769",title:"Prof.",name:"Ignacio",middleName:null,surname:"Jáuregui Lobera",slug:"ignacio-jauregui-lobera",fullName:"Ignacio Jáuregui Lobera"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"188555",title:"Prof.",name:"Francisco J.",middleName:null,surname:"Vaz-Leal",fullName:"Francisco J. Vaz-Leal",slug:"francisco-j.-vaz-leal",email:"fjvazleal@gmail.com",position:null,institution:null},{id:"188719",title:"Dr.",name:"María Cristina",middleName:null,surname:"Álvarez Mateos",fullName:"María Cristina Álvarez Mateos",slug:"maria-cristina-alvarez-mateos",email:"cristinaalvarezmateos@gmail.com",position:null,institution:null},{id:"195142",title:"Dr.",name:"Laura",middleName:null,surname:"Rodríguez Santos",fullName:"Laura Rodríguez Santos",slug:"laura-rodriguez-santos",email:"laura@unex.es",position:null,institution:null},{id:"195143",title:"Dr.",name:"María I",middleName:null,surname:"Ramos Fuentes",fullName:"María I Ramos Fuentes",slug:"maria-i-ramos-fuentes",email:"miramos@unex.es",position:null,institution:null}]},book:{id:"5372",title:"Eating Disorders",subtitle:"A Paradigm of the Biopsychosocial Model of Illness",fullTitle:"Eating Disorders - A Paradigm of the Biopsychosocial Model of Illness",slug:"eating-disorders-a-paradigm-of-the-biopsychosocial-model-of-illness",publishedDate:"February 1st 2017",bookSignature:"Ignacio Jauregui-Lobera",coverURL:"https://cdn.intechopen.com/books/images_new/5372.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"55769",title:"Prof.",name:"Ignacio",middleName:null,surname:"Jáuregui Lobera",slug:"ignacio-jauregui-lobera",fullName:"Ignacio Jáuregui Lobera"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"10188",leadTitle:null,title:"Orthotics and Prosthetics",subtitle:null,reviewType:"peer-reviewed",abstract:"\r\n\tDifferent prostheses and orthoses can be powerful devices for the standing, walking, and conservative treatment of a variety of pathologies that affected joint function, motor function, sensation/proprioception, and deformities such as upper limb disorders, lower limb disorders, spinal disorders, sports-related or overuse disorders. In prosthetics using, the aims are to restore normal walking the same to healthy subjects. The aims of treatment using orthotics are to restore normal performance, as well as to try to prevent further progression of the disease process affecting the body. This can be achieved by designing orthotics to correct or provide control and support.
\r\n\r\n\tThere are different types of prostheses. Recently more advanced prostheses were developed by many companies in this field. Orthoses are readily available in three forms, prefabricated off-the-shelf orthoses, custom made orthoses, and custom-molded orthoses manufactured from a model of the patient’s body. Each type of orthoses based on the designs and fabrication models have advantages and disadvantages.
\r\n\r\n\tIn this book based on the body sections, the specific prostheses and orthoses based on the biomechanical principle, function, and efficacy of them in the treatment and management of disorders and amputations will be explained.
",isbn:"978-1-83962-901-3",printIsbn:"978-1-83962-900-6",pdfIsbn:"978-1-83962-905-1",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"77fd1757d9fb545ad40d0dfa6e865d0b",bookSignature:"Dr. Mokhtar Arazpour",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10188.jpg",keywords:"Orthoses, Design Challenges, Efficiency of Orthoses, Braces, Biomechanical Principle of Orthoses, Future Directions of Orthoses, Conservative Management, Disability, Disorders, Disability, Disorders, Design of Orthoses",numberOfDownloads:209,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"July 1st 2020",dateEndSecondStepPublish:"October 5th 2020",dateEndThirdStepPublish:"December 4th 2020",dateEndFourthStepPublish:"February 22nd 2021",dateEndFifthStepPublish:"April 23rd 2021",remainingDaysToSecondStep:"5 months",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:"Dr. Mokhtar Arazpour has a Ph.D. in Orthotics and Prosthetics from the University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran. His research interests include lower-limb orthotics, osteoarthritis of knee and hand joints, design and construction of new lower-limb orthosis, and waling analysis.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"179731",title:"Dr.",name:"Mokhtar",middleName:null,surname:"Arazpour",slug:"mokhtar-arazpour",fullName:"Mokhtar Arazpour",profilePictureURL:"https://mts.intechopen.com/storage/users/179731/images/system/179731.jpg",biography:'Dr. Mokhtar Arazpour is an Assistant Professor, at Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Dr. Arazpour has a PhD in Orthotics and Prosthetics from the University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran. He is Faculty member as Assistant Professor in the Department of Orthotics and Prosthetics since 2013. Dr. Mokhtar received his B.S. and M.Sc. and PhD in Orthotics and Prosthetics from USWR. His PhD thesis was "Design, Construction and Evaluation of the New Powered Gait Orthosis for Walking in Spinal Cord Injury Patients". Research interest of Dr. Mokhtar include lower limb orthotics, osteoarthritis of knee and hand joints, design and construction of new lower limb orthosis and waling analysis.',institutionString:"University of Social Welfare and Rehabilitation Sciences",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Social Welfare and Rehabilitation Sciences",institutionURL:null,country:{name:"Iran"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:[{id:"74125",title:"Design and Fabrication of Prosthetic and Orthotic Product by 3D Printing",slug:"design-and-fabrication-of-prosthetic-and-orthotic-product-by-3d-printing",totalDownloads:78,totalCrossrefCites:0,authors:[null]},{id:"74805",title:"Audio-Vestibular Neurosensory Prosthetics: Origins, Expanding Indications and Future Directions",slug:"audio-vestibular-neurosensory-prosthetics-origins-expanding-indications-and-future-directions",totalDownloads:62,totalCrossrefCites:0,authors:[null]},{id:"74616",title:"Orthoses Development Using Modern Technologies",slug:"orthoses-development-using-modern-technologies",totalDownloads:50,totalCrossrefCites:0,authors:[null]},{id:"73928",title:"Impact of Self-Selected Customized Orthotics on Lower Limbs Biomechanics",slug:"impact-of-self-selected-customized-orthotics-on-lower-limbs-biomechanics",totalDownloads:23,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"247041",firstName:"Dolores",lastName:"Kuzelj",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/247041/images/7108_n.jpg",email:"dolores@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. Mauricio Barría",coverURL:"https://cdn.intechopen.com/books/images_new/6550.jpg",editedByType:"Edited by",editors:[{id:"88861",title:"Dr.",name:"R. Mauricio",surname:"Barría",slug:"r.-mauricio-barria",fullName:"R. Mauricio Barría"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"43694",title:"Review of Tools Used for Assessing Teachers’ Level of Knowledge with Regards Attention Deficit Hyperactivity Disorder (ADHD)",doi:"10.5772/54277",slug:"review-of-tools-used-for-assessing-teachers-level-of-knowledge-with-regards-attention-deficit-hypera",body:'ADHD is currently one of most widely studied neuro-developmental disorders in children and adolescents. It is a severe disorder that can cause grave problems for sufferers and those around them. The interest in the study of ADHD in the scientific community is undeniable, as proved by the multitude of articles and books on the subject published annually. As indicated by Lavigne and Romero [1], interest in this condition is such that it has breached the boundaries of academic research and study and has become a social phenomenon in itself, to such an extent that any child who shows a certain degree of activity, who does not remain seated and quiet for hours and does not instantly obey each and every instruction he or she receives is immediately suspected of having ADHD. The readiness with which children are labeled as having ADHD is surely due, in part, to the lack of information about the various factors apart from ADHD, that cause lack of attention, hyperactivity and/or impulsiveness.
Neither are teachers free from the tendency to attribute ADHD to too many children in spite of having greater possibilities of obtaining more reliable information about ADHD either through professional articles and books, training courses or other professionals at their schools that work with pupils with ADHD, etc. Despite this greater ease of access to information, various studies have shown that teachers’ knowledge of ADHD could be improved [2-7]. Furthermore the knowledge teachers have about ADHD is also the source of ever greater interest among scientists as they are actors with a key role in the development of the condition. The training of educators in this area is of direct benefit to students with ADHD and their families. For this reason, in order to find out exactly what level of knowledge teachers have about this problem it is crucial to have assessment tools with appropriate psychometric properties, that are reliable and valid and that provide accurate data about teachers’ knowledge of ADHD.
In this chapter, the fundamental reasons for which teachers have to have a basic level of knowledge of ADHD are examined, an exhaustive analysis is carried out of the main instruments which have been developed to assess teachers’ knowledge of ADHD, and the chapter ends with the main conclusions drawn from this study.
ADHD is currently one of the disorders that has generated the largest number of research studies among the scientific community but despite this, in the words of Barkley [8], a lot remains unknown or misunderstood about it. Teachers, along with the family, are one of the most important agents of socialization during infancy, so they are one of the most suitable groups to receive information and training with regard to ADHD. A significant percentage of teachers have false ideas or gaps in their knowledge of ADHD, which causes them to behave inappropriately in the classroom. In this regard, it has been observed that specific training of teachers in the field and positive attitudes on their part have positive consequences for children with ADHD.
Soroa, Balluerka and Gorostiaga [9] hold that infant and primary school teachers should have general and specific knowledge about ADHD for six fundamental reasons. Firstly, because ADHD is one of the most common psychological disorders among children. The American Psychiatric Association [10] indicates that between 3% and 5% of school children suffer from ADHD, that is to say that on average there is one pupil with ADHD in every classroom of 25 [11-13].
Secondly, teachers are in a uniquely advantageous position for detecting possible cases of ADHD. They can pretty accurately distinguish normal development from what is not. Therefore, increasing teachers’ knowledge about ADHD can facilitate, among other factors, early detection of the disorder and the application of the appropriate treatment [4, 14].
Thirdly, it should be noted that the role of the teacher is also essential in establishing the diagnosis. The assessments made of the behavior of the students, along with those of the parents and the results of other tests to which children are subjected, are part of the data that allow the diagnosis to be established [4-6].
Fourthly, it should be noted that teachers play a very important role in the implementation, evaluation and support of the treatment received by children with ADHD [14]. Their cooperation is necessary for the results of the treatment received by the child to be successful, and their evaluation of and opinions about the treatment of ADHD have a profound effect on its efficacy [15].
A fifth reason for teachers to be trained about ADHD lies in direct contact they have with the parents of the children. Several authors have argued that teachers make recommendations, appropriate or inappropriate, about ADHD to the parents, who tend to follow such recommendations [14, 16].
The sixth and final reason is that the knowledge that teachers have about ADHD affects their behavior and attitudes towards children with this condition [17]. Teachers with more knowledge about ADHD have a more favorable conduct and attitudes towards students with this disorder [3, 16, 18].
In spite of the existence of many reasons why teachers should have knowledge on ADHD, various studies have shown that, in general, teachers show only moderate knowledge of ADHD and that it is necessary to improve this level of knowledge [3-6, 19, 20]. Also it must be noted that many teachers present a general lack of knowledge and/or false ideas on the nature, course, consequences, causes and treatment of ADHD [21]. In some research programmes the average percentage of correct answers by teachers to questionnaires prepared in order to measure their knowledge on ADHD was around 80% [14, 18, 22-24], while in other studies the average percentage of correct answers did not exceed 53% [4-6, 20, 25]. At world level there is much research in progress on the knowledge that teachers have on ADHD; however, there is a scarcity of instruments to measure this knowledge precisely [9].
It has been found that teachers who consider that their level of knowledge about ADHD is optimum do not seek additional information; in contrast, those who consider that they do not understand many aspects referring to this topic, do look for it. For this reason, it is important that the teachers should be aware of their actual knowledge about ADHD and the possible repercussions of a lack of knowledge or erroneous knowledge. For this purpose, it is essential to use evaluation instruments which have appropriate psychometric properties for measuring such knowledge.
Over recent decades, many instruments have been developed in order to assess the level of knowledge of teachers regarding ADHD. Given that the school setting is probably the place where children and young people spend most of the day, it is important to have a range of instruments to measure teacher knowledge about ADHD throughout the different stages of child development. These instruments, in addition to identifying gaps that teachers may have in their knowledge of the disorder, can be useful to educate the teachers about the need for more training in this area.
In this section a review is carried out of each of the main instruments developed for the evaluation of teachers’ knowledge about ADHD. In the course of the description of each instrument their general characteristics are set out (the construct evaluated, items, response format, dimensionality, etc.), as well as their scoring rules and psychometric properties. Their strengths and weaknesses are also evaluated. The instruments are presented in chronological order.
This instrument was developed by American and Canadian researchers, in the English language, in order to assess the general knowledge of teachers regarding ADHD. It consists of two sections, the first includes 20 items that are socio-demographic in nature (age, sex, training about ADHD, etc.) in a multiple choice format, and a second section with 20 items, 13 positive and 7 negative, with a dichotomous (True/False) response format.
In the preparation of the questionnaire, the authors contacted several teachers and directors of special education to review the instrument. The authors do not provide more information about the process.
The instrument was applied to a sample of 1289 elementary school teachers, 439 in the United States and 850 in Canada. No information is given about the sampling procedure. 46% of the sample in the United States was made up of teachers from the state of New York school district, and 54% by teachers from Broward County in Florida. The majority were women (86%), aged between 31 and 50 (67%) and had been teachers for 9 or more years. 79% taught the general school population in ordinary classes while 21% were special education teachers. The Canadian sample consisted of teachers from a wide area of south west Ontario and no further information is given by the authors about it.
Correct answers receive 1 point and incorrect ones 0 points. So the range of possible scores goes from 0, the lowest level of knowledge, to 20, for the highest.
No publications have been found which provide validity evidences or reliability indices.
This is believed to be the first study designed to test the knowledge of elementary school teachers about ADHD. A great number of subsequent studies have used this questionnaire or been inspired by it due to its simplicity and that the fact that it was a pioneer in the field that concerns us here. Furthermore, the sample used is very broad and heterogeneous. However, the response format is dichotomous, so does not provide detailed information about the real knowledge the teachers have about ADHD. Furthermore, the psychometric properties of the questionnaire are not provided.
