\r\n\tRadiation monitoring deals with the sampling and measurement of different products found in different radiation pathways from the environment ending with consumption in humans. Gamma-spectroscopy is the main tool for measurement of these radiations.
\r\n
\r\n\tThe aim of this book is to investigate the radionuclide concentrations in the most consumable food products, air, water and soil. Particularly, it is essential to investigate the radiations level in the surroundings of a nuclear facility.
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1. Introduction
Oxidative stress occurs in the body when the production of oxidants exceeds the antioxidant capacity of the body system and plays a role in the pathogenesis of several chronic diseases such as diabetes, cardiovascular diseases, stroke, and renal failure. Using antioxidants, for instance, vitamin E, vitamin C, and flavanones, can improve antioxidant capacity in the body. Degenerative diseases such as cardiovascular diseases, diabetes, stroke, cancers, and renal disorders are global health problems and it can be predicted that lack of control and attention will involve a lot of costs. Lack of physical activity, nonhealthy diet patterns, and eating salty fast foods are the main causes of these chronic diseases; while change in life style, eating healthy foods like fruits and vegetables can prevent chronic diseases. Herbal extracts and drinks were used to prevent or control diseases from ancient times. Several investigations’ results show that there are several components such as flavanones, isoflavanones, and other antioxidants in herbal components that can improve antioxidants in blood and, so, can prevent chronic diseases. Tea, sesame seed, and burdock root (Arctium lappa L.) are the important and effective herbal components in this regard. Our results in Tabriz University of Medical Sciences showed the effectiveness of herbal components in improving oxidative stress and suppressing the side effects of diabetes, rheumatoid arthritis, and osteoarthritis. The results indicate that total extract of black tea and its fractions can increase antioxidants such as Super Oxide Dismutase (SOD), Glutathione Peroxides (GPX) and total antioxidants and can decrease oxidants like malondialdehyde (MDA). So, these herbal compounds can improve oxidative stress in diabetes rats. In a study by Alipour et al. [1], it has been concluded that injection of total extract and 20% fraction of black tea had positive effect on blood lipid profile in diabetic rats. In one study, using sesame seeds in arthritis improved the antioxidant capacity; therefore, it decreased pain in the mentioned patients. Burdock root, in arthritis patients, improved the antioxidant capacity and decreased the intensity of the pain. It can be concluded that the positive effects of these herbal components are due to the presence of antioxidants. The aim of this chapter is to review the antioxidant capacity of tea, sesame seed, and burdock root, as well as to discuss their biological effects in human beings.
2. Oxidative stress
When the production of free radical moieties exceeds the antioxidant capacity of a cellular system, oxidative stress takes place. Radicals will attack and damage proteins, lipids, and nucleic acids if cellular antioxidants do not remove them. The oxidized or nitrosylated products of free radical attack may decrease biological activity, leading to loss of energy metabolism, cell signaling, transport, and other major functions. These altered products also lead to proteosome degradation and further decrease cellular function, resulting in cell death through necrotic or apoptotic mechanisms [2].
2.1. Background
Free radicals were defined as a Pandora’s Box of evils that may account for cellular damage, mutagenesis, cancer, and, last but not least, the degenerative process of biological aging [3]. Mittal and Murad [4] suggested that the superoxide anion, through its derivative, the hydroxyl radical, stimulates the activation of guanylate-cyclase and formation of the “second messenger” cGMP. Related effects were reported for the superoxide derivative hydrogen peroxide as it was discovered that nitric oxide (NO) has independent role as a regulatory molecule in the control of smooth muscle relaxation and in the inhibition of platelet adhesion [5]. It is recognized that the production of T-cell growth factor and interleukin-2, an immunologically important T-cell protein, is increased in activated T-cells by superoxide anion or low micromolar concentrations of hydrogen peroxide. Studies have shown that the expression of the hemeoxygenase (HO-1) gene is induced by hydrogen peroxide and it has also induction effects on several genes in bacteria, as well as stimulation of the transcription factor nuclear factor κB (NF-κB) in mammalian cells. There is a large amount of proof showing that living organisms have not only adapted to an unfavorable coexistence with free radicals but also have developed mechanisms for the advantageous use of free radicals. The following includes vital physiological functions that involve free radicals or their derivatives: regulation of vascular tone, sensing of oxygen tension and regulation of functions that are controlled by oxygen concentration, improvement of signal transduction from various membrane receptors including the antigen receptor of lymphocytes, and oxidative stress responses that ensure the maintenance of redox homeostasis [5]. In consideration of the role that oxidative stress has been found to play in numerous disease conditions, the field of redox regulation is also receiving growing attention from clinical colleagues. These conditions show the biological significance of redox regulation. The balance between the advantageous and hurtful effects of free radicals is clearly an important aspect of life. The science of biological “redox regulation” is a rapidly growing area of research that has effect on various disciplines including physiology, cell biology, and clinical medicine [5].
2.2. Oxidative stress biomarkers
Oxidative stress biomarkers’ measurement is an important step in order to understand the pathogenesis of and developing treatments for some diseases like diabetes. Measurements of the reduction of antioxidant reserves, changes in the activities of antioxidant enzymes, free radical production, and presence of protein, lipid, and DNA free radical adducts are several methods that may be accepted. As enzyme activities and cellular antioxidants are likely to display transient changes, for the purposes of clinical assessment, measurements of end products of free radical attack may be the most reliable determination of the occurrence of oxidative stress. An indication of the stress level experienced in a cell or tissue can be provided by the enzymes responsible for detoxifying free radicals or regenerating antioxidant molecules and they can be measured by in vitro activity assays; however, changes in transcription can also provide evidence of cell stress. For example in long-term diabetes, catalase, GSH reductase, GSH peroxidase, and SOD decrease in complication-prone tissue [2].
2.3. Plasma markers of oxidative stress
The body\'s total antioxidant capacity functions in order to protect cells from excess production of reactive oxygen/nitrogen species (RONS) [6]. Antioxidant capacity includes endogenous (e.g. uric acid, superoxide dismutase, catalase, glutathione peroxidase) and exogenous (e.g., carotenoids, tocopherols, ascorbate, bioflavonoids) compounds. The exogenous antioxidants are consumed in the diet mainly from fruits and vegetables [7]. Dietary habits can alter an individual’s susceptibility to oxidative damage since these exogenous compounds contribute to antioxidant capacity.
Oxidative stress can be defined by formation of RONS that exceed the body’s antioxidant capacity [8]. Cellular metabolism as well as environmental (e.g., cigarette smoke, ozone, certain nutrients) and physiological (e.g., physical and mental stress) challenges can form RONS in the body. Cellular harms and disease generation that may accompany oxidative stress are related to those macromolecules (nucleic acid, protein, and lipid) that are targeted by RONS, the frequency and duration of attack, and the tissue-specific antioxidant defenses present [9]. For instance, RONS reacting with DNA can create wide strand breakage and degradation of deoxyribose, an effect caused by formation of hydroxyl radicals [10]. Over time such changes may lead to disease because of the alterations in nucleotide roots. The presence of 8-hydroxydeoxyguanosine (8-OHdG), an irregular intermediate in nucleotide metabolism, in urine and blood shows oxidative DNA damage. Biomarkers of protein oxidation represent amino acid modifications such as phenylalanine residues alteration to o-tyrosine or tyrosine to dityrosine, as well as overall modifications such as the alteration to carbonyl derivatives. Aromatic and sulfllydryl-containing residues are chiefly vulnerable to oxidation, often causing loss of catalytic or structural function in the affected proteins, makeing them susceptible to proteolytic degradation [11]. Proteins oxidation has been associated with disease like cancer, diabetes, and cardiovascular disease [12]. Lipid peroxidation has been recognized as a main mechanism of cellular damage in humans along with DNA and protein oxidation [13]. Polyunsaturated lipids are mainly vulnerable to damage in an oxidizing environment and may make lipid peroxides that can react to form malondialdehyde (MDA). MDA that can be measured in plasma is regularly used to estimate lipid-specific oxidative stress [14]. While MDA has been a practical indicator of oxidative stress for clinical studies [15], other lipid biomarkers, such as F2-isoprostanes, have gained agreement in recent years [16].
2.4. Oxidative stress and disease
Oxidative stress plays a role in several pathophysiologic conditions, for example, malignant diseases, diabetes, atherosclerosis, chronic inflammation, human immunodeficiency virus (HIV) infection, ischemia reperfusion injury, and sleep apnea. These diseases are divided into two types. In the first type, diabetes mellitus and cancer display a pro-oxidative shift in the systemic thiol/disulfide redox state and impaired glucose clearance, proposing that skeletal muscle mitochondria may be the major site of elevated reactive oxygen species (ROS) creation. These conditions may be referred to as “mitochondrial oxidative stress,” which, without healing intervention may lead to massive skeletal muscle wasting, indicative of aging-related wasting. The second type refers to “inflammatory oxidative conditions,” because it is usually associated with stimulation of NAD(P)H,H+ oxidase activity by cytokines or other agents. In this case, changes in intracellular glutathione levels or increased ROS levels are often associated with pathological changes revealing a disregulation of signal cascades and/or gene expression, demonstrated by altered expression of cell adhesion molecules [5].
2.5. Oxidative stress and antioxidants
Several free radical species are produced in the body to carry out specific functions. O2-, H2O2, and NO are three free radical reactive oxygen species (ROS) that are crucial for body physiology. However, they can accelerate the process of aging, mediate cellular degeneration in disease states, and produce highly active singlet oxygen, hydroxyl radicals, and peroxy-nitrite that can attack proteins, lipids, and DNA. Antioxidants by donating at least one hydrogen atom to a free radical can result in the termination of radical chain reactions. Extra production of free radicals can cause oxidative stress. Acute hyperglycemic episodes such as an oral glucose tolerance test or a meal can increase oxidative stress in diabetic patients and decrease the antioxidant ability of plasma in both normal and diabetic subjects. Elevated basal levels of free radical production and decreased antioxidants are strengthened by elevated plasma glucose. Analysis of individual vitamin and enzyme components of the antioxidant system in man shows that the levels of vitamins A and E and catalase activity are decreased in both type 1 and 2 patients compared with controls. Whereas GSH-metabolizing enzymes are decreased in type 1 but not type 2 patients, SOD activity is lower in type 2 but not type 1 [2].
3. Antioxidants
3.1. Definition
Antioxidants are defined as any compound that can donate at least one hydrogen atom to a free radical so that it can result in the termination of radical chain reactions. A substitute type of antioxidant is defined by its ability to prevent the initiation of a free radical chain reaction rather than to terminate them. This latter type of antioxidant includes ceruloplasmin, transferrin, and albumin that are usually dependent upon the ability to bind metal ions. Cells must preserve the levels of antioxidants, often defined as antioxidant potential, through dietary uptake or de novo synthesis. Excess production of free radicals can reduce the intracellular antioxidants, resulting in oxidative stress [2].
3.2. Classification
Ingold [17] classified all antioxidants into two groups, namely primary or chain-breaking antioxidants, and secondary or preventive antioxidants.
3.2.1. Primary or chain-breaking antioxidants
Primary antioxidants can react with lipid radicals to convert them to more stable products. The major lipid radical at normal oxygen pressures is the alkylperoxy radical ROO, which is an oxidizing agent and is readily reduced to the related anion and then converted to a hydroperoxide by an electron donor, or which may be directly converted to a hydroperoxide by a hydrogen donor, AH. Alkyl radicals are in general reducing agents and are scavenged by electron acceptors. Inhibition by electron acceptors is not significant in most food systems, but it can become important in biological tissues since the oxygen pressure is much lower in healthy tissues.
3.2.2. Secondary or preventive antioxidants
Secondary antioxidants are the compounds which decelerate the degree of autoxidation of lipids by processes other than that of interrupting the autoxidation chain by changing free radicals to more stable species. These may function by several mechanisms including compounds that bind metal ions, scavenge oxygen, decompose hydroperoxide to non-radical species, absorb UV radiation, or deactivate singlet oxygen. Secondary antioxidants show antioxidant activity if a second minor component exists in the sample.
4. Natural antioxidants in foods
Reports in recent years both in the popular and scientific press have stressed the value and advantages of natural ingredients as food preservatives. There is an implied assumption of safety for compounds that occur naturally in foods and that have been consumed for many centuries. Natural antioxidants in foods may be from (a) endogenous compounds in one or more components of the food; (b) substances formed from reactions during processing; and (c) food additives isolated from natural sources.
Natural antioxidants may function in one or more of the following ways: (a) as reducing agents, (b) as free radical scavengers, (c) as complex of pro-oxidant metals, and (d) as quenchers of the formation of singlet oxygen. The compounds are most commonly phenolic or polyphenolic from plants sources. The most common natural antioxidants are flavonoids (flavanols, isoflavones, flavones, catechins, and flavanones), cinnamic acid derivatives, coumarins, tocopherols, and polyfunctional organic acids [18].
4.1. Tea antioxidants and oxidative stress
Tea (from the plant Camellia sinensis), consumed by over two-thirds of the world’s population, is the most desirable beverage next to water. About three billion kilograms of tea are produced and consumed annually [19-21]. Thease are the enzymes in tea which catalyze oxidation. During fermentation in which tea pectins are demethylated, polyphenolic compounds are decomposed which as a result of the quinone appearance, turn into colorful agents including theaflavin and thearubigin, both of which are plentiful in black tea [22-24]. More than 600 volatile agents have been documented in tea, most of which are yellow in color and have a characteristic scent. Linalool is the chief essence in tea, others of lesser importance being dihydroactinide iolido paravinile phenol, hexenol, hexenal, aldehydes, phenyl ethyl alcohols, phenols, and geraniols [22]. According to the preparation method, the degree to which it is fermented and the steps it goes through during production, different types of tea consumed all over the world are classified into at least six categories. The less processed the tea, the greater the polyphenols content will be, which the extent of oxidation accounts for [25].
