Therapeutic communication techniques.
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"1422",leadTitle:null,fullTitle:"Sintering of Ceramics - New Emerging Techniques",title:"Sintering of Ceramics",subtitle:"New Emerging Techniques",reviewType:"peer-reviewed",abstract:"The chapters covered in this book include emerging new techniques on sintering. Major experts in this field contributed to this book and presented their research. Topics covered in this publication include Spark plasma sintering, Magnetic Pulsed compaction, Low Temperature Co-fired Ceramic technology for the preparation of 3-dimesinal circuits, Microwave sintering of thermistor ceramics, Synthesis of Bio-compatible ceramics, Sintering of Rare Earth Doped Bismuth Titanate Ceramics prepared by Soft Combustion, nanostructured ceramics, alternative solid-state reaction routes yielding densified bulk ceramics and nanopowders, Sintering of intermetallic superconductors such as MgB2, impurity doping in luminescence phosphors synthesized using soft techniques, etc. Other advanced sintering techniques such as radiation thermal sintering for the manufacture of thin film solid oxide fuel cells are also described.",isbn:null,printIsbn:"978-953-51-0017-1",pdfIsbn:"978-953-51-4334-5",doi:"10.5772/1882",price:159,priceEur:175,priceUsd:205,slug:"sintering-of-ceramics-new-emerging-techniques",numberOfPages:626,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"285c4e1c255669f44ed4f19f066c84cb",bookSignature:"Arunachalam Lakshmanan",publishedDate:"March 2nd 2012",coverURL:"https://cdn.intechopen.com/books/images_new/1422.jpg",numberOfDownloads:141744,numberOfWosCitations:187,numberOfCrossrefCitations:54,numberOfCrossrefCitationsByBook:16,numberOfDimensionsCitations:179,numberOfDimensionsCitationsByBook:27,hasAltmetrics:0,numberOfTotalCitations:420,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 12th 2011",dateEndSecondStepPublish:"May 10th 2011",dateEndThirdStepPublish:"September 14th 2011",dateEndFourthStepPublish:"October 14th 2011",dateEndFifthStepPublish:"February 13th 2012",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7,8",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"94482",title:"Dr.",name:"Arunachalam",middleName:null,surname:"Lakshmanan",slug:"arunachalam-lakshmanan",fullName:"Arunachalam Lakshmanan",profilePictureURL:"https://mts.intechopen.com/storage/users/94482/images/system/94482.jpg",biography:"Dr. Arunachalam Lakshmanan obtained his Bachelor and Master Degree in Physics with Distinction at the Annamalai University. He joined Bhabha Atomic Research Centre in 1971 and served as a scientific officer until 1990. He obtained his PhD degree on Thermoluminescence at the\nBombay University in 1981. In 1982 and 1983 he worked as a Scientific Associate at CERN, Geneva, Switzerland. For a period of 2 years, Dr. Lakshmanan worked as a AvH fellow at the University of Wuppertal, Germany. He was a visiting Professor in several universities in Japan, France and South Korea. He was an Editorial Board Member in Radiation Protection Dosimetry Journal, UK. From 1990 to 2007, Dr. Lakshmanan was head of the Radiation Dosimetry Section at the Indira Gandhi Centre for Atomic Research. In 2008, Dr. Lakshmanan published a book titled 'Luminescence of Display Phosphors- Phenomena and Applications”. Presently he is working as a Research Dean and Physics Professor at the Saveetha Engineering College, Chennai, India. His research areas include Synthesis of Luminescence Phosphors and Exploiting Zero Point Energy for power production. Additionally he has developed sintering techniques to process sea sand for civil construction.",institutionString:"Saveetha Engineering College",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"2",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"923",title:"Process Engineering",slug:"ceramics-process-engineering"}],chapters:[{id:"29775",title:"Microwave Fast Sintering of Ceramic Materials",doi:"10.5772/34181",slug:"-microwave-fast-sintering-of-ceramic-materials",totalDownloads:7909,totalCrossrefCites:6,totalDimensionsCites:28,hasAltmetrics:0,abstract:null,signatures:"Romualdo R. Menezes, Pollyane M. Souto and Ruth H.G.A. 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Nursing",doi:"10.5772/intechopen.74995",slug:"effective-communication-in-nursing",body:'\n
Nurses are critical in the delivery of essential health services and are core in strengthening the health system [1, 2]. They bring people-centred care closer to the communities where they are needed most, thereby helping improve health outcomes and the overall cost-effectiveness of services [3]. Nurses usually act as first responders to complex humanitarian crises and disasters; protectors and advocates for the community and communicators and co-ordinators within teams. Communication skills for nurses are essential but may be difficult to master. Communication is the exchange of information between people by sending and receiving it through speaking, writing or by using any other medium. Clear communication means that information is conveyed effectively between people. To be a successful nurse, excellent communication skills are required [4]. Nurses speak to people of varying educational, cultural and social backgrounds and must do so in an effective, caring and professional manner, especially when communicating with patients and their families [5]. The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. This influence can play a very important role in areas such as patient health, education and adherence [6]. Good communication plays an important role in the organization’s effective functioning [7, 8, 9]. A nurse must therefore, continuously try to improve his/her communication skills as poor communication can be dangerous and lead to confusion.
\nPrinciples of communication can be summarized as follows:
Communication is a process;
Communication is not linear, but circular;
Communication is complex;
Communication is irreversible; and
Communication involves the total personality [5].
Interaction between people is cyclic, which means that what one person says and does evokes a reaction from the other person, and this reaction again stimulates another reaction from the first person [10, 11]. Three things are needed for successful communication. They are:
A sender;
A clear message; and
A receiver [12].
The purpose of communication is to inquire, inform, persuade, entertain, request and investigate. A single message can have one or more of the following purposes:
To convey information/opinion, for example, “I have headache” or “I am here to give you medication”.
To request information/opinion/behavior, for example, “Are you allergic to penicillin?” or “Tell me more about the injury”.
To give social acknowledgement, for example, “Hello” or “Good morning”.
These three primary types of messages can be combined in many ways so that they form an interaction (conversation). The goals of the interaction can be comprehensive. Nurses strive to make all their communication with patients therapeutic, that is, their communication is purposefully and consciously planned to promote the patient’s health and wellbeing.
\nVerbal and non-verbal communications are the two main types of communication used by human beings.
\nVerbal communication is associated with spoken words and is vitally important in the healthcare context. Members of the multi-disciplinary healthcare team communicate verbally with one another and with patients as well as family members.
\nNon-verbal communication is not reliant on words. It is sent through the use of one’s body rather than through speech or writing. This kind of communication, called body language, can tell a great deal or can totally the wrong impression. It is worth noting that body language may indicate a different meaning to what is spoken. As approximately 60% of communication is non-verbal, non-verbal skills are essential for effective communication [8]. Often non-verbal messages send stronger signals than verbal messages. Non-verbal communication is made up of:
\nThe communication process may be explained by means of a linear model of communication, interactive model of communication or transactional model of communication [11].
\nLinear model of communication entails a sender, a message, a receiver and noise (Figure 1).
\nLinear model of communication.
Interactive model of communication gives a slightly more complex explanation of the communication process. Communication is seen as a process in which the listener gives feedback or responds to a message after a process of interpretation. A communicator creates and interprets a message with a personal field of expertise and/or a frame of reference Figure 2).
\nInteractive model of communication.
Transactional model of communication acknowledges and gives emphasis to the dynamic nature of interpersonal communication and the multiple roles of the communicators. Features such as time, messages, noise, fields of experience, frames of reference, meanings, shared systems of communicators and personal systems all pay a role in the process of communication. Communicators often participate simultaneously (sending, receiving and interpreting). The unique interpretive and perceptual processes of individuals thus play an essential role in the communication process.
\nEffective communication skills and strategies are important for nurses. Clear communication means that information is conveyed effectively between the nurse, patients, family members and colleagues. However, it is recognized that such skills are not always evident and nurses do not always communicate well with patients, family members and colleagues. The message sent may not be the message received. The meaning of a message depends on its literal meaning, the non-verbal indicators accompanying it and the context in which it is delivered. It is therefore, easy to misinterpret the message, or to interpret it correctly, but to decide not to pursue its hidden meaning this leads to obstruction to communication. Continuous barriers to effective communication brings about a gradual breakdown in relationships. The barriers to effective communication outlined below will help nurses to understand the challenges [8].