This is an instrument drawn up in the United States and in the English language to investigate teachers’, counselors’ and principals’ knowledge of ADHD in school age children. The instrument has two sections. The first is made up of six items that gather information of a socio-demographic character (sex, training, education experience, etc.) and a second made up of 35 items which evaluates participants’ knowledge of ADHD. The 35 items were taken from the DSM-III: 15 related to Attention Deficit Disorder (ADD), 11 related to diagnostic criteria for Conduct Disorder (CD) and 9 that deal with Oppositional Defiant Disorder (ODD). Participants are asked to identify the 15 statements that best characterize children with ADHD with an X marking the space before each statement.
The instrument was applied to a stratified sample of 303 participants in the Kansas School district: 160 teachers, 61 principals and 82 counselors. 91 were male and 212 female. Hardly any other information is given about the sample.
Correct answers to the items received 1 point, while the rest of the answers received 0 points. Thus, the possible scores ranged from 0, for the lowest level of knowledge, to 15, for the highest.
No publications have been found which provide validity evidences or reliability indices.
This is a simple and easy instrument to apply. The problem is that the response format is similar to the dichotomous one and respondents can try to guess the right answer. Furthermore, the psychometric properties of the instrument are not known.
This is an instrument developed in the United States and in the English language in order to examine the effectiveness of a training program on ADHD given to infant and primary school teachers. The questionnaire is based on the items produced by Jerome et al. [23] and consists of two sections: A first socio-demographic section and a second section consisting of 27 items that assess teachers’ knowledge regarding ADHD. The response format of the instrument is dichotomous (True, False), and includes positive and negative items (the authors do not specify the number of positive and negative items).
The questionnaire was administered to 44 teachers, of whom 33 were women and 11 men. The mean age of participants was 42 years, and they had an average of 15 years of teaching experience. 66% were ordinary classroom teachers while the remaining 34% were specialists (art, music, physical education, etc.). They had an average of 24 students per teacher. 77% had not received any training on ADHD while being trained as teachers and 27% had received no training in the subject after completion of their studies.
Correct answers received a score of 1 and incorrect ones 0. Thus, the possible scores ranged from 0, for the lowest level of knowledge, to 27, for the highest.
No publications have been found which provide validity evidences or reliability indices.
This is a simple and easy instrument to apply. However, the sample is very small and the dichotomous response format (True/False) places limits on the possibility of assessing the real level of knowledge of the teachers as the absence of a third (Don’t Know) option invites respondents to guess the right answer. Furthermore, the psychometric properties of the instrument are not known.
It was developed in the United States and in the English language. This is one of the most widely used instruments to assess the level of knowledge of teachers regarding ADHD, and is the first instrument whose indices of reliability and validity were published in this field. It consists of 36 items, 18 positive and 18 negative, and measures three areas of knowledge related to ADHD: 1) Symptoms/Diagnosis of ADHD (9 items), 2) General information on the nature, causes and impact of ADHD (15 items), and 3) Treatment of ADHD (12 items). It has a three option response format (True, False, Don’t Know), which allows it to overcome the limits of previously used dichotomous formats (True, False) and collect more detailed information about the knowledge of teachers with respect to ADHD. The use of the three option response format allows the authors to discern those areas in which teachers have more knowledge, areas where they have the least knowledge and the areas in which they commit the greatest number of errors.
In the drawing up of the items the authors strove to include only those with the support of the scientific literature, citing references for each item in the manual accompanying the instrument. They also sought to include positive and negative aspects relating to ADHD, and positive and negative statements in nature.
Once they had drawn up the items the authors contacted a group of 40 students working for doctorates in clinical and child psychology. The participants, based on the three sub-scales provided by the authors, had to assign each item to one of the sub-scales provided. An item was considered as belonging to a particular sub-scale if at least 75% of the group was in agreement with the decision.
The authors then conducted a series of preliminary investigations to explore the reliability coefficients of the instrument. They administered an instrument of 27 items with a dichotomous response format (True, False) to 73 teachers of kindergartens and elementary schools [27] and obtained a Cronbach’s alpha of 0.38 for the total scale. In a subsequent study they modified the items that had an inadequate item-total correlation and incorporated the three option (True, False, Don’t Know) response format. The resulting scale was administered to 46 undergraduate and graduate education students and the overall alpha coefficient obtained for this version was 0.71 [27]. Several items were reformulated and 9 new items were included in the final version of the instrument which now had 36 items and which Bender [28] administered to 63 prospective elementary teachers, obtaining a coefficient alpha of 0.81.
Finally, Sciutto et al. [5] administered the resulting 36 item scale along with a socio-demographic questionnaire (age, sex, teaching experience, teaching speciality, etc.) and a scale of seven points dealing with respondents’ self-perception of their effectiveness as teachers of children with ADHD to a broader sample. 149 primary school teachers from six public schools participated in the validation of the instrument. The sampling procedure is not explained. There were 134 female and 9 male participants; the sex of six participants was not given. Their average age was 41 years (SD=11.43) and they had an average of 12.57 years of experience as teachers (SD=8.06). 19% of the sample were special needs teachers and 37% said they had done special needs teaching at some point. 79% of participants had a Master’s degree, whereas the other 21% reported having a Bachelor’s degree. With regard to ADHD, 52% of the teachers said that had taught at least one pupil who had been diagnosed with this condition.
It is worth pointing out that Sciutto and Terjesen [29] carried out an additional study on primary school teachers and university students in the state of Ohio to expand the reliability and the evidence of validity of KADDS. This study has not been published and no more data is available about the sample. However, the authors refer to this study along with the study Sciutto, Nolfi & Bluhm [30] carried out on primary school teachers with the KADDS manual.
1 point was given for correct answers and 0 for incorrect ones and gaps in knowledge. Thus, the possible scores ranged from 0, for the lowest level of knowledge, to 36, for the highest.
For reliability analysis, internal consistency was first calculated, producing a Cronbach’s alpha of 0.71 for each sub-scale and 0.86 for the scale as a whole. Furthermore, it was also seen that each KADDS sub-scale had a high correlation with the total KADDS score (range r=0.85 to r=0.91) and that there was a correlation between the three sub-scales (range r=0.63 to r=0.69). In order to analyze the stability of the scale, Sciutto and Terjesen [29] administered the KADDS in two occasions to a group of 185 university students (what they were students of is not stated) leaving an interval of two weeks between one application and the other. The test-retest correlations for the KADDS scores range between r=0.59 and r=0.70 for the three sub-scales and were r=0.76 for the scale as a whole.
No test was carried out on the factorial structure of the instrument. In order to find evidence of validity, the correlations between the scale scores and a series of variable related to the construct to be measured were examined. With regard to the previous exposure of teachers in their classrooms to pupils diagnosed with ADHD, statistically significant differences were found in the KADDS scores obtained (p<0.01), as well as in various sub-scales (p<0.01 for the General information and Symptoms/Diagnosis sub-scales). The same occurred with the university students who knew a person with ADHD. In the KADDS and the Treatment sub-scale they achieved significantly higher scores (p<0.01) than those that had no contact whatever with people with ADHD [29]. Furthermore the authors of the KADDS have pointed out that the scores obtained by the teachers on the scale correlated in a statistically significant and positive way with the number of ADHD students that had in their classes (r=0.23, p<0.01 for the New York sample and r=0.31, p<0.01 for the Ohio sample in the KADDS total) [5, 30]. In this case, the same phenomenon also occurred with the university students that had some kind of contact with people with ADHD (r=0.18, p<0.01 for the KADDS total) [29]. Finally, they found that people with more information about ADHD had higher KADDS scores, both in the case of teachers (r=0.40, p<0.001 for the KADDS total) [30] and in the case of university students (r=0.36, p<0.001 for the total KADDS score) [29].
Considering that the validation of the KADDS was carried out mainly based on the study of Sciutto et al. [5], it should be emphasized that the sample used is fairly small in size and geographically homogenous. Furthermore, the specific data from the Ohio sample are not known [29].
The reliability of the KADDS was analyzed satisfactorily. As to evidence of validity, we believe that it could be improved but this is understandable considering it was the first instrument constructed to assess knowledge of teachers regarding ADHD whose psychometric properties have been published. The authors provide information on content validity, thanks to which it is known that they tried to be careful in their selection of test items but they do not provide detailed information about the construction of the instrument (number of items initially created, etc.), and the panel of experts consulted in the process for getting content validity was fairly homogeneous (students in the same doctoral program). Furthermore, there is no factorial analysis which would justify the sub-scales defended by the authors of the KADDS.
In any case we regard the instrument developed by Sciutto et al. [5] to be a significant reference point for any researcher trying to create one with a similar purpose because it was a pioneering effort in the field with good reliability and sufficient external validity. As well as that, it is an instrument that is easy to answer due to its brief and precise instructions, its small size and its three option response format. It is also worth mentioning that it has a simple scoring system and thanks to the aforementioned response format, it provides information regarding the knowledge, false beliefs and areas of lack of knowledge of the teachers, information which the previous instruments, with their dichotomous response format, could not provide.
This is the Spanish adaptation of the KADDS [5]. Like the original instrument it has 36 items, 18 positive and 18 negative, and it measures three areas of knowledge related to ADHD: 1) Symptoms/Diagnosis of ADHD (9 items), 2) General information on the nature, causes and impact of ADHD (15 items), and 3) Treatment of ADHD (12 items). The three option response format (True, False, Don’t Know) is the same as that of the original instrument and it has a more extensive socio-demographic section than the original instrument (age, sex, years of experience as a teacher, teaching speciality, etc.).
In the first phase of the adaptation process of the instrument, two doctoral students in developmental and educational psychology translated KADDS into Spanish making the adjustments required for the new socio-cultural context. After that, native speakers of English translated the text back into English to test the validity of the original translation. In this second phase the authors found 18 words different from the original version and agreed on a final version of the translation of those words and drew up initial version of the instrument. The initial version was sent to 15 experts in ADHD (ADHD researchers and educational psychologists) who were asked to place each of the items on one of the three sub-scales that make up the instrument. The level of agreement on the assignment of items to the sub-scales was 94%. Finally, a pilot study was conducted on a sample of 35 primary school teachers who were asked to reply to the scale and indicate errata, difficulties to understand expressions or doubts that may have arisen during completion of the questionnaire. Corrections were made and the final version was thus produced.
For the analysis of reliability and validity of the final version of the instrument, the authors contacted various public and subsidized schools in the province of Valencia. The sampling was not random. The Spanish version of the KADDS was administered to 193 teachers, 68 from infant education and 125 from primary education, of whom 130 were women and 43 men (20 teachers did not specify their sex). They had a mean age of 42 years (SD=11.40), and an average of 17 years of teaching experience (SD=12.03). 13.8% were special education teachers. 51.6% had received specific training on ADHD, with an average of 7.80 hours (SD=17) training. In addition, 59.1% of the teachers had had some experience teaching children with ADHD, and the average number of children with ADHD that they had in their classrooms during the previous two school years was 1.39 (SD=1.89).
Identical to KADDS [5].
The reliability of the scale, measured by the Cronbach’s alpha coefficient showed adequate internal consistency. The alpha coefficient ranged between 0.74 and 0.77 for the three sub-scales and was 0.89 for the total scale. These rates were higher than those obtained by Sciutto et al. [5] in the original instrument. In addition, each of the sub-scales showed a high correlation with the total scale score (range r=0.85 to r=0.90), and there also was correlation between the three sub-scales (range r=0.62 to r=0.69). These data are also consistent with those provided by Sciutto et al. [5]. There was no test-retest reliability check conducted.
The validity of the scale was studied using a series of Pearson correlations between teacher knowledge of ADHD and various socio-demographic variables, specifically, teachers’ knowledge of ADHD correlated in a statistically significant way with the number of hours of training they had received, r(152)=0.17, p=0.036; with the number of children with ADHD they had taught, r(180)=0.29, p=0.001; with the number of courses during which they had children with ADHD in their classes, r(172)=0.23, p=0.002; and their self-perceived level of effectiveness as teachers of children with ADHD, r(179)=0.50, p=0.001.
The sample used for the KADDS adaptation was quite small and geographically homogeneous. Also, test-retest reliability was not checked and the factorial structure of the scale was not analyzed. Apart from these weaknesses and those mentioned in the original version of KADDS, it should be noted that the instrument has adequate internal consistency and some evidence of external validity.
This instrument was developed in the United States in the English language and consists of 21 items, 8 positive and 13 negative with a dichotomous response format (True, False). The lead author of AKOS-IV participated in the development of different versions of the instrument. The first version was designed to analyze the level of knowledge among parents regarding ADHD [see 32]. There is a lack of published information about the second version. The third version was used to assess the level of knowledge that teachers of primary and secondary education have regarding ADHD [33], and the fourth and final version [31] has not been published, so its target population is unknown.
1 point was given for correct answers and 0 for incorrect ones and gaps in knowledge. Thus, the possible scores ranged from 0, for the lowest level of knowledge, to 21, for the highest.
No publications have been found which provide validity evidences or reliability indices.
On the positive side, it should be noted that the questionnaire is short and simple to complete, but it uses a response format with two options (True, False) which can lead to a bias in the collection of information as those subjects who did not know what to answer are required to choose one of the two alternatives provided. In addition, there is a lack of published information relating to the development of the instrument and its psychometric properties.
This is an instrument developed in the United States in the English language and it is aimed at primary school and special education teachers. Its aim is to test their knowledge of the nature of ADHD and its treatment through stimulant medication. The questionnaire is divided into six sections. The first consists of 8 socio-demographic items: The number of students the teacher has, the number of students diagnosed with ADHD, years of teaching experience, etc. The second section is made up of 47 Likert scale items with 5 options (1=Strongly Disagree, 2=Disagree; 3=Neutral/Don’t know, 4=Agree, 5=Strongly Agree) divided into three blocks: A first block of 13 items to assess factual knowledge about ADHD and the use of stimulant medication, a second block of 23 items that asked participants to indicate their views about the effects of stimulant medication on classroom behavior, and a third block of 11 items assessing teachers’ experience and involvement with students who have ADHD. In the third section the subjects have to state which sources they regard as most reliable for obtaining information about ADHD. In the fourth section they had to state which people usually recommend that children suspected of having ADHD be evaluated by. In the fifth section the teachers are asked about what teaching techniques they have most frequently used for dealing with children with ADHD. In the sixth and final section, there is an open question which enquires about teachers’ opinions regarding the use of stimulant medication for the treatment of students with ADHD.