White tea: White tea is manufactured only from the buds or first leaves of C. sinensis. It is the least processed type of tea and is simply steamed and dried without a prior withering stage; therefore, the concentrations of EGCG and also methylxanthines (like caffeine) are enriched in white tea compared with green and black tea.
Yellow tea: It usually refers to a special tea processed in a similar way to green tea; but the drying process takes place at a slower rate. The damp tea leaves are allowed to sit and yellow. Its taste resembles that of green and white teas.
Green tea: To manufacture green tea, first the fresh leaves are steamed, then primary drying-rolling, rolling, and secondary drying-rolling, final drying-rolling, and at last drying are performed. No fermentation takes place in this type of tea.
Oolong tea: Fresh leaves undergo solar withering at the first step, then indoor withering and rolling, pan firing, rolling, mass breaking and drying are the steps taken, to produce oolong tea. In this kind of tea, partial fermentation occurs after the rolling.
Black tea: The manufacturing process for black tea includes withering of fresh leaves, rolling, fermenting, and drying. Thorough fermentation is done in black tea.
Pu-Erh: Pu-Erh reffers to old tea with extreme fermentation [22, 25-27].
Regular intake of tea is associated with low risk of certain types of cancer, coronary heart disease, atherosclerosis, stroke, reduced mutagenicity and inflammation, protection against neurodegenerative diseases, and increasing insulin sensitivity since it can improve antioxidant status in vivo conditions [28,29]. Tea is a great source of antioxidants especially flavonoids. Animal studies have strongly supported the idea of tea being an efficient suppressor of oxidative stress [30]. Several studies have shown that different types of tea are potentially effective in reducing oxidative stress and related diseases [31]. Attempts have been made to manufacture products containing tea bioactive compounds for prevention and treatment of the aforementioned diseases. To design such products, the effective compounds of tea and their safe doses must be first identified. For instance, EGCG (Epicatechingallate) has been revealed to act as a pro-oxidant when administered in high doses, leading to apoptosis. Moreover, compounds other than catechins may exert the desired effects too [32-34]. To determine the compounds acting as antioxidants in black tea, Alipour et al., in 2009 [35] performed a study in which diabetic rats were supplemented total extract of black tea and its fractions. Total extract and fractions were attained by hydromethanol method and solid phase extraction using Sep-Pak, respectively. Results of this study indicated that injection of total extract and 20% fraction of black tea decreased malondialdehyde (MDA) and increased total antioxidant, Super oxide Dismutase (SOD), Glutathione Peroxides (GPX), and Glutathione in diabetic rats. To determine the major substances in the 20% fraction, Analytical HPLC, Preparative HPLC (High Performance Liquid Chromatography), and NMR (Nuclear Magnetic Resonance) (CNMR and HNMR) were employed. Caffeine, EpicatechinGallate, Quercetin, and Kampferol were the main compounds capable of fighting oxidative stress, determined in 20% fraction of tea [31]. Caffeine is a strong antioxidant; its activity is equal to that of glutathione and exceeding that of vitamin C [36,37]. The free radical scavenging capacity of flavonoids is due to the 3\', 4\' dihydroxyl and 3\' hydroxy in the β ring of its structure [38]. The 20% fraction of black tea has been shown to be more effective than the other fractions, which may be explained by the high concentration of the aforementioned compounds in it and absence of polyphenol antagonists in the very extract prepared [35]. Tea polyphenols have been found to induce expression of phase II enzymes and endogenous antioxidants that protect cells from oxidative stress. Phase II enzymes have vital antioxidant properties in fighting reactive oxygen species and xenobiotics (foreign substances), including potential carcinogens. Induction of phase II detoxifying and antioxidant enzymes is mediated through cis-regulatory DNA sequences known as antioxidant-response elements (AREs) that are found in the promoter or enhancer region of the gene. The major ARE transcription factor nuclear factor E2-related factor 2 (Nrf2) is a key agent in the initiation of antioxidant and detoxifying enzymes, such as heme oxygenase-1 (HO-1), glutathione S-transferases (GSTs), and reduced nicotinamide adenine dinucleotide phosphate:quinone oxidoreductase [39]. Nrf2 binds to Kelch-like ECH-associated protein 1 (Keap1) under nonstressed conditions. Keap1 in complex with cullin3, Rocl, and E2 proteins provides ubiquitination followed by proteasomal degradation. When oxidative stress occurs, oxidation of Keap1 leads to inability to bind Nrf2 protein by forming intramolecular disulfide bonds. Then, Nrf2 migrates into the nucleus and binds a protein of Maf family (like sMaf) and CBP/p. This complex is formed on ARE promoter region of certain genes leading to transcription activation. Phosphorylation of by protein kinases which may be activated by oxidants is one way to provide Nrf2 migration in nucleus [40].
4.2. Sesame and oxidative stress
In recent years, there has been a growing attention paid to natural antioxidants of plants and their use is gaining importance as nutraceuticals and phytoceuticals as they have significant effect on the status of human health and disease prevention [41]. For thousands of years sesame (Sesamum indicum L.) is an important traditional health food that has been used to improve nutritional status and prevent various diseases in Asian countries. The results of several studies support the hypothesis that sesame seed and its lignans may have antioxidant and hypo-cholesterolemic effects [42-45]. Alipour et al. in 2012 [46] showed that sesame seed supplementation decreased serum TC, LDL-C, and lipid peroxidation, and increased antioxidant status in hyperlipidemic patients. A positive effect of sesame seed was seen in improving lipid profile and oxidative stress in patients with knee OA, indicating that sesame seed might be of help to reduce oxidative stress in OA patients [47]. Sesame seeds are not only rich in oil and protein, but also in lignans (e.g., sesamin and sesamolin) [48] especially phenolic lignans such as sesamol. Antioxidant effects of lignans were shown in former studies [49,50]. Furthermore, it is obvious that diets containing polyphenols and flavonoids increase catalase and SOD activity, decrease MDA and improve lipid profile [51,52]. Nakai et al. [52] revealed that sesame metabolism by CYP450 in liver results in inversion of methylene dioxyphenyl to dihydrophenyl (strong radical scavenger). Previously, scientific evidence has showed the fact that protective effects of sesame seed are because of the suppression of oxygen species production [53]. Moreover, sesame lignans have an ability to increase vitamin E levels in various tissues [54,55] and increase gamma-tocopherol levels that could lead to the suppression of different free radicals (those that usually increase in age-related diseases) [56]. In a study on fifty patients with knee OA, supplementation with sesame seed improved clinical signs and symptoms and indicated that sesame might be a viable adjunctive therapy in treating OA [57]. Epidemiological studies have shown that high HDL-cholesterol concentration could potentially contribute to its anti-atherogenic properties, including its ability to inhibit LDL-oxidation and protect endothelial cells from the cytotoxic effects of oxidized LDL [58]. Presently, sesame seed powder administration has shown to elevate HDL-C levels in hypercholesteremic animals [59]. Several studies reported that high antioxidant properties of sesame seed appear to be related to its lignans- sesamol, sesamolinol, pinoresinol, and sesaminol [60-64], as well as vitamin E [65]. The tocopherol of sesame seed has been shown to be mainly y-tocopherol, with only less amounts of a-tocopherol [66]. In addition, Kahae et al. [67] indicated that γ -tocopherol in sesame seed exerts vitamin E activity equal to that of α-tocopherol through a synergistic interaction with sesame seed lignans. These compounds also have inhibitory effects on membrane lipid peroxidation, the microsomal peroxidation induced by ADP-Fe3+/NADPH [61], and the oxidation of LDL induced by copper ions [64].
4.3. Burdock and oxidative stress
The examination of burdock (Arctium lappa L.) protective effects on oxidation of low-density lipoprotein (LDL) and nitric oxide production showed that methanolic extracts of burdock (MEB) and their major components, chlorogenic acid (CHA) and caffeic acid (CA), have antioxidant effects against oxidative damages. For many decades in Taiwan and Japan, burdock (Arctium lappa L.) has been consumed as a vegetable and beverage. Furthermore, burdock is also used as a folk medicine, such as a diuretic and antipyretic [68]. Analyses of its components [69], investigation of desmutagenic effect, and hepatoprotective efficacy [70] have been described. Chen (2004) [68] finds that burdock has significant free radical scavenging activity, which was mainly attributed to chlorogenicacid (CHA) and caffeic acid (CA). Duh in 1998 [71] presented that burdock, with or without heat treatment, acts as a primary and secondary antioxidant, as well as active oxygen scavenger. In addition, burdock displayed potential inhibitory action on microbial growth [72]. Although burdock showed the biological activity mentioned above, whether it has any protective effects on biomolecules and nitric oxide production remains uncertain. The protective activities of CA and CHA on LDL oxidation and nitric oxide production have been established [73,74]. Several reports showed that oxidatively damaged LDL as an atherogenic agent is clearly a main risk factor for cardiovascular disease. Thus, the bioactive activity of MEB on LDL oxidation and nitric oxide production needed to be examined. MEB inhibited oxidation of phospholipid, protein and deoxyribose, which are components of the cells. So, MEB can protect cells and tissues against oxidative damage. CA and CHA, which were major compounds present in MEB [69], showed notable inhibitory effect on oxidative damage of liposome, deoxyribose, and protein. Maghsoumi et al. in 2014 [75] suggested that Arctium lappa L. root tea improves inflammatory status and oxidative stress in patients with knee osteoarthritis.
4.4. Lentil and oxidative stress
Several studies have shown that legumes consumption has many effects in health improvement, control, and protection against metabolic diseases such as type 2 diabetes and CVDs [76]. Lentils (Lens culinaris), the most consumed legume grains, are good sources of dietary fiber, resistant starch, tannins, β-glucan, functional antioxidant ingredients, a wide range of phenolic acids including gallic acid, proanthcyanidins, prodelphinidin, procyanidins, catechins, epicatechin, kampferol, quercetin, cinapic acid, and apigenin [77]. Lentil contains about 28% protein on a dry weight basis [78]. The effects of lentil sprouts (LS) on glycemic parameters are associated with its fiber content. The fiber content of lentil seed is 3.7 g per 100 g; lentil seed also has low glycemic index (21/2). After germination of the lentil seeds, the amount of fiber and protein are increased [79]. The enzymatic hydrolysis of lentil proteins have resulted in bile salts binding activity and the production of hydrolysates with ACE-inhibitory activity [80, 81]. Furthermore, it has been recognized that specific fragments from legumin, vicilin, and convicilin with amino acid sequences contribute to the antioxidant and ACE-inhibitory activity of lentil hydrolysates [82]. Epidemiological studies recommend that lentils through biological activities including antioxidant, anticancer, angiotensin I-converting enzyme inhibition, reducing blood lipid, and reducing the risk of cardiovascular diseases, confer protection against chronic diseases [83,84]. Studies show that bioactive proteins of lentil decrease plasma levels of LDL-C, triglyceride content of the liver, and adipose tissue lipoprotein lipase activity; moreover, polyphenols of lentil could prevent angiotensin II-induced hypertension, and pathological changes including vascular remodeling and vascular fibrosis [85,86]. Lentils have a higher oxygen radical absorbing capacity (ORCA) value than most of the common fruits and vegetables [87]. In a study by Aslani et al. in 2014 [88], effects of lentil sprout (LS) consumption on glycemic parameters and anthropometric measurements in overweight and obese patients with type 2 diabetes were investigated. They found that LS consumption could have favorable effects on glycemic control in overweight and obese patients with type 2 diabetes. They showed that consumption of LS as supplementary treatment in type 2 diabetes could have favorable effects on HbA1c (Glycated hemoglobin), FBS (fasting blood glucose), QUICKI (quantitative insulin sensitivity check index), and HOMA-IR (homeostasis model assessment- Insulin resistance).
5. Biological effects of food antioxidants
The human organism, like that of animals, is oxygen-dependent. This suggests that oxygen, essential for life, works through a succession of mechanisms which indeed have their limits and their side effects. The survival of the species means that biochemical protection systems have developed in parallel with that promoting oxygen utilization. More generally, it may be considered that oxidation involves loss of one or more electrons that is of negative electric charges [89]. However, more complex oxidation reactions occur, with the production of toxic radicals, which, in the absence of antioxidant mechanisms, would soon destroy the vital elements of the cell [90]. The accumulation of hydroperoxides, for instance, requires the intervention of catalase, tocopherol, selenium, or reduced glutathione and its conversion enzymes; their deficiency would promptly lead to an attack on membranes [91,92]. The multiplicity of in- vivo cellular reaction allowing aerobic life to develop implies extremely active binding as well as exchanges of oxygen molecules with other radicals. Whereas some of these metabolic sequences require radicals interacting with reactive oxygen the synthesis of prostaglandins, the metabolism of molecules with quinone structures, or the activity of macrophages, for instance these radicals may also be at the origin of chain reactions eliciting deleterious effects at the level of cell particles. The survival of tissues requires in turn that other molecules either terminate oxidative chain reactions or scavenge the excess of the generated free radicals [89].
