\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"469",leadTitle:null,fullTitle:"Carbon Nanotubes - From Research to Applications",title:"Carbon Nanotubes",subtitle:"From Research to Applications",reviewType:"peer-reviewed",abstract:"Since their discovery in 1991, carbon nanotubes have been considered as one of the most promising materials for a wide range of applications, in virtue of their outstanding properties. 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Naraghi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"465",title:"Carbon Nanotubes",subtitle:"Applications on Electron Devices",isOpenForSubmission:!1,hash:null,slug:"carbon-nanotubes-applications-on-electron-devices",bookSignature:"Jose Mauricio Marulanda",coverURL:"https://cdn.intechopen.com/books/images_new/465.jpg",editedByType:"Edited by",editors:[{id:"9142",title:"Prof.",name:"Jose Mauricio",surname:"Marulanda",slug:"jose-mauricio-marulanda",fullName:"Jose Mauricio Marulanda"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"79356",slug:"corrigendum-graves-disea-3",title:"Corrigendum: Graves’ 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\r\n\tCredit risk remains the most important and frequent risk in commercial bank activities. In order to survive in the long-term credit risk management, banks are trying to maintain credit risk exposure within proper and acceptable parameters. However, the lessons learned from the 2008 financial crisis indicated the need for re-evaluation of the credit risk management systems and models that are used by commercial banks.
\r\n\r\n\tThe aim of this book is to cover various aspects of credit risk. First, it intends to present different elements of credit risk, including determinants of credit risk, the causes of credit risk, its advantages and disadvantages, as well as international perspective in terms of credit risk. Furthermore, the book aims to provide today's most up-to-date techniques and models for identification, measurement, monitoring, and controlling credit risk exposure. It will include the analysis of new sophisticated methods for credit risk measurement, information about the newest modeling tools for managing credit risk, assessment of alternative approaches to credit risk modeling, etc. Industry 4.0 technologies can be an important and valuable source of information also for risk management and risk prevention. Therefore chapters related to the information on how Industry 4.0 can help by the credit risk management process are also expected. A special place in the book will be dedicated to the case studies adapted from real-life examples.
\r\n\r\n\tThis book will be useful for bankers and other financial decision-makers as well as for a wide spectrum of academics and practitioners in credit risk.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"ac590597c4f3409f34f96851b19b0c47",bookSignature:"Dr. Michael Murg",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10155.jpg",keywords:"Credit Risk Elements, Credit Risk Determinants, Credit Risk Measurement, New Measurement Frameworks, Quantifying Risk Drivers, Credit Risk Management, Best Practices, Alternative Approaches, Industry 4.0, Internet of Things, Artificial Intelligence",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 7th 2019",dateEndSecondStepPublish:"March 27th 2020",dateEndThirdStepPublish:"May 26th 2020",dateEndFourthStepPublish:"August 14th 2020",dateEndFifthStepPublish:"October 13th 2020",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"313602",title:"Dr.",name:"Michael",middleName:null,surname:"Murg",slug:"michael-murg",fullName:"Michael Murg",profilePictureURL:"https://mts.intechopen.com/storage/users/313602/images/system/313602.jpg",biography:"Dr. Michael Murg is chair of the Institute of Banking and Insurance Industry at FH Joanneum University of Applied Sciences, Austria. He has more than ten years’ experience as a financial advisor for private wealth management and corporate finance and spent several years in the financial industry. Dr. Murg’s scientific career began at the Department of Finance, University of Graz, Austria, where he was a quantitative research scientist and lecturer for finance. He is a licensed exchange trader for spot and derivative markets (XETRA) and was co-founder and the head of Portfolio and Risk Management for a FinTech company before returning to academia.\nDr. Murg’s current research focuses on the digitization of business models in finance, banking and insurance industries, innovation management in insurance companies and banks, digitization of business processes, and data analytics.",institutionString:"Universities of Applied Sciences Joanneum",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Universities of Applied Sciences Joanneum",institutionURL:null,country:{name:"Austria"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"7",title:"Business, Management and Economics",slug:"business-management-and-economics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"252211",firstName:"Sara",lastName:"Debeuc",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/252211/images/7239_n.png",email:"sara.d@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:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"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:"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:"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:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"117",title:"Artificial Neural Networks",subtitle:"Methodological Advances and Biomedical Applications",isOpenForSubmission:!1,hash:null,slug:"artificial-neural-networks-methodological-advances-and-biomedical-applications",bookSignature:"Kenji Suzuki",coverURL:"https://cdn.intechopen.com/books/images_new/117.jpg",editedByType:"Edited by",editors:[{id:"3095",title:"Prof.",name:"Kenji",surname:"Suzuki",slug:"kenji-suzuki",fullName:"Kenji Suzuki"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3569",title:"Biodegradation",subtitle:"Life of Science",isOpenForSubmission:!1,hash:"bb737eb528a53e5106c7e218d5f12ec6",slug:"biodegradation-life-of-science",bookSignature:"Rolando Chamy and Francisca Rosenkranz",coverURL:"https://cdn.intechopen.com/books/images_new/3569.jpg",editedByType:"Edited by",editors:[{id:"165784",title:"Dr.",name:"Rolando",surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"69551",title:"Towards Salutogenetic Birth Space",doi:"10.5772/intechopen.89771",slug:"towards-salutogenetic-birth-space",body:'This text regards the “birth environment” as every space where a woman gives birth, regardless of being a dedicated space such as a maternity hospital or a birth centre or a space temporarily adapted for birth (e.g., home birth), or an environment that was not deliberately chosen for birth (if the birth process surprises a woman and has such a rapid course that she has to give birth in an environment such as in a car). A birth environment consists of a birth space and the people in it. Before the intensive institutionalisation of birth, which peaked in the second half of the twentieth century, women normally gave birth in their home towns, most frequently at home or where contractions caught them. In the (post)modern globalised world, hospitals are perceived as a “normal” birth environment. As they are a predominant and socially desirable choice, they are often also compulsorily chosen as the only possible place for childbirth.
However, several different birth environments are appearing: midwifery units in hospitals and birth centres led by midwives. Home birth has never completely disappeared. This text relates to birth environments in healthcare institutions: both maternity departments in a hospital or autonomous maternity hospitals. We are focusing on a single aspect of the birth environment, the issue of “birth space”. Another aspect is otherwise crucial for the birth process—people—the woman giving birth, her relatives, the newborn, midwife, obstetrician and other medical experts and doulas—since we know that birth space significantly defines their well-being, actions and behaviour. Verbal and non-verbal messages are ideally mutually supporting (congruent) and relate to the messages of the birth space.
Buildings or different environments built and designed by humans—from micro- to macro-level, that is, from an individual residential space to a metropolis—influence health significantly. In the last quarter of the twentieth century, the number of studies of relations between built environments and health increased. The American architect Roslyn Lindheim is among key authors today regarded as one of the founders of interdisciplinary studies of health-related spaces and healthy places, including the hospital environment. In her article “Environments, People, and Health”, published in 1983 and co-authored with S.L. Symen in the Annual Review of Public Health, she emphasised that our health is integrally dependent on two crucial types of bonds: bonds with other people and bonds with our biological and cultural heritage; if these are broken, our health is endangered [1]. With such insights, a new approach to hospital planning began: planning of spaces where ill and injured persons are treated. Contrary to self-evidently perceiving the hospital environment as non-harmful per se, research has shown that this environment either promotes health or influences it adversely and supports treatment, healing, recovery or not. Cooperation between architects, urbanists, psychologists, sociologists, theoreticians, who look at a space in terms of philosophy and cultural studies, and various medical experts has evolved gradually to co-create hospitals that would support health and transform existing buildings from potentially or actually “pathogenic” to more neutral or ideally to “salutogenetic environments”. This transdisciplinary collaboration is essential, because it makes it possible to surpass the (overly) narrow traditional views of key phenomena, birth and space.
If we speak of a directly man-made environment and health, we think of the physical building and the environment it creates, of its psycho-social influence and of meanings of the space, man-made environment and equipment, as perceived/understood by an individual. The space enables certain activities but limits and prevents others and also (to a certain extent) defines how particular activities and a certain physical activity will be performed. The environment influences our well-being and our attitude towards a particular action. To sum up, individual messages of the space span from pathogenetic on the one hand to salutogenetic on the other, but their final effect is more than just a sum of these factors.
Since the beginnings of humanity, an ill or injured man sought shelter for healing; as healing tools and effective medication were scarce, a safe and supportive environment with natural forces that supported healing and recovery processes was especially significant [2]. Every approach to treatment is related to a specific culture and understanding of health, disease, life and transitions such as birth and death. According to historical sources, healing places were planned and designed, for example, in ancient Egypt—we should not forget that the architect Imhotep was also the first known doctor in the world—some temples were renowned healing places. The Egyptologist Franҫois Daumas discovered a sanatorium [3] in a temple, dedicated to the goddess Hator in Dendera in Egypt, while the temple complex in Deir el-Bahari was a place where pilgrims sought health during the Ptolemaic era. In ancient Greece, healing temples or asclepeions were dedicated to Asclepius, the god of medicine, for example, the temple in Epidaurus in the Peloponnese, which is one of the best-known healing places in the ancient world. Their location and architecture supported the healing of the patient.
