Microbial diseases associated with health care waste (Akter, 2010)
\\n\\n
Dr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\\n\\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\\n\\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\\n\\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\\n\\nThank you all for being part of the journey. 5,000 times thank you!
\\n\\nNow with 5,000 titles available Open Access, which one will you read next?
\\n\\nRead, share and download for free: https://www.intechopen.com/books
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Preparation of Space Experiments edited by international leading expert Dr. Vladimir Pletser, Director of Space Training Operations at Blue Abyss is the 5,000th Open Access book published by IntechOpen and our milestone publication!
\n\n"This book presents some of the current trends in space microgravity research. The eleven chapters introduce various facets of space research in physical sciences, human physiology and technology developed using the microgravity environment not only to improve our fundamental understanding in these domains but also to adapt this new knowledge for application on earth." says the editor. Listen what else Dr. Pletser has to say...
\n\n\n\nDr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\n\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\n\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\n\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\n\nThank you all for being part of the journey. 5,000 times thank you!
\n\nNow with 5,000 titles available Open Access, which one will you read next?
\n\nRead, share and download for free: https://www.intechopen.com/books
\n\n\n\n
\n'}],latestNews:[{slug:"stanford-university-identifies-top-2-scientists-over-1-000-are-intechopen-authors-and-editors-20210122",title:"Stanford University Identifies Top 2% Scientists, Over 1,000 are IntechOpen Authors and Editors"},{slug:"intechopen-authors-included-in-the-highly-cited-researchers-list-for-2020-20210121",title:"IntechOpen Authors Included in the Highly Cited Researchers List for 2020"},{slug:"intechopen-maintains-position-as-the-world-s-largest-oa-book-publisher-20201218",title:"IntechOpen Maintains Position as the World’s Largest OA Book Publisher"},{slug:"all-intechopen-books-available-on-perlego-20201215",title:"All IntechOpen Books Available on Perlego"},{slug:"oiv-awards-recognizes-intechopen-s-editors-20201127",title:"OIV Awards Recognizes IntechOpen's Editors"},{slug:"intechopen-joins-crossref-s-initiative-for-open-abstracts-i4oa-to-boost-the-discovery-of-research-20201005",title:"IntechOpen joins Crossref's Initiative for Open Abstracts (I4OA) to Boost the Discovery of Research"},{slug:"intechopen-hits-milestone-5-000-open-access-books-published-20200908",title:"IntechOpen hits milestone: 5,000 Open Access books published!"},{slug:"intechopen-books-hosted-on-the-mathworks-book-program-20200819",title:"IntechOpen Books Hosted on the MathWorks Book Program"}]},book:{item:{type:"book",id:"6678",leadTitle:null,fullTitle:"Antioxidants in Foods and Its Applications",title:"Antioxidants in Foods and Its Applications",subtitle:null,reviewType:"peer-reviewed",abstract:'Free radicals are atoms or molecules containing unpaired electrons. Damage occurs when the free radical encounters another molecule and seeks to find another electron to pair its unpaired electron. Free radicals can cause mutation in different biological compounds such as protein, nucleic acids, and lipids, and the damage caused by the free radicals lead to various diseases (cancer, cardiovascular disease, aging, etc.). Antioxidants are helpful in reducing and preventing damage from free radical reactions because of their ability to donate electrons, which neutralize the radical without forming another. Ascorbic acid, for example, can lose an electron to a free radical and remain stable itself by passing its unstable electron around the antioxidant molecule. Unfortunately, new data indicate that the synthetic antioxidants used in the industry could have carcinogenic effects on human cells, thus fueling an intense search for new, natural, and efficient antioxidants. Therefore, the current book discusses the role and source of antioxidant compounds in nutrition and diets. Also, the current book includes nine chapters contributed by experts around the world, and the chapters are categorized into two sections: "Antioxidant Compounds and Biological Activities" and "Natural Antioxidants and Applications."',isbn:"978-1-78923-379-7",printIsbn:"978-1-78923-378-0",pdfIsbn:"978-1-83881-640-7",doi:"10.5772/intechopen.72008",price:119,priceEur:129,priceUsd:155,slug:"antioxidants-in-foods-and-its-applications",numberOfPages:178,isOpenForSubmission:!1,isInWos:1,hash:"819eb2d8d2c889ef23affd7fd01e4e98",bookSignature:"Emad Shalaby and Ghada Mostafa Azzam",publishedDate:"July 11th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6678.jpg",numberOfDownloads:11646,numberOfWosCitations:24,numberOfCrossrefCitations:23,numberOfDimensionsCitations:41,hasAltmetrics:1,numberOfTotalCitations:88,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 3rd 2017",dateEndSecondStepPublish:"November 24th 2017",dateEndThirdStepPublish:"January 23rd 2018",dateEndFourthStepPublish:"April 13th 2018",dateEndFifthStepPublish:"June 12th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,editors:[{id:"63600",title:"Prof.",name:"Emad",middleName:null,surname:"Shalaby",slug:"emad-shalaby",fullName:"Emad Shalaby",profilePictureURL:"https://mts.intechopen.com/storage/users/63600/images/system/63600.png",biography:"Dr. Emad Shalaby is a professor of biochemistry on the Biochemistry Department Faculty of Agriculture, Cairo University. He\nreceived a short-term scholarship to carry out his post-doctoral\nstudies abroad, from Japan International Cooperation Agency\n(JICA), in coordination with the Egyptian government. Dr.\nShalaby speaks fluent English and his native Arabic. He has 77\ninternationally published research papers, has attended 15 international conferences, and has contributed to 18 international books and chapters.\nDr. Shalaby works as a reviewer on over one hundred international journals and is\non the editorial board of more than twenty-five international journals. He is a member of seven international specialized scientific societies, besides his local one, and\nhe has won seven prizes.",institutionString:"Cairo University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Cairo University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"217233",title:"Dr.",name:"Ghada Mostafa",middleName:null,surname:"Azzam",slug:"ghada-mostafa-azzam",fullName:"Ghada Mostafa Azzam",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"323",title:"Food and Nutrition",slug:"food-and-nutrition"}],chapters:[{id:"60270",title:"Antioxidants from Natural Sources",doi:"10.5772/intechopen.75961",slug:"antioxidants-from-natural-sources",totalDownloads:3073,totalCrossrefCites:8,totalDimensionsCites:16,signatures:"Haseeb Anwar, Ghulam Hussain and Imtiaz Mustafa",downloadPdfUrl:"/chapter/pdf-download/60270",previewPdfUrl:"/chapter/pdf-preview/60270",authors:[{id:"240684",title:"Dr.",name:"Haseeb",surname:"Anwar",slug:"haseeb-anwar",fullName:"Haseeb Anwar"},{id:"244522",title:"Dr.",name:"Ghulam",surname:"Hussain",slug:"ghulam-hussain",fullName:"Ghulam Hussain"},{id:"244523",title:"Ms.",name:"Jaweria",surname:"Nisar",slug:"jaweria-nisar",fullName:"Jaweria Nisar"},{id:"244524",title:"Mr.",name:"Imtiaz",surname:"Mustafa",slug:"imtiaz-mustafa",fullName:"Imtiaz Mustafa"}],corrections:null},{id:"60113",title:"Biological Activities of Plants from Genus Annona",doi:"10.5772/intechopen.75299",slug:"biological-activities-of-plants-from-genus-annona",totalDownloads:1271,totalCrossrefCites:0,totalDimensionsCites:0,signatures:"Norma Francenia Santos-Sánchez, Raúl Salas-Coronado, Beatriz\nHernández-Carlos, Aleyda Pérez-Herrera and Dora Jhanina\nRodríguez-Fernández",downloadPdfUrl:"/chapter/pdf-download/60113",previewPdfUrl:"/chapter/pdf-preview/60113",authors:[{id:"148546",title:"Dr.",name:"Norma Francenia",surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez"},{id:"193718",title:"Dr.",name:"Beatriz",surname:"Hernández-Carlos",slug:"beatriz-hernandez-carlos",fullName:"Beatriz Hernández-Carlos"},{id:"234670",title:"Dr.",name:"Raúl",surname:"Salas-Coronado",slug:"raul-salas-coronado",fullName:"Raúl Salas-Coronado"},{id:"235943",title:"Dr.",name:"Aleyda",surname:"Pérez-Herrera",slug:"aleyda-perez-herrera",fullName:"Aleyda Pérez-Herrera"},{id:"235944",title:"MSc.",name:"Dora Jhanina",surname:"Rodríguez-Fernández",slug:"dora-jhanina-rodriguez-fernandez",fullName:"Dora Jhanina Rodríguez-Fernández"}],corrections:null},{id:"60461",title:"Biological Activities of the Doum Palm (Hyphaene thebaica L.) Extract and Its Bioactive Components",doi:"10.5772/intechopen.74772",slug:"biological-activities-of-the-doum-palm-hyphaene-thebaica-l-extract-and-its-bioactive-components",totalDownloads:3005,totalCrossrefCites:5,totalDimensionsCites:9,signatures:"Hossam S. El-Beltagi, Heba I. Mohamed, Hany N. Yousef and Eman\nM. Fawzi",downloadPdfUrl:"/chapter/pdf-download/60461",previewPdfUrl:"/chapter/pdf-preview/60461",authors:[{id:"138817",title:"Dr.",name:"Heba",surname:"Mohamed",slug:"heba-mohamed",fullName:"Heba Mohamed"},{id:"240003",title:"Prof.",name:"Hossam",surname:"El-Beltagi",slug:"hossam-el-beltagi",fullName:"Hossam El-Beltagi"},{id:"251695",title:"Prof.",name:"Eman",surname:"Fawzi",slug:"eman-fawzi",fullName:"Eman Fawzi"},{id:"251950",title:"Dr.",name:"Hany",surname:"Yousef",slug:"hany-yousef",fullName:"Hany Yousef"}],corrections:null},{id:"60078",title:"Natural Beverages and Sensory Quality Based on Phenolic Contents",doi:"10.5772/intechopen.74823",slug:"natural-beverages-and-sensory-quality-based-on-phenolic-contents",totalDownloads:640,totalCrossrefCites:3,totalDimensionsCites:3,signatures:"Saúl Saucedo-Pompa, Guillermo Cristian Guadalupe Martínez-Ávila,\nRomeo Rojas-Molina and Ernesto Javier Sánchez-Alejo",downloadPdfUrl:"/chapter/pdf-download/60078",previewPdfUrl:"/chapter/pdf-preview/60078",authors:[{id:"180273",title:"Dr.",name:"Guillermo",surname:"Martínez-Ávila",slug:"guillermo-martinez-avila",fullName:"Guillermo Martínez-Ávila"},{id:"242293",title:"Dr.",name:"Ernesto J.",surname:"Sánchez-Alejo",slug:"ernesto-j.-sanchez-alejo",fullName:"Ernesto J. Sánchez-Alejo"},{id:"242294",title:"MSc.",name:"Saúl",surname:"Saucedo-Pompa",slug:"saul-saucedo-pompa",fullName:"Saúl Saucedo-Pompa"},{id:"242295",title:"Dr.",name:"Romeo",surname:"Rojas",slug:"romeo-rojas",fullName:"Romeo Rojas"}],corrections:null},{id:"60554",title:"Plant Extracts as Antioxidant Additives for Food Industry",doi:"10.5772/intechopen.75444",slug:"plant-extracts-as-antioxidant-additives-for-food-industry",totalDownloads:1376,totalCrossrefCites:0,totalDimensionsCites:3,signatures:"Ludy C. Pabón-Baquero, Ángela María Otálvaro-Álvarez, Margarita\nRosa Rendón Fernández and María Patricia Chaparro-González",downloadPdfUrl:"/chapter/pdf-download/60554",previewPdfUrl:"/chapter/pdf-preview/60554",authors:[{id:"236194",title:"M.Sc.",name:"Ludy C.",surname:"Pabón Baquero",slug:"ludy-c.-pabon-baquero",fullName:"Ludy C. Pabón Baquero"},{id:"236204",title:"MSc.",name:"Margarita R.",surname:"Rendón F.",slug:"margarita-r.-rendon-f.",fullName:"Margarita R. Rendón F."},{id:"236205",title:"MSc.",name:"María Patricia",surname:"Chaparro G.",slug:"maria-patricia-chaparro-g.",fullName:"María Patricia Chaparro G."},{id:"236206",title:"Dr.Ing.",name:"Ángela María",surname:"Otálvaro Álvarez",slug:"angela-maria-otalvaro-alvarez",fullName:"Ángela María Otálvaro Álvarez"}],corrections:null},{id:"59636",title:"Traditional Foods as Putative Sources of Antioxidants with Health Benefits in Konzo",doi:"10.5772/intechopen.74523",slug:"traditional-foods-as-putative-sources-of-antioxidants-with-health-benefits-in-konzo",totalDownloads:719,totalCrossrefCites:1,totalDimensionsCites:1,signatures:"Paulin Mutwale Kapepula, Désiré Tshala-Katumbay, Dieudonné\nMumba, Michel Frédérich, Théophile Mbemba and Nadege\nKabamba Ngombe",downloadPdfUrl:"/chapter/pdf-download/59636",previewPdfUrl:"/chapter/pdf-preview/59636",authors:[{id:"235679",title:"Prof.",name:"Paulin",surname:"Mutwale Kapepula",slug:"paulin-mutwale-kapepula",fullName:"Paulin Mutwale Kapepula"},{id:"241925",title:"Prof.",name:"Désiré",surname:"Tshala-Katumbay",slug:"desire-tshala-katumbay",fullName:"Désiré Tshala-Katumbay"},{id:"241926",title:"Prof.",name:"Dieudonné",surname:"Mumba",slug:"dieudonne-mumba",fullName:"Dieudonné Mumba"},{id:"241927",title:"Prof.",name:"Michel",surname:"Frédérich",slug:"michel-frederich",fullName:"Michel Frédérich"},{id:"241930",title:"Prof.",name:"Théophile",surname:"Mbemba",slug:"theophile-mbemba",fullName:"Théophile Mbemba"},{id:"241931",title:"Prof.",name:"Nadège",surname:"Ngombe Kabamba",slug:"nadege-ngombe-kabamba",fullName:"Nadège Ngombe Kabamba"}],corrections:null},{id:"60194",title:"Antioxidants in Maca (Lepidium meyenii) as a Supplement in Nutrition",doi:"10.5772/intechopen.75582",slug:"antioxidants-in-maca-lepidium-meyenii-as-a-supplement-in-nutrition",totalDownloads:862,totalCrossrefCites:3,totalDimensionsCites:6,signatures:"Serol Korkmaz",downloadPdfUrl:"/chapter/pdf-download/60194",previewPdfUrl:"/chapter/pdf-preview/60194",authors:[{id:"234259",title:"Dr.",name:"Serol",surname:"Korkmaz",slug:"serol-korkmaz",fullName:"Serol Korkmaz"}],corrections:null},{id:"59906",title:"The Use of Iodine, Selenium, and Silicon in Plant Nutrition for the Increase of Antioxidants in Fruits and Vegetables",doi:"10.5772/intechopen.75069",slug:"the-use-of-iodine-selenium-and-silicon-in-plant-nutrition-for-the-increase-of-antioxidants-in-fruits",totalDownloads:725,totalCrossrefCites:3,totalDimensionsCites:3,signatures:"Julia Medrano-Macías, Rosalinda Mendoza-Villarreal, Valentín\nRobledo-Torres, Laura Olivia Fuentes-Lara, Francisca Ramírez-\nGodina, Miguel Ángel Pérez-Rodríguez and Adalberto Benavides-\nMendoza",downloadPdfUrl:"/chapter/pdf-download/59906",previewPdfUrl:"/chapter/pdf-preview/59906",authors:[{id:"213225",title:"Dr.",name:"Adalberto",surname:"Benavides Mendoza",slug:"adalberto-benavides-mendoza",fullName:"Adalberto Benavides Mendoza"},{id:"214612",title:"Mrs.",name:"Julia",surname:"Medrano-Macías",slug:"julia-medrano-macias",fullName:"Julia Medrano-Macías"},{id:"233122",title:"Dr.",name:"Rosalinda",surname:"Mendoza-Villareal",slug:"rosalinda-mendoza-villareal",fullName:"Rosalinda Mendoza-Villareal"},{id:"233123",title:"Dr.",name:"Valentin",surname:"Robledo Torres",slug:"valentin-robledo-torres",fullName:"Valentin Robledo Torres"},{id:"233124",title:"Dr.",name:"Francisca",surname:"Ramirez-Godina",slug:"francisca-ramirez-godina",fullName:"Francisca Ramirez-Godina"},{id:"233274",title:"Dr.",name:"Miguel Angel",surname:"Perez-Rodriguez",slug:"miguel-angel-perez-rodriguez",fullName:"Miguel Angel Perez-Rodriguez"},{id:"240863",title:"Dr.",name:"Laura Olivia",surname:"Fuentes-Lara",slug:"laura-olivia-fuentes-lara",fullName:"Laura Olivia Fuentes-Lara"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},relatedBooks:[{type:"book",id:"8008",title:"Antioxidants",subtitle:null,isOpenForSubmission:!1,hash:"76361b4061e830906267933c1c670027",slug:"antioxidants",bookSignature:"Emad Shalaby",coverURL:"https://cdn.intechopen.com/books/images_new/8008.jpg",editedByType:"Edited by",editors:[{id:"63600",title:"Prof.",name:"Emad",surname:"Shalaby",slug:"emad-shalaby",fullName:"Emad Shalaby"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"497",title:"Soybean and Nutrition",subtitle:null,isOpenForSubmission:!1,hash:"11aa0c9ed0f6ea8da765be93b50954bb",slug:"soybean-and-nutrition",bookSignature:"Hany El-Shemy",coverURL:"https://cdn.intechopen.com/books/images_new/497.jpg",editedByType:"Edited by",editors:[{id:"54719",title:"Prof.",name:"Hany",surname:"El-Shemy",slug:"hany-el-shemy",fullName:"Hany El-Shemy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"496",title:"Soybean and Health",subtitle:null,isOpenForSubmission:!1,hash:"66d40dbc031b2825ba95f7ac2bfae1b6",slug:"soybean-and-health",bookSignature:"Hany El-Shemy",coverURL:"https://cdn.intechopen.com/books/images_new/496.jpg",editedByType:"Edited by",editors:[{id:"54719",title:"Prof.",name:"Hany",surname:"El-Shemy",slug:"hany-el-shemy",fullName:"Hany El-Shemy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1018",title:"Milk Production",subtitle:"An Up-to-Date Overview of Animal Nutrition, Management and Health",isOpenForSubmission:!1,hash:"0666bd242c21546d0c83c0290bd114ea",slug:"milk-production-an-up-to-date-overview-of-animal-nutrition-management-and-health",bookSignature:"Narongsak Chaiyabutr",coverURL:"https://cdn.intechopen.com/books/images_new/1018.jpg",editedByType:"Edited by",editors:[{id:"76047",title:"Prof.",name:"Narongsak",surname:"Chaiyabutr",slug:"narongsak-chaiyabutr",fullName:"Narongsak Chaiyabutr"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2066",title:"Milk Production",subtitle:"Advanced Genetic Traits, Cellular Mechanism, Animal Management and Health",isOpenForSubmission:!1,hash:"0bce9f57b06503666b182457b414a9de",slug:"milk-production-advanced-genetic-traits-cellular-mechanism-animal-management-and-health",bookSignature:"Narongsak Chaiyabutr",coverURL:"https://cdn.intechopen.com/books/images_new/2066.jpg",editedByType:"Edited by",editors:[{id:"76047",title:"Prof.",name:"Narongsak",surname:"Chaiyabutr",slug:"narongsak-chaiyabutr",fullName:"Narongsak Chaiyabutr"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6155",title:"Diabetes Food Plan",subtitle:null,isOpenForSubmission:!1,hash:"b826ff12304ae270954a41210f4e1582",slug:"diabetes-food-plan",bookSignature:"Viduranga Waisundara",coverURL:"https://cdn.intechopen.com/books/images_new/6155.jpg",editedByType:"Edited by",editors:[{id:"194281",title:"Dr.",name:"Viduranga Yashasvi",surname:"Waisundara",slug:"viduranga-yashasvi-waisundara",fullName:"Viduranga Yashasvi Waisundara"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6538",title:"Current Topics on Superfoods",subtitle:null,isOpenForSubmission:!1,hash:"42525eaf5a539bc1e2318f4eb8dfea5a",slug:"current-topics-on-superfoods",bookSignature:"Naofumi Shiomi",coverURL:"https://cdn.intechopen.com/books/images_new/6538.jpg",editedByType:"Edited by",editors:[{id:"163777",title:"Prof.",name:"Naofumi",surname:"Shiomi",slug:"naofumi-shiomi",fullName:"Naofumi Shiomi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8030",title:"Malnutrition",subtitle:null,isOpenForSubmission:!1,hash:"d8254ed8fa15ca6eb142607d145873df",slug:"malnutrition",bookSignature:"Muhammad Imran and Ali Imran",coverURL:"https://cdn.intechopen.com/books/images_new/8030.jpg",editedByType:"Edited by",editors:[{id:"194146",title:"Dr.",name:"Muhammad",surname:"Imran",slug:"muhammad-imran",fullName:"Muhammad Imran"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8023",title:"Honey Analysis",subtitle:"New Advances and Challenges",isOpenForSubmission:!1,hash:"d0cd45987714a9e6f8e5f9cf7fe67495",slug:"honey-analysis-new-advances-and-challenges",bookSignature:"Vagner de Alencar Arnaut de Toledo and Emerson Dechechi Chambó",coverURL:"https://cdn.intechopen.com/books/images_new/8023.jpg",editedByType:"Edited by",editors:[{id:"117226",title:"Prof.",name:"Vagner De Alencar",surname:"Arnaut De Toledo",slug:"vagner-de-alencar-arnaut-de-toledo",fullName:"Vagner De Alencar Arnaut De Toledo"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8926",title:"The Health Benefits of Foods",subtitle:"Current Knowledge and Further Development",isOpenForSubmission:!1,hash:"fc0b94fd149503cbe9b4ff3fc06e969e",slug:"the-health-benefits-of-foods-current-knowledge-and-further-development",bookSignature:"Liana Claudia Salanță",coverURL:"https://cdn.intechopen.com/books/images_new/8926.jpg",editedByType:"Edited by",editors:[{id:"203097",title:"Dr.",name:"Liana Claudia",surname:"Salanta",slug:"liana-claudia-salanta",fullName:"Liana Claudia Salanta"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"57158",slug:"correction-to-chemical-composition-and-biological-activities-of-mentha-species",title:"Correction to: Chemical Composition and Biological Activities of Mentha Species",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/57158.pdf",downloadPdfUrl:"/chapter/pdf-download/57158",previewPdfUrl:"/chapter/pdf-preview/57158",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/57158",risUrl:"/chapter/ris/57158",chapter:{id:"54028",slug:"chemical-composition-and-biological-activities-of-mentha-species",signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",dateSubmitted:"June 7th 2016",dateReviewed:"December 19th 2016",datePrePublished:null,datePublished:"March 15th 2017",book:{id:"5612",title:"Aromatic and Medicinal Plants",subtitle:"Back to Nature",fullTitle:"Aromatic and Medicinal Plants - Back to Nature",slug:"aromatic-and-medicinal-plants-back-to-nature",publishedDate:"March 15th 2017",bookSignature:"Hany A. El-Shemy",coverURL:"https://cdn.intechopen.com/books/images_new/5612.