Example of a focus group survey instrument: Subset of comments, permission requests, and questions.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\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:"695",leadTitle:null,fullTitle:"Hemophilia",title:"Hemophilia",subtitle:null,reviewType:"peer-reviewed",abstract:"This book demonstrates the great efforts aimed at further improving the care of the hemophilia, which may bring further improvement in the quality of life of hemophilia persons and their families.",isbn:null,printIsbn:"978-953-51-0429-2",pdfIsbn:"978-953-51-6941-3",doi:"10.5772/1204",price:119,priceEur:129,priceUsd:155,slug:"hemophilia",numberOfPages:142,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"09ecad102ddb4ada9276e82fed981400",bookSignature:"Angelika Batorova",publishedDate:"March 30th 2012",coverURL:"https://cdn.intechopen.com/books/images_new/695.jpg",numberOfDownloads:28002,numberOfWosCitations:8,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:6,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:15,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 8th 2011",dateEndSecondStepPublish:"March 8th 2011",dateEndThirdStepPublish:"July 13th 2011",dateEndFourthStepPublish:"August 12th 2011",dateEndFifthStepPublish:"December 10th 2011",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"70984",title:"Associate Prof.",name:"Angelika",middleName:null,surname:"Batorova",slug:"angelika-batorova",fullName:"Angelika Batorova",profilePictureURL:"https://mts.intechopen.com/storage/users/70984/images/2566_n.jpg",biography:"Angelika Batorova is a Medical Director of the National Hemophilia Centre and Hemostasis and Thrombosis Unit of the Department of Hematology and Transfusion Medicine, University Hospital, Bratislava.Dr Batorova received her medical education from Comenius University, Bratislava, where she specialised in the Internal Medicine,Hematology and Transfusion Medicine. 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In autumn of 2017, two faculty and 13 undergraduate students from Dickinson College—located in Carlisle, Pennsylvania, US—traveled to Panchkahl Municipality of Kavrepalanchok District, Nepal, to engage in 3 weeks of field research. Fieldwork consisted of numerous interviews conducted in four different wards of Panchkahl. When they returned to the US, each team completed a 50-page research paper that focused upon the ability of the respective community members to handle risks to their human security stemming from shortages of fresh water resources. In spring of 2018, the authors studied the four reports to distill high-level themes. As well, they constructed a basic yet original systems model to frame the relationships emerging in the reports.
\nVia that inductive process, this chapter offers the following thesis. Although the availability of fresh water was scarce and access to fresh water was constrained: (1) a successful collaboration among the community members and nongovernmental organizations had enhanced the capabilities relevant to adaptability and resilience, and thus, human security; and (2) future progress was contingent on the additional empowerment of women as well as the ability of the government to become a more trusted collaboration partner.
\nThe students and faculty who conducted the field research were participants in a semester long Dickinson Global Mosaic Program [1], “Climate Change and Human Security in Nepal [2].” The program was 2 years in the making. As part of the building process, the Dickinson professor who initiated the program traveled to Nepal on two occasions and established a relationship with the Institute for Crisis Management Studies (ICMS), a master’s program affiliated with Kathmandu-based Tribhuvan University. The director of the ICMS designated a project coordinator for the initiative.
\nThe professor and the project coordinator negotiated the activities, locations, and logistics. The Coordinator suggested four wards as the research sites: Hokse, Kharelthok, Koshidekha, and Sathighar Bhagawati. The wards, located to the east of Kathmandu, were part of Panchkhal Municipality of Kavrepalanchok District, located in Province 3 of Nepal. As well, the Coordinator agreed to recruit ICMS graduate students who would provide general assistance to the Dickinson students and serve as guides and translators during the field-research.
\nFourteen students enrolled in the program. It consisted of three phases. Phase one included 9 weeks of study in Carlisle that incorporated three courses each taught by a different professor1 plus one team-taught qualitative research methods course.2 Furthermore, in phase one, the students were assigned to one of four teams.
\nPhase two consisted of 3 weeks of field research in Nepal that lasted from late October to mid-November. The advantage of the four-course structure was that there were no scheduling issues when faculty and students traveled to Nepal.3\n
\nDuring phase three, which lasted for 4 weeks, each team generated a 50-page research report that summarized their findings. Those four written reports provided the qualitative data for this chapter.
\nThe United Nations Development Programme [3] offered the first generally accepted description of the term human security. Many alternatives have since been proposed. One schema, designed with Nepal in mind, illustrates interconnections among ecosystems and climate security; water and energy security; food and health security; environmental security; and nuclear and biological security ([4], p. 3).
\nMany definitions have also been proposed for resilience. Nevertheless, a description offered by Twigg [5] is helpful. Community resilience includes the capacities to: “anticipate, minimize and absorb potential stresses or destructive forces through adaptation or resistance”; “manage or maintain certain basic functions and structures during disastrous events”; and “recover or ‘bounce back’ after an event ([5], pp. 8-9).” A caveat he offers ([5], p. 10) is relevant to this chapter.
\nIndividuals can be members of several communities at the same time, linked to each by different factors such as location, occupation, economic status, gender, religion or recreational interests. Communities are dynamic: people may join together for common goals and separate again once these have been achieved.
\nIn recent decades, the environments confronting citizens and professionals in all domestic and global settings have exhibited rapid change and increasing complexity [6]. Those developments have made collaboration among organizations an increasingly relevant way to achieve objectives beyond the reach of any single entity. For example, Goal 17 of
In 2010, Nepal’s Ministry of Environment released the
Meadows [10] explains that a human system has three essential components: elements; interconnections; and a purpose. Elements may be either physical items or intangible items. Interconnections are the relationships that hold the elements together: for human systems, they include customs, rules, or laws. The purpose of the system reflects intended outcomes. Since systems can be nested within systems, purposes can be nested inside other purposes.