Whatever is considered a desired property of the healing environment to maintain or restore health and heal injuries also applies to the birth process to a certain extent. The needs of a woman giving birth and the newborn for a safe shelter during birth and immediately after it conform to the needs of a person who requires a safe, calm and beneficial place to overcome a disease. As far as can be ascertained, the women of ancient Egypt, Greece and Rome mostly gave birth in the spaces where they lived their ordinary life and birth only rarely took place in a dedicated space far from home. Some assume that in ancient Egypt, women gave birth on rooftops or perhaps in garden sheds, but it is also possible that they used a special space in their local settlement, which was formed like a pavilion and made from papyrus, decorated with vine leaves [4]. Individual, usually smaller temples were located within temple complexes, dedicated to goddesses of motherhood, fertility, birth and rebirth, where births of deities were worshipped and fertility rituals were performed. The French Egyptologist and linguist Jean-Franҫois Champollion coined a name for them using the Coptic words “mammisi”, which is supposed to mean a birth place; a birth house as referred to in modern literature does not match the meaning of a modern “birth house” or birth centre. The people of ancient Rome also knew them. These are smaller chapels, free-standing or a part of a bigger temple, for example, the one in Dendera or in Edfu in Egypt, built according to Imhotep’s plans; “mammisi” is also a part of the temple in the Egyptian city of Kom Ombo. There are no authentic sources with regards to women actually giving birth there. What is more, women in the late stages of pregnancy and after birth were generally forbidden from entering temples, intended for healing. We barely know any more about the birth environments of common women than that they gave birth in a standing position with other women present, using dedicated accessories such as “birth bricks” [4].
Nowadays, we can relate the findings of studies of the healing environments of the old world, understanding their integration in the culture and spiritual tradition, with scientific insights into ways of designing, building and measuring and transforming “healing environments”. We are establishing the key elements of “healing environments” that very likely contribute to optimising physical, mental, emotional and spiritual healing according to individual patient needs—considering the patient’s different circumstances, cultures and wide spectre of beliefs and approaches to illness and health [2].
We presume that individual environmental elements can be ranged from harmful to those that are physically and mentally safe. The atmosphere of the space influences those who are using it. Environmental elements of spaces for the ill should be inherently salubrious or promote health [2]. Environments should be actively “salutogenetic” or ensure a “positive context” to actions. Due to the complexity of factors that co-create a common message of the space and due to the lack of research in this field, the preparation of common guidelines to design salutogenetic spaces remains unfinished. By reviewing modern findings, we already contribute to considering, analysing and actually (re)designing health-related spaces. Based on the increasing number of findings, we can conclude that the appearance of buildings, our experience of them and their functioning influence our well-being, for example, experiencing stress, because people respond to the environment and are sensitive to it [5]. Studies confirmed the connection between stress and our physical environment, and minimising stress is also one of the key elements that support health. Architects are increasingly including aesthetic aspects to improve hospital spaces and minimise stress and anxiety, increase patient satisfaction and promote health and treatment [2].
Our starting point is the fact that the birth experiences of women are always shaped and characterised by the space where they give birth. Birthing includes complex physiological processes that (only) in certain situations become pathological and require medical interventions; at the same time, birth includes biological, cultural and psychological factors that influence its course and are closely intertwined. The more we understand them and are capable of considering them in forming birth environments, the more they will meet the needs of a woman giving birth. In a transformative process, an individual requires an environment that is as supportive as possible. According to anthropological studies, birth is the culmination of a key life transition of an (usually) adult woman. Due to the liminal status in this process, they are especially sensitive and susceptible for messages from the environment; one level of the process contains information on the birth process and the second contains key messages of the dominant culture about the woman and her role (for more about authoritative knowledge, and the position of mothers and midwives, see [6]). By reviewing the messages of the particular birth space, we can clearly recognise if the woman giving birth has enough freedom and room in the birth room or is she just a passive patient who lies obediently on the bed most of the time?
In the second part of the twentieth century, births are finally moved to a hospital environment, the medicalisation of birth is in full swing and care for the woman giving birth starts to follow the “production line” idea. Examples of routine care were established for uncomplicated births, equal for all—consisting of vaginal examinations at admission and throughout labour, shaving and enema, showering, often inducing or accelerating labour using medications, lying on the delivery bed on the back in the first and second stage of labour, often or even continuous monitoring of the status of the newborn and contractions using a CTG, frequent use of episiotomy and fundal pressure, cutting the umbilical cord right after childbirth and taking care of the newborn away from the mother. Much has been written on such technocratic obstetric care already. The majority of critics of medicalised births criticised the routinely and too frequently used processes and procedures and overconfidence in technology, alerted to the underestimations of women’s labouring abilities, the inferiority of the woman giving birth and the objectivisation of the female body [7, 8]. An analysis of the spatial aspect of perinatal care in such a paradigm indicates a distribution of the birth process between various spaces in the hospital, from the admission room with a dressing room, enema room with toilets and shower, room for the first stage of labour, delivery room for the birth of the child to the post-natal department for mothers and nurseries for newborns. As a result, the woman was treated similarly to an object on a production line, which travels through functionally specialised hospital areas where she was often treated by different experts. The above has resulted in separation of the mother and the newborn immediately after birth in the delivery room and later while staying in the hospital, when the newborn spent time with the mother only at predefined time periods for breastfeeding. The newborn could not make bonds with the father until partners were allowed (sic!) to be present at birth and to make visits at the post-natal department. The described manner of obstetric maternity care and inability to choose a different birth environment from a hospital one in countries with no established birth assistance at home or in birth centres resulted in a forced temporary separation of the female from her partner, her relatives and home. This was maybe of benefit for females who had been experiencing intimate partner violence or other abusive domestic relationships. All others were deprived of the presence, assistance, support and encouragement from their relatives, which is much needed for women giving birth and a great majority of mothers with babies. In short, according to experience, a medicalised birth space negatively affects the behaviour of the woman giving birth and the course of labour; it has iatrogenic effects on the woman giving birth and on the baby.
In the last decades of the twentieth and the beginning of the twenty-first century, this concept is slowly changing and with it birth assistance practices. By merging modern findings of medicine, midwifery, physiology, neuroscience, cultural science and other sciences, the theory and practice of birth assistance are being shaped to focus on the needs of the woman giving birth and the baby. The already established co-habitation of the mother and the newborn is among the more prominent changes in Slovenia—Slovene architect Kristl [9] already researched it in 1981 to transform post-natal hospital spaces—their separation became an anachronism; the importance of skin-to-skin contact right after birth is increasingly recognised and applied in practice together with a sensitive attitude towards the newborn. To achieve this, rooms for newborns required a different status and rooms for women after birth required enough space for a baby bed and appropriate surfaces for baby care. The possibility of the partner’s presence at birth (and with it some open questions on its influence on the labour process, discussed by, e.g., M. Odent) and spatial aspects related to his (presumed) activities also had to be reconsidered. Space for the future father needed to be created literally. Every change in the birth assistance concept also changes the role of medical experts. In this way, the co-habitation of the mother and the baby has changed the activity of the nurse: She took care of the baby in front of the mother, taught her and helped her change nappies. She was also there to help mothers with lactation and breastfeeding issues and questions related to their own health and well-being and that of their baby. These activities were only possible in changed spatial circumstances. This also changed the nature of relationships between the mother and the medical experts.
Considerations on paradigmatic shifts from a technocratic paradigm to a humanistic one and then to a holistic paradigm of birth assistance, conceived by the well-established American cultural anthropologist Davis-Floyd [7], were mainly focused on otherwise important questions related to the choice of an institutional or home environment as the place of birth. Nevertheless, a theoretic approach to the issue of birth environment did not get much attention for a long time despite numerous experiences and insights. To develop a theory of birth space, a profound understanding of the birth process is required, which is summarised below.
An individual experiences the messages of a space in a subjective way; they are always “filtered” by human perception, processing of information and judgement of their meaning [10, 11]. Our subconscious responds to numerous stimuli from the environment most of the time; even if we do not observe it actively, we sense it and respond to it. Our conscious and unconscious abilities to perceive, experience and synthesise numerous messages from the environment and from our interior (ourselves) are crucial for the survival of humanity and man as an individual. We are constantly responding to these messages to survive as organisms, to remain alive as individuals and to continue our species. Both aspects are being condensed during labour for the survival of the woman giving birth and the newborn and to continue the functioning of the biological pattern, which is directed to continue the species.
The experience of the space by the woman giving birth and the personnel in the building and designing modern birth spaces in hospitals has mostly been overlooked until recently or at least not regarded as a priority. This applies to health-related spaces in general and is partly due to the fact that these processes are mostly subconscious.
Examinations of childbirth in humans, the physiology of birth and the biology of a newborn show that these have not changed very much, unlike the circumstances surrounding them that have changed very much in a relatively short period of time (considering the timescale of evolution) [12, 13]. The current prevailing medicalised birth environments in maternity hospitals present a deviation from recognising and considering these rather long-lasting patterns that could be classified into pathogenic birth environments according to their effects on the woman giving birth.
