\r\n\tThe primary objective of this book is to provide the specialists involved in the clinical management and experimental research of acute and chronic leukemias updates on the theoretical aspects as well as state-of-the-art diagnostic and clinical management of acute and chronic leukemias.
\r\n
\r\n\tThe book is intended to cover a broad spectrum of leukemia-related topics such as: \r\n\t-novel and still evolving insights into the biology and diagnosis and how these result in new drug approvals and new therapeutic options with a focus on molecular and immunotherapeutic targeted therapeutics, \r\n\t- the molecular and functional features of leukemic stem cells and their interaction with the microenvironment, \r\n\t- preleukemic hematopoiesis and clonal diversity, \r\n\t- new standard treatment algorithms, \r\n\t- mechanisms of resistance and disease progression \r\n\t- diagnosis and management of rare acute leukemia subtypes, \r\n\t- Covid-19 aspects in specific leukemia categories, \r\n\t- real-world data \r\n\t- new drugs in development
",isbn:"978-1-80356-906-2",printIsbn:"978-1-80356-905-5",pdfIsbn:"978-1-80356-907-9",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"30b431385424f0b84aee499d839f46cc",bookSignature:"Prof. Margarita Guenova and Prof. Gueorgui Balatzenko",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11599.jpg",keywords:"Leukemogenesis, Diagnosis, Target Therapies, Minimal Residual Disease, COVID-19, Molecular Biology, Mechanisms of Resistance and Disease Progression, Treatment-Free Remission, New Drugs in Development, Acute Lymphoblastic Leukemia, Chronic Lymphocytic Leukemia, Acute Myeloid Leukemia, Biomarkers",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 5th 2022",dateEndSecondStepPublish:"June 15th 2022",dateEndThirdStepPublish:"August 14th 2022",dateEndFourthStepPublish:"November 2nd 2022",dateEndFifthStepPublish:"January 1st 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"20 days",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Head of the national reference diagnostic laboratory for malignant blood diseases, professor of hematology, member of national and international medical societies, and author/co-author of research papers related to leukemia.",coeditorOneBiosketch:"Dr.Balatzenko is a Professor of Hematology and Blood Transfusion at the Laboratory of Cytogenetics and Molecular Biology at the National Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria. He has authored and co-authored many articles in peer-reviewed journals and book chapters. He is a member of several professional societies, such as the Bulgarian Society of Hematology, the Bulgarian Society of Genetics, and the European Hematology Association; a life member of the UICC.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"52938",title:"Prof.",name:"Margarita",middleName:null,surname:"Guenova",slug:"margarita-guenova",fullName:"Margarita Guenova",profilePictureURL:"https://mts.intechopen.com/storage/users/52938/images/system/52938.jpg",biography:"Professor Dr. Margarita Guenova received her medical training at the Medical University of Sofia and her PhD degree at the National Center of Haematology in 2000. She is employed as Head of the Laboratory of Haematopathology and Immunology and Professor of Hematology and Blood Transfusion at the National Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria, teaching both undergraduate and graduate studies at the Sofia Medical University. She specializes in the field of leukemia and lymphoma diagnostics. In regard to her scientific interests, she worked on the elucidation of critical mechanisms of leukemia pathogenesis and progression, investigation of clinically relevant biomarkers and potential targets for therapy in leukemias and lymphomas, characterization of leukemic stem cell populations, minimal residual disease, and implementation of a multifaceted approach in oncohematology. Dr. Guenova has authored and coauthored many abstracts, articles in peer-reviewed journals, and book chapters. She serves on several editorial boards and is the Past-president of the Bulgarian Society of Hematology as well as a member of several professional societies, such as the Bulgarian Society of Pathology, the Bulgarian Association of Clinical Immunology, the European Hematology Association, the European Association of Haematopathology, and the International Society of Haematology.",institutionString:"Laboratory of Haematopathology and Immunology, National Specialized Hospital for Active Treatment of Haematological Diseases",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"3",institution:null}],coeditorOne:{id:"56314",title:"Prof.",name:"Gueorgui",middleName:null,surname:"Balatzenko",slug:"gueorgui-balatzenko",fullName:"Gueorgui Balatzenko",profilePictureURL:"https://mts.intechopen.com/storage/users/56314/images/5371_n.jpg",biography:"Professor Dr. Gueorgui Balatzenko received his medical training at the Medical University of Sofia and his PhD degree at the National Center of Haematology in 2002. He obtained additional qualifications at the Red Cross Blood Bank, Groningen-Drenthe, the Netherlands; Institute Paoli-Calmettes, Marseille, France; and Necker-Enfants Malades, Paris, France. He is Professor of Hematology and Blood Transfusion at the Laboratory of Cytogenetics and Molecular Biology at the National Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria, teaching both undergraduate and graduate studies at the Sofia Medical University. His major interest is in the field of molecular investigations in leukemias. In regard to his scientific achievements, he worked on the elucidation of \nthe incidence and clinical relevance of molecular biomarkers in chronic and acute leukemias as well as on the molecular monitoring of treatment response. Dr. Balatzenko has authored and coauthored many articles in peer-reviewed journals and book chapters. He is a member of several professional societies, such as the Bulgarian Society of Hematology, the Bulgarian Society of Genetics, and the European Hematology Association; a life member of the UICC; and a referee for international journals.",institutionString:"Laboratory of Cytogenetics and Molecular Biology at the National Specialised Hospital for Active Treatment of Haematological Diseases",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"440204",firstName:"Ana",lastName:"Cink",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/440204/images/20006_n.jpg",email:"ana.c@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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1. Introduction
Clean water is important for every living organism to withstand life, but due to rapid increase in growth population and industrialization, there is more demand for clean, safe and drinkable water [1]. About 97% of water is stored in oceans as salty water which is not good for human consumption or agricultural use, only less than 3% water on planet is available for drinking and agricultural use [2]. Most available water is highly contaminated by effluent from agricultural and industrial activity and cannot be consumed therefore water quality and quantity are the main problems that need to be solved [3]. Removal of contaminants/water pollutants is required as to avoid negative effects on the environment as well as human health [4].
Several techniques have been developed for treatment of wastewater; such methods include reverse osmosis [5] ion exchange [6] gravity [7] and adsorption [8] among others. Adsorption has been widely used to remove water contaminants due to its low cost, available of different adsorbents and easy operation. Different adsorbents that have been used include use of magnetic nanoparticles [9] activated carbon [10], nanotubes [11] and polymer nanocomposites [12]; these can remove different contaminants including heavy metals that are very harmful even at low concentrations. Even though adsorption can remove most of water pollutants, it has some limitations such as lack of appropriate adsorbents with high adsorption capacity and low use of these adsorbents commercially [13]. Hence there has been a need for more efficient techniques such as membrane technology. Membrane separation or treatment process mainly depends on three basic principles, namely adsorption, sieving and electrostatic phenomenon [14]. The adsorption mechanism in the membrane separation process is based on the hydrophobic interactions of the membrane and the solute (analyte). These interactions normally lead to more rejection because it causes a decrease in the pore size of the membrane [15]. The separation of materials through the membrane depends on pore and molecule size [16]. For this reason, various membrane processes with different separation mechanisms have been developed. These include microfiltration (MF), ultrafiltration (UF), nanofiltration (NF), forward osmosis (FO) and reverse osmosis (RO).
Therefore the aim of this chapter is review different membrane technology processes used for treatment of wastewater in the last 5 years (2014–2018). The advantages, challenges/limitations associated with the use of each membrane technology and possible solutions are also discussed briefly.
2. Challenges
Membrane processes such as MF, NF, UF and RO are currently used for water reuse, brackish water and seawater [17]. Polymer based membranes are mostly used membrane material but because polymers such as polysulfone and polyethersulfone, are hydrophobic [18], polymeric membranes are prone to fouling [19]. This leads to blockage of membrane pores and decrease membrane performance [20], also increases operation cost by demanding extra cleaning process. There are factors causing membrane fouling, such as deposition of inorganic components onto the surface membrane/solute absorption pore blocking, microorganism and feed chemistry [21]. This results to either reversible or irreversible membrane fouling [22]. Reversible fouling formed by attachment of particles on the membrane surface, irreversible which occurs when particles strongly attach the membrane surface and cannot be removed by physical cleaning. When there is a formation of strong matrix of the fouled layer with the solute during continuous filtration process will turn reversible fouling to irreversible fouling layer [23].