6. Conclusion and future trends
There is now an agreement among scientists regarding the effect of uncontrolled oxygen radicals in the deterioration of health. Oxidative stress has been showed to play an important role in initiation and progression of disease. Thus, to prevent the very consequences of oxidative stress, it seems logical to take the necessary steps to reduce it. Antioxidants have been reported to be effective in achieving this goal. Some of these antioxidants are flavanols, isoflavones, flavones, catechins, flavanones and probiotics which are assessed for treatment and/or prevention of diseases such as diabetes [18, 93-97]. Routine methods for the determination of oxidation and peroxidation levels further need to be developed. It is recommended that well-designed, controlled clinical trials be done taking into account all the factors affecting the oxidative status of the patients and using sensitive and specific indicators of oxidative stress. By analyzing the results of studies, several nutritional factors that are effective in reducing oxidative stress markers should be recognized in order to be used as functional foods and supplements for controlling oxidative stress.
\n',keywords:"antioxidants, food, natural compounds, oxidative stress",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/48813.pdf",chapterXML:"https://mts.intechopen.com/source/xml/48813.xml",downloadPdfUrl:"/chapter/pdf-download/48813",previewPdfUrl:"/chapter/pdf-preview/48813",totalDownloads:1730,totalViews:330,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,impactScore:0,impactScorePercentile:1,impactScoreQuartile:1,hasAltmetrics:0,dateSubmitted:"October 11th 2014",dateReviewed:"May 13th 2015",datePrePublished:null,datePublished:"November 11th 2015",dateFinished:"July 27th 2015",readingETA:"0",abstract:"Oxidative stress happens in body when the production of oxidants exceeds the antioxidant capacity of body system and plays a role in pathogenesis of several chronic diseases such as diabetes, cardiovascular diseases, stock, and renal failure. Tea, sesame seed, and burdock root (Arctium lappa L.) may improve oxidative stress and suppress the side effects of diabetes, rheumatoid arthritis and osteoarthritis. Total extract of black tea and its fractions can increase antioxidants such as Super oxide Dismotase (SOD), Glutathione Peroxides (GPX) and total antioxidants and can decrease oxidants like malondialdehyde (MDA). So, these herbal compounds can improve oxidative stress in diabetes rats. The injection of total extract and 20% fraction of black tea had positive effect on blood lipid profile in diabetic rats. Sesame seeds improved the antioxidants capacity in arthritis; therefore, decreased pain. Burdock root, in arthritis patients improved the antioxidants capacity and decreased the intensity of the pain. It can be concluded that the positive effects of these herbal components are due to the presence of antioxidants. The aim of this chapter is to review the antioxidant capacity of tea, sesame seed, and burdock root as well as to discuss their biological effects in human being.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/48813",risUrl:"/chapter/ris/48813",book:{id:"4597",slug:"basic-principles-and-clinical-significance-of-oxidative-stress"},signatures:"Davood Maleki, Aziz Homayouni Rad, Leila Khalili and Baitullah\nAlipour",authors:[{id:"53877",title:"Dr.",name:"Aziz",middleName:null,surname:"Homayouni Rad",fullName:"Aziz Homayouni Rad",slug:"aziz-homayouni-rad",email:"Homayounia@tbzmed.ac.ir",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/53877/images/4276_n.jpeg",institution:{name:"Tabriz University of Medical Sciences",institutionURL:null,country:{name:"Iran"}}},{id:"91984",title:"Dr.",name:"Baitullah",middleName:null,surname:"Alipoor",fullName:"Baitullah Alipoor",slug:"baitullah-alipoor",email:"balipoor@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Tabriz University of Medical Sciences",institutionURL:null,country:{name:"Iran"}}},{id:"174038",title:"Ms.",name:"Leila",middleName:null,surname:"Khalili",fullName:"Leila Khalili",slug:"leila-khalili",email:"saye_beautygirl@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"174039",title:"Dr.",name:"Davood",middleName:null,surname:"Maleki",fullName:"Davood Maleki",slug:"davood-maleki",email:"davood.maleki@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Oxidative stress",level:"1"},{id:"sec_2_2",title:"2.1. Background",level:"2"},{id:"sec_3_2",title:"2.2. Oxidative stress biomarkers",level:"2"},{id:"sec_4_2",title:"2.3. Plasma markers of oxidative stress",level:"2"},{id:"sec_5_2",title:"2.4. Oxidative stress and disease",level:"2"},{id:"sec_6_2",title:"2.5. Oxidative stress and antioxidants",level:"2"},{id:"sec_8",title:"3. Antioxidants",level:"1"},{id:"sec_8_2",title:"3.1. Definition",level:"2"},{id:"sec_9_2",title:"3.2. Classification",level:"2"},{id:"sec_9_3",title:"3.2.1. Primary or chain-breaking antioxidants",level:"3"},{id:"sec_10_3",title:"3.2.2. Secondary or preventive antioxidants",level:"3"},{id:"sec_13",title:"4. Natural antioxidants in foods",level:"1"},{id:"sec_13_2",title:"4.1. Tea antioxidants and oxidative stress",level:"2"},{id:"sec_14_2",title:"4.2. Sesame and oxidative stress",level:"2"},{id:"sec_15_2",title:"4.3. Burdock and oxidative stress",level:"2"},{id:"sec_16_2",title:"4.4. Lentil and oxidative stress",level:"2"},{id:"sec_18",title:"5. Biological effects of food antioxidants",level:"1"},{id:"sec_19",title:"6. Conclusion and future trends",level:"1"}],chapterReferences:[{id:"B1",body:'Alipour B.A., Ostad Rahimi A.R., Delazar A., Mesgari M., Asnaashari S., Vatankhah A.M., Alipour Azhiri S., Safaeian A.A.R. The effect of total extract and its different hydromethanol fractions of Iranian black orthodox tea on blood lipid profile in type 1 diabetic rats. Med J Tabriz Univ Med Sci; 2008. p83-87.'},{id:"B2",body:'Vincent A.M., Russell J.W., Low P., EVA L. Feldman E.L. Oxidative stress in the pathogenesis of Diabetic Neuropathy. Endocr Rev; 2003. p612-628.'},{id:"B3",body:'Harman D. Aging: A theory based on free radical and radiation chemistry. J Gerontol; 1956. p298-300.'},{id:"B4",body:"Mittal C.K., Murad F. 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Life Science; 2000. p161-171.'},{id:"B65",body:'Lemcke-Norojarvi M., Kamal-Eldin A., Appelqvist L.-A., Dimberg L.H., Ohrvall M., Vessby B. Corn and sesame oils increase serum g-tocopherol concentrations in healthy Swedish women. J Nutri; 2001. p1195-1201.'},{id:"B66",body:'Fukuda Y., Osawa T., Namiki M., Ozaki T. Studies on antioxidative substances in sesame seed. Agric Biol Chem; 1985. p301-306.'},{id:"B67",body:'Kahae Yamashita, YÃoeÃoeKoohhara, KÃoeMikokatayama,MitsÃoeOnamiki. Sesame seed lignans and y-tocopherol act synergistically to produce vitamin E activity in rats. Nutrition, 1992. P2440-2446.'},{id:"B68",body:'Chen F.A., Wu A.B., Chen C.Y. The influence of different treatment on the free radical scavenging activity of burdock and variations of its active components. Food Chem; 2004. p479-484.'},{id:"B69",body:'Fuchigami M., Kishigami Y., & Sasaki A. Pectic polysaccharides in edible burdock root. J Home Econ Japan; 1990. p947-962.'},{id:"B70",body:'Lin S.C., Lin C.H., Lin C.C., Lin Y.H., Chem C.F., Chem I.C., et al. Hepatoprotective effects of ArctiumlappaLinne on liver injuries induced by chronic ethanol consumption and potentiated by carbon tetrachloride tetrachloride. J Biomed Sci; 2002. p401-409.'},{id:"B71",body:'Duh P.D. Antioxidant activity of burdock (ArctiumlappaLinne): Its scavenging effect on free-radical and active oxygen. J Am Oil Chem Soc; 1998. p455-461.'},{id:"B72",body:'Chow L.W., Wang S.J., Duh P.D. Antibacterial activity of burdock (ArctiumlappaLinne). Food Sci; 1997. p195-202.'},{id:"B73",body:'Dinis T.C., Santosa C.L., Almeida L.M. The apoprotein is the preferential target for peroxynitrite-induced LDL damage protection by dietary phenolic acids. Free Radic Res; 2002. p531-543.'},{id:"B74",body:'Soliman K.F., Mazzio E.A. In vitro attenuation of nitric oxide production in C6 astrocyte cell culture by various dietary compounds. 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Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition; 2014. p430-435.'},{id:"B95",body:'Homayouni A., Payahoo L., Azizi A. Effects of probiotics on lipid profile: A review. Am J Food Technol; 2012. p251-265. '},{id:"B96",body:'Homayouni A., Amini A., Khodavirdivand Keshtiban A., Mortazavian A., Esazadeh K., Pourmoradian Samira. Resistant starch in food industry: A changing outlook for consumer and producer. Starch/Stärke; 2013. p1-13.'},{id:"B97",body:'Homayouni Rad A. Therapeutical effects of functional probiotic, prebiotic and synbiotic foods. Tabriz Univ Med Sci; 2008.'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Davood Maleki",address:null,affiliation:'
Hematology and Oncology ward, Urmia University of Medical Science, Urmia, Iran
Department of Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, I.R, Iran
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1. Introduction
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Children of parents with a mental illness face childhoods that can be full of challenging experiences, threatening their quality of life, development and long-term outcomes [1, 2, 3, 4]. However, these children are not an officially recognised group in the UK, and data and statistics are not gathered about them. While UK policies recognise the needs of young carers, they do not address the specific challenges experienced by children whose parents have a mental illness. This is not the case in other countries; in Australia, these children are officially known as children of parents with mental illness (COPMI) and as “young relatives” in most Nordic countries. Children of parents with a mental illness remain a hidden group in the UK, and many are reluctant to identify as young carers due to the shame and stigma often associated with mental illness, making them vulnerable and at risk of neglect.
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The UK Children’s Commissioner Vulnerability Report (2018) found that in an average classroom, eight children have a parent with mental health problems—this is the equivalent to 25% of the UK school population [3]. In 2018, Our Time, a UK charity that advocates for and offers support to this group did an analysis of the existing data (supported by a team from Ernst and Young), which found that in excess of 3.4 million children and young people in the UK are currently living with a parent with a mental illness [5]. Further evidence indicates that, without support, 70% of these children are likely to go on to develop mental health problems themselves. With two ill parents, there is a 30–50% chance of the child developing a serious mental illness later in life [6]. A WHO review stated: “Children with a parent who has a mental illness or substance use disorder are placed at high risk of experiencing family discord and psychiatric problems. The intergenerational transfer of mental disorder is the result of interactions between genetic, biological and social risk factors occurring as early as pregnancy and infancy” [7, 8].
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In Germany, where Our Time’s partners, the “KidsTime Netzwerk”, use the KidsTime Workshop model to support children and families, research has identified 3.8 million children affected by parental mental illness [9].
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1.1 Summary of key facts and statistics
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In excess of 3 million children in the UK live with a parent with a mental health issue.
Average of 8 children in an average classroom will be in this situation.
20–25% of the school population.
70% likely to develop a mental health condition.
Parental mental illness is one of the 10 adverse childhood experiences (ACEs), which has a lifetime impact on both physical and mental health.
Parental mental illness (PMI) is a root cause of many other ACEs.
WHO identifies PMI as one of the most important public health issues of our generation.
Intervention late after the onset of an ACE is less likely to be effective. Rising thresholds for acute support are exacerbated by significant reductions in early intervention spending by local authorities.
By focusing on clinically diagnosable mental illnesses, the children and adolescent service (CAMHS) interventions are too late to address ACEs.
In 2018 the Children’s Commissioner reported that despite the new provisions in law, 4 in 5 young carers were not identified.
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Research into adverse childhood experiences, known as ACEs [10], identifies parental mental illness as one of the ten most powerful sources of toxic stress in young people. The presence of mental illness in a parent is known to negatively impact a child’s cognitive and language development, educational achievement and social, emotional and behavioural development [2, 3, 4, 10]. It can lead to anxiety and guilt coming from a sense of personal responsibility. Where there is severe mental illness in a parent and no second parent who is well it can lead to neglect or abuse. These children are also at greater risk of bullying, a lower standard of living and financial hardship [2, 3, 4, 5, 9].
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Figures 1 and 2 show the lifetime impact of adverse childhood experiences affecting the mental and physical health of the individual as a result of toxic stress.
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Figure 1.
The ACE pyramid (Centers for Disease Control and Prevention, cdc.gov).
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Figure 2.
Long-term effects of ACEs (Centers for Disease Control and Prevention, cdc.gov).
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1.2 A hidden risk
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The hidden status of these young people in the UK means that they have no statutory entitlement to specific support related to parental mental illness. Provision of formal, organised support or targeted intervention is therefore at the discretion of local funding bodies or entirely dependent on the voluntary sector. Any informal support is dependent on the awareness and understanding of professionals coming into contact with these children to identify and support their needs. However, this sometimes requires stepping outside of the remit of current practice and expertise, adding an additional “burden” to already high workloads. Additionally, many professionals report worrying about talking to children in this situation, as they are concerned about “saying the wrong thing” or “making the situation worse”. Social service providers are dominated by risk concerns and are therefore reluctant to intervene in this area, which means that low intensity, early help is not commissioned. Despite these challenges, there are things that can be done to help children in this situation, enabling them to thrive, despite their adversity. There is evidence to suggest that relatively simple and low-cost interventions can build protective factors and the resilience of children and young people affected by parental mental illness, reducing their risk of harm and of developing problems themselves in later life [2, 11].