\nLanguage differences between the patient and the nurse are another preventive factor in effective communication. When the nurse and the patient do not share a common language, interaction between them is strained and very limited [9, 10, 11]. Consequently, a patient may fail to understand the instructions from a nurse regarding the frequency of taking medication at home.
\nCulture is another hindrance. The patient’s culture may block effective nurse–patient interactions because perceptions on health and death are different between patients [12, 13, 14]. The nurse needs to be sensitive when dealing with a patient from a different culture [9, 15, 16]. What is acceptable for one patient may not be acceptable for another. Given the complexity of culture, no one can possibly know the health beliefs and practices of every culture. The nurse needs check with the patient whether he/she prefers to be addressed by first name or surname. The use of eye contact, touching and personal space is different in various cultures and rules about eye contact are usually complex, varying according to race, social status and gender. Physical contact between sexes is strictly forbidden in some cultures and can include handshakes, hugging or placing a hand on the arm or shoulder. A ‘yes’ does not always mean ‘yes’. A smile does not indicate happiness, recognition or agreement. Whenever people communicate, there is a tendency to make value judgements regarding those perceived as being different. Past experiences can change the meaning of the message. Culture, background and bias can be good if they allow one to use past experiences to understand something new; it is when they change meaning of the message that they interfere with the communication process [12]. It is important for nurses to think about their own experiences when considering cultural differences in communication and how these can challenge health professionals and service users.
\nConflict is a common effect of two or more parties not sharing common ground. Conflict can be healthy in that it offers alternative views and values. However, it becomes a barrier to communication when the emotional ‘noise’ detracts from the task or purpose. Nurses aim for collaborative relationships with patients, families and colleagues.
\nThe factors in care setting may lead to reduction in quality of nurse–patient communication. Increased workload and time constraints restrict nurses from discussing their patients concerns effectively [16]. Nurses work in busy environments where they are expected to complete a specific amount of work in a day and work with a variety of other professionals, patients and their families. The roles are hard, challenging and tiring. There is a culture to get the work done. Some nurses may consider colleagues who spend time talking with patients to be avowing the ‘real’ work and lazy. Nurses who might have been confident in spending time with patients in an area where this was valued, when faced with a task-orientated culture have the dilemma of fitting into the group or being outside the group and spending time engaging with patients. Lack of collaboration between the nurses and the doctors in information sharing also hinder effective communication. This leads to inconsistencies in the information given to patients making comprehension difficult for the patient and their families.
\nInternal noise has an impact on the communication process. Fear and anxiety can affect the person’s ability to listen to what the nurse is saying. People with feelings of fear and anger can find it difficult to hear. Illness and distress can alter a person’s thought processes. Reducing the cause of anxiety, distress, and anger would be the first step to improving communication.
\nIf a healthcare professional feels that the person is talking too fast, not fluently, or does not articulate clearly etc., he/she may dismiss the person. Our preconceived attitudes affect our ability to listen. People tend to listen uncritically to people of high status and dismiss those of low status.
\nPeople can experience difficulty in speech and hearing following conditions like stroke or brain injury. Stroke or trauma may affect brain areas that normally enable the individual to comprehend and produce speech, or the physiology that produces sound. These will present barriers to effective communication.
\nMedication can have a significant effect on communication for example it may cause dry mouth or excess salivation, nausea and indigestion, all of which influence the person’s ability and motivation to engage in conversation. If patients are embarrassed or concerned that they will not be able to speak properly or control their mouth, they could be reluctant to speak.
\nEquipment or environmental noise impedes clear communication. The sender and the receiver must both be able to concentrate on the messages they send to each other without any distraction.
\nSome ways of improving communication are as follows:
Listen without interrupting the sender.
Show empathy at all times and try to understand.
Try to stay focused on the conversation. Do not however, force the patient to continue if he/she becomes anxious or seems to wish to change the subject.
Use the body language that indicates your interest and concern. Touch the patient if it seems appropriate. Lean forward, listen intently and maintain eye contact if it culturally acceptable.
Offer factual information. This relieves anxiety. Do not offer your personal opinion. Assure the patient that you have professional discretion.
Try to reflect the feelings and thoughts the patient is expressing by rephrasing questions and comments using their own words.
Avoid unclear or misleading messages.
Avoid giving long explanations.
Give your co-workers your full attention when communicating with them.
Ask questions to clarify unclear messages.
Do not interrupt until the sender has completed the message.
Provide a quiet environment without distractions.
Be convincing wen communicating [17].
There are several points to be kept in mind when communicating with patients. The first point is that you are there to provide care and support to the patient.
Be open, respectful and gracious in all your interactions with the patient and keep his/her cultural preferences in mind.
Answer nurses’ bells promptly.
Make sure you have the patients’ attention when communicating.
Use words that are non-threatening – explain what you would like to do and do not give orders to the patient.
Use simple, understandable phrases, not medical terms as most patients do not understand these terms.
Speak clearly and courteously.
Use a pleasant and normal tone of voice to the hard of hearing.
Always stand so that the patient can see the nurse’s face when communicating, as lip reading is part of all normal hearing.
Use body language that is appropriate.
Explain facts and procedures before donning a mask that covers the wearer’s mouth and lower face.
Be alert to the patient’s needs. Allow time for answers to your requests and to answer patient’s questions [17].
Nurses often communicate over the phone with patients, family members and colleagues and this can lead to misunderstandings. The way in which the pone is answered and a message is interpreted needs special skills because the body language of the person at the other end of the phone line cannot be seen. When answering the phone or making a call:
Always speak clearly into the mouthpiece of the phone.
Offer a greeting for example, good morning or good afternoon.
Identify the unit or place of work.
Identify yourself by indicating who you are and where you are phoning from.
Identify the person to whom you are speaking.
Politely listen to the message and make notes if you think you may not remember all the information.
If you are asked to call another person, note the date, time, caller’s name and telephone number together with the message.
Date and sign the message [17].
The skill of assertiveness is important to nurses. Nurses are expected to be the patients’ advocates. So, they need to have the assertive communication skills in order to be able to be patients’ advocates. Assertiveness enables a person to be honest with him/herself and in relationships with others. Assertiveness helps to enhance relationships, avoid power games and is a vehicle for clear outcomes. Hargis as cited by van Niekerk identifies four elements of assertive communication [8]:
Therapeutic interactions are purposeful as opposed to social. Social interaction entertains the participants, but in a professional situation, the nurse usually has a clinical objective that he/she wants to achieve with communication. The nurses therefore, decides on the purpose of the interaction before or shortly after it begins. The following purposes are common in nursing:
After the purpose of the therapeutic interaction has been established, the following guidelines assist in conducting a successful interaction:
\nThe nurse must strive to maintain a low-authority profile at the beginning of the conversation. As the conversation progresses, the nurse can use more directive techniques to find out specific information. There are usually differences in age, sex, occupation, cultural background, moral and religious convictions between the nurse and the patient. These differences make it impossible for the nurse to fully understand the patient’s behavior and reactions. It is therefore, important for the nurse to understand and accept differences in patients’ cultures and beliefs. When in doubt, check with the patient. If trust is established, patient will be willing to teach the nurse.
\nThe nurse should determine the patient’s level of understanding and if necessary change the use of language, comments and questions. Using the terminology which the patient does not understand can also frighten the patient and make him/her think that he/she has a more serious problem than he/she originally wanted help for. At the same time, the patient could give incorrect information because due to confusion, he/she may give affirmative answers to questions about symptoms that he/she has not actually experienced [18]. Nurses should share their aims with patients before expecting them to participate in the interaction. They should understand that there is a mutual understanding of each other’s point of departure. In an assessment interview, the nurse can, for instance, say: “Mr Jones, I would like to give you information on how to lose weight so as to bring down you high blood pressure, but I first need to find out what you already know about the condition”. It is not only important that the patients understand what nurses expect from the conversation; it is also essential that nurses understand the patients and convey this understanding before they participate in the conversation. When providing emotional support, this understanding is often all that is necessary. For nurses to understand patients, they must encourage them to talk – not just about facts, but also about their feelings. The nurse must listen more than speak, both to what the patient is saying verbally and what is being said non-verbally. Having listened carefully, the nurse then concentrates and responds empathetically to the patients’ feelings. Only when the nurse has a reasonably complete understanding of the patient’s situation and has communicated this understanding, can she proceed to interventions, such as giving information or solving a problem.
