Avenues for patient safety education.
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"5507",leadTitle:null,fullTitle:"Current Topics in Lactation",title:"Current Topics in Lactation",subtitle:null,reviewType:"peer-reviewed",abstract:"Lactation is a fascinating process. Research over the last decade has provided new insights into the regulation of mammary gland development and involution. Lactation is the last step in reproduction, and therefore it is linked to reproduction strategy. Photoperiod species such as sheep, or pseudo-ovulatory (at mid-gestation) species as the rodent Lagostomus maximus, are interesting and unique models to study mammary gland physiology. This book also offers updated insights into the mechanisms that control postlactational involution, therefore also providing information to better understand breast cancer. Small noncoding RNA has opened new understanding in gene regulation. In this regard, our knowledge of mammary gland development and milk secretion has increased extremely. This book provides current scientific information on all these interesting topics. It will certainly be of great benefit to those interested in biomedical sciences.",isbn:"978-953-51-3138-0",printIsbn:"978-953-51-3137-3",pdfIsbn:"978-953-51-4848-7",doi:"10.5772/63182",price:100,priceEur:109,priceUsd:129,slug:"current-topics-in-lactation",numberOfPages:90,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"ac8a108f23ad313d4ea64202d68c7502",bookSignature:"Isabel Gigli",publishedDate:"May 10th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5507.jpg",numberOfDownloads:7665,numberOfWosCitations:13,numberOfCrossrefCitations:8,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:18,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:39,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 3rd 2016",dateEndSecondStepPublish:"May 24th 2016",dateEndThirdStepPublish:"August 28th 2016",dateEndFourthStepPublish:"November 26th 2016",dateEndFifthStepPublish:"December 26th 2016",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"175679",title:"Dr.",name:"Isabel",middleName:null,surname:"Gigli",slug:"isabel-gigli",fullName:"Isabel Gigli",profilePictureURL:"https://mts.intechopen.com/storage/users/175679/images/system/175679.jpeg",biography:"ISABEL GIGLI finished Veterinary Medicine and received her Doctoral of Science degree in Physiology (2001); she completed her doctoral research training at the Institute of Biology and Experimental Medicine (IByMe), in Buenos Aires, Argentina. Afterwards, she completed a three year Post doctoral training at the University of Cornell, USA. In addition, she worked two years at the University of Palermo, Italy. Her field of research is mammary gland physiology. With an increasing interest in sustainability and environment, in the last couple of years she focused her research on alternative uses of whey. Dr Gigli is a full-time professor at the School of Agriculture at the National University of La Pampa (UNLPam), Argentina, teaching physiology of lactation and milk production.",institutionString:"National University of La Pampa",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"National University of La Pampa",institutionURL:null,country:{name:"Argentina"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"384",title:"Chemical Biology",slug:"chemical-biology"}],chapters:[{id:"54791",title:"Introductory Chapter: Insights into Lactation",doi:"10.5772/intechopen.68395",slug:"introductory-chapter-insights-into-lactation",totalDownloads:1259,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Isabel Gigli",downloadPdfUrl:"/chapter/pdf-download/54791",previewPdfUrl:"/chapter/pdf-preview/54791",authors:[{id:"175679",title:"Dr.",name:"Isabel",surname:"Gigli",slug:"isabel-gigli",fullName:"Isabel Gigli"}],corrections:null},{id:"52861",title:"Ovarian, Hypophyseal and Hypothalamic Hormones Coordinate Mammary Gland Remodeling in Adult Lagostomus maximus: a Rodent that Shows Pseudo-Ovulation at Mid-Gestation",doi:"10.5772/66155",slug:"ovarian-hypophyseal-and-hypothalamic-hormones-coordinate-mammary-gland-remodeling-in-adult-lagostomu",totalDownloads:1241,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Adult female mammary glands go through extensive tissue remodeling during pregnancy, lactation and after the weaning of the neonates. Here we characterize mammary gland morphology of adult females of Lagostomus maximus, a hystricomorph rodent with a pseudo-ovulatory event at mid-gestation, and describe how the glandular tissue changes its architecture in response to variations of the hormonal environment. At mid-gestation, pseudo-ovulation is seen as an essential event increasing the number of secondary corpora lutea and thus rising the circulating levels of progesterone that help to maintain pregnancy to term. As a side effect, mammary gland development is favored early during the long-lasting pregnancy of L. maximus, preparing females for the nutritional need of fully developed pups in this k-strategist species.",signatures:"Julia Halperin, Veronica B. Dorfman and Alfredo D. Vitullo",downloadPdfUrl:"/chapter/pdf-download/52861",previewPdfUrl:"/chapter/pdf-preview/52861",authors:[{id:"191434",title:"Ph.D.",name:"Julia",surname:"Halperin",slug:"julia-halperin",fullName:"Julia Halperin"},{id:"195479",title:"Dr.",name:"Veronica Berta",surname:"Dorfman",slug:"veronica-berta-dorfman",fullName:"Veronica Berta Dorfman"},{id:"195481",title:"Dr.",name:"Alfredo Daniel",surname:"Vitulo",slug:"alfredo-daniel-vitulo",fullName:"Alfredo Daniel Vitulo"}],corrections:null},{id:"52981",title:"Role of Melatonin and the Biological Clock in Regulating Lactation in Seasonal Sheep",doi:"10.5772/66208",slug:"role-of-melatonin-and-the-biological-clock-in-regulating-lactation-in-seasonal-sheep",totalDownloads:1682,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Impact of light on animal behavior has been known for a long time—from 1925, Rowan [30] showed that lighting conditions influence gonad activity in birds and the related processes are controlled not only by means of intraorganic signals. Studies carried out in subsequent years have established that, also in mammals, the gland reacting to changes in light conditions is the pineal gland, producing a substance called melatonin. Biosynthesis of melatonin in most animals studied to date occurs at a rhythm dependent on the photocycle. The highest concentrations of this hormone—often called “the hormone of darkness”—are recorded at night. Seasonal changes in melatonin secretion conditioned by activity of the biological clock, known also as “biochemical calendar”, are the key signals in the annual reproductive cycles of animals exhibiting seasonality of reproduction. Seasonality in sheep refers not only to the reproduction itself but also to lactation. One of the main hormones conditioning initiation and maintenance of lactation, synthesis of milk proteins, fat and immunoglobulins is prolactin (PRL), secreted primarily by lactotrophic cells in the adenohypophysis. Prolactin is also produced locally by the mammary gland—the hormone of this origin is identical to prolactin secreted by the pituitary gland. Until now, it was considered that the level of milk production in mammals is determined by both genetic and environmental factors. However, in recent years, many studies focused on the role of light as a modulator of prolactin levels. In livestock, changes in light-period length play a very important role as this determines their productivity and milk yield. Photoperiod is particularly important in short-day breeder animals (sheep), for which the length of light period is associated with changes in melatonin level. The modulating effect of melatonin on secretion of prolactin may take place via two different mechanisms. One is associated with the circadian rhythm, wherein—directly or through the medium of a factor popularly termed “tuberalin”—melatonin stimulates the release of prolactin. However, this effect is short-lived and is most likely applicable only to prolactin stored in lactotrophic cells of the pituitary. The second mechanism regulating the secretion of melatonin and prolactin is associated with the annual rhythms of secretion—melatonin, due to its lipophilic characteristics, has a direct effect on the secretion of prolactin. Under natural conditions, the maximum concentration of prolactin in the blood of sheep is observed over the long-day period, during which the melatonin level decreases. The lowest prolactin concentration is observed over the short-day period, where melatonin levels are at their highest. Changes in secretion of prolactin during lactation in sheep undoubtedly affect the amount of milk produced.",signatures:"Edyta Molik and Dorota