\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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\r\n\tThe advent of next-generation sequencing along with the development of bioinformatics tools has opened avenues to explore this technology in numerous fields of biomedical research. This book evaluates and comprehensively summarizes the scientific findings which have been achieved through RNA-Seq technology. RNA-Seq allows us to accurately capture all subtypes of RNA molecules, in any sequenced organism or single-cell type, under different experimental conditions. RNA-Seq transcriptome profiling of healthy and diseased tissues allows understanding the alterations in cellular phenotypes through the expression of differentially spliced RNA isoforms. Assessment of gene expression by RNA-Seq provides new insight into host response to pathogens, drugs, allergens, and other environmental triggers.
\r\n\r\n\tRNA-sequencing becomes even more powerful when combined with other assays. Merging genomics and transcriptomic profiling provides novel information underlying causative DNA mutations and the cellular effects of genetic variants caused by SNPs, indels, etc. Combining RNA-Seq with immunoprecipitation and cross-linking techniques is a clever multi-Omics strategy assessing transcriptional, posttranscriptional and posttranslational levels of gene expression regulation. The optimization of RNA-Seq technology will allow countless opportunities in our pursuit of achieving the goals of individualized medicine.
",isbn:"978-1-83962-815-3",printIsbn:"978-1-83962-686-9",pdfIsbn:"978-1-83962-816-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"62399ea4ed0544b946dcbd1853b2d1b8",bookSignature:"Prof. Irina Vlasova-St. Louis",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10369.jpg",keywords:"RNA-Seq, Genomics, Transcriptomics, Gene Expression, Transcriptome Profiling, Genetic Variation, Single-Cell Genomics, Single-Cell Genome, Data Mining, Bioinformatics, Transcriptomic Biomarkers, Inherited and Somatic Diseases",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 25th 2020",dateEndSecondStepPublish:"October 23rd 2020",dateEndThirdStepPublish:"December 22nd 2020",dateEndFourthStepPublish:"March 12th 2021",dateEndFifthStepPublish:"May 11th 2021",remainingDaysToSecondStep:"3 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. St. Louis conducts discovery research in several key areas including infectious diseases, immunology, and oncology. By integrating specific areas of expertise - genomics, transcriptomics, proteomics, ribonomics, and bioinformatics - Irina’s group is studying normal and pathological conditions at the molecular, cellular, and organismal levels.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"211159",title:"Prof.",name:"Irina",middleName:null,surname:"Vlasova-St. Louis",slug:"irina-vlasova-st.-louis",fullName:"Irina Vlasova-St. Louis",profilePictureURL:"https://mts.intechopen.com/storage/users/211159/images/system/211159.png",biography:"Irina St. Louis earned her M.D. and Ph.D. degrees from Ural State Medical Academy, Yekaterinburg, Russia. She completed her residency in lab pathology at Russian Medical Academy for Postgraduate Education, Moscow. She joined the Department of Microbiology at the University of Minnesota, as a postdoctoral trainee, followed by fellowships at the University of Minnesota Supercomputing Institute and Lymphoma Research Foundation.\r\nPresently, Dr. St. Louis is appointed as an Assistant Professor at the Department of Medicine at the University of Minnesota. \r\nDr. St. Louis conducts discovery research in several key areas including infectious diseases, immunology, and oncology. By integrating specific areas of expertise - genomics, transcriptomics, proteomics, ribonomics, and bioinformatics - Irina’s group is studying normal and pathological conditions at the molecular, cellular, and organismal levels.\r\nThe basic research in Dr. St. Louis’ laboratory is centered on post-transcriptional gene expression regulation, specifically, through messenger RNA turnover. Her translational research focuses on immune restoration disorders (IRD). Dr. St. Louis is engaged in a number of clinical studies, within the Global Health & International Medicine Program. These studies involve the stratification of AIDS patients, for optimal treatment regimens. The studies also include searches for biomarkers of immune reconstitution inflammatory syndrome (IRIS). Additionally, Dr. St. Louis’ lab collaborates with the Division of Hematology-Oncology and Transplantation, on virus-specific immune reconstitution after various hematopoietic cell transplantation regimens. 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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. 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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:"65782",title:"Clinical Evaluation of Horizontal Pediatric Strabismus and the Management Challenges",doi:"10.5772/intechopen.82547",slug:"clinical-evaluation-of-horizontal-pediatric-strabismus-and-the-management-challenges",body:'Strabismus is defined as deviation from normal position of alignment resulting in the eyes pointing in different directions [1]. From the historical perspective existed, the concept that there is spasm of the bodies which move the eye balls and there is oblique tendency of the muscles [2]. Ocular movement is controlled by six muscles comprising the four recti muscles (superior, inferior, medial, and lateral) which arises from the annulus of Zinn [3]—a fibrous structure which is fused to the optic nerve and foramen and the two oblique muscles [4]. The medial rectus takes a course close to the medial orbital wall, while the lateral rectus course is close to the lateral orbital wall before they reach their respective points of insertion. Primary action of medial rectus is adduction and lateral rectus abduction. The two are called the horizontal recti muscles. The superior and inferior recti muscles are called vertical muscles. The superior rectus muscle ran a course anteriorly above the eye ball, over the insertion of the superior oblique forming an angle of 23° with the visual axis. The primary function of superior rectus is elevation, secondary action is intorsion, and tertiary action is abduction. The inferior rectus passes anteriorly above the orbital floor and below the eye ball to which it is inserted at 23° to the visual axis. In the primary position, the main action of inferior rectus is depression, secondary action is extortion, and tertiary action is adduction. Superior oblique arises from the orbital apex above the annulus of Zinn, courses anteriorly close to the superior medial orbital wall. It becomes tendinous as it passes through the trochlear—a cartilage-like structure attached to the superior nasal orbital part of the frontal bone. The muscle tendon turns backward and inserted in the posterior medial quadrant of the eye ball under the superior rectus muscle forming a 51° angle with the visual axis [5]. In primary position, the action of superior oblique is intorsion, secondary action is depression, and tertiary action is abduction. Inferior oblique muscle originates from the periosteum of the maxillary bone behind the orbital rim and lateral to the entrance of the lacrimal fossa. It then passes laterally, superiorly, and posteriorly below the inferior rectus, under the lateral rectus and inserted into the posterior lateral quadrant of the eye ball. In the primary position, its primary action is extortion, secondary action is elevation, and tertiary action is abduction. The spiral of Tillaux describes the distance in millimeters from limbus to the insertion point of the four recti muscle: superior rectus (7.7 mm), lateral (96.9 mm), inferior (6.5 mm), and medial (5.5 mm). The lateral rectus is supplied by the abducent nerve, superior oblique by trochlear nerve, and the oculomotor nerve supplies all the rest (superior/medial/inferior recti and inferior oblique). Extra ocular muscles are supplied by muscular branches of the ophthalmic artery. The larger medial muscular branch supplies the inferior/medial recti and inferior oblique, while the lateral muscular branch supplies the lateral/superior recti, superior oblique, and the levator palpebrae superioris muscle. Eye