Elements of schemes for the informal economy, design elements, and universal coverage.
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These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\nInitially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\nThese books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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The genetic diversity between and within populations displayed by molecular markers receive extensive interest due to the usefulness of this information in breeding and conservation programs. In this concept molecular markers give valuable information. The increasing availability of PCR-based molecular markers allows the detailed analyses and evaluation of genetic diversity in animals and also, the detection of genes influencing economically important traits. The purpose of the book is to provide a glimpse into the dynamic process of genetic variation in animals by presenting the thoughts of scientists who are engaged in the generation of new idea and techniques employed for the assessment of genetic diversity, often from very different perspectives. The book should prove useful to students, researchers, and experts in the area of conservation biology, genetic diversity, and molecular biology.",isbn:null,printIsbn:"978-953-51-0093-5",pdfIsbn:"978-953-51-5214-9",doi:"10.5772/2072",price:139,priceEur:155,priceUsd:179,slug:"analysis-of-genetic-variation-in-animals",numberOfPages:374,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"2dbc70699ec1ca38dc2175c6aeebe710",bookSignature:"Mahmut Caliskan",publishedDate:"February 29th 2012",coverURL:"https://cdn.intechopen.com/books/images_new/1610.jpg",numberOfDownloads:50405,numberOfWosCitations:55,numberOfCrossrefCitations:24,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:60,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:139,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 13th 2011",dateEndSecondStepPublish:"May 11th 2011",dateEndThirdStepPublish:"September 15th 2011",dateEndFourthStepPublish:"October 15th 2011",dateEndFifthStepPublish:"February 14th 2012",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"51528",title:"Prof.",name:"Mahmut",middleName:null,surname:"Çalışkan",slug:"mahmut-caliskan",fullName:"Mahmut Çalışkan",profilePictureURL:"https://mts.intechopen.com/storage/users/51528/images/system/51528.png",biography:"Mahmut Çalışkan is a Professor of Genetics and Molecular Biology in the Department of Biology, Biotechnology Division, Istanbul University, Turkey. He obtained a BSc from Middle East Technical University, Ankara, and a Ph.D. from the University of Leeds, England. 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Roth, D. Chamoret, J. Badin, JR. Imbert and S. 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This chapter examines health insurance systems from the perspective of how health insurance access can be expanded in environments characterised by high levels of informality in employment, relative unaffordability of premiums, low benefit or service levels, revealed preference for private health care, and high inefficiencies in the management of social health insurance funds. This type of environment is prototypical not only for the Philippines but for other low to middle-income countries. Informal labour markets present a challenge to health insurance systems as there is no employer to co-share premium payments, nor are they adequately covered in government subsidies extended for those considered poor through the means test. It is this gap that is often cited as ‘the missing middle’ in social health insurance systems’ [1].
Assessments of health coverage for the informal sector examine demand and supply-side issues peculiar to the sector, such as willingness to pay and ability to pay, premium levels, and collection structures, including cost-sharing modalities and fund sustainability. This chapter takes on the perspective of understanding the institutional context, the nature of coordination arrangements required to ‘fit’ the informal sectors’ conditions into social health insurance schemes or in reverse, structure systems to cater to social insurance schemes for the more unorganised groups.
Health insurance systems have two inherent features—information asymmetries and adverse selection. Yet social health insurance schemes often bypass these concerns in the development of schemes to cover the informal sector. Information asymmetry fosters moral hazard, whereby insurance status signals the choices on diagnostics or treatment and quality of services recommended by providers, described in standard textbooks [2]. Moral hazard happens when the insured takes more risks, such as unhealthy or incautious consumption behaviour (smoking, driving under the drugs, or alcohol influence) as a result of the risks being insured. Adverse selection is created when risk pools may be more attractive to sicklier individuals. Private health insurance is known to select lower-risk individuals. These features create the knowledge gaps to coordinate transactions and behaviour in the informal sector, thus limiting health insurance coverage. The promise of social health insurance or universal health coverage (UHC) is premised on greater financial protection in the face of health risks, a larger population coverage to spread risks, and wider sets of services or benefits covered. These pillars of UHC form its mandate, affecting interactions among stakeholders and thus creating operating pressures for programme implementation.
The Philippines launched its universal health care Act in 2020, following the approval of a fresh-minted law, Republic Act 11223 in February 2019. Implementation was set for January 2020, when the COVID-19 pandemic struck. This twin setback provides an opportunity for reflection on an institutional design that is more inclusive, efficient, equitable for greater health security.
This section covers the estimates of the informal economy for the country, its features in terms of demographics, and some context.
Using a proxy indicator1 based on its labour force surveys, in the absence of a direct survey, the Philippine’s Department of Labour and Employment (DOLE) representative to the Global Knowledge Sharing forum shared the statistics on the informal economy. Figure 1 shows that from 2008 to 2017, there was an average of 21.1 million workers in the informal economy (estimated by the number of self-employed without paid employees, unpaid family workers, and wage and salary workers in precarious employment). This comprised 56% of the total employment; while workers in the formal economy (estimated by the employer in own family farm or business, and the wage and salary workers with the permanent job or business) were 44% of total employment or an average of 16.1 million workers. The figures include the agricultural sector. This figure of 56% of total employment as informal is relatively lower than the 68.2% regional average, with agriculture and China included, for the Asia and Pacific [4].
Size of informal employment. Source: Department of Labour and Employment (2018). Size of the Informal Economy in the Philippines [
Out of the 21.2 million workers in the informal economy in the Philippines, in the 10-year average, the self-employed accounted for 10.8 million (51%), followed by wage and salary workers in precarious employment with 6.5 million (31%), and unpaid family workers with a total of 3.8 million (18%). In 2017, there were 17.62 million workers in formal employment and 22.68 million in informal employment. In the 10 years, informal employment grew by 16.5%.