Scientific studies help us find answers to questions concerning the ideal birth environment if we look through the prism of evolution. Studies of births in primates and indigenous people [14] and research into motherhood [15, 16] help us greatly. According to numerous findings, we conclude that female primates (including women) need a natural and well-known “domestic”, non-intimidating and pleasant environment without disturbing elements, for example, related to cultural forms that co-design the everyday life of a certain group and those that are typical for behaviour at birth. For a smooth birth, the female or woman giving birth needs to define the limits of the specified “birth area” to control the “birth territory”, allowing no intrusions. Consequently, she can give birth with all her powers and abilities without any situations that could evoke fear and with it a defensive response, withdrawal or a passive response or “freezing” (fight, flight or freeze response). A spontaneous physiological birth enables a female free movement and actions stimulated by her body; her group is nearby but respects the limits of the birth territory by maintaining an appropriate distance. In contrast to other primates, the thinking brain “silences” the instinctive behaviour of a woman at birth. Some researchers propose that for a smooth course of childbirth, women should give birth in an environment that enables them to activate the neocortex to a lesser degree and act more spontaneously, that is, according to the “primitive mammal brain” [15, 17, 18, 19]. The findings of research on specific behaviours described as “nesting” indirectly confirm its advantages. Nesting was monitored in women in less institutionalised environments such as birth centres [20] but can also be seen in modern planned home births. Research into traditional birth cultures and the practices of indigenous people unveiled some common features: birth usually occurs when accompanied by a known person. Women rarely choose to give birth accompanied by strangers and they usually give birth at home or in their current place of residence; a non-domestic environment is uncommon. If chosen, this is usually an environment that belongs to a close relative or is a special space for female activities in a certain community. A woman usually gives birth in a separate space that is usually protected, for example, divided by a blanket. A woman rarely gives birth outdoors, and companions usually motivate her and support the birth process. A woman is free to move and crouches, kneels or sits while giving birth, often supported by a person who stands or sits behind her. A (normally female) birth expert is mostly present. Females usually form the complete birth support circle [21, 22]. Studies of various birth cultures—of indigenous people as well as a modern medicalised birth—indicated different specific features of individual birth assistance in generic birthing patterns. These features reflect the prevailing beliefs of the woman’s body and its abilities and are based on a specific view of a woman and her social position.
Expert literature on midwifery in popular culture also includes statements on ancient birth practices that idealise pre-medicinal forms of birth assistance and the figure of a lay midwife. These statements should be replaced by critical reflection based on facts. Due to the rapid development of information technology, data acquisition on past and current forms of birth assistance and its circumstances including spatial factors is significantly easier. We can include them in our set of knowledge and skills as part of humanity’s immaterial heritage (or midwifery heritage). These forms of birth assistance need to be studied in terms of wholesomeness and the risks for the mother and child and include them in practical use if they are deemed suitable and effective.
We can summarise that only both factors—well-functioning biological patterns and chosen positive cultural practices and messages—ensure the right circumstances for an optimal physiological birth.
The findings of neuroscience and neurobiology on the complex “game of hormones” including oxytocin, endorphins and catecholamines in a woman giving birth and to a certain extent also in the present midwife explain the significant influence of the environment on the course of childbirth. Simply said: a space has an important role in enabling or inhibiting a physiological birth because of its inhibiting or stimulating effects on the excretion of antagonistic hormones: oxytocin and adrenaline. Homelike and friendly spaces adapted to the woman giving birth trigger “positive” feelings or moods via the parasympathetic nervous system and enable a pulsatory release of oxytocin in the mother’s body. Birth contractions are effective and the body opens. We can mitigate or prevent negative influence on the woman giving birth by understanding which aspects of space trigger or increase stress and cause anxiety, fear and unease, related to adrenaline, and by taking suitable spatial measures according to these findings. The welfare of the woman giving birth is always of prime importance, but other people who use these spaces should also be considered because of their influence on the well-being of the woman giving birth and themselves. A midwife and the partner who feel unwell in a birth space, for example, due to the lack of a comfortable seat or being exposed to strong lights without the possibility to relax, will negatively affect the woman giving birth and the course of childbirth by building up tension and uneasiness.
The quality of the birth environment should be studied in terms of salutogenesis, which means researching it according to the following basic question: does an individual birth environment enable and support a physiological course of childbirth and post-natal period for a woman and a newborn or not or to what extent? Research findings and theoretical considerations on the influence of the birth environment on the woman giving birth and the baby are presented below. Based on them and the presentations of some already proven solutions, we give some proposals on how to create a salutogenetic birth environment that supports the health of the mother and the baby.
The messages of a pathogenetic birth space are as follows: As the woman giving birth you are in a demanding process. It is doubtful whether you can manage it which is why you should lie on the bed and hence the visible appliances to check your condition and that of your baby and to solve complications. There is not enough space beside the bed, centred in a small room that you see for the first time and feel a bit confused, to move at ease and change positions. The floor is uncomfortable for bare feet, the room’s surfaces are metallic and shiny and the walls are white or in intense colours. The space is cold, sterile and clinical. There is no toilet, shower or birthing pool in the delivery room. We need to hurry; the clock is clearly visible. Doors do not protect your private space; the personnel do not knock or wait to enter and slam the door or even keep it open. You can hear loud conversations and debates because there is no special room where the staff could discuss in private. The room has no sound insulation and noise breaks into the room from the hallway; you can hear the voices of other women giving birth, which scares you. You do not dare be loud for fear of affecting other women. When you are on the bed with your legs spread apart, you can be seen directly from the door; there is no privacy. You are not connected to your partner because he is also scared while standing/sitting by your head. You cannot relax because the room is too bright, too cold or too hot and you cannot influence these factors. You are not connected to the midwife because she also takes care of other women giving birth and comes and leaves the room constantly to check on you and your baby and the course of birth. You feel exposed to controlling looks and criticised for your behaviour. The room has no windows or a nice view of nature; it is generally not pleasant. All of this causes frustration, feeds fear, increases stress, prevents the excretion of oxytocin and endorphins and stimulates the excretion of catecholamines. Such factors inhibit physiological birth. The female body can only respond to such an environment as presenting a danger for her, the birth process and her newborn and prepares for defence or withdrawal or becomes unresponsive. The organism chooses the best possible survival response in a given situation. Since a woman cannot escape the delivery room and fight the danger, her defensive mechanisms lower the intensity and frequency of contractions or stop them completely and that disturbs the normal birth process. If the mother’s nervous system interprets the detected messages of the birth environment as dangerous, spontaneous childbirth is significantly more difficult due to these hormonal activities [23].
To summarise, a smooth childbirth is not possible in certain spaces. A medicalised birth space negatively affects the behaviour of the woman giving birth and the course of labour; it has iatrogenic effects on the woman giving birth and on the baby.
Two health-relevant complementary approaches to research health-related environments: (a) quantitative and (b) qualitative. When “health-related places” were conceptualised, quantitative studies prevailed at the beginning, based on studying spatial factors that influence health, such as size, illumination, temperature, noise and the well thought-out distribution of spaces for the efficient movement of medical staff. This means research into physical, quantitatively measurable determinants of spaces and their rational, efficient use, for example, to improve control over infections, to separate clean and unclean paths without crossing etc. Architects use these determinants to design the so-called healthcare evidence-based architecture of hospitals and other healthcare institutions.
To understand the experiencing of hospital spaces, we require qualitative research that highlights how patients experience the building, spaces and interior design according to their need for peace, privacy, positive stimuli and connection with people and nature. Quantitative data turned out to be useful and beneficial for designing birth environments, but if we limit ourselves to such criteria, this is especially inadequate if we wish to establish good birth environments. In contrast to treating a disease or injury, birth is about a woman’s physiological activity that includes extraordinary physical processes, concentrated in a fairly short time period. A woman requires an environment with specific features that will enable birth. A leap to a new quality is only possible by researching how women giving birth experience a space and to what extent it meets their needs and by studying the embodied experiences of women. Using qualitative methods, different ways of how the women giving birth, midwives and companions use an individual birth space and create certain patterns with their movements should be considered in designing new spaces or re-designing the existing ones. Experiences of a space are being explored based on the birth stories of individuals. The experiences of women giving birth with the building and interior design of spaces intended for perinatal care and individual birth rooms are being analysed.
When focusing on the development of qualitative methodological approaches, we need to highlight contributions from female architects who were sensitive to the specific needs of women during birth. Lindheim already recognised the iatrogenic issue, related to the medicalisation of the birth environment. According to the comparable needs of a carefully designed space that protects one’s privacy and also enables close contact with relatives, she paralleled two key life transitions, birth and death. She studied the spatial contexts of birth and explored the attributes of births in hospitals and birth centres and at home [24], significantly influencing “birth design” and also co-operating in changing the circumstances of birth, similar to the Italian architect Bianca Lepori at a later time [25, 26].
More systematic considerations about the influences of the space on birth and initiatives to implement changes to hospitals and similar institutions have only recently received more attention in academic circles. At the turn of the twenty-first century, the birth environment is already becoming the central topic of certain scientific articles and publications with fresh perspectives on the issue of “birth territory” and interesting insights into relationships between the woman giving birth and the designed space [27, 28, 29, 30].