movements can be uniocular (ductions) or binocular (versions). Movement of the eye nasally is called adduction, temporally abduction, downward infraduction, and upward supraduction. Nasal rotation of the superior corneal meridian is called intorsion or incycloduction, while temporal rotation is termed extortion or excycloduction. An agonist is the primary muscle involved in moving the eye in a given direction. A synergist is the muscle in the same eye that acts with the agonist to produce a given movement. An antagonist is a muscle in the same eye that produces action opposite that of the agonist. According to Sherrington’s law [6] of reciprocal innervation, increased innervation and contraction of a given extra ocular muscle is associated with decrease innervation and contraction of its antagonist. Conjugate binocular eye movements which ensure the eyes move in the same direction are called versions; disconjugate movements which make the eyes move in opposite directions are called vergences. By this notation, right gaze is dextroversion, left levoversion, upward sursumversion, and downward deorsumversion. Rotating the eyes such that such that the superior pole of both corneal meridians is turned to the right is called dextrocycloversion, when to the left levocycloversion. Yoke muscles are two muscles in separate eyes that are prime movers for any given position [7]. All the muscles have respective partners that they work simultaneously to produce binocular movement. According to Hering’s law [8] of motor correspondence, equal and simultaneous innervation goes to yoke muscles to produce binocular movement in desired direction. Convergence arises when the two eyes move nasally from any initial position, and divergence is when they move temporally from relative initial position. Nasal rotation of the vertical pole of both corneal meridians is incyclovergence, while temporal rotation is excyclovergence. The relative position of the eyes at rest is that of divergence, hence tonic convergence maintains the position of the eyes during wake period. The synkinetic near reflex consists of accommodation, convergence, and miosis. There is consistent increase in accommodative convergence (AC) for each diopter of accommodation (A) [9]. When the accommodative convergence/accommodation (AC/A) ratio is high, excess convergence could result in esotropia when viewing near objects. Voluntary convergence can consciously be induced as part of the near synkinesis. Proximal convergence can be produced based on the psychological awareness of nearness of the object. Bitemporal retinal image disparity stimulates fusional convergence which insures the image of an object is projected on corresponding retinal points. Conversely, fusional divergence could occur as an optomotor reflex to align the eyes so that images fall on corresponding retinal points. Retina stimulation is perceived as light coming from a specific visual direction in space. Retinal correspondence is said to occur when light stimulates two points in both eyes which share a common visual direction. Corresponding retinal points share a common relationship with the fovea in both eyes, and such relationship is described as normal retinal correspondence (NRC) [10]. Anomalous retinal correspondence (ARC) occurs when two points in the retina of both eyes do not share similar relationship with the fovea. Normal fovea and extra foveal NRC result in binocular single vision. Similarly, points in both eyes with similar fixation/orientation appear singly so far as they fall on a point that passes through the optical center of each eye and fixation point (Vieth-Muller circle). The process of cortical image unification of objects that fall on corresponding retinal points is called fusion. Retinal images are fused in the cortex when they are similar in shape, size, and clarity. Fusion has sensory, motor, and stereopsis components. The sensory part deals with relationship of the retinal points in the two eyes, while motor fusion is vergence movement that ensures retinal image fall and is maintained on corresponding points. Stereopsis is said to occur when disparity in image size is big enough not to permit cortical fusion but not enough to cause diplopia. Stereopsis is a binocular perception of depth that adds to quality of vision and three dimensions.
The techniques of assessing vision in children are tailored to fit the patient’s age. It is often challenging and tasking irrespective of the age and requires gaining the trust of the child and the parent. The clinic environment should to some extent fit ideal setting to do so. This is frequently not available in some low income countries as few pediatric ophthalmic clinics are purposefully designed. Frequently, the same make soft clinic area is used for all purposes. The CSM (Central, Steady, and Maintained) criterion can be used for preverbal children. This involves determining the location of the corneal reflex which should be central in a normal child while mono-fixating with the contra lateral eye occluded. The location of the reflex should be central in both eyes as uncentral position is abnormal. The fixation should be steadily (S) maintained with the light in stationary position and when moved in other directions. Fixation should be (M) maintained in both eyes, and failure in one eye may indicate the presence of amblyopia. A child would elicit avoidance movement when the seeing eye is occluded and can be indifferent when occlusion involves an amblyopic eye. Illiterate “E” chart “game” can be used to assess vision in preschool children. HOTV test can be used as it employs matching of objects placed on the distant display and a hand held version that enables the child to indicate similar images. Children of school age can have vision tested with Snellen’s chart which has the drawback of crowding of letters that make its use limited in those with amblyopia. Various picture charts are developed showing objects that are commonly seen in the locality instead of trains and busses that may be unfamiliar to children in the developing world.
Light reflex tests consist of the Hirschberg and Karimsky. The Hirschberg test measures the extent of decentration of the corneal reflex, and 1 mm of decentration is equivalent to 7° or 15 prism diopters. When the light reflex is at pupillary margin, there is (15°), mid iris is (30°), and at limbus (45°) of deviation, respectively. The Krimsky test uses corneal reflex from both eyes and a prism is placed before the fixating eye and adjusted till alignment is achieved. The test is ideally performed at near gaze position. To a lesser extent, Bruckner’s test [11] can be used to detect (without quantifying) the presence of a squint. Light from an ophthalmoscope is shone directly into both eyes, and the reflection from the deviating eye is brighter than in the fixating eye. The light reflex tests can be affected by angle kappa (the angle between the anatomical and visual axis of the eye). In normal situations, the fovea is usually temporal to the pupillary center making the corneal reflex slightly nasal (the resulting positive angle Kappa that appears like an exodeviation), and this can affect the light reflex test though it has no impact on cover tests.
Cover tests are employed to assess misalignment. Monoocular test such as cover-uncover is used to distinguish heterophoria from heterotropia. When one eye is covered, the uncovered eye moves to take up aligned position, and the movement is reversed when the cover is removed. The test is based on the principle that breaking up of binocular vision during the test leads to adjustment in alignment in those with phorias. In the presence of manifest squint, the test is started with a deviated eye, and at the end, it is noted that the deviation is maintained by the index or contra lateral eye. Alternate cover test is done to determine and quantify the extent of deviation whether latent or manifest by the placement of a prism is in front of the eye. The base of the prism is placed opposite the direction of the deviation. The amount of deviation is measured with prisms as the cover is moved from one eye to another till alignment is achieved. Simultaneous prism and cover test can be employed to determine extend of manifest deviation when both eyes are uncovered [12].