3. Promising solutions
For polymeric membranes, surface modification of the polymer is essential; such surface modification includes grafting, blending and incorporation of nanomaterials such as TiO2 [24]), ZnO [25], Al2O3 [26], carbon nanotubes [27] and graphene oxide [28]. Among these, graphene oxide membranes (GMs) are very promising in water treatment application such as desalination and wastewater treatment, due to their hydrophilic properties, flexibility and high mechanical strength; GMs have been reported to give wide range of pure water flux [28, 29, 30, 31, 32].
4. Membrane processes
4.1. Microfiltration (MF)
Microfiltration is a pressure driven process where separated compounds are 0.1–0.2 μm such as nanoparticles [33, 34]. It is regarded as the first pre-treatment of NF and RO membrane processes. MF removes little or no organic matter; however, when pre-treatment is applied, increased removal of organic material can occur. MF can be used as a pre-treatment to RO or NF to reduce fouling potential [35]. The main disadvantages of MF is that it cannot eliminate contaminants (dissolved solids) that are <1 mm in size. In addition, MF is not an absolute barrier to viruses. However, when used in combination with disinfection, MF appears to control these microorganisms in water [35].
4.2. Ultrafiltration (UF)
Ultrafiltration membrane process can separate compounds between 0.005 ≈ 10 μm which is between MF and RO [36]. UF membranes are highly prominent water filters with low energy consumption in removal of pathogenic microorganisms, macromolecules and suspended maters among others [37]. However, UF has some limitations including its inability to remove any dissolved inorganic substances from water and regular cleaning to maintain high pressure water flow [38]. Mocanu and others developed a synthetic procedure for hybrid ultrafiltration membrane for water treatment. They used wet-phase inversion method with polysulfone and graphene nanoplatelets modified with poly (styrene) to obtain their membranes. ZnO was deposited on one surface of the membrane with polymers that are soluble in water [39]. In the study reported by Igbinigun and others, the modified GO-membrane showed 2.6 times better flux recovery compared to the unmodified membrane and this shows that it is wise to modify membrane with GO to increase flux recovery. They used a simple method known as UV induced amination which has high flux UF membrane found to be resistant to organic fouling, and the resulting membrane can be applied in waste water treatment application. Incorporating hydrophilic materials onto the surface of these polymers will lead to more hydrophilic surface membrane [40].
4.3. Nanofiltration (NF)
NF is capable of removing ions that contribute significantly to the osmotic pressure hence allows operation pressures that are lower than those RO. For NF to be effective pre-treatment is needed for some heavily polluted waters; Membranes are sensitive to free chlorine. Soluble elements cannot be separated from water [41]. In the study reported by Yang and co-workers, PMIA/GO composite nanofiltration membranes were used for water treatment. The prepared composite membrane had greater hydrophilic surface which gave rise to high pure water flux compared to that of the pure polymer (PMIA). The results obtained showed high dye rejection and enhanced fouling resistance to bovine serum albumin (BSA) [42]. Xu and others reported NF membrane for textile wastewater treatment, the prepared membrane displayed good removal of heavy metal ions, common salts and dyes, showing high removal efficiency toward metal ions and cationic dyes [43]. Lin and others reported nanofiltration membranes for dye (Congo red and direct red) and salt rejection, the results showed high dye rejection and low salt rejection which shows the possibility of the salt reuse in FO.
4.4. Forward osmosis (FO)
FO is a natural occurrence where the solvent moves from a region of lower concentration to the region of higher concentration across a permeable membrane [44]. This method is found to be highly efficient with low rate production of brine and is well studied as it promise to solve water problems worldwide, however regeneration of the draw solution is highly expensive for desalination processes hence the use of nanofiltration or reverse osmosis for regeneration of draw solution [45].
4.5. Reverse osmosis (RO)
RO is pressure driven technique used to remove dissolved solids and smaller particles; RO is only permeable to water molecules. The applied pressure on RO must be enough so that water can be able to overcome the osmotic pressure. The pore structure of RO membranes is much tighter than UF, they convert hard water to soft water, and they are practically capable of removing all particles, bacteria and organics, it requires less maintenance [46]. Some disadvantages include the use of high pressure, RO membranes are expensive compared to other membrane processes and are also prone to fouling. In some cases, high level of pre-treatment is required [47]. RO has extremely small pores and able to remove particles smaller than 0.1 nm [48]. Huang and others, reported RO membranes coated with azide functionalized graphene oxide hence created smooth, antibacterial and hydrophilic membrane, which removed Escherichia coli and reduced BSA fouling [49].
5. Application of membrane technology for wastewater treatment
Zinadini and his group used zinc oxide nanoparticles to coat multiwalled carbon nanotubes (MWCNTs) which were later blended in polyethersulfone (PES) membrane. Incorporation of ZnO coated MWCNTs increased pure water flux due to the hydrophilic properties added. The results showed increase in antifouling properties as well as decrease in surface roughness brought by the embedded nanoparticle. ZnO/MWCNTs composite membrane showed greater dye removal compared to pure PES membrane [50]. Polymeric membranes in water treatment can reject up to 98% Cd ions through asymmetric polysulfone membrane [51]. Hybrid membranes are also used in removal of water contaminants as they introduce adsorptive capability, photocatalytic and antibacterial capabilities. This will lead to improved water flux and rejection value [52]. Aromatic polyamide is among other polymers that have been used in membrane industries. High pressure membrane includes tight UF, NF and RO, these are operated at high transmembrane pressure (>200 kPa) and low pressure membrane includes lose UF and MF. Usually fouling turn to occur when transmembrane increases, as to maintain flux or when there is decrease in flux [53].
Qiu and others have reported the use of hybrid microfiltration-osmosis membrane bioreactor to remove nitrogen and organic matter in municipal wastewater. Results showed decrease in fouling and reduced bacteria deposition [54]. In the study reported by Ochando-Pulido and others in olive mill wastewater and the rejection efficiency was 99.1% [55]. Microfiltration membrane has been applied in domestic wastewater and the amount percentage recovery of phosphorus was found to be 98.7% [56]. Combination of UF/NF/RO have been used in rendering plant wastewater (RPW) and the rand filtration was used as an effective pre-treatment for UF hence lowering membrane fouling [57]. Another form of membrane called membrane with a molecular weight cut-off (MWCO) was used to treat municipal and industrial wastewater, the obtained results showed complete resistance to irreversible fouling and high dye rejection [58]. UF and NF membranes have been used for waste stream purification also known as backwash water, which is obtained by washing filtration beds from swimming pool water system [59] (Table 1).
This review provides detailed information about the current applications (2014–2018) of the membrane technology for treatment of wastewater. Generally, literature proved that different membrane technologies can be used to treat efficiently wastewaters from different activities. However, membrane fouling and membranes sensitivity to toxicity are the main limitations of the membrane technology. For this reason, Researchers has developed number of ways to overcome membrane technology. These ways include the incorporation of nanomaterials such as graphene oxide and nanometer sized metal oxides (zinc oxide), among others. In overall it can be concluded that membrane technology has been found to be a very promising method for wastewater treatment.
Acknowledgments
I would like to thank National Research Foundation (NRF, grant no. 99270) and Nanotechnology Innovation Centre (UJ Water Node) for providing financial support and the University of Johannesburg for making this study possible by making laboratory facilities available.
Conflict of interest
There is no conflict of interest.