To enhance our understanding of existing birth spaces and clarify the image of those we wish to design in the future, we present a couple of steps from initial studies of birth space to thorough and specifically targeted qualitative research.
Phenomenological studies present an important approach to studying birth space. They highlight the individual experiences of women, midwives and partners from different angles to clarify meanings, attributed by them.
Studying birth experiences is of great help and (also) understood by researchers as characterised by space. Women share their experience and story in questionnaires, detailed, most often semi-structured interviews or testimonies. The English organisation The National Childbirth Trust was among the first that published the significant findings of women’s experiences of hospital birth spaces in 2003 [31]. The analysis of respondents to closed and open questions indicated that women giving birth found it very important: (a) to have control over the illumination and temperature of the space; (b) to have a pleasant and clean, domestic, “non-clinical” space; (c) to have room for movement, walking and enough pillows, bean bags and floor mats; (d) to have the assurance that others cannot hear them; (e) to have an accessible corner with snacks and drinks; (f) to have a birthing pool ready; (g) to have a comfortable chair for their companion and (h) bathroom with shower and bath, which would be a part of the birth space or have simple access to them [31]. The women giving birth also found it important not to be observed, to be able to control who enters the delivery room, not to change spaces during birth—they desired the freedom to do what they feel while giving birth. This report, based on the experiences of women, proved that the physical environment influences the birth experience. It demonstrated how women experienced birth environments and exposed their needs but especially emphasised that one half of respondent women giving birth did not have access to what they desired [31].
The experience of birth and birth space is an embodied experience, which is why researchers based their studies on philosophers, architects and artists who surpassed the Cartesian separation of the body and the mind such as Maurice Merleau-Ponty with the phenomenology of perception [32] and James J. Gibson by studying visual perception. Important “perspective openers” include “poetics of space” by the French philosopher Bachelard [33], “poetics of light” by the artist James Turrell, the concept of the multi-sensory architectural experience by the Finnish architect Pallasmaa [34] and “attunement” by the architect Alberto Pérez-Gómez [35] and the theory of “transcending architecture” by Bermudez [36], among others.
For a broader embrace of these considerations and experiences, the inclusion of interpretative methodology was logical. It includes visual qualitative methods by analysing photographs of delivery rooms, using videos and reflective interviews [37] or using a semiotic analysis of architectural plans and documentation to build and operate maternity departments or maternity hospitals. If such methodology is used in researching birth spaces, for example, exploring light has a substantially different meaning. It is not merely about the suitable illumination of the midwife’s work space and the baby-changing place etc. but about the role of light in the birth process, the understanding that it has an important role in the birth experience. It is about the creative use of “light-colours-darkness, the inseparable trio”, the key factor in forming a birth experience according to the researcher of birth environments Doreen Balabanoff [38].
As it was important to “give voice” to women and their stories in historiography, it is essential to enable women to “occupy” the room and use it. Here, concepts of the “birth territory” have a central role [39]. By observing the activities of the woman giving birth and the midwife in various modern medicalised, institutionalised birth environments and by analysing influences on birth, it was emphasised that the birth space directs certain activities of the woman giving birth and medical staff while hindering, disabling or preventing others [40, 41]. Even if something is not explicitly forbidden, it is practically infeasible. For example, a woman can hardly move in a relaxed manner and take different positions in a very small delivery room where the bed occupies most of the space, its walls have no handles and the metal horizontal surfaces of the furniture are not meant to offer support. The mere message that welcomes a woman who enters the room is clear, even if the staff are silent: “just lay on the bed”, as there is no other space for her anyway.
Research has compared different birth environments and established that women need a relaxed and domestic atmosphere, their own room and freedom of movement [37, 42]. Such spaces are more often designed in birth centres than hospitals. When women described giving birth in birth centres, they said they experienced them “as home”, “an oasis of peace”, “motivating environment”, “a nurturing environment”, where you can “build a nest” [20].
Specific research established, for example, the sub-threshold, subliminal effects of messages of hospital birth environments, which medicalise the understanding of childbirth in women giving birth and render them more passive than otherwise [43]. Research focused primarily on the negative influences of the delivery bed, especially if this is a typical childbirth bed, if it is in the centre of the delivery room and visible directly from the door. The bed became a synonym for hospital births. In their conclusions, researchers proposed a different space organisation to ensure the woman had the best possibilities for movement and changing positions while giving birth [12, 40, 44]. Some researches formed concrete proposals for different ground plans including equipment, for example, moving the bed away from the centre of the room or having a folding bed that can be folded into a closet. Promising proposals also included transferring the bed from the delivery room to another auxiliary space where it is quickly and easily available if the woman giving birth desired to lie down or if needed due to complications [44, 45, 46].
Research into the spontaneous use of the space by the women giving birth in an individual stage of labour, especially where influences of the technocratic paradigm are minimal (e.g., home birth), is very useful. Studies can answer the question if we can define certain typical sequences of movement and physical activities and patterns of positions that should be considered in the planning of birth spaces in institutions.
As we defined at the beginning, the birth environment consists of the physical environment (birth space) and the people who are present at birth. It is characterised by a unique specific understanding of the meaning of private and public space for a woman, her socially desired roles—should she take care of the home and the family and/or be employed, to what extent and how control should be exerted over her as a mother, her behaviour and body. Research into social interactions and the balance of power relations indicates that both home and the delivery room in a maternity hospital are places where a woman could be under control and her decisions would not be autonomous. However, the opposite can also be the case; in both these environments, the woman can have control over the environmental factors and birth assistance too and decide freely. The French philosopher Michel Foucault already alerted to the importance of recognising an institutionalised space as the space that defines specific human relationships and as being shaped by relationships at the same time. A typical example is the structure of a panopticon and its function in economy of controlling people. In the buildings and spaces of medical institutions such as hospitals, traces of power relations that define the place of a patient can be read. We should reconsider the prevailing patterns of social interactions in the spaces of maternity hospitals, birth centres or homes—by changing the environment, equipment and sequence of spaces and locations of various elements and their relations, unsuitable hierarchical relationships can be transformed into more collaborative ones, ensuring a central role for the woman.
Some research has focused on the issue of the production line model applied to modern birth, primarily due to the lack of privacy and feeling of safety, and wishes to bring changes [47]. This can be done by rearranging “typical” delivery rooms in such a way that (a) one room is intended only for one woman giving birth from admission to the end of childbirth or until the departure of the mother with the baby; (b) the personnel knocks and waits for permission to enter; (c) the woman giving birth is not visible from the door: the doors are covered by curtains; the space intended for active birth is not in the field of view, including the bed and the birthing pool and (d) each delivery room has its own bathroom with shower.
As we deviate from the data within a medical-mechanic definition of birth to studying personal birth experiences, besides narrower medical and health-related aspects, categories/terms such as connection with the whole and others as movement, flow, privacy, intimacy, sensuality, interconnection, interlacing of a female and the direct environment, altered states of consciousness, resonance, phenomenological perception and undisturbed excretion of oxytocin that enables the course of birth are also included [48]. These aspects are important for all included in the process of childbirth, and a high-quality birth space should consider them.
Connection with elements of nature is especially significant for a woman giving birth. The findings of studies of natural and built environments in terms of evolution have already brought an understanding of the complex influences of built environments and the designing of healthy spaces [14]. Our emotional and cognitive brain has been shaped by the natural environment as have the brain’s responses to it, which is why we are able to identify natural dangers quickly and reliably, respond appropriately and spontaneously look for environments that are as safe as possible. But we have not yet developed a “system” to identify dangers, “built in” man-made objects and our related defensive mechanisms. A soothing environment for a man still includes contact with nature and natural elements [49], for we are oriented towards life and give priority to impulses from the environment, connected to vivacity, which are therefore also aesthetically pleasing. This is a common human attribute. Intercultural research has shown that our well-being increases when we are in contact with the natural elements—we speak of human “biophilia”, love for nature [50, 51]. What is more, we may claim that a human does not only feel well when in contact with nature, but also nature actually enables and stimulates regeneration. This meaning of the embrace of nature for human existence was summed up by the Slovene architect and urbanist Janko Rožič in an insightful thought: For modern human, it is extremely beneficent to “… descend to nature’s level and blend in with the whole which heals. [52]”, which reminds us that etymologically speaking the word “whole” comes from an Old English “hāl” meaning “healthy, safe”.
For a woman who gives birth physiologically, the sensual experiences of a birth space, enriched with natural elements, for example, the pleasant scents of fresh flowers, natural sounds, the feeling of pleasure as the body immerses into a sufficiently sized bath or birthing pool, a floor mat, pleasant for bare feet, wooden furniture and photographs of nature, will trigger responses that lead to (increased) trust and help her relax.