Dissimilar image tests involve making the images appear dissimilar in both eyes. The principle is that in the normal eye, the image falls on the fovea, while in the deviating eye, it falls elsewhere in the retina. A patient sees the images appearing somewhat homonymously in esotropia and crossed in exotropia. The Maddox rod consists of parallel cylinders that convert a point source of light into a straight line that is at right angle to the arranged cylinders. In normal situation of orthophoria, a person looking at a distant pointed light source with the rod placed before one eye would see a straight line (with the eye wearing the Maddox rod) and a point source of light (with the other eye). The light spot will appear to be at the center of the line. Maddox rod can be used to measure horizontal and vertical deviations. The relationship of the line relative to the spot of light determines the type of deviation. To quantify the deviation, a prism can be placed before the deviating eye till the state or orthophoria is achieved with the spot of light superimposed on the middle of the line. Cyclo deviations can also be measured with double Maddox road [13].
This test involves making the eyes to be exposed to different targets at the same time and measuring the extent of deviation with one eye fixating then the other. Patients with esotropia will have crossed fixation and exotropes homonymous diplopia. The Lancaster red-green test consists of red-green goggles that can be reversed, red/green slit projector, and a ruled screen with many small squares. With red lens on the right, the patient is requested to superimpose the green slit, and the goggles are reversed to run the test again. This test is done in patients with diplopia from incomitant squint and may not apply to children who rarely present with this type. The mayor amblyoscope is calibrated to measure the extent of vertical, horizontal, and torsional deviations when the patient look through and superimpose dissimilar targets.
Children require an adult who may be a parent, sibling, or other relations to accompany them to the hospital. The mother is the person closest to the child and in better position to offer more reliable information on the ocular condition of the patient. However due to religious and socio cultural practices, it is not unusual to see grandmothers and other relations who have minimal knowledge are made to accompany the children to the clinic. In vast rural communities, there is virtually no documentation of medical illness and recollection of what happens in the past is quite vague. Coverage of antenatal care by orthodox methods is largely poor with cost, distance, and attitude of healthcare providers constituting a barrier. Squint and other ocular conditions that are not associated with dramatic pain or debility may not attract attention warranting prompt medical care. There is varied individual and community perception of squint based on cultural and religious beliefs resulting in poor awareness of the cause and availability of treatment often leading to social stigmatization [14]. There is poor perception of strabismus in community that could partly be due to poor knowledge of the condition [15]. Deviating eye may be considered as an act of creation by God. In some communities, there is taboo and superstition attached to it resulting in stigmatization and ostracism. In the United States, an estimated 4% of children have strabismus [1]. In sub-Saharan Africa, population prevalence statistics are at best scarce, and the exact extent is likely to be known. A study involving thousands of elementary school children showed that esotropia and exotropia occurred in 0.14% of the population [16]. The prevalence varies between countries and the type of study conducted ranging from 0 to 2% in Ghana [17], 1.1% in Ethiopia [18], 0.5% in Tanzania [19], and 1.22% in Cameroons [20]. As much as is realizable, it is important to determine the onset, description of the type, laterality, variation with time, and duration of the deviation. Key knowledge includes determining whether it affects one eye or alternates. Any associated ocular features such as leucocoria to suggest secondary causes like cataract and retinoblastoma [21]. The clinician should obtain the history of previous spectacle prescriptions or ocular surgery performed. There may be a positive family history of similar symptoms and where available photographs could provide further clues in the patient’s evaluation.
Strabismus is a Greek term which simply means ocular misalignment. Manifest deviations that are detectable when both eyes are opened are called tropia and may present as a constant or intermittent deviation involving one eye or both eyes. Latent deviations are termed phorias and detectable only when one eye is covered so that the vision is monocular. In phorias, the misalignment is minor and corrected by cortical adjustment of the extra ocular muscles. Deviations are said to be comitant when they are the same in amplitude and degree of misalignment in all directions of gaze. Incomitant deviations vary in degree and amplitude with direction of gaze. Horizontal deviations could be nasal termed as esotropia or temporal exotropia. Other less common deviations in childhood include vertical (hyper deviation or hypo deviation) and torsional (incyclodeviation or excyclodeviation). Deviation could also manifest as a combination of the above. Pediatric strabismus can be infantile or acquired. Risk factors for infantile strabismus include a positive family history among first and second degree relatives, maternal alcohol ingestion in pregnancy, maternal smoking [22], genetic disorders (such as Crouzon’s and Down’s syndromes), prematurity and or, low birth weight, congenital ocular defects, and cerebral palsy. Causes of acquired strabismus include refractive error (particularly hyperopia), head injury that could include birth trauma, and neurological conditions (such as cranial nerve palsy involving nerves 3, 4, 6, and spina bifida).
Esodeviations can be described as a latent or manifest convergent ocular misalignment. The latent type (esophoria) is negated by the fusional mechanism of the brain. Intermittent esotropia is the type that is to some extent controlled by fusional mechanism, and deviations manifest under conditions of stress or fatigue when the fusional mechanism becomes obviated. Esotropia noted within the first 6 months of life is termed infantile (or congenital) and in most instances is present in an otherwise normal child. Although the etiology is unclear, Worth’s concept postulates a deficiency in cortical in the brain, while Chavasse postulates a possible mechanical cause [23], and thus cure can be achieved by eliminating the deviation in infancy. In developed countries where health documentation is the norm, a positive family is often present, while in sub Saharan Africa, such information is rarely obtained. Children with esotropia elicit alternate fixation, those with large angle deviation uses the adducted eye to fixate on objects in the contra lateral visual field (crossed fixation). The deviation is large and often greater than 30 prism diopters. Quite frequently the patients tend to have demonstrable inferior oblique overreaction in over 50% [24].
The assessment of degree and extend of deviation are important in addition to cycloplegic fundal examination to rule out other secondary causes of misalignment such as a cataract or retinoblastoma. There may be a need to examine and refract the child under anesthesia. This warrants clinical examination by a pediatrician in addition to laboratory tests such as electrolytes and urea, and hemogram and hemoglobin electrophoresis as sickle cell disorder is frequent in SSA. Cycloplegic refraction often reveals a hyperopia of not more than two diopters, though in some instances, patients may be myopic or have astigmatism. It is necessary to correct any detected refractive error fully and promptly. In most instances, surgical correction is required preferably within the first 24 months of life. Early surgery is aimed at reducing deviation as much as could be achieved and obtaining orthotropia. This would enable better alignment and achieving fusion [25], characterized by favorable cosmetic appearance, improved peripheral fusion, and central suppression.
This includes accommodative [26], nonaccommodative, and nystagmus associated esotropia. Accommodative esotropia presents between second and third year of life and is associated with activation of the accommodation reflex. It is characteristically intermittent at onset and later becomes constant and there may be associated amblyopia. In aged children, diplopia may be elicited before the onset of facultative suppressive scotoma. This type of esotropia has a hereditary component and could be precipitated by illness or trauma. Refractive accommodative esotropia is associated with hypermetropia, accommodative convergence, and insufficient fusional divergence. The esotropia is equal for both far and near fixation. Treatment involves cycloplegic refraction and dispensing of full correction to ensure good outcome [27]. Parental counseling to ensure constant use of spectacle correction is important in achieving compliance. Children who manifest non-accommodative component or fail to regain fusion with glasses may require surgery.