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This chapter will explain the impact of parental mental illness on children and the associated risk factors. We will provide examples of approaches proven to help children in this situation, using the KidsTime model as a case study. We will describe the approaches and methods of this practice model and explain how a combination of family therapy and systemic therapy approaches, together with drama, can create an effective multi-family therapy intervention. We will provide evidence of the impact of the KidsTime model and highlight some of the barriers to securing investment for preventative approaches. The chapter will conclude with recommendations for practice.
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2. Parental mental illness (PMI) and its impact on children and young people
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This section outlines some of the common difficulties experienced by children and young people who have a parent with a mental illness. These include but are not limited to:
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2.1 Parental emotional availability and its impact on the child-parent relationship
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Research, using case studies and personal testimonies, depict the kinds of difficulties experienced by children and young people growing up in a family where there is a parent with a mental illness. For example, it is common for children, particularly younger children, to report experiencing the same symptoms as their parents, i.e., symptoms caused by the parent’s diagnosis, such as delusions [12]. explains this can be due to the parent’s illness limiting their emotional availability to their child. Both symptoms of the illness and side-effects of the medication can result in emotional withdrawal from the child, which the child typically perceives as rejection. The child therefore intensifies his or her attempts to achieve closeness with the parent, which may cause the parent to withdraw further. Not only does this create a vicious cycle of interaction between the parent and the child, but these attempts can expose the child to further risk, such as the distress of being drawn into the parent’s psychopathological symptoms that are not their own. This is particularly likely in the absence of a sufficient explanation of the parent’s mental illness that could enable the child to differentiate between behaviours caused by the illness and those that are not [12, 13].
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2.2 Burden of caring roles and responsibilities on young people
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The experience of living with a parent who has a mental illness often means that the child or young person often adopts caring roles in their family, which are not age-appropriate. They may fill any gaps in their parent’s role, which the parent is not consistently able to fill themselves due to their illness. This is the case both when the parent is markedly unwell and thus genuinely less able and also when the parent is able, but the child has become used to fulfilling this role or does so in anticipation of the parent’s next period of illness. The young person may care for their parent and other family members practically, through assuming responsibility for structuring the daily life of the family, fulfilling siblings’ needs or household tasks, but also emotionally, in that their mind is occupied by issues related to their parent’s wellbeing [12, 13]. These children also experience frequent role reversal, as they help their parent manage symptoms of their mental illness, such as emotional distress or behavioural difficulties. This often leads to parentification and loss of focus on the child’s needs by both the affected parent and the child themselves [9, 14].
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The long-term impact of such experiences can be that children in this situation gradually form a view of the adults around them as having limited capabilities and therefore do not trust or expect adults to meet their needs. The responsibilities they believe they must fulfil themselves are a large burden for a young person to carry. These young people will often experience feelings of guilt in taking over the parent’s role and inadequacy, while trying, and inevitably failing, to navigate such unrealistic responsibilities. This can also negatively impact their own self-esteem and sense of self-efficacy, and they may start to question their capabilities in other spheres of their life, which also has an adverse effect on their wellbeing. This combination of taking responsibility for others and worrying that they are not up to it is often carried into later life and causes hidden stress and sometimes prevents them from fulfilling their full potential [14, 15].
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2.3 Shame and stigma
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Children of parents with a mental illness and their families suffer from the shame and stigma surrounding mental illness in multiple ways [9, 14, 16]. It hinders communication about mental illness and emotions more generally within the family. It also hinders communication and the development of supportive bonds outside of the family, i.e., with extended family, community and other social networks. This leads to feelings of isolation and withdrawal from social interaction [9, 14]. As a result, many children of parents with a mental illness feel very different to their peers:
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“Well, all of last week I wasn’t in (school), because I was ill. I think, sometimes, my friends might think that I’ve been avoiding them, or bullies might think they have affected me so much that I’m not coming to school anymore.” (Young boy, KidsTime Workshop)
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“So, it’s nice to finally meet people that know how it feels, especially, like in school, barely anybody would have the same situation, but when I come to KidsTime, there’s all these people around me that have similar situations to my family and me.” (Teenage girl, KidsTime Workshop)
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Such shame, stigma and isolation, combined with children’s imagination, means many of these children live with damaging fears and/or misconceptions about mental illness. For example, they fear they will “catch” their parent’s illness, that they are predetermined to developing it themselves, or that they caused the illness or its symptoms [15, 16]. The shame, stigma, fear and isolation further decrease the likelihood that they will ask for help, advice or information that would reassure them and enable them to make sense of their situation and develop strategies for coping with it.
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3. Protective factors
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The KidsTime model is built on three principles in its work with children and families affected by parental mental illness and will be described in more detail in the next section [2, 11].
Having a good explanation
Having a trusted adult to talk to
Knowing you are not alone
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3.1 The importance of a good explanation
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Many children affected by parental mental illness report receiving little or no information or explanation about their parent’s illness. Even at the point of hospitalisation, only ~1 in 3 young people receive any information about their parent’s situation [17]. Not having an explanation or not understanding what is happening can be an unsettling experience in itself. However, young people who have been given an explanation often identify this as a key factor in helping them to cope with their situation. Receiving an explanation about their parent’s mental illness could make a significant difference in helping affected children to feel more in control of their situation. It could also mitigate the impact or even prevent the development of frightening misconceptions about mental illness and the confusion and self-blame many young people feel about the origins of the illness and its symptoms. This would enable children to differentiate between their parent’s “ill” and “non-ill” behaviours and thus also decrease the likelihood of adopting any of these behaviours themselves [13]. Having a good explanation is one of three protective factors identified by international research as key in building resilience for children whose parent/s have a mental illness.
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There is a lack of specialist support for children affected by parental mental illness in the UK. These children may cross paths with multiple services, such as health services, children’s social care, schools or professionals directly involved in their parent’s psychiatric or social care. However, these professionals do not have the awareness or understanding of the unique experiences of children living with, or caring for, a parent with mental health issues and also often lack confidence in speaking to children about mental illness. The negative impact of this is twofold: Firstly, it reinforces these young people’s disillusionment with adults as protective or supportive figures. Secondly, these young carers remain under the radar and are therefore unlikely to receive a satisfactory explanation or helpful support. However, the potential harm and many of the risks associated with having a parent with a mental illness can be addressed by training adults to provide good, child-friendly explanations and appropriate support, which increase the protective factors and develop the child’s resilience, examples of which will be given in the following sections.
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4. Specialist intervention: the KidsTime Workshops
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Adverse childhood experiences (ACE) have recently become the focus of research and public discourse. However, despite its official recognition as an ACE, parental mental illness has been somewhat overlooked in this debate, and there is no recognition or provision for children affected by parental mental illness in England.
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Our Time is a UK charity that was set up to advocate on behalf of this group through raising awareness of the issue and developing specific support through the KidsTime Workshop approach, which has been adopted across the UK, Germany and Spain. These are multi-family support groups that combine systemic family therapy approaches, drama and play to provide families with the three protective factors outlined above. There are currently 12 KidsTime Workshops operational in England, supporting up to 250 children and their families.
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5. The KidsTime model
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KidsTime Workshops take place once a month, after school, for ~2.5 h, and are run by a multidisciplinary team of at least three members of staff. The model requires the following critical staff members:
Clinical Lead, with a clinical background working in mental health services (often a psychiatrist or clinical psychologist or family therapist)
Drama Lead, who has experience in creative and drama-led group work with children
Logistical Lead/Coordinator, responsible for managing referrals, engaging and supporting families to attend the workshop and logistics (venue, equipment, transportation, etc.)
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5.1 Workshop structure
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5.1.1 Seminar (adults and children together)
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The group begins with all staff and families, (typically 6–10 families per workshop), coming together for a playful activity, followed by a seminar-style session that explores a single topic related to (parental) mental illness. The Clinical Lead facilitates this session using informal discussion and playful activities. Importantly, the particular topic will have been identified by the families themselves as something they want to discuss, for example, what to do in a crisis.
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The KidsTime Workshops have developed a model for explaining mental illness to children. Explanations are provided by the Clinical Lead, which is relevant to the seminar topic (i.e., not at every workshop). The Clinical Lead will employ visual aids and clear, simple and child-friendly language to describe how the brain works and how it can become “overloaded” as well as other aspects of mental illness (e.g., side-effects of medication) without being a diagnosis specific. An example of this can be seen in the videos, “What does it mean to have a parent with a mental illness?” and, for younger children, “Making sense of mental illness”, available on the Our Time website: www.ourtime.org.uk.
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5.1.2 Group work (adults and children separate)
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After the seminar, the families separate into two groups, one for adults and the other for children, which run in parallel for 1 h. The children’s group is facilitated by the Drama Lead. It starts with group games to help the children relax and focus, followed by drama work during which the young people create, rehearse, perform, and film a dramatic scene. The drama content will often be related to the seminar topic, but it is important that the children are free to set and interpret the topic themselves. The drama allows the children and young people to address issues of interest or concern without having to expose their own personal situation, giving them a voice and a way to explore different perspectives and reactions to difficult family issues.
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The adult group consists of the parents or carers (sometimes guardians, grandparents or close relatives), with or without a mental illness, and explores their experiences of being a parent with a mental illness or supporting the family in which this is the issue, sometimes using the seminar topic as a starting point. The discussion is facilitated by the Clinical Lead who ensures that the experiences and needs of the children are a central focus. The adult group provides an opportunity for parents to talk more openly about their own experience and the challenges of parenting with a mental illness in a non-judgemental environment and to receive support and encouragement from one another.
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5.1.3 Community time and reflection (adults and children together)
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The children, parents and staff reunite after their respective groups for 30–45 min. First, everyone takes a break and shares food together (traditionally pizza because the children like it and it is easy to prepare). Then, everyone watches the film of the young people’s drama, which leads to a collective group discussion about what the drama communicates and what insights the children and young people have demonstrated in their dramatisation. The parents contribute to the discussion by sharing a summary of their group discussion and their own reflections from watching the drama.
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While the KidsTime Workshop model draws on some therapeutic methods and techniques, KidsTime is not designed as a form of therapy, but it is therapeutic in its effects. The design aims to create a community where the families can safely share their experience and knowledge and are listened to and able to ask the questions they need to ask without fear of judgement or having solutions imposed on them. The aim is to provide information, support and some relief to the families through a social intervention, while children and their needs remain the focus. Cooklin et al. state that an explicitly therapeutic intervention directed at the children may lead to the child seriously misjudging their predicament and adding to the sense that they (the child) are the problem and encourage further mistrust in adults [16] because they are not taken seriously. Firstly, the offer of therapy to the child may be falsely perceived as confirmation that they, like their parents, are going to develop a mental illness. Secondly, as these children will often adopt responsibilities beyond their years, in nature and volume, there is a risk that the child or young person would conclude that they are somehow failing to solve the problem or feel dismissed and undermined, if treated as a passive recipient of therapy. Therefore, the approach of professionals should aspire to take the role of an understanding, friend/mentor or relative rather than the formal and inevitably hierarchical role in which a therapist may be perceived.
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“KidsTime has helped myself and my son to learn about my mental health, together. There’s a great understanding of how they can help us, how they can help myself, my child, and, also, it’s a place that you are accepted to have mental health (problems) and it not be a stigma. For the first time you can openly talk about any of your issues and concerns.” (Mother, KidsTime)
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“Because it’s somewhere where you can go to be with somebody that you know understands how you feel, and they might have the same situation too, and they just cheer you up, so it’s a great place to go. Sometimes your parents are on medication or there is something wrong, so this just is a place to come to to calm you down.” (Young boy, KidsTime)
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6. Key approaches
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This section outlines some of the key approaches employed by the KidsTime model to achieve the desired protective factors, particularly and uniquely, an age-appropriate explanation of mental illness, its treatments and impact.
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6.1 Systemic influences
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The model views and encourages families to appreciate the systemic contributors to experiences; that the experience of each individual in the family results from their relationships with other members of the family; and what their feelings and thoughts about these relationships are. Based on this, the individual forms their view of themselves and perceptions of others. Bringing the whole family together to think about their situation and find ways of managing their lives in the context of the illness is one of the innovative and most powerful aspects of the model.
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The KidsTime model recognises and aims to counter the potentially damaging effect of parental mental illness on the quality of social interactions within the family and with the wider social environment and support networks (other families and services, etc.) including social care providers, teachers and even the school. It aims to do so through facilitating communication between family members, with the focus of helping them understand the role of each person and the impact of parental mental illness on them. The model aims to promote social ties and trust between family members, neighbours and the general social world within which the family is located.
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In general, families develop different patterns of internal communication and sharing of experiences. In families affected by parental mental illness, there is often little or no communication about the mental illness, due to shame and stigma, and a lack of understanding about mental illness [15, 16]. KidsTime Workshops aim to combat this stigma and social withdrawal by encouraging families to speak more freely about mental illness and finding creative ways to make this easier. Adapted systemic therapy methods, such as sculpture work, are used to help families visualise relationships and patterns of communication; this facilitates mutual reflection and discussion in the group helping them to identify their current patterns and how to develop healthier ones [18].