The woman’s need to create a personal, comfortable, pleasing and safe environment to relax and abandon herself to the birth process is rooted in the biological birth-giving of primates. To give birth, a woman needs to be able to create her own “personal territory”, a limited environment that she can “control” and make decisions about, whether it is in a maternity hospital or birth centre or at home. We cannot take this for granted for all of the above environments. Nevertheless, we might reasonably claim that due to their relative unadaptability, more needs to be done in public hospital-like institutions to transform birth spaces than in birth centres or at home. According to modern findings, the planning of a new maternity hospital or its upgrade must consider and apply designs of the building and its interior with foreseeable and indirectly measurable conscious and subconscious effects, which will ensure positive physiological responses while strengthening their synergy. This also applies to the planning and building of new smaller birth environments, like an autonomous midwifery centre or a midwife maternity ward, which is still waiting for its realisation in the future in some European countries including Slovenia. To respond to the current issue of prevailing hospital births, we need to form smaller birth places. Every birth environment, regardless of whether it is an institution or a home, should become a place of health and emotional security [53].
The majority of women do not require a very structured clinical environment to give birth. If today’s delivery rooms in hospitals were conceived, built and designed within the technocratic paradigm that treated birth as a potentially pathologic event, we need to adapt hospitals to the needs of most women and babies without overlooking the needs of women who experience complications at birth. We need to create such spaces that will enable relaxed movement, not hinder the spontaneous behaviour of women and set minimal limitations for them to connect with their biological and cultural heritage. If we follow the thesis of R. Lindheim, the architect mentioned in the beginning of this chapter, consistently, we may claim that a salutogenetic birth environment enables both connections: expressions of still well-functioning biological birth patterns, supported by thoughtfully chosen positive cultural messages.
According to the nowadays recognised role of hormones required for a smooth course of childbirth, a birth environment needs to be formed, which enables, “allows”, strengthens and stimulates the optimal secretion of natural oxytocin, endorphins as well as adrenaline (but only when a woman really needs it to birth the baby), because they reduce the need of procedures and interventions, carried out by medical staff on female bodies. In every birth environment, the circumstances that hinder a spontaneous course of birth must be identified. The environmental elements that evoke fear, anxiety and prevent relaxation must be changed and transformed for the well-being of the woman. This is why the renovation of birth spaces is definitely not about applying some makeup. An inner transformation is required, which will respond to the needs of women and result in a quality birth environment.
It seems that birth spaces should resemble “spas” or “wellnesses” in being comfortable, pleasant and beautiful, that is, spaces intended for well-being. According to the determined properties of a quality birth space, considerations on hotel-type delivery rooms with a bathroom, birthing pool or bath, atrium, small kitchen and bed where the woman’s partner can also spend the night are in the foreground. In such a space, childbirth takes place from admission of the mother to leaving the hospital with the baby. Continuous care of “one midwife for one woman” (one-to-one midwifery) is easier to implement, at least during her stay in the institution. According to the latest findings, this type of care has several advantages over the usual shared care.
Access to maternity wards within hospitals should be separate from the entrance of patients and visitors of other hospital units and services. In this way, women or couples that come to give birth do not meet the sick or their visitors. By placing a maternity ward next to the hospital building or constructing a completely separate unit (birth centre), we avoid these challenges in a simple but effective manner. All types of birth environments require a carefully and thoughtfully designed access to the building, that is, the transfer from a public area to a half/institutionalised environment.
An ideal birth space should ensure that the course of birth maintains its potential energy intact as much as possible and enable its free flow, so the woman giving birth “adopts” it and actually becomes a driving force of her own birth through her activities and the use of the birth space.
While observing health safety criteria, the appropriate hygienic standards, a suitable logistical connection of multi-purpose spaces etc., a quality birth space also reflects the findings on the experience of the birth space. It makes it possible for the women to experience it as pleasant, domestic, comfortable and beautiful. Atmosphere is important and consists of carefully chosen colours, textures, materials, visual messages, interior design and furniture elements including doors and windows. An informally designed space with a thoughtful ground plan and pleasant corners for activities and rest and for relaxation and refreshment with food and beverages, with ergonomic furnishing, artistic objects, beautiful views, natural materials (stone, clay, wood, cotton, linen, wool etc.), harmonised colours in shades of the earth, sky, water, greenery, using few or no intense saturated colours, with textures that offer visual and haptic pleasures, with soft lights and a pleasant temperature foster a sense of acceptance, familiarity and warmth and create options for a woman giving birth to relax and indulge in the course of birth, accept it in its nature of “ordered chaos”.
Women need a birth environment that expresses compassion, warmth, love and care; such an environment supports her in various emotional states during birth, and it tells her that her needs are accepted and assures her that she will be listened to.
Salutogenetic birth environments enable the dynamic integration of people according to the needs of the woman giving birth: they enable a woman to connect with herself, her feelings and experiences, the baby, her partner, other relatives and the medical staff. Therefore, the possibilities of establishing emotional and physical presence between the (future) parents, the newborn and the mother, father, between the woman giving birth and the midwife need to be ensured. If she needs support, a touch, massage or a hug from her partner or other companion or doula, a salutogenetic space makes this easily possible because it is conceived multi-dimensionally, enabling various possible “uses” and activities. The space sends all involved a message that her loved ones are welcome and that people and their presence and support and assistance have priority over technological solutions and medication whenever possible, which is why medical equipment is “hidden from sight”.
A salutogenetic space is simple and sufficiently spacious; contraptions for an active birth are readily available, deliberately chosen and unobtrusive when not in use and equipment is functional and defines the use of the room as little as possible; the bed is not in the centre of the room or is located in the neighbouring room. The space is not too strictly defined, the bed is hidden and emptiness lets the woman giving birth know that she can move as her body tells her and that she can be active and take a rest and breathe. It should enable various activities and ensure varied uses of spatial elements according to the changing needs of an individual. An individual place in a chosen birth environment allows different uses of equipment and space.
In-depth research findings otherwise indicate common patterns of needs of women giving birth and the newborn, which should serve as a foundation for designing a birth space that should also be simply adaptable to the dynamics of birth. Its openness to adaptations to the specialities of an individual woman (and the newborn) and relationships that are being formed between her and the environment from one moment to the next is essential, and influence birth physiology, experience and results.
Therefore, such birth spaces are required that are designed thoughtfully and in a somewhat restrained fashion. In this way, women can co-shape them according to their current need. Based on these findings, it is not recommended to paint the walls with intense, saturated colours or to install stationary equipment and predefine the location where a woman should give birth. Women can be fully involved in care, which is not routine but individually adaptable. Each woman decides what is most suitable for her [54].
A salutogenetic space by using various sensory channels ensure that the woman giving birth has contact with natural elements such as water, stone, wood, fresh air and natural light and can see plants, animals, for example, birds in the park, the landscape, the sky and weather phenomena such as rain and snow, and allows connection with nature.
A salutogenetic birth space ensures privacy with different options to establish a personal and intimate area; it allows women to temporarily “adopt” it, “control” who enters and what is going on with the space in general. In it, women giving birth regulate heat and light in simple ways; the space has sound insulation. In a salutogenetic birth space, women are not exposed to a controlling look and cannot be observed from the hallway or through openings in doors or the wall. As opposed to a medicalised environment, nothing/no one “regulates” their behaviour or personal expression. A good-quality birth space guarantees that the woman giving birth can maintain her intimate and personal area as much as she needs it. If she or her companions need some extra personal space, they can be present in the space without crossing personal borders.
Due to the extended alienation from basic birth patterns and the related normalisation of medicalised birth assistance, some women require intensified messages to be able to safely let go; a birth environment for a physiological birth should also have a stimulating effect. Usually, it is however already enough that a birth environment enables birth to “happen” and supports processes in the baby, mother and father right after birth; in such cases, stimulation is redundant and disturbs spontaneous processes.
In the attempt to pass into a humanistic paradigm, this space, intended for a special, embodied experience, needs to be specifically designed for a woman to “settle in” and to temporarily adopt it and to think that this is actually doable. We are giving the woman back her voice, body and space. When creative and sensitive architects design a birth space, they bear in mind that a woman giving birth is going through dynamic processes including mental activities and rational decision-making, altered states of consciousness, states of contemplation and mindfulness and various physical activities that are beyond an everyday experience and at times extremely difficult. Using thoughtful spatial design solutions, they create opportunities for the space to resonate emotionally and spiritually with the life-giving process. They are striving to achieve harmony between the space and the woman giving birth. In this way, “woman-centred perinatal care”, one of the key features of the humanistic birth paradigm, embodies itself in the space. A quality birth environment surpasses the existing paradigm of designing hospital spaces, which still includes maternity wards. It is exceptionally important in increasing the chances that women will (more often, frequently) give a normal, physiological birth. In birth spaces meant for high-risk births, additional medical-technical requirements must be observed.
Although it may seem that space is something that is most unalterable, research confirms that the goal of providing a birth space, which enables and supports care that is tailored to an individual woman, is realisable.
The architect Juhani Pallasmaa emphasises that a building guides, measures and frames actions, mutual relationships, sensations and thoughts and that in this sense, basic architectural experiences play the role of verbs [55]. The experiences of modern birth spaces as such should create suitable contexts for childbirth and the processes of the woman connecting with her inner self, with herself and her baby, and outwards with her relatives, medical staff, nature, and beauty; everything should align itself for a smooth childbirth.
The theory of birth space with the emergent architectural language of designing salutogenetic birth spaces is important for raising awareness and informing future designers and planners of birth environments. It should serve as a tool to face architectural challenges. New findings change the perspective of decision makers, medical staff and users. The people who decide on the planning of new birth spaces or renovate existing ones must be acquainted with it.