\nShe also explains that systems have three important attributes: self-organization, hierarchy, and resilience. Self-organization is the “capacity of a system to make its own structure more complex” ([10], p. 79). Hierarchy is the arrangement of systems and subsystems that tends to arise when self-organizing systems engage in the “process of creating new structures and increasing complexity” ([10], p. 82). In a manner consistent with Twigg [5], Meadows says resilience arises from the rich structure of many feedback loops that can work in different ways to restore a system even after a large disturbance. Resilient systems can be dynamic in nature and evolve over time.
\nA few weeks into the semester, the three Dickinson professors assigned the students to one of four research teams. The teams were asked to develop questions for three different types of semi-structured interviews. Each type was intended for one of three different groups of interviewees: individual household members; key informants; and focus group participants. The teams shared proposed interview questions with the professors, took their comments, and engaged in fine-tuning. When ready, each team forwarded their work to the ICMS graduate students, who provided further comments to the students and translated the survey instruments. All four teams used the “Toolkit for Measuring Community Disaster Resilience” [11] and Twigg [5] as their points of reference for designing their surveys. To illustrate, \nTable 1\n provides a condensed version of the focus group survey instrument created by one of the four teams.
\nThank you for taking the time to talk with us today. We are a group of students from Dickinson College in the United States and we are working with the Institute for Crisis Management Studies of Tribhuvan University in Kathmandu to learn about your community and the challenges it faces. The goal of the interview is to understand how weather and climate-related events and other hazards have affected your community and how resilient you and the community are in anticipating and adapting to these events and disasters.. .. Participation in the conversation is totally voluntary.. .. May we have your permission to audio and video record the conversation? \n Prompt: Disasters (large storms, landslides, earthquakes, floods, and disease) Prompt: Weather or climate related (heat, drought, erosion, and rainfall) \n \n \n \n Prompts: Food availability/production, water, health, livelihoods, and income. What areas of the community are most at risk to the hazards? \n Prompts: Women/men, poor/wealthy, and caste/ethnicity Why do you think this is? \n Have the actions you described improved the situation and/or reduced risks? How does the community work together to cope or respond to changing conditions? Where does the community get information to improve the situation? If something happens (weather event, disaster, etc.), where does the community turn for help? Do you seek assistance (financial, resources, and training) from groups outside the community? Has it been helpful? Do you think the community has a clear understanding of actions that can reduce risks associated with hazards? \n | \n
Example of a focus group survey instrument: Subset of comments, permission requests, and questions.
The geography of Kavrepalanchok District, and Nepal more generally, includes five major zones. From the lowest elevation to the highest, they are the Terai, Siwalik, Middle Hills, High Hills, and the Mountains including the Himalayas.
\nThe two major agricultural regions that served as the focus of the Nepal Mosaic were the Terai and the Siwalik. The Terai has a warm, subtropical climate, and land that can be irrigated to grow rice and vegetables. The Terai generates most of Nepal’s’ agricultural output [12].
\nAt the time of the research, teams learned that farmers of the Siwalik primarily planted maize and millet as their major subsistence crops on terraces dug into the hillsides. Rainfall was a major source of water in the zone, but the land did not retain much of the water that resulted from rainfall. Springs, streams, and natural aquifers were other important water sources that were supplemented by man-made water-channeling infrastructure and water-storage ponds and facilities. Land in the Siwalik was subject to landslides. Far more devastating, in April of 2015, an earthquake of magnitude 7.8 on the Richter scale, centered in Gorkha, a district near Kathmandu, killed 9000 people and resulted in billions of rupees in damage. In the wards of Panchkhal located in the Siwalik, the earthquake destroyed buildings and homes, and disrupted aquifers and water-infrastructure.
\nDue to the elevation differences, each zone had its own microclimate. Nonetheless, all models forecasted increases in temperatures at the country level in coming decades that ranged from 2° to 6° Celsius, increases more pronounced than those at the global level. Projections for rainfall trends were even more varied than those of climate change, yielding results that ranged from a 30 percent decrease to a 100 percent increase by 2100, when compared to the 1970–1999 average. Moreover, climate change could destabilize the monsoon season, leading rainfall to increase and become more intense during a shorter season [13].
\nThose factors led Nepal’s Ministry of Population and the Environment ([14], p. 1) to say:
\nNepal is one of the most vulnerable countries to climate change, water-induced disasters and hydro-meteorological extreme events such as droughts, storms, floods, inundation, landslides, debris flow, soil erosion, and avalanches.
\nNepal’s population tripled between 1960 and 2010. As of 2017, it totaled approximately 30 million people and was expected to continue to grow into the future, though at a slower rate. Nepal was characterized as a Least Developed Country by the United Nations. Roughly one in four people lived below the international poverty level of US$ 1.25 per day. Agriculture accounted for nearly one-third of Nepal’s GDP; thus, the onset of climate change had contributed to the struggles of the people ([15], p. 17). Furthermore, Nepal had inadequate infrastructure and was not a destination for foreign direct investment, factors that together suggested a shortage of the technological and financial resources needed to adapt to climate change.
\nNepal broke into a civil war in 1996, fueled by sharp disparities in living standards between rural and urban populations and by discrimination against social classes, women, and indigenous ethnic groups. A peace agreement was signed between insurgents and authorities in 2006. An Interim Constitution agreed in 2007 ended the 240-year-long Hindu Monarchy. In the ensuing decade, nine different coalition governments were formed. In September of 2015, the current Constitution of Nepal replaced the 2007 Interim constitution.
\nIn the decade following post-war reunification, government reform was slow in coming. For example, the first local elections in 20 years in the wards of Panchkahl took place in the summer of 2017 [16], only a few months before the Dickinson research trip. At the outset, local governments were headed by unelected bureaucrats or community leaders, leading to increases in corruption [17]. During that era, building capacity for local governance was clearly not a priority. To fill the void, community groups emerged and worked alongside nongovernmental organizations to help promote collaboration and resilience in the face of challenges.