Zięba-Przybylska",downloadPdfUrl:"/chapter/pdf-download/52981",previewPdfUrl:"/chapter/pdf-preview/52981",authors:[{id:"139135",title:"Dr.",name:"Edyta",surname:"Molik",slug:"edyta-molik",fullName:"Edyta Molik"}],corrections:null},{id:"53252",title:"Postlactational Involution: Molecular Mechanisms and Relevance for Breast Cancer Development",doi:"10.5772/66526",slug:"postlactational-involution-molecular-mechanisms-and-relevance-for-breast-cancer-development",totalDownloads:1473,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Mammary gland tissue changes appearance and functionality in different sequential steps. The tissue of virgin, pregnant, or lactating mammary glands changes controlled by finely regulated physiological processes. A fourth stage (involution), triggered upon weaning, involves remodeling, and the gland regresses to resemble a prepregnant stage. This highly complex process characterized by a high degree of epithelial cell death and tissue remodeling can be divided into phases, which can be independent of each other. The present article describes a variety of signaling pathway components, transcription factors, and mRNA stabilization proteins that play a role in the regulation of cell fate during the involution process. These molecular actors are finely related in health to trigger the delicate mechanism that govern involution after weaning, leaving the gland in a latent stage until needed again. Importantly, it has been shown that this process may contribute to cancer development in the years following childbirth, mainly because of the involvement of inflammatory and remodeling factors.",signatures:"Edith C. Kordon and Omar A. Coso",downloadPdfUrl:"/chapter/pdf-download/53252",previewPdfUrl:"/chapter/pdf-preview/53252",authors:[{id:"191370",title:"Ph.D.",name:"Edith",surname:"Kordon",slug:"edith-kordon",fullName:"Edith Kordon"},{id:"195749",title:"Dr.",name:"Omar",surname:"Coso",slug:"omar-coso",fullName:"Omar Coso"}],corrections:null},{id:"53907",title:"Non-Coding RNA Roles in Ruminant Mammary Gland Development and Lactation",doi:"10.5772/67194",slug:"non-coding-rna-roles-in-ruminant-mammary-gland-development-and-lactation",totalDownloads:2012,totalCrossrefCites:6,totalDimensionsCites:13,hasAltmetrics:0,abstract:"The ruminant mammary gland (MG) is an important organ charged with the production of milk for young and human nourishment. Many factors influence MG productivity, including nutrition, genetics, breed, epigenetics (including non-coding RNA [ncRNA]), disease pathogens and other environmental factors. In recent years, increasing research is beginning to determine the role of non-coding RNA in MG functions. Non-coding RNAs (small interfering RNA [siRNA], microRNA [miRNA], PIWI-interacting RNA [piRNA], small nucleolar RNA [snoRNA] and long non-coding RNA [lncRNA]) are a class of untranslated RNA molecules that function to regulate gene expression, associated biochemical pathways and cellular functions and are involved in many biological processes. This chapter presents a review of the current state of knowledge on the role of ncRNAs (particularly miRNAs and lncRNAs) in the MG and lactation processes, lactation signalling pathways, lipid metabolism, MG health of ruminants as well as miRNA roles in milk recipients. Finally, the potential application of new genome editing technology for ncRNA studies in MG development, the lactation process and milk components is presented.",signatures:"Duy N. Do and Eveline M. Ibeagha-Awemu",downloadPdfUrl:"/chapter/pdf-download/53907",previewPdfUrl:"/chapter/pdf-preview/53907",authors:[{id:"191336",title:"Dr.",name:"Eveline",surname:"Ibeagha-Awemu",slug:"eveline-ibeagha-awemu",fullName:"Eveline Ibeagha-Awemu"},{id:"191339",title:"Dr.",name:"Duy",surname:"Do",slug:"duy-do",fullName:"Duy Do"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"5060",title:"Milk Proteins",subtitle:"From Structure to Biological Properties and Health Aspects",isOpenForSubmission:!1,hash:"4a7d2e5f38e97aaea90bb3fec55b3751",slug:"milk-proteins-from-structure-to-biological-properties-and-health-aspects",bookSignature:"Isabel Gigli",coverURL:"https://cdn.intechopen.com/books/images_new/5060.jpg",editedByType:"Edited by",editors:[{id:"175679",title:"Dr.",name:"Isabel",surname:"Gigli",slug:"isabel-gigli",fullName:"Isabel Gigli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8625",title:"Whey",subtitle:"Biological Properties and Alternative Uses",isOpenForSubmission:!1,hash:"449a36f43c9a30ae4d43f9775599e8ac",slug:"whey-biological-properties-and-alternative-uses",bookSignature:"Isabel Gigli",coverURL:"https://cdn.intechopen.com/books/images_new/8625.jpg",editedByType:"Edited by",editors:[{id:"175679",title:"Dr.",name:"Isabel",surname:"Gigli",slug:"isabel-gigli",fullName:"Isabel Gigli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2553",title:"Lipid Peroxidation",subtitle:null,isOpenForSubmission:!1,hash:"b39734aa940b2d63ae5e8773d3dd5280",slug:"lipid-peroxidation",bookSignature:"Angel Catala",coverURL:"https://cdn.intechopen.com/books/images_new/2553.jpg",editedByType:"Edited by",editors:[{id:"196544",title:"Prof.",name:"Angel",surname:"Catala",slug:"angel-catala",fullName:"Angel Catala"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2323",title:"Carbohydrates",subtitle:"Comprehensive Studies on Glycobiology and Glycotechnology",isOpenForSubmission:!1,hash:"f7c2e6a3566eee14c9884ad0820a6416",slug:"carbohydrates-comprehensive-studies-on-glycobiology-and-glycotechnology",bookSignature:"Chuan-Fa Chang",coverURL:"https://cdn.intechopen.com/books/images_new/2323.jpg",editedByType:"Edited by",editors:[{id:"145728",title:"Prof.",name:"Chuan-Fa",surname:"Chang",slug:"chuan-fa-chang",fullName:"Chuan-Fa Chang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"372",title:"Aflatoxins",subtitle:"Biochemistry and Molecular Biology",isOpenForSubmission:!1,hash:"b7f7359995dc5ee04e12df282495f77e",slug:"aflatoxins-biochemistry-and-molecular-biology",bookSignature:"Ramón Gerardo Guevara-González",coverURL:"https://cdn.intechopen.com/books/images_new/372.jpg",editedByType:"Edited by",editors:[{id:"62559",title:"Dr.",name:"Ramon G.",surname:"Guevara-Gonzalez",slug:"ramon-g.-guevara-gonzalez",fullName:"Ramon G. 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\r\n\tCandidiasis is an infection caused by Candida spp., mostly Candida albicans. Although, Candida, a yeast, normally exists in human body; on the skin and in the mouth, throat, gut and vagina, it does not normally cause infection. However, sometimes, yeast proliferation occurs, and Candida spp. cause several infections, such as oral infection affecting the mouth and throat, called oropharyngeal candidiasis (thrush), as well as vulvovaginal, oesophageal, intestinal and invasive candidiasis. Oesophageal candidiasis is a common infection in HIV/AIDS patients. Besides this, the pathogenesis of candidiasis in humans is not completely understood. Infection caused by Candida spp. presents a serious problem because of its drug resistance. Investigation of new and effective active substances against pathogenic Candida spp. and a better understanding of the role of molecular mechanisms involved in the formation of antifungal resistance will help prevent Candida infection among individuals with immunological deficiency and will make the antifungal therapy much more effective and improved. This book is intended to provide a comprehensive overview of the latest information on Candida spp. and Candidiasis.
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Kapetanovic",coverURL:"https://cdn.intechopen.com/books/images_new/671.jpg",editedByType:"Edited by",editors:[{id:"68650",title:"Dr.",name:"Izet",surname:"Kapetanović",slug:"izet-kapetanovic",fullName:"Izet Kapetanović"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},onlineFirst:{chapter:{type:"chapter",id:"79011",title:"Patient Safety: Preventing Patient Harm and Building Capacity for Patient Safety",doi:"10.5772/intechopen.100559",slug:"patient-safety-preventing-patient-harm-and-building-capacity-for-patient-safety",body:'Certain healthcare settings and situations are also prone to higher levels of hazards and chances of error. For example, intensive care unit (ICU) patients’ care is complex with multiple disciplines involved performing numerous activities and procedures that increase the potential risk of error [3]. A recent study reports that drug management (25%, 95% confidence interval 16% to 34%, I2=98%) and other therapeutic management incidents (24%, 21% to 30%, I2=98%), surgical procedures (23%, 9% to 38%, I2=98%) and healthcare infections (16%, 11% to 22%, I2=98%) are the leading causes of preventable patient harm [2, 4, 5]. Lastly, fear around reporting medical errors manifests strongly within the healthcare culture in numerous places around the world, and contributes to stunting advancement towards error prevention and patient safety [5].