The accommodative synkinetic reflex consists of accommodative esotropia, convergence, and miosis. The age of onset range ages between 6 months and 7 years; it is intermittent at onset, and later becomes constant; symptoms may be precipitated by trauma or illness; and often there is associated amblyopia and is of hereditary nature.
This type of esotropia is associated with uncorrected hyperopia, accommodative convergence, and fusional divergence insufficiency. Accommodation is stimulated due to existing hyperopia to obtain better retinal focus. Accommodative esotropia accounted for 18% of 7000 school children is examined [16]. Esotropia could manifest early [28], and the extent of deviation is the same for far and near. The amount of hyperopia is about +4 diopters, and the degree of deviation is in the range of 30–40 prism diopters. The aim is to do a cycloplegic refraction and offer full correction to be worn at all times. Counseling of the parents is important as treatment may not completely eliminate the deviation. Indication for surgical correction includes failure to attain fusion and presence of nonaccommodative component of the deviation.
This type of esotropia can be refractive or nonrefractive. In hyperopia, excess convergence can result with accommodation for near objects. The degree of esotropia is more for near than distance vision. There is a detectable difference in extent with varied distance of accommodation. Nonrefractive accommodative esotropia can occur with normal levels of hyperopia, astigmatism, and myopia. Refractive esotropia with high AC/A can occur with hyperopia, and when associated with myopia or emmetropia, it is described as nonrefractive accommodative esotropia. Partially, accommodative esotropia could arise from decompensation of fully accommodative esotropia or an esotropia that develop subsequent accommodative component.
Bifocals are prescribed for treatment of nonrefractive accommodative esotropia. Flat top executive types of bifocal are preferred with power of +3.00 diopter sphere. The caregiver needs to be advised on consistent use and patient monitored to achieve restoration of fusion and stereopsis. The goal is to attain fusion with less than 10 prism diopters of residual esotropia for near vision with patient wearing the correction. Relative high AC/A has been observed even with bifocals use over time period [29]. Other measures include use of long-acting anticholinesterases such as 0.125% ecothiopate iodide drops. The treatment should commence with maximum dose and tailored based on response. Anticholinesterases have complications arising from depletion of pseudocholinesterases leading to increased susceptibility to depolarizing muscle blockers such as succinylcholine. Surgery can be performed to correct the esotropia instead of the earlier listed modalities. The normal trend with hyperopia is that it increases about the age of 5–7 years. Partially, accommodative esotropia is treated with full cycloplegic refraction and prescription of full correction. There is often a need for concurrent treatment of associated amblyopia.
This type of esotropia presents between the ages of 1 and 5 years. It may acutely present the following disruption of binocular vision from amblyopia treatment or after ocular injury. There may be associated underlying neurological disease or malignancy [30]. When clinical neurological assessment is normal, binocular vision is restored with prisms or surgery.
This arises from occlusion of the visual axis from other ocular condition such as cataract [31], corneal opacity, glaucoma [32], and retinoblastoma [21]. This requires prompt removal of the underline cause wherever possible and treatment of any resulting amblyopia.
Surgical esotropia is also referred to as consecutive esotropia. This form of esotropia arises as a result of surgical correction of exotropia (perhaps due to overcorrection). The deviation may improve spontaneously and when it this doesn’t happen, prisms are used to correct it. The presence of abduction deficiency should raise suspicion of a slipped lateral rectus muscle [33], and patient may require transposition procedure.
The near reflex has accommodative, convergence, and miosis components. There may be a manifest cycle of esotropia and orthotropia. The cause may not necessarily be organic and could be due to psychological factors. The patient has no demonstrable abduction paralysis. Cycloplegic refraction and prompt correction lead to improvement, and in the presence of hyperopia, the patient may require bifocal correction.
This deviation varies in severity with the position of gaze and is due to abducent nerve paralysis. Cross fixation can be mistaken for this type of esotropia. In the absence of strabismic amblyopia, the vision in both eyes is comparably normal. Sixth nerve paralysis is rare at infancy, and its presence in childhood should raise the suspicion of an intracranial mass. Therefore, full neurological screening including brain CT scan and MRI is needed. Infectious causes such as meningococcal and tuberculous meningitis are more common causes in SSA. Treatment involves correction of any associated hyperopia, patch therapy for amblyopia, and use of membrane (Fresnel-press on) prism. Those with underlying medical condition should be treated in collaboration with respective specialists.
Divergent squints can be latent (exophoria-negated by the fusional mechanism) or manifest (exotropia). Exophorias can be demonstrated by breaking the fusional mechanism (uniocular occlusion as in cover test). Exophoria is often small, and there may not be a need for treatment unless an exotropia develops.
This is the most common type of exodeviation and can be latent or intermittent and usually present before the age of 5 years. The deviation is associated with fatigue, stress, and periods of relative inattention. Initially, the deviation tends to be greater for distance (intermittent distant exotropia—IDEX) than near, and later, the extent is similar irrespective of relative object’s position. The disparity could be due to high AC/A ratio or tenacious proximal fusion which arises from slow relaxation of the fusional mechanism, thus limiting conversion of exophoria to exotropia. Progression to constant exotropia is common though there is usually no associated amblyopia. Management involves assessment using the Newcastle control score [34]. Good control is defined when exotropia manifests only with cover test with resumption of vision without blink/refixation. Fair control is defined when exotropia manifests after cover test and fusion resumes with blinking or refixation. Poor control is defined as spontaneous manifestation of exotropia and remaining for extended period. The degree of deviation is assessed at a distance using prism and cover test. Patients’ with high AC/A will have less deviation with +3.00 diopters. Intermittent esotropia can be classified based on observed differences in prism and alternate cover tests for near and distance. In the basic type, the deviation is the same for distance and near. In divergence excess, the deviation is greater for distance than near, and convergence insufficiency is present when the deviation is greater for near than distance. Nonsurgical management involves providing appropriate refractive correction in patients with myopia, astigmatism, or hyperopia. Minus lenses of 2–4 diopter sphere can be used to stimulate accommodative convergence and delay surgery. Part time patching (4–6 h daily) and alternate day patching can produce some improvement which can be used before surgery. Some clinicians advocate orthoptic treatment consisting of training for diplopia awareness and fusional convergence. Base in can be used as short-term treatment as their long-term use is associated with reduced fusional convergence amplitude. Surgery should be considered when deviation is present more than half of the time and consists of bilateral recession of lateral rectus muscle, or recession of one lateral rectus with ipsilateral medial rectus resection. Bilateral lateral rectus recession could result in postsurgical (consecutive) esotropia usually of less than 15 prism diopters and may require treatment with press-on prism if persistent beyond 4 weeks of postoperative period. Without evidence of slipped muscle, observation over a few months of period is advocated as spontaneous resolution is common. A review has shown that despite the absence of natural history data of IDEX, unilateral surgery appears to be more effective than bilateral surgery [35].