\nSaying something does not necessary mean that the message has been received and understood. It is the responsibility of the nurse to ensure that the person with whom he/she is conversing understands the message. To ensure this, the message has to be adapted to the language, culture and socio-economic status of the patient. The emotional or physical condition of patients may also make it difficult for them to receive long of complicated messages or even any message. There may also be other disturbances in the immediate environment for example, noise that can make the patient not to hear or understand the message. The message must also be adapted to the age of the patient [10].
\nValidation means that you ask the patient whether your interpretation is correct or not. You therefore, ask him/her to confirm your understanding of what he/she said. Many misunderstandings arise because people interpret other people’s words without checking their interpretation. The nurse should try to eliminate misunderstandings in the conversations by checking meaning with the patient.
\nActive listening means concentrating all your senses and thoughts on the speaker. One can usually deduce whether a person is listening actively by looking at the following non-verbal indicators:
Is the eye contact maintained with the person who is speaking?
Are the body and face turned towards the speaker?
It is, of course, also clear from the verbal responses:
Are there regular verbal responses, even if these consist only of encouraging sounds?
Does the response indicate understanding, not only of the facts, but also of the feelings and the implications of the facts?
It is much easier to speak than to listen. Nurses are, in general, very active people, who want help b acting quickly. To ‘just listen’ without expressing opinions or offering advice is therefore, often not in their nature. Active listening is a valuable skill to acquire [10, 17, 18].
\nIn the interest of nurse–patient relationship, it is essential that they ascertain whether their communication has been successful. The following criteria can be used:
Table 1 gives an overview of therapeutic communication techniques and provides examples of each technique [10, 13].
\nGeneral area of issue | \nTherapeutic communication techniques | \nRationale | \nExamples | \n
---|---|---|---|
To obtain information | \nMake broad opening remarks | \nThis gives the patient the freedom to choose what he/she wishes to talk about | \n“Please tell me more about yourself” | \n
Use open-ended questions | \nThis type of question allows the patient to talk about his/her views about the subject. In this way, what the patient sees as important, what his/her intellectual capacity is and how well-orientated he/she is, becomes clear. This encourages the patient to say more and does not limit answers to a ‘yes’ or ‘no’ | \n“How did you experience the pain?” “You say you felt dizzy, and then…” “Tell me more about that” | \n|
Share observations and thoughts | \nThis shows that you are aware of what is happening to the patient and encourages him/her to talk about it | \n“You seem to be upset” | \n|
Confrontation | \nThis entails confronting the patient with an observation you have made and assess his/her reaction to it. This technique is useful when verbal and non-verbal communication do not match | \n“You say that your ankle is very painful, but you do not react when I bend the ankle. How is it possible?” | \n|
Reflection | \nThis means that you repeat what the patient said in the same or different words. This shows you are involved in what the patient is saying and that he/she should talk more about a specific point, or explain further | \nPatient: “It is sore”. Nurse: “Very painful?” | \n|
Encourage description | \nThis is used to obtain more information about patient’s views and feelings | \n“Tell me how it happened” | \n|
Validate what is being said | \nThis is to make sure that you understand the patient correctly | \n“Do I understand you correctly when you say…” | \n|
Offer your presence | \nThe nurse offers his/her attention and interest without making demands | \n“I will be with you until they come to fetch you for the operation in theater” | \n|
Summarizing | \nBy organizing and checking what the patient has said, especially after a detailed discussion. This technique is used to indicate that a specific part of the discussion is coming to an end and that if the patient wishes to say any more, she should do so | \n“You went for a walk and then you felt the sharp chest pains, which radiated down your arm” | \n|
Use of interpretation | \nDraw a conclusion from the information you have gathered and discuss it with your patient to see whether it is true. The patient can then disagree with it, or confirm that your conclusions are true | \n“You must have been exhausted after walking a long distance from home to the hospital” | \n|
To give support | \nSupportive remarks | \nMake supportive remarks to encourage the patient to participate in the conversation. Show that you are listening | \n“Yes….” “Mmmm…” “Go on, I am listening” | \n
Appropriately touch the patient | \nTouch can assure the patient that the nurse cares and is present | \nHold his/her hand. Consider the cultural belief and comfort of the patient before touching | \n|
Paraphrasing | \nThis conveys understanding of the patient’s basic message | \n“It sounds as though the most important problem is the diet” | \n|
To assist in analysis and problem solving | \nAcknowledge the person | \nThis promotes a sense of dignity | \n“Good morning Mr. Jones” | \n
Sequencing | \nThis helps the patient to see the connection between the parts of an occurrence. To effectively assess the patient’s needs, the nurse often needs to know the time frame within which symptom sand /or problems developed or occurred | \n“Did you experience this sharp pain before or after eating?” | \n|
Ask for clarification | \nThis helps the nurse to understand and the patient to communicate more clearly | \n“What do you mean by everybody?” | \n|
Ask for alternatives | \nThis stimulates creative thought and promotes finding solutions | \n“What else can you try?” | \n|
Use of transition | \nThis is used to guide the conversation to another subject, without losing the continuity of the conversation | \n“It seems to me that you have solved the problem of poor appetite, but I would like to hear more about your diabetes. How long have you been aware of this illness?” | \n|
Comparison | \nUse of examples and comparisons to concrete objects. In this way, a vague or abstract concept can be more easily explained | \n“Does the pain feel like a sharp or a blunt object that hits you?” | \n|
Use silence | \nThis gives the patient the chance to think, and/or to his/her organize thoughts. Silence also give a nurse an opportunity to observe the patient. However, the nurse should avoid silences that last too long because they can make the patient anxious | \n\n | |
To instruct the patient | \nGive information | \nThis explains information and puts it at the patient’s disposal | \n“After the operation, you will have a drainage tube” | \n
Orientate the patient towards reality | \nWhen the patient interprets something incorrectly, the nurse draws his/her attention to reality | \n“I am not your daughter, I am Nurse Jones” | \n|
Query what the patient says | \nThe patient’s observation is called into question without belittling him/her, or arguing about it | \nAre you sure about that?” | \n|
Withhold social reward | \nDo not give social approval to wrong behavior so as not to encourage a repeat of the wrong behavior | \nDo not smile, nod or agree when the patient jeopardizes his/her recovery with wrong behavior | \n|
Give social reward | \nReward behavior that promotes health to encourage a repeat of the correct behavior | \nNod is approval at a patient with a weight problem who declines to eat a heavy meal | \n
Therapeutic communication techniques.
There are certain counter-productive communication techniques that the nurse should avoid as they do not assist in the recovery of the patient and do not have any therapeutic value. Table 2 shows counter-productive communication techniques, explains why these should be avoided and gives examples [10, 18].
\nNon-therapeutic techniques | \nRationale | \nExamples | \n
---|---|---|
Inappropriate reassurance | \nThe nurse attempts to brush aside the patient’s aside the patient’s worry by acting as though it is unnecessary or inappropriate. Reassurance is not based on fact or real certainty. This helps the nurse more than it helps the patient | \n“Do not worry; everything will be fine” | \n
Passing judgment | \nThe nurse passes judgment on the patient’s behavior, thoughts or feelings and in doing so, places herself in the position of an adversary or a person who knows better and more | \n“As a Christian, I do not think you should terminate this pregnancy” | \n
Giving advice | \nThe nurse tells the patient how he/she ought to feel, think or act. This implies that she has the correct information and knows better than the patient. This is particularly problematic when the advice is based on limited assessment and knowledge of the patient and the situation | \n“I think you must…” | \n
Closed questions | \nThese questions require only a single word as an answer when specific information is needed. If this type of question is used often, the patient are less inclined to give the information and may be interpreted as an interrogation | \n“Do you feel any pain in your arm?” | \n
‘Why’ questions | \nThese questions demand that the patient explains behavior, feelings or thoughts that he/she often does not understand himself or herself. These questions are often asked early in a conversation when the nurse cannot even be certain that the patient wants to explain himself of herself to the nurse | \n“Why are you upset?” | \n
Offering platitudes | \nThis is stereotyped expression of something the patient is in any case aware of and which, therefore, helps little. This is similar to giving advice | \n“Everybody goes through this in life” | \n
Defensiveness | \nThe nurse tries to defend someone or something the patient criticized. This places the nurse and the patient on opposite sides and does not promote further openness on the part of the patient | \n“We are very short-staffed; so we cannot help everyone at the same time” | \n
Non-therapeutic communication techniques that should be avoided.