Informality in employment is expected to increase due to the restrictions on movement and outright lockdown of workplaces and cities due to the pandemic. The Asian Development Bank reported that by January 2021, 1.7 million wage and salary jobs were lost and the informal sector numbers rose to 435 thousand. This was just one year from the start of the pandemic in 2020 [5]. Further surges in infections and movement restrictions as part of pandemic control are likely to see rising numbers of people getting off formal work in favour of more flexible arrangements. While informal work numbers indicated that there are estimated to be comprising the second quintile of families in the distribution of income, working arrangements particularly in the sharing economy sector, such as Uber, Grab drivers and online sellers will see the expansion of the informal sector towards the middle quintiles.
The country’s national health insurance program was instituted in 1995, with health funds carved out from the social security system for employed workers who paid in monthly contributions towards health, work accident, life insurance, and pensions since 1969. The Philippine Health Insurance Corporation (PhilHealth) absorbed and managed health insurance funds and progressively overtook other health insurance schemes, such as those for overseas Filipino workers for their families left behind, those covered by charitable agencies, and its name is synonymous with the national health insurance programme.
In the late 80s to 90s, Medicare, the health insurance programme attached to the private social security system (SSS), was involved in working with organised groups, mostly community groups, some on rotating savings schemes, who were enjoined to include health insurance coverage as a benefit to members. Technical assistance and material support for operating systems were provided by the Medicare programme, through the German aid programme (GTZ) called SHINE. When the Indigent Programme got into good momentum, many of the groups were incorporated in the LGU sponsorship, others closed.
PhilHealth instituted a voluntary contribution scheme in early 2012 targeting informal employment workers belonging to cooperatives or those organised through non-government organisations (NGOs) through the organised groups programme. The institution made various efforts to gather these groups, providing incentives to the savings associations, cooperative banks, or non-government organisations to collect funds from members, advance or loan members their premium payments in 2017. When group collectors were no longer willing to collect, organised member groups thus reverted to individually paying membership. It was reported in 2014 that dropout rates or regular non-payment of premiums were two-thirds of the membership in the individual economy scheme (as the informal sector programme has been renamed) [6].
PhilHealth has other member categories, aside from those in formal employment. The ‘sponsored member’ group is the largest, comprising 50% of membership in 2015. Sponsored members are those who enjoy full state or other state agencies’ subsidies for premiums. The biggest group of sponsored members belongs to the beneficiaries of the government’s conditional cash transfer (CCT) programme. In this cash transfer programme, a means test is utilised to target the deserving beneficiaries who are considered poor through 24 sets of proxy variables of income and well-being variables. Other sponsored members, including retirees and pensioners (aged over 60), are considered lifetime members and non-paying. Under the new UHC Act, sponsored members are fully protected by the no-balance-billing policy. This policy mandates that as long as there are public hospital wards available, these members cannot be charged with other expenses exceeding their PhilHealth benefits.
In 2015, sponsored members comprised 50% of PhilHealth membership, followed by 30% from the formal sector, 9.5% from the retirees or lifetime members. The balance, or around 10%, was from the informal and self-employed members. This share has gone up to 18% according to a 2020 study [7].
The idea of public-organised groups’ partnerships in funds collection has been pioneering [6]. The problems related to the informal sector programme of PhilHealth can be traced to the following—(1) relatively unaffordable premiums for its target informal sector groups; (2) lack of systems to verify membership with contributions and thus smoothen authorisations at the time of use; (3) low level of benefits and substantial out-of-pocket expenses; (4) learning by doing approach that lacked consultation and evidence-based studies which led to policy confusion for implementors; and (5) a complex financial management system which made funds tracking unwieldy. PhilHealth experienced fund deficits arising from its expansion of coverage to other sponsored members, diversification to non-hospital-based benefits, and other fund management issues. The fund which reported a surplus for much of its existence [8] suffered deficits when subsidies overtook member payments as the dominant revenue source [9]. Media reported on anomalies involving the PhilHealth Board’s authorisation of across-the-board payroll bonuses to employees. This was eventually ruled by the highest court to be illegal and without proper authorisation [10].
This assessment can apply to the whole PhilHealth programme; notwithstanding strides taken in continuing efforts to increase coverage and improve equity [11]. Benefits have been bolstered as well with the inclusion of other outpatient benefits, including costly procedures, such as dialysis and cataract operations, and catastrophic care packages, such as Z benefits [12]. These gains were obtained at the cost of financial weakening and other administrative setbacks, which caused delays in payment to providers and heightened the lack of trust and other credibility issues with stakeholders [13].
In the light of the new UHC Act and the attention directed to the health sector due to the pandemic, a primordial question is raised. What is the appropriate governance structure framing a pluralistic health system often found in many low and middle-income countries (LMIC), such as the Philippines? From an economic organisation perspective, Williamson ([14], p. 673) viewed operationalising the concept of governance from ‘the lens of a contract (rather than the neoclassical lens of choice)’. This perspective views the unit of analysis concerning the organisation problem not in terms of the individual but of the transaction. According to the early (mid-twentieth century) institutional economist, J. Commons, a contract ‘must contain the three principles of conflict, mutuality and order’ ([14], p. 673). This section extends the analysis of the organisation of national health insurance as a social contract problem, examining the nature of transactions in health care, the practice of rules, regulations, source(s) of organisational stability, and the relations with stakeholders fostered.
Commons’ view of the contract contextualised in economic organisation lens as conflict-mutuality-order is similar to the impetus for the classical social contract. The work of early political philosophers, however, emanated from the perspective of
In relation to the organisation of an inclusive national health insurance scheme in a pluralistic health system, one may say that it is a source of conflict. It is, thus, also a source of measuring power relations among societal groups or the political economy view. Bloom, Standing, and Lloyd [16] covered the political economy perspective and examined the issue of power emanating from knowledge gaps in different health care social contracts. From an economic perspective, the conflict that arises from the access and exercise of the state’s power over the public-private purse in health financing involves transaction costs. Transaction cost refers to the cost of bargaining, contracting, and monitoring [17]. Avoiding or minimising transaction costs underpins arguments, at both theory and policy levels, on the types of arrangements or governance systems to bring out societal or organizational outcomes. Mutuality lies in the consensus on the goals of efficiency, equity, and quality of care. Will the order established following the pandemic and the launch of the new UHC Act be one of breakdown or continuity?