Though patient safety is an essential principle of health care, yet many medical practices and risks related with healthcare are major challenges for patient safety. In high-income countries, one in 10 patients experiences an adverse event during their hospital stay [4]. In the United States, medical error is the third leading cause of death after cancer and heart disease, resulting in 250,000 deaths annually, and in the United Kingdom, a patient is reported to be harmed every 35 seconds [5, 6]. Low and middle-income countries fare far worse as one in four patients is estimated to be harmed, which results in 2.6 million yearly deaths [4].
Additionally, the cost of medical errors associated with poor care is an enormous economic burden. Unsafe practices which result in death or permanent disability have cost some countries between US $6 billion and US $29 billion per year [5]. Furthermore, the psychological cost to the patient and families associated with a loved one’s death or disability, and loss of trust in the healthcare system are immeasurable [5]. Studies report that annual global economic growth could be boosted by over 0.7% if harmful medical practices are eliminated [4].
The joint commission gathers new evidence on emerging patient safety issues to inform goals for every year. Below are the brief descriptions of common safety issues, its burden, and the steps that can be taken to improve each.
Medical errors are events that occur during medical care which can lead to adverse consequences to patients. It is the third leading cause of death in the United States behind heart disease and cancer; about 250,000 deaths can be attributed to medical errors, including medication errors [7, 8]. They can be related to events when a wrong action was taken (error of commission) or when an action was not taken (error of omission). Additionally, medical errors can have consequences to health care professionals and institutions due to negative financial outcomes [9]. Healthcare providers can experience negative psychological responses with fear of punishment, and therefore be hesitant to report errors. It has been suggested that acknowledging healthcare providers are fallible and promoting a culture that focuses on mental health can lead to improved care for patients [10].
Several aspects of medical care can lead to medical error, including misdiagnosis, procedures, medication and/or dosage, patient identification and billing. It is important to recognize why they occur, foster a culture that encourages quality improvement, and cautions against an environment of blame and punishment [11]. There is often multiple causes of medical error: insufficient training, responsibilities performed by inappropriate staff, rare diseases, complexity of illness, unsatisfactory testing, time restraints, patient’s age, and newer procedures, amongst others [7]. It is important for all members of the healthcare delivery team to be involved in all aspects of patient safety and improvement.
Diagnostic errors have been estimated to be associated with up to 40,000 to 80,000 deaths or injuries per year. These include situations when a diagnosis was an unintentional delay, incorrect, or overlooked, and can occur in all specialties over a wide range of diagnoses. Preventing errors in diagnosis is a multifaceted approach, ranging from ensuring awareness of conditions that are often misdiagnosed, acknowledging first impression bias, discussion with appropriate specialists, and clear communication and documentation. This includes a complete differential diagnosis, appropriate handoffs, if applicable, and knowing which patients are at higher risks of diagnostic error, such as those with multiple medical conditions, patients with language and socioeconomic barriers, and patients with poor follow-up and compliance. Interventions to reduce diagnostic errors should not only be at the individual level, but should ideally be focused at the systems based level. System related errors include technical and equipment problems, organizational failures, “no-fault” errors like unusual presentation or conditions, and patient-related issues, such as compliance and misrepresenting symptom concerns [12, 13, 14].
The COVID-19 pandemic brings to light the importance of medical errors, including diagnostic errors as it relates to learning a new disease entity, as well as compromised physical and psychological aspects of healthcare providers that can affect clinical reasoning [15]. Additionally, system-based factors, such as staffing, capacity of the healthcare facility, and new care delivery systems, could be prone to delayed diagnosis due to postponement in patients coming to seek evaluation of symptoms or preventive screenings. It has been suggested that strategies to mitigate diagnostic error during these challenging times can be helpful: decision support tools, electronic health record, triage protocol, optimized use of telemedicine and follow-up, encouraging patients to seek care, education on safety protocols, a strong healthcare leadership team, open door for concerns without fear of judgement, continued support for education of trainees, and opportunities for discussion among colleagues for challenging cases and situations [16].
Sepsis is a syndrome characterized by life-threatening organ dysfunction in response to an infection. It is frequently not diagnosed early enough to save a patient’s life. Because these infections are often resistant to antibiotics, patients are at high risk for complications and death and have higher health care costs [17].
In October 2015, the Centers for Medicare and Medicaid Services (CMS) began requiring U.S. hospitals to report compliance rates with the sepsis CMS core measure SEP-1 (Severe Sepsis and Septic Shock Management Bundle). It puts out guidelines for frontline hospital clinicians fighting sepsis. SEP-1 focuses on timely sepsis recognition and early intervention with lifesaving therapies [22]. Preliminary data from CMS indicate that the majority of SEP-1 cases nationally fail the measure and cases that fail have higher mortality rates than cases that pass [23]. E
Radiation therapy, consisting of targeting malignant cells with ionized radiation, is an increasingly important cancer therapy with approximately 50% of all cancer patients receiving radiation during their illness [25]. Toxicities and adverse side effects of this therapy are related to the dose of radiation given and therefore dose calculation and regulation is of concern with regards to patient safety.
Radiation therapy safety and regulation has been under scrutiny and overhaul following a New York Times article from 2010 describing several patient stories with devastating outcomes [26, 27]. Many of the errors described are related to patients receiving several times the intended dose of radiation or miscalculations of the field resulting in areas of the body receiving radiation which were not intended or planned. Unfortunately, these errors are caused by flaws in an exceedingly complicated series of calculations and considerations depending heavily on computers systems and software. In fact, data shows that in radiation oncology, 30% of errors occur in the planning phase of therapy and 29% of errors are discovered in the treatment step of therapy [27]. This may suggest that the planning phase needs a more robust universally standardized control system and many studies have attempted to elucidate areas of improvement regarding geometric discrepancies resulting in errors [28, 29, 30].
As medicine becomes increasingly more complex, so does error analysis. In the field of radiation oncology, the multidisciplinary team adds to this complexity. The specific skill sets that are required to plan and execute a radiation treatment cannot be expected of one provider and so several health care providers are needed to successfully implement a complex therapy, including a highly specialized physician, medical physicist, and radiation therapist/dosimetrist. This is no doubt overall beneficial in the big picture for patient outcomes, however, advanced software and multiple highly specialized providers means that the way providers consider their options when an image or patient is in front of them requires far more critical thinking than what may have been expected from an average physician 30 years ago. Each provider must critically look at the information in front of them and understand and accept that there are parts of the treatment plan and the method in which they were derived that they do not fully comprehend. This requires all the members of the treatment team to trust the computer systems and software, as well as other providers, which are all integral in planning of radiation therapy. At the same time, all involved must realize the limitations of technology and consider human error on the part of their colleagues. This makes error analysis in the field of radiation oncology intricate, and one might argue that a key consideration in the future may be cognitive biases among providers and need for structured training to minimize them [27].
Every year, millions of people undergo surgical treatment for various ailments and disease processes. Surgical interventions account for an estimated 13% of the world’s total disability-adjusted life years (DALYs). These procedures are intended to improve and save lives; however, unsafe surgical care can cause substantial harm. A modeling study, published in Lancet in 2008, estimated that 234 million operations are carried out every year across the world [31]. This translates to one operation for every 25 people, which is more than the number of children born worldwide each year. Current estimates of morbidity and mortality following surgery indicate that over 7 million people (about twice the population of Oklahoma) worldwide will suffer complications following surgery. One million of these people will die as a result. This correlates to an overall mortality rate of 0.5-5%. Complications in inpatient operations occur in up to 25% of our patients, which accounts for nearly half of all adverse events in hospitalized patients [31]. Regrettably, it is estimated that in at least half of the cases, in which surgery led to harm, were considered preventable. Several surgical societies and hospital administrations have put forth recommendations, and in many cases requirements, to help ensure our patients have a safe journey through our operating rooms.