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"54719",title:"Prof.",name:"Hany",middleName:null,surname:"El-Shemy",slug:"hany-el-shemy",fullName:"Hany El-Shemy"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",fullName:"Fatiha Brahmi",slug:"fatiha-brahmi",email:"fatiha.brahmi@univ-bejaia.dz",position:null,institution:{name:"University of Béjaïa",institutionURL:null,country:{name:"Algeria"}}},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",fullName:"Khodir Madani",slug:"khodir-madani",email:"madani28dz@yahoo.fr",position:null,institution:null},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",fullName:"Pierre Duez",slug:"pierre-duez",email:"pduez@umons.be",position:null,institution:null},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",fullName:"Mohamed Chibane",slug:"mohamed-chibane",email:"chibanem@yahoo.fr",position:null,institution:null}]}},chapter:{id:"54028",slug:"chemical-composition-and-biological-activities-of-mentha-species",signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",dateSubmitted:"June 7th 2016",dateReviewed:"December 19th 2016",datePrePublished:null,datePublished:"March 15th 2017",book:{id:"5612",title:"Aromatic and Medicinal Plants",subtitle:"Back to Nature",fullTitle:"Aromatic and Medicinal Plants - Back to Nature",slug:"aromatic-and-medicinal-plants-back-to-nature",publishedDate:"March 15th 2017",bookSignature:"Hany A. El-Shemy",coverURL:"https://cdn.intechopen.com/books/images_new/5612.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"54719",title:"Prof.",name:"Hany",middleName:null,surname:"El-Shemy",slug:"hany-el-shemy",fullName:"Hany El-Shemy"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",fullName:"Fatiha Brahmi",slug:"fatiha-brahmi",email:"fatiha.brahmi@univ-bejaia.dz",position:null,institution:{name:"University of Béjaïa",institutionURL:null,country:{name:"Algeria"}}},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",fullName:"Khodir Madani",slug:"khodir-madani",email:"madani28dz@yahoo.fr",position:null,institution:null},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",fullName:"Pierre Duez",slug:"pierre-duez",email:"pduez@umons.be",position:null,institution:null},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",fullName:"Mohamed Chibane",slug:"mohamed-chibane",email:"chibanem@yahoo.fr",position:null,institution:null}]},book:{id:"5612",title:"Aromatic and Medicinal Plants",subtitle:"Back to Nature",fullTitle:"Aromatic and Medicinal Plants - Back to Nature",slug:"aromatic-and-medicinal-plants-back-to-nature",publishedDate:"March 15th 2017",bookSignature:"Hany A. El-Shemy",coverURL:"https://cdn.intechopen.com/books/images_new/5612.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"54719",title:"Prof.",name:"Hany",middleName:null,surname:"El-Shemy",slug:"hany-el-shemy",fullName:"Hany El-Shemy"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"8440",leadTitle:null,title:"Nanoemulsions",subtitle:"Properties, Fabrications and Applications",reviewType:"peer-reviewed",abstract:"Fluidics, an increasingly examined topic in nanoscience and nanotechnology is often discussed with regard to the handling of fluid flow, material processing, and material synthesis in innovative devices ranging from the macroscale to the nanoscale. Nanoemulsions - Properties, Fabrications and Applications reviews key concepts in nanoscale fluid mechanics, its corresponding properties, as well as the latest trends in nanofluidics applications. With attention to the fundamentals as well as advanced applications of fluidics, this book imparts a solid knowledge base and develops skill for future problem-solving and system analysis. This is a vital resource for upper-level engineering students who want to expand their potential career opportunities and familiarize themselves with an increasingly important field.",isbn:"978-1-78984-176-3",printIsbn:"978-1-78984-175-6",pdfIsbn:"978-1-83881-939-2",doi:"10.5772/intechopen.78812",price:119,priceEur:129,priceUsd:155,slug:"nanoemulsions-properties-fabrications-and-applications",numberOfPages:136,isOpenForSubmission:!1,hash:"d753b932aeea0109c1ab04d6745d4941",bookSignature:"Kai Seng Koh and Voon Loong Wong",publishedDate:"September 11th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/8440.jpg",keywords:null,numberOfDownloads:4262,numberOfWosCitations:9,numberOfCrossrefCitations:13,numberOfDimensionsCitations:26,numberOfTotalCitations:48,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 17th 2018",dateEndSecondStepPublish:"October 8th 2018",dateEndThirdStepPublish:"December 7th 2018",dateEndFourthStepPublish:"February 25th 2019",dateEndFifthStepPublish:"April 26th 2019",remainingDaysToSecondStep:"2 years",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:"Edited by",kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"222878",title:"Dr.",name:"Kai Seng",middleName:null,surname:"Koh",slug:"kai-seng-koh",fullName:"Kai Seng Koh",profilePictureURL:"https://mts.intechopen.com/storage/users/222878/images/system/222878.png",biography:"Kai Seng, KOH is an assistant professor in Chemical Engineering from Heriot-Watt University Malaysia. He has a broad range of academic as well as industry interests including microscale fluid dynamics, multiphase flow, MEMS device packaging of design and fabrication, energetic material synthesis and characterization, and life science application using the technology of droplet microfluidic. Dr. Koh currently resides in Kuala Lumpur, Malaysia with his family and travels to different countries for research inspiration is his main hobby.",institutionString:"Heriot-Watt University Campus",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Heriot-Watt University",institutionURL:null,country:{name:"United Kingdom"}}}],coeditorOne:{id:"224066",title:"Dr.",name:"Voon Loong",middleName:null,surname:"Wong",slug:"voon-loong-wong",fullName:"Voon Loong Wong",profilePictureURL:"https://mts.intechopen.com/storage/users/224066/images/system/224066.png",biography:"Dr. Wong Voon Loong obtained his Bachelor Degree of Chemical Engineering with First Class Honours (Book Prize Winner) from Universiti Tunku Abdul Rahman in 2010. He continued his studies at the University of Nottingham and graduated with a PhD Degree in Chemical Engineering in 2015. Wong Voon Loong’s research focuses on multiphase flow and transport phenomena in microfluidic systems. Currently, he is also involved as a key team member of research projects in the field of solar photovoltaic, particles synthesis for wastewater treatment and drug delivery system. He\ncurrently serves as an Assistant Professor at Heriot Watt University\nMalaysia Campus.",institutionString:"Heriot-Watt University Campus",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"508",title:"Nanochemistry",slug:"chemistry-physical-chemistry-nanochemistry"}],chapters:[{id:"67779",title:"Introductory Chapter: From Microemulsions to Nanoemulsions",slug:"introductory-chapter-from-microemulsions-to-nanoemulsions",totalDownloads:425,totalCrossrefCites:1,authors:[{id:"222878",title:"Dr.",name:"Kai Seng",surname:"Koh",slug:"kai-seng-koh",fullName:"Kai Seng Koh"},{id:"224066",title:"Dr.",name:"Voon Loong",surname:"Wong",slug:"voon-loong-wong",fullName:"Voon Loong Wong"}]},{id:"65648",title:"In vitro Antimicrobial Activity Evaluation of Metal Oxide Nanoparticles",slug:"-em-in-vitro-em-antimicrobial-activity-evaluation-of-metal-oxide-nanoparticles",totalDownloads:1061,totalCrossrefCites:7,authors:[{id:"272164",title:"Dr.",name:"Alejandro",surname:"Vega-Jiménez",slug:"alejandro-vega-jimenez",fullName:"Alejandro Vega-Jiménez"},{id:"273073",title:"Dr.",name:"América",surname:"Vázquez-Olmos",slug:"america-vazquez-olmos",fullName:"América Vázquez-Olmos"},{id:"273075",title:"Dr.",name:"Enrique",surname:"Acosta-Gío",slug:"enrique-acosta-gio",fullName:"Enrique Acosta-Gío"},{id:"273078",title:"Dr.",name:"Marco Antonio",surname:"Alvarez-Pérez",slug:"marco-antonio-alvarez-perez",fullName:"Marco Antonio Alvarez-Pérez"}]},{id:"67020",title:"Nanoformulated Delivery Systems of Essential Nutraceuticals and Their Applications",slug:"nanoformulated-delivery-systems-of-essential-nutraceuticals-and-their-applications",totalDownloads:458,totalCrossrefCites:1,authors:[{id:"275575",title:"Prof.",name:"Lebogang",surname:"Katata-Seru",slug:"lebogang-katata-seru",fullName:"Lebogang Katata-Seru"},{id:"300636",title:"Dr.",name:"Bathabile",surname:"Ramalapa",slug:"bathabile-ramalapa",fullName:"Bathabile Ramalapa"},{id:"300637",title:"Mr.",name:"Lesego",surname:"Tshweu",slug:"lesego-tshweu",fullName:"Lesego Tshweu"}]},{id:"65728",title:"Development of Nano-Emulsions of Essential Citrus Oil Stabilized with Mesquite Gum",slug:"development-of-nano-emulsions-of-essential-citrus-oil-stabilized-with-mesquite-gum",totalDownloads:578,totalCrossrefCites:0,authors:[{id:"93593",title:"Dr.",name:"Margarita",surname:"Sanchez-Dominguez",slug:"margarita-sanchez-dominguez",fullName:"Margarita Sanchez-Dominguez"},{id:"284208",title:"Dr.",name:"Maira B.",surname:"Moreno-Trejo",slug:"maira-b.-moreno-trejo",fullName:"Maira B. Moreno-Trejo"},{id:"284211",title:"Dr.",name:"Angela",surname:"Suarez-Jacobo",slug:"angela-suarez-jacobo",fullName:"Angela Suarez-Jacobo"},{id:"290287",title:"Dr.",name:"Arturo A.",surname:"Rodríguez-Rodríguez",slug:"arturo-a.-rodriguez-rodriguez",fullName:"Arturo A. Rodríguez-Rodríguez"}]},{id:"66445",title:"An Update on Nanoemulsions Using Nanosized Liquid in Liquid Colloidal Systems",slug:"an-update-on-nanoemulsions-using-nanosized-liquid-in-liquid-colloidal-systems",totalDownloads:809,totalCrossrefCites:2,authors:[{id:"271775",title:"Dr.",name:"Praveen Kumar",surname:"Gupta",slug:"praveen-kumar-gupta",fullName:"Praveen Kumar Gupta"},{id:"288900",title:"Ms.",name:"Nividha",surname:"Bhandari",slug:"nividha-bhandari",fullName:"Nividha Bhandari"},{id:"288901",title:"Mr.",name:"Hardik",surname:"N Shah",slug:"hardik-n-shah",fullName:"Hardik N Shah"},{id:"288902",title:"Ms.",name:"Vartika",surname:"Khanchandani",slug:"vartika-khanchandani",fullName:"Vartika Khanchandani"},{id:"288903",title:"Ms.",name:"Keerthana",surname:"R",slug:"keerthana-r",fullName:"Keerthana R"},{id:"288904",title:"Ms.",name:"Vidhyavathy",surname:"Nagarajan",slug:"vidhyavathy-nagarajan",fullName:"Vidhyavathy Nagarajan"},{id:"288954",title:"Dr.",name:"Lingayya",surname:"Hiremath",slug:"lingayya-hiremath",fullName:"Lingayya Hiremath"}]},{id:"66762",title:"Importance of Surface Energy in Nanoemulsion",slug:"importance-of-surface-energy-in-nanoemulsion",totalDownloads:553,totalCrossrefCites:2,authors:[{id:"280003",title:"Dr.",name:"Kaustav",surname:"Bhattacharjee",slug:"kaustav-bhattacharjee",fullName:"Kaustav Bhattacharjee"}]},{id:"65520",title:"Synthesis, Properties, and Characterization of Field’s Alloy Nanoparticles and Its Slurry",slug:"synthesis-properties-and-characterization-of-field-s-alloy-nanoparticles-and-its-slurry",totalDownloads:382,totalCrossrefCites:0,authors:[{id:"277158",title:"Associate Prof.",name:"Chaoming",surname:"Wang",slug:"chaoming-wang",fullName:"Chaoming Wang"},{id:"288713",title:"Mrs.",name:"Xinran",surname:"Zhang",slug:"xinran-zhang",fullName:"Xinran Zhang"},{id:"288714",title:"Mr.",name:"Wenbing",surname:"Jia",slug:"wenbing-jia",fullName:"Wenbing Jia"},{id:"290365",title:"Dr.",name:"Wei",surname:"Wu",slug:"wei-wu",fullName:"Wei Wu"},{id:"290366",title:"Prof.",name:"Louis",surname:"Chow",slug:"louis-chow",fullName:"Louis Chow"}]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"252211",firstName:"Sara",lastName:"Debeuc",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/252211/images/7239_n.png",email:"sara.d@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"5849",title:"Molecular Self-assembly in Nanoscience and Nanotechnology",subtitle:null,isOpenForSubmission:!1,hash:"ed0dd5b8311f232ce2a0e51f907f7ac5",slug:"molecular-self-assembly-in-nanoscience-and-nanotechnology",bookSignature:"Ayben Kilislioğlu and Selcan Karakuş",coverURL:"https://cdn.intechopen.com/books/images_new/5849.jpg",editedByType:"Edited by",editors:[{id:"139903",title:"Prof.",name:"Ayben",surname:"Kilislioglu",slug:"ayben-kilislioglu",fullName:"Ayben Kilislioglu"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"44569",title:"Health Care Waste Management – Public Health Benefits, and the Need for Effective Environmental Regulatory Surveillance in Federal Republic of Nigeria",doi:"10.5772/53196",slug:"health-care-waste-management-public-health-benefits-and-the-need-for-effective-environmental-regulat",body:'\n
Waste generated by health care activities includes a broad range of materials, from used needles and syringes to soiled dressings, body parts, diagnostic samples, blood, chemicals, pharmaceuticals, medical devices and radioactive materials (WHO, 2011).
\nPoor management of health care waste potentially exposes health care workers, waste handlers, patients and the community at large to infection, toxic effects and injuries, and risks polluting the environment. It is essential that all medical waste materials are segregated at the point of generation, appropriately treated and disposed of safely(WHO, 2011). Healthcare waste (HCW) is a by-product of healthcare that includes sharps, non-sharps, blood, body parts, chemicals, pharmaceuticals, medical devices and radioactive materials.
\nWHO Programme activities include developing technical guidance materials for assessing the quantities and types of waste produced in different facilities, creating national action plans, developing national healthcare waste management (HCWM) guidelines and building capacity at national level to enhance the way HCW is dealt with in low-income countries (LICs).
\nClassification of Health Care wastes shows that
\nOf the total amount of waste generated by health-care activities, about 80% is general waste.
The remaining 20% is considered hazardous material that may be infectious, toxic or radioactive.
Every year an estimated 16 000 million injections are administered worldwide, but not all of the needles and syringes are properly disposed of afterwards.
Health-care waste contains potentially harmful micro organisms which can infect hospital patients, health-care workers and the general public.
Health-care activities protect and restore health and save lives. But what about the wastes and by-products they generate
\n\n Types of waste\n
\nWaste and by-products cover a diverse range of materials, as the following list illustrates (percentages are approximate values):
\n\n Infectious waste: waste contaminated with blood and its by-products, cultures and stocks of infectious agents, waste from patients in isolation wards, discarded diagnostic samples containing blood and body fluids, infected animals from laboratories, and contaminated materials (swabs, bandages) and equipment (such as disposable medical devices); are considered as infectious waste, all wastes that are susceptible to contain pathogens (or their toxins) in sufficient concentration to cause diseases to a potential host. Examples of infectious waste include discarded materials or equipment, used for the diagnosis, treatment and prevention of disease that has been in contact with body fluids (dressings, swabs, nappies, blood bags…). This category also includes liquid waste such as faeces, urine, blood or other body secretions (such as sputum or lung secretions).
\n\n Pathological waste: recognizable body parts and contaminated animal carcasses; Pathological waste consists of organs, tissues, body parts or fluids such as blood. Even if pathological waste may contain healthy body parts, it has to be considered as infectious waste for precautionary reasons.
\n\n Anatomical waste is a sub-group of pathological waste and consists in recognisable human body parts, whether they may be infected or not. Following the precautionary principles, anatomical waste is always considered as potential infectious waste.
\n\n Pharmaceutical wastes: expired, unused, and contaminated drugs; vaccines and sera; Pharmaceutical waste includes expired, unused, spilt and contaminated pharmaceutical products, drugs and vaccines. In this category are also included discarded items used in the handling of pharmaceuticals like bottles, vials, connecting tubing. Since various ministries of health or their equivalents usually put in place specific measures that will reduce the the wastage of drugs, Health care facilities should deal only with small quantities of pharmaceutical wastes. This category also includes all the drugs and equipment used for the mixing and administration of cytotoxic drugs. Cytotoxic drugs or genotoxic drugs are drugs that have the ability to reduce/stop the growth of certain living cells and are used in chemotherapy for cancer. Cytotoxic waste is dealt with under a separate heading.
\n\n Genotoxic waste: highly hazardous, mutagenic, teratogenic or carcinogenic, such as cytotoxic drugs used in cancer treatment and their metabolites; Genotoxic waste derives from drugs generally used in oncology or radiotherapy units that have a high hazardous mutagenic or cytotoxic effect. Faeces, vomit or urine from patients treated with cytotoxic drugs or chemicals should be considered as genotoxic. In specialised cancer hospitals, their proper treatment or disposal raises serious safety problems.
\n\n Radioactive waste: such as glassware contaminated with radioactive diagnostic material or radiotherapeutic materials; Radioactive waste includes liquids, gas and solids contaminated with radionuclides whose ionizing radiations have genotoxic effects. The ionizing radiations of interest in medicine include X- and g-rays as well as a- and b- particles. An important difference between these types of radiations is that X-rays are emitted from X-ray tubes only when generating equipment is switched on whereas g-rays, α- and β- particles emit radiations continuously.
\nThe type of radioactive material used in HCF results in low level radioactive waste. It concerns mainly therapeutic and imaging investigation activities where Cobalt 60Co, Technetium 99mTc, Iodine 131I and Iridium 192Ir are most commonly used.
\nWith the noticeable exception of Cobalt 60Co, their half-life is reasonably short (6 hours for 99mTc, 8 days for 131I and 74 days for 192Ir) and the concentrations used remain low. A proper storage with an appropriate retention time is sufficient to prevent radioactivity spillage in the environment.
\nInfectious and anatomic wastes together represent the majority of the hazardous waste, up to 15% of the total waste from health-care activities. Sharps represent about 1% of the total waste but they are a major source of disease transmission if not properly managed. Chemicals and pharmaceuticals account for about 3% of waste from health-care activities while genotoxic waste, radioactive matter and heavy metal content account for around 1% of the total health-care waste.
\nThe major sources of health-care waste are:
\nhospitals and other health-care establishments
laboratories and research centres
mortuary and autopsy centres
animal research and testing laboratories
blood banks and collection services
Nursing homes for the elderly.
High-income countries generate on average up to 0.5 kg of hazardous waste per bed per day; while low-income countries generate on average 0.2 kg of hazardous waste per hospital bed per day. However, health-care waste is often not separated into hazardous or non-hazardous wastes in low-income countries making the real quantity of hazardous waste much higher.
\n\n Laboratory waste: This is also high risk category waste. This includes chemicals used in the pathological laboratory, microbial cultures and clinical specimens, slide, culture dish, needle, syringes, as well as radioactive waste such as Iodine-125, iodine -131.
\n\n Health impact\n
\nHealth-care waste contains potentially harmful micro-organisms which can infect hospital patients, health-care workers and the general public. Other potential infectious risks may include the spread of drug-resistant micro-organisms from health-care establishments into the environment.
\nWaste and by-products can also cause injuries, for example:
\nradiation burns;
sharps-inflicted injuries;
poisoning and pollution through the release of pharmaceutical products, in particular, antibiotics and cytotoxic drugs;
poisoning and pollution through waste water; and
Poisoning and pollution by toxic elements or compounds, such as mercury or dioxins that are released during incineration.
\n Sharps\n
\nWHO estimates that, in 2000, injections with contaminated syringes caused 21 million hepatitis B virus (HBV) infections, two million hepatitis C virus infections and 260 000 HIV infections worldwide. Many of these infections were avoidable if the syringes had been disposed of safely. The re-use of disposable syringes and needles for injections is particularly common in certain African, Asian and Central and Eastern European countries.