There is a gap between the possibilities of modern-day birth environments and assured best conditions for a physiological birth and the earliest post-natal period. A salutogenetically designed birth environment supports the holistic health of the woman giving birth, the mother, the baby and the family. When a physiological birth is possible according to the medical condition of the mother and the baby and when a woman desires it and it takes place in salutogenetic birth environments, that is, environments that co-create health, we can look forward to seeing positive short- and long-term medical results of births for women, newborns and families.
The late German sociologist Niklas Luhmann asked in a book published in 1986 about what religion and theology could offer to address the ecologic crises, beyond sheer attitudes of protest and obvious statements about the need to engage for greater care of our natural environment [1]. His view was quite provoking, and it questioned which role religious institutions could play in relationship to great systems, like economy and politics. Indeed, what was at stake concerned the function of religion in advanced societies, and therefore, to what extent religious performance can involve such big issues. Many are convinced that its role is much more modest and restricted to managing uncertainties, or to reduce the excess of complexity. In fact, in Luhmann’s model, religion works somewhat to reduce uncertainty, not to increase it denouncing great dangers and scaring people: the message would be rather “Be quiet, things will adjust with the help of divine providence”.
Obviously, the described starting point is too reductive and ignores the great complexity affecting social system’s relationships, including religion, and other elements that clearly fall upon environmental issues, like values, cultural background, or general beliefs. If we want to tackle the question about the role that religion can play in addressing sustainability issues, then we need absolutely to broaden our vision to include more factors and to raise the complexity level, especially considering a post-secularization state in which religion does not compete with politics and other social spheres but collaborates and becomes better integrated into the social fabric.
Trying to better describe what is understood for sustainability, the present essay follows the broad model coined with the acronym ESG and amply assumed in international organisms: environmental issues; social and equality concern; and governance at organizational level. The idea is to assume a very comprehensive view that encompasses different dimensions involved in ensuring a balanced and better future for all.
In a nutshell, religion is clearly related to sustainability, and the connections are several. For instance, religious bodies are clearly affected by those trends: if our world is not sustainable, neither will be its religious institutions. This general rule finds an exception in those more inspired and motivated by apocalyptic expectations, whose interest is less to assist in sustaining our world, but rather the opposite. But the issue can be seen in a more specific way: in times of strong religious decline, what is at stake is the continuity or sheer survival of religious congregations, which appear for many – in the current conditions – as little sustainable; in fact, even if advanced societies could survive and thrive, churches would sharply decline and even disappear. However, the implication could be more constructive: some religious forms appear as ‘adaptive’ in the sense that they help a population to better adapt to their environmental conditions, something that has happened in the past and can be traced back, integrating well their own environment and building more resilient societies [2]. However, a look to the ample published literature offers a different view: how religious beliefs and values inform and influence attitudes toward the environment. This happens at more levels: theological or reflexive, ethical or practical, and ritual.
If sustainability needs to be seen as a broader concept, and hence not just focused on environmental issues, but as a normative idea embracing social justice or equality as well as good governance, then the application range of religion or its possible contacts and effects will increase, as the concept “integral ecology” might imply. In any case, we need to better determine how these interactions proceed, in both senses: how religion impacts in sustainable policies and at the sociocultural level; and how sustainability as a normative idea influences religious faith and practice in the current conditions and in more concerned cultures. The proposed topic can be studied at several levels. The first one is structural or systemic, since religion can be conceived and analysed as a social sub-system entertaining complex relationship with the whole system and the other sub-systems. The second is more cultural and can make good use of cultural evolution and adaptation theories as a framework, and other studies that highlight the important role that culture plays in social and personal dynamics. The third moves more to the area of personal beliefs and values, or to what can be designed as “the human factor” in sustainability, where religion surely is more salient, and as a factor that could weight strongly in the development of a more sustainable society.
The present article will review the suggested three scenarios where the mutual interactions between religion and sustainability can be better described. The ultimate aim of this short analysis is to better assess religions’ possibilities and limits regarding the high priority and urgency that we recognize to programs for enforcing a sustainable future. The inspiring motive is that sustainability models suggest integration and a holistic view, where every dimension contributes to general stability and wellbeing.
The systemic and structural level is probably the most abstract and hard to describe when trying to analyse how religion interacts with society in a whole and with other social systems to achieve goals related to the sustainability ideal, but it becomes a good guide into such dynamics.
Taking the social systems theory of Niklas Luhmann as a general framework [3] and trying to update and adapt it to new circumstances, we can develop a model that could reveal several hidden dynamics when religion is thought as part of a system aimed at becoming sustainable.
Luhmann never ignored religion as a relevant social sub-system, and he devoted several essays along his fruitful career to dissect the functions that religion could perform in highly differentiated societies [4]. From this broad view, to speak about social systems and sustainability would be a redundancy: indeed, per definition, a social system is an entity that subsists despite the odds and manages to articulate a network of meaningful communications in contrast with its noisy environment. The general idea is that a social system is a living case of social survival, and societies exist since a very early stage of human evolution, but they have evolved too, following a path that moved from more hierarchical to more meshed, differentiated and specialized structures, well ingrained and inter-dependent. It is apparent that that evolution has been positive and helped to better adapt to changing circumstances: a progress arrow can be described. In the developed stage, several sub-systems arise to better address their functional issues, like in the case of economy, politics, science, and others. Religion experiences its own evolution, from providing the description and meaning of the entire system, to be a part dealing with a specific issue: managing the residual contingency, or those problems other systems could not manage or fix. In this schema, religion becomes the ultimate resource for unsolvable or pending issues beyond the reach of economic, political, or scientific intervention [5].
Luhmann’s analysis moved later to still more abstract functions, like dealing with the paradoxes that unavoidably engenders a self-referential social system like ours. In principle, the sustainability of a society depends on some balance between the differentiation process, that leads to a high specialization of each sub-system, and the integration or coordination of such autonomous instances, with their own approach and communication codes. Furthermore, a society is sustainable when it is able to keep a balance with its own environment – not just natural – and its internal functions. Each sub-system needed to contribute in the right way, performing its own function. The schema reserves a place and a role to religion as an instance able to tackle the hardest or ultimate issues through a code that distinguishes between immanence and transcendence, and remits to a transcending dimension what cannot be adjusted in the immanent or immediate reality.
The emergency we try to address under the label of ‘sustainability’ forces us to observe our social systems from a different perspective, even if in continuity with what sociologists like Talcott Parsons and Niklas Luhmann could observe from their systemic gaze. The point is not so much how stable societies are at the present, and how they manage to keep so, but rather, how they can preserve in the future a condition that is now perceived as deeply endangered by several disrupting factors. Even if we managed to survive as integrated societies until now, despite many disasters, plagues, and wars, we can no longer take for granted such resilience, when the current conditions appear as more threatening and climate change is setting a concerning trend, together with other contingencies we do not manage to address.
The new condition puts religion under a rising tension, since the growing uncertainties, or non-manageable risks, increase the pressure on the function that the social systems theory assigned to religion. However, providing hope or even to establish a sharp distinction between this-worldly and other-worldly expectations – the first one doomed and the second one open to be revealed – does help only in a relative way, and clearly reduces the range of religious function when the entire system is in question.
Religions have always played a ‘vicary role’ in many societies, trying to address sectors that were incompletely covered by secular means. In that sense, the idea of ‘residual management’ acquires a new meaning. In fact, Christian churches have engaged many times in supplying material and human resources to cover gaps in the education, health and welfare systems in many societies. It has been a constant provider of such services during the 19th and 20th centuries in many Westers areas, a model later transferred to other societies in worse conditions. Even today, and as the American anthropologist Tanya Luhrmann stated [6], many Churches in America provide assistance to people suffering psychological illnesses and difficulties, and in that way, they help to remedy a shortage in services that cannot be covered by other administrative or social resources of the Welfare State. The point is that religions show a very adaptive flexibility that clearly contributes to fill gaps and to render the entire social system more resilient and sustainable.
The question is: To what extent do evolved religions exhibit this adaptive capacity, and will become useful to address the far greater concerns linked to sustainability? My proposal has been to expand the basic idea of Luhmann’s social systems theory to assume that religion has been vicarious and has always addressed residual problems or has filled empty gaps in the social fabric no other systems were able to fill, or simply inadvertently opened. If this is the case, then, this other great emergency, threatening humanity’s future, will mobilize all the available resources to cope with this risk, not just providing hope, but encouraging practices and pressing to reach more reassuring conditions.
Obviously, it is not easy to compare churches interventions aimed at alleviating educational needs, physical or mental health demands, and other social deficits, and to remedy a state of things that could bring to a general collapse. In the first case, concrete actions are expected in schools, hospitals, and charities; in the present emergency it is less about assisting people in need, and more about changing minds and hearts and to interact with other social systems exerting some pressure or lobbying for sustainable management. Several churches and religions have already adopted such a strategy, at least at the level of their declarations and intentions. It is less clear to what extent these religious bodies could effectively interact with more powerful systems, like economy and politics, to achieve these goals.