On a global scale, the World Health Organization (WHO) is the leading authority on patient safety and has undertaken essential global and regional initiatives to address surgical safety. WHO established the Second Global Patient Safety Challenge, “Safe Surgery Saves Lives,” in 2007. This program proposed to improve the safety of surgical care around the world by defining a core set of safety standards which led to the Surgical Safety Checklist, a 19-item tool created by WHO in association with the Harvard School of Public Health. This safety checklist aims to decrease errors and adverse events by increasing communication and teamwork in surgery [32]. Improving teamwork and communication is one of the main goals of using a checklist. The checklist is a simple tool designed to improve the safety of surgical procedures by bringing together the whole operating team (surgeons, anesthesia providers and nurses) to perform key safety checks during vital phases of perioperative care: prior to the induction of anesthesia, prior to skin incision, and before the team leaves the operating room. Between October 2007 and September 2008, the effect of the Checklist was studied in eight hospitals in eight cities (Toronto, Canada; New Delhi, India; Amman, Jordan; Auckland, New Zealand; Manila, The Philippines; Ifakara, Tanzania; London, UK; and Seattle, USA) representing a wide variety of health-care settings, economic circumstances and diverse patient populations and demonstrated dramatic improvements in both processes and outcomes. The study showed use of the WHO Surgery Checklist, reduced the rate of deaths and surgical complications by more than one-third across all eight pilot hospitals. The rate of major inpatient complications dropped from 11% to 7%, and the inpatient death rate following major operations fell from 1.5% to 0.8% [33].
Many hospitals are already performing most of the items on the list but not reviewing them as a team. Good data has now proven that implementation of the 19-item checklist results in a significant reduction in both morbidity and mortality [33]. The WHO continues to develop patient safety action plans with an action-oriented framework to facilitate the implementation of strategic patient safety interventions at all levels of health systems. Because complications will strike, we must strive for perfection, by adhering to proven protocols, meticulously preparing, conducting, and caring for our surgical patients.
Each day, life-saving blood transfusions are needed in hospitals and emergency treatment facilities across the United States. There are more than 13.2 million blood donors in the U.S., resulting in a total of 17.2 million transfused blood product units per year. Worldwide, approximately 118.5 million blood donations are collected [34]. How do we ensure safety with this staggering number? In the U.S., the federal agencies responsible for keeping our blood safe are the Centers for Disease Control (CDC), protecting health through investigations and surveillance [35]. The U.S. Food and Drug Administration (FDA) ensures safety of blood donations by protecting the health of donors. The National Institutes of Health (NIH) performs research on blood transfusion basic science, epidemiology, and clinical practices. Safety is also the responsibility of the blood centers and hospitals that collect and transfuse millions of units of blood each year. On the donor end, each donor is screened for risk of transmissible disease by questionnaire, which asks standard health questions to determine eligibility to donate. Additionally, each unit of donated blood in the U.S. is routinely screened for various infectious disease pathogens, using FDA approved assays [35]. The blood is then tested for blood type (ABO group) and Rh type (positive or negative). Prior to transfusion, the donor and blood unit are also tested for certain proteins (antibodies) that may cause adverse reactions in a person receiving a blood transfusion.
Presently, the most significant risk for a transfusion complication occurs due to noninfectious hazards from deficient processes [36]. The goal of providing safe transfusion therapy depends on a complex process that requires integration and coordination among multiple hospital services, including laboratory medicine, nursing, anesthesia, surgery, clerical support, and transportation. Most healthcare institutions in the United States have formed a multidisciplinary hospital-based transfusion committee to review blood transfusion practices and adverse outcomes. The Center for Medicare/Medicaid Services (CMS) requires such a process to receive payment for transfusion services. However, CMS does not require a specific committee be assigned to oversee the review process. This process must include a program of quality assessment and performance improvement, which is ongoing, hospital-wide, data-driven, reflects the complexity of the hospital’s organization and services, and involves all hospital departments and services (including those contracted) [37]. If a hospital elects not to receive payments from Medicare, it must still comply with applicable sections of the Code of Federal Regulations pertaining to transfusion services.
Venous thromboembolism (VTE) is a frequent complication of hospitalized patients and a leading cause of preventable hospital death and increased hospital length of stay in the United States and worldwide. Hospital-acquired VTE is defined as VTE occurring during or within 3 months after hospitalization and accounts for >50% of the population burden of VTE in the United States. Although, the precise number of people affected by VTE is unknown, it is estimated as many as 900,000 people are affected (1 to 2 per 1,000) each year in the United States, resulting in an estimated loss of 60,000-100,000 American lives. As one might expect, there is an exponential increase with age from 1 per 10,000 in young adults to 1 per 100 in the elderly. Data from two large U.S. studies place the estimated absolute risk of VTE after age 45 to be 8.1% overall, 10.9% in obese patients, 11.5% in blacks, 17.1% in those with factor V Leiden mutation, and 18.2% among blacks with sickle cell trait [38]. Of these patients, two-thirds will present with Deep Vein Thrombosis (DVT) only and the remaining presenting with Pulmonary Embolism (PE) as the first manifestation and primary cause of VTE related mortality.
Early data regarding COVID-19 patients developing VTE suggests substantial risk. Reports have ranged from 1.1% in non–intensive care unit (ICU) hospital wards to 69% in ICU patients. More data is necessary regarding the relationship between COVID-19 and increased risk of VTE. Currently, many of reports are from small sample sizes and retrospective in design. However, it seems prudent that all patients admitted to a hospital unit receive pharmacologic prophylaxis. The question of whether to administer full therapeutic dose versus prophylactic dose anticoagulant in critically ill patients is controversial and is actively being studied [39].
Venous thromboembolism remains one of the most preventable causes of hospitalized patients. Risk stratification and prophylactic measures have proven to be safe, cost effective, and most importantly, save lives. The data regarding VTE morbidity and mortality is not new yet, despite decades of solid evidence from multiple randomized clinical trials, thromboprophylaxis remains either underused or misused. The key is for health care providers to adhere to proven protocols and policies. Multiple policy statements have been published focusing efforts to eliminate unnecessary human death and suffering. Five major areas of policy guidance have put forth by the American Heart Association that they believe will lead to improved implementation, tracking and prevention of VTE events. They include assessment and reporting the level of VTE risk in all hospitalized patients, integrating preventable VTE as a benchmark for hospital comparison and pay-for-performance programs, supporting appropriation to improve public awareness of VTE, tracking VTE nationwide with the use of standardized definition and developing a centralized data steward for data tracking on VTE risk assessment, prophylaxis, and rates [40].
Diagnosis and defining exactly who should be screened remains challenging because the clinical features are often non-specific, and testing can be falsely negative or positive. Therefore, risk stratification scoring systems have been proposed and used widely. The Wells DVT and Wells PE scoring systems, as well as the Geneva PE score, have been adopted by many major medical centers in the U.S. and around the world. These scoring systems have been used in conjunction with objective diagnostic imaging, providing a high degree of accuracy in making the diagnosis of VTE. Some of these diagnostic testing modalities includes compression ultrasonography, computed tomography angiography, ventilation-perfusion scintigraphy or single-photon emission tomography, magnetic resonance angiography and echocardiography.
Another method of making healthcare administrator’s and medical practitioners take notice is by making them financially aware of the devasting avoidable cost to our healthcare industry. When factoring in the VTE-related morbidity of VTE, including post-phlebitic syndrome occurring in 30-50% of patients with proximal DVT, and chronic thromboembolic pulmonary hypertension occurring in 4% of patients within 2 years of PE survival, the estimated annual cost of preventable hospital acquired VTE is $7-10 billion per year [41]. Regardless of the method, it is our duty as healthcare providers to take on the challenge by educating our healthcare colleagues and soliciting the support of our administrators in establishing hospital wide protocols to prevent this devastating, albeit preventable, disease process.