\nAs of 2017, the governance structure of Nepal consisted of seven provinces, which collectively comprised 77 districts. In turn, each district was made up of municipalities, each municipality of wards, and each ward of various villages or clusters of people who did not have their own formal governance structures.
\nOnce in Nepal, the Dickinson student teams were partnered with a pair of graduate students—one male and one female for each team—who served as guides, and as language and cultural translators. In the field, each of the four teams conducted interviews in accordance with the semi-structured interviews they had previously created. Each team managed to conduct about 20 household interviews, six or so expert interviews, and two focus group interviews. (In each case, teams asked for participants’ permission to record the interview.) Given the outmigration in some wards by single young men and by husbands in search of more stable income for their families, women were more highly represented than men in the interviews.
\nWhile in the field, students took turns each day asking primary and follow up questions and taking notes. Each evening, the teams reviewed what they had heard, and revised and upgraded their notes. When the teams returned to campus, they spent the final 4 weeks of the semester further refining their data and revisiting course materials and other sources as they completed their respective 50-page team-written research reports.
\nIn spring of 2018, Ms. House and Mr. Weisman, students who had both participated in the program, enrolled in a special co-research course with Professor Fratantuono. Together, all three carefully reread and discussed the 50-page papers submitted by each student team at end of 2017. As they did so, Professor Fratantuono took the lead in shaping a systems-model that synthesized concepts from the program and themes that emerged as all three authors interpreted the reports. As the model evolved, it served as a framework for describing data. First versions of this chapter were written in spring of 2018. Since that time, Professor Fratantuono has revised the model and the chapter.
\nThe model incorporates ideas and imagery suggested by Meadows. She illustrates systems using stocks, flows, flow valves, and feedback loops. She explains that systems may display sub-optimal or problematic behavior. If so, she proposes 12 leverage points to promote system alteration ([10], pp. 145-165). Although Meadows does not make the distinction, the three authors say that the 12 alterations may be of two types: system modification or system transformation. Modification entails adjusting, repairing, rearranging, or embellishing components of an existing sub-system or system. Transformation entails either changing the membership, rules, purpose, or even the conceptualization of an existing system; or incorporating a new sub-system into an existing hierarchy. The model—a diagrammatic representation [18]—is presented in \nFigure 1\n. \nFigure 2\n is the Legend for the symbols in \nFigure 1\n.
\nModel of elements and interconnections that promote human security.
Legend for
Recalling Twigg [5], the upper left corner of \nFigure 1\n identifies four relevant types of community members: households and proprietors, organized community groups, nongovernmental organizations, and local government officials.
\nThe model includes three tiers. The left-most stock of the upper tier represents tangible resources (people and economic resources) and intangible resources (trust, legitimacy, intercultural competency, and goal-related knowledge) available to community members. The second stock represents capabilities (organizational and operational) relevant to a community’s efforts to adapt to challenges, and hence relevant to the community’s resilience in the face of fresh water shortages Twigg [5].
\nThe upper tier also includes two flow valves. Flow valves control the volume and rate at which information, water, money or other factors flow from stock-to-stock. Valves are adjusted by either natural forces or human actions. The left-most valve indicates that developments beyond the system boundary contribute to resources available to a community. The second indicates that members will use the stocks of available resources as inputs to capabilities ([19], pp. 103-105).
\nThe bottom tier of the model includes three more stocks and four more flow valves. The first three valves suggest the ability of members to leverage one or more of the capabilities included in stock 2 as they engage in actions that, respectively, influence flows into one of the three stocks. The fourth, right-most valve indicates that the level of human security attained in a community may have implications for developments beyond the system boundary. Of note, stock 2 and stock 5, labeled in larger font, are the most important to the specification of the model: contingent on human actions, Capabilities enabling Adaptation and Resilience in the face of fresh water scarcity contribute to rising Levels of Human Security.
\nBalancing and reinforcing feedback loops are present throughout the model. The loops influence the degree to which human actions open or close a flow valve. In this model, while balancing loops amplify actions that deplete a stock’s magnitude, reinforcing loops amplify actions that restore or elevate a magnitude. In the top and bottom tiers, the model includes loops between one stock and one flow valve.
\nFor example, in the bottom tier, the flow valve that precedes the stock of available water represents actions by community members—for example, fetch water—to make fresh water available for use. A reinforcing loop indicates the ability of rainfall—perhaps enhanced by new storage methods—to restore or amplify the stock. In turn, the valve that follows the stock represents actions that that draw down the water stock. The associated balancing feedback loop (illustrated with a dashed arrow) indicates that both the use of water, plus other contributing factors such as a hotter climate, will draw down the magnitude of the stock.
\nThe middle tier includes two lightly shaded stocks: satisfaction or frustration experienced by community members resulting from the outcome of previous efforts to enhance human security. As suggested by the various rays, respectively, emanating from those two stocks, satisfaction will enhance the influence of reinforcing loops throughout the model, and frustration the influence of balancing loops.
\nThe students did encounter subcommunities that had different vulnerabilities to shortages of fresh water.
\nIn Koshidekha ward, located in the Terai, members explained that many people had to travel long distances to collect water from a holding pond, or from the Sun Koshi River. In Hokse ward, while some farmers worked the land of the Siwalik, others worked the land of the Terai. A subset of the latter group, those working the valley floor and growing crops near a stream, had reliable access to water for field irrigation, resulting in larger crop yields and higher incomes than those realized by farmers working the nearby hills, who had to carry water to their crops.
\nIn both wards, location-related factors created disparities in the vulnerability of some people: those who resided the farthest from sources had to work much harder at water fetching and storage (stock 3 and the associated inflow valve). Furthermore, at that point in time, there were no capabilities (stock 2) that could be leveraged in the short-term to overcome those location-related challenges.