From a conceptual point of view, a governance lens covers three alternative arrangements—markets, hierarchies, and networks (MHN). Hence, a transaction cost analysis can present the problem as an organisational and design issue. This framework has seen the wide application since the beginning of the new public management reforms in the 80s. It has informed changing managerial practice in health care in countries, particularly health systems similarly organised as the English National Health Service [18].
This section investigates the nature of exchange or interactions in the health system. The starting point is considering interactions in health care or insurance as a transaction of exchange. The discussion on the features of health insurance, at the beginning of the chapter and from microeconomic theory, highlights the argument that health care and health insurance are unlike other commodities traded in the market. The nature of transactions in health insurance is such that premiums, or the price of insurance, and pay-outs, or claims, in the form of benefit services, are not equivalent to the price and quantity nexus in the normal demand (and supply) for goods [2]. Presently, under pandemic conditions, for instance, there is more certainty to the need for health insurance. However, insurance cover for a ‘sure thing’, given prevalence and transmissibility, will not be available, or when available will be quite costly. With uncertainty in the amount and timing of incomes, an inherent feature of informal work, health insurance may be unaffordable. If it is unaffordable, then there is a lack of effective demand (and supply is not interested in lower prices).
Willingness to pay for health insurance is between 1.18–1.39% of GDP per capita for a year’s contribution from the 16 studies included in a systematic review [19]. The lack of a general understanding of the benefits of health insurance has been the point of entry for randomised controlled trials involving the informal sector in Vietnam, China, and Philippines [20, 21, 22]. Observations were made on whether those who were provided with more information on health insurance, its benefits, and how to access them in the country would behave differently from those that did not receive such information. Other tweaks to the field experiments included having transport vouchers and/or having some handholding navigators who directed and even accompanied study respondents to the insurance offices. Evidence gathered from these studies indicated small improvements in demand, but severe income constraints and the lack of affordability prevailed. Other reasons cited were related to the perception of poor quality of services covered and complicated enrolment procedures.
In the original tenets of Coase [23], market transactions have zero transaction cost, and the decision to be in the hierarchical ordering, that is, establish the firm, is a way to counter increasing transaction costs [24]. Public policy applications highlight the costs to the hierarchical arrangements, that is, government institutions. The costs of government intervention can be assessed and compared to outcomes that would have risen had they been left to the market. The government’s exercise of influence, if not control, on the behaviour of various agents, is a source of conflict. Balancing competing interests has its costs and benefits. In standard economics language, a Pareto solution reconciles everyone’s interests, with the winners compensating the losers. In the health system, a social contract solution holds when institutions come to an agreement or reconcile their interests for the common good, to achieve desired outcomes.
The government’s role in the health sector, given the inherent failures in the market, is seen as being provider, funder, and regulator. Standard textbooks view regulations as correcting for market failures, particularly in sectors with high externalities, non-competitive markets, and with deep information asymmetries [25]. National health service types of systems, such as in the UK and Canada, started as largely state provision and funding. The late 80s to 90s saw their evolution into quasi-market organisations separating state provision from state funding. The provision remains with the state, but some institutions are governed by boards and can compete for state funds and across other state bodies [26, 27].
How the government succeeds in its role can determine its ability to manage conflict and establish order. From an economic organisation perspective, government mirrors vertical integration or the hierarchical structure. In a pluralistic economy, where the private sector is extensively involved, the government’s ability to be a balancing force is affected by the extent to which providers and other groups influence the regulatory process. Government reaches to other agents to secure its goal of assuring and protecting the health of citizens. The capability of the government to enter into commitments, usually through contracts with other sectors, has a consequence for transaction costs in the interaction. Schuhmann and Bautista explored the nature of contracting envisioned in the new Philippine UHC Act [28]. Government regulators deal with its ‘regulatory hands’ through command and control, delegation to the professions to practice self-regulation, contracting, and/or through the use of incentives to elicit desired behaviour.
There is mixed evidence on the role of incentives in improving health service performance [29]. The use of incentives is attempt to counter the limitations of the regulatory approach in the light of ‘influence activities’ [30] or regulatory capture, leading to corruption and inefficient public services. Low powered incentives, such as low salaries, can impede actions towards creating greater efficiencies. It is in the compatibility of incentives with the goals set out that the directions of policy reforms and the preferences of the legislature and the bureaucracy can be discerned. Eijkenaar, et al systematic review of systematic reviews on the effects of pay-for-performance in health care did not find convincing evidence of cost-effectiveness and instead found persistent inequalities and some unintended consequences for unincentivized care [31].
Salazar [32] found shortcomings in financial reporting practices by PhilHealth, along with declining financial health from 2015. From 2006 to 2015, premiums exceeded benefit claims. Until 2013, premiums from paying members were the most important source of revenues. Average contributions from the informal sector payors were below premiums due, because of the overstatement in the members list and lack of tracking for delinquency in payments or inactive members. The category of non-paying members, those that received government subsidies widely instituted through the ‘sin tax’ law, grew by 37% in 2015. The study noted that 53% of benefit claims were made by non-paying members’ benefits. Benefit claims from the informal economy were three times their premium contributions. The new UHC Act full implementation is expected to expand subsidies. Citing a study by Gertler and Solon [33] 86% of increases in funding to PhilHealth went to payments for health care providers as profits or higher salaries. Cross-subsidisation was maintained, with formal workers subsidizing benefits of other sectors on some periods, while subsidised members by government pro-poor programmes showed some volatility between negative and positive net contributions. The informal economy members were consistently at the receiving end of cross-subsidies. The medium-long term prospects of PhilHealth’s net worth were not optimistic. In the midst of the fight against the pandemic, with the various anomalies in fund utilisation and employees’ behaviour, the President of the country announced that he would make a request to Congress to abolish PhilHealth [34]. This remains an empty threat, however, as Presidential elections are scheduled for May 2022.