\n',keywords:"wastewater, membrane technology, nanofiltration, forward osmosis, ultrafiltration, reverse osmosis",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/60850.pdf",chapterXML:"https://mts.intechopen.com/source/xml/60850.xml",downloadPdfUrl:"/chapter/pdf-download/60850",previewPdfUrl:"/chapter/pdf-preview/60850",totalDownloads:3010,totalViews:1780,totalCrossrefCites:17,totalDimensionsCites:35,totalAltmetricsMentions:0,impactScore:11,impactScorePercentile:98,impactScoreQuartile:4,hasAltmetrics:0,dateSubmitted:"October 21st 2017",dateReviewed:"March 20th 2018",datePrePublished:"November 5th 2018",datePublished:"August 29th 2018",dateFinished:"April 19th 2018",readingETA:"0",abstract:"Water contamination by heavy metals, cyanides and dyes is increasing globally and needs to be addressed as this will lead to water scarcity as well as water quality. Different techniques have been used to clean and renew water for human consumption and agricultural purposes but they each have limitations. Among those techniques, membrane technology is promising to solve the issues. Nanotechnology present a great potential in wastewater treatment to improve treatment efficiency of wastewater treatment plants. In addition, nanotechnology supplement water supply through safe use of modern water sources. This chapter reviews recent development in membrane technology for wastewater treatment. Different types of membrane technologies, their properties, mechanisms advantages, limitations and promising solutions have been discussed.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/60850",risUrl:"/chapter/ris/60850",book:{id:"6539",slug:"wastewater-and-water-quality"},signatures:"Azile Nqombolo, Anele Mpupa, Richard M. Moutloali and Philiswa\nN. Nomngongo",authors:[{id:"191669",title:"Dr.",name:"Philiswa",middleName:null,surname:"Nomngongo",fullName:"Philiswa Nomngongo",slug:"philiswa-nomngongo",email:"pnnomngongo@uj.ac.za",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Johannesburg",institutionURL:null,country:{name:"South Africa"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Challenges",level:"1"},{id:"sec_3",title:"3. Promising solutions",level:"1"},{id:"sec_4",title:"4. Membrane processes",level:"1"},{id:"sec_4_2",title:"4.1. Microfiltration (MF)",level:"2"},{id:"sec_5_2",title:"4.2. Ultrafiltration (UF)",level:"2"},{id:"sec_6_2",title:"4.3. Nanofiltration (NF)",level:"2"},{id:"sec_7_2",title:"4.4. Forward osmosis (FO)",level:"2"},{id:"sec_8_2",title:"4.5. Reverse osmosis (RO)",level:"2"},{id:"sec_10",title:"5. Application of membrane technology for wastewater treatment",level:"1"},{id:"sec_11",title:"6. Conclusions",level:"1"},{id:"sec_12",title:"Acknowledgments",level:"1"},{id:"sec_15",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Adeleye AS, Conway JR, Garner K, Huang Y, Su Y, Keller AA. Engineered nanomaterials for water treatment and remediation: Costs, benefits, and applicability. Chemical Engineering Journal. 2016;286:640-662'},{id:"B2",body:'Santhosh C, Velmurugan V, Jacob G, Jeong SK, Grace AN, Bhatnagar A. Role of nanomaterials in water treatment applications: A review. Chemical Engineering Journal. 2016;306:1116-1137'},{id:"B3",body:'Bethi B, Sonawane SH, Bhanvase BA, Gumfekar SP. Nanomaterials-based advanced oxidation processes for wastewater treatment: A review. Chemical Engineering and Processing: Process Intensification. 2016;109:178-189'},{id:"B4",body:'Moussa DT, El-Naas MH, Nasser M, Al-Marri MJ. A comprehensive review of electrocoagulation for water treatment: Potentials and challenges. 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Chemical Engineering Journal. 2017;316:91-100'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Azile Nqombolo",address:null,affiliation:'
Department of Applied Chemistry, University of Johannesburg, Johannesburg, South Africa
Department of Applied Chemistry, University of Johannesburg, Johannesburg, South Africa
'},{corresp:null,contributorFullName:"Richard M. Moutloali",address:null,affiliation:'
Department of Applied Chemistry, University of Johannesburg, Johannesburg, South Africa
'},{corresp:"yes",contributorFullName:"Philiswa N. Nomngongo",address:"pnnomngongo@uj.ac.za",affiliation:'
Department of Applied Chemistry, University of Johannesburg, Johannesburg, South Africa
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1. Introduction
Medical equipment is a product that can directly affect human lives. They have been and are considerable investments and in many cases have high maintenance costs. That is why it is important to have a well-planned, managed maintenance program that can keep medical equipment in a reliable, safe, and available medical service. In addition, such a management program extends the life of the equipment and minimizes the cost of its maintenance [1].
A modern medical equipment maintenance strategy includes periodic inspection procedures to which preventive maintenance (PM) and corrective maintenance (CM) are added when necessary. Performance inspections ensure that the equipment operates correctly within the limits set by the manufacturer or according to the standards in force for that type of equipment. Safety inspections ensure that the equipment is safe to use for both patients and operators. Preventive maintenance (PM) aims to extend the life of the equipment and reduce the downtime of medical equipment [2].
In addition, there may be some hidden issues that can be easily detected during a scheduled inspection. The technical inspection procedure of medical equipment only ensures that the device is in good working order at the time of inspection and cannot eliminate the possibility of a malfunction during future use. It must be borne in mind that by their nature, electrical and mechanical components can be damaged at any time. Corrective maintenance (CM) restores the operation of a defective device and allows it to be put back into operation in optimal parameters.
2. Maintenance program planning (inventory and resources)
Planning a maintenance program requires more effort to establish a comprehensive medical equipment management program. There are a number of critical factors to consider:
Inventory – types and models of medical equipment to be followed by technical staff and the steps by which they are specifically included in specific maintenance programs;
Methodology – identify the method by which maintenance will be provided to the medical equipment included in the program;
Resources – the financial, technical, and human resources included in the program.
In the process of planning a maintenance program, it is essential to determine the types of medical equipment they need to be included in a maintenance management program. This fact will depend on the types of medical services to be provided covered by the program, ranging from primary care clinics to hospitals as well as the range of equipment in them. The clinical engineering department of the hospital is the one that has to identify and select the medical equipment to be included in the inventory and to include it in the maintenance program [3].
A maintenance program can be implemented in several ways, the variety of methodologies available at a given time must be taken into account. For example, the healthcare provider may enter into service contracts with device manufacturers, independent service organizations, or a combination of both, in addition to the assistance that their own technical staff can provide.
As for the resources needed for maintenance, they are difficult to predict. This requires a well-maintained maintenance history, personnel requirement calculations, test equipment as well as their technical knowledge to repair defective equipment. Outside suppliers are required for the maintenance of complex equipment. Maintenance often requires access to equipment that can be difficult to obtain due to budget constraints and purchasing difficulties, especially when buying from abroad (Table 1). In order to meet such challenges, it is important to consider the financial advance, technical, and human resources required to properly carrying out the planned activities [4].
Initial cost
Operating cost
Technical resources
Space, tools, test equipment, and computer resources
Utilities, operation, maintenance, and calibration
Human resources
Recruiting and initial training
Salaries and continuing education
Maintenance
Not applicable
Service contract, spare parts, and materials
Table 1.
Financial resources required for a maintenance program.
A maintenance schedule is also based on a defined number of physical resources. This category includes workspace, tools and test equipment, consumables, spare parts, and maintenance and service manuals required to perform maintenance. Various testing tools and equipment are required to perform PM and/or CM procedures, depending on the type of medical equipment. It is possible to perform many PM and CM with a basic set of electronic service instruments and test equipment (e.g. temperature meter, voltmeter, power indicator, oscilloscope, and electrical safety meter) (Table 2). However, all these involve additional costs that must be provided in the financial and technological management.
Medical device
Test equipment required
All electrical equipment
Electrical safety analyzer
ICU monitors and ECG machines
Simulators/arrhythmia simulators
Defibrillators
Defibrillator analyzer
Electrosurgical units
Frequency electrosurgical analyzer
Ventilators, heart-lung machine, and anesthesia machine
Pneumatic tester and pneumatic flow meter
Noninvasive blood pressure monitors
Noninvasive blood pressure simulator
Anesthesia machines and ventilators,
Gas flow meters
Table 2.
Test equipment for some medical device category.
3. Operational management (developing or changing inspection and preventive maintenance procedures)
Fortunately, in hospitals, we see more and more technology. And this can only make us happy, proving to us that medicine is advancing, so the diagnosis is made earlier and more precisely, the treatment is more personalized and more effective. Overall, technology allows us to better care for the patient for his/her benefit, but also for the doctor, who has powerful tools to practice his/her profession. At the same time, the presence of these increasingly sophisticated medical equipment comes with the need for medical engineers in hospitals who know how to use this equipment, to identify when they are not used correctly or when they no longer work at optimal parameters.
For a patient, the staff of a hospital means doctors, nurses, and sisters, and it is normal to be like that, because only with them they interact but, a hospital in order to operate continuously, 24/7, in safe conditions, there is a whole team of technicians behind it, which makes this possible. Someone has to make sure that the medical equipment, the ventilation systems, the medical gas systems, and the electrical network are working properly, and these are the bioengineers, the clinical engineers, and the medical engineers.
Operational management involves making very diverse decisions, which can be classified into two broad categories: strategic and tactical. Strategic decisions have a longer time horizon and are less structured than tactical ones. They focus on the entire organization, drawing certain lines and directions, while tactical decisions are more focused on departments, teams, and issues. Device management takes place within a generalized business model, so clinical engineers work in collaboration with the financial and procurement departments of the institution to ensure efficient management of technical equipment, but also assistance policies are properly implemented through the efficient use of financial resources [5]. Consequently, the role of clinical engineering includes the development of equipment support strategies, the management and periodic review of these strategies, as well as the management of both fiscal resources and specialized personnel. Various problems may occur with medical devices resulting from device malfunctions, equipment operation problems, or malfunctioning devices [6, 7].