\nIn Kharelthok ward, located in the Siwalik, the research team interviewed a teacher at a school for disabled children. She explained that her students had historically been socially ostracized by other ward members and thus disadvantaged. As well, the level of human security of the children (stock 5) was fragile, since their capacity for adaptation was quite limited (stock 2) and they required more fresh water resources than other community members to perform activities that supported contributors to human security (stock 3 and stock 4 and associated flow valves). To illustrate, their education involved training in self-care skills such and using the toilet, and they needed to bathe and have their clothes washed more often than did other same-age children. Essentially, the training was intended to help them leverage the capabilities relevant to the three sets of inflow valves in the lower tier of \nFigure 1\n.
\nGiven efforts by the school to raise awareness, community members had begun to recognize the children’s basic rights, to respect their participation in the community, and to recognize they needed support in times of need. Enhanced recognition and ensuing social validation elevated the children’s human security (stock 5).
\nIn Nepali society, husbands and fathers often dominated a household. In community meetings, the voice of men could override the opinions of women; or worse, women were sometimes discouraged by men from using newly formed skills. Those dispositions made it difficult for women to advocate their interests and to express their insights with other ward members about ways that water might be more effectively and efficiently utilized (inflow valve to stock 5). Those factors essentially acted as constraints on the influence of reinforcing feedback loops on the intangible stocks of knowledge and on capabilities relevant to adaptation and resilience (stock 1 and stock 2), and as well increased frustration (shaded stock) among women.
\nFurthermore, women were disproportionately impacted by the shortage of fresh water. They bore the responsibility for making difficult daily decisions about priorities and tradeoffs in order to conserve scarce water for their families (flow from stock 3 to stock 4).
\nMore dramatic, fresh water shortages and existing social mores had implications for a woman’s health (stock 4 and stock 5). For example, the strenuous chore of collecting and carrying water (inflow valve to stock 3) could lead a woman to suffer a prolapsed uterus.
\nAs well, women who attempted to maintain hygiene during menstruation were challenged by a lack of fresh water (stock 4). Even more troubling, the leader of a women’s group located in Hokse explained that the general water shortage had led farmers to turn to various chemically based products such as pesticides to boost productivity; thus, when rains did occur, chemical residuals included in water runoff resulted in health threats when women used the supposed fresh water for personal care (stock 5).
\nFurthermore, women of the Kharelthok and Sathighar Bhagawati wards said other challenges arose when a woman was pregnant. That is, since some men prioritized water use for agriculture (inflow valve to stock 3), a lack of fresh water for properly preparing food could reduce a woman’s intake of important sources of nutrition, thereby threatening the health of both the woman and her unborn child (stock 5).
\nFrustrations were often associated with Government Initiatives. As a first illustration, in Sathighar Bhagawati, in the wake of the earthquake, one person said that a local NGO had to pressure the government to bring relief. Another said that when providing relief, the government did not deliver all the funds it had promised and that the funds had been unequally shared (stocks 1 and 2 and associated inflow valve to stock 2). As a result, community stakeholders were unsure whether they should wait for the remaining promised funds and projects or should themselves take the first steps. The uncertainty hindered progress toward improving community resilience (balancing feedback loops influencing stock 2).
\nOne farmer took issue with the arms-length relationship the ward office had with community members. Although receptive to immediate needs, the office had little interest in prevention and rarely visited locales to get a first-hand understanding of a reported problem. That disposition squeezed information flows and detracted from the government’s ability to provide in a timely fashion appropriate resources to enhance capabilities and strengthen resilience. As well, those factors increased frustration and thus the detrimental effects of the balancing feedback loops associated with stock 1 and stock 2.
\nA technician working at an agricultural cooperative said that the government had not provided enough support after the earthquake. That perception eroded trust in government and caused both decreased political engagement and lower voter turnout in subsequent elections.
\nPerhaps most provocative, a person in Kharelthok explained that the 2015 earthquake had damaged homes and other infrastructure throughout the ward. Water (stock 3) was needed to do construction; but water was also in short supply for other uses. The government announced an initiative to build a road that ran upward from the valley, through the village of Manesau, and then further upward to the village of Manegau. To help finance the project (stock 1), the ward office collected NPR 15,000 (US$ 134) from each Manegau household. Nonetheless, construction stalled, leading villagers to claim that ward officials had misused the funds. A budget released by the ward office included reimbursement; but that did not quell the anger of villagers. In protest, they cut off supply from a water tap running downhill to Manesau. Experiencing an extreme shortage of fresh water, the downhill community chopped down trees to further impede access to Manegau. At the time of the research, local leaders were holding hearings to resolve the conflict; but the team could not stay on site long enough to hear the outcome.
\nIn contrast to the previous set of examples, the following set illustrates that successful collaborative efforts generated satisfaction among stakeholders.
\nAcross the four wards, the research teams met women who had been motivated to form self-help groups in which they had autonomy and that enabled them to provide inclusive, informal support to one another and other villagers. Despite challenges, including a shortage of financial resources (stock 1), the women’s groups had earned trust and legitimacy both within the community, and with external organizations.
\nSome women’s groups tried to help poor and uneducated women by reaching out to them via pamphlets posted on community information boards about their activities. They initiated training programs to improve various skills, including IT and computer courses and unemployment training (stock 2); and supported sewing shops that employed women (stock 4). As well, one team found that the group they interviewed collected funds and provided loans in times of hardship (stock 1), a model based on historic self-help councils.
\nWomen had sometimes benefitted from external assistance. For example, the Red Cross had provided training in rudimentary medical matters to members of one group, who then passed their knowledge on to other villagers (stock 1). Through hard work, those women had become authorities on healthcare and livelihood training (stock 4) in their respective villages.
\nCollectively, those initiatives suggested capabilities associated with two thematic arenas of resilience suggested by Twigg [5]: knowledge and education (stock 1); and risk management and vulnerability reduction (stock 2).
\nIn Hokse, the team interviewed the Vice President (VP) of an agriculture-focused cooperative that was active among several villages of the ward. The organization was the product of a merger between two previously existing but independently operating cooperatives. The first had provided seeds, tools and water pumps to farmers at subsidized rates; the second had concentrated on helping manage villagers’ savings. When founded in 2012, the cooperative had 30 members. By 2017, membership had expanded to roughly 800 people. Cooperative members had to be Nepali citizens and residents of a ward within the municipality. Membership fees ranged from $3 to $25; but nonmembers could make contributions.