Referring to a ‘broad set of collaborative approaches that are useful for bringing stakeholders together’ [35], network arrangements can be considered a looser organisational form. Whether it can be viewed as a third-best alternative, when ‘market fails’ or ‘regulations fail’ is a normative question. A convenient view would be to see it as running along the same continuum—straddling the range of market and hierarchy, a hybrid of elements from both, plus other features. This is possibly an appropriate perspective for the subject of interest—the informal labour sector. This issue means balancing interests in informal sector’s access to social health financing and health service benefits. To bring the interests of disadvantaged groups in the bargaining processes for the health care system’s allocation calls for mediating institutions. The experience with financing cooperatives has not sustained membership for the individual economy programme. A leading cooperative planned to set up its own facility. The increased funding in the Z benefit programme (for catastrophic cases) and the coverage of some chronic disease maintenance costs, including dialysis, has seen private sector investments in stand-alone clinics. Patient groups have also been increasingly engaged in the discussion.
A review of widespread adaptation of networks in the British health service showed its growth among primary care, and other settings, and a reduction in the role of acute hospitals. The buzzword is ‘collaboration’ as opposed to ‘competition’ in market arrangements. It is also recognised in the participation of voluntary and private sectors in outsourced work ‘commissioned’ by the public sector. Performance tracking is a central activity. The latter’s role has moved out from direct provision to one of purchaser or funder [36, 37].
From an LMIC perspective, collaboration takes place when the government reaches out to non-governmental organisations (NGOs) as well as the private sector to perform its traditional functions. The use of cooperative banks and other financial institutions to collect premium payments from the informal sector is one form. But it is not extensive enough to be called a network, rather public-private partnership has been used to describe it (Joint Learning Network). Examples remain few in the Philippines, surprisingly since it has one of the most vibrant NGO sectors actively engaging in the public sphere. There are no accounts of the private health clinic being contracted by the government to deliver primary care in geographically isolated areas where primary care needs abound. There are private clinics contracted to provide overseas employment medical checks, but for the most part, private and public health sectors in the Philippines are co-existing in parallel, if not in competition. Massive public sector investments in government health facilities have seen expanding capacities, in beds, laboratories, and services; while recent private sector developments have seen growing corporatisation and subsidiarity.
Aside from income and basic demographic characteristics affecting demand for social health insurance from among the informal sector, trust in these institutions, from registering enrolment, collecting premiums, providing the medical services, including the attitudes of doctors and staff were found to determine willingness to pay and utilisation of services [38]. This was confirmed in a 2020 systematic review study by Miti et al. [39]. Willingness to pay for health insurance and pension scheme among informal economy sectors were strongly associated with income and trust. Experience of illness, attitude, and presence of doctors as well as distanced all played a role. The credibility of institutions to the people and trust are key to insurance products [40] and the lack thereof undermines it.
We explored insights into the relational arrangements to find an appropriate conceptual ‘fit’ for the tenets of governance under a social contract. The ‘state of nature’ in the current market and hierarchical provisioning is failing and heightens the need for alternative governance mechanisms. Will the new UHC Act establish order and be the disruption the Philippine health system needs? Universal health coverage in general and the Philippine UHC Act, in particular, represents a new agreement drawn by citizens’ representatives and the government. This section discusses governance issues that impinge on UHC implementation and the operational trajectories affecting those in the informal economy. The intention of the section is not so much as a technical discussion, but to pinpoint directions for a re-thinking that needs to take place alongside post-pandemic reflections on the new normal.
At the centre of governance, analysis is transaction cost minimisation. The new settlement or social contract on universal health coverage poses the following boundary issues.
The law divides the fiscal resources and responsibilities into two key agencies—the Department of Health (DOH) for population health and the PhilHealth for personal health. Local government units (LGUs), the owners of public health facilities, were given roles and tasks but hardly any authority and funding allocations. They received their own mandate through Executive Order 135 known as the Mandanas ‘law’ [41]. This order simply affirms the additional funding as part of their internal revenue allocation (from national taxes). Amounts will vary depending on the scale and scope of health services that are under them. The funding source for this is from the new tax sources recently introduced. The additional funds, however, are not earmarked for health. This constitutes one of the peculiarities of Philippine politics, ‘giving a little for everyone’. LGUs will now confront the question whether paying premiums to PhilHealth for coverage of its ‘nonpaying’ constituents present a better deal for its resources as opposed to providing free services in their ‘owned’ facilities. The added resources strengthen the position of local units in bargaining with the health funders and bargaining costs incurred should be factored as part of transaction costs to the implementation of the new UHC Act.
The current dominant purchaser of health services is the Philippine Health Insurance Corporation. Managed as a quasi-government body or a government corporation, it has enjoyed some autonomy in its operations, with the Secretary of Health serving as Board Chairperson. The new UHC Act has provisions for reforms on board qualifications and membership, currently filled by government finance and health institutions, as well as private and labour sectors. PhilHealth’s financial position has been under threat, and with providers faced with persistent payment delays (a case study was presented in ref. [13]), non-participation in the new UHC is also a threat by private providers [42]. Internally, implementation glitches and court cases against its officers and among themselves have dented the credibility of the institution. The President’s threat of abolishing PhilHealth reverberates (as documented in [34]). The scale might be an issue, with the institution being a case of ‘too big to fail’. Insights from the health insurance system in Thailand may point on the way forward, where the institutions are managed across three separate groups—civil servants, private employees, and the rest of the population [43]. Cross-subsidisation is valued for social solidarity purposes. However, in the Philippine case, scale economies are not realisable given human, technological, and systemic incapacities demonstrated by the organisation. The system before 1995 was tripartite as in Thailand when the Philippine population was 68.18 million and not 110.8 million as of 2021.