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“My daughter, she was very quiet. She would sit in her room all the time and now, because of KidsTime, we can have half an hour to 45 minutes family time, and ask, “How has your day been?” and we can get a nice polite answer (from her). If anything does affect her, she can open up and get it off her chest, and if we can help, we can help.” (Father, KidsTime)
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While the effect of parental mental illness on the children is the overarching focus of the parent and children’s groups within the KidsTime model, parents’ reactions to the impact of their illness are also actively discussed and considered. This results in children communicating their experiences to, and receiving feedback from, their family and the wider group (and vice versa), leading to a multi-systemic perspective rather than one-direction linear communication. This also leads to group interactions in which everyone is considered on the same level and equally able to contribute to discussion, thereby recognising the young people’s knowledge and experience and the roles they perform within family life.
\n
Also consistent with systemic approaches, the KidsTime model puts special emphasis on recognising and promoting families’ capabilities. Families are respected as autonomous, self-organising systems and capable experts in their own situation. Within this, particular efforts are made to appreciate the young people’s knowledge and expertise in their parent’s mental health. Indeed, young carers will often notice signs of crisis or decline in their parents far earlier than the parent themselves or professionals. However, for a number of reasons that can be very frustrating and damaging for the child, this expertise is often invalidated in their interactions with the adults around them. Children and young people express frustration that they are often the closest observer of the parent and have responsibilities beyond their years and yet are not consulted, listened to, and frequently talked over by professionals. This combination of shouldering adult responsibility and being treated as a child who has no information or insight is particularly difficult and leads to mistrust and resignation on the child’s behalf, adding to the notion that they are on their own with the problem and that adults cannot be relied upon, which leads to hyper-independence. The KidsTime model aims to be realistic about the different family situations and challenges and to support and empower affected young people within their roles to develop appropriate coping strategies that will help them to understand and manage their own situation rather than “fixing” the problem for them and importantly knowing what to do in a time of crisis and developing a network of people to whom they can turn to for help when they notice that their parent’s mental health is deteriorating. This means that awareness raising and the education of professionals is a key factor in supporting these children and young people.
\n
\n
\n
6.2 Multi-family work
\n
Multi-family work is based on systemic approaches; it aims to combine the benefits of single-family therapy with group therapy while still encouraging the agency of all individuals participating.
\n
The coming together of families in similar situations has multiple benefits, particularly when the shared experiences are as stigmatised and hidden as those related to parental mental illness. It enables affected families to discuss mental health issues without one child, parent or family feeling exposed, judged or different. It is also crucial that facilitators do not single anyone out. The KidsTime Workshop model encourages openness and reflection, and, through conversations about mental illness and common experiences, it reduces the often-associated stigma and shame-induced isolation. Unlike in the outside world, at KidsTime, the individuals and families are no longer the odd ones out:
\n\n
“Since we’ve been coming here for a year and a half they (the children) get to see other children with parents with mental health (problems), and there’s other families in same situation, so they don’t feel so alone, because, I think, before, they thought our family was really strange. They’ve seen other people the same as us.” (Mother, KidsTime)
\n\n
Multi-family work, in this context, is intended to enable solidarity and a sense of community between families, a sense that “we are all in this together”. The individual family is viewed as part of the wider system of multiple families—a system that all families contribute to and benefit from. The families build a social network and mutually support each other. One of the most powerful ways in which this happens is the socialising and exchanging of experiences, ideas and advice facilitated by the multi-family model. In the KidsTime Workshop, families use each other as resources. Sharing in a multi-family group means they learn from each other’s experiences and perspectives and are empowered to make changes themselves. In this sense, the multi-family model is intended to contribute towards helping families to help themselves; it allows individual parents and children to hear both positive and corrective responses from other adults and children, which may be both more acceptable and meaningful than comments from professionals [16, 18].
\n
Actively involving families in discussion of similar problems in other families strengthens the self-esteem and agency of all involved. When experiencing difficulties, people tend to develop rigid and narrow ways of problem solving but are still often able to offer useful ideas to others in similar situations. Drawing on the expertise and experiences of families in similar situations leads to families viewing themselves more positively, as more capable. This strengthens self-esteem and the family’s sense of agency and for the adults, in particular, a sense of pride as capable parents. In turn, this may enable families to become more resourceful and creative in finding solutions for their own difficulties [18]. Thus, the group becomes more powerful than any single therapist.
\n
\n
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6.3 Drama work
\n
Methods of creative therapy and drama work are powerful tools in creating a playful attitude and a relaxed, light-hearted atmosphere. This facilitates young people to have fun and foster positive relationships with each other and their families. It is within this type of setting that the young people are able to relax and to engage with drama as a powerful, therapeutic tool in the ways outlined below. Children of parents with a mental illness are often highly anxious and stressed, and the drama and games, first and foremost, allow them to forget their worries and just have fun, to be a child and to be able to play like a child, free from the burden of looking out for their parents, because they are safe in the parent’s group.
\n
In the young people’s group, playful exercises are combined with devising and acting out fictional scenes together. Designing the content of these dramas acts as a channel of free expression for fear, anger and anxiety or other difficult emotions that a young carer may struggle to access and express in daily life. The invention of fictional characters also means children can choose to play out different perspectives and new narratives—ideals of who they want to be. This encourages optimism and gives them a sense of control over their situation, thereby enhancing their self-esteem and trust in their ability to take action.
\n
While the dramas do address parental mental illness, they often do so in an indirect or metaphorical way. They allow the children to differentiate from the illness, exploring it from a removed and outside perspective and not getting caught up in it. Indeed, the staff are careful not to lead the young people into sharing their specific experiences, as the drama work is intended to act as a helpful tool to enable young people to explore their experiences from a distance, to make up stories and create roles that focus on general aspects of mental illness and crisis.
\n
The dramas tend to capture the everyday experiences of the children and, in a more or less explicit way, the impact of their parent’s mental illness. The dramas are filmed and played back to parents and staff and therefore serve as an effective channel for young people to communicate their experiences and fears. Moreover, the themes and experiences depicted in the dramas are not owned by one person; they are devised, played out and therefore communicated, as a group; this feels safer and less threatening for the young people to express and for the adults to receive.
\n
The dramas are also useful in communicating important messages and explanations of mental illness to young people. The KidsTime model emphasises that explanations should address and challenge presumptions and fears that young people have about mental illness, for example, that they might “catch the illness themselves”, which the dramas frequently illustrate. In order to reduce rigid ideas and fears about mental illness in young people, the dramas should also present mental illness as a changeable process rather than as a fixed, constant entity. Including the subject of mental illness in dynamic dramas is particularly useful as it depicts mental illnesses through characters’ experiences rather than through listing signs and symptoms of diagnostic criteria.
\n
The drama work contributes to the aim of the workshops in creating a space where “kids can be kids”. The drama is part of a predictable and secure structure within which children do not take the lead, do not have to feel responsible and are thus able to relax and play in their more age-appropriate roles. In this way, the drama work enables the team to strike the important balance between the serious and the playful. The overall aim of the workshops is to provide a relaxed environment within which young people can explore and recognise their own roles, and the challenges within these, and have this validated by others while remaining optimistic and hopeful for the future. At KidsTime, young people are encouraged to recognise their successes and strengths despite their difficult situation and to have fun while doing so, which is enabled by creating an environment where they can engage in more age-appropriate roles and activities. The ability to play is a fundamental aspect of psychological health and creativity, and this is built into the method. It is noticeable that when children first come into the workshop, the ability to join in and play is very low but grows quite quickly once they feel safe.
\n\n
“It’s good, because we get to play games, and parents get to go upstairs, and we get to stay downstairs and have some fun.”
\n\n\n
“KidsTime is a good place to go because you get to play games, run about, have fun and have pizza.”
\n\n\n
“KidsTime is a wonderful place to go and you can express your feelings.” (Testimonies from young children, KidsTime)
\n\n
\n
6.3.1 KidsTime participant (aged 17)
\n\n
“People think depression is when you feel low and want to kill yourself. But there is so much more to it than that. My mum has schizoaffective disorder. That means she gets schizophrenia symptoms, such as hallucinations, and mood disorder symptoms, including mania and depression. She mixes up reality with imagination. She takes antidepressants and sleeping pills but there is often no way of knowing what state she is going to be in.
\n
My dad found out about KidsTime when he was looking for ways to help me. I already knew about my mum’s illness, but it was good to know that there are people who, like me, have to remind their parents to shower and eat.
\n
People say mental illness is invisible, but you can usually tell by the look on someone’s face or the way they are not keeping up with personal hygiene that they are unwell. Being a carer for my mum is not a bad thing, but it is a responsibility. I know that sometimes she does not want to talk she just wants me to sit with her. The annoying thing is that because I have lived with my mum, I can usually tell when other people are down as well. You start to feel guilty if the people around you are not happy, which is illogical, but I cannot help it. That is one of the things we have talked about at KidsTime—the burden of having that insight. My school and college mates do not understand that, but with my friends from KidsTime we can just jump straight into a deep conversation, and that means a lot to me.”
\n\n
\n
\n
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7. Impact and evaluation of the KidsTime Workshops
\n
To date, several evaluations of the KidsTime Workshops have been carried out, using a variety of methodologies, the findings of which are summarised in the following paragraphs. As a general rule, individual feedback forms are completed by the adults and children after each workshop. A study of the German KidsTime Workshops found that [19]:
95% of families submitting evaluations stated they benefited from attending the workshops and wanted to continue attending.
All family members stated they had learned something new about mental illness at the workshops and that the workshops helped them to talk about mental illness within and outside of their families.
Watching and reflecting on the children’s drama film, as well as the multi-family group format (particularly the feeling of solidarity among families) were viewed as helpful catalysts in enabling the open discussion of issues that may have been perceived as being too “shameful” to talk about outside of the group.
\n
Similar themes were present in the children’s feedback; however, the most important impact for children was the sense of freedom they experienced in being able to return some of the responsibility to adults they could trust and talk to and in connecting with adults in a more positive way, challenging their previous thoughts and feelings about adults and professionals coming into contact with them and their families. The feedback especially highlighted how children experienced KidsTime Workshops as a secure framework within which they could act more freely [19].
\n
In England, an evaluation by the Anna Freud Centre for Children and Families found that the workshops increased understanding of mental illness, improved parent-child relationships, reduced feelings of fear, shame and isolation and boosted confidence in children and young people [2, 11]. Due to the nuances and the number of factors at play within the workshops, Our Time has found that case studies are a useful tool in understanding the impact of these interventions on children and families. An analysis of recent family case studies in England has identified the following key themes: Rise in confidence among children and young people, improved relationships within and outside of the family, making new friendships and increased knowledge and understanding of mental illness.
\n
Findings from the different evaluations undertaken to date demonstrate that the strength of the workshops lies in their ability to facilitate communication and positive relationship building within and outside of the family, providing effective peer support for children and parents and, in tackling the shame, stigma and misconceptions surrounding mental illness, reducing feelings of fear and isolation and raising young people’s confidence and self-esteem [2, 11, 19].
\n
\n
\n
8. The case for investing in preventative approaches
\n
A common barrier to setting up and maintaining a KidsTime Workshop is securing funding for a preventative model. The fundamental rationale for the workshops is to prevent young people from developing psychopathology themselves. However, funding for support for people who do not have a formal diagnosis is almost impossible to obtain within curative and risk-oriented medical systems, which are often the result of restrictive fiscal policies that will only allocate funding for critical interventions. However, what such policies and approaches fail to address is that, without appropriate universal, preventative support in place beneath thresholds for critical services, the demand for these services will continue to grow at an alarming rate, leading to significantly increased costs in the medium to long term.
\n
In relation to children of parents with a mental illness, the stakes are high. An estimated 3.4 million children and young people in the UK live with a parent with a mental illness. Without help, 70% (3.1 million) of these children will go on to develop mental health problems themselves at huge expense to the public purse [6]. For example, if a quarter of these young people develop depression by 2021, the projected cost to the UK government could be up to £470 million [5]. This is the tip of the iceberg—depression is just one of many ill consequences likely to befall this group. Other potential long-term consequences include disrupted education, restricted peer relationships (due to carer role), financial hardship, potential separation from parents, stigma, future physical and mental health problems, greater risk of suicide, unemployment, marital problems and crime and violence [2, 3, 4, 5, 10]. Consequently, without intervention, the long-term prospects are bleak, and the cost of doing nothing could amount to £17 billion per year in the UK alone [20]. In comparison, the cost of preventative approaches is relatively small. To give an example, in England, it costs ~£2000 per family, per year, to take part in a monthly KidsTime Workshop, while an initial assessment by Child and Adolescent Mental Health Services costs £700 per child, prior to any intervention taking place.
\n
While the case for prevention is clear, support for early intervention requires a culture shift across the health, social care and education system, which can only be achieved through policy change and the allocation of appropriate funds to facilitate this at a more local level. This will have to include training and awareness raising for professionals who deal with children in the course of their work, including adult mental health professionals. For this reason, organisations such as Our Time are campaigning for government to count the numbers of children affected by parental mental illness and to invest in prevention to help break the cycle of intergenerational mental illness.