Promoting effective communication in health care is demanding and challenging because of the nature of the work environment. Nurses who have received training in communication skills communicate effectively and show increased confidence in communicating with patients. Many nurses choose to work in other countries, providing an opportunity to broaden their experience and knowledge. However, it is important that nurses who have the opportunity to work in other countries develop communication skills, cultural awareness and sensitivity before arriving. For example, in China talking about death is taboo [19]. In South Africa, maintaining eye during communication may be regarded as being disrespectful by Black people [11]. This article provides a reflective account of the experiences of one of the authors of working overseas. This chapter provides the effective communication and interpersonal skills that enhance professional nursing practice and nursing relationships by explaining principles of communication, communication process, purpose of communication, types of communication, barriers to effective communication, models of communication and strategies of improving communication and guidelines for successful therapeutic interactions.
\nThe author wishes to acknowledge the Durban University of Technology for funding this book chapter.
\nThe author declares that there is no conflict of interest in this chapter.
Contrast media is a substance that is used to enhance the differentiation of tissues within the body in medical imaging. They are administered either intravenously, intraarterially, orally or into body cavities, majority being administered intravenously. Over the past few years there has been an increase in the number of radiographic examinations that use contrast media for better lesion characterization, more so in CT and MRI examinations [1]. Although contrast media has become progressively safer over time, especially with the use of low osmolar contrast media (LOCM), anaphylactic reactions still do occur. It is estimated that 0.6% of iodinated and 0.12% of gadolinium contrast cause anaphylactic reactions [2, 3, 4]. Reactions to contrast media range from mild reactions to life threatening severe reactions. Most acute reactions occur within 1 hour of contrast media administration, with majority occurring within the first 20 minutes. Therefore, it is important to be aware of these reactions, to monitor the patient closely in this period and to manage the reactions when they do occur [5].
There are two main types of iodinated contrast comprising high osmolar (HOCM) or ionic contrast that dissociates in solution to form particles and low osmolar or non-ionic that does not dissociate in solution. Contrast media osmolality is determined by the number of particles formed in solution. Ionic contrast media dissociates into osmotically active ions in solution and therefore have a higher osmolality. Non-ionic agents do not dissociate to ions when dissolved in solution and hence have a lower osmolality. In recent years there has been a shift to using the LOCM because of associated fewer reactions therefore making contrast administration safer. Nevertheless, acute anaphylactic reactions can still occur unpredictably and therefore must be recognized and managed promptly. Some of the commonly used iodine-based contrast agents and their osmolality are listed in Table 1 above.
Types of contrast media | ||||
---|---|---|---|---|
Contrast | Trade name | Ionic/Non-ionic | Iodine content | Osmolarity |
Diatrizoate | Gastrografin | Ionic | 300mg/ml | 1550 |
Ioxaglate | Hexabrix | Ionic | 320mg/ml | 580 |
Ultravist | Iopromide | Non-ionic | 300mg/ml | 607 |
Optiray | Ioversal | Non-ionic | 300mg/ml | 651 |
Isovue 370 | Iopamidol | Non-ionic | 370mg/ml | 796 |
Omnipaque 300 | Iohexol | Non-ionic | 300mg/ml | 672 |
Ioxilan 350 | Oxilan | Non-ionic | 350mg/ml | 695 |
Iotrol 300 | Iotrolan | Non-ionic | 300mg/ml | 310 |
Visipaque 320 | Iodixanol | Non-ionic | 320mg/ml | 290 |
Types of iodine based contrast media and osmolarity.
Gadolinium based MRI contrast agents have been shown to be safe for intravenous administration, and actually a better safety profile than iodinated contrast for CT and other radiographic examinations. However acute reactions do occur and include urticaria, nausea and vomiting, and rarely anaphylaxis. In a study of 141,623 doses of MRI contrast administered Jae-woo et al. identified 0.079% immediate hypersensitivity reactions including urticaria, angioedema, bronchospasm and anaphylaxis and one fatality giving a mortality rate of 0.007% [6].
Reactions can be categorized as mild, moderate and severe as well as immediate and delayed. Mild reactions are usually self-limiting and require just supportive treatment, whereas moderate to severe reactions require prompt treatment. Delayed reactions such as abdominal pains, joint pains, fever and chills, diarrhea, headache, rashes and dizziness may be seen within two weeks from the date of contrast administration. Renal toxicity is also a commonly encountered side effect of contrast reactions manifesting as impaired renal function within two weeks of contrast administration.
Table 2 below shows the different types of reactions seen.
Severity | Reaction |
---|---|
Mild reactions | Urticaria |
Hives | |
Nausea | |
Vomiting | |
Moderate reactions | Facial oedema |
Severe vomiting | |
Bronchospasm | |
Laryngeal oedema | |
Severe reactions | Pulmonary oedema |
Cardiac arrythmia | |
Cardiovascular collapse | |
Respiratory collapse |
Classification of contrast media reactions.
Anaphylactic reaction usually occurs within one hour of contrast administration, with majority occurring within the first 20 minutes. This is a life-threatening reaction and manifests with hypotension, bronchospasm/laryngeal oedema and circulatory collapse. Patient evaluation algorithm is as outlined inFigure 1 above.
Patient evaluation algorithm.
Although contrast side effects are infrequent, the knowledge of their presentation, their relationship with pre existing conditions and their management is required to ensure optimal patient care [2, 7]. Non ionic agents are iso-osmolar or low osmolar in nature and have fewer adverse effects [8, 9].
Majority of contrast reactions occur unpredictably and severe reactions may occur even when there has been a previous uneventful examination.
Risk factors that increase the likelihood of occurrence of adverse reactions [10, 11, 12] include:
Previous history of allergy like reaction to contrast media.
Allergy to food or other drugs.
History of asthma.
Renal insufficiency.
Cardiac disease e.g. Congestive cardiac failure, angina.
Anxiety.
Infants and neonates.
Elderly, above the age of 60 years.
Hematological disorders: sickle cell anemia, polycythemia vera, multiple myeloma.
Use of drugs like beta blockers.
A detailed history should be obtained and pre medication administered prior to contrast use to reduce the risk of reaction occurrence.
Adverse reactions to contrast can be divided into organ specific and non organ specific or general reactions. They can also be classified into acute and delayed based on the timing after contrast administration.
Acute hypersensitivity reactions are those that develop within 1 hour of contrast administration and can classified into allergic-like and physiologic [13]. Allergic-like reactions are largely dose and concentration independent. They do not require prior sensitization or Ig-E and are thus called idiosyncratic /anaphylactoid reactions. They occur via direct mast cell stimulations or via activation of complement by immune complexes [14]. These are the most frequent type of adverse reactions and may have serious, occasionally fatal, complications.
Physiologic reactions are those that are dose and concentration dependent are thus called non idiosyncratic reactions. They are due to direct chemotoxic or osmotoxic effects of the contrast media [15].
These acute reactions can be further subclassified into into 3 categories based on severity-mild, moderate and severe [11]. Mild reactions are those that are self limiting. The mild allergic-like reactions include limited urticaria, pruritus, cutaneous edema, nasal congestion while the physiologic reactions include limited nausea and vomiting, transient flushing, headache, dizziness, anxiety and vasovagal reactions that resolve spontaneously [16]. Moderate reactions are those that are progressive and more pronounced and require medical management [17, 18]. The moderate allergic-like reactions include diffuse urticaria/pruritus, diffuse erythema with normal vital signs, facial edema, throat tightness, wheezing and bronchospasms. While the moderate physiological reactions include protracted vomiting, hypertensive urgency, vasovagal reactions that require treatment and respond to it [13]. Severe reactions are those that are potentially life threatening with impending death if not managed properly [2]. The severe allergic-like reactions include diffuse edema with dyspnea, diffuse erythema with hypotension, laryngeal edema with stridor, bronchospasms with hypoxia and anaphylactic shock. The severe physiologic reactions include vasovagal reactions resistant to treatment, convulsions, arrhythmia and hypertensive emergency [13]. The end result of severe allergic like and physiologic reactions is CPA which is a medical emergency and prompt and proper management using the BLS protocol and drugs including epinephrine, vasopressors, antihistamines and inhaled B-agonists is necessary to save lives.