Failure to design and manage an information system accounts in large part for this failure, relying instead on manual authorisations and adjudication of claims. The system requirements are substantial and the treatment of information system costs as part of capital investment will bypass the 12% cap on administrative costs. However, government infrastructure projects in health care are known for being slow and cumbersome [44], requiring an inter-agency investment committee, among other concerns.
Under the new UHC, every citizen will choose a General Practitioner (GP) for primary care, who will, in turn, be networked to diagnostic services and a tertiary hospital either at provincial or city levels. This introduces a novel element to the health system. Under the current system, anyone seeking care may go to any facility, doctor, or specialist so long as one is able to pay. Being tied to a GP entails availability or the supply of GPs in the first place. There is a viable public rural health system and stations spread across the archipelago. In more isolated and poorer areas, arrangements will need to be made for the outreach of public medical facilities or contracted private providers. In the towns and cities, private facilities will have to be willing to participate in the provider network to receive patients on referral. Participation will be on the application and submission of documentary requirements, including cost structure and subscription to the information system to be followed. This imposes costs to the private sector, as well as to local governments, the de-facto facility owners. Information technology (for example, telemedicine), including medical outreach, costs can be factored in for remote settings. Incentives are discussed in the UHC Act in the context of the private sector and LGU cooperation.
These governance options can inform whether the social contract embedded in the new UHC Act will minimise transaction costs and maximise benefits and health protection for the larger and more vulnerable groups. Mediating institutions and groups may be necessary to reach and navigate citizen engagement. The ability to contract would strengthen implementation efficiencies. When monitoring and delivery systems are not fully in place, leakages abound, responsibilities overlap, and absorptive capacities of both recipients and implementers are compromised. Implementation issues, gaps, and program weaknesses highlight the need for a more responsive approach when it comes to universal coverage of health insurance, particularly to the informal sector.
Table 1 summarises the key concerns related to the health insurance coverage of the informal sector. This is not the place to be detailed as technical elements can be further studied. The table though captures the key elements of contributory schemes and how it relates to informal economy issues. It subsequently identifies strategic design and operating elements and how it can work out with UHC as the ‘sweet spot’ for the implementation of overall social protection programmes for the non-poor. The last column highlights what the system would be like if the schemes (social security, and health insurance) were to shift to and be under one platform of universal coverage.
Issues with the structure of health insurance schemes | Informal economy issues | Key operating or design elements | Universal coverage |
---|---|---|---|
Low coverage of the informal economy | Geographic location – reach and access to health facilities | Membership, enrolment become moot issues as new UHC mandates coverage for all | Reaching the population with information drives on rights and responsibilities and services |
Intermittent contributions; drop-outs | Not too poor for pro-poor subsidies paid by the government from national taxes; no employer counterpart | Graduated subsidies from local government (LG) as part of business registration and renewals; Bundled with other contributions, for example, pension, accident insurance | No direct contributions from informal sector earning below a certain level (determined locally; with LG performance in the coverage of IFS tracked) |
Utilisation of Health Care as part of benefits | High cost of care due to users’ charges; Delayed care due to cost concerns Health insecurity due to nature of work | Member education Annual basic medical check-ups Assurance of adequacy in the supply of staff and medicines needed when on acute care for no balance billing arrangement | Inclusion in the No balance billing (NBB)arrangement Health technology assessment |
Portability | Mobile population | Navigation and Information technology solutions | Information systems Use of Human Navigators Health passbook |
Elements of schemes for the informal economy, design elements, and universal coverage.
There are high transaction costs involved in getting and maintaining participation of the informal sector. However, the new UHC Act considers everyone as a member. Even as their incomes and timing of receipt of incomes are not low enough to qualify them for national subsidies, transaction costs will be high trying to collect individually or tying individuals to a group. Localising subsidies from local tax sources will bundle business registration with other businesses in the local city or municipality office, the usual point of entry for local business. This will encourage the informal economy to gain a foothold into formality with the enticement of free health insurance. Insuring the informal sector, based on the population discussed in section 2, and using the 10 year average and current PhilHealth premiums of P2,400, will amount to an estimated PhP51 billion (US$1 billion). This amount is approximately 5.1% of the annual health budget of the government. These subsidies will tie the funding of the informal economy health insurance coverage with the gains and benefits of coverage, not only as revenues (to fund local health facilities) but also as social capital, enhancing the credibility of local institutions [45].
Since local governments also ‘own’ the facilities, it is within their jurisdiction to provide free care for those in need, especially those that are not in the means-tested poor, of which many in the informal economy may fall under. No balance billing should be for all in the locally owned facilities and some capped charges, if outside the catchment area. Assurance of annual health checks will promote health maintenance and health security. The health technology assessment bureau, newly established under the UHC Act will recommend what the basic health service package will be.
Portability is key to universal health coverage. A Thailand study showed the popular use of non-designated facilities by low-income members [46]. Among mobile populations, working across provincial and city boundaries, where designated facilities may be accessed, local budget systems must be interconnected. Navigators or guides will be needed at facility levels. The Philippines’ use of navigators has been singled out for promoting equity among the sponsored members [47]. Additionally, information systems that interconnect provider and patient information with the health insurance office and a health passbook, physical record on members’ hands where utilisation and coverage in terms of fees are recorded, has been the glue to Taiwan’s health insurance system, which began around the same time as PhilHealth in the mid-90s. Taiwavn achieved universal health coverage within the decade of its founding.
The study explored the issues related to the planning and inclusion of the informal labour sector into national health insurance schemes. While universal health coverage (UHC) may have raised this as a non-issue, with its coverage ‘for all’, resources flowing to the same structures for implementation will encounter the same problem of high transaction costs. A re-framing analysis that pushed the issue of transaction costs into the discussion showed that hierarchical or government structures wielding tight command and control are not informal sector—friendly. Informal sector participants may not fall within the strict proxy variable means tests for the poor. Thus, their non-inclusion in the no-balance-billing thrust of the UHC still creates high user charges which minimise the benefits of health insurance against any contribution on premiums they make.