The pilot version was administered to 15 teachers participating in a graduate clinical experience at the University of Wisconsin. Small changes were made in the wording of the items and it was confirmed that the time required to respond to the questionnaire was about 10 to 15 minutes.
The definitive version of the questionnaire was administered to 145 teachers in Wisconsin, 29 women and 116 men. The subjects were randomly chosen from the Department of Public Instruction. Among the participants 43% were special education teachers and 30% general education teachers. The teachers had an average of 16.5 years of teaching experience (SD=9.46).
Not provided.
No publications have been found which provide validity evidences or reliability indices.
On the positive side, it should be noted that this is a questionnaire with clear instructions and is easy to fill out. However, the response format used by the authors (Likert 5 options) may complicate the interpretation of the results, since it offers the option to partially agree or disagree with the questionnaire items. Moreover, the sample used for the application of the instrument was small and geographically homogeneous, and the psychometric properties of the instrument are not known. Finally, it should be noted that one of the main objectives of the questionnaire was to analyze teachers\' knowledge of stimulant medication, a very specific purpose and one distinct from the object of study of the other questionnaires that have been examined in this chapter.
This instrument was drawn up in Australia in the English language to test the perceived and real knowledge of primary teachers and trainee teachers of ADHD. Section b) of the questionnaire was drawn up to examine this main point and contains some items from Jerome et al. [23], Sciutto et al. [5] and another series of items taken from the scientific literature related to ADHD. The instrument was made up of 131 items divided into six sections. Section a) collects information on socio-demographic aspects of the sample and included an analog scale of 10 cm on which respondents had to indicate what they thought they knew about ADHD. The bottom end of this scale indicates the minimum level of knowledge (Very Little), while the upper level indicates the maximum level (A Lot). Section b) includes 27 items, 11 positive and 16 negative, with a three option response format (True, False, Don’t know) drawn up to assess respondents real knowledge of ADHD. Section c) has a focus on identifying the teaching strategies which subjects might use with pupils with ADHD. For this purpose they were given a brief description of a practical case and a series of multiple choice and open questions. Section d) collects information about participants’ beliefs about ADHD and the possibility of having pupils with it in their classes. For this purpose it had 31 items which required a response on an analog scale of 10 cm the bottom of which indicated complete agreement with the statement (Strongly Agree) and the top of which indicated complete disagreement (Strongly Disagree). Section e) was designed to evaluate beliefs regarding the different strategies for action possible in classes with pupils with ADHD. It has 56 items divided into various sub-sections to which respondents had to respond on 10 cm analogical scales the bottom ends of which indicated complete agreement (Strongly Agree) and the upper ends of which indicated complete disagreement (Strongly Disagree). Finally, section f) includes two multiple choice items to which subjects have to respond regarding whether or not they want more training on ADHD and to specify the way they believe most appropriate to find out more about ADHD.
The questionnaire was revised by two educational and developmental psychologists not associated with the study. It was later piloted on a sample of 9 primary school teachers from Victoria (Australia), arising from which no change was made. The questionnaire was finally administered to 120 primary school teachers in Victoria, 91 women and 29 men with an average age of 39.2 years (SD=10.2), and 45 students in the last year of their education degree, all women and with an average age of 23.6 years (SD=5.6). The sampling procedure was not explained.
Section b) of the questionnaire had 27 items. Correct responses received a score of 1 and incorrect ones, 0. Thus, the possible scores ranged from 0, for the minimum level of knowledge, to 27, for the maximum level. The scoring standards for the other sections were not given.
No publications have been found which provide validity evidences or reliability indices.
On the positive side, it should be noted that the authors have attempted to develop an instrument that collects a variety of information relating to ADHD. However, the instrument has many weaknesses: The sample used is quite small and geographically homogeneous, the information given relating to the development of the instrument is scant, the presentation of the items and response formats vary from one section to another, and there are questions with 34 possible answers and analog scales of 10 cm which make it difficult to interpret the response provided by the subject. In short, it is a long and complex questionnaire for the subject. Additionally, the psychometric properties are not known.
This instrument was developed in the United States and in the English language. Its purpose is to analyze the knowledge that elementary school teachers have about ADHD and assess their level of acceptance with respect to the medication and behaviorist treatments that are used with children with ADHD. The instrument is divided into three sections. The first section collects socio-demographic data. The second section consists of 43 items, positive and negative in nature (the authors do not specify the number of each), and is divided into two sub-scales: A first sub-scale assesses knowledge of the etiology, symptoms and prognosis of ADHD (31 items), and a second sub-scale assesses knowledge about treatments that are used most frequently in ADHD cases (12 items). The third and final section consists of 10 items divided into two sub-scales: The first sub-scale assesses the level of acceptance that subjects presented with respect to medication (5 items), and the second sub-scale assesses the level of acceptance of the behavioral intervention guidelines used with children with ADHD (5 items). The second section of the instrument has a response format of three options (True, False, Don’t Know) and the third section, being an opinion section, has a Likert-type response format of 4 options (1=Not at all Likely, 2=Somewhat Likely, 3=Moderately Likely, 4=Very Likely).
The preliminary version of the instrument was made up of 59 items. 20 experts, members of the International Society for Research in Child and Adolescent Psychopatology who had conducted research in the area of ADHD and/or treatment acceptability were called upon to revise it. The items that received a negative evaluation from these experts were modified or removed.
Finally, the study was carried out on 47 elementary school teachers in five different districts of Pennsylvania and New Jersey. The sampling procedure was not specified. 94% of the sample was female and had an average of 13 years of teaching experience (SD=8.76). 85% of the teachers were general teachers, while 4.35% worked in special education and 10.6% worked in both areas.
In the second section of the instrument 1 point was given for correct answers and 0 for incorrect ones and gaps in knowledge. Thus, the possible scores ranged from 0, for the lowest level of knowledge, to 43, for the highest. The scoring standards for the third section of the questionnaire are unknown.
For the reliability analysis, the internal consistency was first calculated, obtaining a Cronbach’s alpha coefficient that ranged from 0.58 (Knowledge of treatments sub-scale) to 0.81 (Behavioral management acceptability sub-scale) for the four sub-scales in the questionnaire. In order to analyze the stability of the instrument, the authors administered the KARE a second time to a sample of 24 subjects (without further details being given of the sample) with a time interval of four weeks between the first and the second administration. The test-retest reliability ranged from 0.76 (Behavioral management acceptability sub-scale) to 0.80 (Medication acceptability and Knowledge of treatment sub-scales).
No publications have been found which provide validity evidences.
On the positive side, it should be noted that this is a not too long instrument with response formats that are easy to fill out. It also has an acceptable internal consistency for three of the four subs-scales that compose it, and has good test-retest stability. However, the sample used for obtaining the reliability indices is small, and no published validity evidences of the instrument have been found.
This instrument was drawn up in the United States in the English language. The main purpose of it is to assess the level of knowledge of elementary school teachers regarding ADHD before and after they received a specific training program on the subject. The instrument consists of 23 items and has a multiple choice format: Each item is followed by five possible answers, one correct and four distractors.
In the course of its development process, the instrument was administered to 10 doctors working as psychologists in the Cypress-Fairbanks school district (Texas) to receive their feedback. Adjustments have been made for a better understanding of the items and response options (the authors did not provide further details). The test authors also conducted a pilot study with 133 participants (no further description were given of the sample), as a result of which a number of items were removed.
The resulting instrument was administered to 47 elementary school teachers in the Cypress-Fairbanks school district. 91.5% of the participants were female and 8.5% male. 55.3% of them were general teachers while 44.7% were special education teachers. The age of the teachers ranged from 18 upwards, and they had an average of 11 years teaching experience. 30% of the sample had never received training about ADHD, and 95.7% had a child in their classroom with the disorder diagnosed in recent years.
1 point was given for each correct answer so the possible scores ranged from 0, for the lowest level of knowledge, to 23, for the highest level.
The reliability of the instrument was calculated using the Kuder-Richardson formula 20, and a reliability of 0.65 was obtained. No publications have been found that provide validity evidences.
On the positive side, it should be noted that this is a not too long instrument with a novel response format in the field that concerns us. However, the authors provide few details about the construction process of the test, the sample that has been used with the final instrument is quite small and homogeneous, and has a low reliability index. Furthermore, the validity evidences of the instrument were not provided.
This is an instrument that was drawn up in Australia in the English language in order to assess the knowledge about ADHD of primary and secondary teachers and parents of children with the same condition. It consists of a scale of 67 items, constructed on the basis of 20 items from the KADDS [5]. It has a three option response format (True, False, Don’t Know) and measures three areas of knowledge connected to ADHD: 1) Causes of ADHD, 2) Characteristics of ADHD, and 3) Treatment of ADHD. Like the KADDS scale it has positive and negative items, and for the drawing up of which the authors made efforts to use only those items with support in the scientific literature.
The KADD-Q authors obtained the sample needed for the analysis of reliability and validity of the scale by making a random selection of schools in metropolitan Perth (Western Australia) and by way of the Centre for Attention and Related Disorders of The University of Western Australia. The sample consisted of 348 participants: 256 teachers (51% primary and 43% secondary) and 92 parents. Of the teachers involved in the sample, 22% were male and 78% female. 180 teachers were recruited in their workplaces and had an average of 20.2 years (SD=10.3) of teaching experience, the remaining 76 teachers were recruited through the Centre for Attention and Related Disorders, and had an average amount of teaching experience of 15.8 years (SD=10). 96% of teachers said they had a student with ADHD in the classroom at some point and 20% were qualified in special education. As for the group of 92 parents participating in the study, it should be noted that 8% were male and 92% female. In addition, the average age at which their child had been diagnosed with ADHD was 10.3 years (SD=3.1). 23% of the parents were attending a support group for parents of children with ADHD and 31% had attended informational seminars about ADHD in the preceding 12 months.
In the SPSS statistical package correct answers were coded with a 1, incorrect ones with a 0, and the gaps as a missing value. Possible answers ranged from 0, for the minimum level of knowledge, to 67, for the maximum level.
The reliability of the KADD-Q and its sub-scales was estimated using Cronbach’s alpha coefficient. The results suggest that the internal consistency of the KADD-Q is high for the sample of teachers (alpha=0.91) and parents (alpha=0.93). For the sub-scales Causes, Characteristics and Treatment, alphas obtained were of 0.86, 0.80 and 0.79 for teachers and 0.85, 0.84 and 0.84 for the parents, respectively. In addition, each of the sub-scales of the KADD-Q had a high correlation with the total scale score (range r=0.73 to 0.92) in both the sample of teachers and parents. There were moderate correlations between the three sub-scales of teachers in the sample (range r=0.34 to 0.56), and somewhat ones higher in the sample of parents (range r=0.56 to 0.77). There was no test test-retest reliability conducted.
Convergent validity was not evaluated, nor was any test of the factorial structure of the instrument made. The scale authors present data on a series of relationships that exist between the scale scores and several variables related to the construct they purport to measure, which provide certain information concerning the external validity. The level of teachers’ knowledge about ADHD was significantly higher depending on the stage of their profession they were at. Primary school teachers obtained higher scores than their secondary education colleagues (p=0.001). Teachers who had attended to professional development sessions about ADHD in the previous 12 months and those who had specific training in special education had higher scores on the scale (p<0.001 and p=0.024, respectively).
On the positive side, it is noteworthy that the authors of KADD-Q have tried to create a single instrument to assess the knowledge of teachers in primary and secondary education and the parents of children with ADHD. This instrument has an easily completed response format and has good internal consistency. However, the teachers and parents samples used for the study were small and geographically homogeneous, the information relating to the development of the instrument is scant, the instrument lacks test-retest reliability indices, evidence of convergent validity is not provided, and nor is there any factorial analysis to confirm the presence of the three sub-scales of the instrument. To all this must be added the fact that data concerning the external validity of the instrument are scarce.
This instrument was drawn up in the United States and in the English language for the purpose of assessing teachers’ knowledge of ADHD after they have receiving training related to it. It consists of 25 items with a dichotomous response format (True, False). The items were designed to cover six areas of content: 1) Causes of ADHD, 2) Assessment of ADHD, 3) ADHD sub-types, 4) Associated problems of ADHD, 5) Treatment of ADHD, and 6) Specific school-based behavioral strategies for children with ADHD.
The questionnaire was administered to a non-random sample of 142 elementary school teachers in the Washington DC metropolitan area, of whom 74 belonged to the experimental group receiving training in ADHD and the remaining 68 to a control group that did not receive such training. The average age of all participants in the sample was about 37 years (SD=12.45) and they had an average amount of teaching experience of 11.34 years (SD=10.40). 92% were women and only 17% were special education teachers. Approximately 34% of the sample had had experience of a child with ADHD in their classroom.
1 point was given for correct answers and 0 for incorrect ones, so the range of possible scores went from 0, for the lowest possible level, to 25, for the highest possible level.
Internal consistency scores were 0.68 and 0.97 before and after training, respectively. No publications have been found which provide validity evidences of the instrument.
On the positive side, it should be noted that the questionnaire is short and easy to fill out. However, it uses a dichotomous response format which prevents information being collected about the areas where the teachers’ lack of knowledge is concentrated. Furthermore, information about the validity of the instrument is not available.
This is a newly developed questionnaire produced in Spain in the Basque language and which has yet to be published. Its purpose is to assess the knowledge of infant and primary school teachers about ADHD. It is divided into two sections. The first collects socio-demographic data (age, sex, teaching speciality, teaching experience, etc.) as well as data on the perceived knowledge of teachers of ADHD and their perceived capacity to teach children suffering from this condition. The second section assesses their real knowledge of these matters with 26 items that use a three option response format (True, False, Don’t Know). The questionnaire items, 21 positive and 5 negative, assessed four areas of knowledge related to ADHD: 1) General information about ADHD (4 items), 2) Symptoms/Diagnosis of ADHD (11 items), 3) Etiology of ADHD (4 items), and 4) Treatment of ADHD (7 items). The questionnaire items were developed from an extensive review of the literature on ADHD.