The first maintenance policies developed consisted of interventions on the devices that worked until their accidental shutdown (breakdown) due to wear and tear or due to the occurrence of malfunctions. The intervention is considered satisfactory as long as the device/system is operating at a minimum acceptable level (reactive maintenance) [8].
The development and increase in the complexity of medical equipment have led to the modernization and updating of maintenance techniques and policies. The preventive and predictive activity makes it possible to plan the shutdown, prepare the intervention team, ensure the necessary spare parts, and respectively, reduce to a minimum the parking time for repair [9]. Predictive maintenance is a qualitative leap forward in a modern maintenance system, regardless of the scope or specifics of production, as it provides all the information needed to:
early detection of defects;
their location;
fault diagnosis; and
calculation of the safe operating time of the machine.
Many healthcare providers have now implemented continuous quality improvement programs based on innovation in the way care is provided in order to improve safety, control costs, and make these services more accessible and effective for patients. Staff involved in operational management also use risk management methodologies to optimize hospital resources to provide a healthcare technology management program that focuses on ensuring that the hospital’s clinical work can be performed safely and cost-effectively.
The lack of specialized technical staff, including medical bioengineers and clinical engineers in hospitals, as well as an inefficient maintenance system are the major causes that determine incidents of all kinds. This has been highlighted more than ever, during the pandemic, when hospitals and all their medical equipment were and still are overburdened. During this time, more than ever, we have realized that the rules and standards of hospital care (including the care of medical equipment, medical gas networks, ventilation, electrical networks, etc.) need to be improved, and maintenance policies need to be optimized as quickly as possible.
4. Risk-based biomedical equipment management program
Healthcare is one of the largest industries in the world, with a high degree of diversity in terms of therapeutic activities and how they are performed. There is compelling evidence that while healthcare brings enormous benefits to all people, the frequency of errors and unwanted events is increasing, directly related to the development of innovation in biomedical technologies. Understanding and ensuring the safety of medical care is an extreme challenge in health system management [10].
For departments and organizations that target medical devices, whether they are manufactured or used, one of the key goals should be patient safety and risk management. Risk management is a complex process of identifying, analyzing, and responding to potential risks, through a documented approach, which uses material, financial, and human resources to achieve objectives, aiming to reduce their exposure to losses [11]. Thus, internal control is directly associated with risk management, because, through the measures taken, a functional framework is reasonably ensured that allows that entity to achieve its objectives [12].
The risk appetite of the organization must be clearly articulated in the policy, and this can be informed through legal and financial issues. Policy should also clearly define roles and responsibilities in risk management. There must also be a periodic review process in which each risk is reviewed to ensure that control measures are effective and that the residual risk is properly classified. The policy should set out the process, methods, and tools used to manage the risks within the organization.
Risk management is a cyclical process, which takes place throughout the course of an activity and involves several stages of work as shown in Figure 1.
Figure 1.
Risk management cycle.
4.1 Risk identification
The first step in the risk management process involves focusing efforts on identifying all possible sources of risk that could affect in any way the development of the project or activity analyzed. Effective risk management assumes that risk identification is an ongoing process that allows the entity to connect to the process of change and adaptation. An efficient risk management process at the level of the entity must also take into account the priorities of the institutions under coordination/subordination or under authority, which contribute to the achievement of the objectives of the respective entity [13].
The sources of risk come from both inside and outside an organization that provides healthcare services. External sources are those sources of risk that are the result of events outside the organization under analysis. The main factors that can influence the external risk environment and that need to be taken into account are as follows:
regulations and/or legislation – each healthcare provider must identify those laws and regulations under which they operate and which define the limits of action of this entity;
modifying/updating the objectives – in some situations, the treatment of some risks by the managers of the organization is influenced by the external decisions that influence the own activities;
sometimes, budget cuts can affect the achievement/limitation or stoppage of some professional activities or the number of employees.
Due to the fact that in the case of external risk no preventive measures can be taken, the only way to act is by insurance. Internal sources are the result of events within the organization. These sources of risk can be controlled. In this category, we can distinguish the risks of using technology equipment, the risks of specialized labor, or the risks associated with organizational management. These risks can be prevented by simply eliminating the sources that produce them, which is possible due to the fact that they are generated by the activity of the organization, so they come from within it.
4.2 Risk assessment (impact/probability)
There are two main categories in the risk analysis process:
qualitative risk analysis;
quantitative risk analysis.
The results of the qualitative risk analysis are less accurate, as they are more indicative than precise. In the qualitative analysis, the Probability Impact Matrix technique can be used, a technique that combines the two components of risk, thus presenting an overview of it [10]. This method can be applied at several levels, with varying degrees of difficulty. Most healthcare organizations use a 535 risk matrix based on Australian standards AS/4360: 2004, where the two axes correspond to the scales for consequences, sometimes called severity and probability as illustrated in Figure 2 [14].
Figure 2.
Probability impact matrix examples.
If these results are not satisfactory, the risk management also provides the quantitative analysis which presents results in numerical form as a result of the calculations made. If the risk analyst cannot give an accurate probability of such an event occurring, he/she can instead calculate the size of the losses or depreciations generated.
In this sense, risk management has developed a series of calculation methods and techniques such as [15]:
SWOT analysis (Strengths, Weaknesses, Opportunities and Threats): in practice, a few risk analyses have been shown to be effective when using this simple and well-known method.
Concatenation principle: by concatenating the risks, a chain of risky events is identified, and these will be analyzed together.
Script technique: this technique involves describing one or more possible ways of conducting an event from a concrete situation.
Expected value analysis.
Decision-based tree analysis.
Monte Carlo simulation method.
4.3 Reaction to risk/attitude toward risk
Measures should be taken to reduce the probability (possibility) of occurrence of the risk and/or to reduce the consequences (impact) on the results (objectives), if the risk is materialized. Risk response is a reduction in risk exposure if it is a threat.
If disposal is not feasible, control measures should be put in place:
Elimination or avoidance
Replacement
Control of risks at source
Separation and isolation
Safe working procedures
Training, instruction, and supervision
Personal protection
Other considerations: social assistance facilities, first aid, and emergency procedures
Lack of control can compromise the entire risk management process.
4.4 Risk monitoring, review, and reporting
In general, the risk management framework should not be seen as a single task but should be continually reviewed to ensure that it remains fit for purpose. There are a variety of technical standards for medical devices designed to ensure the consistency of a device’s safety throughout its life [16, 17]. These should be seen as a starting point in the risk profile and are the basis of the medical device directives: directive on implantable active medical devices (90/385/EEC), Medical Devices Directive (93/42/EEC), and directive on in vitro diagnostic medical devices (98/79/EEC). Another useful standard is BS ISO 31100 which sets a framework for incorporating risk management into any organization [18].
5. Work order system for corrective maintenance
A very important component in the management of medical technologies is represented by the realization of a maintenance program in which to take into account the characteristics and failures of medical equipment. At the moment of including such a maintenance strategy, a distinction will have to be made between older medical devices and high-tech devices, as they cannot be effectively managed if the same maintenance strategies are used [19]. The World Health Organization has issued guidelines for the application of corrective maintenance at the hospital level. Corrective maintenance is actually a whole process from identifying the defect to repairing the device and putting it back into operation.
5.1 Troubleshooting and repair
The first step in the corrective maintenance process is to report a fault/incident to a user. Also, a malfunction can be found when a medical technician/bioengineer from the Department of Clinical Engineering performs the periodic technical inspection. In order to make the maintenance process more efficient, the first step is the realization of the finding and then the corrective maintenance is initiated. A reduction in the failure time of the defective medical device can be achieved when the medical technician/bioengineer performs some corrective maintenance steps himself/herself and uses internal expertise or external service providers. This corrective maintenance may be accomplished at various levels:
component level: old generation equipment requires isolation of the fault by troubleshooting and repairing the level of components. In the case of new generation medical equipment, electronic devices, repairing the level of components can be time-consuming and difficult. In addition, this type of maintenance is not feasible, so the repair of the board level or even the system level is applied.
board level: in the case of modern electronic equipment, the faults of a certain circuit board are isolated, and the entire board is replaced.
device or system level: in the case of modern equipment, troubleshooting and repairing at the plate level are sometimes difficult and time-consuming. Therefore, if the cost of a repair exceeds 60% of the value of the purchase of new equipment, it is more profitable to replace the entire device or subsystem.
The type of corrective maintenance applied at the hospital level is dependent on a number of cumulative factors including the availability of financial, physical, and human resources, as well as the urgency of a particular request for repair. One strategy that can be considered is the application of repairs at the device level, in emergency situations and when more time is available, the repair can be used at the plate level or at the component level. If it is proposed to repair the component level, parts may need to be replaced.