This includes constant exotropia that could arise from decompensated intermittent or sensory manifest exotropia and can be treated with similar surgical procedure as intermittent exotropia. Infantile exotropia typically present within the first 6 months of life is usually associated with neurological anomalies. Sensory exotropia could arise from disease causing uniocular visual deprivation such as cataract, corneal opacity, gross retinal anomalies, and optic nerve atrophy. Convergence insufficiency esotropia is not common in children.
Amblyopia is defined as the reduction of best-corrected visual acuity of one or both eyes that cannot be attributed exclusively to a structural abnormality of the eye. It develops during childhood and results in the interruption of normal cortical visual pathway development and is characterized by a difference in best-corrected visual acuity of two or more lines between the eyes [36]. A study in Asia, Latin America, and Africa indicated a prevalence of 1.52 per 1000 children [37]. In amblyopia, there is reduced visual acuity and contrast sensitivity due to the abnormal processes in the visual cortex [38]. The causes of amblyopia include uncorrected refractive error, strabismus, and obstruction of the visual axis. There is the traditional view that treatment should commence before the age of 8–9 years, and a study suggests that the treatment can extend into early adulthood as the ability of the brain to adjust (plasticity) extends to such period [39]. Treatment involves correction of refractive errors with guidance on consistent use of the prescribed glasses. Children with conditions giving rise to occlusion of the visual axis (cataract, corneal opacity) should have the cause removed without delay. The patients with strabismus should be accessed, and appropriate treatment measures should be instituted. Patching therapy is indicated to encourage the weaker eye take up fixation and realign with the visual cortex. There are various regimes based on hours per day or, alternate days. It is of importance to monitor the child by both clinician and caregiver to assess progress. Penalization can be employed as alternative to patching, and it involves the use of atropine eye drops to blur images in the better eye, thus encouraging the child to use the so-called weaker eye [40].
Childhood strabismus strabismus, presenting unit challenges, is evaluation and management. There is poor recollection of medical history and often children are not accompanied to the hospital by their biological parents. Poor knowledge results in misconception and stigmatization of children with squint. Religious and cultural practices coupled with inequity in access to health care could result in amblyopia, thus retarding the child’s development.
Appreciation to the management of Bayero University Kano—Nigeria for providing an enabling academic environment.
None.
The increasing integration of digital technologies in all aspects of our lives is both a benefit and a challenge for organizations, employers, and employees.
\nOrganizations are benefiting from such digital transformation including also digitization of the workplace, i.e., through increased productivity, cost savings, a more mobile and agile workforce, increased flexibility, and adaptability in marketplace. Enterprises are collaborating more globally and with more diverse and global staff. Employees could work from anywhere and stay connected through smartphones, collaborate with peers, and stay on top of digital trends. Organizations should be proactive in creating new systems and policies and rethinking their culture around digital developments in the workplace in order not to lose clients, productivity, and employees.
\nThe keys of success of digital workplaces are an effective implementation of a digital workplace strategy with a changed learning and culture. Culture is an incentive for behavior; organizations and managers should assure that staff behavior suits to technological solutions, supports its adoption, and uses it for work, communication, and cooperation. Entrepreneurship education should be also adapted to digital transformation in order to prepare employees and employers for digital workplaces.
\nThis chapter presents besides some aspects like a digital European workplace initiative and a framework, which could be the basis of a digital workplace strategy, some proposals for improving entrepreneurship skills. As an important issue of a digital workplace strategy is a suitable learning concept to foster a digital culture and employees’ behavior which can be integrated into entrepreneurship education and training programs.
\nThe role of entrepreneurs and of entrepreneurship education and how it will be changed in order to prepare entrepreneurs for the digital transformation and digital workplaces are shortly presented.
\nThe scope of this chapter is on one hand to discuss with academics who work in the field of digital transformation and with students to find new scientific methods for problems like cultural and behavior change; on the other hand, the author has experience in learning methods for entrepreneurs and would like to help organizations and employees particularly in SMEs to achieve skills and competences for a successful digital transformation and digital workplace results.
\nThe author works in many European projects aimed to improving work and education/training of entrepreneurs in digital era and included in this chapter issues necessary for small- and medium-sized companies (SMEs) resulted from surveys done within some of these projects about SMEs’ problems that have in connection with digital transformation and of organized training. The author works currently at the planned training modules and will organize training sessions with SMEs from Germany within the current European project Reinnovate.
\nWe think the problems discussed in this chapter will be used also within the German initiative Mittelstand 4.0-Kompetenzzentrum standards which supports companies and staff within digital changes. The author discussed with some companies within this program about changing culture and staff behavior within digital workplaces and how to improve entrepreneurs’ digital skills.
\nIt is known that the development and proliferation of information and communication technology changed the ways in which employees connect, collaborate, and communicate.
\nThese changes have been accelerated also due to trends like:
Aging workforce and the need to capture their knowledge;
Necessity to meet the varying needs of a multi-generational workforce;
Information overloaded and technology helping employees to find what they need to work faster.
These trends require a digital transformation and a reshaping of work environment.
\nDigital transformation can be understood as improved business processes through digital technology. It means better collaboration between staff, efficient collaboration with customers, stronger and more productive relationships with partners, and increased potential by changing work styles.
\nThe main drivers of digital transformation include traditional digital technologies [1, 2], i.e., infrastructures (i.e., networks, computer hardware) and applications (i.e., apps on smartphones, web applications), and the digital exploitation potentials [2], i.e., possible digital business models and digital value creation networks.
\nIn the narrower sense, digital transformation often refers to the change process within a company triggered by digital technologies and customer expectations. However, it is a process of change affecting a variety of aspects of our society and does not end up in companies [3].
\nDigital transformation in organizations happens in many ways; employees and employers have different hopes [4]:
\nManagers want:
that their employees work together more effectively to boost productivity;
that their clients are content and to gain new ones through better customer service;
to use digital technologies to minimize costs;
to improve business processes;
to be better than their competitors;
to use digital transformation to remain relevant in the face of the quickening pace of technology advances.
Employees would like:
to work with digital toolsets according to their tasks, experience, and working style;
to have workspaces making possible to collaborate more effectively within their jobs and also due demands to increase productivity and cut costs, making it harder for employees;
to be helped to meet market expectations.
Achieving such goals can be a long and difficult process because digital technology and change management issues influence workplace transformation. Developing and working on a digital workplace strategy can challenge the most forward thinking of business leaders.
\nThere are big differences between organizations referring their digital transformation initiatives:
Some of them develop some strategy and understand the benefits.
Others are still in the early stages of developing a plan not knowing valuable ways about how to go about defining their goals for a digital transformation.
The emerging digital workplace, considered the natural evolution of the workplace, can address issues listed above and helping organizations [5, 6].