Health-care associated infections (HCAIs) are infections acquired by patients 48 hours or more to within 30 days after receiving care from various health care settings, which include acute-care facility, long-term facility, family medicine clinics, ambulatory care and home care [42]. HCAIs are the most common complications of hospital care and one of the top 10 causes of mortality worldwide [42]. Numerous factors heighten the risk for developing HCAIs, such as increased age, immunosuppression, multiple underlying comorbidities, increased length of hospital stay, admission to the intensive care unit (ICU), mechanical ventilatory support, recent invasive procedures, indwelling devices, frequent visits to healthcare facilities, and infection-control practices at the healthcare facility [43]. Patients’ risk of developing antimicrobial resistance increases highly if they received intravenous antibiotics within 90 days of administration [43]. Even though $28-45 billion is spent annually in the United States, 90,000 deaths still occur due to HCAIs [42]. The World Health Organization (WHO) reports that 7 out of 100 hospital patients in high income countries and 10 out of 100 hospital patients in low-to-middle income countries will acquire HCAIs at any given time [44]. These statistics continue to highlight a major concern to patient safety worldwide.
Surgical site infections (SSIs), also known as wound infections, central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonia (VAP), hospital-acquired pneumonia (HAP) and
The most important practice to prevent and control HCAIs is effective hand hygiene [42, 49]. The World Health Organization (WHO) advocates education and training for all healthcare workers to encourage washing hands for at least 30 seconds before and after touching a patient or their environment, after body fluid exposure, and before and after aseptic procedures using soap and water or alcohol-based sanitizers [42, 49]. Widespread and consistent hand hygiene practices can decrease infection rates by 50% [49].
Personal protective equipment (PPE), for example, face masks, gloves, gowns, protective eyewear, and face shields, reduce transmission of microorganisms and body fluids between healthcare workers and patients [42]. Organisms transmitted through aerosols, such as influenza virus,
Cleanliness of equipment used by healthcare workers is also important to patient safety. A study found medical residents’ coat sleeves (50%), stethoscopes (36.3%), and pagers (36.3%) carried methicillin sensitive
The estimated number of inpatient falls in United States is between 700,000 to 1,000,000, with reported fall rates ranging from 1.3 to 8.9 per 1000 bed-days [54, 55]. In general, fall related injuries are the most common cause of accidental death among hospital patients over 65, resulting in 41 fall-related deaths per 100,000 people per year [54].
Per the World Health Organization, falls are defined as “inadvertently coming to rest on the ground, floor, or other lower level, excluding intentional change in position” and in the inpatient setting, they include slips, trips, faints, collapses and any patient found on the floor unwitnessed [56]. As of 2008, Centers for Medicare & Medicaid Services (CMS) does not reimburse hospital for certain types of traumatic injuries while patients are in the hospital, many of which occur after a fall [57].
Preventing falls in the hospital setting can be challenging. Hospital staff needs to treat patient for their acute condition, keep them safe and help patients maintain and recover physically and mentally. When an adverse event like a fall happens, it may result in high-impact outcomes for a patient, such as decline in function, increased length of hospital stays, and increased cost of health care services. Damage resulting from a fall can affect as many as 50% of patients, and about 44% of falls can result in serious injuries and even death [56]. About 1-3% of falls in hospitals results in fractures [58]. Even without injury, harm to patients, caregivers and hospital staff can manifest as psychological distress, including anxiety and depression, reduced physical activity, fear of future falls, prolonged hospital stay, increased use of restrains and sedating drugs, complaints, litigations, guilt, and dissatisfaction [55, 59]. Fall prevention often consists of managing patients’ underlying fall risk factors. Such risk factors include age, limited mobility, visual impairment, use of some classes of medications (especially psychotropics), medication side effects, change in medications, delirium, change in environment, frequent toilet needs, urinary incontinence, orthostatic hypotension, fall history, and fear of falling. In addition to the elderly, patients with recent diagnoses of stroke or cancer, and patients hospitalized in neurology and rehabilitation units are at increased risk of falls [60]. There are several fall-risk tools to help stratify patients at risk, but many of them are not validated due to their lack of sensitivity and specificity for clinical use. Three of these have been validated in multiple studies across the populations. These are the St Thomas’s Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY), the Morse Fall Scale (MFS), and the Hendrich Fall Risk Model (HFRM). Based on the risk stratification, there is usually a multimodal intervention for inpatient fall prevention, and it can include patient education, bedside risk sign, staff education, alert wristband, footwear, toileting schedules, environmental modifications, movement alarms, bedrail review, hip protection, exercise, restrains, and a review after a fall to identify causes. High quality evidence shows that multicomponent intervention can reduce the risk of inpatient falls by up to 30% [61].
A common taxonomy is needed to standardize and track events to measure particularly when healthcare workers are working between and within different professional backgrounds. The core terms that are essential to know and understand are described below.
Near misses also may be referred to as close calls, near accidents, accident precursors, injury-free events and, in the case of moving objects, near collisions.
A near miss is often an error, with harm prevented by other considerations and circumstances.
The phrase "near miss" should not be confused with the phrase “nearly a miss” which would imply a collision.
A coordinated and practical strategy in which systemwide safety processes are applied across entire healthcare fields through collaboration among diverse stakeholders has been proven to provide the best outcomes. Risks are to be expected as healthcare is and will continue to be an ever evolving. Preventing harm and improving systems will not happen in a vacuum. It takes effort from frontline personnel, educators, trainers, and organizational leaders to create a systemwide approach. In the following section, we will discuss how we can prevent harm with our proactive attitude and build a capacity to improve patient safety when we try to conquer risks and errors spanning the myriad layers of healthcare.
The crucial step towards lowering errors and harms to the patients is educating healthcare professionals about patient safety. Since there is involvement of many individuals at different layers of the system in the delivery of health services, education and training also needs to be multidisciplinary and multi -professional. Education cannot be based on a linear or hierarchical educational model as medicine is often approached. Multimodal approach should be implemented at each level of health professional education.
Association of American Medical Colleges (AAMC) addressed Competency Based Education (CBE) in 2019 with suggestions for improvement for patient safety education. It acknowledges the importance of developing curricula based on competency at each level of learning- undergraduate, graduate, and continued education [62]. The same look but from a distinct perspective - as one accrues knowledge, they begin to see more clearly the finer aspects of how to prevent harm. Multiple avenues exist for formal coursework in patient safety education. Continued Medical Education (CME) is available by multiple formats such as lectures, testing, reading materials. It is the most pervasive patient safety education model; not only does updating clinical knowledge leads to improved outcomes but direct patient safety courses enhance its implementation. Certification courses are available, as well. In recent years there has been as rise in Master\'s degrees in patient safety and healthcare quality.
Several ongoing activities for trainees and experts, either directly or indirectly, enable patient safety education. Accreditation Council for Graduate Medical Education (ACGME) has mandated Quality Improvement (QI) projects in residency. They require pattern recognition for process improvement, inadvertently propelling involved parties to become educated on areas of patient harm. ACGME has appropriately made QI a requirement in physician training [63]. More informally, training occurs in the break rooms or during lunch when knowledge is shared openly, and indirect learning occurs from other’s experience. The table below provides list of some of the pros, cons, and growth opportunities for each educational setting (Table 1).
Type | Description | Pros | Cons | Potential sources of improvement |
---|---|---|---|---|
M&M conference | Healthcare teams thoroughly analyze a case often using the Ishikawa Diagram to discuss errors with an audience to educate and identify improvement |
|
|
|
QI projects | Process improvement using the PDSA cycle |
|
|
|
Case analysis | Experts reviewers who are familiar to the system and individuals find issues leading to patient harm |
|
|
|
CME | Short formal sessions on specific topics on patient safety |
|
|
|
Courses | Longer formal training on specific topics on patient safety |
|
|
|
Multidisciplinary rounds | Involve multiple patient team member- such as provider, nurse, pharmacist, residents, fellows, etc to oversee patient care and provide increased oversight to prevent patient harm |
|
|
|
Books/Articles/News | Dedicated books on/patient-oriented perspectiveopinions on patient safety |
|
|
|
Avenues for patient safety education.