To obtain data on content validity, the authors of the instrument sought the cooperation of 8 experts in ADHD (university lecturers from different fields of knowledge and clinical or educational psychologists). Thanks to their participation the initial questionnaire of 105 items was reduced to 76 which were distributed into their corresponding sub-scales of the questionnaire when there was an agreement level of 70% among the experts. Subsequently, a pilot study was conducted on 98 infant and primary school teachers in the Autonomous Community of the Basque Country and Navarre. 83 participants were women and 15 men, with a mean age of 40 years (SD=9.8). They had an average of 15 years (SD=10) in the teaching profession, 50.5% had never received training about ADHD, and 47% said they had experience of having a child with ADHD in their classroom. 86% were infant education specialists or primary teachers and 8% were special education teachers. Thanks to the participation of these teachers, the authors of the questionnaire selected those items with high discrimination power and revised the wording of 6 statements, obtaining a preliminary instrument of 51 items.
The draft instrument was finally applied to a sample of 752 infant and primary education teachers in 84 schools in the Autonomous Community of the Basque Country and Navarre. The schools were randomly selected. 86% of participants were female and 14% male, with a mean age of 42 years (SD=9.68). They had an average of 17 years (SD=10.55) experience as teachers, 80% were infant and primary teachers and 12% special education teachers. 59% said they never received training about ADHD, and 54% stated that they had had experience of children with ADHD during their careers. The final instrument of 26 items as described earlier in this section was thus obtained.
1 point was given for each correct answer and 0 for incorrect ones and gaps in knowledge. Thus, the possible scores ranged from 0, for the minimum level of knowledge, to 26, for the highest level.
With the purpose of selecting the final items for the IRA-AGHN, a factor analysis with oblique rotation was carried out. Items with a factor loading equal to or greater than .35, and which adequately reflected the underlying construct, were selected. Using the 26 selected items, the dimensionality of the instrument was examined by means of an exploratory factor analysis based on polychoric correlations. The Unweighted Least Squares (ULS) estimation method was used. Kaiser procedure was used to decide the number of factors, and the Direct Oblimin rotation method was selected in order to simplify the factor structure. The resulting structure confirmed the multi-dimensional character of the construct. Four factors were obtained which explained 53.2% of the variance: The first factor, Etiology of ADHD, explained 29.15% of the variance; the second factor, Symptoms/Diagnosis of ADHD, explained 9.8% of the variance; the third factor, General information about ADHD, explained 7.8% of the variance; and the fourth and final factor, Treatment of ADHD, explained 6.4% of the variance.
For the reliability analysis, the internal consistency was first calculated, with an Omega coefficient which ranged from 0.76 to 0.90 being obtained for the four sub-scales. For the purpose of analyzing the stability of the instrument the authors administered the IRA-AGHN a second time to a sample of 123 teachers with a period of four weeks between the first and second administration. The Spearman’s Rho test-retest correlations for the IRA-AGHN scores ranged from r=0.49 to r=0.77 (p<0.01) for the four sub-scales.
Convergent validity was tested by comparing the results obtained by the subjects in the IRA-AGHN with the results obtained in the Spanish version of the KADDS [4]. The correlation between the scores obtained by the subjects in the dimensions shared by both questionnaires was r=0.54 for the General information sub-scale, r=0.45 for the Symptoms/Diagnosis sub-scale and r=0.33 for the Treatment sub-scale (p<0.01 in all cases).
Finally, to obtain evidence of external validity, the relationships between the scores obtained by the participants in the IRA-AGHN sub-scales and a series of variables related to the construct that it was sought to measure were examined. The data showed that the scores obtained by the teachers in the Symptoms/Diagnosis sub-scale had a moderate correlation with variables such as the number of children diagnosed with ADHD the teachers had taught in the course of their careers (r = .29, p = .001), the teachers’ perceived knowledge of ADHD (r = .37, p = .001), and the teachers’ perceived capacity to teach effectively children with ADHD (r = 0.30, p = 0.001). Meanwhile, it was observed that the scores obtained by the teachers in the General information sub-scale showed a moderate correlation with the teachers’ perceived knowledge of ADHD variable (r = .30, p = .001). In addition, using the Mann-Whitney U test a comparison was drawn between the average score ranges obtained by teachers who had taught children diagnosed with ADHD in the course of their careers and those who hadn’t. Results showed that there were statistically significant differences between the groups’ mean score ranges in the Symptoms/Diagnosis sub-scale (Mann-Whitney U test = 44503; p = .0001; r = .29).
On the positive side, it should be noted that this is a short questionnaire and easy to complete with a three option response format (True, False, Don’t Know), and that it successfully evaluates teachers’ knowledge, false beliefs and areas of lack of knowledge regarding ADHD. The sample used for the validation of the instrument is geographically diverse and extensive, being representative of the target population for the questionnaire. The instrument development process was thorough and rigorous, and has appropriate psychometric properties, although evidence of external validity is not supported by high levels of correlation.
This is a questionnaire recently produced in Spain in the Spanish language and which has yet to be published. The description is the same as that for the above mentioned version of the instrument in the Basque language.
To obtain evidence of content validity, the authors of the instrument sought the cooperation of 8 experts in ADHD (university lecturers from different fields of knowledge, child and youth psychiatrists, pediatricians, one educational psychologist and one education expert who are members of various associations of families of children with ADHD). Thanks to their participation, the initial questionnaire of 105 items was reduced to 76 items that were distributed in the corresponding sub-scales of the questionnaire with the agreement of at least 70% of the judges. Subsequently, a pilot study was conducted on 68 infant and primary school teachers in the Autonomous Community of the Basque Country and Navarre. 53 participants were women and 15 men, with a mean age of 43 years (SD=10.87). They had an average of 18 years (SD=11.67) in the teaching profession, 47% had never received training regarding ADHD, and 73% said they had a child diagnosed with ADHD in their classroom at some point in their career. 73% were infant or primary school teachers, and 15% were special education teachers. Thanks to the participation of these teachers, the authors of the questionnaire selected those items with high discrimination power and revised the wording of two of the statements, obtaining a preliminary instrument of 51 items.
Finally, the draft instrument was applied to a sample of 526 infant and primary school teachers in 57 schools in the Autonomous Community of the Basque Country and Navarre. The schools were randomly selected. 85% of participants were female and 15% male, with a mean age of 43 years (SD=10.89). They had an average of 17 years (SD=11.31) experience as teachers, 77% were infant or primary teachers and 11% were special education teachers. 56% said they had never received training regarding ADHD, and 67% stated that they had a child diagnosed with ADHD in their classroom at some point in their career. From this study the final 26 items instrument was obtained.
Identical to those in the Basque language version of the questionnaire.
With the aim of selecting the final items for the MAE-TDAH, a factor analysis with oblique rotation was carried out. Items with a factor loading equal to or greater than .35, and which adequately reflected the underlying construct, were selected. Using the 26 selected items, the dimensionality of the instrument was examined by means of an exploratory factor analysis based on polychoric correlations. The Unweighted Least Squares (ULS) estimation method was used. Kaiser procedure was used to decide the number of factors, and the Direct Oblimin rotation method was selected in order to simplify the factor structure. The resulting structure confirmed the multi-dimensional character of the construct. Four factors were obtained which explained 60.73% of the variance: Etiology of ADHD explained 34.04% of the variance, General information about ADHD explained 12.14% of the variance, Treatment of ADHD explained 8.92% of the variance, and the fourth and final factor, Symptoms/Diagnosis of ADHD, explained 5.6% of the variance.
For reliability analysis, the internal consistency was first calculated and an Omega coefficient which ranged from 0.83 to 0.91 for four sub-scales was obtained. In order to analyze the stability of the instrument, the authors administered the MAE-TDAH a second time to a group of 112 teachers four weeks after the first application. The Spearman’s Rho test-retest correlations for the MAE-TDAH scores ranged from r=0.62 to r=0.79 (p<0.01) for the four sub-scales.
Convergent validity was tested by comparing the results obtained by the subjects in the MAE-TDAH with the results obtained in the Spanish version of KADDS [4]. The correlations observed between the scores obtained by the subjects in the dimensions shared by both questionnaires were r=0.58 for the General information sub-scale, r=0.43 for the Symptoms/Diagnosis sub-scale, r=0.30 for the Etiology and r=0.39 for the Treatment sub-scale (p<0.01 in all cases).
In order to find evidence of external validity the authors of the MAE-TDAH examined the correlations between the questionnaire scores and a series of variables related to the construct it was sought to measure. Significant statistical differences were found between the teachers’ perceived knowledge of ADHD and the scores they obtained for all the sub-scales of the questionnaire (r=0.38 for General information, r=0.37 for Symptoms/Diagnosis, r=0.30 for Etiology and r=0.31 for Treatment; p=0.001 for all cases), as well between the teachers perceived capacity to effectively teach children with ADHD and the scores obtained in the sub-scales General information and Symptoms/Diagnosis of ADHD (r=0.29, p=0.001 and r=0.30, p=0.001, respectively).
These are similar to those set out regarding the Basque language version of the questionnaire. The main difference is that in this case the sample used for the validation of the questionnaire was quite homogenous as it was confined to two autonomous communities of the Spanish state.
In the review that has been carried out in this chapter, it has been observed that there exist a great number of tools that have been developed to assess the level of knowledge of teachers regarding ADHD. However, most of them do not have good psychometric properties. The authors of this chapter consider necessary to develop and validate instruments with psychometric properties to measure teachers’ knowledge of ADHD with rigor. These instruments, in addition to identifying gaps in teachers’ knowledge of the disorder, can be useful in raising the awareness of teachers about the need for more training in this area, help in the design of training tailored to the needs of teachers, and ultimately, promote the welfare of children and young people with ADHD.
This lack of methodological rigor in these measurement instruments may cause the obtaining of erratic and false results. With regard to the measurement instruments used to assess teachers’ knowledge of ADHD it can be seen that this knowledge varies among the studies examined here. This variability may, in part, be due to an increase in teachers’ knowledge of ADHD over recent decades but it might also be due to methodological reasons such as the following: The number and content of the items in the various instruments varies; the response formats also differ and this affects the results; the size of the samples also varies considerably, in some cases being very big and in others quite small; different studies have collected different socio-demographic data from their sample, which affects the description made of it and the interpretations which might be made of the reasons for the knowledge teachers have about ADHD. All these aspects should be taken into account when it comes to interpreting, comparing and generalizing the results obtained from these instruments.
Regarding the dimensionality of the instruments analyzed here, it should be noted that five of the twelve (KADDS [4, 5], KARE [35], KADD-Q [6], Teacher Knowledge About ADHD [24], and IRA-AGHN/MAE-TDAH) used a number of dimensions ranging from 2 to 6 for the assessment of teachers knowledge of ADHD. It can be seen that Treatment is the only common to all the instruments. In general, the various dimensions proposed by the authors deal with the symptoms, sub-types, associated problems, evaluation, prognosis and etiology of ADHD. However, it should be noted that only one of the instruments reviewed, the IRA-AGHN/MAE-TDAH conducted a factor analysis to confirm the multidimensional nature of the construct.
Furthermore, the external validity of the instruments analyzed provides information about the variables that can influence the knowledge that teachers have regarding ADHD. Three of the twelve instruments reviewed (KADDS [4, 5], KADD-Q [6], and IRA-AGHN/MAE-TDAH) provide evidence of external validity. If we focus on those variables that have relationships with knowledge about ADHD with effect size equal to or greater than 0.30 in any of the instruments, it can be concluded that the variables that correlated with teachers’ knowledge about ADHD are: Prior exposure of teachers to children diagnosed with ADHD in the classroom, the number of children with ADHD teachers have had in their classrooms, having had specific training about ADHD, the degree of teachers’ self-perceived efficacy in teaching children with ADHD and teachers’ self-perceived knowledge of ADHD.
Finally, it should be pointed out that we consider the present chapter to be of interest because it provides an exhaustive review of the main instruments identified in the scientific literature to assess teachers’ knowledge of ADHD. The identification of instruments with optimal psychometric properties is fundamental because it allows for the obtaining of valid and reliable data about the construct being studied. With regard to teachers’ knowledge of ADHD it has been shown that there exist a significant percentage of teachers with gaps in this area [3-7, 19, 20]. For this reason, we believe that the use of instruments which measure this knowledge with rigor could contribute to devising of training materials and courses appropriate for the needs of teachers. And this would, of course, result in benefits for the children who suffer from this condition.
The authors appreciate the cooperation of all those authors who provided additional information about the assessment instruments examined in this chapter.
This work was partially funded by a grant from the Research Bureau of the University of the Basque Country UPV/EHU (General Funding for Research Groups, GIU11/29).
Packaging industry stands at third position globally, next to food and petroleum industries contributing nearly 2% of Gross National Product in developed nations [1]. Approximately 51% of all packaging applications are dedicated to food sector [2]. Consumer inclination towards safe and healthy food have led to the development of state-of-the-art and unique approaches in food processing and packaging. One such development is the introduction of smart packaging technologies. Smart packaging although interchangeably used for intelligent packaging at times, refers to combination of active and intelligent packaging [3]. The Framework Regulation on Food Contact Materials (1935/2004) defines “active materials and articles” as materials intended to extended the shelf-life or to maintain or improve the condition of packaged food; they are designed to deliberately incorporate components that would release or absorb substances into or from the packaged food or the environment surrounding the food. Similarly, according to Framework Regulation (EC) No. 1935/2004 materials and articles which monitors the condition of packaged food or the environment surrounding the food are defined as “intelligent materials and articles” [2]. Most of the smart packaging interventions in food sector are limited to fruits and vegetables, fish products, meat and seafood [4] indicating huge scope and potential to be explored for dairy products.
\nActive and intelligent packaging market was estimated at 17.50 billion US $ in 2019 and expected to reach at 25.16 billion US $ by 2025 witnessing a CAGR of 6.78%. Asia Pacific region was identified as the fastest growing market including China, Japan, India and South Korea and North America as the largest market with WestRock®, Honeywell®, BASF® and Amcor Ltd. as the major market players. Oxygen and moisture scavengers are the utmost commercialized forms of active packaging. Gas scavengers for food was the most marketed active packaging technique in USA during 2018–2019 [5]. During past ten years, the research interestedness in active and intelligent packaging has increased steadily as indicated by the trend of peer-reviewed publications in Figure 1 during 2010–2019. As per a survey conducted by O’Callaghan and Kerry (2016) [6] for applicability of smart packaging to cheese, the future is highly optimistic with consumers willing to pay more on receiving the information provided by these advanced technologies. However, to the best of our knowledge, not a single article has reviewed the application and future research directions of smart packaging technologies in cheese. Therefore, the present review offers insight to active and intelligent packaging systems for cheese and future research aspects.