Replacement can be done with specialized parts from the manufacturer or with spare parts recovered from malfunctioning or obsolete equipment (only after the announced risk assessment).
5.2 Factors affecting equipment failures
In the event of an unforeseen fault, environmental factors must also be considered, such as stabilizing the power supply sources by using voltage regulators, installing uninterruptible power supplies (UPS), using surge protection devices and avoiding connection. Another important environmental aspect is the interaction of medical devices with other utility systems (e.g. medical gas and vacuum systems, temperature and ventilation control systems, water supply, and information technology).
There must be a permanent collaboration with the other categories of engineers in the organization in order to optimize the capacity of the utility systems so that the medical equipment works in optimal parameters. The environment in which medical equipment is used should be controlled in terms of temperature and humidity. There are situations in which some medical equipment is designed to be used in accordance with the specific climate of a country/region. In this case, the maintenance procedures in a particular country or region are adjusted according to these local factors. Other important environmental factors are the age and condition of medical equipment or old facilities built to old standards that are not applicable.
5.3 Inspection and return to service
The actions required after the repair is completed include recalibration processes and a performance and safety inspection. These activities are essential for measuring device performance. Once these activities are completed, the medical equipment will be returned for use to the patient care.
5.4 Reporting
In the case of corrective maintenance, a decisive role is played by the periodic technical verification, part of the preventive maintenance process. The technical file of the medical device in which any intervention made on the medical device is recorded is a reference document in corrective maintenance that helps to make decisions. Existing data in the worksheet includes the actions performed, the parts replaced, and their cost helps to identify if or when the parts need to be replaced again and helps to explain the condition of the parts during the current inspection.
5.5 Safety
An important aspect in the corrective maintenance process is the consideration of safety aspects. In this case, procedures must be included regarding the safety of the technical staff during maintenance, the safety of the user after maintenance, and the general control of infections. In order to increase the safety of service personnel, it is necessary to train and use personal protective equipment and knowledge of techniques that will allow technical personnel to work safely in dangerous conditions.
Following maintenance, in particular following procedures which could have affected the safety features of a medical device, the technical staff must check that the device is safe to use, mechanically and electrically. Particular attention shall be paid to the electrical safety of medical devices so that they are earth-proof and leakage current is measured to ensure that they are within the applicable limits. (In the absence of electrical safety test equipment, technical personnel must rely on careful repair techniques and simple electrical tests to verify the integrity of the device). Physicians should be advised to check the settings of the device and perform basic operational checks before using the device with patients [20].
An important conclusion we can draw is that the best maintenance strategy is to apply the mixed maintenance strategy. This process is due to the fact that we are talking about a very large number of medical equipment and complex technologies. The maintenance process must be divided between the parts: internal maintenance is adopted for surgical lamps, sciatic lamps, and telemetry devices. In the case of critical devices, maintenance is covered by full-risk agreements with authorized manufacturers or service centers.
External maintenance is adopted for anesthesia machines, mechanical ventilators, electrocardiographs, patient monitors, and surgical tables [21].
6. Managing a maintenance program in a hospital
Good management of medical technologies at the hospital level can minimize malfunctions in medical devices. If we refer to developing countries, here the problem is the limited financial resources. In this case, a proper management of medical technologies, based on increasing reliability and reducing failures, could lead to the provision of good health services in limited economic conditions. Assessing the effectiveness of any maintenance program is critical to optimizing the use of available resources within the hospital. The emphasis cannot be placed solely on scheduled maintenance [22].
Patients’ access to an accurate diagnosis, effective treatment, or rehabilitation process with appropriate medical devices is related to the efficient management of the maintenance of medical devices. This process can increase the efficiency and productivity of medical technology resources, which is especially important when resources are limited (Figure 3) [23].
Figure 3.
A summary of basics for evaluating and identifying the mode of operation within the clinical engineering department of any hospital.
A possible approach to medical technology management involves the inclusion of a priority analysis step. The division into three levels of emergency (high, medium, and low) can be proposed based on the operation and implementation of subsequent actions in appropriate stages, appropriate to urgency, criticality, and seriousness. This analysis of priorities can be done both in terms of preventive maintenance, corrective maintenance, and in the case of a replacement program. In this case, the management priority can be recognized by the maintenance [24].
Another operational diagram that can be applied to evaluate the management process of medical technologies is the Ishikawa diagram or the fish bone diagram. This diagram is a verbal tool that has the relationship between an effect (a problem) and all possible causes that influence the effect (Figure 4).
Figure 4.
Ishikawa diagram or the fish bone diagram applied to the management process of medical technologies.
The optimization of the functions of the maintenance department can be obtained by implementing a procedure that includes three important aspects: the task of the annual maintenance plan, the time available for the technical department, and the amount of equipment to be maintained. Taking into account these parameters, it is possible to estimate the personnel necessary to perform the maintenance function, responding to the most critical component of the management act – human resources [25]. Another approach involves designing a set of key performance indicators (KPIs) useful for assessing the performance of medical equipment maintenance in the management process (Figure 5).
Figure 5.
Block diagram of the process required to calculate the set proposed by the KPI, starting from technological, organizational, and financial data.
A proper evaluation of the medical equipment maintenance process should include the development of a checklist for evaluating medical technology management. Implementing a list can be helpful in ensuring the profitability of health facilities and the reliability of medical equipment. In addition, she/he is involved in decision-making in support of the selection, measurement, repair, and maintenance of medical equipment, in particular for capital equipment managers and hospital medical engineers, and also for the evaluation of this process.
An example of a maintenance management evaluation checklist proposes the inclusion of 15 indicators: type of medical equipment, quality control tests, application of training processes, correct storage of medical equipment and spare parts, existence of maintenance contracts, supervision of the process of operation, the existence of the decommissioning procedure, the existence of the reintegration system in use/system and the reporting of adverse events, ensuring the supply of electricity in optimal conditions, implementation of a process of continuous development of maintenance, general administration, management, and allocation of a separate budget for medical equipment maintenance services [23].
Another approach to evaluating the management process was implemented by Herrera-Galán and included evaluating the performance of the maintenance function by implementing management audits. Assessments include equipment availability, response to a service request, monitoring and control of biomedical equipment, staff training, quality of work performed by maintenance technicians, workload of maintenance technicians, control of work performed by maintenance technicians, effectiveness of annual planning, and maintenance and performance of the department. The results of this research show that the audit technique is a valuable checklist in evaluating the performance of a hospital. And in this case, it was highlighted that the most critical component of the results of a management audit is human resources [26].
Amerion et al. managed to identify the effective factors that influence the management of medical technologies at the level of a military hospital. Following the study, 26 components with an important influence on the management process were extracted. These are user training, human resources, user engagement and experience, the foreign exchange market, regular checks, and trade name. Attention to the evaluation of these components could reduce maintenance costs and increase the lifespan of medical equipment. The process of training users that must be continuous and the quality of human resources are the two main aspects [27].
A general conclusion regarding the implementation of management strategies in the maintenance of medical equipment shows us that the necessary adequate resources underlying are human resources, material, financial, and documentation resources [28].
7. Conclusion
The maintenance of medical equipment becomes more expensive every year, and to optimize maintenance programs and reduce total cost of ownership, hospital management structures are constantly looking for solutions to extend the time of operation of equipment, in the required safety and technical performance and through the efficient use of available resources. The analysis and substantiation of capital expenditures in medical organizations must be based on quantifiable factors, with a direct impact on the full associated costs. In order to optimize operating and support costs, medical technology management structures develop medical equipment maintenance programs, based on assessments and prioritization, based on risks and costs. The development of alternative plans for medical equipment must take into account the complexity and large number of existing equipment, the skills of its own specialists and their number, the technical means of calibration and control, and the budgetary resources available.
In this regard, healthcare facilities need to implement evidence-based maintenance strategies, through the development of prioritization procedures aimed at a balanced assessment of relevant factors in the life of medical equipment, through an integrated approach to the elements of reliability-based maintenance, on risk-based conditions and maintenance.