WHO has recognized the need for an international leader in patient safety education. In 2013, WHO published a Multi-professional Patient Safety Curriculum Guide for standardization of patient safety education, an update to its earlier Curriculum Guide for Medical Schools published in 2009 [64]. Additionally, during their 2021 assembly, the WHO adopted the first ever Global Patient Safety Action Plan 2021 – 2030, a global initiative to eliminate avoidable harm. Amongst other things, it will focus on involving patients and families for patient safety [44]. Smaller entities, such as Improvement for Healthcare Safety (IHI) or Patient Safety Network (PSNET), have perceived this necessity and invested in producing a concise platform for medical professionals as well [65, 66] attempting to innovate this field of learning.
Having recognized the need for such courses in medical educational infancy, the new trend has been to incorporate patient safety education across the globe [67]. By creating patient safety education early on, lifelong learners of patient safety can be made.
COVID-19 pandemic has provided fertile ground for medical errors as the medical system was stretched thin [68]. Much learning and teaching had internationally shifted to the virtual world. If this shift can be harnessed to standardize patient safety education as we continue to grapple with COVID as a reference, it may allow us to build a more robust patient safety instruction. Updating courses in medical school to incorporate patient safety is a new trend [69]. While each organization and individual will need to adapt proposed training, interactive learning curriculums improve student learning of difficult concepts such as patient safety and “just culture”. With the correct attitude, continually renewed educational offerings, and standardization of basics globally, we can navigate the complex and evolving nature of medicine better.
Effective leadership is necessary to lead an organization down the path to establishing a culture of safety. Primarily, the leadership needs to be persistent and well-balanced. Stable organizational leadership allows organizations to grow and transform successfully. According to the American College of Healthcare Executives and the Lucian Leape Institute, there are 6 key domains that healthcare leaders need to focus on to create a long-lasting organizational culture of safety [70]:
Establishing a compelling vision for safety
Build trust, respect, and inclusion
Select, develop, and engage your Board
Prioritize safety in the selection and development of leaders
Lead and reward a just culture
Establish organizational behavior expectations
These domains do not exist by themselves and must always be looked at as a cohesive unit.
To successfully lead an organization on its path to a safer patient experience, the leader must set clear priorities and communicate a sharp vision. A shared vision is a fundamental part of highly effective organizations, and this endeavor is no different. Because so much of patient safety initiatives involves voluntary reporting by staff, the role of leadership building trust amongst their employees and selecting managers who prioritize safety cannot be understated. Many staff members view patient safety reports as “snitching” and do not understand the fundamental importance of identifying these sentinel events. Leaders and managers leading by example in reporting events concerning them and by ensuring the principles of “just culture” are on display is necessary to ensuring the organization becomes a champion for patient safety.
The pairing of high-quality education and transformative leadership based on the 6 domains are two-parts to a successful, patient-focused organization. Neither will be successful alone and without coordination of educational programming and leadership efforts, they will not be successful either. Leaders will need to work with organization educational designers to create engage, transformative educational material that will motivate staff to focus on patient safety as a core value of the organization [71].
“Just Culture” refers to a system of shared accountability in which organizations are accountable for the systems they have designed and for responding to the behaviors of their employees in a fair and just manner. Employees are accountable for the quality of their choices and for reporting errors and system vulnerabilities. While the organization has a duty and responsibility to employees and to patients, all employees are held responsible for the quality of their choices [72].
Promoting a just culture is to implement a nonpunitive response to error in improving patient outcome and safety. Just culture encourages employee to focus on compliance and corrective actions instead of fear of punitive actions. Creating a safe and transparent environment encourages reporting of mistakes and hazards and improves the care provided to patients. Lack of reported information decreases the organization ability to proactively address patient-safety issues and improves the existing work infrastructure.
For health care systems to be successful in achieving the above goals of patient safety they need to foster a just culture [72].
These examples address an aspect of just culture that goes beyond ensuring that employees feel free to report errors. Exceptionally reliable organizations and industries promote mindfulness in their workers.
Weick and Sutcliffe describe mindfulness in terms of 5 components [73]:
A constant concern about the possibility of failure
Deference to expertise regardless of rank or status
Ability to adapt when the unexpected occurs
Ability to concentrate on a task while having a sense of the big picture
Ability to alter and flatten the hierarchy to fit a specific situation
Mindfulness throughout an organization considers moves beyond events and occurrences. Everyone in the organization is continually learning, adjusting, and redesigning systems for safety and managing behavioral choices.
A fair and just culture improves patient safety by empowering employees to proactively monitor the workplace and participate in safety efforts in the work environment. Improving patient safety reduces risk by its focus on managing human behavior (or helping others to manage their own behavior) and redesigning systems. In a just culture, employees are not only accountable for their actions and choices, but they are also accountable to each other, which may help some overcome the inherent resistance to dealing with incompetency [72].
Secondary benefits of a just culture include the ability to develop a positive patient safety profile to respond to outside auditors, such as The Joint Commission. When implemented, a just culture fosters innovation and cross-departmental communication. An example is the opportunity to revitalize the morbidity and mortality conference to cross specialty lines and develop a patient-centered focus. In a just culture, both the organization and its people are held accountable while focusing on risk, systems design, human behavior, and patient safety [72].
The process of implementing the just culture is not one that happens overnight. However, a health care organization can build an infrastructure to embed this methodology by achieving it through education and allocation of resources to training the employee.
“Engagement of patients and families resides at the core of the framework for safe, reliable, and effective care. In safe and reliable organizations, patients and families are as much members of the care team as clinicians and other health care staff” [74].
The joint commission mandated that healthcare organizations “encourage patient’s active involvement in their own care as a patient safety strategy”. Because of this action, hospitalized patients, as well as patients receiving care on outpatient basis, are routinely surveyed about their satisfaction with the care they received [75].
Studies in the in-patient setting have found that patients often report errors that were not detected through traditional mechanisms, such as chart review [75]. Unless patient involvement through surveys after service was considered, these errors would not have been detected. Therefore, patient engagement and involvement practices in the day-to-day functions of an organization is essential in ensuring a safe environment.
Some examples of safety targets in patient care that show patient outcome improvement and risk reduction through patient engagement in hospitals and outpatient settings include: improved anticoagulation management with reduction in risks of thromboembolic events and mortality, improved hypoglycemia management in diabetes, increased medication adherence, reduced medication administration errors, improved hospital readmissions rates, and reduced hospital acquired infections when patient education and engagement is optimized and encouraged [76].
With all the evidence demonstrating patient involvement and participation supporting positive outcome, the next step is for health care teams to partner with patients and caregivers to integrate effective patient engagement into clinical practice and health care systems.
The following elaborates on proposed methods to involve and engage patients in the care they receive from organizations to ensure patient satisfaction and safety outcomes [74]:
Patients should be included in decision making process. While it is the clinical team’s responsibility to provide key facts and advise to patients, the patients and/or their representatives should be given opportunity to have input in decision-making process. It is easier to reach a common goal when all parties are informed and well educated on real expectations. This will minimize unnecessary steps and reduced risks and negative outcomes associated with those steps.
Healthcare teams and organizations should provide a safe environment for patients to express concerns, questions, and ideas openly and without judgment. The clinical team should avoid negative reactions to foster more comprehensive and accurate information exchange between patients and organizations/healthcare teams. As a result, patients will be more forthcoming about their incompliances and will provide more accurate information. This process will help providers utilize factual data to come up with a plan of care that reduces unintentional harm to patients.