The ability of the system to provide universal financial protection will still depend on subsidies managed through mediating institutions, including facilities, that need to be brought in as part of the new social contract. There will be widespread subsidies as the impetus for the universal health care Act itself is the anticipated fiscal space provided by the passing of new tax laws that included a tax on the sugar content of beverages. The pandemic has seen increased fiscal flows to the health sector; but more importantly, it surfaced the inefficiencies and corruption of the implementing agencies. The protection required in the new social contract is safeguarding the health insurance funds and the balancing of current expenditures and future funds sustainability. The rights and responsibilities implicitly pressed on citizens, providers, implementers by the new Act are directed towards ensuring the social insurance funds are protected. This is only possible if payments are made in terms of ability to pay, pay-outs designed based on needs, incomes drawn from the fund (by providers and other vendors) are fair, and systems and safeguards are in place for greater accountability. Universal health coverage is possible with better governance and undertaken in the spirit of a new social contract.
The article used parts of an unpublished report by the author submitted to the International Labour Organisation Regional Office in Bangkok, as part of a consultant’s report on the project Stocktaking Study on Social Protection for the Informal Economy in 2018. Permission to recognise their copyright has been obtained and much appreciated.
No conflict of interest is declared by the author.
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Colitis",slug:"the-role-of-intestinal-barrier-function-in-early-life-in-the-development-of-colitis",totalDownloads:4693,totalCrossrefCites:13,totalDimensionsCites:32,abstract:null,book:{id:"1056",slug:"colitis",title:"Colitis",fullTitle:"Colitis"},signatures:"R.C. 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Among cancers that affect both men and women, it accounts for >8% of all cancer incidence, making it the third most common cancer worldwide (behind lung and breast cancer). There were an estimated 14.1 million cancer cases around the world in 2012-last data available; 7.4 million were in men and 6.7 million in women. Of that, nearly 1.4 million new cases were from colorectal cancer. And, it has consistently been shown that the developed world carries the majority of the burden (Australia, New Zealand, Canada, the United States and parts of Western Europe), likely due to similarity in lifestyles and diets.",book:{id:"4723",slug:"screening-for-colorectal-cancer-with-colonoscopy",title:"Screening for Colorectal Cancer with Colonoscopy",fullTitle:"Screening for Colorectal Cancer with Colonoscopy"},signatures:"Camille Thélin and Sanjay Sikka",authors:[{id:"175650",title:"M.D.",name:"Camille",middleName:null,surname:"Thelin",slug:"camille-thelin",fullName:"Camille Thelin"}]},{id:"57197",doi:"10.5772/intechopen.70781",title:"Acquired and Intrinsic Resistance to Colorectal Cancer Treatment",slug:"acquired-and-intrinsic-resistance-to-colorectal-cancer-treatment",totalDownloads:1402,totalCrossrefCites:3,totalDimensionsCites:10,abstract:"First line therapy for colorectal cancer (CRC) is usually fluoropyrimidine monotherapy and oxaliplatin, or irinotecan-based therapy. Additionally, targeted therapies such as bevacizumab, aflibercept, ramucirumab, regorafenib, cetuximab and panitumumab are indicated in combination with chemotherapy in metastatic CRC. Resistance of CRC to treatment is the principal rationale for treatment failure. Resistance can be intrinsic (primary resistance) or acquired (secondary resistance). Here, we discuss the classical model of resistance, which focuses primarily on mechanisms involving alterations in drug metabolism, increased drug efflux, secondary mutations in drug targets, inactivation of apoptotic pathways, p53 and DNA damage repair. Other resistance mechanisms, including the Warburg effect, cancer stem cells, intra-tumor heterogeneity and pharmacoepigenomic mechanisms will also be discussed. We conclude the chapter with a systems medicine approach to predict response to treatment for the discovery and validation of predictive biomarkers that are urgently needed.",book:{id:"6177",slug:"colorectal-cancer-diagnosis-screening-and-management",title:"Colorectal Cancer",fullTitle:"Colorectal Cancer - Diagnosis, Screening and Management"},signatures:"Romina Briffa, Simon P. Langdon, Godfrey Grech and David J.\nHarrison",authors:[{id:"181205",title:"Dr.",name:"Godfrey",middleName:null,surname:"Grech",slug:"godfrey-grech",fullName:"Godfrey Grech"},{id:"208013",title:"Dr.",name:"Romina",middleName:null,surname:"Briffa",slug:"romina-briffa",fullName:"Romina Briffa"},{id:"208931",title:"Dr.",name:"Simon",middleName:null,surname:"Langdon",slug:"simon-langdon",fullName:"Simon Langdon"},{id:"210845",title:"Prof.",name:"David J",middleName:null,surname:"Harrison",slug:"david-j-harrison",fullName:"David J Harrison"}]},{id:"49037",doi:"10.5772/61012",title:"Building up the Future of Colonoscopy – A Synergy between Clinicians and Computer Scientists",slug:"building-up-the-future-of-colonoscopy-a-synergy-between-clinicians-and-computer-scientists",totalDownloads:1808,totalCrossrefCites:4,totalDimensionsCites:9,abstract:"Recent advances in endoscopic technology have generated an increasing interest in strengthening the collaboration between clinicians and computers scientist to develop intelligent systems that can provide additional information to clinicians in the different stages of an intervention. The objective of this chapter is to identify clinical drawbacks of colonoscopy in order to define potential areas of collaboration. Once areas are defined, we present the challenges that colonoscopy images present in order computational methods to provide with meaningful output, including those related to image formation and acquisition, as they are proven to have an impact in the performance of an intelligent system. Finally, we also propose how