\n
\n
\n
9. Conclusion and recommendations for practice
\n
This chapter has provided an overview of the workings and impact of multi-family approaches in supporting families affected by parental mental illness, using the KidsTime Workshops as a case study example. It has described the benefits of a more informal and non-therapeutic, multi-family intervention in helping children and families to understand and communicate about mental illness. As well as highlighting the potential risks associated with having a parent with a mental illness, it has demonstrated the power of receiving a clear explanation in helping children to understand and cope with their situation. Access to a supportive and non-judgmental environment where families can share experiences and talk to others in the same situation has been identified as a key protective factor for children and their parents, as illustrated in the feedback and testimonials from families listed in this article. Recommendations for professionals and practitioners working with children and young people affected by parental mental illness are to:
Notice these children, and recognise the role they play in caring for their parents.
Recognise and acknowledge that they are experts in their family situation, with often very advanced knowledge and insight into their parent’s illness and/or behaviours.
Provide children with clear explanations of their parent’s illness and what is happening to the parent and for the reasons behind decisions (e.g., when a parent is hospitalised).
Recognise that these children may fear or reject traditional interventions. Ask children what would help and listen to what they have to say, so that any support offered does not undermine or further isolate the child or young person.
\n
Those interested in trialling multi-family interventions for children affected by parental mental illness should pay attention to the following principles:
Create a relaxed, safe and supportive environment that is welcoming for parents and children.
Avoid imposing traditional hierarchical structures, i.e., of professional and patient, and, instead, encourage staff to adopt the role of a friendly helper to facilitate trust and communication within and outside of the family.
Provide clear age-appropriate explanations for mental illness.
Use a range of creative methods, such as drama, to engage and make it a fun experience for children, to enable exploration of the subject from different perspectives and to encourage reflection.
\n
Further information and guidance about the KidsTime model, including how to set up a KidsTime Workshop, is available on the Our Time website: www.ourtime.org.uk.
\n
\n\n',keywords:"parental mental illness, children, multi-family, systemic therapy, drama",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/68306.pdf",chapterXML:"https://mts.intechopen.com/source/xml/68306.xml",downloadPdfUrl:"/chapter/pdf-download/68306",previewPdfUrl:"/chapter/pdf-preview/68306",totalDownloads:958,totalViews:0,totalCrossrefCites:1,dateSubmitted:"November 27th 2018",dateReviewed:"May 23rd 2019",datePrePublished:"July 26th 2019",datePublished:"September 25th 2019",dateFinished:"July 26th 2019",readingETA:"0",abstract:"This chapter will introduce children of parents with mental illness (COPMI) as a group and explain the impact and risk factors of parental mental illness on children. We will provide examples of approaches that can help children in this situation, using the KidsTime Workshop model as a case study. We will describe the approaches and methods of the KidsTime practice model and explain how a combination of family therapy and systemic therapy influences, together with drama, can create an effective multi-family therapy intervention. It will describe the impact of the KidsTime model, including testimonials from children and families, and highlight the evidence in support of preventative approaches, as well as the barriers to securing investment for these interventions. The chapter will conclude with recommendations for practice.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/68306",risUrl:"/chapter/ris/68306",signatures:"Klaus Henner Spierling, Kirsty Tahta-Wraith, Helena Kulikowska and Dympna Cunnane",book:{id:"8864",type:"book",title:"Family Therapy",subtitle:"New Intervention Programs and Researches",fullTitle:"Family Therapy - New Intervention Programs and Researches",slug:"family-therapy-new-intervention-programs-and-researches",publishedDate:"September 25th 2019",bookSignature:"Floriana Irtelli",coverURL:"https://cdn.intechopen.com/books/images_new/8864.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-78984-302-6",printIsbn:"978-1-78984-301-9",pdfIsbn:"978-1-83962-191-8",isAvailableForWebshopOrdering:!0,editors:[{id:"174641",title:"Dr.",name:"Floriana",middleName:null,surname:"Irtelli",slug:"floriana-irtelli",fullName:"Floriana Irtelli"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"287221",title:"Mr.",name:"Klaus Henner",middleName:null,surname:"Spierling",fullName:"Klaus Henner Spierling",slug:"klaus-henner-spierling",email:"h.spierling@diako-online.de",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"288316",title:"Dr.",name:"Kirsty",middleName:null,surname:"Tatah-Wraith",fullName:"Kirsty Tatah-Wraith",slug:"kirsty-tatah-wraith",email:"ktwraith@hotmail.co.uk",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"288320",title:"Mrs.",name:"Helena",middleName:null,surname:"Kulikowska",fullName:"Helena Kulikowska",slug:"helena-kulikowska",email:"helena.kulikowska@ourtime.org.uk",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"308129",title:"Dr.",name:"Dympna",middleName:null,surname:"Cunnane",fullName:"Dympna Cunnane",slug:"dympna-cunnane",email:"dympna.cunnane@ourtime.org.uk",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_1_2",title:"1.1 Summary of key facts and statistics",level:"2"},{id:"sec_2_2",title:"1.2 A hidden risk",level:"2"},{id:"sec_4",title:"2. Parental mental illness (PMI) and its impact on children and young people",level:"1"},{id:"sec_4_2",title:"2.1 Parental emotional availability and its impact on the child-parent relationship",level:"2"},{id:"sec_5_2",title:"2.2 Burden of caring roles and responsibilities on young people",level:"2"},{id:"sec_6_2",title:"2.3 Shame and stigma",level:"2"},{id:"sec_8",title:"3. Protective factors",level:"1"},{id:"sec_8_2",title:"3.1 The importance of a good explanation",level:"2"},{id:"sec_10",title:"4. Specialist intervention: the KidsTime Workshops",level:"1"},{id:"sec_11",title:"5. The KidsTime model",level:"1"},{id:"sec_11_2",title:"5.1 Workshop structure",level:"2"},{id:"sec_11_3",title:"5.1.1 Seminar (adults and children together)",level:"3"},{id:"sec_12_3",title:"5.1.2 Group work (adults and children separate)",level:"3"},{id:"sec_13_3",title:"5.1.3 Community time and reflection (adults and children together)",level:"3"},{id:"sec_16",title:"6. Key approaches",level:"1"},{id:"sec_16_2",title:"6.1 Systemic influences",level:"2"},{id:"sec_17_2",title:"6.2 Multi-family work",level:"2"},{id:"sec_18_2",title:"6.3 Drama work",level:"2"},{id:"sec_18_3",title:"6.3.1 KidsTime participant (aged 17)",level:"3"},{id:"sec_21",title:"7. Impact and evaluation of the KidsTime Workshops",level:"1"},{id:"sec_22",title:"8. The case for investing in preventative approaches",level:"1"},{id:"sec_23",title:"9. Conclusion and recommendations for practice",level:"1"}],chapterReferences:[{id:"B1",body:'Wiegand-Grefe S, Jeske J, Bullinger M, Plass A, Petermann F. Lebensqualität von Kindern psychisch kranker Eltern. Zusammenhänge zwischen Merkmalen elterlicher Erkrankung und gesundheitsbezogener Lebensqualität der Kinder aus Elternsicht. Z f Psychiatrie, Psychologie und Psychotherapie. 2010;58(4):315-322'},{id:"B2",body:'Cooklin A. Promoting children’s resilience to parental mental illness: Engaging the child’s thinking. Advances in Psychiatric Treatment. May 2013;19(3):229-240'},{id:"B3",body:'Children’s Commissioner Vulnerability Report. 2018'},{id:"B4",body:'Welsh Adverse Childhood Experiences (ACE) study. Public Health Wales. Centre for Public Health, Liverpool John Moores University; 2015'},{id:"B5",body:'Ernst and Young. Sizing the Problem—Analysis. Our Time'},{id:"B6",body:'Rubovits PC. Project CHILD: An intervention programme for psychotic mothers and their children. 1996'},{id:"B7",body:'Effective Interventions and Policy Options, WHO (2004). Parents with Mental Disorders and Mental Health Fact Sheet 2016. Available from: www.who.int/mediacentre/factsheets.f220/en/'},{id:"B8",body:'Hetherington R, Baistow K, Katz I, Trowell J. The Welfare of Children with mentally ill parents: Learning from Inter-country comparisons WHO paper. 2001'},{id:"B9",body:'Mattejat F, Remschmidt H. Kinder psychisch kranker Eltern. Deutsches Ärzteblatt. 2008;105(23):413-418'},{id:"B10",body:'Felitti Vincent J, Robert A, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventative Medicine. 1998;14(4):245-258'},{id:"B11",body:'Evaluation Report of KidsTime Workshops, Anna Freud Centre, (2010-2011). KidsTime Workshop Manual, & Wolpert. An exploration of the experience of attending the KidsTime programme for children with parents with enduring 7 mental health issues: Parents’ and young people’s views, Clinical Child Psychology and Psychiatry; 2014'},{id:"B12",body:'Wiegand-Grefe S, Cronemeyer B, Plass A, Schulte-Markwort M, Petermann F. Psychische Auffälligkeiten von Kindern psychisch kranker Eltern im Perspektivenvergleich. Kindheit und Entwicklung. 2013;22(1):31-40'},{id:"B13",body:'Cooklin A, Cunnane D. Learning from the kidstime model. Rotenburg: Conference bag-kipe; 2018'},{id:"B14",body:'Wagenblass U. Risiko-und Schutzfaktoren bei Kindern psychisch kranker Eltern. In: Vortrag im Rahmen der Fachtagung vom Runden Tisch in Braunschweig: Frühe Kindheit—Frühe Hilfen; 2009. Im Web: https://wwwvhs-braunschweigde/vhshdf/downloads/hdf-fachtagung/Prof-Dr-Wagenblass_15-05-09pdf [Zugriff: 4 November 2015]'},{id:"B15",body:'Wiegand-Grefe S, Halverscheid S, Plass A. Kinder und ihre psychisch kranken Eltern. Familienorientierte Prävention—Der CHIMPs-Beratungsansatz. Göttingen: Hogrefe; 2011'},{id:"B16",body:'Cooklin A, Bishop P, Francis D, Fagin L, Asen E. The Kidstime Workshops. A Multi-Family Intervention for the Effects of Parental Mental Illness. London: CMHS Publications; 2012'},{id:"B17",body:'Bohus M, Schehr K, Berger-Sallawitz F, Novelli-Fischer U, Stieglitz R, Berger M. Kinder psychisch kranker Eltern. Eine Untersuchung zum Problembewußtsein im klinischen Alltag. Psychiatrische Praxis. 1998;25:134-138'},{id:"B18",body:'Asen E, Scholz M. Praxis der Multifamilientherapie. Heidelberg: Carl-Auer; 2012'},{id:"B19",body:'Spierling KH. Kidstime workshops—ein Projekt mit Multifamilienarbeit für Familien mit psychisch erkrankten Elternteilen. Systeme. 2016;30(1):54-74'},{id:"B20",body:'The Cost of Late Intervention: Early Intervention Foundation Analysis. 2016'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Klaus Henner Spierling",address:"h.spierling@diako-online.de",affiliation:'
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Definition of Terms:
\n\n
Book - collection of Works distributed in a book format, whose selection, coordination, preparation, and arrangement has been performed and published by IntechOpen, and in which the Work is included in its entirety in an unmodified form along with one or more other contributions, each constituting separate and independent sections, but together assembled into a collective whole.
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Work - a book Chapter (as well as Conference Papers), including any and all content, graphics, images and/or other materials forming part of, or accompanying, the Chapter/Conference Paper.
\\n\\n
Attribution – appropriate credit for the used Work or book.
\\n\\n
Creative Commons licenses – enable licensors to retain copyright while allowing others to use their Works in an appropriate way.
\\n\\n
Rules of Attribution for Works Published by IntechOpen
\\n\\n
With the purpose of protecting Authors' copyright and the transparent reuse of OA (Open Access) content, IntechOpen has developed Rules of Attribution of Works licensed under Creative Commons licenses.
\\n\\n
\\n\\t
All Chapters published in IntechOpen books prior to October 2011 are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported license (CC BY-NC-SA 3.0);
\\n\\t
All Chapters published in IntechOpen books after October 2011 are licensed under the Creative Commons Attribution 3.0 Unported license (CC BY 3.0);
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\\n\\n
In case you reuse or republish any of the Works licensed under CC licenses, you must abide by the guidelines outlined below:
\\n\\n
1. Rules for reusing of books in their entirety or significant parts of books
\\n\\n
All rights to Books and other compilations published on the IntechOpen platform and in print are reserved by IntechOpen. The Copyright to Books and other compilations is subject to a separate Copyright from any that exists in the included Works.
\\n\\n
A Book in its entirety or a significant part of a Book cannot be translated freely without specific written consent by the publisher. Further information can be obtained at permissions@intechopen.com.
\\n\\n
In instances where permission is obtained from the publisher for reusing or republishing the Book, or significant parts of the Book, all of the following conditions apply:
\\n\\n
\\n\\t
Information about the first publisher must be provided – please note the fact that the material was originally published by IntechOpen as an OA (Open Access) publication must be acknowledged;
\\n\\t
All original Academic Editor(s) must be credited;
\\n\\t
Since you are reusing content that someone else created and allowed you to use freely, you must credit all Authors involved;
\\n\\t
The type of license that is available for the Works must be indicated, as well as a link to the license provided, so that others can investigate the terms of the license. You will be aware that the material can be used for free in consequence of the CC license attribution, so you must acknowledge that fact. It is not sufficient that the material is Creative Commons, because that says nothing about how the material can actually be used. There are different CC licenses and you have to identify the specific license that is being used;
\\n\\t
Any original Copyright Notices associated, with the Works which constitute the Book must be kept intact;
\\n\\t
Provision of the original title of the Book, as well as the original titles of any individual Works;
\\n\\t
Provision of the URL where the Book is hosted, with a notice to the effect that the Book is an OA (Open Access) publication;
\\n\\t
Provision of the URL to every individual Work which constitutes the Book with a notice that the Work is an OA (Open Access) publication. As the material has been accessed for free, it is incumbent upon you to provide the source so that others can also access it for free.