\nIn developing countries, additional hazards occur from scavenging at waste disposal sites and the manual sorting of hazardous waste from health-care establishments. These practices are common in many regions of the world. The waste handlers are at immediate risk of needle-stick injuries and exposure to toxic or infectious materials.
\n\n Vaccine waste\n
\nIn June 2000 six children were diagnosed with a mild form of smallpox (vaccinia virus) after having played with glass ampoules containing expired smallpox vaccine at a garbage dump in Vladivostok (Russia). Although the infections were not life-threatening, the vaccine ampoules should have been treated before being discarded.
\n\n Radioactive waste\n
\nThe use of radiation sources in medical and other applications is widespread throughout the world. Occasionally, the public is exposed to radioactive waste, which originates from radiotherapy treatment, which has not been disposed of properly. Serious accidents have been documented in Brazil in 1988 (where four people died and 28 had serious radiation burns), Mexico and Morocco in 1983, Algeria in 1978 and Mexico in 1962.
\nBoxes for sharps disposal (AIHPPRP, 2007)
Risks associated with other types of health-care waste, in particular blood waste and chemicals, may be significant but have not been fully assessed. In the meantime, precautionary measures should be taken.
\n\n Risks associated with waste disposal\n
\nAlthough treatment and disposal of health-care waste reduces risks, indirect health risks may occur through the release of toxic pollutants into the environment through treatment or disposal.
\nLandfills can contaminate drinking-water if they are not properly constructed. Occupational risks exist at disposal facilities that are not well designed, run, or maintained.
Incineration of waste has been widely practised but inadequate incineration or the incineration of unsuitable materials results in the release of pollutants into the air and of ash residue. Incinerated materials containing chlorine can generate dioxins and furans, which are human carcinogens and have been associated with a range of adverse health effects. Incineration of heavy metals or materials with high metal content (in particular lead, mercury and cadmium) can lead to the spread of toxic metals in the environment. Dioxins, furans and metals are persistent and bio-accumulate in the environment. Materials containing chlorine or metal should therefore not be incinerated.
Only modern incinerators operating at 850-1100 °C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins and furans.
Alternatives to incineration are now available, such as autoclaving, microwaving, steam treatment integrated with internal mixing, and chemical treatment.
\n\n Waste management: reasons for failure\n
\nLack of awareness about the health hazards related to health-care waste, inadequate training in proper waste management, absence of waste management and disposal systems, insufficient financial and human resources and the low priority given to the topic are the most common problems connected with health-care waste. Many countries either do not have appropriate regulations, or do not enforce them. An essential issue is the clear attribution of responsibility for the handling and disposal of waste. According to the \'polluter pays\' principle, the responsibility lies with the waste producer, usually the health-care provider, or the establishment involved in related activities. To achieve the safe and sustainable management of health-care waste, financial analyses should include all the costs of disposal.
\n\n Steps towards improvement\n
\nImprovements in health-care waste management rely on the following key elements:
\nbuilding a comprehensive system, addressing responsibilities, resource allocation, handling and disposal. This is a long-term process, sustained by gradual improvements;
raising awareness of the risks related to health-care waste, and of safe and sound practices;
selecting safe and environmentally-friendly management options, to protect people from hazards when collecting, handling, storing, transporting, treating or disposing of waste.
Government commitment and support is needed for universal, long-term improvement, although immediate action can be taken locally.
\n\n World Health Organisation response\n
\nThe first global and comprehensive guidance document, Safe management of wastes from health-care activities, originally released by WHO in 1999, addresses aspects such as regulatory framework, planning issues, waste minimization and recycling, handling, storage and transportation, treatment and disposal options, and training.
\nIt is aimed at managers of hospitals and other health-care establishments, policy makers, public health professionals and managers involved in waste management. It is accompanied by a Teacher\'s guide, which contains material for a three-day workshop aimed at the same audience.
\nAdditionally, WHO guidance documents on health-care waste are now available including:
\na monitoring tool
a cost assessment tool
a rapid assessment tool
a policy paper
guidance to develop national plans
management of waste from injection activities
management of waste at primary health care centres
management of waste from mass immunization activities
Management of waste in emergencies.
Poor management of health care waste potentially exposes health care workers, waste handlers, patients and the community at large to infection, toxic effects and injuries, and risks polluting the environment. It is essential that all medical waste materials are segregated at the point of generation, appropriately treated and disposed of safely.
\nHowever in most countries including Nigeria, such wastes are not given appropriate treatment, thus it is impacting negatively on the environment.
\nIn Europe, wastes are defined by their European Waste Catalogue (EWC) Codes. EWC Codes are 6 digits long, with the first two digits defining the overarching category of waste, the next two defining the sub-category, and the last two defining the precise waste stream. Clinical waste comes under the "18" codes, for example: "18 01 01" corresponds to healthcare waste (18), from humans (01), that is sharp and not infectious [01].
\n\n United Kingdom\n
\nIn the UK, clinical waste and the way it is to be handled is closely regulated Applicable legislation includes the Environmental Protection Act 1990 (Part II), Waste Management Licencing Regulations 1994, and the Hazardous Waste Regulations (England & Wales) 2005, as well as the Special Waste Regulations in Scotland.
\n\n United States\n
\nIn 1988 the Federal government passed The Medical Waste Tracking Act which set the standards for governmental regulation of medical waste. After the Act was repealed in 1991, States were given the responsibility to regulate and pass laws concerning the disposal of medical waste. All fifty states vary in their regulations from no regulations to very strict. Disposal of this waste is an environmental concern, as many medical wastes are classified as infectious or biohazardous and could potentially lead to the spread of infectious disease. Examples of infectious waste include blood, potentially contaminated "sharps" such as needles and scalpels, and identifiable body parts. Sharps include used needles, lancets, and other devices capable of penetrating skin. Infectious waste is often incinerated. The most common method of sterilization is an autoclave. The autoclave uses steam and pressure to sterilize the waste. Additionally, medical facilities produce a variety of hazardous chemicals, including radioactive materials. While such wastes are normally not infectious, they may be classified as hazardous wastes, and require proper disposal.
\nIn the United States, there are three main methods for medical waste generators to dispose of their waste: On-site, truck service, and mail-back disposal. On-site treatment involves the use of very expensive equipment, and is generally only used by very large hospitals and major universities who have the means to afford such equipment. Truck service involves hiring of a medical waste disposal service whose employees are trained to collect and haul away medical waste in special containers (usually cardboard boxes, or reusable plastic bins) for treatment at a facility designed to handle large amounts of medical waste. Mail-back medical waste disposal is similar, except that the waste is shipped through the U.S. postal service instead of by private hauler. Although currently available in all 50 U.S. states, mail-back medical waste disposal is limited to very strict postal regulations (collection and shipping containers must be approved by the postal service for use) and only available by a handful of companies.
\nIn developing countries like Nigeria, where many health concerns are competing for limited resources, it is not surprising that the management of healthcare wastes has received less attention and the priority it deserves (Abah and Ohimain, 2010). Unfortunately, practical information on this important aspect of healthcare management is inadequate and research on the public health implications of inadequate management of healthcare wastes are few and limited in scope (Abah and Ohimain, 2010). Although reliable records of the quantity and nature of healthcare wastes and the management techniques to adequately dispose of these wastes has remained a challenge in many developing countries of the world, it is believed that several hundreds of tones of healthcare waste are deposited openly in waste dumps and surrounding environments, often alongside with non hazardous solid waste (Alagoz and Kocasay, 2007; Abah and Ohimain, 2010).
\nA near total absence of institutional arrangements for HCW in Nigeria has been reported by others (Coker et al., 1998). Various methodologies have been used all over the world to assess and quantify HCW. They include the use of physical observation, questionnaire administration and quantification (Adegbita et al., 2010; Olubukola, 2009; Phengxay et al., 2005), as well as checklists (Townend and Cheeseman, 2005) and private and public records (Coker et al., 2009). Recent studies in Nigeria has estimated waste generation of between 0.562 to 0.670 kg/bed/day (Abah and Ohimain, 2011) and as high as 1.68 kg/bed/day (Abah and Ohimain, 2011). As reported in the literature, there may not be much of a difference in the way and manner wastes generated in various health care institutions are managed in Nigeria. A good example is given by the findings of the study in Lagos by Olubukola which reported the similarity in waste data and HCW management practices in two General hospitals, characterized by a lack of waste minimization or waste reduction strategies, poor waste segregation practices, lack of instructive posters on waste segregation and disposal of HCW with general waste (Olubukola, 2009). The mismanagement of healthcare waste poses health risks to people and the environment by contaminating the air, soil and water resources. Hospitals and healthcare units are supposed to safeguard the health of the community. However, healthcare wastes if not properly managed can pose an even greater threat than the original diseases themselves (PATH, 2009).
\nA study of Health Care Waste management in Jos Metropolis, Nigeria has demonstrated that the waste management options in the hospitals did not meet the standard practices (Ngwuluka et al., 2009). Waste management with safe and environmentally sound methods cannot be over-emphasized. The hospital management board and the hospitals should make a conscious and deliberate effort to ensure they do not contribute to the present and future threats to human health and the environment by poor waste management practices. In order to execute standard waste management, an understudy of a healthcare establishment with standard waste management practices in or outside the country may be the first practical step to undertake (Ngwuluka et al., 2009). A waste management team should be constituted which will prepare waste management plan, policy documents and technical guidelines and in addition supervise waste management activities (Ngwuluka et al., 2009).
\nIn another study in Port-Harcourt metropolis, Nigeria carried out to assess hospitals waste management practice (Ogbonna, 2011). The study enquired into waste generation rates and various waste disposal options by different categories of hospital. It was further evident in this study that hospital waste management issues and problems are not peculiar to Port Harcourt metropolis alone. Solid waste disposal methods indicated that open dump sites is most preferred while incineration was non existent in the hospitals, clinics. Most other hospitals do not segregate wastes into marked or colour coded containers for the different waste streams neither do they keep records of waste generation and disposal (Ogbonna, 2011). In addition, the survey revealed that both hospital waste generators and handlers treat hospital wastes as a usual domestic waste (Ogbonna, 2011).
\nDomestic Waste Dump Site at LSUTH-Ayinke House (AIHPPRP, 2007)
Therefore disposal of ashes containing toxic metals from Hospital waste incineration can be done through solidification-stabilization of fly and bottom ash with cement because it appears to be the best method to render ash less toxic. Similarly, the concentration of toxic heavy metals in the ash of hospital waste incinerator can be avoided to some extent through segregation of the waste prior to incineration. Lack of relevant training and protective equipment for waste handlers was a common feature in the survey. Generally, Port Harcourt, as a fast growing city in Nigeria, like most developing countries, lacked the infrastructure, as well as institutional capacity necessary to effectively manage medical wastes as part of the effort to enhance protection of human life and the environment from health hazards arising from improper management of hazardous waste (Ogbonna, 2011).
\nIt was further observed that open dump sites are not even engineered or treated, thus expose the entire public to risks of infection. Ogbonna (2011) reported that except for the oil company clinics such as the SPDC, all the other hospitals sampled do not have any unit or department responsible for waste management. Knowledge, attitude and practices towards environmental issues are relatively low among the various actors in the tasks of hospital waste management.
\nTemporary storage area at NOH, Igbobi (AIHPPRP, 2007)
The following groups of persons are at the risk of health care waste Medical staff: doctors, nurses, sanitary staff and hospital maintenance personnel; In and out-patients receiving treatment in healthcare facilities as well as their visitors. Workers in support services linked to healthcare facilities such as laundries, waste handling and transportation services; Workers in waste disposal facilities and the general public. Presence of various microorganisms such as pathogenic viruses and bacteria have been investigated by both cultivation and by (RT)-PCR assays. A number of (opportunistic) pathogenic bacteria, including Pseudomonas spp., Lactobacillus spp., Staphylococcus spp., Micrococcus spp., Kocuria spp., Brevibacillus spp., Microbacterium oxydans, and Propionibacterium acnes, were identified and reported from the various medical wastes. In addition, pathogenic viruses such as noroviruses and hepatitis B virus have been also detected in human tissue wastes. Commonly identified bacterial and viral pathogens such as Pseudomonas spp., Corynebacterium diphtheriae,\n\n Escherichia coli, Staphylococcus spp., and respiratory synctial virus (RSV) have been reported to be part of the medical wastes. Medical waste should be carefully controlled and monitored to prevent nosocomial infection associated with the exposure to these wastes (Nascimento et al., 2009)
\nHealth service waste gives rise to controversy regarding its importance for human, animal and environmental health (Nascimento et al., 2009). Occurrences of clinically relevant bacteria in piles of health service waste in a sanitary landfill and their antimicrobial susceptibility profile have been previously studied by Nascimento et al., 2009. Nascimento et al., 2009 reported that aliquots of leachate from health care waste in Brazil contained pathogenic strains of Staphylococcus sp, Gram-negative rods of the Enterobacteriaceae family and non-fermenters. Bacterial resistance to all the antimicrobials tested was observed in all microbial groups, including resistance to more than one drug. This makes it possible to suggest that viable bacteria in health service waste represent risks to human and animal health. Furthermore, occurrences of multi-resistant strains support the hypothesis that health service waste acts as a reservoir for resistance markers, with an environmental impact. The lack of regional legislation concerning segregation, treatment and final disposal of waste may expose different populations to risks of transmission of infectious diseases associated with multi-resistant microorganisms.
\n\n S/N\n | \n\n Microbial Group\n | \n\n Type of Disease caused\n | \n
1 | \nBacterial | \nTetanus, gas gangrene and other wound infection, anthrax, cholera, other diarrhoeal diseases, enteric fever, shigellosis, plague etc | \n
2 | \nViral | \nVarious hepatitis, poliomyelitis, HIV-infections, HBV, TB, STD rabies etc. | \n
3 | \nParasitic | \nAmoebiasis, Giardiasis, Ascariasis, Ancylomastomiasis, Taeniasis, Echinococcosis, Malaria, Leishmaniasis, Filariasis etc. | \n
4 | \nFungal infections | \nVarious fungal infections like Candidiasis, cryptococcoses, coccidiodomycosis etc. | \n
Microbial diseases associated with health care waste (Akter, 2010)
Transmission of disease through infectious waste is the greatest and most immediate threat from healthcare waste.
\nIf waste is not treated in a way that destroys the pathogenic organisms, dangerous quantities of microscopic disease-causing agents—viruses, bacteria, parasites or fungi—will be present in the waste. These agents can enter the body through punctures and other breaks in the skin, mucous membranes in the mouth, by being inhaled into the lungs, being swallowed, or being transmitted by a vector organism (World Health Organization, 1992).People who come in direct contact with the waste are at greatest risk. Examples include healthcare workers, cleaning staff, patients, visitors, waste collectors, disposal site staff, waste pickers, drug addicts and those who knowingly or unknowingly use “recycled” contaminated syringes and needles. Although sharps pose an inherent physical hazard of cuts and punctures, the much greater threat comes from sharps that are also infectious waste. Again, healthcare workers, waste handlers, waste pickers, drug addicts and others who handle sharps can, and have, become infected with HIV/AIDS and hepatitis B and C viruses through pricks or reuse of syringes/needles. These infections may be fatal (Johannessen, 2000). Contamination of water supply from untreated healthcare waste can also have devastating effects. If infectious stools or bodily fluids are not treated before being disposed of, they can create and extend epidemics, since sewage treatment in Africa is almost nonexistent.
\nFor example, the absence of proper sterilization procedures is believed to have increased the severity and size of cholera epidemics in most parts of Africa during the last decade.
\n\n Chemical and toxic threats\n
\nChemical and pharmaceutical wastes, especially large quantities, can be health and environmental threats. Since hazardous chemical wastes may be toxic, corrosive, flammable, reactive, and/or explosive, they can poison, burn or damage the skin and flesh of people who touch, inhale or are in close proximity to them. If burned, they may explode or produce toxic fumes. Some pharmaceuticals are toxic as well (Johannessen, 2000).
\nWhen chemical and pharmaceutical waste is disposed of in unlined landfills, especially unlined pits, these wastes may contaminate ground and surface water—particularly when large quantities are disposed of. This can threaten people who use the water for drinking, bathing and cooking, and damaging plants and animals in the local ecosystem. Burning or incinerating healthcare waste, while often a better option than disposal in an unlined pit, may create additional problems. Burning or incineration of healthcare waste may produce toxic air pollutants such as Nitrogen Oxides (NOx), particulates, dioxins and heavy metals and distribute them over a wide area. Dioxins and heavy metals are of particular concern (Prüss and Townend, 1998). Dioxins believed to be potent cancer-causing agents, do not biodegrade, and accumulate in progressively higher concentrations as they move up the food chain (WHO, 1999).
\nHeavy metals such as mercury and cadmium are toxic and/or cause birth defects in small quantities and can also concentrate in the food chain.
\nDisposable pressurized containers pose another hazard for incineration, as they can explode if burned.
\nIn fact, disposal of large quantities of hazardous chemicals and pharmaceuticals is a serious problem. In most of Africa, no methods are available to small-scale facilities that are safe and affordable (Prüss and Townend, 1998).
\nImprovised incinerator at UCH, Ibadan
Medical waste storage area at LUTH, Lagos, Nigeria without proper symbols to differentiate wstes into categories (AIHPPRP, 2007)
\n Antibiotic resistance spread in the Environment through improperly disposed Health Care Wastes\n
\nAntimicrobial resistance (AMR) is resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive. Resistant organisms (they include bacteria, viruses and some parasites) are able to withstand attack by antimicrobial medicines, such as antibiotics, antivirals, and anti-malarials, so that standard treatments become ineffective and infections persist and may spread to others. AMR is a consequence of the use, particularly the misuse, of antimicrobial medicines and develops when a microorganism mutates or acquires a resistance gene (WHO, 2012). In places like Nigeria most families become financially distressed after hospitalization of members of their families. Many infectious diseases risk becoming uncontrollable and could derail the progress made towards reaching the targets of the health-related United Nations Millennium Development Goals set for 2015. When infections become resistant to first-line medicines, more expensive therapies must be used. The longer duration of illness and treatment, often in hospitals, increases health-care costs and the financial burden to families and societies (WHO, 2012). Multidrug resistance is described as a phenomenon where a microbial pathogen resists at least three groups of antibiotics (CDC, 2005). Healthcare liquid wastes are the reservoirs of harmful infectious agents such as the pathogens and multiple drug resistant microorganisms (Sharma et al., 2010). Potential infectious risks include the spread of infectious diseases and microbial resistance from health-care establishments into the environment and thereby posing risks of getting infections and antibiotic resistance in the communities (Sharma et al., 2010).
\nTherefore, even if the hospitals are discharging their healthcare liquid waste into Sewage system, it is mixed with the sewage and gets in surface water without proper treatment. If the hospital effluents are not treated, concentrated forms of infectious agents and antibiotic resistant microbes are shed into communities resulting in water borne diseases such as cholera, typhoid fever, dysentery and gastroenteritis. Antibiotics, disinfectants and bacteria resistant to them have been detected in the environmental compartments such as waste water, surface water, ground water, sediments and soils (Kummerer, 2004). Studies have discovered trace level concentrations of antibiotics in waste water treatment plant effluents and surface waters (Kolpin et al, 2002). Long term exposure of microorganisms to low concentrations of antibiotics in wastewater and surface water has the potential for the development of antibiotic resistance in these organisms (Smith et al., 1999).
\nThe concerns about antimicrobial resistance are increasing. In a report by the United Kingdom, House of Lords, it is stated that the resistance to antibiotics and other anti-infective agents constitutes a major threat to public health and ought to be recognized (HLSCST, 1998). Input of resistant bacteria as well as of antibiotics can disturb the established well balanced and important interdependencies (Hiraishi, 1998). The input of resistant bacteria into the environment seems to be an important source of resistance in the environment.
\nTherefore, the development of antibiotic resistance in bacteria and their dissemination in the environment is of serious public health concern because an individual patient can develop an antibiotic resistant infection by contacting a resistant organism and spread in the communities. Hospitals and public health care units must safeguard the health of the community. However, the waste produced by the health care centres if disposed of improperly, can pose an even greater threat than the original diseases themselves due to the presence of concentrated forms of numerous risks including pathogenic and antibiotic resistant microorganisms (Sharma et al., 2010).
\nIn Nepal, where several thousand die due to infectious diseases and several more, losing quality of lives, untreated hospital liquid waste discharge into surface water directly or indirectly must have been adding more problems. It is our common observation that majority of the healthcare facilities do not practice safe healthcare liquid waste treatment and disposal.
\n\n Basel convention\n
\nThis convention is a global agreement, ratified by some 178 member countries to address the problems and challenges posed by hazardous waste. Nigeria is a signatory to this convention.
\nThe Secretariat, based in Geneva (Switzerland) is administered by UNEP. It facilitates the implementation of the Convention and related agreements. It also provides assistance and guidelines on legal and technical issues and conducts training on the proper management of hazardous waste.
\nThe key objectives of the Basel Convention are:
\nto minimize the generation of hazardous wastes in terms of quantity and hazardousness;
to dispose of them as close to the source of generation as possible;
to reduce the movement of hazardous wastes.
A central goal of the Basel Convention is “environmentally sound management” (ESM), the aim of which is to protect human health and the environment by minimizing hazardous waste production whenever possible. ESM means addressing the issue through an “integrated life-cycle approach”, which involves strong controls from the generation of a hazardous waste to its storage, transport, treatment, reuse, recycling, recovery and final disposal. Health Care Related Wastes (HCRW) is one of the categories of hazardous wastes covered by the Convention. It was adopted in 1989. During its first decade, the Convention’s principal focus was the elaboration of controls on the “transboundary” movement of hazardous wastes that is the movement of such wastes across international frontiers and the development of criteria for environmentally sound management of the wastes. More recently the work of the Convention has emphasized full implementation of treaty commitments, promotion of the environmentally sound management of hazardous wastes, a lifecycle approach, and minimization of hazardous waste, generation. The Convention entered into force 5 May 1992. (HCWC, 2007).