A main difficulty can be devised in this context: even if religion can play a vicarious role at filling gaps left in the social fabric, it becomes harder to contrast the own dynamics presiding contemporary standard economy, based on increasing production and conspicuous consumption. In this case, religion does not just provide some remedies, without interfering with other system’s development, but might contrast and even disrupt those same systems which follow a divergent logic. From a systemic point of view, such interferences should lead to new configurations and adaptations in each system, but the problem could subsist and leave open wounds in the social body.
I have mentioned from the beginning that the interaction works as a two-way dynamic: it is not just about how religions contribute to ensure a sustainable future, but how the model of sustainability can influence and help these religious entities. The expectation is that such a model informs and inspires these institutions, and that they assume sustainability as their main goal, for them and for all the society in which they are inserted. That means a special emphasis and a style more sensitive towards the common shared future and a revision of everything from this priority. Religious organizations confront similar – or even worse – scenarios as every other social body, and they need to focus more on something that was quite neglected until recently, since the stability of those organizations was presumed. This shared sense of risk clearly invites to redefine priorities and to adapt the organization to whatever can ensure a viable future.
The suggested perspective should assist in redefining the mission of religious organizations according to the current emergency. The central question is whether withdrawing religion and churches from the equation, things could stay the same or even improve to reach better levels in sustainability rankings. This would be the ultimate test when trying to ascertain the function that religion still plays in societies struggling with several threats and a highly uncertain future. The expectation is that the religious sub-system can assume a greater commitment in this field, and that doing so, it focuses all its resources to contribute to assuring life and stability for next generations, beyond providing transcending hope. The point is that such development could work to reintegrate religion and its function into this new context that demands to all social systems to engage – each one in its own way – in improving the present conditions. Not just religion, but every social sub-system needs to review and update its priorities, functions and performance according to that broad goal: ensuring a sustainable future. That goal will redescribe the social system with its many components or sub-systems, now more encompassed according to the current emergencies. Religion will probably not play a leading role in this new configuration as in earlier times, but it could nevertheless make a difference in dealing with the described challenges. Religion is called to contribute to render a society more sustainable than other society without.
Until now, religion has been described in highly general and abstract terms, avoiding the reference to specific religious traditions. Probably each religion offers its own style and rules to better address the described challenge, and surely some religions will be better endowed than others to assume that task and to tackle those issues. We need to move further to practice this analysis in a more accurate and nuanced way. Some steps have been already done, and several studies have been published focusing on particular religious traditions [7, 8, 9], but more needs to be done in order to better specify the connections between each religious expression and the described agenda, however this work transcends the limits of the present essay.
The second level to examine is the cultural one. Culture plays a central role in inspiring behaviours and it is very flexible and dynamic, changing in the last times at an accelerated pace. It is clear too that cultures are very complex sets of beliefs, values, and views, shared by a population when they reach some critical mass, and providing orientation and legitimation for individuals and groups. Cultural contents and preferences clearly bias not just personal views or judgements, but decisions and attitudes. Regarding sustainability, a sharp distinction can be traced between those cultural configurations that help to address such concerns, and cultures that become ‘counter-adaptive’ or that nourish living styles that become less sustainable. A good example is consumerism as experienced in Western societies [10]; we have in mind a cultural framework nourished by publicity encouraging living styles that threaten the future of the entire planet. Other cultural forms clearly support a more austere attitude or living standards which contribute to a more sustainable society.
The idea that culture plays a big role in motivating more sustainable behaviours by individuals and societies alike invites to explore what can render a culture more fitting and less counter-adaptive, and to discern whether religion can play a role in this area. To the first question, it is apparent that cultural expressions are the result of many elements contributing to create a broadly shared opinion, sensitivity, or to build ‘collective imaginaries’; among them the media take a first position; then perhaps politicians and authorities with some prestige; and – recently – the so-called ‘influencers’. The media continue to be powerful levers in this process, but in the last times, other social media are competing to nourish the cultural milieu and they often reach a critical mass, competing with traditional ones. Media contend with strongly held traditions, with education programs, and with other sources of what is called ‘high culture’. However, culture is not a unique container, but a plural one, and this is still more the case in our times and societies. Nevertheless, we can identify ‘dominant cultures’ and ‘minority cultures’, which often are linked to social minorities with their own codes, symbols, values, and references. A tension grows between different and sometimes competing cultural expressions. Indeed, a vectors field of forces and attractors, like in physics, could be a more proximate representation about how cultures influence and gain more or less sway in a social setting.
Regarding religion, it is broadly assumed that religious beliefs and values are often integrated into a general culture or appear as minority expressions in clear contrast with dominant forms. In the first case, they configure traditions and nourish a mentality that is learned and assumed in less secularized societies, or even leave a rest in local cultures, as an element hard to disentangle from those massive worldviews. But, in other cases, religious culture becomes just a minority expression that challenges several positions in the dominant culture. The described situation could lead even to ‘culture wars’ or big tensions between different and contrasting values and worldviews. The point is that religion usually plays an important role in the cultural field, but this role is obviously more or less powerful depending on the secularization levels in a given society: a very secular context is one in which religious culture plays a very limited role or is unable to define any value; a postsecular one offers new opportunities for religious cultural leverage.
Cultures evolve, as a growing specialized literature reveals [11]. This is just a starting point; it is harder to specify the ways and conditions leading cultural evolution. The easiest approach is to assume the same process that applies in the biological realm: cultures know variations, selection of the fittest, and replication. However, the experts have pointed to many specific traits in cultural evolution that discourage such a model as too simplistic. Indeed, cultural transmission is not just genetic, but it works at more levels, like learning. Useful information is the basic unit in that process, and it can be transmitted in a richer way as does the biological model. At the moment some consensus has been reached that recognizes an equal value to cultural and genetic dynamics in the general process that governs human evolutionary history.
It might seem that I am deviating from our main goal and taking a bypass when trying to highlight the importance of culture in social processes and to better describe the role that religion plays. In reality, this alternative focus is just complementary to the first one exposed above: religion can be observed as a cultural expression assuming all the characteristics we can attribute to such social phenomena. In other words, recognizing to religion the status of a culture means that it interacts in a complex way with other cultural configurations assuming similar functions or capacities.
Back to our main argument, the question is how religion might work as a cultural instance connecting with sustainability demands, or able to encourage sustainable styles and organizations. At least three possibilities arise: convergence between cultural expressions aimed at similar goals; resistance against negative cultural forms; and complementarity, providing inputs that other cultural forms neglect.
The first relevant model points to cultural convergence. In a social configuration where many cultural forms coexist, competition and clash between cultures emerges often, but in other case we can observe cultural cooperation and mutual enrichment. Christian culture could converge in the last couple of centuries in many areas with local and national cultures, and indeed a long historical season has witnessed this dangerous conflation between nationalism and Catholicism or other Christian confessions. Some experiences or attempts have been done trying to join Christian faith and some contemporary political movements, like fascism or communism. We can now judge such attempts as mostly misguided and flawed in their outcomes. In other cases, some Christian cultures – like Catholicism – have moved towards great hostility and concurrence with other expressions, giving place to ‘culture wars’; this was the case with liberalism during the XIX and a good part of 20th century; or socialism later. In many cases, the ideals, values, and expectations of a secular State were seen with suspicion by many Churches. Something similar can be perceived in some expressions of conflict between religious and scientifically inspired cultures in our days. Then some religious cultures could feel in clear contrast with popular cultures exalting narcissism, individualism, and hedonism.
We assist now to a different process, one in which more common ground can be found and explored. In this new development, the urgencies and dangers we foresee constrain us to rather unite forces and to build a more constructive approach able to summon different sensitivities or cultural backgrounds. Sustainability reflects not just a cultural form or a living style, but it represents a call to engage for the goodness and wellbeing of everybody, involving all possible sectors and cultural forms. Many cultural expressions, like living religions, ideologies, or sensitivities can get together under the same flag and contribute from one’s own specific cultural motives to the same cause.
Pope’s Francis last Encyclical
Besides the convergence model, other models come to mind when considering religions as cultural forms. In fact, it is quite usual to advance a model of resistance and contrast. This is characteristic for expressions that have a cause to vindicate or to fight for, and it is associated to protest movements, but it can be expanded to many cultural forms that resist being assimilated to a majority or dominant culture that ignores or even dismisses other views and rights, calling for greater justice, equity and respect for the ‘others.’ Indeed, a part of the standard ESG model that rules in the world of sustainable assessments places emphasis not just on environmental issues, but on social ones, including equity and equality or social justice. The point is that religion as a cultural expression sometimes needs to assume a similar version of resistance and protest, to contrast cultural dominant forms that result in margination, injustice or justifying the powerful and the abuses against those worse off.
Religion as a culture plays both games: converging with cultural expressions engaging in a similar interest to ensure a more sustainable future; and the contrasting game, against cultures that endanger our planet’s equilibrium or that cover injustice and inequality. This ‘double game’ poses the question about the required discernment to find out when a religious body feels more called to engage in one or the other strategy, depending on circumstances and facts – not just ideas.