\\n
\\n\\n
Every single Work that is used has to be attributed in the way described. If you are unsure about proper attribution, please write to permissions@intechopen.com.
\\n\\n
2. Rules of attribution for works published by IntechOpen
\\n\\n
Individual Works originally published in IntechOpen books are licensed under Creative Commons licenses and can be freely used under terms of the respective CC license, if properly attributed. In order to properly attribute the Work you must respect all the conditions outlined below:
\\n\\n
\\n\\t
Credit all Authors – since you are reusing contents that someone created and allowed you to use freely, you have to acknowledge authorship;
\\n\\t
Indicate the type of license under which the Work is available and provide the URL to the license so others can find out the license terms. Preferably keep intact any original Copyright Notice associated with the Chapter (if any). You will be aware that the material can be used for free in consequence of the CC license attribution, so you must acknowledge that fact. It is not sufficient that the material is Creative Commons, because that says nothing about how the material can actually be used. There are different CC licenses and you have to identify the specific license that is being used;
\\n\\t
Provide the URL where the Work is hosted, preferably providing the original title of the Work, as well as the original title of the Book with a notification that the Work is an OA (Open Access) publication. As the material has been accessed for free, it is incumbent upon you to provide the source so that others can also access it for free;
\\n\\t
Provide information about the first publisher – please note the fact that the material was originally published by IntechOpen as an OA (Open Access) Work must be acknowledged.
\\n
\\n\\n
Every single Work that is used has to be attributed in the way as described. If you are unsure about proper attribution, please contact Us at permissions@intechopen.com.
\\n\\n
In the event that you use more than one of IntechOpen's Works published in one or more books (but not a significant part of the book that is under separate Copyright), each of these have to be properly attributed in the way described.
\\n\\n
IntechOpen does not have any claims on newly created copyrighted Works, but the Works originally published by IntechOpen must be properly attributed.
\\n\\n
All these rules apply to BOTH online and offline use.
\\n\\n
Parts of the Rules of Attribution are based on Work Attributing Creative Commons Materials published by the Australian Research Council Centre of Excellence for Creative Industries and Innovation, in partnership with Creative Commons Australia, which can be found at creativecommons.org.au licensed under Creative Commons Attribution 2.5 Australia license, and Best practices for attribution published by Creative Commons, which can be found at wiki.creativecommons.org under the Creative Commons Attribution 4.0 license.
\\n\\n
All the above rules are subject to change, IntechOpen reserves the right to take appropriate action if any of the conditions outlined above are not met.
Work - a book Chapter (as well as Conference Papers), including any and all content, graphics, images and/or other materials forming part of, or accompanying, the Chapter/Conference Paper.
\n\n
Attribution – appropriate credit for the used Work or book.
\n\n
Creative Commons licenses – enable licensors to retain copyright while allowing others to use their Works in an appropriate way.
\n\n
Rules of Attribution for Works Published by IntechOpen
\n\n
With the purpose of protecting Authors' copyright and the transparent reuse of OA (Open Access) content, IntechOpen has developed Rules of Attribution of Works licensed under Creative Commons licenses.
\n\n
\n\t
All Chapters published in IntechOpen books prior to October 2011 are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported license (CC BY-NC-SA 3.0);
\n\t
All Chapters published in IntechOpen books after October 2011 are licensed under the Creative Commons Attribution 3.0 Unported license (CC BY 3.0);
\n
\n\n
In case you reuse or republish any of the Works licensed under CC licenses, you must abide by the guidelines outlined below:
\n\n
1. Rules for reusing of books in their entirety or significant parts of books
\n\n
All rights to Books and other compilations published on the IntechOpen platform and in print are reserved by IntechOpen. The Copyright to Books and other compilations is subject to a separate Copyright from any that exists in the included Works.
\n\n
A Book in its entirety or a significant part of a Book cannot be translated freely without specific written consent by the publisher. Further information can be obtained at permissions@intechopen.com.
\n\n
In instances where permission is obtained from the publisher for reusing or republishing the Book, or significant parts of the Book, all of the following conditions apply:
\n\n
\n\t
Information about the first publisher must be provided – please note the fact that the material was originally published by IntechOpen as an OA (Open Access) publication must be acknowledged;
\n\t
All original Academic Editor(s) must be credited;
\n\t
Since you are reusing content that someone else created and allowed you to use freely, you must credit all Authors involved;
\n\t
The type of license that is available for the Works must be indicated, as well as a link to the license provided, so that others can investigate the terms of the license. You will be aware that the material can be used for free in consequence of the CC license attribution, so you must acknowledge that fact. It is not sufficient that the material is Creative Commons, because that says nothing about how the material can actually be used. There are different CC licenses and you have to identify the specific license that is being used;
\n\t
Any original Copyright Notices associated, with the Works which constitute the Book must be kept intact;
\n\t
Provision of the original title of the Book, as well as the original titles of any individual Works;
\n\t
Provision of the URL where the Book is hosted, with a notice to the effect that the Book is an OA (Open Access) publication;
\n\t
Provision of the URL to every individual Work which constitutes the Book with a notice that the Work is an OA (Open Access) publication. As the material has been accessed for free, it is incumbent upon you to provide the source so that others can also access it for free.
\n
\n\n
Every single Work that is used has to be attributed in the way described. If you are unsure about proper attribution, please write to permissions@intechopen.com.
\n\n
2. Rules of attribution for works published by IntechOpen
\n\n
Individual Works originally published in IntechOpen books are licensed under Creative Commons licenses and can be freely used under terms of the respective CC license, if properly attributed. In order to properly attribute the Work you must respect all the conditions outlined below:
\n\n
\n\t
Credit all Authors – since you are reusing contents that someone created and allowed you to use freely, you have to acknowledge authorship;
\n\t
Indicate the type of license under which the Work is available and provide the URL to the license so others can find out the license terms. Preferably keep intact any original Copyright Notice associated with the Chapter (if any). You will be aware that the material can be used for free in consequence of the CC license attribution, so you must acknowledge that fact. It is not sufficient that the material is Creative Commons, because that says nothing about how the material can actually be used. There are different CC licenses and you have to identify the specific license that is being used;
\n\t
Provide the URL where the Work is hosted, preferably providing the original title of the Work, as well as the original title of the Book with a notification that the Work is an OA (Open Access) publication. As the material has been accessed for free, it is incumbent upon you to provide the source so that others can also access it for free;
\n\t
Provide information about the first publisher – please note the fact that the material was originally published by IntechOpen as an OA (Open Access) Work must be acknowledged.
\n
\n\n
Every single Work that is used has to be attributed in the way as described. If you are unsure about proper attribution, please contact Us at permissions@intechopen.com.
\n\n
In the event that you use more than one of IntechOpen's Works published in one or more books (but not a significant part of the book that is under separate Copyright), each of these have to be properly attributed in the way described.
\n\n
IntechOpen does not have any claims on newly created copyrighted Works, but the Works originally published by IntechOpen must be properly attributed.
\n\n
All these rules apply to BOTH online and offline use.
\n\n
Parts of the Rules of Attribution are based on Work Attributing Creative Commons Materials published by the Australian Research Council Centre of Excellence for Creative Industries and Innovation, in partnership with Creative Commons Australia, which can be found at creativecommons.org.au licensed under Creative Commons Attribution 2.5 Australia license, and Best practices for attribution published by Creative Commons, which can be found at wiki.creativecommons.org under the Creative Commons Attribution 4.0 license.
\n\n
All the above rules are subject to change, IntechOpen reserves the right to take appropriate action if any of the conditions outlined above are not met.
\n\n
Policy last updated: 2016-06-09
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Results from experimental and simulative investigation of 2D non-stationary temperature distribution in the longitudinal section of beech and pine logs with a diameter of 0.24 m and length of 0.48 m during their many hours freezing in a freezer and subsequent defrosting at room temperature are presented, visualized, and analyzed.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Nencho Deliiski and Natalia Tumbarkova",authors:[{id:"43040",title:"Prof.",name:"Nencho",middleName:"Stanev",surname:"Deliiski",slug:"nencho-deliiski",fullName:"Nencho Deliiski"},{id:"284649",title:"Dr.",name:"Natalia",middleName:"Yordanova",surname:"Tumbarkova",slug:"natalia-tumbarkova",fullName:"Natalia Tumbarkova"}]},{id:"67626",doi:"10.5772/intechopen.86738",title:"The Boundary Element Method for Fluctuating Active Colloids",slug:"the-boundary-element-method-for-fluctuating-active-colloids",totalDownloads:920,totalCrossrefCites:0,totalDimensionsCites:2,abstract:"The boundary element method (BEM) is a computational method particularly suited to solution of linear partial differential equations (PDEs), including the Laplace and Stokes equations, in complex geometries. The PDEs are formulated as boundary integral equations over bounding surfaces, which can be discretized for numerical solution. This manuscript reviews application of the BEM for simulation of the dynamics of “active” colloids that can self-propel through liquid solution. We introduce basic concepts and model equations for both catalytically active colloids and the “squirmer” model of a ciliated biological microswimmer. We review the foundations of the BEM for both the Laplace and Stokes equations, including the application to confined geometries, and the extension of the method to include thermal fluctuations of the colloid. Finally, we discuss recent and potential applications to research problems concerning active colloids. The aim of this review is to facilitate development and adoption of boundary element models that capture the interplay of deterministic and stochastic effects in the dynamics of active colloids.",book:{id:"8416",slug:"non-equilibrium-particle-dynamics",title:"Non-Equilibrium Particle Dynamics",fullTitle:"Non-Equilibrium Particle Dynamics"},signatures:"William E. Uspal",authors:[{id:"279308",title:"Prof.",name:"William",middleName:null,surname:"Uspal",slug:"william-uspal",fullName:"William Uspal"}]},{id:"66487",doi:"10.5772/intechopen.85735",title:"Mean Aspects Controlling Supercritical CO2 Precipitation Processes",slug:"mean-aspects-controlling-supercritical-co-sub-2-sub-precipitation-processes",totalDownloads:736,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The use of supercritical CO2 is an excellent alternative in extraction, particle precipitation, impregnation and reaction processes due to its special properties. Solubility of the compound in supercritical CO2 drives the precipitation process in different ways. In supercritical antisolvent process, mass and heat transfers, phase equilibria, nucleation, and growth of the compound to be precipitated are the main phenomena that should be taken into account. Mass transfer conditions the morphology and particle size of the final product. This transfer could be tuned altering operating conditions. Heat transfer in non-isothermal process influences on mixing step the size of generated microparticles. In rapid expansion of supercritical solution, phenomena as the phase change from supercritical to a CO2 gas flow, rapid mass transfer and crystallization of the compound, and expansion jet define the morphology and size of the final product. These phenomena a priori could be modulated tuning a large number of operating parameters through the experiments, but the correlations and modeling of these processes are necessary to clarify the relative importance of each one. Moreover, particle agglomeration in the expansion jet and CO2 condensation are determinant phenomena which should be avoided in order to conserve fine particles in the final product.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Antonio Montes, Clara Pereyra and Enrique J. Martínez de la Ossa",authors:[{id:"55991",title:"Mr.",name:"Antonio",middleName:null,surname:"Montes",slug:"antonio-montes",fullName:"Antonio Montes"},{id:"55992",title:"Dr.",name:"Clara",middleName:null,surname:"Pereyra",slug:"clara-pereyra",fullName:"Clara Pereyra"},{id:"55993",title:"Dr.",name:"Enrique",middleName:null,surname:"Martinez De La Ossa",slug:"enrique-martinez-de-la-ossa",fullName:"Enrique Martinez De La Ossa"}]},{id:"66317",doi:"10.5772/intechopen.85254",title:"Review Heat Transfer of Non-Newtonian Fluids in Agitated Tanks",slug:"review-heat-transfer-of-non-newtonian-fluids-in-agitated-tanks",totalDownloads:1001,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The heating and cooling of non-Newtonian liquids in tanks with mechanical impellers are operations commonly employed as chemical reactors, heat exchangers, distillers, extractors, thinners and decanters. In particular, the design of heat exchangers (jackets, helical coils, spiral coils and vertical tubular baffles) in tanks requires the prior knowledge of the rheology of the liquid for the calculation of the convection coefficients and the Reynolds number, in order to obtain the area thermal exchange. This chapter aimed to present the basic concepts of tanks with agitation, non-Newtonian liquids, hydrodynamics, heat transfer and, finally, with a practical design example for engineers and undergraduate students.