Today's modern hospital is highly dependent on different types of medical equipment to help diagnose, monitor, and treat patients. Medical equipment maintenance is important to reduce costs, reduce patient dissatisfaction, treat the patient in a timely manner, and reduce mortality and risks during patient care. Good maintenance management is important to have well-planned and implemented programs through which hospitals can minimize medical device failures or other problems with the operation of medical equipment. Medical equipment plays an important role in the hospital system; therefore, the acquisition, maintenance, and replacement of medical equipment are key factors in hospitals for the implementation of the health service. Thus, in order to ensure the quality of medical devices for the provision of medical care, it is imperative to evaluate the safety of using hospital maintenance management. In order to achieve these goals, hospitals must develop checklists that identify the state of performance of medical equipment maintenance. It is essential for clinical managers and engineers not only to increase the capacity of the hospital but also to predict the risks of sudden failure. Given the lack of unique and comprehensive maintenance management checklists, the current goal is to design and develop medical equipment maintenance management checklists.
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Popa University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"466086",title:null,name:"Fuior",middleName:null,surname:"Robert",fullName:"Fuior Robert",slug:"fuior-robert",email:"fuior.robert@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"466089",title:null,name:"Doru",middleName:null,surname:"Andritoi",fullName:"Doru Andritoi",slug:"doru-andritoi",email:"andritoi.doru@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"466091",title:null,name:"Catalina",middleName:null,surname:"Luca",fullName:"Catalina Luca",slug:"catalina-luca",email:"luca.katalina@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Maintenance program planning (inventory and resources)",level:"1"},{id:"sec_3",title:"3. Operational management (developing or changing inspection and preventive maintenance procedures)",level:"1"},{id:"sec_4",title:"4. Risk-based biomedical equipment management program",level:"1"},{id:"sec_4_2",title:"4.1 Risk identification",level:"2"},{id:"sec_5_2",title:"4.2 Risk assessment (impact/probability)",level:"2"},{id:"sec_6_2",title:"4.3 Reaction to risk/attitude toward risk",level:"2"},{id:"sec_7_2",title:"4.4 Risk monitoring, review, and reporting",level:"2"},{id:"sec_9",title:"5. Work order system for corrective maintenance",level:"1"},{id:"sec_9_2",title:"5.1 Troubleshooting and repair",level:"2"},{id:"sec_10_2",title:"5.2 Factors affecting equipment failures",level:"2"},{id:"sec_11_2",title:"5.3 Inspection and return to service",level:"2"},{id:"sec_12_2",title:"5.4 Reporting",level:"2"},{id:"sec_13_2",title:"5.5 Safety",level:"2"},{id:"sec_15",title:"6. Managing a maintenance program in a hospital",level:"1"},{id:"sec_16",title:"7. Conclusion",level:"1"},{id:"sec_17",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Kihiu J, Maranga S, Mutia D. Maintenance management of medical equipment in hospitals. Industrial Engineering Letters. 2012;2(3):9-19'},{id:"B2",body:'Patil PJ, Patil SP, Jaltade VG, Gupta SS. Departmental equipment maintenance system in government medical college. International Archives of Integrated Medicine. 2015;2(3):79-86'},{id:"B3",body:'Bahreini R, Doshmangir L, Imani A. Affecting medical equipment maintenance management: A systematic review. Journal of Clinical and Diagnostic Research. 2018;12(4):1-7'},{id:"B4",body:'Bahreini R, Doshmangir L, Imani A. Influential factors on medical equipment maintenance management. Journal of Quality in Maintenance Engineering. 2019;25(1):128-143'},{id:"B5",body:'Subhan A. Equipment Maintenance, Biomedical. In: Webster JG, editor. 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Predictive maintenance application for health technology management. 2013 8th International Symposium on Advanced Topics in Electrical Engineering (ATEE). IEEE; 2013. pp. 1-4. doi: 10.1109/ATEE.2013.6563431'},{id:"B10",body:'Corciovă C, Andritoi D, Ciorap R. Elements of risk assessment in medical equipment. In: 2013 8th International Symposium on Advanced Topics in Electrical Engineering (ATEE). IEEE; 2013. pp. 1-4. DOI: 10.1109/ATEE.2013.6563427'},{id:"B11",body:'Brown AS. Chapter 6 - Risk Management. In: Taktak A, Ganney P, Long D, White P, editors. Clinical Engineering. USA: Elsevier Academic Press; 2014. pp. 77-92. ISBN: 9780123969613. DOI: 10.1016/B978-0-12-396961-3.00006-8'},{id:"B12",body:'Anderson FA. Medical device risk assessment. In: The Medical Device Industry: Science, Technology, and Regulation in a Competitive Environment. New York: Marcel Dekker Ltd.; 1990. pp. 487-493'},{id:"B13",body:'Goode J. Use of international standard ISO 10993-1. 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Prioritisation assessment and robust predictive system for medical equipment: A comprehensive strategic maintenance management. Frontiers in Public Health. 2021;9:782203. DOI: 10.3389/fpubh.2021.782203'},{id:"B25",body:'Herrera-Galán M, Martínez-Delgado E. Management audit applied to the maintenance department in hospital facilities. Ingeniería Mecánica. 2017;20(3):152-159ISSN 1815-5944'},{id:"B26",body:'Herrera-Galán M. Management audit applied to the maintenance department in hospital facilities. Ingeniería Mecánica. 2017;20(3):152-159'},{id:"B27",body:'Amerion A, Alijanzadeh M, Teymourzadeh E. Effective factors on the management of medical equipment maintenance in a military hospital: A qualitative study in Iran. EBNESINA. 2015;17(3):11-18'},{id:"B28",body:'Wang B. Medical equipment maintenance: Management and oversight. Synthesis Lectures on Biomedical Engineering. 2012;7(2):1-85'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Călin Corciovă",address:"calin.corciova@umfiasi.ro",affiliation:'
Medical Bioengineering Faculty, University of Medicine and Pharmacy Grigore T. Popa, Iași, Romania
Medical Bioengineering Faculty, University of Medicine and Pharmacy Grigore T. Popa, Iași, Romania
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The chapter highlights the associated aspects of childhood and adolescence, raised by helicopter parenting. As parents have their own concern about raising their children in certain manner, it is important to understand the underlying mechanism of parenting style. Therefore, this chapter also describes the theoretical framework. The associated mental health issues and supportive psychological intervention to be also discussed.",book:{id:"9043",slug:"parenting-studies-by-an-ecocultural-and-transactional-perspective",title:"Parenting",fullTitle:"Parenting - Studies by an Ecocultural and Transactional Perspective"},signatures:"Deepika Srivastav and M.N. Lal Mathur",authors:[{id:"320545",title:"Ph.D.",name:"Deepika",middleName:null,surname:"Srivastav",slug:"deepika-srivastav",fullName:"Deepika Srivastav"},{id:"322605",title:"Dr.",name:"M.N.Lal",middleName:null,surname:"Mathur",slug:"m.n.lal-mathur",fullName:"M.N.Lal Mathur"}]},{id:"45760",title:"Parenting and Culture – Evidence from Some African Communities",slug:"parenting-and-culture-evidence-from-some-african-communities",totalDownloads:9583,totalCrossrefCites:10,totalDimensionsCites:25,abstract:null,book:{id:"3440",slug:"parenting-in-south-american-and-african-contexts",title:"Parenting in South American and African Contexts",fullTitle:"Parenting in South American and African Contexts"},signatures:"Patricia Mawusi Amos",authors:[{id:"162496",title:"Mrs.",name:"Patricia",middleName:"Mawusi",surname:"Amos",slug:"patricia-amos",fullName:"Patricia Amos"}]},{id:"72914",title:"Parent-Adolescent Relationship and the Impact of Substance Dependency within the Trajectory of Adolescent Substance Use Disorder",slug:"parent-adolescent-relationship-and-the-impact-of-substance-dependency-within-the-trajectory-of-adole",totalDownloads:645,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Adolescents strive for freedom and autonomy; thus, communication with their parents needs to be enhanced. Building solid healthy relationships at this stage of their lives is of utmost importance to help them cope with the changes and challenges they are experiencing. The purpose of this chapter is to explore the parent-adolescent relationship in the substance dependency field. The focus is on the relationship between parents and their adolescents who have a substance use disorder. Parenting adolescents poses its own set of challenges, making it difficult to build and maintain healthy parent-adolescent relationships. We argue that although adolescent substance use disorder has been extensively researched, the relationship between parents and adolescents with substance use disorder has surprisingly not received the same attention. It is this gap that this chapter seeks to address. With this in mind, the ecological systems theory was employed here to shed light on the importance and significance of developing healthy parent-adolescent relationships. The findings show that the parent-adolescent relationship primarily informs the daily living of both the parents and the adolescents. The parent-adolescent relationship is therefore very important as it represents whole-family functioning.",book:{id:"9043",slug:"parenting-studies-by-an-ecocultural-and-transactional-perspective",title:"Parenting",fullTitle:"Parenting - Studies by an Ecocultural and Transactional Perspective"},signatures:"Faith Mathibela and Rebecca Mmamoagi Skhosana",authors:[{id:"317920",title:"Mrs.",name:"Faith",middleName:null,surname:"Mathibela",slug:"faith-mathibela",fullName:"Faith Mathibela"}]},{id:"56390",title:"Introductory Chapter: Sociology of Knowledge and Epistemological Paradox of Globalization",slug:"introductory-chapter-sociology-of-knowledge-and-epistemological-paradox-of-globalization",totalDownloads:1823,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"5924",slug:"epistemology-and-transformation-of-knowledge-in-global-age",title:"Epistemology and Transformation of Knowledge in Global Age",fullTitle:"Epistemology and Transformation of Knowledge in Global Age"},signatures:"Zlatan Delić",authors:[{id:"31746",title:"Dr.",name:"Zlatan",middleName:null,surname:"Delic",slug:"zlatan-delic",fullName:"Zlatan Delic"}]}],onlineFirstChaptersFilter:{topicId:"276",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:319,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:133,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:16,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,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. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null,scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