\nThe digital workplace includes all digital technologies and services people use to get work in today’s workplace—both which already exist and ones to be implemented. It ranges from HR applications and core business applications to e-mail, instant messaging, and enterprise social media tools and virtual meeting tools.
\nFrank Schönefeld defines the digital workplace as the “totality of the required access infrastructure, applications and device platforms of information or knowledge workers who need them to perform their work tasks and engage in collaboration” [7].
\nDigital workplaces could:
support changes in working styles enabling employees to work more transparently and better use social networks.
unify offline and online communications by keeping employees connected through their mobile devices to provide anywhere, anytime access to tools and corporate information.
focus on employee experience by providing them with user experience they have outside the firewall. They provide choice, flexibility, and personalization.
support virtual work environments that allow employees to stay connected in distributed and virtualized work locations while balancing customer privacy and operational risk.
minimize spending and enhance productivity by providing employees with the right tools and right information at the right time.
win the war on talent by offering the progressive and innovative environments that top candidates now [8].
Digital workplace as a portal is “a solution for the integration of information and services in a common user interface” [9] because different services and components are combined in one user interface and made available to the user mostly web-based.
Integrated data can be used via interfaces in different applications. Users can combine existing data and create new applications based on it.
\nThe conception and deployment of the workplace are among the key strategic activities for the European Commission in the years to come. The digital workplace initiative is also an important part of the ICT chapter of the 2016 Synergies and Efficiency Review.
\nThe digital workplace initiative will provide staff with the right IT tools, platforms, and services, enabling users to work and collaborate anywhere, anytime with a fit-for-purpose security and optimizing their work experience and productivity. It will be adaptive and flexible to incorporate different types of users, new behaviors, and new technologies [10].
\nWithin the conceptual framework underpinning the digital workplace initiative in the Commission staff is at the center, with a particular focus on the excellence of user experience. A staff member should be able to connect anywhere and at any time, through simple and secure authentication mechanism, on a variety of mobile devices to a number of corporate services. The data will be stored on a hybrid cloud model, ranging from on-premise (European Commission Datacenters) to public clouds depending on the classification of the data [10].
\nThe six strands of the digital workplace initiative are:
A balanced mix of mobile devices, either corporate or BYOD, allowing connection from anywhere and at any time. There are constraints about using corporate tools on private devices and vice versa, but they may be resolved with a good compromise between usability and security.
Office automation comprising supported operating systems, word processors, spreadsheets, presentation-authoring tools, access to files, etc. An architecture enabling hybrid services become progressively more important especially when the mobile dimension perspective is incorporated.
Mail and calendaring, including the central role of e-mail and its tight integration with calendar tools as a way to send messages, share information, and manage time and meetings.
Unified communication encompasses different sources of real and near-real-time communication, which include videoconferencing and the future of telephony (telephony becomes an app, the classical telephone is replaced by the single mobile device).
Collaboration and social networking, covering the main aspects of collaboration (from document to tasks), communities, and social networking, with special attention on their right availability, security, and integration in mobile platforms. Fast access to the relevant information is an essential in the digital workplace. Therefore information management and corporate search, as very strong integration elements, will be part of this component.
Integration and identity and access management. The future digital workplace will be based on a hybrid platform with a combination of on-premise and cloud-based solutions to take the maximum benefit of technology development and to allow mobility.
By implementing the digital workplace initiative in the European Commission, it is intended to realize the following objectives:
Increase staff engagement. Engage employees and raise motivation through an effective, efficient digital workplace.
Increase staff productivity. Allow productivity improvements by providing the most suitable and effective digital workplace to each staff member.
Enable a more modern and efficient office space design.
Staff from many organizations already use many of digital components, i.e., responding to e-mails from smartphones, checking their paying online, or digitally enter a sales opportunity, so that organizations do not have to build the digital workplace from the ground up.
In the next years, the workplace continues to evolve, and employee expectations shift so that organizations that do not embrace digital workplace risk falling behind [10].
\nThe key of success of digital workplaces lies in an effective implementation of a digital workplace strategy, and the first step in this transformation strategy is a cultural change supported by learning measures.
\nDigital workplace strategy can be understood as the dynamic alignment of an organization’s work patterns within the digital work environment to enable peak performance and reduce costs. As each workplace strategy, a digital one supports to fulfill business objectives such as reducing property costs, improving business performance, merging two or more organizations/cultures, and relocating or consolidating occupied buildings. The workplace strategy and its implementation quite often occur at an opportune moment such as a property lease break or a company merger or acquisition [4, 11].
\nSome special reasons to build and adopt a digital workplace strategy could be the following [4, 12, 13, 14]:
Talent attraction: many employees would opt for a lower paying job if they could work out of office, i.e., at home.
Employee productivity can increase through online social networks.
Employee satisfaction can be higher by installing and using social media tools internally.
Employee retention is more stable when employee engagement increases.
Newer communication tools, particularly instant messaging, are preferred over more traditional ones like e-mail or team workspaces.
Many organizations are convinced about the importance of a digital workplace strategy and invest money in supporting digital workplace strategies that promise ROI. Sure, to support these outcomes, you need to assure for employee’s tools they need to collaborate, communicate, and connect with each other. Clear road maps should be created to ensure digital workplace with measurable business, deliverable, and minimal risks.
\nBusiness drivers for building a digital workplace strategy are:
Rapid technology change is enabling a different workplace and work; some examples are artificial intelligence (AI) and big data combined with increasingly available collaboration tools.
Employees’ expectations of a different workplace experience supported by ubiquitous connectivity and rapidly advancing social technologies.
Citizens demand digital service delivery and a different relationship with the government: There is clear citizen demand for quality online services to match their experiences with other service providers. This requires a digital-first workplace to work effectively.
Often workplace strategies are developed by specialist workplace consultants, or by an architectural practice. “The successful implementation of a workplace strategy requires an interdisciplinary team, internal and external to the organization. A workplace consultant may be retained to engage the team, help define success criteria, manage the process, and assess results” [13].
External workplace consultants are professionals from a number of backgrounds: business management, interior design and architecture, building surveying, real estate and facility management, human resources, and building research.
In the file [8], a proposal for a digital workplace framework is presented with the following layers:
\nThe employees should be able to do their job by using digital technologies for collaborating, communicating, and connecting with others. Productive business relationships can be created within and beyond natural work groups and enable knowledge sharing across the organization. In the next part, we develop this issue.
\nEach organization already has a digital workplace toolbox with different tools to support digital workplace in different ways. It is necessary to adopt the right tools for employees to do their jobs. The digital workplace toolbox can be defined in categories to support the ways in which you communicate, collaborate, connect, and deliver day-to-day services. Often the development of digital tools does not follow a digital workplace strategy where the business focus is clearly defined. Organization culture should be also considered.
\nSome components of digital workplace governance are:
Guiding principles: identify the business goals to be achieved with the digital workplace, and translate them into guiding principles to drive ongoing development.