The Agency for Healthcare Research and Quality (AHRQ) is one of twelve agencies within US Department of Health and Human services (HHS). It is a lead federal agency charged with improving the quality and safety of America’s health system performance, offers practical and research-based tools with resources to support healthcare organizations, providers, hospital staff, patients and others that make care safer in healthcare settings. These organized tools and resources help staff in hospitals, emergency departments, long-term care facilities, and ambulatory settings to prevent avoidable complications of care. AHRQ contributes to forming a higher performing health system in three main ways: investing in research and evidence to improve safety and quality of healthcare, creating materials to teach and train healthcare professionals to catalyze the improvements in care, and generating measures and data used to track and evaluate progress of US healthcare [77].
AHRQ assists and provides various tools and resources by different settings, quality measures, reports and resources, engaging patients and families, education, and training, etc. Teams STEPPS, is one such teamwork system developed by AHRQ and Department of Defense (DoD) that offers a powerful solution to improving collaboration and communication among healthcare professionals [78]. There are many other quality improvement tools and information, including AHRQ Quality Indicators Hospital Toolkit, ambulatory clinical performance measures, and talking quality, to help staff build the knowledge and develop the skills that impact organizational culture and lead to sustained improvements in safety.
Since quality improvement is a driving force and is a vital part at every level of service delivery in healthcare, collecting and analyzing data are therefore central to the function of quality improvement at all levels. Data not only allows us to accurately recognize problems, it also supports to prioritize quality improvement initiatives, and qualifies objective assessment of whether change and improvement have indeed occurred. Making changes to improve quality is complex business, thus solid evidence in the form of data is required to support decision-making rather than isolated occurrences, assumptions, emotions, or politics.
Role of data in quality improvement is helpful in all five phases of quality improvement: project definition phase (what is the problem?), diagnosis phase (what can we improve?), intervention phase (how can we achieve improvement?), impact measurement phase (have we achieved improvement?), and sustainability phase (have we sustained improvement?) [79].
With good data, we can access: current performance, identify performance gaps, identify problem steps, prioritize opportunities for improvements, establish clear objectives for improvement, prioritize most appropriate interventions, compare the benefits of alternative interventions and implementation strategies, assess impacts of interventions, demonstrate the success of improvement project to stakeholders, provide feedback to reinforce change, demonstrate benefits, identify problems in practice, and need for repeated intervention.
To get quality, unbiased data, one must use sound data collection techniques, appropriate tools, correct sampling techniques, ensure data validity, and confirm it is secured.
The dynamic nature of healthcare delivery where innovative technologies and approaches to care are incorporated constantly into the regular practice, new occasions for unsafe practices are continually created. An attitude of inclusivity for all care teams with necessary education, proper communication, just culture, and engaging leadership will lower errors and harms and improve patient safety. Besides these, proper collection and review of safety data can help serve as a catalyst for increased resources dedication to most needed facet of healthcare in that setup. Thus, if we integrate the science of safety into our daily healthcare practices, we are certain to lessen the magnitude and extent of harm and economic burden and improve patient safety.
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\n\nThe first step in obtaining funds for your Open Access publication begins with your institution or library. IntechOpen’s publishing standards align with most institutional funding programs. Our advice is to petition your institution for help in financing your Open Access publication.
\n\nHowever, as Open Access becomes a more commonly used publishing option for the dissemination of scientific and scholarly content, in addition to institutions, there are a growing number of funders who allow the use of grants for covering OA publication costs, or have established separate funds for the same purpose.
\n\nPlease consult our Open Access Funding page to explore some of these funding opportunities and learn more about how you could finance your IntechOpen publication. Keep in mind that this list is not definitive, and while we are constantly updating and informing our Authors of new funding opportunities, we recommend that you always check with your institution first.
\n\nFor Authors who are unable to obtain funding from their institution or research funding bodies and still need help in covering publication costs, IntechOpen offers the possibility of applying for a Waiver.
\n\nOur mission is to support Authors in publishing their research and making an impact within the scientific community. Currently, 14% of Authors receive full waivers and 6% receive partial waivers.
\n\nWhile providing support and advice to all our international Authors, waiver priority will be given to those Authors who reside in countries that are classified by the World Bank as low-income economies. In this way, we can help ensure that the scientific work being carried out can make an impact within the worldwide scientific community, no matter where an Author might live.
\n\nThe application process is open after your submitted manuscript has been accepted for publication. To apply, please fill out a Waiver Request Form and send it to your Author Service Manager. If you have an official letter from your university or institution showing that funds for your OA publication are unavailable, please attach that as well. The Waiver Request will normally be addressed within one week from the application date. All chapters that receive waivers or partial waivers will be designated as such online.
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Transmission of Malaria: An Old Issue for New Approaches",slug:"residual-transmission-of-malaria-an-old-issue-for-new-approaches",totalDownloads:4713,totalCrossrefCites:78,totalDimensionsCites:174,abstract:null,book:{id:"3092",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",title:"Anopheles mosquitoes",fullTitle:"Anopheles mosquitoes - New insights into malaria vectors"},signatures:"Lies Durnez and Marc Coosemans",authors:[{id:"152754",title:"Prof.",name:"Marc",middleName:null,surname:"Coosemans",slug:"marc-coosemans",fullName:"Marc Coosemans"},{id:"169018",title:"Dr.",name:"Lies",middleName:null,surname:"Durnez",slug:"lies-durnez",fullName:"Lies Durnez"}]},{id:"43899",doi:"10.5772/56117",title:"Distribution, Mechanisms, Impact and Management of Insecticide Resistance in Malaria Vectors: A Pragmatic 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The application of this test has significantly changed the practice of medical laboratories in which it is used for detection and quantification of molecules such as hormones, peptides, antibodies, and proteins. Various technical variants of this test can detect antigen (native or foreign) or antibody, determine the intensity of the immune response whether pathological or not; the type of induced immune response as well as the innate immunity potential; and much more. These capabilities, as well as the high sensitivity and robustness of the test and a small price, make it possible to quickly and reliably diagnose diseases in most laboratories. Besides, ELISA is a test that is also used in veterinary medicine, toxicology, allergology, food industry, etc. Despite the fact that it has existed for almost 50 years, different ELISA tests with different technical solutions are still being developed, which improves and expands the application of the this exceptional test. The aim of this chapter is to empower the rider to optimize, standardize and validate an enzyme linked immunosorbent assay.",book:{id:"9850",slug:"norovirus",title:"Norovirus",fullTitle:"Norovirus"},signatures:"Rajna Minic and Irena Zivkovic",authors:[{id:"325806",title:"Ph.D.",name:"Irena",middleName:null,surname:"Zivkovic",slug:"irena-zivkovic",fullName:"Irena Zivkovic"},{id:"325839",title:"Dr.",name:"Rajna",middleName:null,surname:"Minic",slug:"rajna-minic",fullName:"Rajna Minic"}]},{id:"56750",title:"Laboratory Approach to Anemia",slug:"laboratory-approach-to-anemia",totalDownloads:6255,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Anemia is a major cause of morbidity and mortality worldwide and can be defined as a decreased quantity of circulating red blood cells (RBCs). The epidemiological studies suggested that one-third of the world’s population is affected with anemia. Anemia is not a disease, but it is instead the sign of an underlying basic pathological process. However, the sign may function as a compass in the search for the cause. Therefore, the prediagnosis revealed by thorough investigation of this sign should be supported by laboratory parameters according to the underlying pathological process. We expect that this review will provide guidance to clinicians with findings and laboratory tests that can be followed from the initial stage in the anemia search.",book:{id:"5942",slug:"current-topics-in-anemia",title:"Current Topics in Anemia",fullTitle:"Current Topics in Anemia"},signatures:"Ebru Dündar Yenilmez and Abdullah Tuli",authors:[{id:"183998",title:"Ph.D.",name:"Ebru",middleName:null,surname:"Dündar Yenilmez",slug:"ebru-dundar-yenilmez",fullName:"Ebru