\nGraph illustrating the number of publications on active packaging, intelligent packaging and cheese during the year 2010–2019 (Source: compiled from SCOPUS using document search with title, abstract, keywords).
World cheese production has shown significant increase from 5.43 million tonnes in 1961, 14.58 million tonnes in 1995 to 22.65 million tonnes in 2015 [7]. About 3000 varieties of cheeses are produced throughout the world and the annual total cheese consumption during 2015–2028 is expected to grow at a CAGR of 1.4% [8]. EU 28 (European Union consisting of 28 countries) stood at first position in cheese export by exporting 841.8 thousand tonnes of cheese. The USA accounted for almost 20% of the world’s cheese production and exported 348.5 thousand tonnes of cheese contributing 13.8% of the total export share during 2018 while Japan and Russia were the top export destination [8]. Approximately 40% of world’s milk is converted to cheese with France, USA, Iceland, Finland and other developed nations being the major players in cheese production and consumption [7]. The total cheese production in USA was 5,908 million kg, with an import of 176 million kg [8]. Mozzarella is the highest produced cheese variety in USA and several other major cheese producing nations [9]. Additionally, the retail prices of cheese in almost all the countries had shown an upsurge during last ten years [8]. The detailed information about cheese production, consumption, import, export quantity of several countries and retail price of selected cheeses are presented in Table 1. The total whole cow milk cheese in India was 2250 tonnes in 2014 [7]. It is true that India is not a traditionally structured ‘cheese nation’ but it is gaining pace with increased domestic consumption and exports. India offers only 40 varieties of cheese of which about 60 per cent of the market is dominated by processed cheeses, 30 per cent by cheese spreads and the remaining 10 per cent by flavored and Mozzarella cheese [10].
\nCountry | \nProduction | \nConsumption | \nImports | \nExports | \nRetail Price | \n||
---|---|---|---|---|---|---|---|
Cheese type | \nCurrency | \nPrice/kg | \n|||||
EU28 | \n9376 | \n9652 | \n59 (H) | \n842 (H) | \n\n | \n | \n |
Germany | \n2339 | \n2002 | \n32 | \n130 | \nGouda | \nEUR | \n5.98 | \n
France | \n1725 (A) | \n1721 | \n— | \n117 | \nEmmental | \nEUR | \n8.43 | \n
Italy | \n1101 (A) | \n1320 | \n10 | \n100 | \nMozzarella | \nEUR | \n4.46 | \n
Netherlands | \n880 (A) | \n420 | \n— | \n140 | \nGouda | \nEUR | \n10.98 | \n
Poland | \n825 | \n723 | \n— | \n53 | \nGouda | \nPLN | \n20.69 | \n
Denmark | \n452 | \n166 | \n— | \n73 | \n\n | \n | \n |
United Kingdom | \n426 | \n795 | \n— | \n\n | Cheddar | \nGBP | \n7.28 | \n
Ireland | \n224 | \n31 | \n— | \n49 | \nNS | \nEUR | \n9.60 | \n
Austria | \n200 | \n200 | \n— | \n— | \n\n | \n | \n |
Spain | \n179 (A) | \n416 | \n— | \n— | \nNS | \nEUR | \n8.60 | \n
Czech Republic | \n135 | \n201 | \n— | \n— | \nEdam | \nCZK | \n144.73 | \n
Belgium | \n109 | \n164 | \n— | \n— | \nNS | \nEUR | \n9.65 | \n
Lithuania | \n102 | \n58 | \n\n | — | \nTilsit | \nEUR | \n7.34 | \n
Finland | \n87 | \n142 | \n— | \n— | \nEdam | \nEUR | \n9.08 | \n
Hungary | \n84 | \n129 | \n— | \n— | \nTrappist | \nHUF | \n1700.00 | \n
Sweden | \n82 | \n201 | \n— | \n— | \nHerrgardsost | \nSEK | \n90 | \n
Latvia | \n47 | \n39 | \n— | \n— | \nHard cheese | \nEUR | \n7.89 | \n
Estonia | \n45 | \n32 | \n— | \n— | \nGouda | \nEUR | \n8.24 | \n
Slovakia | \n38 (A) | \n74 | \n— | \n— | \nEdam | \nEUR | \n6.55 | \n
Cyprus | \n3 (A) | \n22 | \n— | \n— | \n— | \n— | \n— | \n
Luxemburg | \n3 | \n16 | \n— | \n— | \n— | \n— | \n— | \n
Other EU | \n— | \n— | \n17 | \n179 | \n— | \n— | \n— | \n
North and Central America | \n|||||||
USA | \n5908 | \n5668 | \n176 | \n348 | \nCheddar | \nUSD | \n11.87 | \n
Canada | \n443 | \n538 | \n31 | \n— | \nNS | \nCAD | \n14.70 | \n
Mexico | \n419 | \n539 | \n123 | \n— | \n— | \n— | \n— | \n
El Salvador | \n— | \n— | \n39 | \n— | \n— | \n— | \n— | \n
Nicaragua | \n— | \n— | \n— | \n41 | \n— | \n— | \n— | \n
South America | \n|||||||
Brazil | \n755 | \n781 | \n— | \n— | \nMozzarella | \nBRL | \n30.49 | \n
Argentina | \n579 | \n574 | \n— | \n49 | \nQuartirolo-type | \nARS | \n184.24 | \n
Chile | \n101 (B) | \n198 | \n— | \n— | \nGouda | \nCLP | \n6396.00 | \n
Colombia | \n97 | \n100 | \n— | \n— | \n— | \n— | \n— | \n
Uruguay | \n45 | \n33 | \n— | \n— | \nNS | \nUYU | \n143.22 | \n
Other Europe | \n|||||||
Russia | \n473 | \n811 | \n263 | \n— | \nNS | \nRUB | \n412.60 | \n
Belarus | \n332 | \n128 | \n— | \n210 | \n— | \n— | \n— | \n
Switzerland | \n190 (A) | \n186 | \n62 | \n68 | \nNS | \nCHF | \n13.32 | \n
Ukraine | \n168 | \n198 | \n— | \n— | \nRussian (50% fat) | \nUAH | \n172.00 | \n
Norway | \n82 (C) | \n101 | \n— | \n— | \n— | \n— | \n— | \n
Iceland | \n11 | \n9 | \n— | \n— | \n— | \n— | \n— | \n
Asia | \n|||||||
Turkey | \n753 (D) | \n714 | \n— | \n— | \n— | \n— | \n— | \n
Israel | \n146 (A) | \n160 | \n— | \n51 | \nEdam | \nILS | \n41.30 | \n
India | \n48 (E) | \n— | \n— | \n— | \nMozzarella | \nINR | \n380.00 | \n
Japan | \n45 (F) | \n321 | \n297 | \n— | \nProcessed | \nJPY | \n1890.00 | \n
China | \n41 (G) | \n149 | \n124 | \n— | \n— | \n— | \n— | \n
Kazakhstan | \n28 | \n47 | \n— | \n— | \n— | \n— | \n— | \n
Republic of Korea | \n4 | \n156 | \n124 | \n— | \nNS | \nKRW | \n16,225.0 | \n
Saudi Arabia | \n— | \n— | \n172 | \n— | \n— | \n— | \n— | \n
Indonesia | \n— | \n— | \n30 | \n— | \n— | \n— | \n— | \n
Philippines | \n— | \n— | \n38 | \n— | \n— | \n— | \n— | \n
Oceania | \n|||||||
New Zealand | \n385 (G) | \n48 | \n\n | 323 | \nCheddar | \nNZD | \n8.84 | \n
Australia | \n344 | \n350 | \n98 | \n176 | \nCheddar | \nAUD | \n13.25 | \n
Africa | \n|||||||
Egypt | \n395 | \n482 | \n— | \n61 | \nNS | \nEGP | \n59.41 | \n
South Africa | \n108 | \n109 | \n— | \n— | \nNS | \nZAR | \n117.19 | \n
Zimbabwe | \n3 | \n9 | \n— | \n— | \nNS | \nUSD | \n4.00 | \n
Total selected countries | \n21,277 | \n\n | \n | \n | \n | \n | \n |
Rest of world | \n— | \n— | \n865 | \n381 | \n— | \n— | \n— | \n
World | \n— | \n— | \n2550 | \n2550 | \n— | \n— | \n— | \n
Cheese production, consumption, imports, exports (in ‘000 tonnes) and retail price during 2018–2019.
(A) Cow’s milk cheese only; (B) Based on production of big dairies; (C) 2018: Cow’s milk cheese- 72,600 tonnes; (D) 2018: Cow’s milk cheese- 658,500 tonnes; (E) Refers to co-operative dairies only; (F) Natural cheese production; (G) Including processed cheese; (H) Excluding Intra-EU trade; NS- Not specified (Source: compiled from Bulletin of the International Dairy Federation 501/2019).
In order to simplify the cheese packaging requirements, its mandatory to classify them in several categories depending on their moisture content (hard, semi-hard, soft, very-soft), shapes (wheels or half-wheel cheese, cheese slabs also known as portioned cheese, sliced cheese, cheese squares, soft and creamy cheese, grated, diced and processed cheese) and preservation techniques (cheese preserved in brine, wax coated, modified atmosphere or vacuum packaged). The very hard, extra hard, hard to semi-hard category of cheese possess moisture content in the range of 36–52% and includes Edam, Gouda, Swiss, Parmesan, Cheshire and Romano [11]. Rindless types of cheese are ripened in their packaging material alike to cheeses having their surface covered with molds, bacteria or yeasts producing enzymes responsible for ripening [12]. The important factors for selecting packaging materials of very hard to hard varieties of cheese are ripening time, temperature, cheese surface area to volume ratio, gas production (if any), cheese product form (sliced, grated, portions) and permeability of packaging materials [13]. The packaging systems for rindless cheeses includes laminates of polyethylene terephthalate- low density polyethylene (PET-LDPE) (300/50 μm thickness), cover film of oriented (O)PET-LDPE (23/75 μm thickness), tubular bags of oriented polyamide (OPA)-LDPE (15/40 μm thickness) and trough film of PET-HMLDPE (high molecular weight LDPE) (200/25/25 μm thickness). Wax coatings (mineral, paraffin and microcrystalline wax) are used to prevent mold growth, moisture evaporation and high gas barrier properties [11]. Modified atmosphere packaging (MAP) with high barrier materials (PA/EVOH (ethylene vinyl alcohol), LLDPE/EVA (ethylene vinyl acetate)/Ionomers) is generally used for portioned or sliced hard cheese owing to their large surface area exposure to light and oxygen. Vacuum packaging is not preferred for cheese with eyes (Swiss, Gouda, Edam) as it rupture the eyes structure [14].
\nThe semi-soft and soft varieties of cheese contain 52–80% moisture and can be further categorized broadly in three groups (i) ripened by bacteria e.g. Brick, Munster; (ii) ripened by surface mold e.g. Limburger, Brie, Camembert and (iii) internally mold ripened e.g. Gorgonzola, Roquefort, Stilton [15]. Packaging requirements of bacteria ripened cheeses is affected by presence of light, humidity, pH and gases. Internally mold ripened cheese should be packed in O2, CO2 and water permeable packages e.g. polystyrene, polyvinyl chloride or thermoformed packages etc., for optimum mold growth [3]. For externally ripened cheese, packaging should not take place until mold had grown to certain extent and packaging material with certain permeability to O2 and H2O are prerequisite to avoid growth of anaerobic proteolytic bacteria and moisture condensation inside cheese pack, respectively. Penicillium camemberti converts lactate to CO2 and H2O, hence perforated OPP (oriented polypropylene) is the suitable material for gas and water passage [16].
\nFresh or unripened cheeses (e.g. cottage, quark, cream etc.) have moisture content greater than 80% and are exposed to lactic acid fermentation. Such cheeses have very high chances of dehydration or whey expulsion owing to their high-water activity. Some of the suitable packaging material for fresh cheeses are injection molded HDPE or PP packages with side slits for whey drainage, paraffin or PVDC (polyvinylidene chloride) coated paper and LDPE or PP laminated aluminum (Al) foil (7–20 μm) [14]. Processed cheese is hot filled into pouches, polymer coated or lacquered Al foils (12–15 μm). Processed cheese slices are packed in laminates of PET-HDPE, PET-PVDC and OPP-EVOH-LDPE and processed cheese spreads in tubes of LDPE/EVOH/PET or metal tubes, PP or PET-LDPE cups heat sealed with Al foil, tin plate or enameled Al cans and glass cups closed with Al foil plastic laminate or lidded with an easy opening tin plate [17]. A comprehensive list of permitted additives and their recommended usage level is presented in Table 2, which could be utilized for the development of legally permitted smart packaging materials. Also, a few commercially available smart packaging systems used for cheese are listed in Figure 2.