Information governance strategy: determine the focus of digital workplace strategy, and align it with organization’s existing information management or information governance strategy.
Roles and responsibilities: identify key stakeholders, and create a suitable and sustainable interaction model.
Training and certification: ensure employees have access to training to be prepared to have advantages of digital developments.
Policy training: in addition to technical training, employees need policy training.
Orchestrated presence: by organizing channels within the digital workplace.
Crisis management: if a crisis occurs, react quickly (within the first day).
To deliver the necessary benefits, an organization should guide the direction of digital workplace development.
\nSome ways to achieve measurable value:
Increase revenue.
Reduce operational costs by introducing more effective ways to meet virtually, cutting travel and telecommunication costs and eliminating wasted time at the airport.
Accelerate time-to-market by using tools to support research and develop, test, and deliver new products and services more quickly.
Enhance innovation.
Improve the customer experience.
Increase agility and flexibility: provide the tools that mimic organization and business changes and reflect employee behaviors.
Heighten staff satisfaction, i.e., by implementing easy-to-use tools.
Strengthen talent recruitment and retention.
Improve employee experience.
One of the first steps in the digital transformation is a cultural change in organizations. Culture is an incentive for behavior; organizations and managers should assure overcoming a culture of learned helplessness and spoon-fed training to encourage ongoing personal learning so that staff behavior suits to technological solutions, supports its adoption, and uses it for work, communication, and cooperation. One important issue of the digital workplace strategy is a clear understanding between organizational culture and technology, and this can be achieved within an adequate learning strategy. It ensures that tools, processes, and systems realize their full potential and will not be a failed initiative.
\nOrganization’s culture influences the way employees behave and work within digital transformation and so organizational performance, success, and failure. This means employee’s culture ultimately determines how and to what extent employees connect, communicate, and collaborate within digital workplaces.
\nIt is important to develop a change management plan and that the digital workplace strategy aligns to organization working culture. This cultural change and suitable technological components can contribute to improve:
Collaboration by integrating intuitive, easy-to-use collaboration tools that enhance employees’ ability to work together and support their own working style and wishes
Communication by using digital tools to create their own content, rather than simply consuming existing content, to support that right information reaches the right audience, bilateral communication, and personalization of content
Connections across the organization and outside
The free flow of information at the digital workplace has a positive impact on agility and innovation of organizations, and it promotes employee engagement and satisfaction by delivering the right information to the right people at the right time. One problem is how managers/leaders in organization can influence employee’s behaviors and practice changes, conducting to innovative products and services that will enable the transition from old business models to ones successful in a digital world.
\nIsaac Sacolick presents three ways to enable employees to participate more in digital programs [15].
\nDetermining possible employees to ask questions enables them to move away from “the way we always do” to discussions what is better to do in digital working places.
\nThat is, operations team wants to explore using automation to eliminate repetitive discussions. Someone asks, “How can we learn to be product owners in its agile development process?”
\nSure, there are some people in the organization wishing to do things in the old way. Asking questions is an approach, which can open a dialog about new solutions.
\nCustomers expect to select products and services intelligent and valuable. Start-ups and market leaders in other categories can steal market share from slow competitors not being in contact with customers but have also opportunities to develop new services into new areas by identifying optimal customer segments to deliver services digitally.
\nLeaders/representatives from organization should go out of the office, learn from customers, take into consideration their needs, and develop a perspective on how to deliver new experiences. Marketing specialists should learn how to best message and target prospects. Sales should be learning whom their new competitors are and how to defend against sales objections. Technologists should learn about the underlying technical capabilities required to fulfill value propositions.
\nA data-driven organization offers practices and tools for people to present a thesis—first presenting data that backs it, then insights they have inferred, and lastly their opinions and conclusions. Behaviors drive organizational change.
\nEmployees’ roles in the organization, their jobs, and how they deliver business value are all subject to be changed in digital transformation, in order to convince more employees to support the digital strategy by challenging the status quo, to learn what customers need today, and to use data efficiently to drive bottom-up and top-down decisions.
\nWhen an organization suffers changes in everyday functioning like digital transformation, both employers and employees must face challenges; if employees do not keep up, chances that transformation to be successful are very low.
\nIn the following experts, make some proposals to help employees to adapt to digital transformation [16].
\nIt is known that employees are sometimes resistant to change when the transformation comes only from up, so it is important to create a dialog with employees to discuss which and how they see improvements in digital transformation. If it is possible, the open dialog should start from the top and involve all employee’s transformation. One leader in organizing digital transformation should bridge the gap between the actual implementation of technology and the workplace culture and demands.
\n“Let people understand the reasons for the change, and make sure they have a clear picture of what will improve when they get there,” says Dr. Daniel Cable, professor and chair of organizational behavior, at London Business School. It is important to foster a culture of change and make sure employees develop the skills to keep up with a fast paced and dynamic environment. All employees should be encouraged to go through the company-training program to drive adoption.
\nFirst employees can freely experiment without fearing the consequences of mistakes. Often, they discover new and faster ways of doing everyday tasks, increasing efficiency and productivity.
\nOnline and offline communication can easily be unified keeping employees connected through their own devices. Digital connections often reach down generational gaps and bring employees of different ages together. New digital communication fosters collaboration in departments and across the organization. The digital transformation should not be felt only as technology change but more like intuitive ways to complete tasks.
\nEmbracing digital transformation is more easily achieved through increased employee engagement. Using digital technologies employees can reach consumers easily and directly.
\nOften, older employees are not enthusiastic about digital transformations, but their insight, wisdom, and experience are invaluable. By improving internal employee engagement, employees can feel more valued and are more open to change. Engagement drives adoption, but digital transformation too can drive engagement. Flexible work has positive effects on employee engagement. In the digital age, flexibility is easier than ever to implement. Employees can work remotely, use their own devices, and utilize digital tools to interact impactful with consumers and each other. Tangible benefits of digital transformations are easier to be evaluated.
\nA key success factor in digital transformation of an organization is a training and learning concept with three areas of focus [17]:
how an organization bridges its digital skills and confidence gaps
how an organization encourages people to take responsibility for their own continuous learning
how an organization challenges and supports its senior people to become digital leaders
Some years ago, learning was focused on training people to fulfill their tasks (job training) and occasional additional skills, and there was little need for most workers to be always learning. Now, when all organizations must cope with the uncertainty, complexity, and ambiguity of the digital economy, they have to try to become more agile and adaptive. Intelligence and small-scale decision-making must be distributed to the edges of the organization, so that each team and function is free to learn and adapt based on customer and market feedback [17].
\nThe learning process in organizations wishing to be successful within digital transformation should be changed from a process-centric world of job training to a service-oriented world of continuous learning and improvement in the flow of work. Many organizations developed digital workplace platforms and tools; learning around the digital workplace should help employees to understand how these tools can improve their work, achieve digital skills, and help the organization to have more advantages from its existing technology investments.