\nAlthough staff at the local cooperative level reported to the district cooperative association, they did not get much technical support from the district—that general support came from regional and national organizations. Nonetheless, the local cooperative did receive loans of up to four million rupees (approximately $62,500 in 2017) from the district office at a low rate of interest. Those resources enabled the co-op to extend loans of up to $1000 that could help farmers harvest crops or purchase livestock and land (stock 1). The VP noted that loans were typically repaid in full and on time; but sometimes, a bad harvest would force farmers to delay their payments until the following year.
\nThe VP explained that if more funds were to become available, then the cooperative could extend loans to help rebuild homes that had been impacted by the 2015 Gorkha earthquake and were still in a state of disrepair. Furthermore, women could apply for loans at a reduced rate of interest that enabled them to explore entrepreneurship.
\nThe VP also offered insights on a few other matters. The expansion of the cooperative had prompted new methods for two-way communication among community members and the cooperative, including a Facebook page, phone calls, and notice boards; an insurance program for local crops and cattle; and training to farmers to introduce organic farming methods (inflow valve to stock 4).
\nNavjyoti is affiliated with the Sisters of Charity of Nazareth, an international congregation. They became active in Nepal in 1988. They focused on the poor and on women via educational initiatives. Community members appreciated their efforts (shaded Stock of satisfaction).
\nA worker for the organization explained that prior to the earthquake of 2015, among other activities, they had provided skills training for women (stock 1 and inflow valve to stock 2) and had channeled funds to women’s-groups for farming or economic development (stock 3). Following the disaster, Navjyoti expanded outreach to the broader Koshidekha community.
\nAt the time of interviews by the research team, several households shared water from a single tap that ran for only part of the day at very low pressure. In response, Navjyoti planned to support the Sun Koshi River Project, an effort to expand the number of pumps that could force-feed water to communities. When completed, the additional pumps would give community members greater access to fresh water (stock 3) that would be used to enhance the Contributors to Human Security (stock 4).
\nHowever, the Project would require substantial monetary resources. Although Navjyoti was willing to cover 60 percent of the cost, they hoped to receive contributions from households to cover the remaining 40 percent. Since many households could not afford the fee, Navjyoti was also ready to recruit volunteers to contribute their time and labor in lieu of money.
\nIn Kharelthok, the Red Cross maintained an active presence. It had helped establish a committee of community members that met each month to identify problems and develop proposed solutions to the Red Cross workers. Ward members explained that the Red Cross had provided different types of assistance, ranging from hearing aids for the elderly to funds for a disabled young woman so she could start a business and support herself (stock 4).
\nCommunity members also noted, however, that Red Cross efforts were sometimes off-target. To illustrate, while some farmers explained the organization had shared seeds (stock 1) with the community that were no longer useful in the dryer climate, others noted that although it had subsidized animal husbandry (stock 2), cattle and goats required a disproportionate amount of water.
\nIn retrospect, in the four wards visited, the stock of fresh water was being drawn down both by typical activities and as well by the influences of climate change, the residual effects of the Gorkha earthquake on water infrastructure, and the atypical need to use water for construction projects to repair earthquake-related damage. Access to fresh water, often determined by locational factors, was a key determinant of human security.
\nThe capabilities required to enhance access to available stocks of fresh water and to more effectively utilize stocks were significant contributors to the level of human security in each of the four wards. In turn, the presence or magnitude of such capabilities was contingent on the degree to which stakeholders had engaged in collaborative efforts. Successful collaborations contributed to positive feedback loops and additional collaboration: success bred success. In contrast, government shortcomings as a collaborator indicated that the bureaus had further work to do in order to be trusted partners.
\nSystem modification had taken place in the wards visited by the teams. Two sets of initiatives had increased information flows. First, the agricultural cooperative used numerous communication strategies to learn about community members’ needs, address those needs, and inform the community about services. Second, the Red Cross and Navjyoti had provided education and training dedicated to enhancing the knowledge of various community members, thereby allowing communities to navigate tough circumstances.
\nLooking ahead, members of various wards identified access to additional financial resources as their most immediate need as a first step toward gaining access to fresh water and thereby enhancing human security. An illustration was associated with the efforts by the agricultural cooperative. Even more striking were the funds sought by Navjyoti to help finance the Sun Koshi River Project, dedicated to installation of numerous water pumps to provide fresh water to communities in the Terai.
\nMeadows [10] says that while “the rules of a system define its scope, boundaries, and degrees of freedom,” ([10], p. 158) self-organization in human systems reflects the ability to “create whole new structures and behaviors” ([10], p. 159). The authors regard alterations of those types as transformations.
\nA striking development in the four wards had been the emergence of citizens groups (women’s groups; agricultural cooperative) and international nongovernmental organizations (Navjyoti; Red Cross) as system stakeholders. Those changes took place in the space left open by immature local government. As a qualification, however, although international NGOs had successfully encouraged communities to generate their own responses and at the same time provided resources to make those responses successful, initiatives that were off target prevented the community from self-organizing and ultimately decreased its ability to respond to its own problems. Nonetheless, and more important, interviews suggested that in most cases, those stakeholders who engaged in collaboration in different subcommunities were the most reliable and effective target for new stocks of tangible and intangible resources.
\nAlterations associated with rules and self-organization had begun to spill over to goals. That is, efforts by IGOs to cooperate with members of villages and wards had for the most part strengthened the capabilities relevant to adaptation and resilience and ultimately to human security. Nevertheless, although increased self-organization had challenged traditional power structures and created new hierarchies, self-organization had also led to conflict as was the case for the protesters who cut off the water flow between Manegau and Manesau. Such instances tended to reduce the levels of trust community members assigned to collaboration partners. At the same time, governments at the ward level—and in some cases even the district level—had not yet earned legitimacy in the eyes of most community members. Essentially, to move on from those types of outcomes and enhance community resilience, there was a need for more learning-by-doing among community members as well as for further maturation and engagement of local government as a system stakeholder.