Contrast induced acute kidney injury and nephropathy can also occur following contrast administration [19]. Risk factors include co morbidities like diabetes mellitus, dehydration, cardiac disease, hypertension and multiple iodinated contrast media doses in less than 24 hours. Baseline serum creatinine +/− glomerular filtration rate should be availed before injection of contrast media in at risk patients [13]. Contrast media administration in such patients can be done with caution by: reduced dose of contrast media, hydration and use of iso-osmolar agents.
Management of acute contrast begins with discontinuation of injection if not completed [13, 20]. General principals of BLS and ACLS should apply in case of cardiorespiratory arrest.
Summary of the management of contrast reactions is as outlined inTable 3 below.
Reaction | Monitoring | Treatment |
---|---|---|
Urticaria (skin rash) | Initial size with marking and follow | Mild-Usually none; if symptomatic consider diphenhydramine, 25–50 mg orally Moderate/Severe-monitor vitals and obtain IV access. Consider diphenhydramine, 25–50 mg orally intramuscularly/ intravenously; epinephrine (1:1,000), 0.1–0.3 mL subcutaneously/intramuscularly |
Bronchospasm | Oxygen saturation, pulse, Blood pressure (BP) | In all forms of bronchospasms: preserve IV access, monitor vitals and oxygen saturation and give oxygen by mask 6-10 L/min Mild: Inhaled B-agonist- 2 puffs at 90mcg/puff and can be repeated up to 3 times. If response is not satisfactory, emergency response team should be contacted. Moderate Inhaled B-agonist- 2 puffs at 90mcg/puff and can be repeated up to 3 times Epinephrine (1:1000), 0.3 mL intramuscularly-this can be repeated every 5-15 minutes as needed up to 1 ml(1 mg)total; OR Epinephrine (1:10,000), 1 mL(0.1 mg) intravenously (slowly) if hypotensive; This can be repeated every few minutes as needed up to 10 ml(1 mg) total call the emergency medical team; call the emergency medical team Severe: Epinephrine (1:1000), 0.1–0.3 mL intramuscularly-this can be repeated every 5-15 minutes as needed up to 1 ml(1 mg)total; OR Epinephrine (1:10,000), 1 mL(0.1 mg) intravenously (slowly) if hypotensive; This can be repeated every few minutes as needed up to 10 ml(1 mg) total Call the emergency medical team and Inhaled B-agonist (may work synergistically). Call the emergency medical team |
Facial or laryngeal edema | Oxygen saturation, pulse, BP | In all forms of laryngeal edema: preserve IV access, monitor vitals and oxygen saturation and give oxygen by mask 6-10 L/min Call the emergency medical team if severe Epinephrine (1:1000), 0.3 mL intramuscularly-this can be repeated every 5-15 minutes as needed up to 1 ml(1 mg)total; OR Epinephrine (1:10,000), 1 mL(0.1 mg) intravenously (slowly) if hypotensive; This can be repeated every few minutes as needed up to 10 ml(1 mg) total call the emergency medical team |
Hypotension(systolic BP <90 mmHg) and tachycardia (>100 bpm) | Oxygen saturation, pulse, BP | Preserve IV access, Elevate legs 60°; oxygen, 6–10 L/min; rapid intravenous fluids(1 liter of 0.9% normal saline or lactated Ringer’s); epinephrine (1:10,000), 1 mL(0.1 mg) intravenously (slowly); This can be repeated every few minutes as needed up to 10 ml(1 mg) total OR Epinephrine (1:1000), 0.3 mL intramuscularly-this can be repeated every 5-15 minutes as needed up to 1 ml(1 mg)total call the emergency medical team |
Hypotension(systolic BP <90 mmHg) and bradycardia (<60 bpm) | Oxygen saturation, pulse, BP | Elevate legs 60°; oxygen, 6–10 L/min; rapid intravenous fluids(1 liter of 0.9% normal saline or lactated Ringer’s) If mild, no further treatment is necessary If patient remains symptomatic despite the above measures: Atropine, 0.6–1 mg intravenously (slowly); repeat to total of 2–3 mg (0.04 mg/kg) if needed; call the emergency medical team |
Cardiac arrhythmia | Oxygen saturation, pulse, BP, ECG | Follow ACLS protocols; call the emergency medical team |
Hypertensive crisis (diastolic BP >120 mmHg; systolic BP >200 mmHg) | Oxygen saturation, pulse, BP, ECG | Nitroglycerine, 0.4 mg sublingually; can repeat every 5-10 minutes OR Labetalol intravenously 20 mg, administer slowly over 2 minutes. The dose can be doubled every 10 minutes. OR Lasix intravenously 20-40 mg,slowly over 2 minutes. Phentolamine, 5 mg intravenously for pheochromocytoma; Call the emergency medical team |
Seizures | Oxygen saturation, pulse, BP, ECG | Observe and protect the patient Secure airway; oxygen, 6–10 L/min; Preserve IV access and give diazepam, 5 mg intramuscularly/intravenously OR midazolam, 0.5–1 mg intravenously OR phenytoin infusion, 15–18 mg/kg at 50 mg/min; call the emergency medical team |
Hypoglycemia | Oxygen saturation, pulse, BP | If patient is able to swallow orally give half a cup of fruit juice or 15 g of glucose Is the patient is unable to swallow safely, obtain IV access and give 50% dextrose, 1 ampule-25gms over 2 minutes OR 100 ml/hr. of 5% dextrose. Is patient is unable to swallow and IV access is not available give intramuscular glucagon 1 mg. |
Pulmonary edema | Oxygen saturation, pulse, BP, ECG | Preserve IV access, Secure airway; oxygen, 6–10 L/min; Elevate head of the bed furosemide, 20–40 mg intravenously (slowly over 2 minutes); morphine, 1–3 mg intravenously; call the emergency medical team |
Management of contrast reactions.
Premedication of patients who have a higher risk of acute allergic like reactions should be considered to reduce the chance of reaction occurrence [18]. For elective premedication oral prednisolone and diphenhydramine are used. For emergency premedication I.V methyl prednisolone sodium succinate or dexamethasone sodium sulfate. I.V diphenhydramine can be used instead of steroids in emergency cases [13].
Intravenous corticosteroids play a role in preventing short term recurrence of an allergic like reactions. They may also be administered to patients having severe allergic like manifestations prior to transport to an emergency unit. They are however not useful in the acute treatment of any reaction.
The hospital administration in liaison with the heads of the radiology department and the radiology contrast committee should set up and publish an institutional policy and procedure manual on contrast media administration.
The purpose of this manual is:
To ensure that administration of contrast media is done according to the protocols set up by the hospital and imaging department.
To ensure that in case of adverse reactions to contrast media, appropriate steps are taken to manage them.
To ensure that patients at risk of contrast media reactions or with prior history of such reactions receive appropriate premedication and are imaged using suitable protocols.
To ensure that patients due to receive intravenous contrast media have appropriate laboratory tests done and reviewed by the radiologist to determine their suitability for the procedure.
Guidelines for administration on intravenous contrast:
Administration of intravenous contrast should be done by a trained radiology technician / nurse under the supervision of the radiologist and these staff should be competent in recognizing and managing an adverse reaction if it occurs.
Standard operating procedures on the administration of intravenous contrast media should be set up and made available to the radiology clinical staff for reference when needed.
The Radiologist should review all the imaging requests that require administration of intravenous contrast, to determine the protocol to be used which will depend on the patient’s condition and clinical indication for the study.
The radiology technician and nurse attending to the patient must take a detailed history on the current clinical condition, current medications, history of allergy, asthma and prior adverse reactions to drugs and contrast media.
If the patient is found to have risk factors or contraindications to administration of contrast media, then the radiologist will determine the protocol to be followed and premedication to be administrated if required.
Protocols on the recognition and management of adverse reactions to contrast media should be set up and made available to all radiology clinical staff. These protocols ought to be illustrated in flow charts and placed in the various imaging sections in which intravenous contrast media is administered to facilitate proper management of these emergencies.