\r\n
\r\n\t
\r\n
\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n
\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
\r\n
\r\n\t
\r\n
\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
\r\n
\r\n\t
\r\n
\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
",coverUrl:"https://cdn.intechopen.com/series/covers/24.jpg",latestPublicationDate:"July 5th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"262440",title:"Prof.",name:"Usha",middleName:null,surname:"Iyer-Raniga",slug:"usha-iyer-raniga",fullName:"Usha Iyer-Raniga",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRYSXQA4/Profile_Picture_2022-02-28T13:55:36.jpeg",biography:"Usha Iyer-Raniga is a professor in the School of Property and Construction Management at RMIT University. Usha co-leads the One Planet Network’s Sustainable Buildings and Construction Programme (SBC), a United Nations 10 Year Framework of Programmes on Sustainable Consumption and Production (UN 10FYP SCP) aligned with Sustainable Development Goal 12. The work also directly impacts SDG 11 on Sustainable Cities and Communities. She completed her undergraduate degree as an architect before obtaining her Masters degree from Canada and her Doctorate in Australia. Usha has been a keynote speaker as well as an invited speaker at national and international conferences, seminars and workshops. Her teaching experience includes teaching in Asian countries. She has advised Austrade, APEC, national, state and local governments. She serves as a reviewer and a member of the scientific committee for national and international refereed journals and refereed conferences. She is on the editorial board for refereed journals and has worked on Special Issues. Usha has served and continues to serve on the Boards of several not-for-profit organisations and she has also served as panel judge for a number of awards including the Premiers Sustainability Award in Victoria and the International Green Gown Awards. Usha has published over 100 publications, including research and consulting reports. Her publications cover a wide range of scientific and technical research publications that include edited books, book chapters, refereed journals, refereed conference papers and reports for local, state and federal government clients. She has also produced podcasts for various organisations and participated in media interviews. She has received state, national and international funding worth over USD $25 million. Usha has been awarded the Quarterly Franklin Membership by London Journals Press (UK). Her biography has been included in the Marquis Who's Who in the World® 2018, 2016 (33rd Edition), along with approximately 55,000 of the most accomplished men and women from around the world, including luminaries as U.N. Secretary-General Ban Ki-moon. In 2017, Usha was awarded the Marquis Who’s Who Lifetime Achiever Award.",institutionString:null,institution:{name:"RMIT University",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:11,paginationItems:[{id:"91",title:"Sustainable Economy and Fair Society",coverUrl:"https://cdn.intechopen.com/series_topics/covers/91.jpg",editor:{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo",profilePictureURL:"https://mts.intechopen.com/storage/users/181603/images/system/181603.jpg",biography:"Antonella Petrillo is a Professor at the Department of Engineering of the University of Naples “Parthenope”, Italy. She received her Ph.D. in Mechanical Engineering from the University of Cassino. Her research interests include multi-criteria decision analysis, industrial plant, logistics, manufacturing and safety. She serves as an Associate Editor for the International Journal of the Analytic Hierarchy Process. She is a member of AHP Academy and a member of several editorial boards. She has over 160 Scientific Publications in International Journals and Conferences and she is the author of 5 books on Innovation and Decision Making in Industrial Applications and Engineering.",institutionString:null,institution:{name:"Parthenope University of Naples",institutionURL:null,country:{name:"Italy"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"179628",title:"Prof.",name:"Dima",middleName:null,surname:"Jamali",slug:"dima-jamali",fullName:"Dima Jamali",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSAIlQAO/Profile_Picture_2022-03-07T08:52:23.jpg",institutionString:null,institution:{name:"University of Sharjah",institutionURL:null,country:{name:"United Arab Emirates"}}},{id:"170206",title:"Prof.",name:"Dr. Orhan",middleName:null,surname:"Özçatalbaş",slug:"dr.-orhan-ozcatalbas",fullName:"Dr. Orhan Özçatalbaş",profilePictureURL:"https://mts.intechopen.com/storage/users/170206/images/system/170206.png",institutionString:null,institution:{name:"Akdeniz University",institutionURL:null,country:{name:"Turkey"}}},{id:"250347",title:"Associate Prof.",name:"Isaac",middleName:null,surname:"Oluwatayo",slug:"isaac-oluwatayo",fullName:"Isaac Oluwatayo",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRVIVQA4/Profile_Picture_2022-03-17T13:25:32.jpg",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},{id:"141386",title:"Prof.",name:"Jesús",middleName:null,surname:"López-Rodríguez",slug:"jesus-lopez-rodriguez",fullName:"Jesús López-Rodríguez",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRBNIQA4/Profile_Picture_2022-03-21T08:24:16.jpg",institutionString:null,institution:{name:"University of A Coruña",institutionURL:null,country:{name:"Spain"}}},{id:"208657",title:"Dr.",name:"Mara",middleName:null,surname:"Del Baldo",slug:"mara-del-baldo",fullName:"Mara Del Baldo",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRLMUQA4/Profile_Picture_2022-05-18T08:19:24.png",institutionString:"University of Urbino Carlo Bo",institution:null}]},{id:"92",title:"Health and Wellbeing",coverUrl:"https://cdn.intechopen.com/series_topics/covers/92.jpg",editor:{id:"348225",title:"Prof.",name:"Ann",middleName:null,surname:"Hemingway",slug:"ann-hemingway",fullName:"Ann Hemingway",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035LZFoQAO/Profile_Picture_2022-04-11T14:55:40.jpg",biography:"Professor Hemingway is a public health researcher, Bournemouth University, undertaking international and UK research focused on reducing inequalities in health outcomes for marginalised and excluded populations and more recently focused on equine assisted interventions.",institutionString:null,institution:{name:"Bournemouth University",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"169536",title:"Dr.",name:"David",middleName:null,surname:"Claborn",slug:"david-claborn",fullName:"David Claborn",profilePictureURL:"https://mts.intechopen.com/storage/users/169536/images/system/169536.jpeg",institutionString:null,institution:{name:"Missouri State University",institutionURL:null,country:{name:"United States of America"}}},{id:"248594",title:"Ph.D.",name:"Jasneth",middleName:null,surname:"Mullings",slug:"jasneth-mullings",fullName:"Jasneth Mullings",profilePictureURL:"https://mts.intechopen.com/storage/users/248594/images/system/248594.jpeg",institutionString:"The University Of The West Indies - Mona Campus, Jamaica",institution:null},{id:"331299",title:"Prof.",name:"Pei-Shan",middleName:null,surname:"Liao",slug:"pei-shan-liao",fullName:"Pei-Shan Liao",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000032Fh2FQAS/Profile_Picture_2022-03-18T09:39:41.jpg",institutionString:"Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan",institution:null}]},{id:"93",title:"Inclusivity and Social Equity",coverUrl:"https://cdn.intechopen.com/series_topics/covers/93.jpg",editor:{id:"210060",title:"Prof. Dr.",name:"Ebba",middleName:null,surname:"Ossiannilsson",slug:"ebba-ossiannilsson",fullName:"Ebba Ossiannilsson",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6LkBQAU/Profile_Picture_2022-02-28T13:31:48.png",biography:"Professor Dr. Ebba Ossiannilsson is an independent researcher, expert, consultant, quality auditor and influencer in the fields of open, flexible online and distance learning (OFDL) and the 'new normal'. Her focus is on quality, innovation, leadership, and personalised learning. She works primarily at the strategic and policy levels, both nationally and internationally, and with key international organisations. She is committed to promoting and improving OFDL in the context of SDG4 and the future of education. Ossiannilsson has more than 20 years of experience in her current field, but more than 40 years in the education sector. She works as a reviewer and expert for the European Commission and collaborates with the Joint Research Centre for Quality in Open Education. Ossiannilsson also collaborates with ITCILO and ICoBC (International Council on Badges and Credentials). She is a member of the ICDE Board of Directors and has previously served on the boards of EDEN and EUCEN. Ossiannilsson is a quality expert and reviewer for ICDE, EDEN and the EADTU. She chairs the ICDE OER Advocacy Committee and is a member of the ICDE Quality Network. 