\nSome aspects should characterize the learning in the time of digital transformation [17]:
The digital workplace needs a learning hub/community to accelerate change and adoption of new ways of working.
A combination of informal, active, social learning + digital guides and a suitable methodology is a good approach to this.
Minimum digital fluency is required to work in modern organizations.
Leadership development programs need to change to avoid the behavior of some senior people becoming the biggest barrier to change.
In the modern technology-augmented organization, learning will not be a separate activity, but a daily part of work with occasional focused learning on new specialist skills.
Referring to necessary skills of entrepreneurs to work within digital workplaces, the European Union team underlines team working, communication, entrepreneurship and innovation, and intercultural skills as as “necessary to drive creativity and innovation and cope with complexity and uncertainty in a fast-evolving workplace” [18, 19] and new skills for success at macrolevel, i.e., digital fluency referring to the ability to use digital tools and resources existing in companies to do a specific task at workplace and be successful. Another skill is the ability to deal with a change which significantly increases. Adaptability and cognitive flexibility help people to change the way when business needs shift.
\nIt is known that information and data are used more frequently to achieve business goals, to make decisions, and to build strategies. The entrepreneurs should be able to asses and analyze data and information.
\nThe EntreComp framework [20] outlined by the EU Commission, 2016, highlights that entrepreneurship should not be limited to those people setting up businesses but in all aspects of life. “Entrepreneurship is when you act upon opportunities and ideas and transform them into value for others. The value that is created can be financial, cultural, or social” [21].
\nEntrepreneurship requires innovation, knowledge about industry/market, and adaptability to different business. In order to be prepared for a successful career, it is necessary that students understand what means entrepreneurship and use entrepreneurial skills to achieve career goals.
\nEntrepreneurship education and training refers to the use of a variety of skills to develop a culture of entrepreneurship [21] aimed at the development of behavior, attitudes, and capacities that create value.
\nEntrepreneurship and entrepreneurship education have an important role in social and economic developments.
\nAddressing a global challenge such as youth employment requires global actions to prepare them for digital workplaces. It is known that young people are natives of the digital realm, relatively few possess the skills needed in the digital economy, and employers around the world are struggling to find skilled professionals equipped with the technical and soft skills they desire. In context of youth employment crisis and the job opportunities available for people equipped with digital skills, the question of skills training and improvement of entrepreneurship education therefore become central.
\nReferring learning methods within entrepreneurship education, Chinnoye and Akinlabi [22] affirm that this is most successful through active learning approaches such as experiential, team-based project, and problem-based approaches.
\nLearning the concept of global citizenship through global collaboration helps students to work cooperatively with people around the world; this is often necessary for their future jobs.
\nSmall- and medium-sized enterprises (SMEs) are very important and numerous in Europe but small, and their resources are constrained. Because, their staffs need to adapt to digital transformation changes and learn new competences and skills relatively quickly; new learning/training opportunities for their staff have to be found, in addition to the daily operations of the company. Most entrepreneurship programs are targeted at new business owners or start-ups. There is, however, less research on the relationship between entrepreneurial skills of employees in existing SMEs, digital transformation, and innovation capacities in this context.
\nThe European ongoing project Reinnovate with participation of the author focusses also on encouraging all employees in SMEs to develop an entrepreneurial mindset, increasing the chances of the small firm’s survival within digital transformation. Project partners come from five European countries (
Reinnovate uses results of the European project Archimedes and a survey with 150 European SMEs about their existing skills and corresponding training needs suitable also in connection with digital transformation. The methodology of Reinnovate is direct including interviews with guest entrepreneurs, recording videos, counseling, if possible, group discussions, active learning, learning from mistakes, process-oriented teaching, practical-operational teaching methods like starting a business, and role play [23].
\nThe Reinnovate methodology should help to:
Take into consideration the most common practices in SMEs which are informal learning and workplace learning.
Take into consideration effective and preferred practices by employees to keep the employees moral at digital workplaces and extend their employability perspectives.
Support the interorganizational level of workplace learning, i.e., regardless of life-cycle stages.
Four training modules will be developed and offered to SME staff, each module over the course of a 6 week period; if a learner takes all four modules, they will accumulate credits for a level 7 certificate award.
\nModule 1 about how to use workplace-oriented research to identify opportunities for new business includes also identifying opportunities from national and international perspective referring digital transformation, social, and cultural problems.
\nModule 2 has the objective to enable learners to gather and analyze the relevant data to allow them to implement a business opportunity or an innovative idea in connection with digital transformation. The module consists of three units, decision-making, gather data, and assess information.
\nModule 3 helps entrepreneurs to manage an own research project and module 4 to evaluate success and feature opportunities.
\nThere is a consensus between researchers, educators, business observers, and entrepreneurs that digital transformation requires many changes, i.e., cultural and behavioral ones, and that entrepreneurship education and training could significantly increase the number and the quality of entrepreneurs working in SMEs or entering the digital economy.
\nThis chapter has involved a review of different articles, the opinion of some practitioners, SMEs, and of the authors about how could be companies helped to solve some problems in connection with digital transformation.
\nFinally, it has been established that it is not easy to scale up business from a traditional small enterprise to one working successful in digital era; through new educational practices and a cooperation between educators, research, and industry entrepreneurial mindsets can be supported including behavioral changes and achieving competences like described in EntreComp and also new work-oriented research skills.
\nThe program being developed within the Reinnovate project to develop entrepreneurial culture in SMEs through the provision of a suitable training program can contribute in this context.
\nThe author will work further in collaboration with SMEs to make some adjustments toward transformational entrepreneurship and a sustainable socioeconomic development of SMEs in the digital era.
\nThis paper describes work within the ongoing Erasmus + project Reinnovate.
\nOve Odredbe i uvjeti ističu pravila i regulacije u svezi korištenja IntechOpenove stranice www.intechopen.com i svih poddomena u vlasništvu IntechOpena, tvrtke sa sjedištem u 5 Princes Gate Court, London, SW7 2QJ, Ujedinjeno Kraljevstvo.
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\\n\\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\\n\\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\\n\\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\\n\\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\\n\\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
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\\n\\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\\n\\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\\n\\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\\n\\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\\n\\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\\n\\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\\n\\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\\n\\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\\n\\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
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\n\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\n\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\n\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\n\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\n\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
\n\nOsim ako nije suprotno navedeno, IntechOpen i/ili svi davatelji licence vlasnici su intelektualnog vlasništva nad svim materijalima na www.intechopen.com. Sva prava intelektualnog vlasništva su pridržana. Stranice sa www.intechopen.com možete gledati, preuzimati, dijeliti, dijeliti poveznice i printati za osobnu uporabu, a temeljem pravila sadržanih u ovim Odredbama i uvjetima.
\n\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\n\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\n\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\n\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\n\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\n\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\n\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\n\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\n\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
\n"}]},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. 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