\nName of the additive (&INS No.) | \nRecommended maximum levels | \n|||
---|---|---|---|---|
Unripened cheese | \n\n#Ripened cheese | \nPlain processed cheese/processed cheese, processed cheese spread | \nNote | \n|
Aspartame (951) | \n1000 mg/kg | \n— | \n— | \nIf used in combination with aspartame-acesulfame salt (INS 962), combined maximum use level, expressed as aspartame, should not exceed this level. | \n
Carotenoids | \n100 mg/kg | \n— | \n100 mg/kg | \n\n |
Chlorophylls and Chlorophyllin, copper complexes | \n50 mg/kg | \n— | \n100 mg/kg (Chlorophyll- INS No.-140) | \n\n |
Canthaxanthin (161 g) | \n15 mg/kg | \n15 mg/kg | \n— | \nFor use in flavored products only | \n
Caramel III - ammonia caramel (150c) | \n15000 mg/kg | \n— | \n— | \n|
Caramel IV-sulfite ammonia caramel (150d) | \n50000 mg/kg | \n— | \n— | \n|
Indigotine (Indigo carmine) (132) | \n200 mg/kg | \n— | \n— | \nFor use in surface treatment only | \n
*Lauric arginate ethyl ester (243) | \n200 mg/kg | \n— | \n— | \nEquivalent to 2 mg/dm2 surface application to a maximum depth of 5 mm, For use in surface treatment only | \n
Natamycin (Pimaricin) (235) | \n40 mg/kg | \n40 mg/kg | \n40 mg/kg | \n|
Phosphates | \n4400 mg/kg | \n— | \n9000 mg/kg | \nAs phosphorus | \n
Polysorbates | \n80 mg/kg | \n— | \n— | \nOn the creaming mixture basis | \n
Ponceau 4R (124) | \n100 mg/kg | \n— | \n— | \nFor use in surface treatment only | \n
Riboflavins | \n300 mg/kg | \n300 mg/kg | \n300 mg/kg | \n\n |
*Sorbates | \n2000 mg/kg | \n3000 mg/kg | \n3000 mg/kg | \nAs sorbic acid, For Chhana and paneer only) | \n
Nisin (234) | \n12.5 mg/kg | \n12 mg/kg | \n12.5 mg/kg | \nFor Chhana and paneer only | \n
Propionic acid, sodium propionate, calcium propionate (singly or in combination, expressed as propionic acid) (280, 281, 282, 283) | \n3000 mg/kg | \n3000 mg/kg | \n— | \n|
Glucono delta lactone (575) | \nGMP | \n— | \n— | \n|
Sunset yellow FCF (110) | \n100 mg/kg | \n— | \n100 mg/kg | \nFor use in surface treatment only | \n
Calcium chloride (509) | \n200 mg/kg | \n200 mg/kg | \n\n | Except cream cheese | \n
Beta-carotenes, vegetable (160a(ii)) | \n600 mg/kg | \n100 mg/kg | \n1000 mg/kg | \nExcept Coulommiers | \n
Carrageenan (407) | \n5000 mg/kg | \n— | \n\n | For cream cheese only | \n
Alginate of sodium/potassium/ calcium (410, 402, 404) | \n5000 mg/kg | \n— | \n— | \nFor cream cheese only | \n
Propylene glycol alginate (405) | \n5000 mg/kg | \n— | \n— | \n\n |
Paprika extract (160c) | \nGMP | \nGMP | \n— | \n\n |
Curcumin (100) | \nGMP | \n100 mg/kg | \n100 mg/kg | \n\n |
Annatto (160b (i) and (ii)) | \nGMP | \n\n$100 mg/kg \n@50 mg/kg | \n50 mg/kg | \n\n$(Norbixin based) \n@(Bixin based) | \n
Lysozyme (1105) | \n— | \nGMP | \n— | \n\n |
Sodium salts of mono/di/poly phosphoric acid (339, 450 (i, ii, iii), 451 (i), 452 (i)) | \n— | \n9000 mg/kg | \n— | \nTotal salt content should not exceed 9000 mg/kg calculated as phosphorous/carbonates /citrate/ chloride | \n
Potassium salts of mono/di/poly phosphoric acid (340, 450 (iv, v), 451 (ii), 452 (ii)) | \n— | \n9000 mg/kg | \n— | \n|
Allura red AC (129) | \n— | \n— | \n100 mg/kg | \n\n |
Diacetyltartaric and fatty acid esters of glycerol (472e) | \n— | \n— | \n10000 mg/kg | \n\n |
Hydroxybenzoates, para | \n— | \n— | \n300 mg/kg | \nAs para-hydroxybenzoic acid | \n
Iron oxides | \n— | \n— | \n50 mg/kg | \n\n |
Sodium aluminum phosphates | \n— | \n— | \n1600 mg/kg | \nFor use in processed cheese only As aluminum | \n
Pimaricin (Natamicin) (235) | \n— | \n2 mg/dm2 surface. | \n— | \nFor surface/rind treatment only Not present in depth below 5 mm | \n
Additives permitted in different varieties of cheese as per FSSAI (Food Safety and Standards Authority of India).
Ingredients permitted in whey cheese includes Lauric arginate ethyl ester (INS No.-243) - 200 mg/kg and Sorbates (1000 mg/kg).&INS- International Numbering System for food additives.
\n$Indicates the amount of annatto if it is norbixin based.
\n@It indicates the amount of annatto if it is bixin based.
\n#Ripened cheese- Cheddar, Danbo, Edam, Gouda, Havarti, Tilisiter, Camembert, Brie, Saint Paulin, Samsoe, Emmentaler, Provolone, extra hard grating/sliced/cut/shredded cheese.
\nSource: Compiled from Manual of Food Safety and Standards Authority of India\n
Commercially available active and intelligent packaging systems for cheese (A) biodegradable active antifungal film Antipack™ AF, Handary, Brussels, Belgium (B) antimicrobial films with natamycin, VGP SL®, Barcelona, Spain (C) edible plastic films developed from casein by Lactips, France (D) pull timer™, time temperature indicator for indicating temperature abuse developed by Macfarlane labels and insignia technologies, Scotland. (Source: compiled from internet).
“Active packaging” term was coined by food scientist Dr. Theodore Labuza [3], which includes oxygen absorbers, carbon dioxide absorbers/emitters, moisture absorbers, self-heating and self-cooling containers, antimicrobial packaging, ethanol emitters, flavor absorbers/releasers and microwave assisted containers [18]. The following section discusses different active packaging systems applicable to cheese and brief studies on active packaging materials for cheese and its products are also presented in Table 3.
\nType of active packaging | \nVariety of cheese | \nDescription | \n
---|---|---|
Antimicrobial packaging | \nCottage cheese [19] | \nSachets of allyl isothiocyanate were effective against yeast and mold | \n
Mozzarella cheese [13] | \nLysozyme and ethylenediaminetetraacetic disodium salt (Na2-EDTA) inhibited the growth of coliform and Pseudomonadaceae without affecting the lactic acid bacteria | \n|
Kashar Cheese [20] | \nZein and zein-wax coating with lysozyme, catechin and gallic acid. Lysozyme based film prevented the growth of Listeria monocytogens\n | \n|
Mozzarella cheese [21] | \nPackages containing calcium lactate and lactic acid-based brine enhanced the shelf-life by 50% | \n|
Surface ripened cheese [22] | \nPolyethylene films coated with polyvinyldichloride and containing natamycin/nisin possessed inhibitory effect against Penicillium expansum in surface ripened cheese i.e. Blatacke zlato and Olomoucke tvaruzky\n | \n|
Zamorano sheep cheese [23] | \nPoly propylene and polyethylene terephthalate films with Origanum vulgare and ethyl lauroyl arginate essential oils inhibited E.coli O157:H7 | \n|
Saloio cheese [24] | \nWhey protein isolate coating containing natamycin reduced water loss, color changes and microbial growth throughout the storage period of 60 days | \n|
Oxygen absorbers | \nLow fat cheese (5% fat in dry matter) [25] | \nMicrobial oxygen absorber; Contains microorganisms which utilizes oxygen e.g. Lactococcus lactis strain; Flavor and odor improved | \n
High fat cheese (60% fat in dry matter) [25] | \nMicrobial oxygen absorber containing Lactococcus lactis strain; Flavor improved and no explicit difference on odor | \n|
Cheddar cheese [26] | \nMicrobial oxygen absorber containing Lactococcus lactis strain; Positive influence on shelf-life | \n|
Delite 5% sliced cheese [26] | \nMicrobial oxygen absorber containing Lactococcus lactis strain; Positive influence on product characteristics | \n|
Moisture absorbers | \nSaloio cheese [27] | \n\nHumidipak®, Moisture controlling sachets with sodium propionate impregnated over it to control mold growth. Extended the shelf significantly by decreasing the water loss | \n
Camembert cheese [28] | \n3-layered film with absorber/desorber film. 10% concentration of water absorbent, maintained attractive white appearance of cheese while 25% caused damage of the varnish layer due to swelling. | \n|
UV light absorbers | \nCheese puffs [29] | \nTricalcium phosphate-based UV light inhibitor could be incorporated directly into dry mix flavor powder of cheese puffs cooked in hot oil to prevent light induced rancidity and spoilage. | \n
Types of active packaging materials/systems explored for cheese and cheese-based products.
The presence of moisture not only affects the package appearance but also leads to poor texture and quality of cheese both microbiologically and chemically. Moisture control in the cheese package reduces the water activity thus preventing microbial growth and leaching of soluble nutrients [17]. Moisture scavengers include desiccants like silica gel, molecular sieves, natural clays like calcium oxide, calcium chloride and modified starch in the form of pads, sheets, sachets and blankets [4]. Moisture control in cheese packages could also be attained by incorporating humectant between different layers of packaging material, while keeping the inside layer water permeable. A two layered packaging material for moisture sensitive products like soft cheese was developed by [30] Marbler & Parmentier, (1999). The packaging material consisted of first functional layer (coated paper) for storing and releasing moisture and second layer (plastic laminate) for controlling gas permeability as a function of moisture content. These types of packaging material find their utility for cheese matured inside the package. Pantaleao, Pintado, & Pocas (2007) [27] successfully demonstrated humidity controller (Humidipak®) with Saloio cheese for shelf-life extension. A dual compartment vacuum packaging system (Tenderpac®) developed by SEALPAC® (Germany) for neatly collecting the drip loss from meat products, could be optimized for fresh unripened cheeses like mozzarella, quarg and cottage [31].
\nOxygen scavengers market size was 1.80 billion USD in 2016 which is estimated to reach 2.41 billion USD in 2022 at a compound annual growth rate (CAGR) of 5.1%. North America (USA, Canada and Mexico) is the leading market while Asia Pacific region (China, India, Japan and South Korea) is the fastest growing market [5]. Oxygen is majorly responsible for cheese spoilage as its presence facilitates the growth of aerobic microorganisms, oxidation of cheese components, nutritional value decline, off-flavors generation, unacceptable color changes, shelf-life reduction and decrease in food safety [32]. Therefore, control of oxygen content inside cheese package is of prime importance. Modified atmosphere packaging (MAP), vacuum packaging and oxygen absorbers are the alternatives available to reduce or completely remove oxygen from the package [25]. However, MAP and vacuum packaging require costly equipment for packing cheese and still do not remove the oxygen completely (residual oxygen could be up to 1% in the headspace). Vacuum packaging can affect the appearance and structure of soft cheeses adversely and oxygen can also permeate through the packaging film during later stages of storage or distribution [33]. Oxygen scavengers provide the best alternative to remove the oxygen permeating through the packaging film and also to overcome the challenges of MAP and vacuum packaging [34].
\nThe shelf-life of cheese tarts increased to 48 days when packaged with an iron-oxide based oxygen scavenger as compared to 7 days for control samples [35]. An oxygen scavenging film containing a blend of ethylene, methyl acrylate and cyclohexene methyl acrylate copolymer as oxygen scavenger resin was developed to overcome the oxidative rancidity in cheeses, dried milk and meat products [36]. A study on the effectiveness of various packaging methods for Gouda cheese revealed that oxygen scavengers (ATCO FT 210) were as effective as vacuum packaging and MAP (40% CO2 and 60% N2) in prolonging its shelf-life [34]. Microbiological oxygen scavenging material consisting of Lactococcus lactis strain was reported to consume oxygen in cheese packs with limited production of acetoin and diacetyl [25]. Graviera cheese when packed using a combination of oxygen scavenger and ethanol emitter showed lower microbial growth as compared to 100% nitrogen modified atmosphere packages. An increase in sensory shelf-life for oxygen scavenger and ethanol emitter combined packages was also observed [33]. Negamold®, an ethanol vapor sachet was developed by Nippon Kayalan firm (Japan) for meat products. Later, Freund corporation (Japan) combined oxygen absorber with Negamold® and used it for cheese packaging [37]. Ozdemir & Sadikoglu (1998) [38] had also suggested the replacement of ethanol emitters in cheese packages with UV-excimer-laser-treatment of polymer films to generate bactericidal properties. BIOPACK is a polylactic acid-based packaging system consisting of oxygen scavengers and preservatives encapsulated in cyclodextrin with an objective to extend the best before date of cheeses from 2 to 3 months to 9 months with minimum effect on cost of package [39].
\nCheeses like Cheddar, Swiss, Blue, Colby etc. are highly prone to lipid oxidation owing to their high fat content. Antioxidants are extensively used to prevent oxidation by scavenging free radical but due to augmented customer trend for additives free food products, incorporation into packaging material is the best option [40]. Antioxidants incorporation into packaging material not only prevents quality deterioration of the product but also stabilizes the polymer [41]. Synthetic antioxidants like butylated hydroxytoluene (BHT) and butylated hydroxy anisole (BHA) are conventionally used in cheese packing. As per Code of Federal Regulation (CFR 21/172.115), the maximum rate of BHT addition to cheese is 200 mg/kg of fat and specific migration limit of BHA is 30 mg/kg of food product as per EU 10/2011 regulations. Asadero cheese was vacuum packed in LDPE co-extruded film containing 8 and 14 mg/g of BHT. Cheese packed in LDPE film incorporated with 8 mg/g of BHT had oxidized flavor while film with 14 mg/g of BHT surpassed the legal limit of BHT addition [42]. Therefore, similar to natural counterparts of other additives the recent focus is on natural antioxidants. Pomegranate peel extract (PPE) incorporated into zein films for packaging of Himalayan Kalari cheese retarded the oxidation of fat and protein due to the presence of polyphenols in PPE [43]. Sliced cheese packed in red algae films incorporated with 1% grape fruit seed extract (GFSE) showed decreased peroxide and thiobarbituric acid value indicating the antioxidant capability of GFSE [44]. Gelatin-chitosan edible film with Boldo herb extract possessed antioxidant and antimicrobial activity and had preservative effect on sliced Prato cheese by preventing psychrotrophs [41]. Similarly, other natural antioxidants like green tea extract [45], catechins [46] and rosemary extract [40] had been explored for their antioxidant potential in cheese packaging but the major challenge with antioxidant incorporated films in cheese packaging is synchronization of antioxidant diffusion rate according to cheese requirement. Also, for natural antioxidant incorporation in continuous film production by extrusion, their stability or thermal degradation is the major concern [46].