\nThe Basel Convention (Article 4) requires each Party to minimize waste generation and to ensure, to the extent possible, the availability of disposal facilities within its own territory. The Conference of the
\nParties at its sixth meeting in December 2002 adopted a Strategic Plan for the implementation of the Basel Declaration to 2010 building on and using the framework of the 1999 Ministerial Basel Declaration on Environmentally Sound Management. The Basel Convention covers wastes that are listed in Annex I, if they display the hazardous characteristics listed in Annex III. Hazardous wastes are those wastes that are: explosive, flammable, poisonous, infectious, corrosive, toxic, or ecotoxic.
\n\n The Stockholm convention on persistent organic pollutants\n
\nThis Convention is a global treaty to protect human health and the environment from persistent organic pollutants (POPs). POPs are chemicals that remain intact in the environment for long periods, become widely distributed geographically, accumulate in the fatty tissue of living organisms and are toxic to humans and wildlife. Persistent Organic Pollutants (POPs) circulate globally and can cause damage wherever they travel. In implementing the Convention, Governments will take measures to eliminate or reduce the release of POPs into the environment. The countries that have signed these conventions are Afghanistan, Albania, Algeria, Andorra, Angola, Antigua and Barbuda Argentina, Armenia, Australia, Austria, Azerbaijan, Bahamas, Bahrain, Bangladesh, Barbados, Belarus, Belgium, Belize, Benin, Bhutan, Bolivia, Bosnia, and Herzegovina, Botswana, Brazil, Brunei, Darussalam, Bulgaria, Burkina Faso, Burundi, Cambodia, Cameroon, Canada, Cape Verde, Central African Rep, Chad, Chile, China, Colombia, Comoros, Congo, Costa Rica, Cote d\'Ivoire, Croatia, Cuba Cyprus, Czech Republic, Dem. Rep. of Korea, Dem. Rep. of the Congo, Denmark, Niger, Nigeria and many more other countries.
\n\n The Stockholm Convention was adopted in 2001. POPs are chemicals that are highly toxic, persistent, bio-accumulate and move long distance in the environment. The Convention seeks the elimination or restriction of production and use of all intentionally produced POPs (i.e. industrial chemicals and pesticides). It also seeks the continuing minimization and, where feasible, ultimate elimination of the release of unintentionally produced POPs such as dioxins and furans. The Convention entered into force17 May 2004 (HCWC, 2007).
\n\n The Rotterdam convention\n
\n\n The Rotterdam Convention was adopted in 1998. In the 1980s, UNEP and FAO developed voluntary codes of conduct and information exchange systems, culminating in the Prior Informed Consent (PIC) procedure introduced in 1989. The Convention replaces this arrangement with a mandatory PIC procedure and information exchange mechanism on hazardous chemicals and pesticides. The Convention entered into force 24 February 2004.
\nThe Rotterdam Convention (Article 5), obliges Parties to notify the secretariat of final regulatory actions taken in respect of banned or severely restricted chemicals, for the information of other Parties and possible listing under the Convention. Developing countries and countries with economies in transition may also propose the listing of severely hazardous pesticide formulations (Article 6).
\n\n The\n Rotterdam Convention apply to any chemical that is banned or severely restricted by a Party. The Prior Informed Consent procedure applies to the following 28 hazardous pesticides: 2,4,5-T, aldrin, binapacryl, captafol, chlordane, chlordimeform, chlorobenzilate, DDT, 1,2- dibromoethane (EDB), dieldrin, dinoseb, DNOC and its salts, ethylene dichloride, ethylene oxide, fluoroacetamide, HCH, heptachlor, hexachlorobenzene, lindane, mercury compounds, monocrotophos, parathion, pentachlorophenol and toxaphene, plus certain formulations of methamidophos, methyl-parathion, monocrotophos, parathion, phosphamidon and a combination of benomyl, carbofuran and thiram. It also covers 11 industrial chemicals: asbestos (actinolite, anthophyllite, amosite, crocidolite, tremolite), polybrominated biphenyls (PBBs), polychlorinatedbiphenyls (PCBs), polychlorinated terphenyls (PCTs), tris (2,3 dibromopropyl) phosphate and tetraethyl lead (TEL) and tetramethyl lead (TML).
\n\n World conventions and Principles of Health Care Waste management\n
\n1. Duty of care principle
\nThis principle stipulates that any organisation that generates waste has a duty to dispose of the waste safely. Therefore it is the HCF that has ultimate responsibility for how waste is containerized, handled on-site and off-site and finally disposed of.
\n2. Polluter pays principle
\nAccording to this principle all waste producers are legally and financially responsible for the safe handling and environmentally sound disposal of the waste they produce. In case of an accidental pollution, the organisation is liable for the costs of cleaning it up. Therefore if pollution results from poor management of health-care waste then the HCF is responsible. However, if the pollution results because of poor standards at the treatment facility then the HCF is likely to be held jointly accountable for the pollution with the treatment facility. Likewise this could happen with the service provider. The fact that the polluters should pay for the costs they impose on the environment is seen as an efficient incentive to produce less and segregate well.
\n3. Precautionary principle
\nFollowing this principle one must always assume that waste is hazardous until shown to be safe. This means that where it is unknown what the hazard may be, it is important to take all the necessary precautions.
\n4. Proximity principle
\nThis principle recommends that treatment and disposal of hazardous waste take place at the closest possible location to its source in order to minimize the risks involved in its transport. According to a similar principle, any community should recycle or dispose of the waste it produces, inside its own territorial limits.
\nFive fundamental principles for handling health care wastes
\nThese principles include Minimization and Recycling, Sorting receptacles and handling, Collection and Storage, Transportation, and Treatment and Disposal (ICRC, 2011).
\n\n Minimization and recycling\n
\nThe reduction of waste generation must be encouraged by the following practices: Reducing the amount of waste at source, Choosing products that generate less waste: less wrapping material, for example, Choosing suppliers who take back empty containers for refilling (cleaning products); returning gas cylinders to the supplier for refilling, Preventing wastage: in the course of care, for example, or of cleaning activities, Choosing equipment that can be reused such as tableware that can be washed rather than disposable tableware (Bassey et al., 2006; ICRC, 2011).
\n\n Sorting receptacles and handling\n
\nSorting consists of clearly identifying the various types of waste and how they can be collected separately. There are two important principles that must be followed. The simplest way to identify the different types of waste and to encourage people to sort them is to collect the various types of waste in separate containers or plastic bags that are colour-coded and/or marked with a symbol (ICRC, 2011).
\nWaste sorting must always be the responsibility of the entity that produces them. It must be done as close as possible to the site where the wastes are produced. There is no point in sorting wastes that undergo the same treatment process, with the exception of sharps, which must at all times be separated at source from other wastes (Longe and Williams, 2006).
\n\n Collection and storage\n
\nWaste must be collected regularly - at least once a day. It must never be allowed to accumulate where it is produced. A daily collection programme and collection round must be planned. Each type of waste must be collected and stored separately with different known signs on the containers (Longe and Williams, 2006).
\nInfectious wastes must never be stored in places that are open to the public.
\nThe personnel in charge of collecting and transporting wastes must be informed to collect only those yellow bags and sharps containers which the care staff have closed. They must wear gloves. The bags that have been collected must be replaced immediately with new bags (Longe and Williams, 2006).
\n\n Transportation\n
\nThis means of conveyance must meet the following requirements: they must be easy to load and unload; they must not have any sharp corners or edges that might tear the bags or damage the containers; they must be easy to clean; (with a 5% active chlorine solution); they must be clearly marked.
\nFurthermore, off-site means of transport must meet the following requirements: they must be closed in order to avoid any spilling on the road; they must be equipped with a safe loading system (to prevent any spilling inside or outside the vehicle); they must be marked according to the legislation in force if the load exceeds 333 kg (for some countries). The entity producing the waste is responsible for packaging and labelling the waste to be transported outside the hospital. Packaging and labelling must be in conformity with national legislation on the transport of dangerous substances and with the Basel Convention in the case of cross-border transport. If there is no national legislation on the subject, the [United Nations] Recommendations on the Transport of Dangerous Goods1312or the European Agreement on the International Carriage of Dangerous Goods by Road (ADR) 1413 should be referred to. If a vehicle is carrying less than 333 kg of medical waste entailing the risk of contamination (UN 3291), it is not required to be marked. Otherwise it must bear sign plates
\n\n Treatment and disposal\n
\nChoices of treatment and disposal technique depend on a number of parameters (Bassey et al., 2006). These include the quantity and type of waste produced, availability of waste treatment site near the waste generating facility, availability of reliable means of transport, availability of National legislation on health care waste management, climate conditions, groundwater level, regular supply of electricity in the area etc. The handling and treatment of waste entails health risks for staff throughout the chain. The purpose of protective measures is seriously recommended. The purpose of protective measures is to reduce the risks of accident/exposure or the consequences (Sharma et al., 2006; Longe and Williams, 2006).
\n\n Federal Ministry of Environment (FMENV)\n
\nThe need to protect the environment in Nigeria started with the pronouncement prohibiting water pollution through the colonial hygiene of public health inspectors. In 1975, a Division was created in the Federal Ministry of Economic Development to deal with pollution and other industrial matters. Lack of effective implementation of its mandate led to the relocation of the Division from one Ministry to another (Rain Forest, 2012; FMenv, 2012)
\nThe discovery of six ship loads of toxic waste of Italian origin in Koko, Delta State in 1988, exposed the need for stringent environmental laws and its effective enforcement with monitoring mechanism put in place. The Federal Government promulgated the Harmful Wastes Criminal Provision Decree 42 of 1988, which made it a criminal offence to import or trade in toxic waste. The Federal Environmental Protection Agency (FEPA) was created by Decree 58 of 1988 as a parastatal of the Ministry of Works and Housing. The agency authority was strengthened through Decree 59 of 1992 and October 12th, 1999 saw the creation of the Federal Ministry of Environment (FMEnv) (FMenv, 2012). The Federal Ministry of Environment is charged with the overall responsibility of protecting the Nigerian environment including biodiversity, conservation and sustainable development of natural resources (Rain Forest, 2012).
\n\n The National Environmental Protection (Pollution Abatement in Industries & Facilities Generating Waste) Regulation S. I 9 of 1991,\n
\nProhibits the release of hazardous or toxic substances into the environment beyond the limits approved by the Agency,
Solid, liquid and gaseous discharge should be analyzed and reported to their nearest office,
The factory is required to submit yearly environmental audit report within 90 days of demand by the Agency( FMenv, 2012).
\n Waste Management and hazardous Waste Regulations of 1991,\n
\nRegulates the collection, treatment and disposal of solid and hazardous wastes from municipal and industrial sources (FMenv, 2012).
\n Guidelines and Standards for Environmental Pollution Control in Nigeria 1991,\n
\nDirects industries to improve the quality of the environment.
Serves more or less as recommended standards of environmentally good behaviour for industries.
\n The Federal Government of Nigeria also passed into law the Environmental Impact Assessment (EIA) Act No 86 of 1992, which is summarized below,\n
\nRequires the government, its agency and private enterprises to carry out EIA study of a proposed project,
The study also covers for proposed expansion of existing project or facility/ industry( FMenv, 2012).
In November 1989, the present Nigeria Environmental Policy was launched to guide environmental activities in Nigeria. The main objective of the policy is to achieve sustainable development which can be achieved by;
\nSecuring for all Nigerians a quality of Environment adequate for their health and well being;
Conserving and using the natural resources for the benefit of the present and future generations;
Restoring, maintaining and enhancing the ecosystem and ecological process essential for the preservation of biological diversity;
Raising public awareness and promoting understanding of the essential linkages between environment and development;
Co-operation with other countries and international organizations and agencies to achieve the above specific goals, and prevent transboundary environmental pollution( FMenv, 2012)..
\n National Environmental Standards and Regulation Enforcement Agency (NESREA)\n
\nThe basis of environmental policy in Nigeria is contained in the 1999 Constitution of the Federal Republic of Nigeria. Section 20 of the Constitution empowers the state to protect and improve the environment; and safeguard the water, air and land, forest and wildlife of Nigeria. Hitherto, various laws and regulations have been enacted to safeguard the Nigerian environment. These include:
\nNational Environmental Protection (Effluent Limitation) Regulations;
National Environmental Protection (Pollution Abatement in Industries and Facilities Generating Wastes) Regulations; and
National Environmental Protection (Management of Solid and Hazardous Wastes) Regulations.
- National Environmental Health Practice Regulations 2007; and
- Nigerian Radioactive Waste Management Regulations 2006.
Environmental Impact Assessment Act of 1992 (EIA Act).
The Petroleum (Drilling and Production) Regulations 1969, made pursuant to The Petroleum Act.
Harmful Wastes (Special Criminal Provisions etc.) Act of 1988 (Harmful Wastes Act).
The National Oil Spill Detection and Response Agency (Establishment) Act 2006 (the NOSDRA Act).
Nigerian Radioactive Waste Management Regulations 2006 issued pursuant to the Nuclear Safety and Radiation Protection Act 1995
The National Environmental Standards and Regulations Agency 2007 (NESREA Act).
The NESREA Act was enacted on the 31st July, 2007 to provide for the establishment of the National Environmental Standards and Regulations Agency (NESREA). This Act repealed the Federal Environmental Protection Agency Act (the FEPA Act) pursuant to which the FEPA which was formerly charged with the protection and development of the environment in Nigeria was established. However all regulations, authorizations and directions made pursuant to the FEPA act and which were in force at the commencement of the NESREA Act shall continue to be in force and have effect as if made by the NESREA Act. The NESREA Act applies to the regulation and the protection and development of the environment in Nigeria with the exception of the oil and gas sector. The NESREA is responsible for the protection and development of environmental standards, regulations, rules, laws, policies and guidelines within Nigeria. The NESREA’s functions do not however include enforcement of environmental standards, regulations, policies and guidelines in the oil and gas sector of Nigeria. The NESREA Act give authorized officers of the NESREA powers to:
\nenter and search any land, building, vehicle, tent, vessel, floating craft or any inland water; for the purpose of conducting inspection, searching and taking samples for analysis which are reasonably believed to be carrying out activities or storing goods which contravene environmental standards or legislation
seize or detain for such a period as may be necessary articles which are reasonably believed to contravene provisions of the legislation or any of its regulations; and
Obtain an order of a court to suspend activities, seal and close down premises including land, vehicle, tent, vessel, floating craft or any inland water and other structure.
\n Functions of NESREA Act\n
\nUnder the NESREA Act, the Minister charged with the responsibility of the environment is empowered by regulations to prescribe any specific removal methods and reporting obligations on the owners or operators of vessels discharging harmful substances and waste into the environment.
Public authorities are statutorily required to inform the public of Environment-related issues. The NESREA Act requires NESREA to enforce compliance with environmental regulations, to create public awareness, provide environmental education on sustainable environmental management and to publish data resulting from the performance of its functions.
The NESREA Act provides that a person who breaches the provisions of the Act commits an offence and shall on conviction be liable to a fine, or imprisonment, or both.
The NESREA Act also provides that where there has been a discharge of any hazardous substance in violation of environmental laws/permits, the person responsible for the discharge will bear the liability of the costs of removal and clean up.
In executing its functions, the NESREA is required to conduct environmental audits and establish a data bank on regulatory and enforcement standards.
\n The following are environmental impacts associated with the improper disposal of medical wastes:\n
\nPollutants from medical waste (e.g. heavy metals and PCBs) are persistent in the environment
\nAccumulation of toxic chemicals within soil (proximity to agricultural fields, humans, soil organisms, wildlife, cattle) ground water contamination, decrease in water quality bio-accumulation in organism’s fat tissues, and biomagnify through the food chain
\nRepeated and indiscriminate application of chemicals over a long period of time has serious adverse effects on soil microbial population - reducing the rate of decomposition, and generally lowering the soil fertility.
\nPathogens leads to long term accumulation of toxic substances in the soil specimens collected for analysis have the potential to cause disease and illness in man, either through direct contact or indirectly by contamination of soil, groundwater, surface water, and air wind blown dusts from indiscriminately dumping also have the potential to carry hazardous particulates with domestic animals being allowed to graze in open dumps, there is the added risk of reintroducing pathogenic micro-organisms into the food chain.
\nPublic nuisance (e.g. odours, scenic view, block the walkway, aesthetics, etc.)
\nImproper sterilization of instruments used in labour room may cause infection to mother and child
\nCombination of both degradable and non-degradable waste increase the rate of habitat destruction due to the increasing number of sites necessary for disposal of wastes (degradation of habitat)
\nPlastic-bags, plastic containers, if not properly destroyed may contaminate the soil and also reduces the chance for water percolation into the soil during precipitation.
\nOpen air burning does not guarantee proper incineration, and releases toxic fumes (dioxin) into the atmosphere from the burning of plastics i.e., PCB’s (Atkin, 2010).
\nMedical waste management has received very little attention in waste management process in Nigeria. Neither the government nor hospital authorities pay proper attention to its management. Unwholesome waste disposal by many hospitals, clinics and health centers in Abuja pose serious health hazard to the city dwellers in general and people living within the vicinity of the health care institutions in particular (Bassey et al., 2006).
\nAlmost all the health care institutions surveyed dispose every kind of waste generated into municipal dumpsites without pre-treatment, leading to an unhealthy and hazardous environment around the health institutions, affecting patients and staff (Bassey et al., 2006).
\nScavengers who collect waste from dustbins are at risk of injury from sharp instruments and direct contact with infectious materials. Liquid medical wastes are disposed directly into the municipal sewer system by all the institutions surveyed (Bassey et al., 2006). Direct disposal of faces and urine of infectious patients in municipal sewer system may cause outbreak of epidemic diseases. The scavengers that engage in recycling operations are unaware of the harmful consequences of exposure to contaminate and hazardous waste (Bassey et al., 2006).
\nScavenging at Ojota dumpsite in Lagos, Nigeria
Infected carcasses gathered in a dump for burning (AIHPPRP, 2007)
Most at times, the absence of Environmental impact assessments before commencement of public health and pharmaceutical industry projects is responsible for the archive of challenges associated waste management in the developing worlds including Nigeria. Nigeria lacks both effective and adequate waste management facilities and an inadequate Government policy to guide health providers and punish offenders. There is great need to incorporate standard EIA processes into the Nigerian regulatory documents for Public health institutions and pharmaceutical industries. These regulatory bodies need to establish mitigatory measures especially on waste management during the EIA process of Health care facility in Nigeria.
\nIncidentally, lapses on these bodies have resulted in no or poor implementation of hazard/ risk/ waste management processes in health care institutions.
\nNESREA and FMEnv are required to follow-up medical laboratories, hospitals, Pharmaceutical companies springing up all over Nigeria on laboratory waste, and Industrial effluent treatment and disposal.
\nWithout this strict implementation of impact mitigation and management of health care waste, Sustainable development is far from being attained.
\nHealth care waste should be treated with utmost attention, since the wastes could be virulent, pathogenic, carcinogenic, mutagenic, and teratogenic. This shows that its impact on environment and human and plant’s health is greater than that of petroleum hydrocarbon spill.
\nThere is no proper waste management system in place in most developing countries. On-site incineration, autoclaving, and steam disinfection are a few processes currently in use for treating very small amounts of hazardous wastes.
\nCountries found to practice incineration are Brazil, Argentina, Peru, India, Pakistan and Bangladesh etc. Clinical waste incinerators, particularly in developing and poorer countries, often operate under sub-optimal conditions. Most of the cases the percentage of incinerators that were functioning poorly or not operational (HCWH, 1999). Most medical administrations usually focus on installing disposal technologies such as incinerators and do not implement a “practice” of waste management within the hospital. Over 6500 incinerators were installed in the US alone in the 1980s (Agarwal, 1998). Chronic problems both relating to very high toxic levels as well as difficulties in operating a sophisticated engineering technology in a medical setting have given rise to a debate which attempts to define a clean technology for medical waste disposal. There are some techniques practiced by different countries all over the world such as: Incineration, Autoclave Disinfection, Microwave Disinfection, and Mechanical/Chemical Disinfection. Each of this technique has limitations in terms of technological aspect, environmental condition and waste composition. Burning and incineration of medical and municipal waste have been linked to severe public health threat and pollution resulting in the release of toxic dioxin as well as mercury and other toxic substances. These substances produce a remarkable variety of adverse affects in humans at extremely low doses (Basset et al., 2006). Putrefaction occurs in portions of refuse, which have not been fully burnt and add to air pollution through foul smells. Sanitary landfill can lead to pollution of ground water if not properly managed.
\nHowever, most of the developed countries have defined policy and regulations to handle and manage medical waste such as Germany, France, Canada, and USA. Unfortunately, health care waste management is not yet carried out with a satisfactory degree of safety in many parts of the globe especially in the underdeveloped world (Stanley et al., 2011).
\nIn Nigeria, the lack of will by policy makers and implementation groups to adopt current technology in Health Care Waste management is an emerging challenge towards HCW management. The Health Care system is not developed in Nigeria, and by extension Health Care Waste Management.
\nIn Nigeria Health Care facilities are constructed and flagged off in terms of operations without due considerations to Environmental Impact Assessment (EIA). Its hazards are numerous to be counted. The regulatory agencies in Nigeria on the Environment such as NESREA, FMEnv etc must rise to the challenges of environmental pollution coming from health care facilities. Community engagement during the process of establishing Public health institutions and pharmaceutical companies is also advisable. This will ensure the development of robust Terms of Reference, EIA document, Environmental Management Plan (EMP). The EMP should address the issues or negative impacts of the health care facility on the bio-physical, social environment and health.