Close liaison between the radiology department, the emergency response team and intensive care unit must be present to ensure that the radiology department will get adequate support in case of an emergency.
All imaging sections in the radiology department must be equipped with the emergency equipment and medication required to monitor and manage a patient in cardiopulmonary arrest and more specifically a patient undergoing a severe reaction to contrast media.
Majority of the emergency equipment and medication are part of the standard crash cart/ emergency trolley; therefore, it is upon the administration of the radiology department to decide whether a dedicated contrast reaction kit is necessary. This will depend on the size of the imaging department, patient numbers and budget allocations.
The basic equipment required to monitor patients experiencing an adverse reaction to contrast media include:
Devices for hemodynamic Monitoring-Pulse and blood pressure monitors.
Devices for respiratory monitoring – Pulse oximeter.
Body temperature monitor – Thermometer or adhesive pads with thermoelectric transducer.
Blood glucose monitor.
Stethoscope.
Equipment and supplies for managing patients in an acute adverse reaction include:
Oxygen supply from a wall unit or oxygen cylinder.
Devices to supply the supplemental oxygen e.g. nasal cannula, simple face mask, face mask with oxygen reservoirs (non-rebreather mask). The latter is preferred as it is able to deliver a large dose of approximately 95–100% oxygen at a flow rate of 10-15 ml/min. Another device is a bag mask device which uses positive pressure ventilation with a face mask or advanced airway to administer a high concentration of oxygen to the patient. These devices must be available in adult and pediatric sizes.
Suction device used to clear the airway of secretions to enable the patient to breath. A patent airway is required for effective cardiopulmonary resuscitation in case of cardiopulmonary arrest in the case of severe contrast media reactions. The suction device may be wall mounted or mobile an I used in conjunction with suction tubing/ catheters.
Basic medication required in case of a contrast media reactions include:
Epinephrine
Emergency trolley / crash carts in hospital setting are usually equipped in 1 mg in 10 ml of epinephrine for intravenous administration (1:10000).
Epinephrine 1 mg in 1 ml vial is used for intramuscular injection.
Epinephrine autoinjectors in pediatric, and adult doses can also be used if available.
Oral and intravenous antihistamines.
Inhaled or nebulized B2 agonists.
Normal saline intravenous fluid in 500 ml and 1 liter bags/ bottles.
Atropine 1 mg in 10 ml for intravenous administration.
Additional medication and supplies include:
Emergency drugs – these include the standards emergency medications which are part of standard crash cart/ emergency trolley.
Supplies that form part of the standard emergency trolley like various sizes of intravenous cannulas, needles, syringes and intravenous giving sets.
Advanced cardiovascular life support equipment including:
Advanced airway adjuncts e.g. endotracheal tube.
Suction catheters.
Automated external defibrillator.
In view that cardiopulmonary arrest and adverse reactions to contrast media in the radiology department are rare, it is imperative that periodic stock checks are done to ensure the equipment and medications stocked for the management of these emergencies are within the recommended validity period.
When faced with a severe reaction to contrast media in which the patient’s condition warrants implementation of basic life support and advanced cardiac life support protocols, it is imperative that the hospital emergency response team be alerted to assist in initiation of these lifesaving protocols.
Modern radiology departments are fitted with an emergency bell that alerts the emergency response team to respond to an emergency in each imaging section. All radiology staff must be made aware of the location of these bells to activate them when needed.
In the event that such a system is not in place, the phone number of an internal/ external emergency response unit should be clearly posted in each imaging section.
Despite the rare occurrence of contrast media reactions, they may carry substantial morbidity and mortality and thus require immediate intervention by the attending staff. These staff must therefore be equipped with the knowledge and skills to initiate effective cardiopulmonary resuscitation in order to manage these emergencies as they await the arrival of the emergency response team.
All clinical staff should receive life support training upon employment and thereafter attend at least three yearly refresher course as recommended by the American heart association.
Continuous medical education on contrast media reactions and their management should be held frequently to ensure these vital knowledge and skills are up to date.
Advanced radiology life support ™ is a course that uses concepts from basic life support and advanced cardiac life support to radiology clinical staff on recognizing and managing life threatening emergencies occurring in the imaging department.
This training covers:
Types of contrast media used in imaging.
Recognition of the signs and symptoms of contrast media reactions.
Risk factors of contrast induced nephropathy and approach to administration of contrast media in renal insufficiency.
Safety of Gadolinium based contrast agents and nephrogenic systemic fibrosis.
Airway management in emergencies.
Safe management of sedated patients in the imaging department.
Advanced radiology life support ™ has been successful in United states of America and Canada in training of radiologists, radiology technicians and nurses in the management of contrast media reactions and cardiopulmonary arrest in the radiology department. Accreditation is by the Mayo clinic of medicine and Science.
This training is available online in form interactive videos, therefore imaging departments should allocate a budget for purchase of this training for each of its clinical staff members.
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Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10669",title:"Corrosion",subtitle:"Fundamentals and Protection Mechanisms",isOpenForSubmission:!1,hash:"4a76d54f8a40fc2e7002a8d13fd617c1",slug:"corrosion-fundamentals-and-protection-mechanisms",bookSignature:"Fahmina Zafar, Anujit Ghosal and Eram Sharmin",coverURL:"https://cdn.intechopen.com/books/images_new/10669.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"89672",title:"Dr.",name:"Fahmina",middleName:null,surname:"Zafar",slug:"fahmina-zafar",fullName:"Fahmina Zafar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10677",title:"Advanced Topics of Topology",subtitle:null,isOpenForSubmission:!1,hash:"bf964c52f9e653fac20a7fcab58070e5",slug:"advanced-topics-of-topology",bookSignature:"Francisco Bulnes",coverURL:"https://cdn.intechopen.com/books/images_new/10677.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11195",title:"Recent Advances in Biometrics",subtitle:null,isOpenForSubmission:!1,hash:"2d32e33e0f499cb5241734bb75dd2a83",slug:"recent-advances-in-biometrics",bookSignature:"Muhammad Sarfraz",coverURL:"https://cdn.intechopen.com/books/images_new/11195.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"238",title:"Psycholinguistics",slug:"psycholinguistics",parent:{id:"21",title:"Psychology",slug:"psychology"},numberOfBooks:3,numberOfSeries:0,numberOfAuthorsAndEditors:80,numberOfWosCitations:15,numberOfCrossrefCitations:31,numberOfDimensionsCitations:89,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"238",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"10889",title:"Aphasia Compendium",subtitle:null,isOpenForSubmission:!1,hash:"f2c0b1c302f68d0c86ae8e057d1cc90e",slug:"aphasia-compendium",bookSignature:"Dragoș Cătălin Jianu and Dafin Fior Mureșanu",coverURL:"https://cdn.intechopen.com/books/images_new/10889.jpg",editedByType:"Edited by",editors:[{id:"45925",title:"Prof.",name:"Dragoș",middleName:null,surname:"Cătălin Jianu",slug:"dragos-catalin-jianu",fullName:"Dragoș Cătălin Jianu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7311",title:"Cognitive and Intermedial Semiotics",subtitle:null,isOpenForSubmission:!1,hash:"2b7d636f6a78bfa31a39bab658a4b18c",slug:"cognitive-and-intermedial-semiotics",bookSignature:"Marta Silvera-Roig and Asunción López-Varela Azcárate",coverURL:"https://cdn.intechopen.com/books/images_new/7311.jpg",editedByType:"Edited by",editors:[{id:"302728",title:"Dr.",name:"Marta",middleName:null,surname:"Silvera-Roig",slug:"marta-silvera-roig",fullName:"Marta Silvera-Roig"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5957",title:"Advances in Speech-language Pathology",subtitle:null,isOpenForSubmission:!1,hash:"0aa9183a00d31fd1970187a4452a62d8",slug:"advances-in-speech-language-pathology",bookSignature:"Fernanda Dreux M. Fernandes",coverURL:"https://cdn.intechopen.com/books/images_new/5957.jpg",editedByType:"Edited by",editors:[{id:"28286",title:"Dr.",name:"Fernanda Dreux Miranda",middleName:null,surname:"Fernandes",slug:"fernanda-dreux-miranda-fernandes",fullName:"Fernanda Dreux Miranda Fernandes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"56330",doi:"10.5772/intechopen.69932",title:"Russian Scientific Trends on Specific Language Impairment in Childhood",slug:"russian-scientific-trends-on-specific-language-impairment-in-childhood",totalDownloads:1950,totalCrossrefCites:0,totalDimensionsCites:23,abstract:"In Russia, there are many decades of experience in the scientific study of the problem of impaired language development in children. Today, the term “Systemic speech-and-language underdevelopment (SLU)” has firmly established in Russian science and practice, implying a complex developmental disorder of speech and language in children with a primary normal hearing and a conserved intellect, in which the main components of the language system are violated: vocabulary, grammar, phonetics, and, as a consequence, dialogic and monologic speech. Traditionally, a differentiated level-by-level analysis of the speech and language abilities of children is used. The variability of the manifestations and severity of speech-and-language disorders were initially systematized and characterized in four levels of underdevelopment: from the complete absence of phrase speech to the availability of simple and complex sentences with lexico-grammatical errors. Effective algorithms of speech therapist work with SLU are introduced. The effectiveness of the application of these models and algorithms on the material of various language groups is proved.