\nCheeses packed with higher CO2 may suffer from sensory related issues as its dissolution leads to formation of carbonic acid [14]. Taleggio cheese produced excessive 2.5 mmol kg-1 day-1 CO2 when stored in nitrogen flushed packages at 6°C causing quality degradation [47]. However, carbon dioxide production is essential in some cheeses to achieve desired texture, eye formation in Emmental and Swiss cheese, and inhibition of microorganisms but excessive production could lead to puffed pouches or package burst [48]. When cheeses are preserved and sold at ambient temperature or when desired shelf life is high, the adverse effects of higher CO2 concentration aggravates many folds [47]. In such circumstances, carbon dioxide absorbers could be used to remove the excess CO2 and create a balanced internal cheese package atmosphere [2]. The only noticeable progress in segment of CO2 absorbers for cheese is by Fellows (2009) [49], who developed a mechanism for CO2 release from mold ripened cheese (e.g. Camembert) package using one-way valve while disallowing other gases to infiltrate. Crump (2012) [50] developed a CO2 absorber pouch using polyethylene that contained 1.1 g of calcium hydroxide (200 mesh) and silica gel each in 2:1 mixture of water for shrink wrapped Swiss cheese (114 g) and reported that the product remained in good color with acceptable taste without any expansion due to CO2 release during storage at 5°C for 4 months. The gas composition and volume of modified atmosphere packed semi-hard cheese (Kadett®, Arla Foods) packages were optimized using mathematical modeling based on gas solubility coefficients, initial carbon dioxide content in cheese and packaging material, thus avoiding consumer rejection due to volume changes [48].
\nLight, and principally UV light, may cause or accelerate various undesirable reactions like lipid oxidation in cheese. Also, riboflavin, an efficient photosensitizer, present in cheeses at levels of 0.30–0.60 mg/100 g, quickly captivates energy owing to its conjugated double bond and generates either free radicals or reactive oxygen species (ROS). These free radicals and ROS are the major causes of lipid oxidation, off-flavors, color bleaching and nutrient losses especially vitamin A in cheeses [51]. Light stabilizers are divided into five major categories namely: light absorbers, light screeners, excited-state quenchers, peroxide decomposers and free radical scavengers based on their mode of action [52]. Kristoffersen, Stussi, & Gould (1964) [53] reported reduced flavor deterioration in consumer packs of cheddar cheese using Uvinul D 49® as a UV light screening material. Uvinul® S-Pack is a novel FDA approved UV absorber for PET packaging films, which prevented the UV degradation of vitamins and β-carotene, thus highlighting its potential of preventing light degradation changes in cheeses kept in refrigerated illuminated cabinet of supermarkets [54]. Recently, flavonoids had been reported to facilitate the dissipation of photon energy to heat thus deterring photodegradation [22]. Thus, flavonoids incorporated packaging material as natural active element for UV light absorption may be explored for cheese.
\nAntimicrobial packaging is the most researched forms of cheese active packaging. Antimicrobial agent at certain minimum concentration (known as minimum inhibitory concentration (MIC)) diminishes or impedes microbial growth [9]. Antimicrobial effect in cheeses is most commonly obtained by organic acids and its salt derivatives (sorbic acid, citric acid and their anhydrides), bacteriocins (nisin, lacticin and pediocin), fungicides (imazalil and natamycin), enzymes (lysozyme and lactoferrin), essential oils (basil leaf, thyme, oregano and cinnamon) and miscellaneous compounds like potassium metabisulphite, allyl isothiocyanate, EDTA (ethylenediaminetetraacetic acid) or a combination of these agents [22, 55, 56]. Antimicrobial agents which are sensitive to higher polymer processing temperature are usually applied as coatings. Gliadin based bioplastic films prepared by casting, and containing cinnamaldehyde as active ingredient inhibited fungal growth in cheese spreads [57]. Immobilization of antimicrobial agents like nisin on the surface of cheese packaging material is a convenient technique, however immobilization is appropriate for fluids because of direct contact between antimicrobial surface and entire liquid food [58]. Active polyethylene terephthalate film immobilized with silver nanoparticles extended the shelf-life of white fresh cheese up to 30 days [59]. Labels containing antimicrobial agents can also be used for enhancing cheese shelf life. Labels containing allyl isothiocyanate enhanced the shelf-life of Danish Danbo cheese to 28 weeks when used in combination with MAP as compared to 18 weeks with MAP alone [60].
\nChitosan, a natural polysaccharide had been utilized for antimicrobial cheese packaging owing to its biodegradable, antimicrobial, filmogenic and metal complexation attributes [61]. Cellulose polymer based antimicrobial films incorporated with nisin and natamycin showed the potential for preservation of sliced Mozzarella cheese [62]. Electrospinning technique was utilized for incorporation of nisin (at the rate of 5 mg/mL) in polyethylene oxide nanofibers to inhibit Listeria monocytogens contamination in cheddar cheeses without affecting its sensory attributes [63]. A novel antimicrobial film based on hybrid organic–inorganic material commonly called as “anionic clays”, consisting of layered double hydroxide intercalated with salicylate and carbonate anions increased the storage life of Mozzarella to three weeks at a storage temperature of 18°C [64]. DSM™ has developed Pack-Age® as a solution for ripening of cheese in a vapor pervious foil united with yeast and mold blockers [65].
\nFlavor emitters are mainly used to impart flavor to any packed product or scalp/downgrade any undesirable flavor due to harsher processing conditions, thereby improving sensorial attributes and chances of modifying product formulation [66]. It may be used for masking off-flavors but food processors may unfairly market their expired, unsafe or low-quality foods without letting the consumers know. ScentSational Technologies® is global leader in developing food packages with controlled release of legally permitted flavor into headspace of a pack at varying intervals and provision for adjustment of flavor intensity [31]. Recently, they have also ventured into developing customized and patented injection molded scented and/or flavored parts of any pack. Kraft foods had developed a system for controlled and prolonged release of volatile flavor upon opening and reopening of the package [67]. Such type of packaging innovation could also be used for cheese products like chiplets, slices, processed cheese etc. which are usually contained in multi-use packages.
\nColor releasing multilayered film is the novel technique for incorporating permitted food grade colors (Table 2) such as annatto over cheese surface. Such films generally find their application when low intensity shade of color is desired or color is adversely affected during any processing step, storage or distribution. Mohan, Ravishankar, & Gopal, (2010) [4] suggested the migration of edible food permitted red color from the wrapper of surimi to provide it a more desirable and acceptable color. Similarly, α, β-citral migrated from the cellulose acetate films and improved the yellowness of Coalho cheese without affecting its texture during 25 days of storage [68].
\nRindless cheeses are cooked or uncooked hard varieties of cheese that are ripened in plastic film which allows little or no gas or moisture movement e.g. Cheddar, Edam, Gouda and Swiss. Natural rind is the outer crust of cheese formed either during cheese making or storage under controlled humidity and temperature [3]. These rinds are highly susceptible to undesirable fungal growth and becomes slimy at times. Gerber, Koehler, Grass, & Stark (2012) [69] developed a three layered, self-cleaning and porous rind inoculated with Penicillium roqueforti. The base layer consisted of polyvinyl chloride (90 μm), living layer of agar (300 μm) with inoculum and porous cover layer of polycarbonate (10 μm) for diffusion of gases and nutrient supply. There is immense future potential for the development of antibacterial self-cleaning rinds using penicillin producing molds (Penicillium jensenii) for cheese varieties [69].
\nMicrowave susceptors are the substances which absorb microwave energy and convert it into heat energy. It consists of Al foil layer deposited on paperboard or polyester film for uniform heating treatment [18]. Emmi®, a USA based cheese manufacturing firm, provides different variants of fondue recipes (melted Swiss cheese) in microwaveable containers which are ready-to-(h)eat, convenient and recyclable [70]. These types of microwave assisted heating packs could be used for melted cheese recipes. The major concern with microwave assisted heating cheese containers is duration of microwave heating. Some pop-up sound mechanism could be attached with package which blows up and makes a noise on complete even heating of the package content [3].
\nPesticide control agents are generally used with secondary packaging systems to prevent insects, or for fungicidal control, during import and export of food products over distant horizons. Packaging material with pesticide control could also be used to prevent detrimental effects of pests and insects for cheeses like Cheddar, Parmesan etc. which require longer ripening period. The major concerns with these types of pesticide control agents containing packaging is their permissible limit and regulatory issues for use with cheeses. Natamycin is a GRAS status (as per FDA) fungicide which is produced during fermentation by Streptomyces natalensis. Romero et al. (2016) [71] showed positive effect of natamycin incorporated biodegradable triticale flour films on mold inhibition when used for wrapping soft cheese.
\nIntelligent packaging has not been researched extensively for cheese as reflected by very few publications in Figure 1. A few intelligent packaging systems investigated for cheese are presented in this section. However, large size of cheese market including import and export offers attractive opportunities. A list of different suppliers of commercially available smart packaging materials along with their head office, website and contact point are detailed in Table 4.
\nType of smart packaging | \nCompany (Head Office) | \nBrand name | \nWebsite | \nDistributor/Contact point in Asia | \n
---|---|---|---|---|
Oxygen scavenger | \nClariant® Chemicals (Switzerland) | \nOXY-GUARD™, O-Buster® | \n\n | \nClariant Chemical, Vadodara | \n
Mitsubishi Gas Chemical (Japan) | \nAgeless | \n\n | \nInformation & Advanced Materials Company, Oxygen Absorbers Division, Japan | \n|
Toppan Printing (Japan) | \nFreshilizer | \n\n | \nMax Speciality Films Limited, Punjab, India | \n|
Multisorb Filtration Group® (New York, USA) | \nStabilOx®, Freshmax | \n\n | \n— | \n|
Southcorp Packaging (Acquired by Visy®) (Australia) | \nZero2\n | \n\n | \nNo facility in India. Available in Thailand. | \n|
AGM Containers (USA) | \nActiSorb®O | \n\n | Clariant India, Maharashtra India | \n|
Time temperature indicator | \nAvery Dennison (California, USA) | \nTT Sensor™ | \n\n | \nBangalore, Karnataka | \n
IntroTech (Netherlands) | \nMonitor Mark® | \n\n | \n— | \n|
Vitsab® (Limhamn, Sweden) | \nCheckPoint® | \n\n | \n— | \n|
TempTime® Corporation (USA) | \nFresh-Check® | \n\n | \nLisaline Lifescience Technologies Pvt. Ltd., Thane, India | \n|
Antimicrobial packaging | \nLife Materials Technology Limited (Hong Kong) | \nAgion® | \n\n | \n— | \n
Addmaster Limited (UK) | \nBiomaster® | \n\n | \nJebsen & Jessen, Indonesia (Contact point in Asia) | \n|
VGP (Barcelona, Spain) | \nNatamycin | \n\n | \n— | \n|
Ethylene scavenger | \nEvert-Fresh Corporation (USA) | \nEvert-Fresh | \n\n | \n— | \n
Sekisui Jushi (Japan) | \nNeupalon | \n\n | \n— | \n|
Peakfresh Products Ltd. (Australia) | \nPeakfresh | \n\n | \n— | \n|
Moisture absorbers | \nSealed Air® Corporation (USA) | \nDri-Loc® | \n\n | \n— | \n
SEALPAC® (Germany) | \nTenderpac® | \n\n | \nSynerchem Sdn. Bhd., Selangor, Malaysia (Contact point in Asia) | \n|
Integrity Indicator | \nFreshpoint Lab (Australia) | \nO2 Sense | \n\n | \n— | \n
Timestrip Ltd. | \nTimestrip | \n— | \n— | \n|
Mitsubishi Gas Chemical (Japan) | \nAgeless Eye | \n\n | \nInformation & Advanced Materials Company, Oxygen Absorbers Division, Japan | \n|
Insignia Technologies Ltd. (Scotland) | \nNovas | \n\n | \n— | \n|
RFID | \nTemptrip LLC (USA) | \nTemptrip | \n\n | \n— | \n
Mondi Plc (Austria) | \nIntelligent Box | \n\n | \n— | \n|
Freshness Indicator | \nCOX Technologies (USA) | \nFresh Tag | \n\n | \n— | \n
Timestrip (UK) | \nTimestrip® | \n\n | \n— | \n|
Ripesense Ltd. (New Zealand) | \nripeSense® | \n\n | \n— | \n|
Microwave susceptors | \nSirane Food Packaging Limited (UK) | \nSira-Crisp™ | \n\n | \nSirane East, Vostok, Russia | \n
VacPac Inc. (USA) | \nSmartPouch | \n\n | \n— | \n
Suppliers and Asian contact point of commercially available smart packaging systems.
Source: compiled from internet using website of the companies.
Gas indicators or package integrity or leak indicators generally indicate the presence or absence of any gas (majorly oxygen) on the basis of certain chemical or enzymatic reactions. Cheeses are packed under modified atmospheres usually devoid of oxygen to enhance their shelf life. However, the gas composition of cheese package may change relying on the microbial growth inside the package, barrier properties of the packaging material, efficiency of packaging system, or physical damage, if any, that causes leakage [72]. So, knowing the level of oxygen is important to ensure cheese quality and safety in the entire supply chain and throughout its shelf-life. Redox dye-based oxygen indicators have been reported to indicate the package integrity and status of MAP in food non-destructively [73]. A schematic illustration of Mozzarella cheese package equipped with an oxygen indicator and oxygen scavenger with dye-based oxygen sensor is presented in Figures 3 and 4, respectively.
\nA schematic illustration of intelligent packaging system using an oxygen indicator applied to mozzarella cheese package (Source: [\n\n15\n\n]).
A schematic illustration of smart (active + intelligent) packaging system for mozzarella cheese package with oxygen indicator (shown in pink color) and oxygen scavenger (O-buster® oxygen scavenger) (Source: [\n\n15\n\n]).
A single use fluorescent-based oxygen sensor prepared using platinum octaethylporphyrin-ketone (PtOEPK), a phosphorescent oxygen-sensitive dye, sensed oxygen concentration changes in MAP cheddar cheese over a period of 4 months. The sensor was reported to possess sensitivity in the range between 0.02% and 100% oxygen. Correlation between oxygen concentration and microbial growth presented an opportunity for assessment of cheese quality using colorimetric oxygen sensor [74]. Similarly, dye based ultraviolet light activated oxygen sensor was successfully developed and characterized for its oxygen sensitivity, oxygen dependent color change and mechanical properties by Deshwal et al. (2018) [75]. The developed indicator was integrated with MAP Mozzarella cheese as an integrity/oxygen indicator, which could be helpful for stakeholders in the entire supply chain [15]. Hempel, Gillanders, Papkovsky, & Kerry, (2012) [76] successfully exploited optical oxygen sensors for detecting integrity (ingress of oxygen) of vacuum packaged cheddar cheese samples during its storage.