\nIt is worthy to note that some health care facilities such as medical and Environmental Laboratories are small projects and may not require full blown EIA. However, the regulatory agencies should develop a module of monitoring their waste disposal to avoid pollution. The situation is bit different in developed countries, where there is integrated Health management system; medical laboratories are usually part of large health care facilities. It is good to state categorical that laboratory wastes are among the most infectious group of health care waste. They contain live virulent pathogens and mutagenic, teratogenic chemicals including dyes. Laboratories must be forced to have a standard waste tracking protocol, in line with the international convention called Polluters Pay Principles (PPP).
\nFederal Republic of Nigeria will gain a lot from the battery of Public health benefits of Health Care waste Management. It is still not well understood why Nigeria at its level of development, Health Care Waste management is not well legislated and thus proper attention has not been given to it by Environmental regulators and Health Care operators. The issues are to be treated as urgent and very critical by Government. Immediate interventions are also required. All hands including the National Orientation Agencies and communities must be on deck to get over this challenge.
\nThere is great need for effective Environmental regulatory Surveillance in Nigeria. National laws on Health Care waste management should be established and be moved to an act.
\nThis is the best time for Nigerian Government to establish a regulatory agency to effectively monitor medical wastes and its treatment in Nigeria. Otherwise, the FMEnv and NESREA are to be strengthened to establish a well funded unit (Finance and good Human Resources) for monitoring of Health Care Institutions over Health Care Wastes.
\nIn the years following Independence in 1964, Zambia, like many African states, viewed education to be pivotal to its development as a nation. This belief in the power of school was partly grounded in what is known as the modernization approach which emphasizes investment in the formation of labour capital [1]. The political leaders were concerned with economic progress and the need to build an inclusive nation [2].
\nAs this mode of national development has emerged, we find that in 2013 a Catholic secondary school in Lusaka’s Matero township, a densely populated low-income section of the city, had approximately 10 percent of its students from the local district. This was because the local children did not reach the school’s Grade VII qualifying grade [3]. As a result, the school, like many other private or semi-private schools, had a preponderance of its students from outside the immediate surroundings.
\nMatero Boys is grant-aided which means that it follows government direction and is also Church sponsored. It thus follows government practice of admitting those who reach a certain academic standard in the belief that this meritocratic way of proceeding is equitable and fair in avoiding marginalization and providing equal opportunity to all [4]. Yet, this mode of procedure appears to work against one of the Catholic school’s prime purposes—inclusion of those at the margins. To better appreciate this paradoxical situation, we turn to a review of its setting.
\nAs a Catholic school, Matero boys is part of a long tradition that heralds social justice which includes concern for the poorest. The first Catholic missionaries generally set up outposts where missionaries had outreach to the poor and were oftentimes accused of giving handouts [5]. Similarly, it is true that in later times such missionaries were branded as instruments of colonialism in so far as they are said to have cooperated with the British colonial state. A significant aspect of this emerged when, by adopting the school as a means of evangelization, the colonial government became more directive. At that point in the late 1920s, the Catholic school, as others, was faced with a dilemma. It could continue largely outside government jurisdiction as a church school or it could become part of the colonial state system.
\nMissionaries found themselves on both sides of this issue but with the visit of Monsignor Arthur Hinsley, the voice of Rome, Catholic missionaries were told to place their schools within the state framework [6]. For the most part, they did this even if sometimes reluctantly. In the long term, this proved to be a good means of outreach in so far as it promised people from the remotest areas escape from the village and the opportunity to find wage labour in the developing mines and towns. Attending school was a means for Northern Rhodesians (Zambians after 1964) to become what has been called the fortunate few [7]. What is evident is that the early missionaries directed their efforts at assisting the poor and, given the climate of the time, they could be seen to be weakly aware of the political implications of their activities one of which included the price of becoming part of the colonial state system.
\nAfter a Church Council called Vatican II ending in 1965, the Church adopted a more political approach with an emphasis on social justice [8]. It stressed individual human rights but extended this to what it called the common good where each person’s participation in the general welfare is highlighted [9]. This ideal was elucidated principally in 1968 through a papal document called Populorum Progressio and formed a key aspect of the Latin American bishops’ conference in Medellin in 1968 [10]. It meant that missionaries began to be conscious of the political dimension of their schools [11].
\nThis took place in the years after 1965 when Zambia was striving to establish itself as a newly Independent state and, as already indicated, it placed a heavy emphasis on education and, under the leadership of President Kaunda, the ideal of equity was fore-grounded. One might conjecture that this meant support for the promotion of social justice and the ideal that everyone would share equitably in the new nation’s development. In that respect, the poorest seemed to have equal opportunity. What was new within this viewpoint, from the point of view of the Catholic Church, was that liberation of the poorest assumed a social structural or political framework. While the old system of assisting individuals to gain uplift remained, the church began to focus on social structures and their capacity to promote or impede social justice. In this way of thinking it was argued that there was a need to contribute towards building a just social order [12]. More specifically, a document called The Catholic School notes:
\nSince it is motivated by the Christian ideal, the Catholic school is particularly sensitive to the call from every part of the world for a more just society, and it tries to make its contribution towards it. It does not stop at the courageous teaching of the demands of justice even in the face of local opposition, but it tries to put these demands into practice in its own community in the daily life of the school [13].
\nThe same document affirmed that, first and foremost, the church offers its educational service to the poor and if the church turns its attention exclusively to those who are wealthier it would be contributing to their privileged position and would thereby favour the development of a society that is unjust.
\nIn this context of commitment to the poorest as developed in terms of the common good, we have the Matero Boys situation where the local poorest are excluded, not because they are unable to pay as was true elsewhere [14], but because they failed to meet government-set academic criteria for entry. One could argue that what Edward Berman spoke about, when he charged missionaries of subordinating their mission to government aims, had come to pass [15]. However, it could also be argued that this was not the case but that the church under the authority of the Zambian Ministry of Education which is now called Ministry of Education, Science, Vocational Training and Early Education (MESVTEE) the merit-based educational system provides an avenue towards equity and social justice and thus avoids marginalization of the poorest [16].
\nWhat follows argues that this claim is false but was uncritically accepted as true by the Catholic Church and more widely. It is a historical approach illustrating how, despite government intentions to create a nation that would not marginalize, the Zambian school system became a pivotal instrument of progressively excluding large sectors of society from the fruits of economic development which meant decreasing access to formal employment and the well-being that it promised.
\nThe discussion emerges from secondary sources--published work, books, journals, educational reports on reforms, adjustments to World Bank demands, undergirded by the author’s long-time experience in the country as a teacher, administrator, and researcher. It engages with such issues as the ideal of justice, opportunity structure, upward mobility, class formation, educational reform, education as reproductive of the status quo as it develops the the notion of marginalization. This speaks of social groups especially the poor in rural areas and densely parts of towns or cities as well as subgroups whose voices were weakly heard—girls, orphans, and those with special needs. As will be seen, the process of marinalization gains momentum when in the mid 1970s a new-found social elite gain control of the education system and strive to ensure that access to school maintains and reproduces its privileged position as the majority are left out.
\nOn gaining Independence in 1964 the new Zambian government had an extremely limited pool of educated labour. Out of a population of about four million only 110,000 had received six years of schooling and of these only fifty-eight percent had completed full primary school. Fourteen percent had passed the two-year junior secondary course as 961 had completed the Cambridge School Certificate [17]. In this setting, government realized that education was a major priority so that it could place its heavily marginalized people in positions of responsibility in the new state.
\nAt the same time, the government lost no time in assuming almost total control of the education system through an Education Act in 1966. Subsequently, its Ministry of Education quickly expanded access to schooling so as to provide universal primary education for every Zambian, which had been a long-term ideal [18]. Given the challenge of creating a nation-state, government also saw schooling as a means towards national unity and prosperity for all. However, within that perspective, the President was concerned to develop a nation where there would be little division between ‘haves’ and ‘have-nots. [19]’ In its egalitarian concern, the Ministry of Education abolished school fees so that schooling would be open to all unlike what had been the case during colonialism.
\nIn pursuing this aim of promoting widespread education for prosperity and inclusion, government adopted what, at the time was seen to be the best or only route, which was seen to be that of modernization [20]. This theory had been popularized in the 1950s and 60s to explain the relative under-development of Latin America, Africa, and Asia. It equated their current stage of under-development to an earlier historical period of the developed nations. It thereby assumed that development was unilinear consisting of a sequence of stages. One of its earliest proponents was Walter Rostow who spoke of the traditional, pre-condition, and take off stages [21].
\nAmong the pivotal preconditions for the so-called take off, Rostow identified the development of natural science and technology and the values that accompany them. This came to mean that academic schooling was seen to be a crucial ingredient. Through the school, children would learn the tools of becoming modern. A key element of this theory would be that the nation-state. Developing countries could pursue a path to their development even if they might helpfully seek advice and assistance from developed countries. Subsequent development of Rostow’s thesis occurred with articulation in 1961 of what was called the human capital approach where education came to be seen as an important investment which would lead to national prosperity [22]. This theory emphasized development of urban modern industrial centres which would then spread employment and prosperity to the whole population.
\nWith this international framework for development in view, Zambia invested heavily in schooling, patterned on the educational systems of Europe with the hope that it would lead to widespread prosperity at the national level. It was founded in an understanding that school had a direct impact on producing a developed nation which would mean widespread, if not full, employment of those educated. In the Zambian context, it meant that government introduced what was a conventionally academic approach to school and saw success in the state academic examinations as perhaps the best and fairest means to national development in so far as it offered equality of access to all though free schools.
\nAs a result, between 1964 and 1970, the number of children in primary schools increased dramatically as it did also at secondary as well as teacher and university education [23]. This surge of enrollment continued as the economy was buoyant and appeared to promise widespread schooling and opportunity to all, which accorded well with the government’s desire to create a nation of equals where even the poorest child in the far off regions of the country would not be marginalized but would have equal chance to succeed as those in the cities coming from well-to-do families. In these early years, where formal employment was abundant for schooled people at primary level and beyond, the system was widely welcomed and enabled many of the poor to move up the social ladder.
\nWithin a few years however this pattern of providing universal schooling and the opportunities that accompanied it began to show signs of break-down. By 1969, despite the promise of universal access to primary school, 33 percent of the seven-year old children were not in school and many of those who completed their primary schooling could not find places in secondary schools [24]. The ideal of universal primary schooling and wholesale employment in the formal sector were in question.
\nIn subsequent years (1970-1975), the situation deteriorated with increasing numbers being excluded from the system at primary, secondary, and tertiary levels in part because the government could no longer afford to provide the kind of universal access which it had originally promised. This needs to be seen particularly in light of the adverse economic situation for Zambia in the 1970s when the price of its main market product—copper—fell dramatically. In the situation of a growing squeeze on revenue and an increasing limit of access to school, by 1975 only 49 percent of the 7-14 year olds were in school.
\nWith awareness of this fast-growing problem of over-emphasis on academic schooling and its failure to deliver equal opportunity and social inclusion in the early 1970s, the government sought an alternative route to development which questioned the modernization school model along socialist lines. The President noted the growing economic and social gap between the urban and rural population as well as the fact that new-found wealth was concentrated in the hands of a small but powerful group where the masses were increasingly marginalized [25].
\nAt the same time, dependency theorists argued against a linear perspective on national development and spoke of core and periphery dimensions of such development within the capitalist order [26]. At the periphery where developing nations were located, development depended principally on what happened in the developed nations at the core. These nations in turn depended on the periphery for their own development and so economic development at the margins was highly dependent, resembling what had taken place in colonial times. Dependency theorists advocated cutting links with the modernization approach and promoting self-reliance. This was already occurring in places like Tanzania and Cuba. Efforts had already been made to diversify the curriculum along these lines but they seemed to be inadequate [27].
\nIt is therefore not so astonishing that in 1973, the President called for a major review of the education system which resulted in a widespread survey, consultation, and a subsequent proposal, Education for Development [28]. It spoke of equity and the need to provide a system that did not favour a minority of the population by preparing an elite for high-status and leadership positions. Though there was appreciation for what the then current system offered in terms of social mobility for the less well-off, it pointed to the growing tendency to become socially reproductive. In that way it enhanced the position of those in power enabling them to maintain their privilege. It was recognized that continuation of the then current education system would result in shrinkage of the opportunity structure for the poorest. In addition, Education for Development questioned the value of schools that were oriented to passing exams with little or no consideration of their wider national economic and industrial roles. It likened the system to a train that travels on a single track bound for one destination ejecting most of the passengers on the way, keeping a small minority [29]. It was nonetheless acknowledged that changing the educational system in itself was insufficient; there was need to transform the socio-economic setting [30]. This signaled anxiety and resistance for those already benefitting from the system.
\nThough the proposal was debated at some length, it was swiftly rejected in favour of essentially maintaining the then current system but including what might be identified as cosmetic reforms in Educational Reform [31]. The revised model focused on capacity building and emphasized education as an instrument for personal and national development. The system took on additional features including keeping an eye on rural development and self-reliance inspired by what appeared to be happening in places like Cuba and Tanzania. By keeping this ideal of self-reliance in the background, it was hoped that national development could be better balanced between what was happening in the urban and rural settings and as a consequence that employment would not be so heavily focused on academic merit. It was moreover seen to be a better way to avoid creating a nation with ‘haves’ linked to jobs in the town and ‘have-nots’ in the rural areas.
\nAs the country emerged from the so-called reforms in 1977, it was clear that control of the system was passing into the hands of what had developed as an elite who had become politically powerful. It favoured the modernization approach to development in its academically selective process even though this meant ever increasing numbers who would be marginalized by it. While, theoretically, the system was still free and open to all, because of its academic and Western-style curriculum including English as the medium of instruction, it favoured those who had become part of the growing elite, becoming reproductive of their status and less disposed to upward mobility for the many at the margins [32].
\nWhat resulted was a continuation of the system as it was but it kept in view the government’s commitment to the promotion of equity in terms of a widespread access to primary schooling. Though this appeared to manifest concern for the so-called marginalized masses, it did not greatly impact the academically selective system which continued to favour those who were part of the growing elite [33]. In addition, because of government’s debt, fees were introduced a few years later at different levels, which more severely impacted the poor.
\nWith the introduction of fees at various points of the system, the Catholic Church, among others, pleaded on behalf of the marginalized sections of society and began to provide grants and bursaries. It had earlier praised the momentum of the first education reform proposal, Education for Development, for its emphasis on including the weaker elements of society and in general came to find itself at odds with the elitist system that had now emerged. It did not openly advocate for radical review or take major steps against what was taking place. This may indeed confirm Berman, in seeing the church subordinating its mission, but it probably makes some sense in so far as the church had to thread a tight line as the state became more authoritarian and intolerant of alternative viewpoints [34].
\nMeanwhile, the education system continued to be informed by a human capital outlook leading to an elitist status for a minority while the political rhetoric spoke in terms of production units and local empowerment. By 1980, there were 493,000 employed in the formal sector of the economy which represented about 27 percent of the working-age sector. Already, 14 percent of the unemployed had some secondary schooling with most from the earlier drop-out points Grade 4 and Grade 7. Progression to Grade 8 pivoted at about 23 percent which meant that large numbers were being forced to leave school with little prospect of formal employment. This concern of relating school with access to jobs had been a crucial issue in the so-called reform movement but little had been done beyond discussion [35]. The curriculum had been designed to secure entry to school and to lead to formal employment. This was happening less and less with more and more children being marginalized. Linear expansion of the system was not sufficient [36].
\nAlthough there were piecemeal attempts to implement the so-called education reform, no comprehensive approach took place till, at the instigation of the World Bank, a major survey was undertaken and a report appeared in 1986 known as the Educational Reform Implementation Project (ERIP) [37]. This document focused on the need for equity in educational development and was seen to be best approached by according priority to primary schooling. It was seen in the light of employment opportunities which left many without the possibility of formal employment. The concern became: how could the school system be revamped to assist the increasing numbers of those who were being marginalized which progressively meant the poorest in society? [38].
\nIn response to the World Bank’s directives and promise of assistance, ERIP proposed large-scale investment in what had been an initial ideal namely primary schooling for all Zambian children [39]. In so doing, there was also a proposed moratorium on investment in secondary and higher education. At the primary level, it meant expansion of provision which led to the construction of schools and invitation to the local community to help in this project. In many instances, the response of the community was predominantly to construct basic schools (schools that added facilities for Grade 7 and 8). This led to increased enrolment in what would often be rather make-shift schools throughout the country and many of these allowed children to enter the lower secondary school level (basic included Grades 8 and 9 which were lower secondary), adding to what already was a bad situation:
\nReports from several parts of the country drew attention to the bad physical condition of school buildings… cracked walls… termite infested… broken or missing doors, windows without glass… leaking water … blocked toilets [40].
\nERIP thus concentrated on how to achieve the long cherished ideal of seven years primary school for every Zambian child, despite a bleak economic climate where government struggled to pay the nation’s external debt and was subjected to conditions set by the International Monetary Fund known as Structural Adjustment Programme (SAP). Educational Reform Implementation Project considered that by widening the net at the primary school level economic growth would be enhanced. It claimed that returns to investment in primary schooling were greater nationally than at higher levels. Besides, investment per student at this level was hugely less costly than investment than at university level [41].
\nWhat was ambiguous was that the report appeared to envisage primary schooling (and less obvioulsy basic schooling) to be the end of the road for most children but that did not fit the long-term understanding that primary school’s real value in the minds of children and their parents. They saw it as a stepping stone to Grade 8 and beyond; hence, local community’s support for basic schools which not only allowed more primary-aged children to be admitted but enabled most of them to stay to Grade 9. The report paradoxically also envisaged the introduction of fees because of the poor condition of the nation’s financial situation, breaking the welfare state system of free schooling that had characterized the nation since Independence and threatening the welfare and access to school for those who were poor [42].
\nTo address the challenge of including all children in quality primary school as a prelude to better economic standing, the new MMD government continued to emphasize self-reliance through production units but after 1991 sought more input from the local community as it further transformed the country into a market-based economy. Under this government, Zambia committed itself to the World Declaration on Education for All. Enrolment in primary (Grades 1-7) and basic (Grades 1-9) increased as initiatives to ensure better inclusion of girls, orphans, special needs, and rural children followed as did monitoring of attainment of basic literacy.
\nNonetheless, enrolment levels were constrained by the introduction of fees in a climate of widespread unemployment as well as by an increasing lack of confidence in the system to deliver much coveted formal employment as the opportunity structure contracted [43]. Fees disproportionately impacted the poor many of whom not only failed to enroll but after enrolment were likely to drop out. Most parents could not afford to meet the obligatory costs of sending their children to school [44]. By 1998, the national average attendance in primary school was 66 percent of which only 50 percent progressed to Grades 8 and about 20 percent to Grade 10. This represented 61 percent in rural versus 80 percent in urban areas [45]. Not only did this reveal how rural children were marginalized but, despite efforts to assist, those excluded were disproportionately girls, those with special needs, and orphans [46].
\nHowever, though the overall impact was that the intake into the primary schools increased, because of government’s financial situation and input, many of the schools were of poor quality leaving one wonder about the level of literacy of those who completed at either primary or basic level [47]. These basic schools provided wider access. However, only 64 percent of richer families enrolled in them. Instead, the better endowed opted for private or faith-based schools some of which did not transform their lower secondary schools to become basic. As a result, they had better facilities which promised better quality learning, increasing their chances of what was severely limited, entry to Grade 10 [48].
\nThis overall movement towards primary and in some cases basic education for all became a leading motif within the system under strain. As a result, by 2001, the primary school enrollment reached 1.77 million as against 1.4 million in 1990. This modest increase nonetheless meant that 65 percent equal to 700,000 of seven-year-olds were not in school. Of those who completed primary school, roughly 50 percent proceeded to Grade 8 (because of the basic school movement) and approximately 20 percent to Grade 10 which represented a significant drop-out rate especially at the end of Grade 9.
\nA key reason for the large out of school population was that, because of fees, the poorest were excluded. Yet, while the overall number gaining primary school education had increased, this did not translate into the fact that they would gain formal employment. What we have instead is a better schooled population within a declining employment rate [49]. Investment in education on a national level had not expanded economic productivity as had been promised and expected. Moreover, in this expansion of provision, as already indicated, the quality of schooling was uneven especially in rural areas, leaving those that completed largely and progressively less qualified in their search for formal employment.
\nThough basic literacy is to be prized as a human right, the universal primary school movement appears to have done little to enable those with primary or basic schooling to avoid marginalization and climb the educational pyramid especially since investment and expansion at the secondary level and higher level had been somewhat frozen. Yet, clearly that was what most desired in the interest of finding formal employment. It came to mean that more and more young people emerged from basic schools with slimmer and slimmer chances of being selected to go further. The opportunities for entry to Grade 10 were clearly linked to those who had quality schooling, which in rural and poor urban communities was less likely because of deprived facilities. Related to this, the question emerged: what was the economic or social value of these years in school when at the end graduates could not find formal employment? This needs to be seen within the context where about 10 percent of Zambia’s employment was then at the formal level [50].
\nSince the majority of children who entered Grade I were blocked from ascending the ladder to higher secondary school (high school as it was called for some years) and beyond, the age-old question of seeking a different kind of schooling re-emerged. Though numbers in school increased, the problem of formal employment for those who emerged remained, resembling what it had happened in the colonial times. It was the long and fast developing problem of ‘educated unemployed’ [51]. Juxtaposed to this was the high poverty level ranging at about 80 percent of the population.
\nAs the overall population increased and as the country went through financial struggle, the Ministry of Education sought more community (local and international)support, moving one might say from a welfare state to a market-based economy. In that setting it pressed ahead with the goal of universal primary schooling under the impression that this was the route not only to greater prosperity but to decreased marginalization and more equitable distribution of resources. The decade between 1990 and 2001 thus witnessed increased enrollment but did little for what was the major concern namely formal employment bringing again to focus the question of how appropriate was the school curriculum for job creation [52].