\nWhile communities had made progress in their efforts to promote human security, there were of course avenues for additional progress associated with system transformation. In the wards visited, there was some early evidence of changing paradigms. The most poignant illustration surfaced in the interview with the woman who headed the school for the disabled. She noted that a greater number of community members had come to recognize the fundamental right of their disabled compatriots to dignity and full status.
\nFurthermore, in the wards visited, there was also some evidence about the rising status and autonomy of women. As a counterpoint, however, there was also evidence that long-held existing paradigms had prevented women from being able to make important decisions regarding water use, elevated threats to their health, reduced their voice in community forums, and constrained their opportunities to develop independent sources of income. The latter set of circumstances suggested that deep-seated cultural dispositions would not be transformed in a short period of time.
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Health",slug:"heavy-metals-and-human-health",totalDownloads:18966,totalCrossrefCites:87,totalDimensionsCites:197,abstract:null,book:{id:"1012",slug:"environmental-health-emerging-issues-and-practice",title:"Environmental Health",fullTitle:"Environmental Health - Emerging Issues and Practice"},signatures:"Simone Morais, Fernando Garcia e Costa and Maria de Lourdes Pereira",authors:[{id:"13875",title:"Prof.",name:"Simone",middleName:null,surname:"Morais",slug:"simone-morais",fullName:"Simone Morais"},{id:"79715",title:"Prof.",name:"Maria De Lourdes",middleName:null,surname:"Pereira",slug:"maria-de-lourdes-pereira",fullName:"Maria De Lourdes Pereira"},{id:"87294",title:"Prof.",name:"Fernando",middleName:null,surname:"Garcia E Costa",slug:"fernando-garcia-e-costa",fullName:"Fernando Garcia E Costa"}]},{id:"36935",doi:"10.5772/37886",title:"Gender Differences in Food Choice and Dietary Intake in Modern Western Societies",slug:"gender-differences-in-food-choice-and-dietary-intake-in-modern-western-societies",totalDownloads:17762,totalCrossrefCites:47,totalDimensionsCites:120,abstract:null,book:{id:"1811",slug:"public-health-social-and-behavioral-health",title:"Public Health",fullTitle:"Public Health - Social and Behavioral Health"},signatures:"Claudia Arganini, Anna Saba, Raffaella Comitato, Fabio Virgili and Aida Turrini",authors:[{id:"114665",title:"Dr.",name:"Aida",middleName:null,surname:"Turrini",slug:"aida-turrini",fullName:"Aida Turrini"},{id:"116008",title:"Dr.",name:"Claudia",middleName:null,surname:"Arganini",slug:"claudia-arganini",fullName:"Claudia Arganini"},{id:"116171",title:"MSc.",name:"Anna",middleName:null,surname:"Saba",slug:"anna-saba",fullName:"Anna Saba"},{id:"116173",title:"Dr.",name:"Fabio",middleName:null,surname:"Virgili",slug:"fabio-virgili",fullName:"Fabio 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Legumes are nutritionally valuable, providing proteins (20–45%) with essential amino acids, complex carbohydrates (±60%) and dietary fibre (5–37%). Legumes also have no cholesterol and are generally low in fat, with ±5% energy from fat, with the exception of peanuts (±45%), chickpeas (±15%) and soybeans (±47%) and provide essential minerals and vitamins. In addition to their nutritional superiority, legumes have also been ascribed economical, cultural, physiological and medicinal roles owing to their possession of beneficial bioactive compounds. Research has shown that most of the bioactive compounds in legumes possess antioxidant properties, which play a role in the prevention of some cancers, heart diseases, osteoporosis and other degenerative diseases. Because of their composition, legumes are attractive to health conscious consumers, celiac and diabetic patients as well as consumers concerned with weight management. The incorporation of legumes in diets, especially in developing countries, could play a major role in eradicating protein-energy malnutrition especially in developing Afro-Asian countries. Legumes could be a base for the development of many functional foods to promote human health.",book:{id:"5963",slug:"functional-food-improve-health-through-adequate-food",title:"Functional Food",fullTitle:"Functional Food - Improve Health through Adequate Food"},signatures:"Yvonne Maphosa and Victoria A. 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The main global health organizations have incorporated patient safety in their review of work practices. The data provided by the medical laboratories have a direct impact on patient safety and a fault in any of processes such as strategic, operational and support, could affect it. To provide appreciate and reliable data to the physicians, it is important to emphasize the need to design risk management plan in the laboratory. Failure Mode and Effect Analysis (FMEA) is an efficient technique for error detection and reduction. Technical Committee of the International Organization for Standardization (ISO) licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. FMEA model helps to identify quality failures, their effects and risks with their reduction/elimination, which depends on severity, probability and detection. Applying FMEA in clinical approaches can lead to a significant reduction of the risk priority number (RPN).",book:{id:"9808",slug:"contemporary-topics-in-patient-safety-volume-1",title:"Contemporary Topics in Patient Safety",fullTitle:"Contemporary Topics in Patient Safety - Volume 1"},signatures:"Hoda Sabati, Amin Mohsenzadeh and Nooshin Khelghati",authors:[{id:"340486",title:"M.Sc.",name:"Hoda",middleName:null,surname:"Sabati",slug:"hoda-sabati",fullName:"Hoda Sabati"},{id:"348872",title:"M.Sc.",name:"Amin",middleName:null,surname:"Mohsenzadeh",slug:"amin-mohsenzadeh",fullName:"Amin Mohsenzadeh"},{id:"348874",title:"MSc.",name:"Nooshin",middleName:null,surname:"Khelghati",slug:"nooshin-khelghati",fullName:"Nooshin Khelghati"}]},{id:"69876",title:"Leadership Styles in Nursing",slug:"leadership-styles-in-nursing",totalDownloads:3122,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Recent developments in the field of management-organization and organizational behavior and new concepts have also led to the emergence of new leadership styles in leadership. Leadership in health services is important for following innovations and adapting to current situations. Nurses working together with other health personnel in hospitals providing health services