to define validation frameworks in order to assess the performance of a given method, making an special emphasis on how databases should be created and annotated and which metrics should be used to evaluate systems correctly.",book:{id:"4723",slug:"screening-for-colorectal-cancer-with-colonoscopy",title:"Screening for Colorectal Cancer with Colonoscopy",fullTitle:"Screening for Colorectal Cancer with Colonoscopy"},signatures:"Jorge Bernal, F. Javier Sánchez, Cristina Rodríguez de Miguel and\nGloria Fernández-Esparrach",authors:[{id:"58626",title:"Mr.",name:"Jorge",middleName:null,surname:"Bernal",slug:"jorge-bernal",fullName:"Jorge Bernal"},{id:"175152",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Sánchez Pujadas",slug:"francisco-javier-sanchez-pujadas",fullName:"Francisco Javier Sánchez Pujadas"},{id:"175153",title:"Dr.",name:"Gloria",middleName:null,surname:"Fernández-Espárrach",slug:"gloria-fernandez-esparrach",fullName:"Gloria Fernández-Espárrach"},{id:"175154",title:"MSc.",name:"Cristina",middleName:null,surname:"Rodríguez De Miguel",slug:"cristina-rodriguez-de-miguel",fullName:"Cristina Rodríguez De Miguel"}]},{id:"28752",doi:"10.5772/28497",title:"Animal Models of Colorectal Cancer in Chemoprevention and Therapeutics Development",slug:"animal-models-of-colorectal-cancer-in-chemoprevention-and-therapeutics-development",totalDownloads:4181,totalCrossrefCites:5,totalDimensionsCites:9,abstract:null,book:{id:"2031",slug:"colorectal-cancer-from-prevention-to-patient-care",title:"Colorectal Cancer",fullTitle:"Colorectal Cancer - From Prevention to Patient Care"},signatures:"Shubhankar Suman, Albert J. Fornace Jr. and Kamal Datta",authors:[{id:"74075",title:"Dr.",name:"Kamal",middleName:null,surname:"Datta",slug:"kamal-datta",fullName:"Kamal Datta"},{id:"121217",title:"Dr.",name:"Shubhankar",middleName:null,surname:"Suman",slug:"shubhankar-suman",fullName:"Shubhankar Suman"},{id:"121218",title:"Dr.",name:"Albert",middleName:null,surname:"Fornace",slug:"albert-fornace",fullName:"Albert Fornace"}]}],mostDownloadedChaptersLast30Days:[{id:"50834",title:"Molecular Mechanisms Involved in the Acquisition of Resistance to Treatment of Colon Cancer Cells",slug:"molecular-mechanisms-involved-in-the-acquisition-of-resistance-to-treatment-of-colon-cancer-cells",totalDownloads:1729,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Cancer cells are remarkably resilient to therapies aimed at their elimination. The exploration of pathways that sustain cancer cells and that allow cancer cells to become resistant has revealed new avenues for chemotherapeutic development, as well as rational approaches to combination therapies based on existing treatment options. Several signaling pathways, such as Wnt, phosphoinositide 3-kinase (PI3K), and Ras-Raf-MEK, constitute integrated networks that work together to maintain cellular homeostasis under basal conditions and to drive cell-mass accumulation and cell cycle progression in the presence of appropriate mitogenic stimuli. During cancer development, these pathways are corrupted in malignant cells to maintain viability and proliferative activity under environmentally stressful conditions such as limited growth factors, oxygen, and nutrients that drive normal cells into quiescence or death. Importantly, dysfunction within any one of these pathways results in compensatory responses from the other networks. Thus, biological research is gradually shifting toward more general approaches that target entire pathways rather than isolated components and integrate those pathways into biological networks.",book:{id:"5122",slug:"colorectal-cancer-from-pathogenesis-to-treatment",title:"Colorectal Cancer",fullTitle:"Colorectal Cancer - From Pathogenesis to Treatment"},signatures:"Dora M. Velázquez, María Cristina Castañeda-Patlán and Martha\nRobles-Flores",authors:[{id:"140473",title:"Dr.",name:"Martha",middleName:null,surname:"Robles-Flores",slug:"martha-robles-flores",fullName:"Martha Robles-Flores"},{id:"142831",title:"Dr.",name:"Maria Cristina",middleName:null,surname:"Castañeda-Patlán",slug:"maria-cristina-castaneda-patlan",fullName:"Maria Cristina Castañeda-Patlán"},{id:"185099",title:"MSc.",name:"Dora M.",middleName:null,surname:"Velázquez",slug:"dora-m.-velazquez",fullName:"Dora M. Velázquez"}]},{id:"45657",title:"Rare Tumors of the Colon and Rectum",slug:"rare-tumors-of-the-colon-and-rectum",totalDownloads:2682,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"3529",slug:"colorectal-cancer-surgery-diagnostics-and-treatment",title:"Colorectal Cancer",fullTitle:"Colorectal Cancer - Surgery, Diagnostics and Treatment"},signatures:"Goran Stanojević and Zoran Krivokapić",authors:[{id:"86108",title:"Prof.",name:"Zoran",middleName:null,surname:"Krivokapic",slug:"zoran-krivokapic",fullName:"Zoran Krivokapic"},{id:"166112",title:"Prof.",name:"Goran",middleName:"Zoran",surname:"Stanojevic",slug:"goran-stanojevic",fullName:"Goran Stanojevic"}]},{id:"48954",title:"Colonoscopy — Indications and Contraindications",slug:"colonoscopy-indications-and-contraindications",totalDownloads:7823,totalCrossrefCites:4,totalDimensionsCites:4,abstract:"This chapter discusses some of the major indications and contraindications for colonoscopy. Advances in colonoscopic techniques have expanded the role of colonoscopy beyond conventional screening, surveillance, and diagnosis to various complex therapeutic and interventional utilities. Several guidelines with new information are being published and updated regularly in the field of colonoscopy and are currently used in clinical practice. However, there is still a lack of well-designed randomized clinical trials investigating the role of colonoscopy in early diagnosis and treatment of various conditions and its impact on long-term survival and disease status. Nevertheless, retrospective observational studies and a few randomized clinical trials abundantly supply data supporting the role of colonoscopy in the diagnosis and management of colonic pathologies in the absence of comparable alternatives.",book:{id:"4723",slug:"screening-for-colorectal-cancer-with-colonoscopy",title:"Screening for Colorectal Cancer with