\nAttention inevitably focused on the nature and role of the Technical Education, Vocational, and Entrepreneurship Authority (TEVETA) which had been set up in the past and provided education more directly linked to employable skills. In 2000, 151 institutions under its control had an overall enrollment of 24,648 students. One might wonder why these settings with promise of some formal and self-employment had not become more attractive. It is true that many were private which entailed fees but perhaps more pivotally academic schooling had been seen for generations to be the pathway to formal and well-paid employment [53]. Thus, getting people interested in this technical mode of schooling proved to be difficult even if it promised to assist students to become productive particularly in the informal sector [54].
\nIn any event, in the light of ERIP, by 2001, there was 1.770,000 million pupils in primary school and the progression rate to Grade 8 had pivoted around 35 percent. This overall increase in the primary and basic school populations resulted in large part because of the growth of basic and latterly community schools [55]. Though both these models of school made a major contribution in reducing the number of out-of-school children largely because they were free, they operated in ways that were rudimentary [56].
\nAs Zambia gained relief from its debt through the Heavily Indebted Poor Countries (HIPC) initiative in 2002, one of its first responses was again to provide free basic schooling in view of achieving universal primary schooling which had been such a long-term issue. This helped. Implementation and interpretation of this free schooling revealed ‘hidden’ fees as well as increased quantity at the cost of quality. There were too many over-crowded classrooms and schools with shortage of teachers. This was especially true in rural areas and densely populated sectors of cities and towns [57].
\nFollowing the re-introduction of the free basic schooling in 2002, enrollments increased though the degree to which the schools were free remained an on-going question. Correlated with this was government’s inadequate support of school infrastructural needs [58]. By 2008, enrollments had increased to 2,909,436 at the primary level and 3,290,000 at the basic level [59]. This could clearly be seen as a major step forward in the goal of providing primary schooling for all Zambian children even if it included a low intake rate of 56 percent for the age 7-13 [60] This pattern of increased enrollment was enhanced in the years following by economic growth in the economy largely because of increased copper sales and greater government investment in schooling.
\nAs the enrollment at the primary and basic levels moved towards the goal of primary schooling for all, it is not surprising that government’s attention moved towards expansion of the secondary and higher levels, which had been on hold since the late 1980s in order to support the movement towards universal primary education as the best effort towards equity creation. This shift to post-primary was also prompted by the fact that the workforce grew at an annual average rate of 4.9 percent between 2005 and 2012. Increasingly, employment went to the more educated. Those with no education and those with Grade 7 found it harder to get jobs while those with Grades 8-12 s and university level had a better chance, prompting a perceived need for higher academic credentials.The majority of school leavers were thus marginalized and faced with employment in the informal sector which TEVET supported. Despite government rhetoric however, its investment in TEVET compared poorly with that of other sectors especially the university [61].
\nWhen the Patriotic Front (PF) government was elected in 2011, it took steps to include more people at the higher levels of the education system. As part of its approach, it renamed and reframed the educational system, reverting to the older system of speaking of primary school as Grades 1–7, secondary school Grades 8–12 followed by tertiary education. The previous system had been introduced to facilitate the inclusion of Grades 8 and 9. The problem had now shifted to include more pupils in Grades 8-12. Access to secondary school and higher levels of education was seen to be part of the route to achieving the country’s middle-income status in the light of Vision 2030. At the same time, government recognized that the dynamic of the current system of education poorly related to the creation of employment and as a result the country still wrestled with high level poverty and marginalization. Would large-scale investment at the higher levels create more employment or would school leavers face the need for higher credentials for roughly the same level of formal employment?
\nWith dramatic expansion at secondary and higher level enrolment in view, the PF government decided through Framework 2012 [62] to leave the system fundamentally as it was but to balance the curriculum so that the technical learning might no longer be seen to be inferior [63]. Instead of a major effort at reform of the system as happened in the mid-1970s, it proposed a two-career twin pathway in the school curriculum–academic and technical. This re-emphasis and effort to better include technical education together with a review of English being displaced by local languages at the lower Grades as the medium of instruction could be seen to re-surface the age-old issue of the relevance of the predominant kind of the schooling on offer. In an effort towards greater inclusion and less marginalization, it also opened pre-schools so that head-starts were not monopolized by the better off members of society.
\nThis concern to integrate the different streams of schooling appears to be well directed but to be effective in breaking the age-old bias against technical education, the overall system may need a greater commitment to educate for formal employment and greater backing for TEVET’s 275 institutions. Currently, the almost exclusive human capital perspective on social development continues to dominate and to be reproductive of the social order with highly unsatisfactory implications for inclusion of the majority. As, at the time of the so-called education reform in 1976, making this job-oriented learning attractive promises to be a hard battle. In the minds of most, formal employment is linked to academic achievement [64]. In some instances as in the case of university academic staff, this appears incontestable [65]. Perception of the opportunity structure remains pivotal and, until that opportunity window opens more widely through better reward for technical qualification, it is difficult to see how any significant change will occur. Middle-income status may be achieved by 2030 but there is still likely to be large sectors of the population, marginalized in poverty with obvious consequences for their wellbeing [66].
\nWithin this setting of overall growth in the economy and in school enrollments no longer principally at primary and basic school levels but at secondary and higher levels, by 2017 the primary school enrollment reached 3, 300,000 [67].The country had almost achieved its target of universal primary schooling. It was noted that this goal, though in sight, was still not achieved as the net enrollment rate of the age-relevant children was 80 percent and completion rate 79 percent [68].Part of the reason entails high repetition and drop-out rates, low quality linked to poor infrastructure including high numbers of students in classrooms, insufficient numbers of teachers, lack of textbooks and free schooling in theory rather than in reality [69]. One could argue that the whole Zambian population has been included in gaining some degree of literacy at the primary level, leaving overall literacy at approximately 75 percent. This of course assumes that completion of primary or even basic school can be correlated with a satisfactory level of literacy [70].
\nWhile this emerges as an unquestionable achievement and the result of a long-time ambition, it has a major shadow. It does not provide the majority with the prospect of formal employment and the rewards associated with that. Instead, it leaves the country, like many other African countries, with 60 percent of the population of approximately 16 million marginalized. They are said to be in poverty of varying degrees, high level or extreme for 5 million and moderate for almost 8 million [71]. One might say that the education system that was originally thought to promote a prosperous nation with wealth equitably shared has delivered something very different.
\nAmong other things, this means that, while 88 percent of students in primary school aspire to university education, only 3-4 percent have access to it. Though one might claim that the system offers equality of opportunity through its meritocratic system, is this true? The boy/girl from Matero who we mentioned at the outset has a much weaker chance of climbing the educational ladder not necessarily because he/she is less gifted but because he/she is located where he/she does not have the resources to enter the school system well equipped. He/she is unlikely to have had pre-school, educated parents, facility in speaking and reading English at home, which most of his/her well-to-do age-mates from more affluence parts of the city have and so they are likely to gain higher grades in the Grade VII test. This enables them to be admitted to the Catholic school which, like most Catholic schools, prides itself on good performance in meritocratic pro-privileged national league Tables [72]. The Matero boy/girl has to travel to where his/her schooling is likely to be less well resourced.
\nThis trend is seen more widely where 37 percent of Grade I students reach Grade 9 or secondary school. Even if he/she finds him/herself in the 26 percent who reach Grade XII, College entry ranges at roughly 3 percent and there is almost no chance of having access to university [73]. Given this pattern that clearly favours the ‘haves’, we find that 77 percent of university students coming from the richest 10 percent of the population and they were assisted with state bursaries at tax-payers’ cost [74].
\nAs the overall rate of inclusion of the population at the primary level is to be commended so too is the overall expansion of those completing secondary and higher education in large part because of widespread development of private contributions so that the country now has five public and upward of 32 private universities and multiple colleges in concord with the human capital approach to the goal of middle-income status in 2030 [75]. However, without large-scale economic development and dramatic increase in the formal employment rate, what is likely to result, will be somewhat like we find in 2017 when the country had 85,000 or so teachers emerging from colleges, there was employment for 2,000 or so, leaving the country with ever larger numbers of marginalized college and university graduates [76]. The linear system, even modified by Framework 2012, still needs urgent and radical reform if it is to deliver not purely middle-income status for a fortunate few.
\nDespite the hopes of those who led the country after 1964 of creating a prosperous nation where the division between those who ‘have’ and those ‘left out’ or marginalized would be small, the modernization mode of schooling by which they strove to achieve this delivered a different outcome, dispelling the persistent myth of achieving equality through a meritocratic system. This was glimpsed early in the history of schooling in the country but adopting an alternative paradigm proved to be difficult not only for the state but even for faith-based public schools because of the power of a newly formed elite.
\nThis discussion has recounted how the Zambian school system has marginalized a major part of the population from access to the kind of lifestyle that each person has reason to value. Government initially attempted to counteract this progressive exclusion of the majority through reform in the 1970s. It failed and resorted to a piece-meal solution along the lines of basic education for all. In the early part of the 21st century, after debt relief and a more buoyant economy, government invested in setting the school system on better footing. Though welcome, this has not confronted the social structure and the school system as part of it, marginalising the majority and frustrating its desire for an acceptably equitable level of well-being for every Zambian.
\nYou have been successfully unsubscribed.
",metaTitle:"Unsubscribe Successful",metaDescription:"You have been successfully unsubscribed.",metaKeywords:null,canonicalURL:"/page/unsubscribe-successful",contentRaw:'[{"type":"htmlEditorComponent","content":""}]'},components:[{type:"htmlEditorComponent",content:""}]},successStories:{items:[]},authorsAndEditors:{filterParams:{sort:"featured,name"},profiles:[{id:"6700",title:"Dr.",name:"Abbass A.",middleName:null,surname:"Hashim",slug:"abbass-a.-hashim",fullName:"Abbass A. Hashim",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/6700/images/1864_n.jpg",biography:"Currently I am carrying out research in several areas of interest, mainly covering work on chemical and bio-sensors, semiconductor thin film device fabrication and characterisation.\nAt the moment I have very strong interest in radiation environmental pollution and bacteriology treatment. The teams of researchers are working very hard to bring novel results in this field. I am also a member of the team in charge for the supervision of Ph.D. students in the fields of development of silicon based planar waveguide sensor devices, study of inelastic electron tunnelling in planar tunnelling nanostructures for sensing applications and development of organotellurium(IV) compounds for semiconductor applications. I am a specialist in data analysis techniques and nanosurface structure. I have served as the editor for many books, been a member of the editorial board in science journals, have published many papers and hold many patents.",institutionString:null,institution:{name:"Sheffield Hallam University",country:{name:"United Kingdom"}}},{id:"54525",title:"Prof.",name:"Abdul Latif",middleName:null,surname:"Ahmad",slug:"abdul-latif-ahmad",fullName:"Abdul Latif Ahmad",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"20567",title:"Prof.",name:"Ado",middleName:null,surname:"Jorio",slug:"ado-jorio",fullName:"Ado Jorio",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidade Federal de Minas Gerais",country:{name:"Brazil"}}},{id:"47940",title:"Dr.",name:"Alberto",middleName:null,surname:"Mantovani",slug:"alberto-mantovani",fullName:"Alberto Mantovani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"12392",title:"Mr.",name:"Alex",middleName:null,surname:"Lazinica",slug:"alex-lazinica",fullName:"Alex Lazinica",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/12392/images/7282_n.png",biography:"Alex Lazinica is the founder and CEO of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his PhD studies in Robotics at the Vienna University of Technology. Here he worked as a robotic researcher with the university's Intelligent Manufacturing Systems Group as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and most importantly he co-founded and built the International Journal of Advanced Robotic Systems- world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career, since it was a pathway to founding IntechOpen - Open Access publisher focused on addressing academic researchers needs. Alex is a personification of IntechOpen key values being trusted, open and entrepreneurial. Today his focus is on defining the growth and development strategy for the company.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"19816",title:"Prof.",name:"Alexander",middleName:null,surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/19816/images/1607_n.jpg",biography:"Alexander I. Kokorin: born: 1947, Moscow; DSc., PhD; Principal Research Fellow (Research Professor) of Department of Kinetics and Catalysis, N. Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow.\r\nArea of research interests: physical chemistry of complex-organized molecular and nanosized systems, including polymer-metal complexes; the surface of doped oxide semiconductors. He is an expert in structural, absorptive, catalytic and photocatalytic properties, in structural organization and dynamic features of ionic liquids, in magnetic interactions between paramagnetic centers. The author or co-author of 3 books, over 200 articles and reviews in scientific journals and books. He is an actual member of the International EPR/ESR Society, European Society on Quantum Solar Energy Conversion, Moscow House of Scientists, of the Board of Moscow Physical Society.",institutionString:null,institution:{name:"Semenov Institute of Chemical Physics",country:{name:"Russia"}}},{id:"62389",title:"PhD.",name:"Ali Demir",middleName:null,surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62389/images/3413_n.jpg",biography:"Dr. Ali Demir Sezer has a Ph.D. from Pharmaceutical Biotechnology at the Faculty of Pharmacy, University of Marmara (Turkey). He is the member of many Pharmaceutical Associations and acts as a reviewer of scientific journals and European projects under different research areas such as: drug delivery systems, nanotechnology and pharmaceutical biotechnology. Dr. Sezer is the author of many scientific publications in peer-reviewed journals and poster communications. Focus of his research activity is drug delivery, physico-chemical characterization and biological evaluation of biopolymers micro and nanoparticles as modified drug delivery system, and colloidal drug carriers (liposomes, nanoparticles etc.).",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"61051",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"100762",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"St David's Medical Center",country:{name:"United States of America"}}},{id:"107416",title:"Dr.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Texas Cardiac Arrhythmia",country:{name:"United States of America"}}},{id:"64434",title:"Dr.",name:"Angkoon",middleName:null,surname:"Phinyomark",slug:"angkoon-phinyomark",fullName:"Angkoon Phinyomark",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/64434/images/2619_n.jpg",biography:"My name is Angkoon Phinyomark. I received a B.Eng. degree in Computer Engineering with First Class Honors in 2008 from Prince of Songkla University, Songkhla, Thailand, where I received a Ph.D. degree in Electrical Engineering. My research interests are primarily in the area of biomedical signal processing and classification notably EMG (electromyography signal), EOG (electrooculography signal), and EEG (electroencephalography signal), image analysis notably breast cancer analysis and optical coherence tomography, and rehabilitation engineering. I became a student member of IEEE in 2008. During October 2011-March 2012, I had worked at School of Computer Science and Electronic Engineering, University of Essex, Colchester, Essex, United Kingdom. In addition, during a B.Eng. I had been a visiting research student at Faculty of Computer Science, University of Murcia, Murcia, Spain for three months.