constitute an important group in leadership. Nursing, which is a key force for patient safety and safe care, is a human-centered profession, and therefore leadership is a key skill for nurses at all levels. The leadership styles of nurse managers are believed to be an important determinant of job satisfaction and persistence of nurses. The need for nurses with leadership skills and the need for nurses to develop their leadership skills are increasing day by day. There are several leadership styles defined in nursing literature. These leadership styles are examined under the titles of relational leadership style, transformational leadership, resonant leadership, emotional intelligence leadership, and participatory leadership. The task-focused leadership style is explored under the headings of transactional and autocratic leadership, laissez-faire leadership, and instrumental leadership.",book:{id:"9047",slug:"nursing-new-perspectives",title:"Nursing",fullTitle:"Nursing - New Perspectives"},signatures:"Serpil Çelik Durmuş and Kamile Kırca",authors:null},{id:"58916",title:"Factors Affecting the Attitudes of Women toward Family Planning",slug:"factors-affecting-the-attitudes-of-women-toward-family-planning",totalDownloads:8541,totalCrossrefCites:9,totalDimensionsCites:18,abstract:"Everyone has the right to decide on the number and timing of children without discrimination, violence and oppression, to have the necessary information and facilities for it, to access sexual and reproductive health services at the highest standard. Deficient or incorrect family planning methods, wrong attitudes and behaviors toward the methods and consequent unplanned pregnancies, increased maternal and infant mortality rates are the main health problems in most countries. Individuals’ learning modern family planning methods and having positive attitude for these methods may increase the usage of these methods and contributes the formation of healthy communities. It is considered important to examine the current attitudes and determinants in order to spread the choice of effective method.",book:{id:"6142",slug:"family-planning",title:"Family Planning",fullTitle:"Family Planning"},signatures:"Nazli Sensoy, Yasemin Korkut, Selcuk Akturan, Mehmet Yilmaz,\nCanan Tuz and Bilge Tuncel",authors:[{id:"216377",title:"Prof.",name:"Nazli",middleName:null,surname:"Sensoy",slug:"nazli-sensoy",fullName:"Nazli Sensoy"},{id:"216589",title:"Dr.",name:"Yasemin",middleName:null,surname:"Korkut",slug:"yasemin-korkut",fullName:"Yasemin Korkut"},{id:"216595",title:"Dr.",name:"Selcuk",middleName:null,surname:"Akturan",slug:"selcuk-akturan",fullName:"Selcuk Akturan"},{id:"216596",title:"Dr.",name:"Canan",middleName:null,surname:"Tuz",slug:"canan-tuz",fullName:"Canan Tuz"},{id:"216598",title:"Dr.",name:"Bilge",middleName:null,surname:"Tuncel",slug:"bilge-tuncel",fullName:"Bilge Tuncel"},{id:"216599",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yilmaz",slug:"mehmet-yilmaz",fullName:"Mehmet Yilmaz"}]},{id:"69631",title:"Cultural Practices and Health Consequences: Health or Habits, the Choice Is Ours",slug:"cultural-practices-and-health-consequences-health-or-habits-the-choice-is-ours",totalDownloads:889,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Human beings are social animals with an innate desire to conform to socially accepted norms and values. Over periods of time, some of these norms become standards that all members of the community are expected to adhere to. Deviance from these standards is seen as absurd, wrong, or frankly abnormal. However, many of these cultural mores have no scientific basis and, some of them actually promote behaviors with negative health consequences. This chapter examines the cultural practices of some communities in Africa and their health consequences and, explores ways to address the challenges.",book:{id:"9138",slug:"public-health-in-developing-countries-challenges-and-opportunities",title:"Public Health in Developing Countries",fullTitle:"Public Health in Developing Countries - Challenges and Opportunities"},signatures:"Radiance Ogundipe",authors:[{id:"302308",title:"Dr.",name:"Radiance",middleName:null,surname:"Ogundipe",slug:"radiance-ogundipe",fullName:"Radiance Ogundipe"}]},{id:"55808",title:"The Role of Legumes in Human Nutrition",slug:"the-role-of-legumes-in-human-nutrition",totalDownloads:5425,totalCrossrefCites:63,totalDimensionsCites:109,abstract:"Legumes are valued worldwide as a sustainable and inexpensive meat alternative and are considered the second most important food source after cereals. Legumes are nutritionally valuable, providing proteins (20–45%) with essential amino acids, complex carbohydrates (±60%) and dietary fibre (5–37%). Legumes also have no cholesterol and are generally low in fat, with ±5% energy from fat, with the exception of peanuts (±45%), chickpeas (±15%) and soybeans (±47%) and provide essential minerals and vitamins. In addition to their nutritional superiority, legumes have also been ascribed economical, cultural, physiological and medicinal roles owing to their possession of beneficial bioactive compounds. Research has shown that most of the bioactive compounds in legumes possess antioxidant properties, which play a role in the prevention of some cancers, heart diseases, osteoporosis and other degenerative diseases. Because of their composition, legumes are attractive to health conscious consumers, celiac and diabetic patients as well as consumers concerned with weight management. The incorporation of legumes in diets, especially in developing countries, could play a major role in eradicating protein-energy malnutrition especially in developing Afro-Asian countries. Legumes could be a base for the development of many functional foods to promote human health.",book:{id:"5963",slug:"functional-food-improve-health-through-adequate-food",title:"Functional Food",fullTitle:"Functional Food - Improve Health through Adequate Food"},signatures:"Yvonne Maphosa and Victoria A. Jideani",authors:[{id:"201151",title:"Ph.D. Student",name:"Yvonne",middleName:null,surname:"Maphosa",slug:"yvonne-maphosa",fullName:"Yvonne Maphosa"}]}],onlineFirstChaptersFilter:{topicId:"200",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82616",title:"The Quantum Theory of Reproduction. How Unique is an Individual?",slug:"the-quantum-theory-of-reproduction-how-unique-is-an-individual",totalDownloads:12,totalDimensionsCites:0,doi:"10.5772/intechopen.105769",abstract:"Our understanding of nature’s way is founded on quantum mechanics. In its existence