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Tatiana Tumanova and Tatiana Filicheva",authors:[{id:"204529",title:"Dr.",name:"Tatiana Volodarovna",middleName:null,surname:"Tumanova",slug:"tatiana-volodarovna-tumanova",fullName:"Tatiana Volodarovna Tumanova"},{id:"208704",title:"Dr.",name:"Tatiana Borisovna",middleName:null,surname:"Filicheva",slug:"tatiana-borisovna-filicheva",fullName:"Tatiana Borisovna Filicheva"}]},{id:"56560",doi:"10.5772/intechopen.70235",title:"The Role of Speech and Language Therapist in Autism Spectrum Disorders Intervention – An Inclusive Approach",slug:"the-role-of-speech-and-language-therapist-in-autism-spectrum-disorders-intervention-an-inclusive-app",totalDownloads:2365,totalCrossrefCites:2,totalDimensionsCites:16,abstract:"The chapter describes the possibilities of involving a speech-language therapist in the assessment of the pragmatic level of communication in autism spectrum disorders (ASD), where one of the most frequently impaired areas is communication pragmatics. These difficulties lead to a disruption of social interaction, which might be one of the obstacles to speech-language intervention in these children. The text is based on an originally developed testing material aimed at selected pragmatic-oriented communication situations relating to everyday activities and real life. Based on a comparison of domestic and international resources in this area, as well as mediated and own empirical experience, our assessment approach is based on the conclusion that pragmatics can be understood in different contexts and perspectives. The text presents the results of a partial survey comparing the performance of children with ASD and children with typical development. The assessment focused on the children’s election of the correct picture of a pair of pictures that represent usual communication and social situations. The results of the research suggest fewer incorrect responses in children with ASD and in different areas compared with children with typical development. However, the results of a qualitative analysis indicate a necessity to expand the assessment of communication pragmatics by adding an individually specific qualitative analysis of children’s performance.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Kateřina Vitásková and Lucie Kytnarová",authors:[{id:"203061",title:"Associate Prof.",name:"Kateřina",middleName:null,surname:"Vitásková",slug:"katerina-vitaskova",fullName:"Kateřina Vitásková"},{id:"212035",title:"MSc.",name:"Lucie",middleName:null,surname:"Kytnarová",slug:"lucie-kytnarova",fullName:"Lucie Kytnarová"}]},{id:"56266",doi:"10.5772/intechopen.69894",title:"Discourse: Assessment and Therapy",slug:"discourse-assessment-and-therapy",totalDownloads:3138,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"Discourse is essential for interaction and for the expression of ideas, feelings and opinions. Telling personal stories, such as talking about your day or recounting what happened in the playground, is essential for communication and establishing relationships. However, due to their language impairments, people with aphasia (PWA) and children with developmental language disorder (DLD) often have problems with everyday discourse which impact on their lives more widely. While improvement in language skills is supported by speech-language pathology (therapy), it tends to focus on smaller linguistic components, such as single words and sentences. This chapter outlines how speakers construct discourse in everyday situations and focuses on the meanings that people use discourse to convey, as well as the lexical and grammatical resources they use to convey these meanings. Current methods for discourse analysis will be outlined and key developments in narrative discourse production therapy will be reviewed.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Lucy T. Dipper and Madeleine Pritchard",authors:[{id:"201158",title:"Dr.",name:"Lucy",middleName:null,surname:"Dipper",slug:"lucy-dipper",fullName:"Lucy Dipper"},{id:"208542",title:"Dr.",name:"Madeleine",middleName:null,surname:"Pritchard",slug:"madeleine-pritchard",fullName:"Madeleine Pritchard"}]},{id:"70186",doi:"10.5772/intechopen.90173",title:"Computational Model for the Construction of Cognitive Maps",slug:"computational-model-for-the-construction-of-cognitive-maps",totalDownloads:792,totalCrossrefCites:5,totalDimensionsCites:7,abstract:"The chapter considers an option for solving the problem of storing data in the Web environment and providing an access to the data, taking into account their semantics, i.e., in accordance with the nature of the tasks solved by users of different classes. The proposed solution is based on the use of presentation of the data in the form of semantic networks. As the main technical tool for describing access methods, the chapter proposes cognitive maps (CMs), which can also be considered as semantic networks of special type. When access is done, the presentation of information consistent with the semantic description of the user is provided. The suggested method of constructing CMs is based on the intensional logic. The solution is presented in the form of a computational model, which provides for the construction of CM’s dependence on the parameter. The proposed method of parametrization makes it possible to take into account the semantic characteristics of users of various classes. Some CM constructions for problem domain description are presented. A method for semantically oriented naming of CMs is proposed. The method is based on building of a functor of special type.",book:{id:"7311",slug:"cognitive-and-intermedial-semiotics",title:"Cognitive and Intermedial Semiotics",fullTitle:"Cognitive and Intermedial Semiotics"},signatures:"Larisa Yu. Ismailova, Sergey V. Kosikov and Viacheslav E. Wolfengagen",authors:[{id:"299703",title:"Dr.",name:"Larisa",middleName:"Yusifovna",surname:"Ismailova",slug:"larisa-ismailova",fullName:"Larisa Ismailova"},{id:"299704",title:"Prof.",name:"Viacheslav",middleName:null,surname:"Wolfengagen",slug:"viacheslav-wolfengagen",fullName:"Viacheslav Wolfengagen"},{id:"299711",title:"Mr.",name:"Sergey V.",middleName:null,surname:"Kosikov",slug:"sergey-v.-kosikov",fullName:"Sergey V. Kosikov"}]},{id:"56281",doi:"10.5772/intechopen.70106",title:"Remote Speech-Language Intervention, with the Participation of Parents of Children with Autism",slug:"remote-speech-language-intervention-with-the-participation-of-parents-of-children-with-autism",totalDownloads:1539,totalCrossrefCites:1,totalDimensionsCites:5,abstract:"The question about the possibility of identifying the best therapeutic approach for children with autism spectrum disorder (ASD) has also been discussed in the literature. The intervention should be individualized, in order to involve the current level of development of the child and to identify the profile of the facilities and difficulties of each child. The families are constantly involved in complex and changeable context and are aware of the importance of access and participation to the treatment chosen, since that service delays can directly affect efficacy. In general, studies on language acquisition and development in autism focus on the child’s communication, and some analyze the mother seeking to understand how the role of parents and caregivers influences the communication of the children with autism. Observing the importance of the active inclusion of parents in the speech and language therapy of children with ASD, a Distance Speech Therapy Intervention project, was developed that would allow language stimulation of a greater number of children and adolescents with autism.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Milene Rossi Pereira Barbosa and Fernanda Dreux Miranda\nFernandes",authors:[{id:"28286",title:"Dr.",name:"Fernanda Dreux Miranda",middleName:null,surname:"Fernandes",slug:"fernanda-dreux-miranda-fernandes",fullName:"Fernanda Dreux Miranda Fernandes"},{id:"171244",title:"Dr.",name:"Milene Rossi P.",middleName:null,surname:"Barbosa",slug:"milene-rossi-p.