\n\nI have published over 40 papers during 5 years in refereed journals, books, and conference proceedings in the areas of electro-physiological signals processing and classification, notably EMG and EOG signals, fractal analysis, wavelet analysis, texture analysis, feature extraction and machine learning algorithms, and assistive and rehabilitative devices. I have several computer programming language certificates, i.e. Sun Certified Programmer for the Java 2 Platform 1.4 (SCJP), Microsoft Certified Professional Developer, Web Developer (MCPD), Microsoft Certified Technology Specialist, .NET Framework 2.0 Web (MCTS). I am a Reviewer for several refereed journals and international conferences, such as IEEE Transactions on Biomedical Engineering, IEEE Transactions on Industrial Electronics, Optic Letters, Measurement Science Review, and also a member of the International Advisory Committee for 2012 IEEE Business Engineering and Industrial Applications and 2012 IEEE Symposium on Business, Engineering and Industrial Applications.",institutionString:null,institution:{name:"Joseph Fourier University",country:{name:"France"}}},{id:"55578",title:"Dr.",name:"Antonio",middleName:null,surname:"Jurado-Navas",slug:"antonio-jurado-navas",fullName:"Antonio Jurado-Navas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/55578/images/4574_n.png",biography:"Antonio Jurado-Navas received the M.S. degree (2002) and the Ph.D. degree (2009) in Telecommunication Engineering, both from the University of Málaga (Spain). He first worked as a consultant at Vodafone-Spain. From 2004 to 2011, he was a Research Assistant with the Communications Engineering Department at the University of Málaga. In 2011, he became an Assistant Professor in the same department. From 2012 to 2015, he was with Ericsson Spain, where he was working on geo-location\ntools for third generation mobile networks. Since 2015, he is a Marie-Curie fellow at the Denmark Technical University. His current research interests include the areas of mobile communication systems and channel modeling in addition to atmospheric optical communications, adaptive optics and statistics",institutionString:null,institution:{name:"University of Malaga",country:{name:"Spain"}}}],filtersByRegion:[{group:"region",caption:"North America",value:1,count:5766},{group:"region",caption:"Middle and South America",value:2,count:5228},{group:"region",caption:"Africa",value:3,count:1717},{group:"region",caption:"Asia",value:4,count:10370},{group:"region",caption:"Australia and Oceania",value:5,count:897},{group:"region",caption:"Europe",value:6,count:15790}],offset:12,limit:12,total:118192},chapterEmbeded:{data:{}},editorApplication:{success:null,errors:{}},ofsBooks:{filterParams:{hasNoEditors:"0",sort:"dateEndThirdStepPublish",topicId:"9,11"},books:[{type:"book",id:"10270",title:"Fog Computing",subtitle:null,isOpenForSubmission:!0,hash:"54853b3034f0348a6157b5591f8d95f3",slug:null,bookSignature:"Dr. Isiaka Ajewale Alimi, Dr. Nelson Muga, Dr. Qin Xin and Dr. Paulo P. Monteiro",coverURL:"https://cdn.intechopen.com/books/images_new/10270.jpg",editedByType:null,editors:[{id:"208236",title:"Dr.",name:"Isiaka",surname:"Alimi",slug:"isiaka-alimi",fullName:"Isiaka Alimi"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10654",title:"Brain-Computer Interface",subtitle:null,isOpenForSubmission:!0,hash:"a5308884068cc53ed31c6baba756857f",slug:null,bookSignature:"Dr. Vahid Asadpour",coverURL:"https://cdn.intechopen.com/books/images_new/10654.jpg",editedByType:null,editors:[{id:"165328",title:"Dr.",name:"Vahid",surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10567",title:"Uncertainty Management in Engineering - Topics in Pollution Prevention and Controls",subtitle:null,isOpenForSubmission:!0,hash:"4990db602d31f1848c590dbfe97b6409",slug:null,bookSignature:"Prof. Rehab O. Abdel Rahman and Dr. Yung-Tse Hung",coverURL:"https://cdn.intechopen.com/books/images_new/10567.jpg",editedByType:null,editors:[{id:"92718",title:"Prof.",name:"Rehab",surname:"Abdel Rahman",slug:"rehab-abdel-rahman",fullName:"Rehab Abdel Rahman"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10519",title:"Middleware Architecture",subtitle:null,isOpenForSubmission:!0,hash:"c326d436ae0f4c508849d2336dbdfb48",slug:null,bookSignature:"Dr. Mehdia Ajana El Khaddar",coverURL:"https://cdn.intechopen.com/books/images_new/10519.jpg",editedByType:null,editors:[{id:"26677",title:"Dr.",name:"Mehdia",surname:"Ajana El Khaddar",slug:"mehdia-ajana-el-khaddar",fullName:"Mehdia Ajana El Khaddar"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10568",title:"Hysteresis in Engineering",subtitle:null,isOpenForSubmission:!0,hash:"6482387993b3cebffafe856a916c44ce",slug:null,bookSignature:"Dr. Giuseppe Viola",coverURL:"https://cdn.intechopen.com/books/images_new/10568.jpg",editedByType:null,editors:[{id:"173586",title:"Dr.",name:"Giuseppe",surname:"Viola",slug:"giuseppe-viola",fullName:"Giuseppe Viola"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10584",title:"Engineered Wood Products for Construction",subtitle:null,isOpenForSubmission:!0,hash:"421757c56a3735986055250821275a51",slug:null,bookSignature:"Dr. Meng Gong",coverURL:"https://cdn.intechopen.com/books/images_new/10584.jpg",editedByType:null,editors:[{id:"274242",title:"Dr.",name:"Meng",surname:"Gong",slug:"meng-gong",fullName:"Meng Gong"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10695",title:"Computational Fluid Dynamics",subtitle:null,isOpenForSubmission:!0,hash:"1f8fd29e4b72dbfe632f47840b369b11",slug:null,bookSignature:"Dr. Suvanjan Bhattacharyya",coverURL:"https://cdn.intechopen.com/books/images_new/10695.jpg",editedByType:null,editors:[{id:"233630",title:"Dr.",name:"Suvanjan",surname:"Bhattacharyya",slug:"suvanjan-bhattacharyya",fullName:"Suvanjan Bhattacharyya"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10769",title:"Supercapacitors",subtitle:null,isOpenForSubmission:!0,hash:"dda2f53b2c9ee308fe5f3e0d1638ff5c",slug:null,bookSignature:"Associate Prof. Daisuke Tashima",coverURL:"https://cdn.intechopen.com/books/images_new/10769.jpg",editedByType:null,editors:[{id:"254915",title:"Associate Prof.",name:"Daisuke",surname:"Tashima",slug:"daisuke-tashima",fullName:"Daisuke Tashima"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10370",title:"Advances in Fundamental and Applied Research on Spatial Audio",subtitle:null,isOpenForSubmission:!0,hash:"f16232a481c08a05cc191ac64cf2c69e",slug:null,bookSignature:"Dr. Brian FG Katz and Dr. Piotr Majdak",coverURL:"https://cdn.intechopen.com/books/images_new/10370.jpg",editedByType:null,editors:[{id:"278731",title:"Dr.",name:"Brian FG",surname:"Katz",slug:"brian-fg-katz",fullName:"Brian FG Katz"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10681",title:"Biodegradation",subtitle:null,isOpenForSubmission:!0,hash:"9a6e10e02788092872fd249436898e97",slug:null,bookSignature:"Ph.D. Kassio Ferreira Mendes, Dr. Rodrigo Nogueira de Sousa and Dr. Kamila Cabral Mielke",coverURL:"https://cdn.intechopen.com/books/images_new/10681.jpg",editedByType:null,editors:[{id:"197720",title:"Ph.D.",name:"Kassio",surname:"Ferreira Mendes",slug:"kassio-ferreira-mendes",fullName:"Kassio Ferreira Mendes"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10683",title:"Hydropower",subtitle:null,isOpenForSubmission:!0,hash:"7ce7ad8768bd2cad155470fe1fd883f4",slug:null,bookSignature:"Dr. Yizi Shang, Dr. Ling Shang and Dr. Xiaofei Li",coverURL:"https://cdn.intechopen.com/books/images_new/10683.jpg",editedByType:null,editors:[{id:"349630",title:"Dr.",name:"Yizi",surname:"Shang",slug:"yizi-shang",fullName:"Yizi Shang"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10651",title:"Machine Learning - Algorithms, Models and Applications",subtitle:null,isOpenForSubmission:!0,hash:"6208156401c496e0a4ca5ff4265324cc",slug:null,bookSignature:"Prof. Jaydip Sen",coverURL:"https://cdn.intechopen.com/books/images_new/10651.jpg",editedByType:null,editors:[{id:"4519",title:"Prof.",name:"Jaydip",surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],filtersByTopic:[{group:"topic",caption:"Agricultural and Biological Sciences",value:5,count:16},{group:"topic",caption:"Biochemistry, Genetics and Molecular Biology",value:6,count:4},{group:"topic",caption:"Business, Management and Economics",value:7,count:1},{group:"topic",caption:"Chemistry",value:8,count:8},{group:"topic",caption:"Computer and Information Science",value:9,count:6},{group:"topic",caption:"Earth and Planetary Sciences",value:10,count:7},{group:"topic",caption:"Engineering",value:11,count:16},{group:"topic",caption:"Environmental Sciences",value:12,count:2},{group:"topic",caption:"Immunology and Microbiology",value:13,count:3},{group:"topic",caption:"Materials Science",value:14,count:5},{group:"topic",caption:"Mathematics",value:15,count:1},{group:"topic",caption:"Medicine",value:16,count:24},{group:"topic",caption:"Neuroscience",value:18,count:1},{group:"topic",caption:"Pharmacology, Toxicology and Pharmaceutical Science",value:19,count:3},{group:"topic",caption:"Physics",value:20,count:3},{group:"topic",caption:"Psychology",value:21,count:4},{group:"topic",caption:"Robotics",value:22,count:1},{group:"topic",caption:"Social Sciences",value:23,count:3},{group:"topic",caption:"Technology",value:24,count:1},{group:"topic",caption:"Veterinary Medicine and Science",value:25,count:1}],offset:12,limit:12,total:22},popularBooks:{featuredBooks:[{type:"book",id:"9385",title:"Renewable Energy",subtitle:"Technologies and Applications",isOpenForSubmission:!1,hash:"a6b446d19166f17f313008e6c056f3d8",slug:"renewable-energy-technologies-and-applications",bookSignature:"Tolga Taner, Archana Tiwari and Taha Selim Ustun",coverURL:"https://cdn.intechopen.com/books/images_new/9385.jpg",editors:[{id:"197240",title:"Associate Prof.",name:"Tolga",middleName:null,surname:"Taner",slug:"tolga-taner",fullName:"Tolga Taner"}],equalEditorOne:{id:"186791",title:"Dr.",name:"Archana",middleName:null,surname:"Tiwari",slug:"archana-tiwari",fullName:"Archana Tiwari",profilePictureURL:"https://mts.intechopen.com/storage/users/186791/images/system/186791.jpg",biography:"Dr. Archana Tiwari is Associate Professor at Amity University, India. Her research interests include renewable sources of energy from microalgae and further utilizing the residual biomass for the generation of value-added products, bioremediation through microalgae and microbial consortium, antioxidative enzymes and stress, and nutraceuticals from microalgae. She has been working on algal biotechnology for the last two decades. She has published her research in many international journals and has authored many books and chapters with renowned publishing houses. She has also delivered talks as an invited speaker at many national and international conferences. Dr. Tiwari is the recipient of several awards including Researcher of the Year and Distinguished Scientist.",institutionString:"Amity University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Amity University",institutionURL:null,country:{name:"India"}}},equalEditorTwo:{id:"197609",title:"Prof.",name:"Taha Selim",middleName:null,surname:"Ustun",slug:"taha-selim-ustun",fullName:"Taha Selim Ustun",profilePictureURL:"https://mts.intechopen.com/storage/users/197609/images/system/197609.jpeg",biography:"Dr. Taha Selim Ustun received a Ph.D. in Electrical Engineering from Victoria University, Melbourne, Australia. He is a researcher with the Fukushima Renewable Energy Institute, AIST (FREA), where he leads the Smart Grid Cybersecurity Laboratory. Prior to that, he was a faculty member with the School of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, USA. His current research interests include power systems protection, communication in power networks, distributed generation, microgrids, electric vehicle integration, and cybersecurity in smart grids. He serves on the editorial boards of IEEE Access, IEEE Transactions on Industrial Informatics, Energies, Electronics, Electricity, World Electric Vehicle and Information journals. Dr. Ustun is a member of the IEEE 2004 and 2800, IEC Renewable Energy Management WG 8, and IEC TC 57 WG17. He has been invited to run specialist courses in Africa, India, and China. He has delivered talks for the Qatar Foundation, the World Energy Council, the Waterloo Global Science Initiative, and the European Union Energy Initiative (EUEI). His research has attracted funding from prestigious programs in Japan, Australia, the European Union, and North America.",institutionString:"Fukushima Renewable Energy Institute, AIST (FREA)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"National Institute of Advanced Industrial Science and Technology",institutionURL:null,country:{name:"Japan"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10065",title:"Wavelet Theory",subtitle:null,isOpenForSubmission:!1,hash:"d8868e332169597ba2182d9b004d60de",slug:"wavelet-theory",bookSignature:"Somayeh Mohammady",coverURL:"https://cdn.intechopen.com/books/images_new/10065.jpg",editors:[{id:"109280",title:"Dr.",name:"Somayeh",middleName:null,surname:"Mohammady",slug:"somayeh-mohammady",fullName:"Somayeh Mohammady"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9644",title:"Glaciers and the Polar Environment",subtitle:null,isOpenForSubmission:!1,hash:"e8cfdc161794e3753ced54e6ff30873b",slug:"glaciers-and-the-polar-environment",bookSignature:"Masaki Kanao, Danilo Godone and Niccolò Dematteis",coverURL:"https://cdn.intechopen.com/books/images_new/9644.jpg",editors:[{id:"51959",title:"Dr.",name:"Masaki",middleName:null,surname:"Kanao",slug:"masaki-kanao",fullName:"Masaki Kanao"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8985",title:"Natural Resources Management and Biological Sciences",subtitle:null,isOpenForSubmission:!1,hash:"5c2e219a6c021a40b5a20c041dea88c4",slug:"natural-resources-management-and-biological-sciences",bookSignature:"Edward R. Rhodes and Humood Naser",coverURL:"https://cdn.intechopen.com/books/images_new/8985.jpg",editors:[{id:"280886",title:"Prof.",name:"Edward R",middleName:null,surname:"Rhodes",slug:"edward-r-rhodes",fullName:"Edward R Rhodes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9671",title:"Macrophages",subtitle:null,isOpenForSubmission:!1,hash:"03b00fdc5f24b71d1ecdfd75076bfde6",slug:"macrophages",bookSignature:"Hridayesh Prakash",coverURL:"https://cdn.intechopen.com/books/images_new/9671.jpg",editors:[{id:"287184",title:"Dr.",name:"Hridayesh",middleName:null,surname:"Prakash",slug:"hridayesh-prakash",fullName:"Hridayesh Prakash"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9313",title:"Clay Science and Technology",subtitle:null,isOpenForSubmission:!1,hash:"6fa7e70396ff10620e032bb6cfa6fb72",slug:"clay-science-and-technology",bookSignature:"Gustavo Morari Do Nascimento",coverURL:"https://cdn.intechopen.com/books/images_new/9313.jpg",editors:[{id:"7153",title:"Prof.",name:"Gustavo",middleName:null,surname:"Morari Do Nascimento",slug:"gustavo-morari-do-nascimento",fullName:"Gustavo Morari Do Nascimento"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9888",title:"Nuclear Power Plants",subtitle:"The Processes from the Cradle to the Grave",isOpenForSubmission:!1,hash:"c2c8773e586f62155ab8221ebb72a849",slug:"nuclear-power-plants-the-processes-from-the-cradle-to-the-grave",bookSignature:"Nasser Awwad",coverURL:"https://cdn.intechopen.com/books/images_new/9888.jpg",editors:[{id:"145209",title:"Prof.",name:"Nasser",middleName:"S",surname:"Awwad",slug:"nasser-awwad",fullName:"Nasser Awwad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9027",title:"Human Blood Group Systems and Haemoglobinopathies",subtitle:null,isOpenForSubmission:!1,hash:"d00d8e40b11cfb2547d1122866531c7e",slug:"human-blood-group-systems-and-haemoglobinopathies",bookSignature:"Osaro Erhabor and Anjana Munshi",coverURL:"https://cdn.intechopen.com/books/images_new/9027.jpg",editors:[{id:"35140",title:null,name:"Osaro",middleName:null,surname:"Erhabor",slug:"osaro-erhabor",fullName:"Osaro Erhabor"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7841",title:"New Insights Into Metabolic Syndrome",subtitle:null,isOpenForSubmission:!1,hash:"ef5accfac9772b9e2c9eff884f085510",slug:"new-insights-into-metabolic-syndrome",bookSignature:"Akikazu Takada",coverURL:"https://cdn.intechopen.com/books/images_new/7841.jpg",editors:[{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8558",title:"Aerodynamics",subtitle:null,isOpenForSubmission:!1,hash:"db7263fc198dfb539073ba0260a7f1aa",slug:"aerodynamics",bookSignature:"Mofid Gorji-Bandpy and Aly-Mousaad Aly",coverURL:"https://cdn.intechopen.com/books/images_new/8558.jpg",editors:[{id:"35542",title:"Prof.",name:"Mofid",middleName:null,surname:"Gorji-Bandpy",slug:"mofid-gorji-bandpy",fullName:"Mofid Gorji-Bandpy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7847",title:"Medical Toxicology",subtitle:null,isOpenForSubmission:!1,hash:"db9b65bea093de17a0855a1b27046247",slug:"medical-toxicology",bookSignature:"Pınar Erkekoglu and Tomohisa Ogawa",coverURL:"https://cdn.intechopen.com/books/images_new/7847.jpg",editors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoglu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoglu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10432",title:"Casting Processes and Modelling of Metallic Materials",subtitle:null,isOpenForSubmission:!1,hash:"2c5c9df938666bf5d1797727db203a6d",slug:"casting-processes-and-modelling-of-metallic-materials",bookSignature:"Zakaria Abdallah and Nada Aldoumani",coverURL:"https://cdn.intechopen.com/books/images_new/10432.jpg",editors:[{id:"201670",title:"Dr.",name:"Zak",middleName:null,surname:"Abdallah",slug:"zak-abdallah",fullName:"Zak Abdallah"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:12,limit:12,total:5238},hotBookTopics:{hotBooks:[],offset:0,limit:12,total:null},publish:{},publishingProposal:{success:null,errors:{}},books:{featuredBooks:[{type:"book",id:"10065",title:"Wavelet Theory",subtitle:null,isOpenForSubmission:!1,hash:"d8868e332169597ba2182d9b004d60de",slug:"wavelet-theory",bookSignature:"Somayeh Mohammady",coverURL:"https://cdn.intechopen.com/books/images_new/10065.jpg",editors:[{id:"109280",title:"Dr.",name:"Somayeh",middleName:null,surname:"Mohammady",slug:"somayeh-mohammady",fullName:"Somayeh Mohammady"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9644",title:"Glaciers and the Polar Environment",subtitle:null,isOpenForSubmission:!1,hash:"e8cfdc161794e3753ced54e6ff30873b",slug:"glaciers-and-the-polar-environment",bookSignature:"Masaki Kanao, Danilo Godone and Niccolò Dematteis",coverURL:"https://cdn.intechopen.com/books/images_new/9644.jpg",editors:[{id:"51959",title:"Dr.",name:"Masaki",middleName:null,surname:"Kanao",slug:"masaki-kanao",fullName:"Masaki Kanao"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9385",title:"Renewable Energy",subtitle:"Technologies and Applications",isOpenForSubmission:!1,hash:"a6b446d19166f17f313008e6c056f3d8",slug:"renewable-energy-technologies-and-applications",bookSignature:"Tolga Taner, Archana Tiwari and Taha Selim Ustun",coverURL:"https://cdn.intechopen.com/books/images_new/9385.jpg",editors:[{id:"197240",title:"Associate Prof.",name:"Tolga",middleName:null,surname:"Taner",slug:"tolga-taner",fullName:"Tolga Taner"}],equalEditorOne:{id:"186791",title:"Dr.",name:"Archana",middleName:null,surname:"Tiwari",slug:"archana-tiwari",fullName:"Archana Tiwari",profilePictureURL:"https://mts.intechopen.com/storage/users/186791/images/system/186791.jpg",biography:"Dr. Archana Tiwari is Associate Professor at Amity University, India. Her research interests include renewable sources of energy from microalgae and further utilizing the residual biomass for the generation of value-added products, bioremediation through microalgae and microbial consortium, antioxidative enzymes and stress, and nutraceuticals from microalgae. She has been working on algal biotechnology for the last two decades. She has published her research in many international journals and has authored many books and chapters with renowned publishing houses. She has also delivered talks as an invited speaker at many national and international conferences. Dr. Tiwari is the recipient of several awards including Researcher of the Year and Distinguished Scientist.",institutionString:"Amity University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Amity University",institutionURL:null,country:{name:"India"}}},equalEditorTwo:{id:"197609",title:"Prof.",name:"Taha Selim",middleName:null,surname:"Ustun",slug:"taha-selim-ustun",fullName:"Taha Selim Ustun",profilePictureURL:"https://mts.intechopen.com/storage/users/197609/images/system/197609.jpeg",biography:"Dr. Taha Selim Ustun received a Ph.D. in Electrical Engineering from Victoria University, Melbourne, Australia. He is a researcher with the Fukushima Renewable Energy Institute, AIST (FREA), where he leads the Smart Grid Cybersecurity Laboratory. Prior to that, he was a faculty member with the School of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, USA. His current research interests include power systems protection, communication in power networks, distributed generation, microgrids, electric vehicle integration, and cybersecurity in smart grids. He serves on the editorial boards of IEEE Access, IEEE Transactions on Industrial Informatics, Energies, Electronics, Electricity, World Electric Vehicle and Information journals. Dr. Ustun is a member of the IEEE 2004 and 2800, IEC Renewable Energy Management WG 8, and IEC TC 57 WG17. He has been invited to run specialist courses in Africa, India, and China. He has delivered talks for the Qatar Foundation, the World Energy Council, the Waterloo Global Science Initiative, and the European Union Energy Initiative (EUEI). His research has attracted funding from prestigious programs in Japan, Australia, the European Union, and North America.",institutionString:"Fukushima Renewable Energy Institute, AIST (FREA)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"National Institute of Advanced Industrial Science and Technology",institutionURL:null,country:{name:"Japan"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8985",title:"Natural Resources Management and Biological Sciences",subtitle:null,isOpenForSubmission:!1,hash:"5c2e219a6c021a40b5a20c041dea88c4",slug:"natural-resources-management-and-biological-sciences",bookSignature:"Edward R. Rhodes and Humood Naser",coverURL:"https://cdn.intechopen.com/books/images_new/8985.jpg",editors:[{id:"280886",title:"Prof.",name:"Edward R",middleName:null,surname:"Rhodes",slug:"edward-r-rhodes",fullName:"Edward R Rhodes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9671",title:"Macrophages",subtitle:null,isOpenForSubmission:!1,hash:"03b00fdc5f24b71d1ecdfd75076bfde6",slug:"macrophages",bookSignature:"Hridayesh Prakash",coverURL:"https://cdn.intechopen.com/books/images_new/9671.jpg",editors:[{id:"287184",title:"Dr.",name:"Hridayesh",middleName:null,surname:"Prakash",slug:"hridayesh-prakash",fullName:"Hridayesh Prakash"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9313",title:"Clay Science and Technology",subtitle:null,isOpenForSubmission:!1,hash:"6fa7e70396ff10620e032bb6cfa6fb72",slug:"clay-science-and-technology",bookSignature:"Gustavo Morari Do Nascimento",coverURL:"https://cdn.intechopen.com/books/images_new/9313.jpg",editors:[{id:"7153",title:"Prof.",name:"Gustavo",middleName:null,surname:"Morari Do Nascimento",slug:"gustavo-morari-do-nascimento",fullName:"Gustavo Morari Do Nascimento"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9888",title:"Nuclear Power Plants",subtitle:"The Processes from the Cradle to the Grave",isOpenForSubmission:!1,hash:"c2c8773e586f62155ab8221ebb72a849",slug:"nuclear-power-plants-the-processes-from-the-cradle-to-the-grave",bookSignature:"Nasser Awwad",coverURL:"https://cdn.intechopen.com/books/images_new/9888.jpg",editors:[{id:"145209",title:"Prof.",name:"Nasser",middleName:"S",surname:"Awwad",slug:"nasser-awwad",fullName:"Nasser Awwad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9027",title:"Human Blood Group Systems and Haemoglobinopathies",subtitle:null,isOpenForSubmission:!1,hash:"d00d8e40b11cfb2547d1122866531c7e",slug:"human-blood-group-systems-and-haemoglobinopathies",bookSignature:"Osaro Erhabor and Anjana Munshi",coverURL:"https://cdn.intechopen.com/books/images_new/9027.jpg",editors:[{id:"35140",title:null,name:"Osaro",middleName:null,surname:"Erhabor",slug:"osaro-erhabor",fullName:"Osaro