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Vitor da Silva Rosa and Deovaldo de Moraes Júnior",authors:[{id:"187128",title:"Ph.D.",name:"Vitor",middleName:null,surname:"Rosa",slug:"vitor-rosa",fullName:"Vitor Rosa"},{id:"188792",title:"Dr.",name:"Deovaldo",middleName:null,surname:"Moraes Júnior",slug:"deovaldo-moraes-junior",fullName:"Deovaldo Moraes Júnior"}]}],mostDownloadedChaptersLast30Days:[{id:"66878",title:"Design of Industrial Falling Film Evaporators",slug:"design-of-industrial-falling-film-evaporators",totalDownloads:1753,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The high performance evaporators are important for process industries such as food, desalination and refineries. The falling film evaporators have many advantages over flooded and vertical tubes that make them best candidate for processes industries application. The heat transfer area is the key parameter in designing of an evaporator and many correlations are available to estimate the size of tube bundle. Unfortunately, most of the correlation is available only for pure water and above 322 K saturation temperatures. Out of these conditions, the areas are designed by the extrapolation of existing correlations. We demonstrated that the actual heat transfer values are 2–3-fold higher at lower temperature and hence simple extrapolated estimation leads to inefficient and high capital cost design. We proposed an accurate heat transfer correlation for falling film evaporators that can capture both, low temperature evaporation and salt concentration effectively. It is also embedded with unique bubble-assisted evaporation parameter that can be only observed at low temperature and it enhances the heat transfer. The proposed correlation is applicable from 280 to 305 K saturation temperatures and feed water concentration ranges from 35,000 to 95,000 ppm. The uncertainty of measured data is less than 5% and RMS of regressed data is 3.5%. In this chapter, first part summarized the all available correlations and their limitations. In second part, falling film evaporation heat transfer coefficient (FFHTC) is proposed and model is developed. In the last part, experimentation is conducted and FFHTC developed and compared with conventional correlations.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Muhammad Wakil Shahzad, Muhammad Burhan and Kim Choon Ng",authors:[{id:"174208",title:"Dr.",name:"Muhammad Wakil",middleName:null,surname:"Shahzad",slug:"muhammad-wakil-shahzad",fullName:"Muhammad Wakil Shahzad"},{id:"249811",title:"Dr.",name:"Muhammad",middleName:null,surname:"Burhan",slug:"muhammad-burhan",fullName:"Muhammad Burhan"},{id:"254696",title:"Prof.",name:"Kim Choon",middleName:null,surname:"Ng",slug:"kim-choon-ng",fullName:"Kim Choon Ng"}]},{id:"66102",title:"Heat and Mass Transfer of Additive Manufacturing Processes for Metals",slug:"heat-and-mass-transfer-of-additive-manufacturing-processes-for-metals",totalDownloads:1302,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Additive manufacturing (AM), a method in which a part is fabricated layer by layer from a digital design package, provides the potential to produce complex components at reduced cost and time. Many techniques (using many different names) have been developed to accomplish this via melting or solid-state joining. However, to date, only a handful can be used to produce metallic parts that fulfill the requirements of industrial applications. The thermal physics and weld pool behaviors in metal AM process have decisive influence on the deposition quality, the microstructure and service performance of the depositions. Accurate analysis and calculation of thermal processes and weld pool behaviors are of great significance to the metallurgy analysis, stress and deformation analysis, process control and process optimization etc. Numerical modeling is also a necessary way to turn welding from qualitative description and experience-based art into quantitative analysis- and science-based engineering branch. In this chapter, two techniques for producing metal parts are explored, with a focus on the thermal science of metal AM: fluid flow and heat transfer. Selective laser melting (SLM) is the one that is most widely used because it typically has the best resolution. Another is named metal fused-coated additive manufacturing (MFCAM) that is cost competitive and efficient in producing large and middle-complex components in aerospace applications.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Zhengying Wei and Jun Du",authors:[{id:"47614",title:"Prof.",name:"Zhengying",middleName:null,surname:"Wei",slug:"zhengying-wei",fullName:"Zhengying Wei"},{id:"282052",title:"Dr.",name:"Jun",middleName:null,surname:"Du",slug:"jun-du",fullName:"Jun Du"}]},{id:"66563",title:"Heat and Mass Transfer in Outward Convex Corrugated Tube Heat Exchangers",slug:"heat-and-mass-transfer-in-outward-convex-corrugated-tube-heat-exchangers",totalDownloads:1037,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Heat and mass transfer in outward convex corrugated tube heat exchangers is of significant importance for the optimization, fabrication, and application of outward convex corrugated tube heat exchangers. This chapter gives a deep investigation of the heat and mass transfer in outward convex corrugated tube heat exchangers. Based on the experimental setup developed, the performances of a novel outward convex corrugated tube heat exchanger are presented. Simulation methods are then used to detail the heat and mass transfer at tube side and shell side of the outward convex corrugated tube heat exchanger, and these include the flow structure, temperature distribution, and turbulence kinetic energy. Heat and mass transfer enhancements of the outward convex corrugated tube heat exchanger are also studied, and they are from tube side, shell side, and overall system aspects. Finally, multi-objective optimization of the outward convex corrugated tube heat exchanger is conducted to obtain the optimal performances through using Response Surface Methodology (RSM) and Non-dominated Sorting Genetic Algorithm (NSGA-II). Main conclusions and future outlook are then briefly stated and summarized. We firmly believe that the contents presented in this chapter can not only enrich the knowledge of heat exchangers but also develop methods for studying heat exchangers.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Huaizhi Han, Bingxi Li, Yaning Zhang, Quan Zhu and Ruitian Yu",authors:[{id:"23828",title:"Dr.",name:"Quan",middleName:null,surname:"Zhu",slug:"quan-zhu",fullName:"Quan Zhu"},{id:"148369",title:"Prof.",name:"Bingxi",middleName:null,surname:"Li",slug:"bingxi-li",fullName:"Bingxi Li"},{id:"196928",title:"Dr.",name:"Yaning",middleName:null,surname:"Zhang",slug:"yaning-zhang",fullName:"Yaning Zhang"},{id:"281875",title:"Prof.",name:"Huaizhi",middleName:null,surname:"Han",slug:"huaizhi-han",fullName:"Huaizhi Han"},{id:"282268",title:"Mr.",name:"Ruitian",middleName:null,surname:"Yu",slug:"ruitian-yu",fullName:"Ruitian Yu"}]},{id:"66317",title:"Review Heat Transfer of Non-Newtonian Fluids in Agitated Tanks",slug:"review-heat-transfer-of-non-newtonian-fluids-in-agitated-tanks",totalDownloads:1001,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The heating and cooling of non-Newtonian liquids in tanks with mechanical impellers are operations commonly employed as chemical reactors, heat exchangers, distillers, extractors, thinners and decanters. In particular, the design of heat exchangers (jackets, helical coils, spiral coils and vertical tubular baffles) in tanks requires the prior knowledge of the rheology of the liquid for the calculation of the convection coefficients and the Reynolds number, in order to obtain the area thermal exchange. This chapter aimed to present the basic concepts of tanks with agitation, non-Newtonian liquids, hydrodynamics, heat transfer and, finally, with a practical design example for engineers and undergraduate students.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Vitor da Silva Rosa and Deovaldo de Moraes Júnior",authors:[{id:"187128",title:"Ph.D.",name:"Vitor",middleName:null,surname:"Rosa",slug:"vitor-rosa",fullName:"Vitor Rosa"},{id:"188792",title:"Dr.",name:"Deovaldo",middleName:null,surname:"Moraes Júnior",slug:"deovaldo-moraes-junior",fullName:"Deovaldo Moraes Júnior"}]},{id:"65692",title:"Advances in Concentrated Solar Power: A Perspective of Heat Transfer",slug:"advances-in-concentrated-solar-power-a-perspective-of-heat-transfer",totalDownloads:1114,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Solar energy has the potential to reduce the dependence on the dwindling supply of fossil fuels through concentrated solar power (CSP) technology. CSP plants utilize solar thermal energy to produce electrical energy based on different thermodynamic power cycles. Solar collectors, reflectors, receivers, thermal fluid, and turbines are the main components of each CSP plant and involve intensive heat transfer at all stages. This chapter illustrates the thermal characteristics of the main components used in CSP technology. In addition, the solar thermal fluid characteristics and its stable operational ranges are discussed in this chapter. Heat capacity, vapor pressure, volume expansion, density and viscosity of the thermal fluid should not differ significantly at different temperatures during various operation stages because these variations can cause failure in the system, which is designed at the fixed material properties. Currently, CSP technology is associated with a higher cost compared to the electricity generated through gas power plants. Many efforts are made to search for sustainable and inexpensive materials to minimize the cost of CSP. One critical issue faced by CSP technology is the intermittent nature of the sun. Modern CSP plants integrate thermal energy storage (TES) unit to smoothen the power production or to shift the production from peak sunshine hours to peak demand hours.",book:{id:"7661",slug:"heat-and-mass-transfer-advances-in-science-and-technology-applications",title:"Heat and Mass Transfer",fullTitle:"Heat and Mass Transfer - Advances in Science and Technology Applications"},signatures:"Fadi Alnaimat and Yasir Rashid",authors:[{id:"151722",title:"Dr.",name:"Fadi",middleName:null,surname:"Alnaimat",slug:"fadi-alnaimat",fullName:"Fadi Alnaimat"},{id:"291252",title:"Mr.",name:"Yasir",middleName:null,surname:"Rashid",slug:"yasir-rashid",fullName:"Yasir Rashid"}]}],onlineFirstChaptersFilter:{topicId:"954",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:8,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:286,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:9,numberOfPublishedChapters:101,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null,scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
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\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
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\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
",coverUrl:"https://cdn.intechopen.com/series/covers/24.jpg",latestPublicationDate:"April 24th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"262440",title:"Prof.",name:"Usha",middleName:null,surname:"Iyer-Raniga",slug:"usha-iyer-raniga",fullName:"Usha Iyer-Raniga",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRYSXQA4/Profile_Picture_2022-02-28T13:55:36.jpeg",biography:"Usha Iyer-Raniga is a professor in the School of Property and Construction Management at RMIT University. Usha co-leads the One Planet Network’s Sustainable Buildings and Construction Programme (SBC), a United Nations 10 Year Framework of Programmes on Sustainable Consumption and Production (UN 10FYP SCP) aligned with Sustainable Development Goal 12. The work also directly impacts SDG 11 on Sustainable Cities and Communities. She completed her undergraduate degree as an architect before obtaining her Masters degree from Canada and her Doctorate in Australia. Usha has been a keynote speaker as well as an invited speaker at national and international conferences, seminars and workshops. Her teaching experience includes teaching in Asian countries. She has advised Austrade, APEC, national, state and local governments. She serves as a reviewer and a member of the scientific committee for national and international refereed journals and refereed conferences. She is on the editorial board for refereed journals and has worked on Special Issues. Usha has served and continues to serve on the Boards of several not-for-profit organisations and she has also served as panel judge for a number of awards including the Premiers Sustainability Award in Victoria and the International Green Gown Awards. Usha has published over 100 publications, including research and consulting reports. Her publications cover a wide range of scientific and technical research publications that include edited books, book chapters, refereed journals, refereed conference papers and reports for local, state and federal government clients. She has also produced podcasts for various organisations and participated in media interviews. She has received state, national and international funding worth over USD $25 million. Usha has been awarded the Quarterly Franklin Membership by London Journals Press (UK). Her biography has been included in the Marquis Who's Who in the World® 2018, 2016 (33rd Edition), along with approximately 55,000 of the most accomplished men and women from around the world, including luminaries as U.N. Secretary-General Ban Ki-moon. In 2017, Usha was awarded the Marquis Who’s Who Lifetime Achiever Award.",institutionString:null,institution:{name:"RMIT University",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",isOpenForSubmission:!0,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",isOpenForSubmission:!0,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. 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Dr. Khalid\\'s research interests include leadership and negotiations, digital transformations, gamification, eLearning, blockchain, Big Data, and management of information technology. Dr. Bilal Khalid also serves as an academic editor at Education Research International and a reviewer for international journals.",institutionString:"KMITL Business School",institution:{name:"King Mongkut's Institute of Technology Ladkrabang",country:{name:"Thailand"}}},{id:"418514",title:"Dr.",name:"Muhammad",middleName:null,surname:"Mohiuddin",slug:"muhammad-mohiuddin",fullName:"Muhammad Mohiuddin",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038UqSfQAK/Profile_Picture_2022-05-13T10:39:03.jpg",biography:"Dr. Muhammad Mohiuddin is an Associate Professor of International Business at Laval University, Canada. He has taught at Thompson Rivers University, Canada; University of Paris-Est, France; Osnabruck University of Applied Science, Germany; and Shanghai Institute of Technology and Tianjin University of Technology, China. He has published research in Research Policy, Applied Economics, Review of Economic Philosophy, Strategic Change, International Journal of Logistics, Sustainability, Journal of Environmental Management, Journal of Global Information Management, Journal of Cleaner Production, M@N@GEMENT, and more. He is a member of CEDIMES Institut (France), Academy of International Business (AIB), Strategic Management Society (SMS), Academy of Management (AOM), Administrative Science Association of Canada (ASAC), and Canadian council of small business and entrepreneurship (CCSBE). He is currently the director of the Research Group on Contemporary Asia (GERAC) at Laval University. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:null,institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda",middleName:"R.",surname:"Gharieb",fullName:"Reda Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. Osma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDv7QAG/Profile_Picture_1626602531691",institutionString:null,institution:{name:"Universidad de Los Andes",institutionURL:null,country:{name:"Colombia"}}},{id:"69697",title:"Dr.",name:"Mani T.",middleName:null,surname:"Valarmathi",fullName:"Mani T. Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/421475",hash:"",query:{},params:{id:"421475"},fullPath:"/profiles/421475",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()