\nFreshness indicators, mostly colorimetric in nature, determine the safety, quality or freshness of product based on microbial growth or chemical change. They trigger a visual indication mechanism by detecting the metabolites of microbial or chemical change [77]. Possibilities of freshness detection of packaged milk, cream and cottage cheese using polymer-based labels was proposed by Chen & Zall (1987) [78]. Major approach for characterizing the deterioration of any cheese is by identifying the volatile organic compounds liberated during its storage (or ripening) using solid phase microextraction-gas chromatography/mass spectroscopy (SPME-GC–MS). Octane, hexanal and 2-pentyl-furan were the indicators for light exposure as obtained during the volatile profile of processed cheese [79]. Fourier Transform Infrared Spectroscopy (FTIR) and near infrared spectroscopy (NIR) have also been used to rapidly identify the chemical groups involved in the Crescenza cheese spoilage for possible development of freshness indicator [80]. Most recently, a biodegradable chitosan film containing pomegranate peels/Melissa officinalis essential oil demonstrated not only antimicrobial potential but also anthocyanins functionality as a spoilage indicator changing its color from blue to red due to pH change of cream cheese during spoilage [77]. A diverse blue cheese classification or identification indicator based on chromogenic array pattern of several pH dyes differentiated five cheeses i.e. Roquefort, Blue Stilton, blue cheese with leaves, blue cheese spread and Cheddar with 100% accuracy [81]. Such type of indicators can be used as freshness indicators of blue cheese where the changes in pH and color could be correlated with cheese spoilage. An attempt for the development of red cabbage extract-based pH indicator for monitoring Ricotta cheese spoilage was reported by Bento, Pereira, Chaves, & Stefani, (2015) [82]. Biogenic amines like histamine, tyramine, tryptamine and phenylethylamine are produced in cheese during ripening. Several reports of histamine poisoning in the past for Gouda, Swiss, Cheddar, Cheshire etc. cheeses indicate the potential of biogenic amines as freshness or spoilage indicators for cheese [83]. Freshness indicators for poultry, fish and seafood are commercially available, but a very few “biological use by date” or “chemical best before date” indicators for dairy products had been reported to the best of our knowledge indicating research possibilities in this area.
\nCheese ripening indicator could be defined as the use of any technique/process/sensor for spotting metabolites (majorly volatiles) or chemical breakdown by-products of glycolysis, proteolysis and lipolysis to quantify the maturity or age of any cheese variety. The earliest attempt in cheese segment included the use of amido black dye for detecting the age of Cheddar and lactose-hydrolyzed cheddar cheese. Dye binding values were correlated with the free amino acid content [84]. Electric nose (or e-nose) had been used for headspace fingerprinting of packaged ripened cheese (Crescenza) volatiles and the data obtained was found to be helpful for its shelf-life measurement [85]. Tavaria, Ferreira, & Malcata, (2004) [86] quantified major ripening descriptors like free fatty acids, acetic, isobutyric and isovaleric acid concentration during 180 days ripening period of Serra da Estrela cheese. These volatile fatty acids furnished information about the optimal consumption time of cheese which could also be successfully used as ripening indicator. Industrially successful models based on infrared reflectance spectra, attributed to the changes in absorbance patterns of alcohol and amide groups have been used to predict the ripening stages and sensory characteristics of Cheddar [87] and Camembert cheese [88] with a minute error of one day.
\nThe shelf-life of any food commodity as mentioned on the package in terms of “biological use by date” or “chemical best before date” is subject to its temperature exposure history owing to temperature dependence of microbial growth, enzyme activity and chemical reactions. Time temperature indicators (TTIs) convey information about the temperature exposure of the food commodity over a period of time [89]. TTIs mainly finds their applications in temperature sensitive food products that are stored or distributed in chilled conditions like milk, cheese, ice-cream, yoghurt, meat, fish etc. Shellhammer & Singh (1991) [90] used enzyme-based full history TTI (I-POINT®) on cottage cheese to correlate temperature variation with cheese quality parameters and reported that the TTIs response was significantly affected by pH, titratable acidity and standard plate count of cheese samples. However, attempts of TTI usage in cheese are few and include shelf-life evaluation of Taleggio cheese [91] and Caprino type cheese [92] using TTIs. Potential of diacetylenic monomers as active ingredient in TTIs based on polymerization reaction for monitoring cheese maturity had also been suggested [93]. A study on evolution of proteolytic activity products in Azeitao cheese with fluctuating temperature revealed prominent presence of two free amino acids (valine and leucine) and two biogenic amines (tyramine and putrescine), which may serve as temperature change indicators for the development of microbial TTI for ripened cheese [94].
\nCheese traceability at batch level is maintained using self-adhesive casein labels, written records, and in advanced cases information is stored in a local database. However, such systems are inefficient considering food safety, counterfeiting risks, voluminous cheese production, warehouse optimization and cost involved in production [95]. So, application of RFID tags at ‘farm to fork’ levels of cheese industry could provide reliable solutions as it stores more information and assess at longer distances [12]. Regattieri, Gamberi, & Manzini (2007) [96] developed a RFID based traceability systems for hard cheese (Parmigiano Reggiano) which detects the history of the product over entire supply chain. Every minute information starting from feed input, production details to detailed pedigree of a cheese piece is available, thus even facilitating consumers to authorize cheese origin and prevent cheese imitation. The final cost of such RFID tags on customer was calculated to be 0.5%. Similarly, improved traceability of long-ripened cheeses (Bra Tenero, Bra Duro, Raschera and Toma Piemontese) with automatic movement recording during production, handling in ripening room and warehouse, delivery, packing and selling was achieved using tags operating at low (125 kHz), high (13.56 MHz) and ultra-high (865 MHz) frequency [12]. RFID tags with an ability to store data related to 200 variables of cheese production not only improved the quality and yield control of the production plant but also possessed robustness against different temperature, humidity, acid and frictional forces [97]. Papetti et al. (2012) [98] designed a web based “infotracing system” for Italian cheese (Caciottina massaggiata di Amaseno) using RFID tags. On linking maturity level of cheeses with quality information (chemical, sensory and spectrophotometric data), RFID system was found to be reliable and compatible with production process. An additional application is “Smart Shelf” which consists of network of RFID antennae for identifying a product’s location. It had been successfully validated for tracking expiry dates of processed cheese [99].
\nPhysical shock indicators are of prime importance for status quo of any fragile product during its rough handling or carriage. Cheeses are often exported across the globe with highest probability of mishandling by personnel during any step of distribution channels or improper selection of transportation channel. Physical shock indicators could be developed using diffusion mechanism, where a fluid leaks and collects irreversibly in another impermeable package, thus indicating the force or pressure to which package content had been exposed. To the best of our knowledge and literature mining no physical shock indicator for cheese and food packaging had been reported. Convex-concave type of metallic structure could also be used to identify the forces to which any cheese packages are exposed over long distances.
\nPackaging could also be used for facilitating the reduction of cholesterol and lactose in cheeses using cholesterol reductase and lactase enzymes. Cholesterol reductase enzyme converts cholesterol to undigested form (coprosterol), reducing its absorption in intestine. An innovative ethylene-vinyl alcohol copolymer (EVOH) plastic encompassing 30% beta-cyclodextrins reduced the cholesterol concentration by 23% in UHT milk [100]. Such type of active plastic films could be incorporated with β-galactosidase enzyme (lactase) and explored for the development of lactose free whey cheeses due to increased incidences of lactose intolerance across the globe [101].
\nCitric acid, ferrous salt/ascorbic acid, cellulose triacetate and activated carbon/clays/zeolites are most commonly used off-odor absorbers finding their use in fish, cereals, fruits and poultry products [3]. Off-flavor and odor scavengers prevent cross contamination of pungent odor and aids in improving the overall acceptance of cheeses. However, it is imperative that the constituents scavenged should not be spoilage indicators or essential for flavor development. Some ketones, aldehydes and esters are associated with fruity flavor of cheeses which may be undesirable for some customers [102]. Aldehyde and ester scavengers in cheese packaging can be helpful in improving its sensorial quality. The identified volatile compounds from the headspace of cheese packages revealed the possibilities for development of absorption system and stabilization of sensory qualities of semi-soft ripened cheese [103].
\nThe earliest documented and patented step to achieve the tack ability of a multilayered polyester film over cheese surface was the electrical discharge or flame treatment of the inner surface [104]. Such films were temporarily adherent and easily peel able while opening cheese package. Presently, these anti-stick films can find their vast application for packaging individual slices of processed cheese or Mozzarella cheese spheres thus, reducing sticking losses.
\nCarbon dioxide and ethanol not only inhibit bacteria, yeasts, molds but also reduces oxidation and could be used individually or in combination for cheese packaging systems to inhibit microbial growth and pack shrinkage [105]. Cheese is most commonly packed with higher CO2 concentration using MAP technique but CO2 dissolves in the product leading to package collapse [6]. Package collapse could be overcome by inserting CO2 emitters in standard MAP cheese trays with perforated false bottom. The controlled release of ethanol in cheese packs could be obtained by encapsulating in a carrier material [65]. Ethicap®, a commercialized ethanol emitter absorbed in silica pads and embedded in sachets made from ethylene vinyl acetate copolymer prevented the growth of molds and yeast, thereby enhancing the shelf-life of soft cheeses [106]. However, objectionable off-flavors involved with higher concentration of CO2 and ethanol are concerning and supplementary flavor mixtures may be required.
\nAn innovative single use package having the ability to absorb oxygen, carbon dioxide and water vapor, comprising of calcium hydroxide which emits water due to CO2 absorption, thus activating transition metal (iron oxide) based oxygen scavenger has been developed. Such containers would be suitable for hard cheeses like Taleggio, which emits large amount of CO2 during ripening and require slight oxygen for maintaining the growth of live cultures [107].
\nSelf-cooling packaging technique is based on an endothermic chemical reaction involving the dissolution of ammonium chloride or ammonium nitrate in water and heat pump technology using water as the heat transmission medium. Such type of packaging systems may remunerate the cold chain conditions, especially where supply channel is inefficient [3]. Initially, thermal sensitive cheese varieties may be shipped using secondary or tertiary thermal management system. Greenbox Thermal Management Systems™ utilizes organic phase change nanomaterial labeled as PureTemp®, to provide specifically designed distribution carriage systems with an ability to maintain temperature precisely for longer durations of supply [108]. It consists of a reusable, recyclable and completely biodegradable boxes in box arrangement with exterior layer of corrugated plastic. Such type of self-cooling containers may be really helpful for exporting cheeses over longer distances without any thermal abuse and quality deterioration.
\nEmmental and Gouda cheese possess typical and desired regular round holes (eyes) owing to the production of large amount of carbon dioxide during lactate metabolism [109]. Dye based CO2 indicators based on color intensity that is correlated with amount of CO2 released could be used to monitor advances in ripening and signpost the accomplishment of optimal ripening. Recently, a novel consumable adhesive CO2 indicator strip consisting of phenol red dye and tetrabutylammonium hydroxide coated onto silica nanoparticles was developed by Wang, Yusufu, & Mills, (2019) [110]. The color response was dependent on temperature and thickness of polymer barrier films. Such type of indicators could be explored for the development of CO2 indicator or freshness indicator for modified atmosphere packaged cheese and cheese-based products.
\nTemperature sensitive networks based on chitosan-poly-(N-isopropylacrylamide) for controlled release were developed by Alvarez-Lorenzo et al. (2005) [111], which can be used in active cheese packaging materials for precise emission of any active component. Films changing their gas permeability in response to degree of temperature and exposure duration may be frequently used during storage and distribution of respiring cheeses like Camembert and Gouda. BreatheWay® membrane technology (Apio Inc., California), based on side chain crystallizable (SCC) polymers provides the solution for gas permeability control according to change in temperature. The change in polymer properties like chain length and side chains can be used for attaining required oxygen and carbon dioxide permeabilities in cheese packages [3].
\nWith the focal point being shifted to consumer convenience, quality and safety, active and intelligent packaging tools may help customers with informed choice. As the world is witnessing increased consumption of cheese, these packaging tools have potential market growth. The expansion of smart packaging technologies in cheese industry remains at a nascent stage. Recent research publications on smart packaging of meat, fish, fruits and vegetables suggest innovative ideas which could be conceptualized for cheese in near future. Smart packaging tools need to be of low cost and multiple benefits. The partnership of active and intelligent packaging can be used to complement each other’s actions. Existing challenges could be overcome by multidisciplinary approaches for the development of smaller, more powerful and cost-effective smart packaging systems. Biotechnology, nanotechnology, food science, sensor technology and information technology could be combined for overcoming the shortcomings. Biosensor and hybrid devices for cheese packaging remains untouched in terms of its development and commercialization. It could be expected that with the continuous advances in intelligent packaging and growing modified atmosphere packaged dairy products market, the demand for such type of intelligent packaging systems is expected to rise.
\nWe are highly thankful to Director, ICAR-National Dairy Research Institute, Karnal for providing the required facilities to carry out the present work.
\nThe authors declare no conflict of interest that might be perceived as affecting the neutrality of the article.
The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.
",metaTitle:"Our story",metaDescription:"The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.",metaKeywords:null,canonicalURL:"/page/our-story",contentRaw:'[{"type":"htmlEditorComponent","content":"We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\\n\\nIn the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\\n\\n2004
\\n\\n2005
\\n\\n2006
\\n\\n2008
\\n\\n2009
\\n\\n2010
\\n\\n2011
\\n\\n2012
\\n\\n2013
\\n\\n2014
\\n\\n2015
\\n\\n2016
\\n\\n2017
\\n\\nWe started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\n\nIn the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\n\n2004
\n\n2005
\n\n2006
\n\n2008
\n\n2009
\n\n2010
\n\n2011
\n\n2012
\n\n2013
\n\n2014
\n\n2015
\n\n2016
\n\n2017
\n\n