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She is a member of the Digital Skills and Jobs Coalition Sweden and Vice President of the Swedish Association for Distance Education. She is currently working on a government initiative on quality in distance education at the National Council for Higher Education. 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He got his Ph.D. in Animal Ecology at Umeå University in Sweden in 1998. He conducted postdoc research in stream ecology at the University of California at Santa Barbara in the USA. After that, he was a postdoc research fellow at the University of British Columbia in Canada to do research on large-scale stream experimental manipulation and watershed ecological survey in temperate rainforests of BC. He was a faculty member at the University of Hong Kong to run ecological research projects on aquatic insects, fishes, and newts in Tropical Asian streams. He also conducted research in streams, rivers, and caves in Texas, USA, to study the ecology of macroinvertebrates, big-claw river shrimp, fish, turtles, and bats. Current research interests include trophic flows across ecosystems; watershed impacts of land-use change on biodiversity and ecosystem functioning; ecological civilization and water resource management; urban ecology and urban/rural sustainable development.",institutionString:null,institution:{name:"Soochow University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null,editorialBoard:null},{id:"95",title:"Urban Planning and Environmental Management",coverUrl:"https://cdn.intechopen.com/series_topics/covers/95.jpg",editor:{id:"181079",title:"Dr.",name:"Christoph",middleName:null,surname:"Lüthi",slug:"christoph-luthi",fullName:"Christoph Lüthi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRHSqQAO/Profile_Picture_2022-04-12T15:51:33.png",biography:"Dr. Christoph Lüthi is an urban infrastructure planner with over 25 years of experience in planning and design of urban infrastructure in middle and low-income countries. 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I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). 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:"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: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:"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"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}},{id:"441116",title:"Dr.",name:"Jovanka M.",middleName:null,surname:"Voyich",slug:"jovanka-m.-voyich",fullName:"Jovanka M. Voyich",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Montana State University",country:{name:"United States of America"}}},{id:"330412",title:"Dr.",name:"Muhammad",middleName:null,surname:"Farhab",slug:"muhammad-farhab",fullName:"Muhammad Farhab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"349495",title:"Dr.",name:"Muhammad",middleName:null,surname:"Ijaz",slug:"muhammad-ijaz",fullName:"Muhammad Ijaz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}}]}},subseries:{item:{id:"95",type:"subseries",title:"Urban Planning and Environmental Management",keywords:"Circular economy, Contingency planning and response to disasters, Ecosystem services, Integrated urban water management, Nature-based solutions, Sustainable urban development, Urban green spaces",scope:"
\r\n\tIf we aim to prosper as a society and as a species, there is no alternative to sustainability-oriented development and growth. Sustainable development is no longer a choice but a necessity for us all. Ecosystems and preserving ecosystem services and inclusive urban development present promising solutions to environmental problems. Contextually, the emphasis on studying these fields will enable us to identify and define the critical factors for territorial success in the upcoming decades to be considered by the main-actors, decision and policy makers, technicians, and public in general.
\r\n
\r\n\tHolistic urban planning and environmental management are therefore crucial spheres that will define sustainable trajectories for our urbanizing planet. This urban and environmental planning topic aims to attract contributions that address sustainable urban development challenges and solutions, including integrated urban water management, planning for the urban circular economy, monitoring of risks, contingency planning and response to disasters, among several other challenges and solutions.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/95.jpg",hasOnlineFirst:!1,hasPublishedBooks:!1,annualVolume:11979,editor:{id:"181079",title:"Dr.",name:"Christoph",middleName:null,surname:"Lüthi",slug:"christoph-luthi",fullName:"Christoph Lüthi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRHSqQAO/Profile_Picture_2022-04-12T15:51:33.png",biography:"Dr. Christoph Lüthi is an urban infrastructure planner with over 25 years of experience in planning and design of urban infrastructure in middle and low-income countries. He holds a Master’s Degree in Urban Development Planning from the University College of London (UCL), and a Ph.D. in Urban Planning & Engineering from TU Berlin. He has conducted applied research on urban planning and infrastructure issues in over 20 countries in Africa and Asia. In 2005 he joined Eawag-Sandec as Leader of the Strategic Environmental Sanitation Planning Group. Since 2015 he heads the research department Sanitation, Water and Solid Waste for Development (Sandec) at the Swiss Federal Institute of Aquatic Research and Technology (Eawag).",institutionString:"Swiss Federal Institute of Aquatic Science and Technology, Switzerland",institution:null},editorTwo:{id:"290571",title:"Dr.",name:"Rui Alexandre",middleName:null,surname:"Castanho",slug:"rui-alexandre-castanho",fullName:"Rui Alexandre Castanho",profilePictureURL:"https://mts.intechopen.com/storage/users/290571/images/system/290571.jpg",biography:"Rui Alexandre Castanho has a master\\'s degree in Planning, Audit, and Control in Urban Green Spaces and an international Ph.D. in Sustainable Planning in Borderlands. Currently, he is a professor at WSB University, Poland, and a visiting professor at the University of Johannesburg, South Africa. Dr. Castanho is a post-doc researcher on the GREAT Project, University of Azores, Ponta Delgada, Portugal. He collaborates with the Environmental Resources Analysis Research Group (ARAM), University of Extremadura (UEx), Spain; VALORIZA - Research Center for the Enhancement of Endogenous Resources, Polytechnic Institute of Portalegre (IPP), Portugal; Centre for Tourism Research, Development and Innovation (CITUR), Madeira, Portugal; and AQUAGEO Research Group, University of Campinas (UNICAMP), Brazil.",institutionString:"University of Johannesburg, South Africa and WSB University, Poland",institution:{name:"University of Johannesburg",institutionURL:null,country:{name:"South Africa"}}},editorThree:null,series:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null},editorialBoard:[{id:"181486",title:"Dr.",name:"Claudia",middleName:null,surname:"Trillo",slug:"claudia-trillo",fullName:"Claudia Trillo",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSAZHQA4/Profile_Picture_2022-03-14T08:26:43.jpg",institutionString:null,institution:{name:"University of Salford",institutionURL:null,country:{name:"United Kingdom"}}},{id:"308328",title:"Dr.",name:"Dávid",middleName:null,surname:"Földes",slug:"david-foldes",fullName:"Dávid Földes",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002nXXGKQA4/Profile_Picture_2022-03-11T08:25:45.jpg",institutionString:null,institution:{name:"Budapest University of Technology and Economics",institutionURL:null,country:{name:"Hungary"}}},{id:"282172",title:"Dr.",name:"Ivan",middleName:null,surname:"Oropeza-Perez",slug:"ivan-oropeza-perez",fullName:"Ivan Oropeza-Perez",profilePictureURL:"https://mts.intechopen.com/storage/users/282172/images/system/282172.jpg",institutionString:"Universidad de las Américas Puebla",institution:{name:"Universidad de las Américas Puebla",institutionURL:null,country:{name:"Mexico"}}}]},onlineFirstChapters:{paginationCount:14,paginationItems:[{id:"82457",title:"Canine Hearing Management",doi:"10.5772/intechopen.105515",signatures:"Peter M. Skip Scheifele, Devan Marshall, Stephen Lee, Paul Reid, Thomas McCreery and David Byrne",slug:"canine-hearing-management",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Recent Advances in Canine Medicine",coverURL:"https://cdn.intechopen.com/books/images_new/11580.jpg",subseries:{id:"19",title:"Animal Science"}}},{id:"82285",title:"Parvovirus Vectors: The Future of Gene Therapy",doi:"10.5772/intechopen.105085",signatures:"Megha Gupta",slug:"parvovirus-vectors-the-future-of-gene-therapy",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Recent Advances in Canine Medicine",coverURL:"https://cdn.intechopen.com/books/images_new/11580.jpg",subseries:{id:"19",title:"Animal Science"}}},{id:"82170",title:"Equine Stress: Neuroendocrine Physiology and Pathophysiology",doi:"10.5772/intechopen.105045",signatures:"Milomir Kovac, Tatiana Vladimirovna Ippolitova, Sergey Pozyabin, Ruslan Aliev, Viktoria Lobanova, Nevena Drakul and Catrin S. 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