Colonoscopy",fullTitle:"Screening for Colorectal Cancer with Colonoscopy"},signatures:"Jigar Bhagatwala, Arpit Singhal, Summer Aldrugh, Muhammed\nSherid, Humberto Sifuentes and Subbaramiah Sridhar",authors:[{id:"174788",title:"Dr.",name:"Humberto",middleName:null,surname:"Sifuentes",slug:"humberto-sifuentes",fullName:"Humberto Sifuentes"},{id:"174959",title:"Dr.",name:"Muhammed",middleName:null,surname:"Sherid",slug:"muhammed-sherid",fullName:"Muhammed Sherid"},{id:"175350",title:"Dr.",name:"Jigar",middleName:null,surname:"Bhagatwala",slug:"jigar-bhagatwala",fullName:"Jigar Bhagatwala"},{id:"175351",title:"Dr.",name:"Arpit",middleName:null,surname:"Singhal",slug:"arpit-singhal",fullName:"Arpit Singhal"},{id:"175352",title:"Prof.",name:"Subbaramiah",middleName:null,surname:"Sridhar",slug:"subbaramiah-sridhar",fullName:"Subbaramiah Sridhar"},{id:"175955",title:"Ms.",name:"Summer",middleName:null,surname:"Aldrugh",slug:"summer-aldrugh",fullName:"Summer Aldrugh"}]},{id:"45753",title:"The Complexity of Colorectal Cancer Biology — Putting Bricks on the Path to Personalized Medicine",slug:"the-complexity-of-colorectal-cancer-biology-putting-bricks-on-the-path-to-personalized-medicine",totalDownloads:1934,totalCrossrefCites:1,totalDimensionsCites:1,abstract:null,book:{id:"3529",slug:"colorectal-cancer-surgery-diagnostics-and-treatment",title:"Colorectal Cancer",fullTitle:"Colorectal Cancer - Surgery, Diagnostics and Treatment"},signatures:"Emilia Balboa, Angel Carracedo and Francisco Barros",authors:[{id:"63723",title:"Ph.D. Student",name:"Emilia",middleName:null,surname:"Balboa",slug:"emilia-balboa",fullName:"Emilia Balboa"},{id:"66279",title:"Dr.",name:"Angel",middleName:null,surname:"Carracedo",slug:"angel-carracedo",fullName:"Angel Carracedo"},{id:"68568",title:"Dr.",name:"Francisco",middleName:null,surname:"Barros Angueira",slug:"francisco-barros-angueira",fullName:"Francisco Barros Angueira"}]},{id:"49127",title:"Basic Endoscopic Findings — Normal and Pathological Findings",slug:"basic-endoscopic-findings-normal-and-pathological-findings",totalDownloads:2990,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Since its inception, colonoscopy has evolved to become the cornerstone for colorectal imaging. The increasing indications for endoscopic evaluation and potential therapeutic intervention parallels technological advances and the expanding diagnostic and therapeutic capabilities of colonoscopy. The diagnostic and therapeutic yield of colonoscopy is highly user dependent. Thus, it is essential for the clinical endoscopist to perform a thorough endoscopic evaluation and be cognizant of normal and pathologic findings. This review details normal and pathologic endoscopic findings in a variety of disease states that are often encountered by the clinical endoscopist including colon polyps, inflammatory bowel disease, and infectious and non-infectious colitides. In addition, we review the diagnostic and therapeutic role of colonoscopy in the evaluation of an acute lower gastrointestinal bleed.",book:{id:"4723",slug:"screening-for-colorectal-cancer-with-colonoscopy",title:"Screening for Colorectal Cancer with Colonoscopy",fullTitle:"Screening for Colorectal Cancer with Colonoscopy"},signatures:"Parth J. Parekh and Sanjay K. Sikka",authors:[{id:"175816",title:"Dr.",name:"Parth",middleName:null,surname:"Parekh",slug:"parth-parekh",fullName:"Parth Parekh"},{id:"177185",title:"Dr.",name:"Sanjay",middleName:null,surname:"Sikka",slug:"sanjay-sikka",fullName:"Sanjay Sikka"}]}],onlineFirstChaptersFilter:{topicId:"1020",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:317,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). 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\r\n\tSustainable development focuses on linking economic development with environmental protection and social development to ensure future prosperity for people and the planet. To tackle global challenges of development and environment, the United Nations General Assembly in 2015 adopted the 17 Sustainable Development Goals. SDGs emphasize that environmental sustainability should be strongly linked to socio-economic development, which should be decoupled from escalating resource use and environmental degradation for the purpose of reducing environmental stress, enhancing human welfare, and improving regional equity. Moreover, sustainable development seeks a balance between human development and decrease in ecological/environmental marginal benefits. Under the increasing stress of climate change, many environmental problems have emerged causing severe impacts at both global and local scales, driving ecosystem service reduction and biodiversity loss. Humanity’s relationship with resource exploitation and environment protection is a major global concern, as new threats to human and environmental security emerge in the Anthropocene. Currently, the world is facing significant challenges in environmental sustainability to protect global environments and to restore degraded ecosystems, while maintaining human development with regional equality. Thus, environmental sustainability with healthy natural ecosystems is critical to maintaining human prosperity in our warming planet.
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After that, he was a postdoc research fellow at the University of British Columbia in Canada to do research on large-scale stream experimental manipulation and watershed ecological survey in temperate rainforests of BC. He was a faculty member at the University of Hong Kong to run ecological research projects on aquatic insects, fishes, and newts in Tropical Asian streams. He also conducted research in streams, rivers, and caves in Texas, USA, to study the ecology of macroinvertebrates, big-claw river shrimp, fish, turtles, and bats. 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Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. 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Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. 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Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. 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