-barbosa",fullName:"Milene Rossi P. Barbosa"}]}],mostDownloadedChaptersLast30Days:[{id:"56698",title:"Risk Factors for Speech-Language Pathologies in Children",slug:"risk-factors-for-speech-language-pathologies-in-children",totalDownloads:1630,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Risk factors are understood to encompass “aspects of individual behavior or lifestyle, environmental exposure, hereditary or congenital characteristics that are associated with a health related condition”. These are conditions that increase the chances of the child presenting speech-language disorders and that can be avoided, controlled, or treated. Risk is defined as the chance of a child exposed to certain factors (environmental or biological) to acquire or develop speech-language disorders. The objectives of the present study were: to identify the risk factors for speech-language disorders in children up to five years of age and to verify the relationship between risk factors and speech-language diagnostic hypotheses. The aspects of being male gender, prematurity, shyness, being an only child or youngest child, presenting deleterious oral habits, having a family history of speech-language disorders, and use of licit or illicit drugs during pregnancy seem to be the factors that should draw the attention of the health professionals in child development. Therefore, the monitoring of children who have these risk factors should be performed in order to promote the necessary stimulation and the construction of healthy environments.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Daniela Regina Molini-Avejonas, Laís Vignati Ferreira and Cibelle\nAlbuquerque de La Higuera Amato",authors:[{id:"38599",title:"Prof.",name:"Daniela",middleName:null,surname:"Molini-Avejonas",slug:"daniela-molini-avejonas",fullName:"Daniela Molini-Avejonas"},{id:"204612",title:"Prof.",name:"Cibelle",middleName:null,surname:"Amato",slug:"cibelle-amato",fullName:"Cibelle Amato"},{id:"210543",title:"Ms.",name:"Laís",middleName:null,surname:"Ferreira",slug:"lais-ferreira",fullName:"Laís Ferreira"}]},{id:"56385",title:"Formulaic Language: The Building Block of Aphasic Speech",slug:"formulaic-language-the-building-block-of-aphasic-speech",totalDownloads:1893,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Aphasia is a condition that may appear when parts of the brain (Broca’s or Wernicke’s area) responsible for language production and processing are damaged. In most cases, patients have the left side of their brain affected. Thus, formulaic language remains intact in most cases. During speech therapy, this can be a solid base to build on. Formulaic language consists of formulas that are fixed phrases, stereotypes that behave as a single-unit lexical item. They have a significant role in language acquisition and fluent discourse production. These ready-made parts of speech are stored in the long-term memory. Studies suggest that the processing of formulaic language engages right hemisphere areas of the brain. Due to their language impairment, people with aphasia often have a lower quality of life, consequently social and professional integration for them being problematic. The investigation of preserved patterns, such as formulaic language and impairments related to different aspects of discourse, may provide insights both for clinical practice and for cognitive science, therefore, facilitating a more efficient approach to treatment.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Annamária Győrfi",authors:[{id:"200880",title:"Dr.",name:"Annamaria",middleName:null,surname:"Gyorfi",slug:"annamaria-gyorfi",fullName:"Annamaria Gyorfi"}]},{id:"72178",title:"Cognitive Semiotics and Conceptual Blend: A Case Study from The Crying of Lot 49",slug:"cognitive-semiotics-and-conceptual-blend-a-case-study-from-em-the-crying-of-lot-49-em-",totalDownloads:724,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Cognitive semiotics has been defined by the linguist Jordan Zlatev as “the need to unify or at least to ‘defragment’ our world-views, the need to come to terms with increasingly higher levels of dynamism and complexity”. If we consider, as it is clear from the second cognitive revolution, when embodiment claimed its leading role, that meaning emerges from the constant interaction of body-brain-environment, we need to redefine the field that asks “what is meaning and how does it emerge.” New theories about metaphors as neural nodes and image schemas would shed light over the emergence of meaning in human communication, and, to do so, the study of conceptual blends as essential cognitive tools and as an integrative theory should be put in the center of the debate. In words of Brandt and Brandt, “blends occur as signs and are therefore a natural subject of cognitive semiotics”. Here, we will represent the emergence of meaning in a blend from the highly dynamic and complex narrative The Crying of Lot 49 by Pynchon and propose a conceptual story (or mental space sequence of the story) of the mentioned blend.",book:{id:"7311",slug:"cognitive-and-intermedial-semiotics",title:"Cognitive and Intermedial Semiotics",fullTitle:"Cognitive and Intermedial Semiotics"},signatures:"Marta Silvera-Roig",authors:[{id:"302728",title:"Dr.",name:"Marta",middleName:null,surname:"Silvera-Roig",slug:"marta-silvera-roig",fullName:"Marta Silvera-Roig"}]},{id:"56266",title:"Discourse: Assessment and Therapy",slug:"discourse-assessment-and-therapy",totalDownloads:3138,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"Discourse is essential for interaction and for the expression of ideas, feelings and opinions. Telling personal stories, such as talking about your day or recounting what happened in the playground, is essential for communication and establishing relationships. However, due to their language impairments, people with aphasia (PWA) and children with developmental language disorder (DLD) often have problems with everyday discourse which impact on their lives more widely. While improvement in language skills is supported by speech-language pathology (therapy), it tends to focus on smaller linguistic components, such as single words and sentences. This chapter outlines how speakers construct discourse in everyday situations and focuses on the meanings that people use discourse to convey, as well as the lexical and grammatical resources they use to convey these meanings. Current methods for discourse analysis will be outlined and key developments in narrative discourse production therapy will be reviewed.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Lucy T. Dipper and Madeleine Pritchard",authors:[{id:"201158",title:"Dr.",name:"Lucy",middleName:null,surname:"Dipper",slug:"lucy-dipper",fullName:"Lucy Dipper"},{id:"208542",title:"Dr.",name:"Madeleine",middleName:null,surname:"Pritchard",slug:"madeleine-pritchard",fullName:"Madeleine Pritchard"}]},{id:"56414",title:"Evidence for Speech Sound Disorder (SSD) Assessment",slug:"evidence-for-speech-sound-disorder-ssd-assessment",totalDownloads:1646,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Comprehensive studies on aspects related to the assessment of different biomedical parameters (acoustic and laryngeal signs and oral airflow amplitude), as well as parameters for speech disorders, articulation rate, speech inconsistency, and speech stimulability, are essential for better professional practice and to understand misarticulations in children with speech sound disorders (SSDs). Different equipments that enable noninvasive collection and analysis of data have become more common in speech-language pathology practice. Studies recently conducted by our research group have emphasized the evaluation of auditory-perceptual processing by means of assessments of central auditory processing, electrophysiology of hearing—considering that pure-tone, speech audiometry, and tympanometry are routinely used with children during the diagnostic phase and motor speech production performed by acoustic analysis of speech, electroglottography, aerodynamic measures, and ultrasound tongue imaging. This chapter presents the recent advances observed in studies with Brazilian-Portuguese speakers aiming to improve the assessment of speech sound disorders and to understand better the relationship between the different processing mechanisms involved in speech.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Haydée Fiszbein Wertzner, Danira T. Francisco, Tatiane F. Barrozo\nand Luciana O. 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Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"243698",title:"Dr.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:null,institution:null},{id:"7227",title:"Dr.",name:"Hiroaki",middleName:null,surname:"Matsui",slug:"hiroaki-matsui",fullName:"Hiroaki Matsui",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Tokyo",country:{name:"Japan"}}},{id:"312999",title:"Dr.",name:"Bernard O.",middleName:null,surname:"Asimeng",slug:"bernard-o.-asimeng",fullName:"Bernard O. Asimeng",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"318905",title:"Prof.",name:"Elvis",middleName:"Kwason",surname:"Tiburu",slug:"elvis-tiburu",fullName:"Elvis Tiburu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"336193",title:"Dr.",name:"Abdullah",middleName:null,surname:"Alamoudi",slug:"abdullah-alamoudi",fullName:"Abdullah Alamoudi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"318657",title:"MSc.",name:"Isabell",middleName:null,surname:"Steuding",slug:"isabell-steuding",fullName:"Isabell Steuding",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"318656",title:"BSc.",name:"Peter",middleName:null,surname:"Kußmann",slug:"peter-kussmann",fullName:"Peter Kußmann",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}}]}},subseries:{item:{id:"3",type:"subseries",title:"Bacterial Infectious Diseases",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools",scope:"