A third possibility – besides those described – can be added when we take religion as a cultural form: complementarity or implementation of neglected issues. This is a topic that requires further study. At first sight, several issues that appear important for most Christian traditions, like family stability, fecundity or intergenerational concern and engagement, could appear as absent in most agendas dealing with sustainable projects; indeed, they are usually missing in the criteria to value and rank ESG or sustainable levels in organizations and countries. However, the religious point of view, grounded in its own tradition and values, and then in common sense, suggests a set of issues that are very related to any sustainable social setting. Some of them are too obvious: a society without stable families will suffer in their present and future development. Furthermore, if families do not form and people do not want to have children, no sustainable future can be conceived. The point of intergenerational concern is perhaps less obvious, but it plays an important role: if elderly people are left alone or there is no concern for the wellbeing of our grandchildren in a long term, then sustainability becomes an empty program or an unsensitive technical issue, not something human and with a soul.
The described contributions in the last point remind us about a role that religions as cultures can still play, and to the idea, already advanced, which renders religions necessary when thinking on a complex program of sustainability. Possibly without the emphasis religions place on these family issues and others regarding human dignity and care for those in need, we would once more notice big gaps and neglects that other cultural systems are unable to address and fill. Religion as a cultural instance becomes then a fundamental factor, whose absence would result in many gaps and neglects.
We move now to the third level in where the relevance of religion for sustainability programs can become more significant, but now the perspective changes from the structural and cultural level to the personal. For many scholars, religion works more at the individual level, or transferring to that level general or social issues, to deal with them better. In fact, religions are usually big organizations with their own structure, and they need to be integrated into the social fabric, through complex interactions, However, its focus is on the person, its beliefs, values and hopes. I will not discuss now about that thesis – if religion resorts mostly to the individual treatment of perceived problems – but we need to pay attention to how religion becomes relevant at that level when we try to better understand its role or function concerning a sustainable future.
A good approach to the question invites us to consider the important role that beliefs play in our societies and how they determine their future and even the legitimacy of democracy and other social entities. According to several recent studies, believing or holding the right or the wrong beliefs becomes the most sensitive factor in open societies affecting their stability [12, 13]. The impact of beliefs and believing on sustainable systems is more than apparent; many examples come to mind. For instance, when a population sector does not believe the scientific reports pointing to climate change, then we can expect that these people will resist demanding policies aimed at contrasting that dangerous trend. When people do not believe in vaccines, then their resulting attitude could jeopardise efforts at fixing a pandemic.
Beliefs are not just self-generated, but they arise from many inputs, perceptions and data, a process now better-known and studied [14, 15]. Recently the enormous expansion of new media, social networks, and the conspicuous diffusion of fake news using those channels prompt a wave of false beliefs, biases and delusions hard to tackle and to confront with the current means. A big issue in our time and social context is – after recognizing the central role that beliefs play – how to help in forming the right beliefs, those more useful or functional, and to avoid beliefs that become destructive and encourage irresponsibility and deceit.
A recent study has highlighted how the ‘human factor’ is missed in most instruments aimed at measuring and valuing levels of sustainability in organizations, or the most standardized ESG [environmental, social and governance] controls and rankings [16]. Possibly the problem lies in that it becomes much harder to assess such a factor, than measure other technical issues, like carbon emissions, or recycling and waste management, or analysing GINI rankings. This is harder, but not impossible when we count now with more sophisticated polling means, and we access much more data revealing beliefs, moods, and feelings towards issues like environment, equality, or social justice. The point is that any program aimed to establish a more sustainable future should avoid ignoring the sets of beliefs, values and hopes that encourage people to behave in a way or the other, or to support policies that could mean more sacrifices in the short run, but which could repay in the long term and correct disastrous trends.
Religion is about beliefs and believing, but it is not the only system that relies on beliefs. Most – if not all – social systems need for their right functioning that individuals commit to a set of shared beliefs and values: this is evident in politics, economy, and the judiciary system, but it reaches to sciences as well, grounded in a network of deeply shared beliefs and values [17]. Religion is not just a system that needs strong beliefs, sometimes quite counterintuitive and counterfactual, but it is for a long time a system to infuse and educate in the right way to believe, a system to watch over beliefs and tries to correct their most dangerous and negative expressions. Believing is indeed a complex cognitive system that clusters several mental functions, including perceptions, probability estimates, emotions and culture [18, 19]. The critical point is whether religions can assist in forming better, more balanced beliefs, and to encourage beliefs that are functional in order to improve our chances for a sustainable future.
The answer needs to be nuanced. Indeed, a set of lightly held beliefs could make little difference. Recent studies reveal the dynamics that render religious belief and practice effective in the long run, and incisive in practical life [20]. The idea is that religious beliefs per se, without the right training and implementation, could have a very limited effect, when it remains too fuzzy and inarticulate to one’s own living. Beliefs come in degrees and express different levels of strength, which then translate into greater or lesser commitment. If faith is not well supported in rituals and practices, it will eventually fade away, lose strength and fail to motivate sustainable living styles.
Religions may be polyvalent and ambiguous in that respect. We can identify apocalyptic versions that do not care for sustainability, but rather long for a world collapse that might give place to a radically different reality presided by a new divinely imposed order. The question is that many religious forms choose now to encourage beliefs and values that lead their faithful towards greater responsibility in that area. Several studies point to this effort and provide examples on how religious beliefs encourage values aimed at supporting sustainable programs [21, 22, 23, 24, 25]. Religious beliefs need to adjust to these new perceived needs, and in that sense, they evolve to make place to such new perspectives, surely absent in former stages of each religious tradition. In this sense too, the mutual model works in both senses: from and towards religions. Sustainability objectives re-entry in the set of religious held beliefs and values, and become integrated into their own symbolic configuration.
The present study tried to address an initial provocation by one of the greatest theoretical sociologists in the late 20th century: religion would have very little to provide when trying to address ecological challenges, and its sometimes very vocal declarations would add rather little to what other social systems can do without such a redundant voice. The radical question is posed in those terms: Can religious traditions improve things and offer a significant contribution to address these pressing issues? Can advanced secular societies do well without religion, which becomes even embarrassing when trying to tackle with its weak means what requires much more technical and harder intervention?
I have tried to show that religion offers an effective contribution at three levels, even if quite related: the systemic, the cultural, and the human or believing system. This quick review has showed that religion – as in other cases – can play a positive or a negative role with respect to sustainability. It happens too in the studies on religious coping: not every religious form becomes helpful when trying to cope with personal crises and distress; actually, some versions could even worsen the problem. In a similar vein, we can discriminate between religious forms that rather hope for a universal collapse and are happy with the self-destructive trends present in our societies and cultures; and other religious forms that engage in pursuing a sustainability agenda. This is clearly a recent trend that needs to be integrated into the body of very traditionally rooted systems of beliefs and values, and conforming cultural clusters; and it is related to an evolutionary process that requires time and changes to better adapt to current conditions. To some extent, we cannot take for granted the connection this article has tried to establish between religion and sustainability. Probably, the conditions that could favour such a link are in place, and each religion has to decide whether it will adapt to this new context integrating such beliefs and values and contributing to the general effort aimed at ensuring a better future for all; or whether it prefers to stand out and to follow its own way, unaffected by those risks and demands, just trying to be faithful to its old traditions.
In a sketch, religions can exert a positive influence on conforming a more sustainable future, if they engage at the systemic level, interacting in a critical way with other social systems; at a cultural level, nourishing the collectively shared views; and at a personal level, encouraging beliefs and values which become functional. However, this is not taken for granted and every religious tradition must make choices in that regard.
In any case, a last reflection invites to assume a more critical stance in dealing with that proposed link. I am aware of internal secularizing effects in many religious organizations when the attention is displaced from the traditional religious activities, aimed at keeping alive the communication on transcendence, towards ethical or even political issues and activities, which appear as more alluring or flattering in some cultural contexts, like embracing secular causes for peace, justice and the environment. My concern points to the necessity to keep a right balance: only when religion develops in a conscious and improved level its own and proper missions to provide transcendent meaning and hope, it can deliver a good assistance to address, together with many other social instances, the current challenges we go through and to heal what is wounded in our planet, our society and in each person.
The author declares no conflict of interest.
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He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"117248",title:"Dr.",name:"Andrew",middleName:null,surname:"Macnab",slug:"andrew-macnab",fullName:"Andrew Macnab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}}]}},subseries:{item:{id:"10",type:"subseries",title:"Animal Physiology",keywords:"Physiology, Comparative, Evolution, Biomolecules, Organ, Homeostasis, Anatomy, Pathology, Medical, Cell Division, Cell Signaling, Cell Growth, Cell Metabolism, Endocrine, Neuroscience, Cardiovascular, Development, Aging, Development",scope:"Physiology, the scientific study of functions and mechanisms of living systems, is an essential area of research in its own right, but also in relation to medicine and health sciences. The scope of this topic will range from molecular, biochemical, cellular, and physiological processes in all animal species. Work pertaining to the whole organism, organ systems, individual organs and tissues, cells, and biomolecules will be included. Medical, animal, cell, and comparative physiology and allied fields such as anatomy, histology, and pathology with physiology links will be covered in this topic. 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The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
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",coverUrl:"https://cdn.intechopen.com/series_topics/covers/38.jpg",keywords:"Human Activity, Pollutants, Reduced Risks, Population Growth, Waste Disposal, Remediation, Clean Environment"},{id:"41",title:"Water Science",scope:"