Erhabor"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10432",title:"Casting Processes and Modelling of Metallic Materials",subtitle:null,isOpenForSubmission:!1,hash:"2c5c9df938666bf5d1797727db203a6d",slug:"casting-processes-and-modelling-of-metallic-materials",bookSignature:"Zakaria Abdallah and Nada Aldoumani",coverURL:"https://cdn.intechopen.com/books/images_new/10432.jpg",editors:[{id:"201670",title:"Dr.",name:"Zak",middleName:null,surname:"Abdallah",slug:"zak-abdallah",fullName:"Zak Abdallah"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7841",title:"New Insights Into Metabolic Syndrome",subtitle:null,isOpenForSubmission:!1,hash:"ef5accfac9772b9e2c9eff884f085510",slug:"new-insights-into-metabolic-syndrome",bookSignature:"Akikazu Takada",coverURL:"https://cdn.intechopen.com/books/images_new/7841.jpg",editors:[{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],latestBooks:[{type:"book",id:"9550",title:"Entrepreneurship",subtitle:"Contemporary Issues",isOpenForSubmission:!1,hash:"9b4ac1ee5b743abf6f88495452b1e5e7",slug:"entrepreneurship-contemporary-issues",bookSignature:"Mladen Turuk",coverURL:"https://cdn.intechopen.com/books/images_new/9550.jpg",editedByType:"Edited by",editors:[{id:"319755",title:"Prof.",name:"Mladen",middleName:null,surname:"Turuk",slug:"mladen-turuk",fullName:"Mladen Turuk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10065",title:"Wavelet Theory",subtitle:null,isOpenForSubmission:!1,hash:"d8868e332169597ba2182d9b004d60de",slug:"wavelet-theory",bookSignature:"Somayeh Mohammady",coverURL:"https://cdn.intechopen.com/books/images_new/10065.jpg",editedByType:"Edited by",editors:[{id:"109280",title:"Dr.",name:"Somayeh",middleName:null,surname:"Mohammady",slug:"somayeh-mohammady",fullName:"Somayeh Mohammady"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9313",title:"Clay Science and Technology",subtitle:null,isOpenForSubmission:!1,hash:"6fa7e70396ff10620e032bb6cfa6fb72",slug:"clay-science-and-technology",bookSignature:"Gustavo Morari Do Nascimento",coverURL:"https://cdn.intechopen.com/books/images_new/9313.jpg",editedByType:"Edited by",editors:[{id:"7153",title:"Prof.",name:"Gustavo",middleName:null,surname:"Morari Do Nascimento",slug:"gustavo-morari-do-nascimento",fullName:"Gustavo Morari Do Nascimento"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9888",title:"Nuclear Power Plants",subtitle:"The Processes from the Cradle to the Grave",isOpenForSubmission:!1,hash:"c2c8773e586f62155ab8221ebb72a849",slug:"nuclear-power-plants-the-processes-from-the-cradle-to-the-grave",bookSignature:"Nasser Awwad",coverURL:"https://cdn.intechopen.com/books/images_new/9888.jpg",editedByType:"Edited by",editors:[{id:"145209",title:"Prof.",name:"Nasser",middleName:"S",surname:"Awwad",slug:"nasser-awwad",fullName:"Nasser Awwad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8098",title:"Resources of Water",subtitle:null,isOpenForSubmission:!1,hash:"d251652996624d932ef7b8ed62cf7cfc",slug:"resources-of-water",bookSignature:"Prathna Thanjavur Chandrasekaran, Muhammad Salik Javaid, Aftab Sadiq",coverURL:"https://cdn.intechopen.com/books/images_new/8098.jpg",editedByType:"Edited by",editors:[{id:"167917",title:"Dr.",name:"Prathna",middleName:null,surname:"Thanjavur Chandrasekaran",slug:"prathna-thanjavur-chandrasekaran",fullName:"Prathna Thanjavur Chandrasekaran"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9644",title:"Glaciers and the Polar Environment",subtitle:null,isOpenForSubmission:!1,hash:"e8cfdc161794e3753ced54e6ff30873b",slug:"glaciers-and-the-polar-environment",bookSignature:"Masaki Kanao, Danilo Godone and Niccolò Dematteis",coverURL:"https://cdn.intechopen.com/books/images_new/9644.jpg",editedByType:"Edited by",editors:[{id:"51959",title:"Dr.",name:"Masaki",middleName:null,surname:"Kanao",slug:"masaki-kanao",fullName:"Masaki Kanao"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10432",title:"Casting Processes and Modelling of Metallic Materials",subtitle:null,isOpenForSubmission:!1,hash:"2c5c9df938666bf5d1797727db203a6d",slug:"casting-processes-and-modelling-of-metallic-materials",bookSignature:"Zakaria Abdallah and Nada Aldoumani",coverURL:"https://cdn.intechopen.com/books/images_new/10432.jpg",editedByType:"Edited by",editors:[{id:"201670",title:"Dr.",name:"Zak",middleName:null,surname:"Abdallah",slug:"zak-abdallah",fullName:"Zak Abdallah"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9671",title:"Macrophages",subtitle:null,isOpenForSubmission:!1,hash:"03b00fdc5f24b71d1ecdfd75076bfde6",slug:"macrophages",bookSignature:"Hridayesh Prakash",coverURL:"https://cdn.intechopen.com/books/images_new/9671.jpg",editedByType:"Edited by",editors:[{id:"287184",title:"Dr.",name:"Hridayesh",middleName:null,surname:"Prakash",slug:"hridayesh-prakash",fullName:"Hridayesh Prakash"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8415",title:"Extremophilic Microbes and Metabolites",subtitle:"Diversity, Bioprospecting and Biotechnological Applications",isOpenForSubmission:!1,hash:"93e0321bc93b89ff73730157738f8f97",slug:"extremophilic-microbes-and-metabolites-diversity-bioprospecting-and-biotechnological-applications",bookSignature:"Afef Najjari, Ameur Cherif, Haïtham Sghaier and Hadda Imene Ouzari",coverURL:"https://cdn.intechopen.com/books/images_new/8415.jpg",editedByType:"Edited by",editors:[{id:"196823",title:"Dr.",name:"Afef",middleName:null,surname:"Najjari",slug:"afef-najjari",fullName:"Afef Najjari"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9731",title:"Oxidoreductase",subtitle:null,isOpenForSubmission:!1,hash:"852e6f862c85fc3adecdbaf822e64e6e",slug:"oxidoreductase",bookSignature:"Mahmoud Ahmed Mansour",coverURL:"https://cdn.intechopen.com/books/images_new/9731.jpg",editedByType:"Edited by",editors:[{id:"224662",title:"Prof.",name:"Mahmoud Ahmed",middleName:null,surname:"Mansour",slug:"mahmoud-ahmed-mansour",fullName:"Mahmoud Ahmed Mansour"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"1067",title:"Maternal-Fetal Medicine",slug:"maternal-fetal-medicine",parent:{title:"Obstetrics and Gynecology",slug:"obstetrics-and-gynecology"},numberOfBooks:8,numberOfAuthorsAndEditors:225,numberOfWosCitations:61,numberOfCrossrefCitations:39,numberOfDimensionsCitations:104,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicSlug:"maternal-fetal-medicine",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"8471",title:"Prediction of Maternal and Fetal Syndrome of Preeclampsia",subtitle:null,isOpenForSubmission:!1,hash:"327257ae2f4783050d327cd524bf2a3e",slug:"prediction-of-maternal-and-fetal-syndrome-of-preeclampsia",bookSignature:"Nidhi Sharma",coverURL:"https://cdn.intechopen.com/books/images_new/8471.jpg",editedByType:"Edited by",editors:[{id:"220214",title:"Prof.",name:"Nidhi",middleName:null,surname:"Sharma",slug:"nidhi-sharma",fullName:"Nidhi Sharma"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7259",title:"Selected Topics in Midwifery Care",subtitle:null,isOpenForSubmission:!1,hash:"e5010271563ab3bbf99a960a183acb80",slug:"selected-topics-in-midwifery-care",bookSignature:"Ana Polona Mivšek",coverURL:"https://cdn.intechopen.com/books/images_new/7259.jpg",editedByType:"Edited by",editors:[{id:"85109",title:"Dr.",name:"Ana Polona",middleName:null,surname:"Mivšek",slug:"ana-polona-mivsek",fullName:"Ana Polona Mivšek"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7173",title:"Multiple Pregnancy",subtitle:"New Challenges",isOpenForSubmission:!1,hash:"f599a465410812da5aee0b247d427e9b",slug:"multiple-pregnancy-new-challenges",bookSignature:"Julio Elito Jr.",coverURL:"https://cdn.intechopen.com/books/images_new/7173.jpg",editedByType:"Edited by",editors:[{id:"35132",title:"Prof.",name:"Julio",middleName:null,surname:"Elito Jr.",slug:"julio-elito-jr.",fullName:"Julio Elito Jr."}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6295",title:"Pregnancy and Birth Outcomes",subtitle:null,isOpenForSubmission:!1,hash:"fc1274517f5c0c09b0a923b3027f3d8a",slug:"pregnancy-and-birth-outcomes",bookSignature:"Wei Wu",coverURL:"https://cdn.intechopen.com/books/images_new/6295.jpg",editedByType:"Edited by",editors:[{id:"178661",title:"Dr.",name:"Wei",middleName:null,surname:"Wu",slug:"wei-wu",fullName:"Wei Wu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5937",title:"Obstetrics",subtitle:null,isOpenForSubmission:!1,hash:"092197b1191815505a23e7dd1c9edde6",slug:"obstetrics",bookSignature:"Hassan Salah Abduljabbar",coverURL:"https://cdn.intechopen.com/books/images_new/5937.jpg",editedByType:"Edited by",editors:[{id:"68175",title:"Prof.",name:"Hassan",middleName:"S",surname:"Abduljabbar",slug:"hassan-abduljabbar",fullName:"Hassan Abduljabbar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"952",title:"Cesarean Delivery",subtitle:null,isOpenForSubmission:!1,hash:"cdde3ddf5707430e18678e9ed4c77f4e",slug:"cesarean-delivery",bookSignature:"Raed Salim",coverURL:"https://cdn.intechopen.com/books/images_new/952.jpg",editedByType:"Edited by",editors:[{id:"91354",title:"Dr.",name:"Raed",middleName:null,surname:"Salim",slug:"raed-salim",fullName:"Raed Salim"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"776",title:"Preterm Birth",subtitle:"Mother and Child",isOpenForSubmission:!1,hash:"4e5369103770cdbf61058ad75e2e63bb",slug:"preterm-birth-mother-and-child",bookSignature:"John C. Morrison",coverURL:"https://cdn.intechopen.com/books/images_new/776.jpg",editedByType:"Edited by",editors:[{id:"68209",title:"Dr.",name:"John",middleName:null,surname:"Morrison",slug:"john-morrison",fullName:"John Morrison"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"233",title:"Ectopic Pregnancy",subtitle:"Modern Diagnosis and Management",isOpenForSubmission:!1,hash:"8c65111e8ad6970e2023fc65cd3a92b5",slug:"ectopic-pregnancy-modern-diagnosis-and-management",bookSignature:"Michael Kamrava",coverURL:"https://cdn.intechopen.com/books/images_new/233.jpg",editedByType:"Edited by",editors:[{id:"30190",title:"Dr.",name:"Michael",middleName:"M",surname:"Kamrava",slug:"michael-kamrava",fullName:"Michael Kamrava"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:8,mostCitedChapters:[{id:"37219",doi:"10.5772/47914",title:"Determining Factors of Cesarean Delivery Trends in Developing Countries: Lessons from Point G National Hospital (Bamako - Mali)",slug:"determining-factors-of-cesarean-delivery-trends-in-developing-countries-lessons-from-point-g-nat",totalDownloads:2528,totalCrossrefCites:6,totalDimensionsCites:15,book:{slug:"cesarean-delivery",title:"Cesarean Delivery",fullTitle:"Cesarean Delivery"},signatures:"I. Teguete, Y. Traore, A. Sissoko, M. Y. Djire, A. Thera, T. Dolo, N. Mounkoro, M. Traore and A. Dolo",authors:[{id:"87496",title:"Dr.",name:"Ibrahima",middleName:null,surname:"Teguete",slug:"ibrahima-teguete",fullName:"Ibrahima Teguete"}]},{id:"27121",doi:"10.5772/27439",title:"Clinical Risk Factors for Preterm Birth",slug:"clinical-risk-factors-for-preterm-birth",totalDownloads:8168,totalCrossrefCites:7,totalDimensionsCites:11,book:{slug:"preterm-birth-mother-and-child",title:"Preterm Birth",fullTitle:"Preterm Birth - Mother and Child"},signatures:"Ifeoma Offiah, Keelin O’Donoghue and Louise Kenny",authors:[{id:"68552",title:"Dr.",name:"Ifeoma",middleName:null,surname:"Offiah",slug:"ifeoma-offiah",fullName:"Ifeoma Offiah"},{id:"70166",title:"Prof.",name:"Louise",middleName:null,surname:"Kenny",slug:"louise-kenny",fullName:"Louise Kenny"},{id:"74717",title:"Dr.",name:"Keelin",middleName:null,surname:"O'Donoghue",slug:"keelin-o'donoghue",fullName:"Keelin O'Donoghue"}]},{id:"27122",doi:"10.5772/27539",title:"Psychobiological Stress and Preterm Birth",slug:"psychobiological-stress-and-preterm-birth",totalDownloads:2435,totalCrossrefCites:2,totalDimensionsCites:10,book:{slug:"preterm-birth-mother-and-child",title:"Preterm Birth",fullTitle:"Preterm Birth - Mother and Child"},signatures:"Curt A. Sandman, Elysia P. Davis and Laura M. Glynn",authors:[{id:"70534",title:"Prof.",name:"Curt",middleName:null,surname:"Sandman",slug:"curt-sandman",fullName:"Curt Sandman"},{id:"74174",title:"Prof.",name:"Laura",middleName:null,surname:"Glynn",slug:"laura-glynn",fullName:"Laura Glynn"},{id:"74177",title:"Prof.",name:"Elysia",middleName:null,surname:"Davis",slug:"elysia-davis",fullName:"Elysia Davis"}]}],mostDownloadedChaptersLast30Days:[{id:"56365",title:"Massive Postpartum Hemorrhage: Protocol and Red Code",slug:"massive-postpartum-hemorrhage-protocol-and-red-code",totalDownloads:1758,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"obstetrics",title:"Obstetrics",fullTitle:"Obstetrics"},signatures:"Jaume Miñano Masip, Laura Almeida Toledano, Sílvia Ferrero\nMartínez and María Dolores Gómez Roig",authors:[{id:"202446",title:"Ph.D.",name:"Maria Dolores",middleName:null,surname:"Gómez Roig",slug:"maria-dolores-gomez-roig",fullName:"Maria Dolores Gómez Roig"},{id:"202447",title:"Dr.",name:"Jaume",middleName:null,surname:"Miñano Masip",slug:"jaume-minano-masip",fullName:"Jaume Miñano Masip"},{id:"202448",title:"Dr.",name:"Laura",middleName:null,surname:"Almeida",slug:"laura-almeida",fullName:"Laura Almeida"},{id:"202449",title:"Dr.",name:"Silvia",middleName:null,surname:"Ferrero",slug:"silvia-ferrero",fullName:"Silvia Ferrero"}]},{id:"62277",title:"Basic Antenatal Care Approach to Antenatal Care Service Provision",slug:"basic-antenatal-care-approach-to-antenatal-care-service-provision",totalDownloads:1963,totalCrossrefCites:1,totalDimensionsCites:1,book:{slug:"selected-topics-in-midwifery-care",title:"Selected Topics in Midwifery Care",fullTitle:"Selected Topics in Midwifery Care"},signatures:"Thembelihle Sylvia Patience Ngxongo",authors:[{id:"243711",title:"Dr.",name:"Thembelihle Sylvia Patience",middleName:null,surname:"Ngxongo",slug:"thembelihle-sylvia-patience-ngxongo",fullName:"Thembelihle Sylvia Patience Ngxongo"}]},{id:"64677",title:"Mistreatment of Women in Health Facilities by Midwives during Childbirth in Ghana: Prevalence and Associated Factors",slug:"mistreatment-of-women-in-health-facilities-by-midwives-during-childbirth-in-ghana-prevalence-and-ass",totalDownloads:849,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"selected-topics-in-midwifery-care",title:"Selected Topics in Midwifery Care",fullTitle:"Selected Topics in Midwifery Care"},signatures:"John Kuumuori Ganle and Ebenezer Krampah",authors:[{id:"261867",title:"Dr.",name:"John",middleName:"Kuumuori",surname:"Ganle",slug:"john-ganle",fullName:"John Ganle"},{id:"276237",title:"Mr.",name:"Ebenezer",middleName:null,surname:"Krampah",slug:"ebenezer-krampah",fullName:"Ebenezer Krampah"}]},{id:"66548",title:"Clinical, Biochemical, and Biophysical Markers of Angiogenesis in Preeclampsia",slug:"clinical-biochemical-and-biophysical-markers-of-angiogenesis-in-preeclampsia",totalDownloads:524,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"prediction-of-maternal-and-fetal-syndrome-of-preeclampsia",title:"Prediction of Maternal and Fetal Syndrome of Preeclampsia",fullTitle:"Prediction of Maternal and Fetal Syndrome of Preeclampsia"},signatures:"Osredkar Joško and Kumer Kristina",authors:[{id:"66896",title:"Prof.",name:"Joško",middleName:null,surname:"Osredkar",slug:"josko-osredkar",fullName:"Joško Osredkar"},{id:"285525",title:"Mrs.",name:"Kristina",middleName:null,surname:"Kumer",slug:"kristina-kumer",fullName:"Kristina Kumer"}]},{id:"64471",title:"Forensic Midwifery",slug:"forensic-midwifery",totalDownloads:461,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"selected-topics-in-midwifery-care",title:"Selected Topics in Midwifery Care",fullTitle:"Selected Topics in Midwifery Care"},signatures:"Sevde Aksu",authors:[{id:"259864",title:"Associate Prof.",name:"Sevde",middleName:null,surname:"Aksu",slug:"sevde-aksu",fullName:"Sevde Aksu"}]},{id:"57672",title:"Ectopic Pregnancy: Diagnosis, Prevention and Management",slug:"ectopic-pregnancy-diagnosis-prevention-and-management",totalDownloads:2073,totalCrossrefCites:0,totalDimensionsCites:3,book:{slug:"obstetrics",title:"Obstetrics",fullTitle:"Obstetrics"},signatures:"Talal Anwer Abdulkareem and Sajeda Mahdi Eidan",authors:[{id:"201127",title:"Prof.",name:"Talal",middleName:"Anwer",surname:"Abdulkareem",slug:"talal-abdulkareem",fullName:"Talal Abdulkareem"}]},{id:"58857",title:"Respiratory Distress Syndrome Management in Delivery Room",slug:"respiratory-distress-syndrome-management-in-delivery-room",totalDownloads:662,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"pregnancy-and-birth-outcomes",title:"Pregnancy and Birth Outcomes",fullTitle:"Pregnancy and Birth Outcomes"},signatures:"Gianluca Lista, Georg M. Schmölzer and Ilia Bresesti",authors:[{id:"179622",title:"Dr.",name:"Georg",middleName:null,surname:"Schmolzer",slug:"georg-schmolzer",fullName:"Georg Schmolzer"},{id:"219228",title:"Ph.D.",name:"Gianluca",middleName:null,surname:"Lista",slug:"gianluca-lista",fullName:"Gianluca Lista"},{id:"238356",title:"Dr.",name:"Ilia",middleName:null,surname:"Bresesti",slug:"ilia-bresesti",fullName:"Ilia Bresesti"}]},{id:"65495",title:"Improving Maternal Health: The Safe Childbirth Checklist as a Tool for Reducing Maternal Mortality and Morbidity",slug:"improving-maternal-health-the-safe-childbirth-checklist-as-a-tool-for-reducing-maternal-mortality-an",totalDownloads:1293,totalCrossrefCites:0,totalDimensionsCites:2,book:{slug:"selected-topics-in-midwifery-care",title:"Selected Topics in Midwifery Care",fullTitle:"Selected Topics in Midwifery Care"},signatures:"Julius Dohbit, Vetty Agala, Pamela Chinwa-Banda, Betty Anane-\nFenin, Omosivie Maduka, Ufuoma Edewor, Ibimonye Porbeni, Fru\nAngwafo and Rosemary Ogu",authors:[{id:"213063",title:"Prof.",name:"Rosemary",middleName:null,surname:"Ogu",slug:"rosemary-ogu",fullName:"Rosemary Ogu"},{id:"241001",title:"Dr.",name:"Pamela",middleName:"Chirwa",surname:"Banda",slug:"pamela-banda",fullName:"Pamela Banda"},{id:"259772",title:"Dr.",name:"Vetty",middleName:null,surname:"Agala",slug:"vetty-agala",fullName:"Vetty Agala"},{id:"270792",title:"Prof.",name:"Fru",middleName:null,surname:"Angwafo",slug:"fru-angwafo",fullName:"Fru Angwafo"},{id:"270799",title:"Dr.",name:"Sama",middleName:null,surname:"Dohbit",slug:"sama-dohbit",fullName:"Sama Dohbit"},{id:"270802",title:"Dr.",name:"Betty",middleName:null,surname:"Anane-Fenin",slug:"betty-anane-fenin",fullName:"Betty Anane-Fenin"},{id:"270803",title:"Dr.",name:"Ufuoma",middleName:null,surname:"Edewor",slug:"ufuoma-edewor",fullName:"Ufuoma Edewor"},{id:"273872",title:"Dr.",name:"Ibimonye",middleName:null,surname:"Porbeni",slug:"ibimonye-porbeni",fullName:"Ibimonye Porbeni"},{id:"273875",title:"Dr.",name:"Omosivie",middleName:null,surname:"Maduka",slug:"omosivie-maduka",fullName:"Omosivie Maduka"}]},{id:"27120",title:"Environmental Exposures, Genetic Susceptibility and Preterm Birth",slug:"environmental-exposures-genetic-susceptibility-and-preterm-birth",totalDownloads:1516,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"preterm-birth-mother-and-child",title:"Preterm Birth",fullTitle:"Preterm Birth - Mother and Child"},signatures:"Regina Grazuleviciene, Jone Vencloviene, Asta Danileviciute, Audrius Dedele and Gediminas Balcius",authors:[{id:"66597",title:"Prof.",name:"Regina",middleName:null,surname:"Grazuleviciene",slug:"regina-grazuleviciene",fullName:"Regina Grazuleviciene"},{id:"66614",title:"Dr.",name:"Jone",middleName:null,surname:"Vencloviene",slug:"jone-vencloviene",fullName:"Jone Vencloviene"},{id:"66615",title:"MSc.",name:"Audrius",middleName:null,surname:"Dedele",slug:"audrius-dedele",fullName:"Audrius Dedele"},{id:"66616",title:"MSc.",name:"Asta",middleName:null,surname:"Danileviciute",slug:"asta-danileviciute",fullName:"Asta Danileviciute"},{id:"66617",title:"MSc.",name:"Gediminas",middleName:null,surname:"Balcius",slug:"gediminas-balcius",fullName:"Gediminas Balcius"}]},{id:"64141",title:"Early Pregnancy Ultrasound Assessment of Multiple Pregnancy",slug:"early-pregnancy-ultrasound-assessment-of-multiple-pregnancy",totalDownloads:1039,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"multiple-pregnancy-new-challenges",title:"Multiple Pregnancy",fullTitle:"Multiple Pregnancy - New Challenges"},signatures:"Panagiotis Antsaklis, Maria Papamichail, Marianna Theodora,\nMichael Syndos and George Daskalakis",authors:[{id:"64707",title:"Dr.",name:"George",middleName:null,surname:"Daskalakis",slug:"george-daskalakis",fullName:"George Daskalakis"},{id:"202113",title:"Dr.",name:"Panagiotis",middleName:null,surname:"Antsaklis",slug:"panagiotis-antsaklis",fullName:"Panagiotis Antsaklis"},{id:"253908",title:"Dr.",name:"Marianna",middleName:null,surname:"Theodora",slug:"marianna-theodora",fullName:"Marianna Theodora"},{id:"268350",title:"Dr.",name:"Maria",middleName:null,surname:"Papamichail",slug:"maria-papamichail",fullName:"Maria Papamichail"},{id:"268351",title:"Dr.",name:"Michael",middleName:null,surname:"Sindos",slug:"michael-sindos",fullName:"Michael Sindos"}]}],onlineFirstChaptersFilter:{topicSlug:"maternal-fetal-medicine",limit:3,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[{type:"book",id:"10176",title:"Microgrids and Local Energy Systems",subtitle:null,isOpenForSubmission:!0,hash:"c32b4a5351a88f263074b0d0ca813a9c",slug:null,bookSignature:"Prof. Nick Jenkins",coverURL:"https://cdn.intechopen.com/books/images_new/10176.jpg",editedByType:null,editors:[{id:"55219",title:"Prof.",name:"Nick",middleName:null,surname:"Jenkins",slug:"nick-jenkins",fullName:"Nick Jenkins"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:8,limit:8,total:1},route:{name:"onlineFirst.detail",path:"/online-first/zambia-s-poorest-progressively-left-behind-well-being-denied",hash:"",query:{},params:{chapter:"zambia-s-poorest-progressively-left-behind-well-being-denied"},fullPath:"/online-first/zambia-s-poorest-progressively-left-behind-well-being-denied",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()