Dündar Yenilmez"},{id:"209103",title:"Prof.",name:"Abdullah",middleName:null,surname:"Tuli",slug:"abdullah-tuli",fullName:"Abdullah Tuli"}]},{id:"33133",title:"Waist Circumference in Children and Adolescents from Different Ethnicities",slug:"waist-circumference-in-children-and-adolescents-from-different-ethnicities",totalDownloads:8023,totalCrossrefCites:4,totalDimensionsCites:7,abstract:null,book:{id:"642",slug:"childhood-obesity",title:"Childhood Obesity",fullTitle:"Childhood Obesity"},signatures:"Peter Schwandt and Gerda-Maria Haas",authors:[{id:"29867",title:"Prof.",name:"Peter",middleName:null,surname:"Schwandt",slug:"peter-schwandt",fullName:"Peter Schwandt"}]}],onlineFirstChaptersFilter:{topicId:"185",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82740",title:"Secondary Pneumothorax from a Surgical Perspective",slug:"secondary-pneumothorax-from-a-surgical-perspective",totalDownloads:4,totalDimensionsCites:0,doi:"10.5772/intechopen.105414",abstract:"Although less frequent than the primary spontaneous pneumothorax (PSP), secondary pneumothoraces (SP) are a common clinical problem with a wide range of severity, depending on the triggering cause(s) and patient clinical condition. By definition, an SP occurs in those patients with an underlying condition that alters the normal lung parenchyma and/or the visceral pleura and determines air entry in the pleural space (e.g., COPD) or, eventually, following trauma or invasive procedures (i.e., iatrogenic pneumothorax). Less frequent, yet described, is SP occurring in neoplastic patients or infectious ones. The gravity of an SP is directly correlated to the underlying cause and patients’ clinical conditions. For example, it may be a life-threatening condition in an end-stage COPD but less severe in a catamenial related syndrome. In this chapter, we are providing a surgical overview of the most relevant and updated information on etiology, incidence, pathophysiology, and management of secondary pneumothoraces.",book:{id:"11045",title:"Pleura - A Surgical Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11045.jpg"},signatures:"Simona Sobrero, Francesco Leo and Alberto Sandri"},{id:"80875",title:"Pneumothorax: A Concise Review and Surgical Perspective",slug:"pneumothorax-a-concise-review-and-surgical-perspective",totalDownloads:42,totalDimensionsCites:0,doi:"10.5772/intechopen.101049",abstract:"Pneumothorax is the collection of air in pleural cavity, which is commonly due to development of a communication between pleural space and alveolar space (or bronchus) or the atmosphere. In this chapter, we will discuss the various aetiologies of pneumothorax, the differences in their pathophysiology and the implications on the management of the disease. The chapter focusses on the surgical aspects in the management, the revolution brought in by video-assisted thoracoscopic surgery (VATS) and the advancement of the field by introduction of uniportal VATS and robotic-assisted thoracic surgery. The principles of management of catamenial pneumothorax are revisited. The chapter also throws light on the nuances of anaesthesia techniques and the latest developments are outlined. Lastly, a section is dedicated to COVID-19 associated pneumothorax and the approach to its management.",book:{id:"11045",title:"Pleura - A Surgical Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11045.jpg"},signatures:"Shilpi Karmakar"},{id:"79289",title:"Indwelling Pleural Catheters",slug:"indwelling-pleural-catheters",totalDownloads:86,totalDimensionsCites:0,doi:"10.5772/intechopen.100645",abstract:"Indwelling pleural catheters (IPC) are now being considered worldwide for patients with recurrent pleural effusions. It is commonly used for patients with malignant pleural effusions (MPE) and can be performed as outpatient based day care procedure. In malignant pleural effusions, indwelling catheters are particularly useful in patients with trapped lung or failed pleurodesis. Patients and care givers are advised to drain at least 3 times a week or in presence of symptoms i.e. dyspnoea. Normal drainage timing may lasts for 15–20 min which subsequently improves their symptoms and quality of life. Complications which are directly related to IPC insertion are extremely rare. IPC’s are being recently used even for benign effusions in case hepatic hydrothorax and in patients with CKD related pleural effusions. Removal of IPC is often not required in most of the patients. It can be performed safely as a day care procedure with consistently lower rates of complications, reduced inpatient stay. They are relatively easy to insert, manage and remove, and provide the ability to empower patients in both the decisions regarding their treatment and the management of their disease itself.",book:{id:"11045",title:"Pleura - A Surgical Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11045.jpg"},signatures:"Yuvarajan Sivagnaname, Durga Krishnamurthy, Praveen Radhakrishnan and Antonious Maria Selvam"},{id:"79221",title:"Surgical Challenges of Chronic Empyema and Bronchopleural Fistula",slug:"surgical-challenges-of-chronic-empyema-and-bronchopleural-fistula",totalDownloads:118,totalDimensionsCites:0,doi:"10.5772/intechopen.100313",abstract:"Chronic empyema has always been a clinical challenge for physicians. There is no standard procedure or treatment to deal with the situation, and multi-modality approach is often necessary. Surgical intervention plays a very crucial role in the treatment of chronic empyema. Since bronchopleural fistula is often seen in chronic empyema patients, therefore it should also be mentioned. In this chapter, the focus will be on the different treatment options, various surgical approaches, and the rationale behind every single modality. Certain specific entity will be included as well, such as tuberculosis infection, post lung resection empyema, and intrathoracic vacuum assisted closure system application. Even with the advancement of technology and techniques, chronic empyema management is still evolving, and we look forward to less traumatic ways of approach with better outcome in the future.",book:{id:"11045",title:"Pleura - A Surgical Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11045.jpg"},signatures:"Yu-Hui Yang"},{id:"78826",title:"Pneumothorax in Children",slug:"pneumothorax-in-children",totalDownloads:94,totalDimensionsCites:0,doi:"10.5772/intechopen.100329",abstract:"Pneumothorax is a common pleural disease worldwide and is defined as the free accumulation of air between visceral and parietal pleura. Pneumothorax can be spontaneous, iatrogenic, and traumatic. Although it is less common than adults, it is seen in about 1.1–4 per 100,000 per year in the childhood age group. In patients presenting with variable clinic according to the cause of etiology, diagnosis is confirmed on a PA chest radiograph, sometimes a computed tomography may be required. The management of pneumothorax is varying from conservative, over intermediate (chest tube drainage) to invasive methods (video-assisted thoracoscopic surgery—VATS, thoracotomy). Here, we planned to write a chapter that includes a text containing general information about pediatric pneumothorax, algorithms, and visual and clinical cases of the causes of pneumothorax in children, including age, etiology, and treatment approach of pneumothorax in children.",book:{id:"11045",title:"Pleura - A Surgical Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11045.jpg"},signatures:"Hatice Sonay Yalçın Cömert"},{id:"78760",title:"Bronchopleural Fistula after Pulmonary Resection: Risk Factors, Diagnoses and Management",slug:"bronchopleural-fistula-after-pulmonary-resection-risk-factors-diagnoses-and-management",totalDownloads:232,totalDimensionsCites:0,doi:"10.5772/intechopen.100209",abstract:"Bronchopleural fistula (BPF) after a pulmonary resection is rare with some of the most life-threatening consequences and a high mortality rate. Contamination of the pleural space resulting in empyema and spillage of the infected fluid into the remaining lung leading to respiratory distress remain the biggest concerns with BPF postoperatively. There are many patient characteristics and risk factors that can be evaluated to decrease the chance of a postoperative BPF. Presentation of BPF can be early or late with the late BPF more difficult to diagnosis and manage. Many options to treat BPF include surgical repair, conservative management, and endoscopic treatment.",book:{id:"11045",title:"Pleura - A Surgical Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11045.jpg"},signatures:"Kristina Jacobsen"}],onlineFirstChaptersTotal:8},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:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:140,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,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:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{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"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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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},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!0,editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. 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He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"117248",title:"Dr.",name:"Andrew",middleName:null,surname:"Macnab",slug:"andrew-macnab",fullName:"Andrew Macnab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}}]}},subseries:{item:{id:"4",type:"subseries",title:"Fungal Infectious Diseases",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment",scope:"Fungi are ubiquitous and there are almost no non-pathogenic fungi. Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",hasOnlineFirst:!0,hasPublishedBooks:!1,annualVolume:11400,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. 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Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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