of over 80 years, quantum theory has been describing the physical world. The attraction of studying quantum mechanics is the perception of the conceptual structure of nature. This is aided by the mathematical structure that exposes the internal logic of the subject by inventing a notation that embeds the philosophy of the question. To describe how unique each individual is. A calculation method was applied. The uniqueness of an individual is one in two nonillion, octillion, septillion, sextillion, quintillion, quadrillion, trillion, billion, million and thousand. Individuals are indefinitely unique.",book:{id:"11284",title:"Studies in Family Planning",coverURL:"https://cdn.intechopen.com/books/images_new/11284.jpg"},signatures:"Zouhair O. Amarin"},{id:"81930",title:"Smoking and Its Consequences on Male and Female Reproductive Health",slug:"smoking-and-its-consequences-on-male-and-female-reproductive-health",totalDownloads:14,totalDimensionsCites:0,doi:"10.5772/intechopen.104941",abstract:"Smoking contributes to the death of around one in 10 adults worldwide. Specifically, cigarettes are known to contain around 4000 toxins and chemicals that are hazardous in nature. The negative effects of smoking on human health and interest in smoking-related diseases have a long history. Among these concerns are the harmful effects of smoking on reproductive health. Thirteen percent of female infertility is due to smoking. Female smoking can lead to gamete mutagenesis, early loss of reproductive function, and thus advance the time to menopause. It has been also associated with ectopic pregnancy and spontaneous abortion. Even when it comes to assisted reproductive technologies cycles, smokers require more cycles, almost double the number of cycles needed to conceive as non-smokers. Male smoking is shown to be correlated with poorer semen parameters and sperm DNA fragmentation. Not only active smokers but also passive smokers, when excessively exposed to smoking, can have reproductive problems comparable to those seen in smokers. In this book chapter, we will approach the effect of tobacco, especially tobacco smoking, on male and female reproductive health. This aims to take a preventive approach to infertility by discouraging smoking and helping to eliminate exposure to tobacco smoke in both women and men.",book:{id:"11284",title:"Studies in Family Planning",coverURL:"https://cdn.intechopen.com/books/images_new/11284.jpg"},signatures:"Amor Houda, Jankowski Peter Michael, Micu Romeo and Hammadeh Mohamad Eid"},{id:"81468",title:"The Knowledge and Use of Intra-Uterine Device by Women Attending Ante-Natal Clinic at Enugu State Teaching Hospital, Parklane",slug:"the-knowledge-and-use-of-intra-uterine-device-by-women-attending-ante-natal-clinic-at-enugu-state-te",totalDownloads:24,totalDimensionsCites:0,doi:"10.5772/intechopen.104097",abstract:"Intrauterine contraception has been recognized globally as one of the modern long-term reversible contraceptive methods suitable for women of all reproductive ages. It represents the most cost-effective method for preventing unwanted pregnancies, scientifically proven for its safety, efficacy and cost-effectiveness and is known to last longer in preventing pregnancy than other methods. This study assessed the knowledge of mothers attending ESUT teaching hospital, Parklane on intrauterine contraceptive device, the use as well as the common side effects experienced by the users. A descriptive survey research design was used to sample 175 mothers. A structured researcher developed questionnaire was used for data collection. The findings revealed that more than half of the respondents have good knowledge of intrauterine device but only 23 (14%) respondents make use of it. The commonly experienced side effects identified were irregular bleeding (75%) and vaginal discharge (62.5%). Although, the respondents had good knowledge of intrauterine device, their uptake of the method was poor. Therefore, there is a need to improve contraceptive counseling to ensure that women understand the relative effectiveness of IUDS. The study also recommended the need for better education for both clients and providers to improve the accessibility and acceptability of intrauterine device.",book:{id:"11284",title:"Studies in Family Planning",coverURL:"https://cdn.intechopen.com/books/images_new/11284.jpg"},signatures:"Chukwuasokam Caleb Aniechi and Uloma Cynthia Ezuma"},{id:"81003",title:"Perspective Chapter: Modern Birth Control Methods",slug:"perspective-chapter-modern-birth-control-methods",totalDownloads:38,totalDimensionsCites:0,doi:"10.5772/intechopen.103858",abstract:"This chapter focuses on various modern birth control methods, including combined oral contraceptives, progestogen-only pills, progestogen-only injectables, progestogen-only implants, intrauterine devices, barrier contraceptives, and emergency contraceptive pills. Each contraceptive method is covered in detail, including mechanism of action, effectiveness, health benefits, advantages, disadvantages, risks, and side-effects.",book:{id:"11284",title:"Studies in Family Planning",coverURL:"https://cdn.intechopen.com/books/images_new/11284.jpg"},signatures:"Rahma Al Kindi, Asma Al Salmani, Rahma Al Hadhrami, Sanaa Al Sumri and Hana Al Sumri"},{id:"80084",title:"Contraceptive Implants",slug:"contraceptive-implants",totalDownloads:174,totalDimensionsCites:0,doi:"10.5772/intechopen.101999",abstract:"Contraceptive implants or implantable contraceptive are five subdermal implants, rods the size of pencil lead that are embedded just under the skin on the inside of the upper arm. The rods contain etonogestrel, the metabolite of desogestrel, an equivalent progestin. Implants are often used during breastfeeding without an impact on milk production. 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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. 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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:"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. 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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.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11405,editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",slug:"luis-villarreal-gomez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",biography:"Dr. Luis Villarreal is a research professor from the Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana, Baja California, México. 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